Taking the CRC^® exam

The CRC examination consists of questions regarding the correct application of ICD-10-CM diagnosis codes used for risk adjustment coding. Scroll down to view specifics of what is covered on the exam.  

Who should take the CRC exam?

You should take the CRC exam if you have a high-level knowledge of medical terminology, anatomy, and pathophysiology, along with an understanding of the proper application of ICD-10-CM diagnosis codes used for risk adjustment coding. 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.

Passing the CRC exam elevates your earning potential. CRCs play a valuable role in physician practices and are often tasked with educating physicians on proper documentation and coding. Because CRCs have a direct and significant impact on revenue, they are well compensated.

What to expect on exam day

The exam has a total of 100 questions with a minimum of 70 to be answered in four hours. People often wonder if the CRC exam is hard. If you have taken the training course, studied, and are familiar with your ICD-10-CM code book, the test will be demanding, but not difficult. 

Here's a quick overview of what you can expect: 

Before you begin the test, take a moment, and breathe. You have prepared for this. You have your code book by your side, and you know how to use it. This is your opportunity to demonstrate your coding expertise. 

You'll have four hours to finish the exam, giving you approximately 2.4 minutes to answer each of the 100 multiple-choice questions. You can save time by reading the answer choices before reading each question and by saving the more difficult questions for last. It’s important to answer every question, even if you aren’t sure. Your best guess is better than no answer at all. 

The questions assess several areas of knowledge, most of which are presented as coding scenarios to test application of ICD-10-CM diagnosis codes used for risk adjustment coding. The end of the exam has 10 cases that test the ability to read and accurately code diagnoses on a medical record. 

You will be able to reference an approved medical code book during the exam — your choice of ICD-10-CM, published in the current year. To be clear, this is the only code book you are allowed to use. 

Passing grades

An overall score of 70% or higher is required to pass the certification exam. For a passing score of 70%, you must get at least 70 questions correct. If you incorrectly answer more than 30 questions, you will not pass. If you don’t pass, you will be notified of the categories/areas of study with sub-scores of 65% or less to help you prepare for retesting. 

All AAPC certification exams exclusively measure proficiencies relating to the one credential named in the exam. To earn additional medical coding credentials, you will be required to pass additional certification exams. 

Your results will be shared with you online in your My AAPC Account Dashboard under My Exams. You can expect the results within 7-10 business days after taking the exam. Once you have passed, your certificate will be sent to you in the mail. 

Materials allowed on the day of the exam

Breakdown of the 100-question CRC exam

Passing the CRC exam requires you to correctly answer a minimum of 70 questions from the domains below. The exam will rely on a level of understanding that enables you to identify the domain. 

•  Compliance (15 questions) 
  These questions will assess your knowledge of the process for prospective audits, for RADV audits, and for retrospective audits, and your ability to identify common coding errors identified in RADV audits. 

• Diagnosis coding (30 questions) 
  These questions will assess your ability to apply Coding Clinic guidance to coding scenarios, and identify common coding errors in risk adjustment as well as the diagnosis codes that risk adjust. Additionally, you must demonstrate the ability to properly code: 

  • Amputations 

  • Artificial openings 

  • Atherosclerosis 

  • AV fistulas 

  • CHF 

  • CKD 

  • Complications of devices 

  • COPD 

  • CVA/Stroke 

  • Dementia 

  • Depression 

  • DVT 

  • Hypertension 

  • Malnutrition 

  • Manifestations of diseases (e.g., DM, stroke, COPD) 

  • Mental disorders 

  • Neoplasms 

  • Pneumonia 

  • Pressure ulcers 

  • Pulmonary embolism 

  • Pulmonary fibrosis 

  • Seizures 

  • Skin ulcers 
    

• Documentation improvement (12 questions) 
  This section will test your knowledge on communicating documentation discrepancies with providers and your ability to identify documentation discrepancies. 

• Pathophysiology/medical terminology/anatomy (5 questions) 
  This section will assess your ability to identify common acronyms for industry and medical terminology, and identify anatomic structures, locations, and functions. You also will be asked to define common medical terms and explain disease processes and interactions for common chronic conditions. 

• Purpose and use of risk adjustment models (10 questions) 
  This section will ask that you explain the use of data mining and predictive modeling from data captured through risk adjustment coding. You must also demonstrate the ability to apply trumping in the risk adjustment hierarchy. 

• Quality of care (3 questions) 
  This area will test your ability to explain the purpose of HEDIS and STAR ratings, as well as their alignment with risk adjustment. 

• Risk adjustment models (15 questions) 
  This section will assess your ability to apply the ACA, CDPS, HCC, and private payer risk adjustment models. You also will be asked to list the elements needed to determine the risk adjustment score.  

• Cases (10 cases):  

  Each case will test your ability to accurately code diagnoses based on medical record documentation and to report diagnoses that risk adjust.