Medical coding accuracy is key to optimal, ethical reimbursement, which makes medical coders integral to the financial resources of every healthcare organization providing treatment and services to patients. For more than three decades, CPCs have established an unwavering reputation of excellence. The title of Certified Professional Coder therefore comes with high expectations, trust, and respect.
The CPC Exam Breakdown
Passing the CPC exam requires you to correctly answer a minimum of 105 questions from the series below. The exam questions, however, will not be identified or sorted by the series to which they pertain. The CPC test will rely on a level of understanding that enables you to identify the series.
10,000 Series CPT®
The 10,000 Series CPT® part of the exam will consists of ten 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.
20,000 Series CPT®
The ten 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.
30,000 Series CPT®
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.
40,000 Series CPT®
Your knowledge of the 40,000 Series CPT® will be tested with ten 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.
50,000 Series CPT®
The CPC exam will assess your knowledge of the 50,000 Series CPT® with ten 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.
60,000 Series CPT®
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.
Evaluation and Management
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 ten 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.
Laboratory / Pathology
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 eight questions.
Anatomy for all systems in the human body will be assessed in eight 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.
HCPCS Level II
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 six questions addressing the ICD-10-CM Official Guidelines for Coding and Reporting, CPT® coding guidelines and parenthetical notes, and modifier use.
Compliance and Regulatory
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.