Certified Professional Coder (CPC^®)

The CPC Exam

• 150 multiple choice questions (proctored)
• 5 hours and 40 minutes to finish the exam
• One free retake
• $425 ($325 AAPC Students) - one free retake
• Open code book (manuals)

The CPC examination consists of questions regarding the correct application of CPT^®, HCPCS Level II procedure and supply codes and ICD-10-CM diagnosis codes used for coding and billing professional medical services to insurance companies. Examinees must also demonstrate knowledge on proper modifier use, coding guidelines and regulatory rules.

The CPC exam thoroughly covers:

Approved Manuals for Use During Examination

• CPT^® Books (AMA standard or professional edition ONLY). No other publisher is allowed.
• Your choice of ICD-10-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 COC 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-10-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:

• Any Procedural Coding Expert
• Any Procedural Professional
• CPT^® Plus! - PMIC
• CPT^® Insider's View - AMA
• ICD-10-CM Easy Coder
• Study Guides

Medical Coding Certification Requirements

• We recommend having an associate’s degree (not required).
• 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 have a current membership at the time of submission and when exam results are released.
• A CPC designation must have at least two years medical coding experience.
• If you have not submitted proof of 2 years on the job experience, a CPC-A designation will be awarded. https://www.aapc.com/certification/apprentice_status.aspx
• Membership is required to be renewed annually and 36 Continuing Education Units (CEU's) must be submitted every two years for verification and authentication of expertise. For CEU requirements please see out CEU Information page.

Note:

Each examination is separate and distinct from one another. To obtain all certifications, each examination must be taken separately and passed.

An overall score of 70% or higher is required to pass an exam. For examinees who do not pass, only the areas of study/categories with a score of 65% or less are provided for examinees’ preparation.

The areas of study reported reflect scores based on the number of questions in each category/section of the exam; each of the category/section may vary in the number of questions asked.

CPC^®, COC^™, Apprentice

Proof of education or experience isn’t necessary to sit for these exams.However, 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. Those who pass the CPC^®, COC^™ exams but have not yet met this requirement will be designated as an Apprentice (CPC-A^®, COC-A^™) on their certificate.

CPC-A^®, COC-A^™Status:

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/ICD-10-CM, or HCPCS Level II code sets. One letter must be on letterhead from your employer*, the other may be from a co-worker. Experience includes time coding for a previous employer and prior to certification. 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 a coding preparation course (not CEUs) 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/ICD-10-CM, or HCPCS Level II code sets.

Send proof of education in the form of a letter from an instructor on school letterhead stating you have completed 80 or more contact hours, a certificate/diploma stating at least 80 contact hours, or an unofficial school transcript.

• If you have completed the Distance Learning course by AAPC your 80 education hours will be automatically applied, you do not need to submit a certificate of completion
• Completion of the AAPC Practicode is counted towards the 1 year of experience a completion certificate must be submitted.

All proof of education must be submitted as a scanned attachment to an email once ALL apprentice removal requirements have been met.

Please allow 2-4 weeks for processing.

* Employers can only verify time spent coding with their organization. Proof of experience letters may be from previous employers, current employers, or a combination of both.

Phone: 800-626-2633
Email: apprenticeremovals@aapc.com

Tips for CPC

• It is all about the guidelines: In preparation for the exam, review all coding guidelines and understand how they are applied. This pertains to all codebooks (CPT^®, ICD-10-CM, HCPCS Level II). Coding conventions and guidelines for ICD-10-CM are found in the front of the codebook. CPTT^® guidelines are found in the introductory sections and throughout the codebook in selected subsections.
• Get your materials organized: Well-marked codebooks can be extremely helpful during the exam. Because coding guidelines contain instructions for what can be reported and what cannot be reported, use different colored highlighters to quickly distinguish between the two.
• Sequencing matters: Follow sequencing rules in coding guidelines and coding conventions. Example: A urine culture confirms the patient’s diagnosis of a UTI caused by E coli. The correct codes and sequence are: 599.0, 041.49. There is a note instructing you to use an additional code to identify the organism, such as Escherichia coli (E.coli). If there are code options with the same codes in a different sequence, pay close attention to the coding conventions and guidelines to guide you in the right selection.
• Parenthetical notes provide valuable information: Paying close attention to information in the CPT^® parenthetical notes prevents you from making coding errors. Example: There is a parenthetical note following code 10030 which states "Do not report 10030 in conjunction with 75989, 76942, 77002, 77003, 77012, 77021. This alerts the coder that imaging guidance cannot be reported with the surgical procedure code.
• Know your modifiers: Review the proper use for each modifier. Understand when each should be appended.
  Example: Modifier 26 is appended to codes with a professional and technical component to indicate the provider you are coding for only performed the professional component. If the question/scenario indicates the procedure is performed in the hospital setting, the coder will be alerted that modifier 26 should be appended to radiology procedures and medicine procedures that apply. If the code description includes professional component (eg 93010), you would not append modifier 26.