Embarking on a career in medical coding offers a stable and growing path in healthcare. The Certified Professional Coder (CPC) credential, offered by the American Academy of Professional Coders (AAPC), stands as a highly respected benchmark in this field. Achieving CPC certification can significantly enhance your resume when applying for medical billing and coding jobs. If you’re exploring this career route, understanding the steps to certification and the exam itself is crucial. This guide provides essential information to navigate your journey towards becoming a CPC certified professional.
Understanding the AAPC and CPC Certification
To appreciate the value of CPC certification, it’s important to understand the organization behind it: the AAPC.
What is the AAPC?
The American Academy of Professional Coders (AAPC) is the leading professional organization for medical coders in the United States. Established to elevate the standards and professional development within the medical coding industry, the AAPC provides certifications across various domains, including medical billing, auditing, compliance, and more. For aspiring and current medical coders, AAPC membership and certifications are key to demonstrating expertise and commitment.
What is AAPC Certification?
AAPC certifications are credentials awarded to individuals who successfully pass AAPC exams. These certifications serve as a testament to your knowledge, skills, and dedication in the medical coding field. For employers, AAPC certification is a reliable indicator of a candidate’s competence and readiness to handle complex coding tasks.
The AAPC offers several core certifications tailored to different medical coding specialties:
- CPC (Certified Professional Coder): This foundational certification is designed for medical coders working in physician offices and covers a broad spectrum of coding knowledge, including CPT, HCPCS Level II, and ICD-10-CM coding, along with guidelines, compliance, and regulatory requirements. The CPC is the most widely recognized and sought-after certification for physician-based medical coding.
- CPC-H (Certified Professional Coder – Hospital Outpatient): Specializing in hospital outpatient coding, the CPC-H certification validates expertise in coding and billing for hospital-based outpatient services. This certification is ideal for coders working in hospital outpatient departments, ambulatory surgery centers, and similar settings.
- CPC-P (Certified Professional Coder – Payer): Focused on the payer side of healthcare, the CPC-P certification is for professionals working for insurance companies, Medicare, or Medicaid. This credential emphasizes knowledge of payer regulations, claims processing, and coding audits from an insurance perspective.
- CIRCC (Certified Interventional Radiology Cardiovascular Coder): This advanced certification is for experienced coders specializing in interventional radiology and cardiovascular coding. The CIRCC demonstrates mastery in coding complex procedures in these specialized medical fields.
Beyond these primary certifications, the AAPC also offers specialty certifications in areas like auditing, compliance, and practice management, allowing coders to further specialize and advance their careers.
AAPC vs. AHIMA: Understanding the Difference
Another prominent organization in health information management is the American Health Information Management Association (AHIMA). AHIMA certifications, such as the Certified Coding Specialist (CCS) and Certified Coding Specialist-Physician-based (CCS-P), are also highly respected. The key difference lies in their primary focus.
AHIMA certifications often emphasize a deeper understanding of coding classification systems and are frequently preferred in hospital inpatient and outpatient settings. In contrast, AAPC certifications, particularly the CPC, are often favored in physician practices and outpatient clinics.
When seeking employment, it’s advisable to check job postings for preferred certifications as some employers may specify whether they prefer AAPC or AHIMA credentials. Both organizations offer valuable certifications that can significantly boost your medical coding career.
Deep Dive into the CPC Exam
The CPC exam is the cornerstone of the Certified Professional Coder credential and is recognized as the gold standard for demonstrating proficiency in medical coding.
What is the CPC Exam?
The CPC exam is a rigorous test designed to assess a candidate’s comprehensive understanding of medical coding. It covers a wide range of coding competencies, ensuring that certified coders possess the expertise to accurately code medical services and procedures. The exam consists of 100 multiple-choice questions spanning 17 key knowledge areas, including:
- CPT (Current Procedural Terminology) coding
- HCPCS Level II (Healthcare Common Procedure Coding System) coding
- ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) coding
- Medical Terminology
- Anatomy
- Coding Guidelines
- Compliance and Regulatory Issues
Read more: CPC or CCA: Which Medical Billing Certification is Right for You?
Is the CPC Exam Hard?
The CPC exam is known to be challenging, requiring thorough preparation. While not inherently “difficult,” passing requires dedicated study and a solid grasp of medical coding principles. A passing score of 70% is required, meaning preparation is key to success.
