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Thread: Elimination of “A” Designation: The Apprentice designation is not needed anymore

  1. #1
    Join Date
    Apr 2007
    Nashville, TN

    Default Elimination of “A” Designation: The Apprentice designation is not needed anymore

    AAPC: Back to School
    The following is a shortened version of an article from the AAPC Coding Edge magazine January 2012 issue written by Reed E. Pew, AAPC Chairman and CEO.

    Effective July 1, 2012, the CPC-A credential will no longer be granted. All current CPC-As would have their “A” removed by doing one of the following:
    1. Getting at least one year of on-the-job experience no later than 12/31/2013, (helpful to those with a job and currently working towards that end)
    2. Successfully passing a clinical exam consisting of coding 20 operative/office notes.
    3. No current CPC-A would be grandfathered into the CPC credential.

    Those taking the CPC exam after July 1, 2012 will have two ways to get their CPC credential:
    1. Have one year of coding experience prior to taking the CPC exam with proof given at the time of the exam, and then pass the CPC exam or
    2. Pass both the CPC exam and a clinical exam by coding 20 operative/office notes.
    On the job experience after taking the CPC exam will not be required. It does not matter in which order the two exams are taken.

    The clinical exam will include a sampling of office visits, surgical notes, E/M coding, ancillary services, modifier usage, and diagnosis coding. A 90% pass rate on the clinical exam will be required and will be determined by correctly coding 18 of the 20 notes. The clinical exam will not be multiple choice, it will be free form and hand graded. The same 5 hours and 40 minutes time restriction and code books will be allowed, and the clinical exam can be taken at any AAPC proctored exam site.

    Both exams will be paid for at the same time and the cost for both exams will increase by $35. Applicants may still take each exam twice to pass it. If the examinee already has one year experience, then he or she would pay only the CPC exam price. If one exam is passed after two attempts, but not the other, then the fee for the exam not passed would be paid to retake it.

    Of course, current CPCs are not affected by this change. We would appreciate comments to this important change to our credentialing program through 1/31/2012. You may go to www.aapc.com/cpc-acomment to submit your comment. From those comments, we will either proceed ahead, make modifications that strengthen the change, or slow down the change due to legitimate concerns that AAPC has not properly considered.

    To me this sounds promising. Though I'm not looking forward to spending a total of over 11 hours of testing time and paying for two exams, but whatever it takes and hopefully it'll better help me reach my goals. I’m not fond of the $35 increase of the CPC exam price, and they don’t mention how much the clinical exam will be, either.

    I’m presuming AAPC has terminated the "Virtual Experience: Apprentice Removal" program. I was seriously thinking of signing up for that, but now am glad I didn’t. I feel badly for those that started that program and were unable to complete it because AAPC brought the program’s website down sometime last year. I would hope AAPC would recognize those that started it and give them some sort of credit towards this new clinical exam, at least financially.

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    I think this is fantastic

    Debra A. Mitchell, MSPH, CPC-H

  3. #3


    I was impressed to read AAPC is encouraging feedback on this decision.

    Now, if the industry would eliminate outsourcing of coding jobs to foreign countries, 2012 would be prosperous for more coders.

  4. #4
    Join Date
    Apr 2007
    Dover Seacoast New Hampshire


    I think that the AAPC is moving in the right direction, by requiring experience in order to be certified. However, the AAPC is in a quandry, in that they really can't leave all of those inexperienced coder apprentices out to dry. They've suffered enough, don't you think? The AAPC has to come up with a reasonable way to move those CPC-As into the CPC designation before it's too late, while maintaining the integrity of the certification (although I am not sure that 20 notes substitutes for a year of sitting in the midst of the revenue cycle). Regardless, I like the format of the exam; it requires some solid coding know-how and independent thinking in order to pass. It's a fair compromise, and will likely provide us with some sharp new CPCs.

    On a go-forward basis, I would prefer that we require at least a year's experience, preferably two...in the medical office setting, medical records, front desk, billing or even coding in order to sit for the CPC exam. I think that the 20-question exam is an appropriate (short term) stop-gap to further certify the current apprentices, but I absoultely disagree that it's sufficient to credential a new CPC. I have long felt that the apprentice designation diluted the certification as a whole....it assumed that as long as you could pass the exam, even if you'd never set foot in a physician's office before, you could code. But I'm only speaking from experience as a hiring manager, who has had to endlessly train new apprentices.

    By the way, who's going to tell all those career schools and community colleges??
    Pam Brooks, MHA, CPC, PCS, COC
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  5. #5


    None of this really makes ANY sense to me. I graduated from an AAPC- approved 1 yr. rigorous coding school 1 yr. ago. At the same time, I was/am pursuing an A.S. degree in Health Information Technology (will graduate in May and then take the RHIT exam). I passed the AAPC certification exam as a CPC-A. I have been very diligent trying to get any experience to get rid of the "A" on the end. I have tried to participate in the Apprentice program that AAPC offers, with the closest office being 45 minutes away from me and they had nothing available for me. My question to ALL seasoned coders, hiring managers, etc.. is how do we gain experience (and therefore get rid of the "A" on our credential) if no one is willing to hire non-experienced coders??? You can't get experience if you don't have any experience!!! It is highly FRUSTRATING!!!!! Passing the CPC exam was grueling in and of its self only to be "awarded" with a credential that means nothing...and even less than nothing if you have the scarlet "A' attached. Woopee, now I get to pay more money, and take yet another test to get rid of the "A".....and guess what, still no experience, so still NO JOB!!!!!

    I am highly-motivated and generally possess a positive attitude, but this whole thing really rubs me the wrong way!!! Any thoughts or suggestions would be greatly appreciated!! Happy New Year!!

