Embarking on a career in medical coding and billing is a rewarding journey, and a crucial stepping stone is achieving your Certified Professional Coder (CPC) credential. Offered through the American Academy of Professional Coders (AAPC), the CPC certification is widely recognized as the gold standard in the industry. It significantly enhances your resume when applying for medical billing and coding positions. If you’re wondering how to navigate the path to certification and what to expect from the final exam, especially after completing a program like Career Step, this guide is for you.
Understanding the AAPC and CPC Certification
The American Academy of Professional Coders (AAPC) plays a vital role in setting the benchmarks for professionals in medical coding. Established to foster professional growth and maintain high standards, the AAPC offers certifications in various domains, including medical billing, auditing, and compliance. For aspiring medical coders, AAPC certification is a testament to their competence and dedication.
What Does AAPC Certification Signify?
Earning an AAPC certification, particularly the CPC, demonstrates to potential employers that you possess a strong foundation in medical coding principles and practices. It’s an official recognition of your skills and knowledge, earned by achieving a passing score on the rigorous CPC exam. This certification is your “badge of competence,” signaling your readiness to excel in the field.
Exploring Different AAPC Certifications
While the CPC is the most popular and foundational certification, AAPC offers several specialized credentials to cater to different career paths within medical coding:
- CPC (Certified Professional Coder): This is the core certification for medical office coders, covering essential aspects like coding guidelines, medical terminology, diagnostic and procedural coding (CPT, HCPCS, and ICD-10-CM). It’s an excellent starting point and the most widely recognized certification.
- CPC-H (Certified Professional Coder – Hospital Outpatient): Designed for coders working in hospital outpatient departments, focusing on the specific coding requirements and regulations within this setting.
- CPC-P (Certified Professional Coder – Payer): Geared towards professionals working for insurance providers, Medicare, or Medicaid, emphasizing payer-specific coding and billing rules.
- CIRCC (Certified Interventional Radiology Cardiovascular Coder): A specialized certification for those handling billing and coding for cardiac and interventional radiology procedures, requiring in-depth knowledge of this complex area.
Beyond these primary CPC certifications, AAPC also offers certifications in specialized areas like Medical Auditing (CPMA), Medical Compliance (CPCO), and Practice Management (CPPM), allowing you to further specialize and advance your career. Specialty certifications in areas like surgery, cardiology, and family practice are also available to deepen your expertise in specific medical fields.
AAPC vs. AHIMA: Key Differences
When exploring medical coding certifications, you might encounter both AAPC and AHIMA (American Health Information Management Association). While both are reputable organizations, they cater to slightly different aspects of health information management.
AHIMA certifications, such as the Certified Coding Specialist (CCS) and CCS-P, are heavily focused on mastery of inpatient and outpatient coding, respectively. AHIMA credentials are often favored in hospital settings and emphasize a broader range of health information management skills.
AAPC’s CPC certification, on the other hand, is laser-focused on professional medical coding, particularly in physician offices and outpatient settings. It’s deeply rooted in coding accuracy and compliance with payer regulations.
The preference between AAPC and AHIMA certifications can sometimes depend on the employer. Some clinics or physician practices may prefer CPC, while hospitals might lean towards CCS. Therefore, when job hunting, it’s wise to check if employers specify a preferred certification.
Deep Dive into the CPC Exam
The CPC exam is the ultimate test of your medical coding proficiency and is considered the gold standard for medical billing and coding professionals. Earning your CPC after passing this exam validates your expertise in coding medical services and procedures accurately.
What to Expect on the CPC Exam
The CPC exam is a comprehensive assessment consisting of 100 multiple-choice questions. These questions evaluate your knowledge across 17 key areas essential for medical coding, including:
- Coding Systems: CPT, HCPCS Level II, and ICD-10-CM coding.
- Anatomy and Medical Terminology: Understanding medical terms, procedures, and human anatomy is crucial for accurate coding.
- Coding Guidelines: Mastery of official coding guidelines is essential for compliant coding.
- Evaluation and Management (E/M) Coding: Selecting the correct E/M codes for physician services in various settings (inpatient, outpatient, etc.).
- Surgical Coding: Coding surgical procedures across different body systems (Integumentary, Musculoskeletal, Digestive, Respiratory, Cardiovascular, Hemic and Lymphatic, Mediastinum and Diaphragm, Urinary, Reproductive, Maternity and Delivery, Endocrine, Nervous Systems).
