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Certified Professional Coder-Hospital Outpatient (CPC-H®)

Outpatient ambulatory coder jobs are trending faster than ever before. As physicians move away from private practice and join hospital groups, career opportunities in Outpatient Facilities such as Ambulatory Surgical Centers or hospital outpatient billing and coding departments are opening for coders. The CPC-H® exam validates your specialized payment knowledge needed for these jobs in addition to your CPT® and ICD-9 coding skills. Invest in your future with the CPC-H® certification.

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 (emergency department visits, outpatient clinic visits, same day surgeries, diagnostic testing (radiology and laboratory) and outpatient therapies (physical therapy, occupational therapy, speech therapy and chemotherapy))
  • Proficiency across a wide range of services, which include evaluation and management, anesthesia, surgical services, radiology, pathology and 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 better 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 UB04
  • Correctly completing a CMS 1500 for ASC services and UB04 for outpatient services, including the appropriate application of modifiers
  • Knowledge of anatomy, physiology and medical terminology commensurate with ability to correctly code provider services and diagnoses
  • A working knowledge in the assignment of ICD-9-CM codes from Volumes 1 & 2

    Note: ICD-9-CM Vol 3 and DRG code assignment (inpatient coding) are not tested during the CPC-H exam

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The CPC-H® Exam

  • 150 multiple choice questions (proctored)
  • 5 hours and 40 minutes to finish the exam
  • 1 free retake

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

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

Note:
Electronic devices with an on/off switch (cell phones, smart phones, tablets, etc.) are not allowed into the examination room. Failure to comply with this policy may result in disqualification of your exam.

Any officially published errata for these manuals may also be used. No other manuals are allowed. Each code set is updated annually; it is essential that examinees use the current calendar year's coding manuals when taking the certification exam. Questions on the CPC®, CPC-P® and 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.

Approved Exam 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

Medical Coding Certification Requirements

  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.
    1. New members must submit membership payment with examination application.
    2. Renewing members must have a current membership at the time of submission and when exam results are released.
  4. Effective January 2010 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 (members with an apprentice designation are not required to have two years medical coding experience.) Membership is required to be renewed annually and 36 Continuing Education Units (CEUs) must be submitted every two years for verification and authentication of expertise.

Note:
For CEU requirements please see our CEU Information page.

Due to the level of expertise required of medical coders, AAPC expects certified coders to be able to perform not only in an exam setting but also in the real world. In addition to passing the certification exam, coders will also be required to demonstrate on-the-job coding experience. Those who pass the CPC®, CPC-H® and/or CPC-P® exams but have not yet met this requirement will be designated as an Apprentice (CPC-A®, CPC-H-A® and/or CPC-P-A®) on their certificate.

CPC-A®, CPC-H-A®, or CPC-P-A® Status: Members with an Apprentice designation are required to submit annual CEUs while completing the coding job requirement.

Requirements for Removal of Apprentice Designation:

To remove your apprentice designation via on-the-job experience, you must obtain and submit two letters of recommendation verifying at least two years of on-the-job experience (externships accepted) using the CPT®, ICD-9-CM, or HCPCS Level II code sets. One letter must be on letterhead from your employer*, the other may be from a co-worker. Both letters are required to be signed and will need to outline your coding experience and amount of time in that capacity. Download our Apprentice Removal Template for easier submission. Letterhead and signatures are still required when using this template.

OR

Submit proof showing completion of at least 80 contact hours of coding education AND one letter, on letterhead, signed from your employer verifying one year of on-the-job experience (externships accepted) using the CPT, ICD-9-CM, or HCPCS Level II code sets.

Send proof of education in the form of a letter from an instructor on school letterhead stating the 80 contact hour course has been completed, a certificate/diploma stating at least 80 contact hours, or a school transcript.

Once ALL apprentice removal requirements have been met, you may submit them via fax, mail, or scanned email. Please allow 2-4 weeks for processing.

*Employers can only verify time spent coding with their organization.

AAPC
2480 South 3850 West
Suite B
Salt Lake City, UT 84120

Phone: 800-626-2633
Fax: 801-236-2258
Email: jane.baldwin@aapc.com