Embarking on a career in medical coding can be a rewarding path, and the Certified Professional Coder (CPC) credential, offered by the American Academy of Professional Coders (AAPC), is widely recognized as a mark of excellence. For those looking to stand out in the competitive field of medical billing and coding jobs, understanding the steps to certification, particularly the role of practical experience, is crucial. Let’s delve into what you need to know about achieving your CPC certification and how a Career Step Medical Coding Practicum can be a pivotal element in your journey.
Understanding the AAPC and CPC Certification
The AAPC, or American Academy of Professional Coders, plays a vital role in the medical coding industry by setting professional development standards. They offer certifications that validate an individual’s expertise in various areas, including medical billing, auditing, compliance, and, notably, medical coding.
An AAPC certification, specifically the CPC, signals to potential employers that you possess a strong foundation and dedicated competency in medical coding. There are several core AAPC certifications available:
- 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 coding principles, guidelines, medical terminology, and diagnostic codes. It’s the most frequently pursued certification and an excellent starting point.
The CPC-H caters to outpatient hospital coders, while the CPC-P is for those working with insurance providers, Medicare, or Medicaid. The CIRCC certification is specialized for cardiac interventional radiology billing.
Beyond these, AAPC also offers certifications in Medical Auditing, Medical Compliance, and Practice Management, allowing for further specialization within the healthcare administration field. Specialty certifications in areas like surgery, cardiology, or family practice can further enhance career prospects.
AAPC vs. AHIMA: Key Differences
It’s important to distinguish between AAPC and AHIMA (American Health Information Management Association). AHIMA certifications, such as Certified Coding Specialist (CCS), primarily focus on inpatient and outpatient coding mastery within hospital settings.
AAPC, on the other hand, emphasizes the education and development of Certified Professional Coders (CPC), often geared towards physician offices and outpatient facilities.
Employer preferences can vary; some may favor AAPC while others might prefer AHIMA certifications. When searching for medical coding positions, always check if employers specify a preferred certification.
The CPC Exam: Your Certification Gateway
The CPC exam is recognized as the gold standard for medical billing and coding certification. Passing this exam demonstrates proficiency in coding medical services and procedures. It is a comprehensive 150-question multiple-choice exam covering 17 knowledge areas, including CPT, HCPCS, and ICD-10-CM coding systems.
CPC Exam Difficulty: Preparation is Key
The CPC exam is known to be challenging, requiring a score of 70% or higher to pass. However, with thorough preparation, it is certainly achievable. Dedicated study time, practice exams, and consistent review of coding materials are crucial for success. If you don’t pass on your first attempt, the exam fee often includes a second try.
Online CPC Exam Option
The CPC exam can be taken online with a remote proctor, offering flexibility. This requires a quiet environment, reliable internet, a computer, and an external webcam to monitor the testing space.
Open Book Policy for the CPC Exam
The CPC exam allows the use of specific coding books as references. Currently approved books are:
- CPT® (Current Procedural Terminology)
- ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification)
- HCPCS Level II (Healthcare Common Procedure Coding System)
Only one copy of each current or previous year’s edition is permitted. While highlighting, tabbing, and handwritten notes are allowed, no loose papers or attachments are permitted in the code books.
CPC Exam Eligibility: Schooling and Experience
While technically you can take the CPC exam without formal schooling, it’s highly discouraged. The exam covers complex medical coding procedures and codes that are best learned through structured education. A medical coding practicum, often part of comprehensive training programs, provides invaluable hands-on experience that significantly improves exam readiness.
Highest Paying Medical Coding Certifications
The Certified Professional Compliance Officer (CPCO®) often tops salary surveys, with an average salary around $81,495. However, income varies based on experience, employer, and location.
CPC Certification Validity and Renewal
CPC certification is valid for two years, requiring 36 Continuing Education Units (CEUs) every two years for renewal.
CPC Exam Study Duration
The required study time for the CPC exam varies per individual. Adequate preparation is essential; avoid last-minute cramming.
Passing Score for the CPC Exam
A score of 70% or higher is needed to pass the CPC exam.
CPC Exam Costs
AAPC membership is required to take the CPC exam. The exam fee is $499, and membership is $210 (student rates may be available).
CPC Exam Registration
Register for the CPC exam through the AAPC website’s “certifications” section, where you can schedule your exam, purchase it, and select a testing option (online or in-person).
CPC Exam Locations
You can take the exam online or at a local testing center. Find testing center locations on the AAPC website.
Number of Questions on the CPC Exam
The CPC exam has 150 multiple-choice questions.
Multiple-Choice Format of the CPC Exam
All questions are multiple-choice, requiring careful attention to detail due to similar-looking coding options.
CPC Exam Time Limit
Test takers have four hours to complete the CPC exam, whether online or in person.
Maximum Missed Questions on the CPC Exam
You can miss up to 45 questions and still pass the CPC exam (aiming for 70% or higher).
CPC Exam Retake Policy
The $499 exam fee typically includes a free retake. Failing both attempts requires repurchasing the exam for another two tries. Investing in thorough preparation, including a medical coding practicum, can save significant costs by increasing your chances of passing on the first attempt.
CPC Exam Question Types
Approximately 70% of the exam questions are coding scenarios, with the remaining covering medical terminology, anatomy, and other related topics.
Key subject areas include:
- Surgical procedures (various body systems)
- Evaluation and Management (E/M) coding
- Anesthesia
- Radiology
- Pathology and Laboratory
- Medicine
- Medical Terminology
- Anatomy
- Coding Guidelines (ICD-10-CM, HCPCS, CPT)
Apprentice Status (CPC-A)
Without two years of prior work experience, passing the CPC exam results in a CPC-A credential (Apprentice). This “A” designation is removed upon submitting proof of two years of coding work experience. A career step medical coding practicum can be a great way to start gaining practical experience.
CPC Certification Reciprocity and Renewal
The CPC is a national certification, valid across all 50 states. Recertification is through CEUs every two years, not re-examination.
Effective CPC Exam Preparation Strategies
Individual study methods vary, but effective strategies include:
- Reviewing areas of weakness from training program assessments.
- Utilizing practicum reports and program materials.
- Seeking advice from forums and support teams.
- Using AAPC practice exams and study guides.
CareerStep: Your Pathway to Medical Coding Expertise
For those serious about a medical coding career, consider comprehensive programs like CareerStep’s online Medical Coding and Billing Professional Program. These programs provide healthcare and coding skills, foundational knowledge for the CPC exam, and often include a medical coding practicum component. A practicum offers crucial real-world experience, bridging the gap between theoretical knowledge and practical application, making you a more competitive candidate and better prepared for the CPC exam. To explore how a career step medical coding practicum and a robust training program can benefit you, call 1-800-411-7073 to learn more about CareerStep.