- Anesthesia, Radiology, Pathology, and Medicine Coding: Specific coding rules and guidelines for these specialized services.
- Compliance and Regulatory Requirements: Understanding HIPAA, fraud and abuse regulations, and other compliance standards.
The exam is designed to be rigorous, ensuring that certified coders possess a high level of competency.
Alt text: Essential medical coding code books for CPC exam preparation: CPT, HCPCS, and ICD-10-CM. These resources are critical for mastering medical billing and coding and passing the career step medical coding and billing final exam.
Is the CPC Exam Difficult to Pass?
The CPC exam is indeed challenging, and a significant amount of preparation is necessary to pass. It’s not designed to be easy, but with focused study and the right resources, it’s definitely achievable. A passing score is 70%, meaning you need to answer at least 70 questions correctly out of 100.
Preparation is key. Dedicate ample time to studying, utilize practice exams to familiarize yourself with the format and question types, and thoroughly review your coding materials. Many successful coders recommend systematic study plans and consistent practice.
If you don’t pass on your first attempt, don’t be discouraged! The exam fee often includes a free retake, giving you another opportunity to demonstrate your knowledge after further study.
Taking the CPC Exam Online
Yes, the AAPC offers the flexibility to take the CPC exam online. This option allows you to test from the comfort of your home, provided you meet specific technical requirements.
For online proctored exams, you’ll need:
- A quiet, private space free from interruptions.
- A reliable, high-speed internet connection.
- A computer with a supported operating system and browser.
- An external webcam that can be positioned to show your face, hands, keyboard, and surrounding area.
Remote proctoring ensures exam integrity and a secure testing environment, mirroring the conditions of a physical testing center.
CPC Exam: Open Book Policy
One helpful aspect of the CPC exam is that it’s considered “open book” – you are allowed to reference specific coding books during the test. Currently, the approved books are:
- CPT® (Current Procedural Terminology)
- HCPCS Level II (Healthcare Common Procedure Coding System)
- ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification)
You are permitted to bring only one copy of each book, and they must be from the current or previous year. For example, you can’t bring both a 2020 and 2022 edition of ICD-10-CM. While you can highlight, tab, and write notes in your code books, you cannot have any loose papers or materials attached.
Permitted Materials for the CPC Exam
On exam day, the only external resources you are allowed to bring are your three official code books (CPT, HCPCS Level II, and ICD-10-CM). These must be current or prior year editions. Remember, no additional notes, papers, or electronic devices are permitted. Ensure your books are prepared with highlighting, tabbing, and handwritten notes only – no glued or stapled materials.
Schooling and the CPC Exam
While technically you can take the CPC exam without formal schooling, it is strongly discouraged. The exam covers a vast amount of highly specialized material, intricate medical coding procedures, and complex coding systems. Without structured medical coding education, such as a program like Career Step’s Medical Coding and Billing Professional Program, passing the exam becomes significantly more challenging.
A comprehensive medical coding program provides the necessary foundational knowledge, practical skills, and coding expertise to adequately prepare you for the CPC exam and a successful career. These programs are designed to cover the exam content areas thoroughly and equip you with effective study strategies.
Alt text: CPC exam preparation tips including utilizing practice exams, reviewing coding guidelines, and focusing on medical terminology to succeed in the career step medical coding and billing final exam.
Highest Paying Medical Coding Certification
While salary varies based on experience, location, and employer, the Certified Professional Compliance Officer (CPCO®) certification is often cited as having a higher average salary in the medical coding and compliance field. However, for entry into medical coding, the CPC is the foundational and most widely sought-after certification.
CPC Certification Validity and Renewal
Your CPC certification is valid for two years. To maintain your active certification status, you need to earn 36 Continuing Education Units (CEUs) every two years. CEUs ensure that CPC-certified professionals stay updated with the latest coding changes, guidelines, and industry best practices.
Study Duration for the CPC Exam
The amount of time needed to study for the CPC exam varies from person to person. It depends on your learning style, prior knowledge, and study habits. However, given the exam’s complexity, adequate preparation time is crucial. Avoid cramming and instead aim for consistent, focused study sessions over a period of weeks or months.
What Constitutes a Good CPC Exam Score?
