The Certified Professional Coder (CPC) credential, offered by the American Academy of Professional Coders (AAPC), stands as a highly respected benchmark in the medical coding industry. It’s a significant step to differentiate yourself when seeking medical billing and coding positions. Understanding how to achieve this certification, including the exam details and associated costs, is crucial for your career journey. Let’s explore what you need to know about taking this vital career step in medical coding.
Understanding the AAPC
The American Academy of Professional Coders (AAPC) is a professional organization dedicated to the advancement of medical coding standards and professional development within the industry. AAPC provides certifications in various areas, including Medical Billing, Medical Auditing, and Medical Compliance, validating the expertise of medical coders in these domains.
AAPC Certification: A Mark of Competence
Earning an AAPC certification signifies to potential employers that you possess a strong foundation in medical coding and have demonstrated competence through rigorous examination. The AAPC issues certifications upon successful completion of CPC exams, marking you as a dedicated and knowledgeable professional.
There are four primary AAPC certifications to consider:
- CPC: Certified Professional Coder
- CPC-H: Certified Professional Coder-Hospital Outpatient
- CPC-P: Certified Professional Coder-Payer
- CIRCC: Certified Interventional Radiology Cardiovascular Coder
The CPC certification is foundational, designed for coders in physician offices, covering essential aspects like coding guidelines, medical terminology, and diagnostic and procedural coding. It’s the most widely recognized and an excellent starting point for a medical coding career.
CPC-H caters to outpatient hospital department coders, while CPC-P is tailored for those working with insurance providers, including Medicare and Medicaid. The CIRCC certification is specialized for billing related to cardiac interventional radiology procedures.
Beyond these core certifications, AAPC also offers credentials in Medical Auditing, Medical Compliance, and Practice Management, allowing for further specialization and career advancement.
Specialty certifications are also available, allowing coders to deepen their expertise in specific medical fields such as surgery, cardiology, and family practice, enhancing their career prospects and earning potential.
AAPC vs. AHIMA: Key Differences
Another prominent organization in health information is the American Health Information Management Association (AHIMA). AHIMA certifications, particularly the Certified Coding Specialist (CCS), are heavily focused on inpatient and outpatient coding mastery.
AAPC, in contrast, centers around the Certified Professional Coder (CPC) and related certifications, emphasizing a broader range of medical coding skills.
Employer preferences can vary; some healthcare providers might favor AAPC or AHIMA certifications. When job hunting, always check if employers specify a preferred certification to align your credentials with their requirements.
Decoding the CPC Exam
The CPC exam is recognized as the gold standard for medical billing and coding certification, confirming your expertise in coding medical services and procedures. This comprehensive exam includes 150 multiple-choice questions, assessing knowledge across 17 key areas, including CPT, HCPCS, and ICD-10-CM codes.
Read more: CPC or CCA: Which Medical Billing Certification is Right for You?
Alt text: Career step in medical coding shown as upward stairs, representing professional growth and advancement in the medical coding field.
CPC Exam Difficulty and Pass Rate
The CPC exam is known to be challenging, demanding thorough preparation. However, with adequate study and resources, passing is achievable. A minimum score of 70% is required to pass. Dedicated study, practice exams, and consistent review of coding materials are essential for maximizing your chances of success.
If you don’t pass on your first attempt, the initial exam fee typically includes a second try, providing another opportunity to achieve certification.
Online CPC Exam Option
The CPC exam can be taken online, offering flexibility and convenience. Online exams are remotely proctored to maintain exam integrity. To take the exam online from home, you need a quiet environment, a stable high-speed internet connection, a computer, and an external webcam to monitor you, your workspace, and your keyboard.
Open Book Policy for the CPC Exam
The CPC exam allows reference to specific coding books. Currently, approved resources are:
- CPT® (Current Procedural Terminology)
- ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification)
- HCPCS Level II (Healthcare Common Procedure Coding System)
You are limited to one copy of each book, and they must be from the current or previous year. While annotations like highlighting, tabbing, and handwritten notes are permitted, loose papers or added materials are not allowed.
Permitted Materials During the CPC Exam
On exam day, you are permitted to bring only your three approved code books: ICD-10-CM, CPT, and HCPCS Level II. These must be current or previous year editions. No additional notes or external materials are allowed, ensuring a standardized testing environment.
CPC Exam Eligibility Without Formal Schooling
While technically you can take the CPC exam without formal schooling, it is strongly discouraged. The exam covers complex material, medical coding procedures, and extensive code sets. Without structured medical coding education, passing the exam becomes significantly more challenging. Investing in a quality medical coding program is a highly recommended career step.
