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Certified Professional Coder-Hospital (CPC-H®)

A Certified Professional Coder-Hospital (CPC-H®) is an individual of high professional integrity who has passed a medical coding certification examination sponsored by the American Academy of Professional Coders (AAPC). In addition to on-the-job experience as a medical coder, a CPC-H® has achieved a measurable level of knowledge and expertise in coding of services, procedures and diagnoses for outpatient facilities.

The CPC-H®'s abilities in regard to outpatient facility/hospital services include:

  • Proficiency in assigning accurate medical codes for diagnoses, procedures and services performed in the outpatient setting.
  • Proficiency is required across a wide range of services, which include:
    • Evaluation and management
    • Anesthesia
    • Surgical services
    • Radiology
    • Pathology
    • Medicine
  • Knowledge of coding rules and regulations along with keeping current on issues regarding medical coding, compliance, and reimbursement under outpatient grouping systems. A trained coding professional can best handle issues such as medical necessity, claims denials, bundling issues and charge capture.
  • Ability to integrate coding and reimbursement rule changes in a timely manner to include updating the Charge Description Master (CDM), fee updates and the Field Locators (FL) on the UB92.
  • A working knowledge of AHA Coding Clinic guidelines in the assignment of ICD-9-CM codes from Volumes 1 & 2.
  • Correctly completing a UB92, including the appropriate application of modifiers.
  • Knowledge of anatomy, physiology and medical terminology commensurate with ability to correctly code provider services and diagnoses.
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  • Apprentice Status
  • Certification Requirements
  • Approved Manuals
  • CPC-H® Exam

CPC®, CPC-H®, or CPC-P® Apprentice: Examinees who are successful in passing the certification examination but have not yet met the required coding work experience will be awarded the initial designation CPC® Apprentice, CPC-H® Apprentice, or CPC-P® Apprentice. The CPC®, CPC-H®, or CPC-P® Apprentice is required to submit the annual CEUs while completing the coding work experience requirement. The apprentice will receive a certificate from AAPC for CPC® CPC-H® or CPC-P® Apprentice.

Requirements for removal of Apprentice designation for the CPC®, CPC-H®, CPC-P®: At least two recommendation letters verifying 2 years of on the job experience using the CPT®, ICD-9-CM, or HCPCS Level II code sets. At least one letter must be from a supervisor outlining your coding experience and amount of time in that capacity.

OR

A minimum 80 hour coding course AND one letter verifying one year of on the job coding experience from a supervisor. Proof of education may be sent in the form of a letter from the instructor stating the amount of contact hours or a certificate of completion stating the amount of contact hours.

Medical Coding Certification Requirements
In order to earn CPC®, CPC-H®, CPC-P® or CIRCC™ credentials:

  1. We recommend having an associate’s degree.
  2. Pay examination fee at the time of application submission.
  3. Maintain current membership with the AAPC.
    a. New members must submit membership payment with examination application.
    b. Renewing members must be current at the time of application submission as well as when results are sent.
    c. See “Fees for Membership and Examination” section for details.
  4. Starting in January 2009 all exams will be reported with exact scores. The CPC-H® exam will report the top three areas of weakness.

A CPC-H® must have at least two years medical coding experience and maintain yearly renewal as well as submit 36 Continuing Education Units (CEUs) every two years for verification and authentication of expertise.

Note:
Each examination is separate and distinct from one another. To obtain all certifications, each examination must be taken separately and passed. Continuing Education Units (CEUs) submissions are required for all certifications. For CEU requirements please see our CEU Policy page.

Approved Manuals for Use During Examination

  • CPT® Books (AMA standard or professional edition ONLY) no other publisher is allowed
  • Your choice of ICD-9-CM
  • Your choice of HCPCS Level II

In addition, any officially published errata update sheets for these manuals may be used. No other manuals are allowed. Examinees may use current calendar year and/or previous year code books. However, it is strongly suggested that only current manuals be used. Questions on the CPC®, CPC-P® or CPC-H® tests do not require the use of any other outside material.

Individuals with a solid understanding of coding fundamentals, anatomy, and terminology should be able to answer each examination question through application of the CPT®, ICD-9-CM, or HCPCS Level II manuals, or through careful reasoning.

List of Approved Manuals

Non-approved Manuals for Use During Examination

Due to the advantages of additional information and/or ease of use, the following books cannot be used during the exam:

  • Current Procedural Coding Expert® - Ingenix
  • Procedural Coding Professional - Contexo
  • Procedural Coding Professional - AAPC
  • Procedural Coding Expert - Contexo
  • Procedural Coding Expert - AAPC
  • CPT® Insider's View - AMA
  • CPT® Plus! - PMIC
  • Coders' Choice CPT® - PMIC
  • ICD-9-CM Easy Coder - Unicor

The CPC-H® Exam

  • 150 multiple choice questions (proctored)
  • 5 1/2 hours
  • 1 free retake
  • $300 ($260 AAPC Students)
  • Open Code book (manuals)

The CPC-H® examination consists of questions regarding the correct application of CPT®, HCPCS Level II procedure and supply codes and ICD-9-CM diagnosis codes used for coding and billing outpatient facility/hospital services to insurance companies. It is designed to evaluate a coder’s knowledge of:

  • Medical Terminology
  • Anatomy
  • Coding Guidelines
  • Payment Methodologies
  • CPT®
  • HCPCS Level II
  • Surgery and Modifiers
  • Code Assignment ICD-9-CM Vols 1 & 2
  • Compliance
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