The CPMA® Exam
- 150 multiple choice questions (proctored)
- 5 hours and 40 minutes to finish the exam
- 1 free retake
- Open code book (manuals)
The CPMA® exam thoroughly covers:
- 26 questions
- The Medical Record
- HIPAA Privacy and Release of Medical Record Information
- Covered Entities
- HIPAA Privacy Regulations
- JCAHO Documentation Standards
- Record Retention
- The Advance Beneficiary Notification
- Legal Requirements of the Medical Record
- Analyzing the Operative Report
- 32 questions
- The Compliance Plan
- Fraud and Abuse
- Civil Monetary Penalties Law
- Federal False Claims Act
- Type of Audits
- OIG Regulations and Workplan
- National Correct Coding Initiative
- CMS guidelines for E/M documentation
- OIG imposed CIA (Corporate Integrity Agreements)
- Recovery Audits and other government programs
- 20 questions
- CPT coding concepts
- Modifier usage
- Diagnosis coding and medical necessity
- Evaluation and Management Documentation Guidelines
- Coding Guidelines versus carrier guidelines
- 11 questions
- Audit scope
- Statistical sampling
Audit Cases including:
- 52 questions (24 audit cases)
- Evaluation and Management
- Physical Therapy
- Infusion Services
- 9 questions
- Validation of Audit Results
- Analysis and Report of Audit Findings
- Communicating Audit Results
- Corrective Action
The majority of the questions are presented in multiple choice format covering
auditing theory, legal and regulatory issues, NCCI, RAC audits, statistical sampling,
coding concepts, and modifiers, etc. In addition, each test taker will need to
audit approximately 20 health care cases.
Approved Manuals for Use During Examination
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.
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/Exam Instructions
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
While there is no experience requirement, we strongly recommend that the candidate
have at least two years of experience in medical auditing.
Please be aware that this is a difficult, high-level examination which is not
meant for individuals with little, limited or no audit experience or training
- We recommend having an associate's degree
- Pay examination fee at the time of application submission
- Maintain current membership with the AAPC
- Renewing members must have a current membership at the time of submission
and when exam results are released.
- Renewing members must be current at the time of application submission
as well as when results are sent
- Materials to bring:
The CPMA® examination is recommended for a certified coder or medical record
auditor who has experience auditing physician services or significant coding
experience and is well versed with a variety of different types of audits including
but not limited to E/M services.Â Auditing involves compliance and regulatory
issues in its day to day work, and the examinee will be tested on these concepts
in addition to coding, modifiers, NCCI usage, and more.
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 our CEU
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.
Continuing Education Unit (CEU) submissions are required for all certifications. For CEU requirements please see our CEU Information page.