Read more: How a Skills-focused CPC Program Can Help You Prepare for the CPC Exam and a Job as a Medical Coder
Alt text: Cost price tag graphic with dollar symbol, representing the financial investment required for the CPC exam and certification.
Highest Paying Medical Coding Certification
The Certified Professional Compliance Officer (CPCO®) certification currently reports the highest average salary in the medical coding field, at approximately $81,495 [ Source (accessed February 20, 2024): AAPC Salary Survey ]. However, salary levels are influenced by factors like experience, employer type, and geographic location.
CPC Certification Validity and Renewal
CPC certification remains valid for two years. To maintain your active status, you must earn 36 Continuing Education Units (CEUs) every two years, ensuring ongoing professional development and up-to-date knowledge.
Recommended CPC Exam Study Duration
The amount of study time needed for the CPC exam varies by individual. Given its challenging nature, avoid last-minute cramming. Adequate preparation over a sustained period is crucial for exam success.
CPC Exam Passing Score
A score of 70% or higher is required to pass the CPC exam. Aiming for well above this threshold provides a comfortable margin and reflects strong competence.
CPC Exam Cost Breakdown
To take the CPC exam, AAPC membership is mandatory. The CPC exam fee is $499, and AAPC membership costs $210 annually. Student membership is available at a reduced rate of $145 for eligible individuals, lowering the initial cost for those currently in education. Consider these costs as an investment in your medical coding career step.
CPC Exam Registration Process
To register for the CPC exam, visit the AAPC website. Navigate to the “certifications” section and select “Schedule Your Exam.” Follow the prompts to complete registration, which includes exam purchase or voucher redemption and choosing a testing location if taking the exam in person.
CPC Exam Locations
You can take the CPC exam online from home or in person at an authorized testing center. The AAPC website provides a tool to locate nearby testing centers if you prefer an in-person exam setting.
Number of Questions on the CPC Exam
The CPC exam comprises 100 multiple-choice questions.
CPC Exam Format: Multiple Choice
All 100 questions on the CPC exam are in a multiple-choice format. While this format might seem straightforward, the similarity of coding options and scenarios requires careful attention to detail.
CPC Exam Time Limit
You are allotted 4 hours to complete the CPC exam, whether taken online or in person. Effective time management during the exam is essential.
Allowable Missed Questions on the CPC Exam
To pass the CPC exam, achieving 70% requires answering at least 70 questions correctly out of 100. This means you can miss a maximum of 30 questions and still pass.
CPC Exam Retake Policy
You can retake the CPC exam as needed, but be mindful of the exam fees. The $499 exam fee typically includes one free retake. If both attempts are unsuccessful, you must repay the exam fee for subsequent attempts. Thorough preparation is financially prudent, saving potentially hundreds of dollars in retake fees.
Types of Questions on the CPC Exam
Approximately 70% of CPC exam questions are coding scenarios, testing your practical application of coding knowledge. The remaining questions cover essential areas like medical terminology and anatomy.
These questions are distributed across 17 subject areas, with up to ten questions in each:
- Surgical procedures (Integumentary, Musculoskeletal, Digestive, Respiratory, Cardiovascular, Hemic and Lymphatic, Mediastinum and Diaphragm, Urinary, Reproductive, Maternity and Delivery, Endocrine, Nervous systems)
- Evaluation and Management (Inpatient, Outpatient, Nursing Facilities, etc.)
- Anesthesia
- Radiology and Laboratory Pathology
- Medicine and Medical Terminology
- Anatomy
- Coding Guidelines, Compliance, and Reporting (ICD-10-CM, HCPCS, CPT)
Apprentice Status (CPC-A)
If you pass the CPC exam without two years of prior work experience, you initially receive a CPC-A credential, with “A” denoting apprentice. Upon submitting proof of two years of coding work experience, the apprentice status is removed, and you become a fully certified CPC.
CPC Certification Portability and Recertification
The CPC certification is nationally recognized across all 50 states. Recertification is based on CEU requirements every two years, not re-examination, ensuring your certification remains current and respected throughout your career, regardless of location.
Effective CPC Exam Preparation Strategies
Effective study habits vary. Consider these preparation strategies:
- Revisit areas needing improvement from CareerStep final exams or similar program assessments.
- Review practicum reports and program materials.
- Utilize CareerStep forums or support teams for exam tips.
- AAPC offers practice exams and study guides, which many find beneficial for focused preparation.
Prepare for a Medical Coding Career Step with CareerStep
Interested in a medical coding career? CareerStep’s comprehensive online Medical Coding and Billing Professional Program provides healthcare and coding skills to launch your career and prepare you for the CPC exam. Contact CareerStep at 1-800-411-7073 to learn more about taking this important career step.
