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Certified Professional Coder (CPC®) - Certification Exam

Become a Certified Professional Coder

GROWING DEMAND FOR MEDICAL CODERS

Over 190,000 certified professionals help maintain compliance and profitability within medical practices through accurate medical coding and documentation. And jobs for certified medical coders will increase 22 percent through the year 2022, according to the U.S. Bureau of Labor Statistics.

Prepare yourself to meet the industry demand. Gaining your CPC certification is the first step to a successful career in the business side of healthcare.

HOW MUCH DOES A CPC MAKE?

The average annual salary for a CPC, in 2018 was $54,401. Keep in mind that a CPC’s salary varies based on location, years of experience, how many credentials held, the employer, and other factors. Click here to calculate the average CPC salary in your area, based on your job responsibility.

SHOW YOUR PROFICIENCY

CPC certification represents excellence in medical coding. Potential employers recognized that the CPC credential equates with proven mastery of all code sets (CPT®, ICD-10-CM, HCPCS Level II), evaluation and management (E/M) principles, surgical coding, and adherence to documentation and coding guidelines.

Passing the CPC test demonstrates you have:

  • Expertise in reviewing and assigning accurate medical codes for diagnoses, procedures, and services performed by physicians and other qualified healthcare providers in the office or facility setting (e.g., inpatient hospital)
  • Proficiency across a wide range of services, including E/M, anesthesia, surgery, radiology, pathology, and medicine
  • Sound knowledge of medical coding guidelines and regulations including compliance and reimbursement—allowing a CPC to better handle issues such as medical necessity, claims denials, bundling issues, and charge capture
  • Understanding of how to integrate medical coding and payment policy changes into a practice's reimbursement processes
  • Knowledge of anatomy, physiology, and medical terminology necessary to correctly code provider diagnosis and services

Double Your Chances of Passing—Learn from the Creators of the CPC Exam

Our goal is to train medical coders to be industry ready. We provide a complete education, preparing you for the CPC test. Our in-depth CPC exam preparation course is for individuals preparing for a career in medical coding. Students preparing for the CPC exam with our preparation courses are twice as likely to pass.

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What Is the CPC Exam?

The CPC exam consists of 150 multiple-choice questions that must be answered within five hours and 40 minutes. You may use approved coding books. Answering 70 percent of the questions correctly is required to pass. The CPC exam costs $399 ($325 for AAPC students) and includes one free retake.

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 of proper modifier use, coding guidelines, and regulatory rules.

The CPC exam thoroughly covers:

The 10,000 Series CPT® part of the exam will consists of 10 questions related to surgical procedures performed on the integumentary system, which includes skin, subcutaneous, and accessory structures, as well as nails, pilonidal cysts, repairs, destruction, and breast.

The 10 questions in the 20,000 Series CPT® will home in on surgical procedures performed on the musculoskeletal system from head to toe. Specifically, these areas include the head, neck, back and flank, spine, abdomen, shoulder, arm, hand and fingers, pelvis and hip, leg, foot and toes.

Ten questions covering the 30,000 Series CPT® focus on surgical procedures performed on the respiratory system, surgical procedures performed on the cardiovascular system, surgical procedures performed on the hemic and lymphatic systems, and surgical procedures performed on the mediastinum and diaphragm.

Your knowledge of the 40,000 Series CPT® will be tested with 10 questions targeting surgical procedures performed on the digestive system, which will focus on these areas: lips, mouth, palate and uvula, salivary gland and ducts, pharynx, adenoids, and tonsils, esophagus, stomach, intestines, appendix, rectum, anus, liver, biliary tract, pancreas, abdomen, peritoneum, and omentum.

The CPC exam will assess your knowledge of the 50,000 Series CPT® with 10 questions pertaining to surgical procedures performed on the urinary system, surgical procedures performed on the male reproductive system, surgical procedures performed on the female reproductive system, including maternity and delivery, and surgical procedures performed on the endocrine system.

Ten questions directed at the 60,000 Series CPT® involve surgical procedures performed on the nervous system and will include codes pertaining to the skull, meninges, brain, spine, spinal cord, extracranial nerves, peripheral nerves, autonomic nervous system.