If you don’t pass on your first attempt, the AAPC allows a second attempt under the initial exam fee, providing a valuable opportunity to reassess and try again.
CPC Exam Format and Logistics
The CPC exam offers flexibility in testing methods.
Can I take my CPC exam online?
Yes, the CPC exam can be taken online with remote proctoring. This option offers convenience and flexibility, allowing you to test from home or another suitable location. To take the online exam, you’ll need:
- A quiet, private space
- Reliable high-speed internet
- A computer with a supported operating system
- An external webcam that can be positioned to show your face, hands, keyboard, and surrounding area.
Is the CPC exam open book?
Yes, the CPC exam is an open book exam, allowing examinees to utilize specific coding reference manuals. Currently, the approved books are:
- CPT® Professional Edition
- ICD-10-CM
- HCPCS Level II
You are permitted to use one copy of each of these code books during the exam. Using multiple editions of the same code book is not allowed.
Am I allowed to bring any notes or books?
Besides the three specified code books, no other external materials, notes, or electronic devices are permitted during the CPC exam. While you can highlight, tab, and write notes directly within your code books, loose papers or attachments are not allowed. Ensure your code books are from the current or previous year to align with the exam content.
Exam Details: Questions, Time, and Scoring
Understanding the structure of the CPC exam is crucial for effective preparation.
How many questions are on the CPC exam?
The CPC exam consists of 100 multiple-choice questions.
Is the CPC exam all multiple choice?
Yes, all questions are in a multiple-choice format. While this format might seem straightforward, the complexity of coding scenarios and the similarity of coding options require careful analysis and attention to detail.
How long is the CPC exam?
You are allotted four hours to complete the CPC exam, regardless of whether you take it in person or online. Effective time management and pacing are essential strategies for completing the exam within the time limit.
How many questions can you miss on the CPC exam?
To achieve a passing score of 70%, you can miss a maximum of 30 questions out of the 100 on the CPC exam. Focusing your study on the key content areas and practicing with sample questions can improve your accuracy and chances of passing.
How many times can you take the AAPC CPC exam?
You can retake the CPC exam as many times as necessary to pass. The initial exam fee covers two attempts. If both attempts are unsuccessful, you will need to pay the exam fee again for subsequent attempts. This highlights the importance of thorough preparation to minimize costs and achieve certification efficiently. Investing adequate time in studying and utilizing resources like practice exams can significantly increase your likelihood of passing on the first or second attempt.
CPC Exam Cost and Registration
Understanding the costs and registration process is a practical step in your certification journey.
How much does it cost to take the CPC exam?
To take the CPC exam, AAPC membership is required. The CPC exam fee is $499, and AAPC membership is an additional cost. Membership fees vary, with a standard fee and a reduced rate for students. Checking the AAPC website for the most current fee structure is recommended.
How do I sign up for the CPC?
Registration for the CPC exam is done through the AAPC website. Navigate to the “certifications” section and select “Schedule Your Exam.” The online registration process will guide you through purchasing the exam or using a voucher, and choosing a testing method (online or in-person).
Where do I take the test?
You can opt for online proctored testing from a location of your choice or choose to take the exam in person at an AAPC-approved testing center. The AAPC website provides a tool to locate nearby testing centers if you prefer the in-person option.
What kinds of questions are on the exam?
Approximately 70% of the CPC exam questions are based on real-world coding scenarios, requiring you to apply your coding knowledge to practical situations. The remaining 30% of questions cover essential knowledge areas such as:
- Medical Terminology
- Anatomy
- Coding Guidelines and Compliance
These questions are distributed across 17 subject areas, with each area potentially having up to ten questions. Key content areas to focus on include:
- Surgical procedures across different body systems (Integumentary, Musculoskeletal, Digestive, Respiratory, Cardiovascular, Hemic and Lymphatic, Mediastinum and Diaphragm, Urinary, Reproductive, Endocrine, Nervous)
- Evaluation and Management (E/M) coding across various settings (Inpatient, Outpatient, Nursing Facilities, etc.)
- Anesthesia
- Radiology
- Pathology and Laboratory
- Medicine
- Medical Terminology
- Anatomy
- Coding Guidelines, Compliance, and Reporting for ICD-10-CM, CPT, and HCPCS Level II coding systems.
