Don’t Stress the First Test

Summit the certification exam using secrets revealed by veteran test-takers.

By Brad Ericson, MPC, CPC, CPCO

You have the experience. You have the education. And you have the resolve. You push the button to register for your first credentialing exam—all five hours and 40 minutes of it—and then it hits you: “What do I do now?”

Prepare Before the Exam

Fortunately, you’re not the first to take an AAPC certification exam, and there’s plenty of great advice you can glean from your local chapter and online. There are also many well-meaning tales that can scare your pants off, so pick the path that works best for you.

AAPC Cutting Edge asked coders for successful exam-taking strategies. Angela Crouch, CPC, said, “Prepare. Prepare. Prepare.” Nearly everyone we talked to agreed that the best way to do that was to study and practice the exam almost daily. Many recommend using AAPC practice exams for each credential. Not only do the practice exams allow you to get a feeling for how the exam is structured, but it helps you develop the pace necessary to complete the exam in time.

There are two schools of thought about how best to work through the questions in the time allotted. Some advocate slogging through the exam from one end to another. While others recommend finishing the exam by not dwelling too long on an extremely difficult question, and going back to the hard questions after the first pass.

AAPC Director of Education Marilyn Holley, RHIT, CPC, CPC-H, CHISP, prefers the latter technique, but she cautions that this can be risky if you don’t keep track of which ones you skipped. To avoid losing track of the questions you still need to answer—and throwing the whole effort out the window—note the skipped questions in the exam booklet. Then, as you return to answer those questions, double check to make sure the exam question number and the number on the answer grid are the same (i.e., question 20 in the exam booklet = question 20 on the answer grid).

James Hargrove, CPC, agrees. “The test is just as much about speed as it is accuracy. Don’t spend more than two minutes on the questions. If you get close to two minutes, skip to the next and go back later,” he advises.

Successful examinees often mention friends or a group who helped them pass. Taryn Linstedt, CPC, advises finding a colleague who can provide support while studying, or getting a study buddy. Many local chapters offer preparation classes, which provide for you an entire room of support.

Prep with Proper Gear

Attempting the exam is like mountain climbing. Mountaineers devote significantly more time to making sure they have proper equipment than they do to the actual climb. Not only must the right climbing gear be packed, but additional materials are always added for contingencies.

At least a couple of weeks before, make sure you have the materials necessary for the actual exam:

Bring the right code books.

Check to see what books are permissible and if any additional material is allowed. If you have the wrong books, you won’t be able to sit for the exam.

Write in your code books.

This trick helped me most. You can’t bring notebooks or sheets of notes, but you can transfer notes to your books to help you code. Don’t be afraid to write in your CPT®, HCPCS Level II, and ICD-9-CM code books to help you quickly identify which codes can be used in certain situations.

Highlight the guidelines in your code books.

Make sure you can easily find the guidelines that matter. Use a highlighter or, if you’re artistic, make meaningful characters or drawings to identify the information.

Tab your code books.

Use pre-made or homemade tabs on your books to identify chapters, frequently used codes or sections, guidelines, appendices, and other places so you don’t waste time rifling back and forth looking for something.

Confirm the date and location.

Be sure you know the date of the exam and where it will be held. Some members advise practicing the drive to the site to account for bottlenecks, parking, and how long it takes. If you don’t want to do that, get driving directions from or, or use a trustworthy GPS.

Make a reservation.

Many members suggest that if you’re exam site requires long distance traveling, book a nearby room so you’re well-rested on examination day. No reason to show up with that thousand-mile stare.

Pick clothes you can layer.

The room’s temperature will change throughout the exam period, so make yourself comfortable.

Sweat the small stuff now.

Make sure you have your photo and member identification cards, plenty of No. 2 pencils, and an eraser. Pack some hard candy to suck on and some ear plugs if you’re easily distracted. Pack up all the items you’ll need at least the night before—not the morning of—the exam.

