Resources and Guidelines

AAPC CEU Mission

All members and business associates of AAPC must uphold a higher standard in education. Certified Professional Coders must choose continuing education that stretches their skill levels. Vendors must provide quality in curriculum. AAPC’s national office must develop a comprehensive list of CEU opportunities, and provide vendors with timely and consistent CEU approvals.

Through AAPC, medical coders undergo a rigorous examination to ensure they are qualified to become Certified Professional Coders. AAPC’s 20 specialty credentials enable coders to demonstrate superior levels of expertise in their respective specialty disciplines. All are expected to update their skills throughout their careers. To verify the continuation of their education, AAPC requires all credentialed coders to obtain continuing education units (CEUs) and submit them to AAPC every two years. The CEUs must come from a large pool of CEUs that have received prior approval by AAPC. AAPC grants prior approval for continuing education programs based on the relevance of the program content to the medical coding, reimbursement, compliance, and billing profession. This document outlines the standards and processes for obtaining AAPC CEUs.

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Event / Product Title

Submit the title exactly as it will appear in all marketing materials.

Approvals are title based; titles are from information provided on the application. All approved titles are valid until the PMCC license expiration date. . The CEU Index number provided to you via our PDF certificate or Code Cards are only valid for the exact title printed on the documents. Do not change titles in anyway once the approval is granted. If you decide that you want to take several of your approved titles and offer them as a boot camp, conference, or workshop contact the CEU Vendor Department to create an entry for the title and total CEUs offered for the conference/summit/workshop, this would provide information for our members via the CEU Search Tool.

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Status / Approval Documents

Status of all applications will appear on the overview screen of your CEU Vendor page. The status includes titles and an indicator icon designating the titles as Pending, Approved, Denied, Withdrawn, Incomplete, and Expiring Soon.

Application Determinations: An email will be sent with the final determination of your application regardless if the application was approved, withdrawn, denied, or incomplete. If denied, withdrawn, or incomplete the email will state the reason for the determination or the request for additional information to continue the review process. If approved, you will be notified that your approval documents are available on the CEU Webpage. Approved titles will have the start and finish (expiration) dates along with separate icons to view and print each PDF document of the Approval Documents: Approval Letter, Certificate, and Invoice.

Multi-specialty Breakout Session Event: Multi-specialty conference with breakout sessions, multi-breakout session event, or multiple active approved titles in a conference format. You can request a CEU Code Card in place of individual PDF Certificates. You will receive two PDF files, one specifically for the attendee with session titles, CEU values, and specialty designations; and one for the vendor that includes the information from the attendee card along with the assigned index numbers.

Distribution of CEU Certificates: Give all attendees a copy of the original PDF certificate or CEU Code Card sent to you by AAPC. These are the only documents AAPC will accept from a member for CEUs. The documents are not to be altered in any way; this includes adding your company logo, company/organization’s president’s name and signature. You can add the name of the attendee, the date of the course, and the approved index number if it is not recorded.

Personalized Certificates: It is acceptable for you to make a personalized certificate for your event that includes the above information. However, it is not permissible to include any of the following on your certificate: the approved index number, CEU value, the AAPC CEU Approved Logo, expiration date, or the statement: "This program has the prior approval of AAPC for _________ continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor."

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Expired CEU Index Numbers

All expiration dates appear below the index number on the certificate and are listed on the overview page of your login CEU Vendor webpage. It is the responsibility of each vendor to monitor expiration dates. The CEU Vendor Department does not monitor this for you. The overview screen on the CEU Webpage will indicate by this icon when a title will expire soon:

You will be contacted if our members report an expired CEU index number to us; we will provide you with expired title and what you need to do to correct the problem.

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Presenters / Post Secondary School Instructors

Presenters: Report CEUs using the same certificate and index# as attendees, index can be submitted only once. AAPC does not award CEUs for time spent in preparation. A maximum of 16 CEUs for first presentations per core credential, per two-year renewal period.