Ten E/M questions will assess your coding proficiency related to place of services, such as office/other outpatient, hospital observation, hospital inpatient, consultations, emergency department, critical care, nursing facility, domiciliary and rest homes, and home services. It will also include questions directed at preventive medicine, non-face-to-face services, neonatal and pediatric critical care, intensive care, prolonged services, chronic care, transitional care, case management, and care plan oversight.

Eight questions related to anesthesia will pertain to time reporting, qualifying circumstances, physical status modifiers, anesthesia for surgical, diagnostic and obstetric services.

The 10 questions in this section of the CPC test will focus on both diagnostic and interventional radiology, including diagnostic ultrasound, radiologic guidance, mammography, bone and joint studies, radiation oncology, and nuclear medicine.

Ten path/lab questions will determine your knowledge of organ and disease panels, drug testing, therapeutic drug assays, evocation/suppression testing, consultations, urinalysis, molecular pathology, MAAA, chemistry, hematology and coagulation, immunology, transfusions, microbiology, anatomic pathology, cytopathology, cytogenetic studies, surgical pathology, in vivo and reproductive.

Ten questions will cover numerous specialty-specific coding scenarios, as well as immunizations, biofeedback, dialysis, central nervous system assessments, health and behavior assessments, hydration, medical nutrition, therapeutic and diagnostic administration, chemotherapy administration, photodynamic therapy, osteopathic manipulative treatment, patient education and training, non-face-to-face nonphysician services, and moderate sedation.

Medical terminology for all systems in the human body will be assessed in 8 questions.

Anatomy for all systems in the human body will be assessed in 8 questions.

Ten questions will require proficiency in diagnosis for all the chapters included in ICD-10-CM, as well as thorough knowledge of the ICD-10-CM Official Guidelines for Coding and Reporting. Additionally, diagnosis questions will appear in other sections of the exam from the CPT® categories.

Five questions on the CPC exam will pertain to HCPCS Level II coding and include questions focusing on modifiers, supplies, medications, and professional services for Medicare patients.

This section of the CPC test will involve 6 questions addressing the ICD-10-CM Official Guidelines for Coding and Reporting, CPT® coding guidelines and parenthetical notes, and modifier use.

Five questions testing your knowledge of compliance and regulations will pertain to services covered under Medicare Parts A, B, C and D; applying coding to payment policy, place of service reporting, fraud and abuse, NCCI edits, NCD/LCD, HIPAA, ABNs, and RVUs.

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Approved Manuals for Use During Examination

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 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

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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.

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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

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Tips for CPC Exam

  • 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.

You need only to purchase the test to register for the CPC exam. You may then log into your account to schedule your exam when you're ready to take it.

A certified professional coder reviews clinical documentation and translates medical procedures, diagnosis, supplies, and services into codes that are submitted on a medical claim to payers for reimbursement. CPCs need a good grasp on medical terminology and anatomy to understand medical charts and abstract important information. They serve a vital role in the financial wellbeing of their employing organization and indirectly influence patient outcomes through accurate medical coding.

CPC's make between $18 and $25 per hour, varying by location, experience and additional credentialing. You can find the most recent salary survey results here.

Sitting for the CPC exam costs $399 ($325 AAPC Students) and includes one free retake. Additional expenses vary, depending on the coursework, books, and practice exams you select to successfully prep for the exam.

The biggest tip to passing the CPC exam is - take the courses! And that includes the medical terminology and anatomy courses because this knowledge is essential to CPCs. Each course is a valuable investment that will profit you many times over. Our interactive lectures, reading assignments, timed assessments, and practical application are strategically designed to impart everything you need to know to earn your certification-including tips for taking the exam.

Most people complete the coursework and pass the exam in 6 to 12 months.

AAPC's CPC certification is renowned globally by physicians, payers, and government agencies. There are other certifications, as well-all of which home in on a medical specialty or a specific business of medicine role. You can find a list of these on our website.

To pass the CPC exam, you need to achieve a passing rate of 70 percent or higher. That means you must answer at least 105 questions correctly.

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CPC Exam Quick Links

All about CPC Exam | Benefits of Being a Medical Coder | Best Career Options in Healthcare | Day of a Medical Coder | How to be a Medical Coder | Step into the Shoes of a Medical Coder | Medical Coding – Are you a Good Fit? | Medical Coding – Myths and Reality | Top Places Where Medical Coders Work

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