Career Advancement and CPC Certification
CPC certification is not just a credential; it’s an investment in your career advancement.
Salary Expectations with CPC Certification
The Certified Professional Compliance Officer (CPCO®) certification is reported to have a high average salary, but CPC certification itself significantly enhances earning potential in medical coding. Salaries vary based on experience, location, and employer type. However, CPC certification generally leads to higher earning potential compared to non-certified coders.
Note: Salary information can be found on resources like the AAPC salary survey https://www.aapc.com/resources/medical-coding-salary-survey. (Accessed February 20, 2024. Please check for the most updated survey data).
Maintaining Your CPC Certification
CPC certification is valid for two years and requires ongoing professional development to maintain.
How long does CPC certification last?
CPC certification remains valid for two years.
Will I ever have to recertify?
To maintain your CPC credential, you must earn 36 Continuing Education Units (CEUs) every two years. CEUs ensure that CPC certified professionals stay updated with the latest changes in coding guidelines, regulations, and industry best practices.
The Apprentice Status
For individuals who pass the CPC exam without the recommended two years of work experience, the AAPC offers an apprentice status.
What is the Apprentice status?
If you pass the CPC exam but lack two years of medical coding work experience, you will initially receive a CPC-A credential. The “-A” signifies apprentice status. Once you accumulate and submit proof of two years of relevant coding experience, the apprentice designation is removed, and you become a fully certified CPC.
What if I move? Will I ever have to recertify?
The CPC certification is nationally recognized across all 50 states. Relocation does not necessitate re-examination. Maintaining your certification requires consistent CEU accumulation every two years, regardless of your location.
Preparing for the CPC Exam
Effective preparation is crucial for CPC exam success. While formal schooling is not mandatory, comprehensive training is highly recommended due to the exam’s complexity and the depth of knowledge required.
Can you take the CPC exam without going to school?
Technically, yes, you can take the CPC exam without formal schooling. However, it is strongly discouraged. The CPC exam demands a detailed understanding of medical coding principles, guidelines, and coding systems. Without structured education or training, passing the exam can be exceedingly challenging.
Read more: How a Skills-focused CPC Program Can Help You Prepare for the CPC Exam and a Job as a Medical Coder
How long should I study for the CPC exam?
The required study time varies based on individual learning styles and prior knowledge. However, adequate preparation is essential and cramming is not advisable. Allocate sufficient time for studying, practice exams, and review of coding materials.
What is a good score for the CPC exam?
A “good” score is any score of 70% or higher, as this is the minimum passing score for the CPC exam. Aim to exceed this benchmark to demonstrate strong competency.
How do I prepare for my CPC exam?
Effective study strategies can significantly improve your exam readiness. Consider these preparation methods:
- Review your training program materials: If you completed a medical coding program like CareerStep’s online Medical Coding and Billing Professional Program, revisit the course materials, practicum reports, and final exam feedback. Focus on areas where you can improve.
- Utilize practice exams: Practice exams are invaluable for simulating the exam environment and identifying knowledge gaps. The AAPC offers practice exams and study guides.
- Engage with study communities: Online forums and study groups, such as CareerStep forums, provide platforms to exchange tips, ask questions, and learn from others’ experiences.
- Consider AAPC resources: The AAPC offers prep books and additional practice exams that many candidates find helpful.
Medical coding books are essential tools for exam preparation and daily work.
Prepare for a Career as a Medical Coding Professional with CareerStep
If you’re interested in pursuing a medical coding career, consider enrolling in a comprehensive training program like CareerStep’s online Medical Coding and Billing Professional Program. This program provides skills-focused training designed to equip you with the necessary knowledge and competencies to succeed in a medical coding career and prepare for the CPC exam. To explore how CareerStep can help you take the next step toward your career goals, contact them at 1-800-411-7073.
Conclusion: Your Career Step with CPC Certification
Earning your CPC certification is a significant career step that can open doors to numerous opportunities in the growing field of medical coding. By understanding the requirements, preparing effectively, and committing to ongoing professional development, you can achieve this valuable credential and build a successful and rewarding career in healthcare. Whether you are interested in inpatient or outpatient coding, the CPC provides a strong foundation. While resources like inpatient books and practice questions such as inpatient 9 answers can be helpful for focused study, a comprehensive approach to learning and utilizing resources like CareerStep medical coding practicum will be key to your success.
