Without risk adjustment coding to ensure that a complete picture of each patient’s health is captured and reported on medical claims, health plans would lack appropriate funding and planning to cover treatment for high-risk patients. Certified Risk Adjustment Coders (CRCs) play a critical role in establishing accurate risk scores for patients, which promotes optimal patient care and ethical payer reimbursement for providers and health plans.
Students earning their CRC credential possess demonstrated expertise in the complexity of diseases associated with chronic conditions and comorbidities, as well as mastery of ICD-10-CM guidelines and risk adjustment guidelines. As CRCs, they are equipped both to ensure clinical documentation accurately portrays the patient’s health status and to ensure all clinically documented diagnoses are properly reported.
While risk adjustment diagnoses are pulled from claims data and medical record documentation in all healthcare settings, CRCs often work for health plans and for vendors working with health plans. They also play a valuable role in physician practices and are often tasked with educating physicians on proper documentation and coding. Because CRC have a direct and significant impact on revenue, they are well compensated, earning an average annual salary of $64,995, according to AAPC's 2022 Salary Survey.
The CRC examination consists of questions regarding the correct application of ICD-10-CM diagnosis codes used for risk adjustment coding.
Officially published errata for the above code books may also be referenced during the CRC exam. Prior to CRC exam day, confirm reference materials allowed during the certification exam.
Official 2021 ICD-10-CM Expert Code Book features expanded quick-view flow charts for quick, accurate information. Easy-to-use coding reference.
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.
The CRC exam is a difficult, high-level exam and not intended for individuals lacking CRC training or equivalent experience working with risk adjustment models.
If you haven’t become an AAPC member, you must do so prior to scheduling your CRC exam. Renewing AAPC members are also required to have a current membership to sit for the CRC certification exam.
An overall score of 70% or higher is required to pass the certification exam.
All AAPC certification exams exclusively measure proficiencies relating to the one credential named in the exam. To earn additional medical coding credentials will require you to pass additional certification exams.
CEU Requirement: Certified coders are required to complete 36 Continuing Education Units (CEU's) every two years. For CEU requirements please see our CEU Information page.