How to be a Certified Professional Coder
The CPC® credential is the most recognized medical coding certification in the healthcare industry. Achieving CPC® certification establishes you as a healthcare professional and increases your chances of being hired in a growing, competitive job market.
Prepare for certification and a career in CPC Exam
Validate your knowledge, skills, and expertise with CPC Exam certification
To earn the CPC® credential, you must demonstrate:
- Proficiency across a range of services (including evaluation and management, anesthesia, surgery, radiology, pathology, and medicine);
- A sound knowledge of medical coding guidelines and regulations;
- Mastery of anatomy, physiology, and medical terminology necessary to code correctly diagnosis and services; and
- An understanding of how to integrate medical coding and payment policy changes into reimbursement processes.
This is achieved in four steps.
Step 1 Pass the CPC® Exam
The CPC® examination tests your ability to correctly apply CPT®, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis codes used to report professional medical services. You also must demonstrate knowledge on proper modifier use, coding guidelines, and regulatory rules.
Exam Format: Know What to Expect
The proctored exam consists of 150 multiple-choice questions, which you must complete within five hours and 40 minutes. You may use approved coding manuals (American Medical Association (AMA) standard or professional edition CPT® code books and your choice of ICD-10-CM and HCPCS Level II code books) and officially published errata for these manuals during the exam. Electronic devices with an on/off switch (cell phones, smart phones, tablets, etc.) are not allowed into the examination room. You must answer at least 70 percent of the exam questions correctly to pass.
The exam costs $380 ($300 for AAPC student members). You are allowed one free re-take, and you may take the exam as many times as necessary to pass.
Prepare Yourself for the Exam
To prepare for the CPC® exam, select either online or classroom training. Study guide books and online practice exams are available . AAPC’s online practice exams are developed by the same people who create the CPC® exam, and simulate the format, difficulty level, and time constraints of the actual exam.
Beginning coders and billers need to know medical terminology and anatomy before starting any medical coding or billing curriculum. More experienced coders might only need a study guide. AAPC recommends that examinees have an associate’s degree, but there are no educational or training prerequisites to take the CPC® exam.
Step 2 Become and Maintain AAPC Membership
New AAPC members must submit membership payment with examination application. Renewing AAPC members must have a current membership at the time of submission and when exam results are released. Membership must be renewed annually.
Step 3 Verify Your Experience
To receive a CPC® designation, you must have at least two years’ medical coding experience. If you do not submit proof of the required on-the-job experience, you will receive a CPC-A® (apprentice) designation.
To remove your apprentice designation, you must obtain and submit two letters of recommendation verifying at least two years of on-the-job experience using the CPT®, ICD-10-CM, or HCPCS Level II code sets. One letter must be from your employer on letterhead. Experience may include time you have coded for a previous employer, or prior to certification.
Another option is to submit proof showing completion of at least 80 contact hours of a coding preparation course and one letter, signed from your employer on letterhead, verifying one year of on-the-job experience using the CPT®, ICD-10-CM, or HCPCS Level II code sets.
Step 4 Maintain Certification Through Continuing Education Units (CEUs)
Healthcare technology and regulation changes rapidly. To demonstrate continued knowledge and expertise, a CPC® must submit 36 continuing education units (CEUs) every two years for verification. CEUs are available through AAPC, often a low or no cost, and through approved vendors.
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