Bring food and water.

There are no intermissions during the exam. Bring a water bottle, but not a noisy one. Stay away from crunchy foods like chips or anything that smells.

Most important, keep practicing, keep studying, and keep a positive attitude. Jenny Oravecz, CPC, told us she studied religiously every day for weeks prior to taking the exam. “I read the chapters over and over and over again, so I could be as familiar as possible with where to quickly locate any code.”

Prepare Mentally

One of the mistakes many examinees make is staying up late the night before the exam, cramming those last few items into their heads. And getting up early to cram is like committing exam suicide. Oravecz also told us, “I would not recommend studying the morning of the exam; use that time to nourish and hydrate yourself, get to your meeting location early and get yourself grounded mentally.”

If you exercise regularly, keep up your routine. Get a good night’s sleep. Have a good breakfast, grab the items you need to take (already organized and packaged for testing), and go early so you can find the perfect chair for the exam.

Sheri Fuchser, CPC, encourages examinees to look at the exam realistically. “As far as physical stress goes, relax! It’s a test, not a sentencing. You’ve studied and you know it. Get a good night’s rest, have a good breakfast, and review for only a little while [don’t cram],” she said. “Then close everything, relax your mind, and go take your test.” Racheal Taylor, CPC, agrees, “Get some rest the night before, and breathe.”

Before they begin their ascension, many climbers take time to center themselves. They breathe deeply and clear their minds to assure they’re in the moment. Though well prepared, every climber knows that it’s each hand and toe hold that makes the climb successful; worrying about making it to the top is fruitless.

Set the Pace and Keep Up Exam Stamina 

Well fed and rested, it’s now time to take the exam. Like mountain climbers, you have to take that first step before you can reach the top. Here are some tips to help you take your first steps during the exam and to proceed with a smooth ascension:

Have your identification (ID) ready – You’ll be asked for a photo ID and your membership card.

Have your code books ready – Proctors will review your code books to make sure they are permissible and haven’t been unfairly augmented.

Kiss your phone goodbye – Don’t bring your tablet, computer, or anything else electronic that might distract you and disturb fellow examinees. Some exam sites check phones at the door; if your site doesn’t, turn it off and put it away. You won’t have time to text (“OMG. I’m taking the exam!”) or play Angry Birds.

Be a good neighbor – Remember the worst roommate you’ve ever had? Don’t be like him or her.

Listen carefully – Your proctor will read the instructions and make other announcements. If you don’t understand the instructions given, ask questions before the examination begins.

Carefully mark your answer sheet – Exams are machine graded, so make sure to correctly fill in your selected “bubble” for each question, as shown in the example on your exam grid, to ensure an accurate score.

Scan the entire exam when you begin – Answer the easiest, shortest questions first. This gives you the taste of success.

Remember to pace yourself – You have an average of two minutes and 15 seconds to answer each question. Stay relaxed and do not panic. You’ll be able to finish.

Read each question carefully – Note such words in the question as not, except, most, least, and greatest. These words are often crucial in determining the correct answer. There are no “trick” questions on the exam, however, so don’t worry about hidden words or meanings.

Answer every question – If you don’t know the right answer, eliminate as many wrong answers as you can, and then select among the remaining possible answers. If you don’t have a clue, guess. A guess is always better than a blank response and guesses often are correct.

Use extra time to check your work – If you finish with some additional time, go back and review any questions you aren’t fully sure you answered correctly. Use your code books again to confirm.

Some members said they actually found the exam fun, a challenge that made them realize how much they knew and how well they code. But remember that not passing the exam on your first attempt is not the end of the world. Refuse to allow a temporary roadblock to shake your confidence or cause you to develop a negative image of yourself and your ability to obtain AAPC certification.

Remember: Never a failure, always a lesson. Dust yourself off, check your ropes, and climb back up. Certification is within your reach.

Brad Ericson, MPC, CPC, CPCO, is director of publishing at AAPC.


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