A score of 70% or higher is considered a passing score on the CPC exam. Aim to exceed this benchmark during your preparation by consistently scoring well on practice exams. A higher score not only ensures you pass but also boosts your confidence in your coding abilities.
CPC Exam Costs and Membership
To take the CPC exam, you must be a member of the AAPC. The CPC exam fee is $499, and AAPC membership costs $210 annually. Student memberships are available at a reduced rate ($145), which can be beneficial if you are currently enrolled in a medical coding program. These fees cover exam administration, scoring, and membership benefits.
CPC Exam Registration Process
Registering for the CPC exam is straightforward through the AAPC website. Navigate to the “Certifications” section and click on “Schedule Your Exam.” The online registration process will guide you through purchasing the exam or redeeming a voucher and selecting a testing location (if you opt for in-person testing).
CPC Exam Locations
You have the option to take the CPC exam online from home or in person at a local testing center. The AAPC website provides a tool to locate nearby testing centers if you prefer the in-person exam experience.
Number of Questions on the CPC Exam
The CPC exam consists of 100 multiple-choice questions. Each question is designed to test your knowledge and application of medical coding principles and guidelines.
Multiple-Choice Format of the CPC Exam
Yes, all 100 questions on the CPC exam are in a multiple-choice format. While some might see this as advantageous, the nuances of coding scenarios and similar-looking answer choices can make it challenging. Careful reading and a strong understanding of coding principles are essential to avoid common pitfalls.
CPC Exam Time Limit
You are allotted 4 hours to complete the CPC exam, whether you take it online or in person. Effective time management during the exam is crucial. Pace yourself, allocate time for each section, and ensure you have enough time to review your answers.
Number of Missed Questions Allowed on the CPC Exam
To pass the CPC exam, you can miss a maximum of 30 questions out of 100. Aim to minimize errors through thorough preparation and careful attention to detail during the exam.
CPC Exam Retake Policy
The AAPC allows you to retake the CPC exam if you don’t pass on your first attempt. The initial exam fee often includes one free retake. If you fail both attempts, you will need to pay the exam fee again for subsequent attempts. This highlights the importance of adequate preparation to minimize costs and pass efficiently.
Types of Questions on the CPC Exam
Approximately 70% of the CPC exam questions are coding scenarios, requiring you to apply your coding knowledge to real-world cases. The remaining 30% cover broader topics like medical terminology, anatomy, coding guidelines, and regulatory compliance. The exam is divided into 17 subject areas, with up to ten questions in each, ensuring comprehensive coverage of essential medical coding competencies.
Understanding the Apprentice Status (CPC-A)
If you pass the CPC exam but lack the required two years of professional coding work experience, you will initially receive a CPC-A credential. The “A” designates “apprentice” status. Once you accumulate and submit proof of two years of coding experience, the apprentice designation is removed, and you achieve full CPC certification.
CPC Certification and Relocation
The CPC certification is nationally recognized across all 50 states. Once you earn your CPC, it remains valid regardless of where you move within the United States. Recertification is based on CEU requirements every two years, not geographical location.
Effective CPC Exam Preparation Strategies
Everyone’s study approach is unique, but here are some highly recommended strategies to maximize your CPC exam readiness, especially after completing a program like Career Step:
- Review Your Career Step Final Exam: Identify areas where you can improve based on your performance on the Career Step final exam. Utilize retakes for additional practice.
- Utilize Practicum Reports and Program Materials: Revisit your practicum reports and key information from your Career Step program. These resources provide valuable insights and reinforce essential concepts.
- Engage with Career Step Support and Forums: Leverage Career Step forums and support teams for exam tips and guidance. Connect with fellow students and graduates for shared experiences and advice.
- AAPC Practice Exams and Prep Books: Consider utilizing AAPC’s official practice exams and preparation books. Many successful CPC certified professionals recommend these resources for targeted preparation and exam simulation.
Career Step: Your Launchpad to Medical Coding Success
If you’re serious about pursuing a career in medical coding, Career Step’s online Medical Coding and Billing Professional Program provides a comprehensive and skills-focused education. This program is specifically designed to equip you with the healthcare and coding expertise needed to excel in the field and confidently prepare for the CPC exam. To explore how Career Step can help you take the next step towards your medical coding career, contact them at 1-800-411-7073.