  6. #6
    Join Date
    Apr 2007
    Wilmington NC


    I have to agree with you. I have worked in the medical field in various capacities for the last 20+ years. I was offered an opportunity to participate in a class that was given to several employees in a local billing office by a certified instructor. Although not a formal class, I participated for over a half a year, attended all but one of the weekly classes and did all of the required work. I am proud to say that I passed the CPC exam on my first try, and, I was the only one of eight students who passed on the first try. The test was grueling, both mentally and physically.
    I now feel that my efforts may have been wasted since my passing that test will basically mean nothing unless I take and pass the new test. I don't feel it's fair that I will have to sit for another 5 1/2 hour exam, which is what I will be required to do given the nature of job openings for coders in my town. Most practices here don't even hire certified coders. The few that do, require 5 years experience. Extern programs are all but non-existent. The ones I checked on require that an extern work during the day. Unfortunately, I have to work at my full-time job in order to pay my bills so this would be impossible. In addition, even if I pass the add-on exam, it will still not give me the coding 'experience' that is required to get a job. I don't see how this is helping apprentices at all. It appears to me that only the AAPC stands to gain since apprenticies will be required to pay additional money to take another exam.
    While I'm at it, I will also say that I know of serveral 'certified' coders who do not have the required experience, but still their employers were willing to write letters for them so they didn't have to have the "A". If this "A" is so important that maybe ALL coders need to take both exams so that it will be a level playing field.
    I will carefully consider what to do since this will now become an issue for me and I'm sure for so many others. I will also make sure to bring this up at my local chapter meeting, which I attend faithfully.
    Thanks so much for making my day!

  7. #7

    Default Apprentice "A" is ridiculous!!

    This "A" designation is absolutely ridiculous! What other field has such a thing?
    I am an RN and when I took my registered nursing exam and passed, I was awarded the title of Registered Nurse (RN). There was no scarlet letter on my sleeve that said I was new and inexperienced. That's what the resume and hopefully interview is about. What I as a new RN could bring to the job and my skill set/experience came through in my discussion w/ the RN hiring manager. I was as much a RN when I first received my results that I had passed as I am today after 25 years experience. No "newbie" designation required!

    I just took the CPC exam and thought it was one of the most, if not "the" most difficult exams I've ever taken. Particularly in the face of the 5 hr. 40 min. time limit. If you can pass this exam, why in the world would yet another exam be needed?! As with all national exams for certification in a particular field, that IS the proof of proficiency! CEU's are needed to further expand on one's expertise in the coding field each year and that is what elevates the coders knowledge, not this philosophy of yet another test!!

  8. #8
    Join Date
    Apr 2007
    Everett, WA


    Pam, I was hoping that you'd respond to this current thread. And, seeing that this is a spin-off to another active thread with the same subject felt reposting might be appropriate..

    Why not simplify the process instead? Why not revamp the actual CPC exam to include scenarios where codes must be selected rather than subsisting entirely of multiple choice questions. The exam is difficiult enough as it is, but by adding this element would really go the one step necessary to test the capability of those testing. Remove the A, and let the resume speak for itself as the candidate and prospective employer can discuss the experience factor. JUST A THOUGHT to add to the mixture---Suzanne E. Byrum CPC

  9. #9
    Join Date
    Apr 2007
    Ft. Myers, Florida

    Question Apprentice "A" for CPC

    I too am an "Apprentice", for sake of a better term. I graduated from a one year AAPC accredited school with coding occurring throughout the course of the class. I have been with a billing and coding company for 21 months, of which, 14 of them have been in the coding department. My supervisor will not approve a letter from corporate for me, beacuse I do not code 'all' of the types of ASC cases that we code for.
    I was trained on how to properly look for and code for ANY type scenerio. I have a "A" hanging over my head, and with the limited range of coding that I am doing, I am not certain that my employer would give me a good reccomendation should I choose to apply elsewhere as a coder. It is frustrating to have to jump through so many hoops, when dependant upon your state, the carrier, and the contract, coding will NEVER be the same from one local to the next. That is why we must continue with our CEU's and the "A" should not exist.
    I understand if your employer places restraints on your coding until such a time that he/she feels confident with your abilities as a coder, but what employer doesn't do that anyway, no matter what job your have? And I too have 25+ years experience in the healthcare field and found that this test was challening, but rewarding. I had one hour remaining when I completed my exam, and passed with an 83%, so WHY do I have to sit with an "A", when I can obviously code?

  10. #10
    Join Date
    Apr 2007
    Hartford, CT


    Many moons ago when i took my exam you were required to have at least two years of experience (and a letter stating such fromyour employer). Why the AAPC moved away from that I don't know. Pam is right the AAPC can't leave alll those CPC-A's hanging out to dry, but in order for the credentials to be taken seriously (and for years they weren't) there has to be some sort of segue. I like the idea of actually coding from the notes rather than a multiple choice test. As difficult as people feel the test is, it doesn't begin to compare with abstracting information from a patient record where not everything is neatly in place for you.

    As for other fields requiring apprentices, physican are not allowed to hang up a shingle once they complete medical school, they are required to go through both an internship and residency. Plumbers, electricians and carpenters all have apprenticeships. And nurses are required to go through clinical rotations PRIOR to graduation.

    Years ago before managed care, HIPAA, the ACA, CERTS, RACs and ZPICs it was easy to walk into a medical office and do any job. Now all that has changed and from my experience, most of the coding courses do not adequately prepare new coders for the "real world". People who have other experience in the medical field are more prepared, but most new coders have never set foot in a medical office except as a patient. One thing the AAPC has accomplished with the apprentice designation is to over saturate the field with inexperienced coders. What is the answer? I'm not sure, but I agree with Pam, I think the AAPC is heading in the right direction.
    Last edited by dclark7; 01-03-2012 at 01:58 PM. Reason: spelling

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