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Medical Coding Certified Professional Coder® (CPC®)
A Certified Professional Coder® (CPC®) is an individual of high professional integrity who has passed a medical coding certification examination sponsored by the American Academy of Professional Coders (AAPC). The examination consists of questions regarding the correct application of CPT®, HCPCS procedure and supply codes and ICD-9-CM diagnosis codes used for billing professional medical services to insurance companies.
A CPC® is an individual who in addition to on the job experience as a medical coder has achieved a measurable level of knowledge and expertise in reviewing and adjudicating coding of services, procedures and diagnoses on medical claims.
- 150 multiple choice questions (proctored)
- 5 1/2 hours
- 1 free retake
- $300 ($260 AAPC Students)
- Open book (manuals)
The CPC®'s abilities include:
- Demonstration of proficiency in adjudication claims for accurate medical coding for diagnoses, procedures and services performed by physicians and recognized licensed non-physician providers in physician-based settings.
- Proficiency is required across a wide range of services, which include:
- Evaluation and management
- Anesthesia
- Surgical services
- Radiology
- Pathology
- Medicine
- A sound knowledge of medical coding rules and regulations go hand in hand with keeping current on issues regarding medical coding compliance, and reimbursement. A trained medical coding professional can best handle issues such as medical necessity, claims denials, bundling issues and charge capture.
- A CPC® will be able to integrate medical coding and reimbursement rule changes into practice culture in a timely manner to include updating fee schedules and super-bills.
- A CPC® has demonstrated knowledge of anatomy, physiology and medical terminology commensurate with ability to correctly code provider services and diagnosis.
The CPC® examination is designed to evaluate a
physician practice coder’s knowledge of:
Section 1: Surgery and Modifiers
10000 (9), 20000 (10), 30000 (10),
40000 (10),
50000 (11), 60000 (10)
Section 2:
Evaluation and Management (10), Anesthesia (8),
Radiology (9), Laboratory and Pathology (10),
Medicine (10)
Section 3: Medical Concepts
Medical Terminology (8), Anatomy and Physiology
(8), ICD-9-CM (10), HCPCS (5)
A CPC® must have at least two years coding experience and maintain yearly renewal as well as submit 36 hours of Continuing Education Units (CEUs) every two years for verification and authentication of membership and expertise.