Certified Professional Coder-Payer (CPC-P®)
The CPC-P® demonstrates a coder’s aptitude, proficiency and knowledge of coding guidelines and reimbursement methodologies for all types of services from the payer's perspective. Contributing developers include Dr. Marc Lieb, M.D., J.D., Susan Goldsmith, CPC, as well as a number of other well-known CPC-Ps in the payer community. Claims reviewers, utilization management, auditors, benefits administrators, billing service, provider relations, contracting and customer service staff can each benefit their practice with the CPC-P® credential.
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The CPC-P® Exam
- 150 multiple choice questions (proctored)
- 5 1/2 hours
- 1 free retake
The CPC-P® certification exam certifies that the successful candidate has the knowledge and skills to adjudicate provider claims effectively. The exam will test the examinee’s basic knowledge of coding-related payer functions with emphasis on how those functions differ from provider coding. The relationship between coding and payment functions will be explored in depth.
The CPC-P® exam consists of two parts, testing coding accuracy and reimbursement methodologies. The Medical Coding Concepts section will test the examinee’s understanding of medical terminology, anatomy and CPT®, HCPCS Level II and ICD-9-CM coding concepts. The Reimbursement Methodologies section will cover physician reimbursement, inpatient payment systems, outpatient payment systems, health insurance concepts and HIPAA.
Approved Manuals for Use During Examination
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® 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.
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
Medical Coding Certification Requirements
- We recommend having an associate's degree.
- Pay examination fee at the time of application submission.
- Maintain current membership with the AAPC.
- New members must submit membership payment with examination application.
- Renewing members must be current at the time of application submission as well as when results are sent.
- Starting in January 2009 all exams will be reported with exact scores. The CPC-P® exam will report the top three areas of weakness.
A CPC-P® must have at least two years of 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 Unit (CEU) submissions are required for all certifications. For CEU requirements please see our CEU Information page.
Due to the level of expertise required of medical coders, the AAPC expects certified coders to be able to perform not only in an exam setting but also in the real world. Consequently, in addition to passing the certification exam, coders will also be required to demonstrate on-the-job coding experience before receiving the full credential. Those who pass the CPC, CPC-H and/or CPC-P exams but have not yet met this requirement will be designated as Apprentices (CPC-A, CPC-H-A and/or CPC-P-A).
CPC®, CPC-H®, or CPC-P® Apprentice Status: Apprentices are required to submit the annual CEUs while completing the coding work experience requirement. The apprentice will receive a certificate from the AAPC for CPC, CPC-H or CPC-P Apprentice. The official credential designations for these certifications are CPC-A, CPC-H-A and CPC-P-A.
Requirements for Removal of Apprentice Designation: At least two recommendation letters verifying two 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 instruction hours or a certificate of completion stating the amount of instruction hours.