Post-Secondary School Instructors: Application is required for prior approval. Instructors may receive up to 16 CEUs per core credential during a two-year renewal period for teaching a face-to-face course specific to the credential.

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Types of CEUs

Two types of CEUs are awarded at AAPC. Core A focuses on the technical side of professional medical coding, while Core B addresses general business skills related to the healthcare field. Coders may claim all of their CEUs earned from core A. Core B can comprise no more than 33% (1/3) of the total CEUs earned per year. Therefore, if one core credential is held, 12 of the 36 CEUs due every two years may be from Core B. Please visit the CEU Information-Members page for further details.

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Calculating CEUs

Curriculum Approvable: Only program content applicable to the coding profession with current year information is eligible for CEUs. CEUs awarded by AAPC, does not guarantee accuracy or quality of curriculum. Quality of curriculum is the responsibility of the vendor. AAPC reserves the right to reject content based on quality issues, and will disclose these issues to the vendor. The principal focus of curriculum considered for CEUs is its educational value and a time element.

CEU Calculations Based on Time: Timed sessions are assigned CEUs based on instruction time. Standard AAPC CEU determination for live education (workshop, audio seminar, conference) is; each 60 minutes of live content is the equivalent of 1.0 CEU. 30 minutes is the equivalent of .5, which is the smallest time increment. The maximum awarded for a single application is 40 CEUs. For written or online CEU calculations, click here.

Ineligible Content/Time: Registrations, welcomes, introductions, and other non-educational activities such as breaks, lunches, and networking lunches are not eligible for CEUs. Time spent taking quizzes or post-tests are not eligible for CEUs.

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Timed Sessions

Live or Recorded events:Include Seminars, Workshops, Audios, Teleconferences, Live Web-Based Trainings, Courses, and Post Secondary School Courses are also considered "Timed Sessions."

Required Content Needed Based on Number of CEUs Requested: A detailed program goal is sufficient for 1.5 CEUs or less; however, you may attach documents you feel may be necessary for the review process. 2.0 or more CEU requests must submit handouts or Power Point presentations and a time-lined detailed agenda with statements for each segment of time, such as an overview of the session with a list of objectives. Session titles are not sufficient.

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Guidelines for all Required Tests and Tests for Supplemental CEUs

Post-test Formatting Guidelines: All required tests and those submitted for supplemental CEUs must follow AAPC guidelines for tests.

• Test content should be sufficiently challenging. Someone should not be able to pass the test without having read the content or listened and learned from a presentation.
• 10 questions are required for each requested CEU; 15 questions are required for 1.5 CEUs, for example.
• Up to 2 of every 10 questions/answers combined may be true/false or yes/no, all of the above, none of the above, mark all that apply, mark none that apply, etc; up to 3 of 15 questions may be true/false or yes/no, all of the above, none of the above, mark all that apply, mark none that apply, etc;
• Multiple choice and fill in the blank questions are preferred.
• Tests must be submitted at the time of application submission.
• All tests must be graded by the sponsoring organization.
• The participant must pass with a score of 70 percent or higher to earn the CEU certificate of completion.

Educational publications: (required) 10 questions without rationales for each requested CEU, with a maximum of 40 questions. The test is required for a participant to access the CEUs catalog number assigned to the publication.

Newsletters and Magazines: (required) 10 questions without rationales for each requested CEU. The test is required for a participant to access the CEUs catalog number assigned to the publication.

Online education: (required) 10 questions without rationales for each requested CEU, with a maximum of 40 questions. Information-rich rationales included with test questions for online education may contribute to the curriculum word count. Word count determinations are based on content and word count of the rationales only.

Live sessions: A post-test is not required. AAPC allows for limited CEUs for testing as a supplement to curriculum if information rich rationales are included.

Recorded products: (required) 10 questions without rationales for each requested CEU. A post-test is required to verify attendance, and to allow a participant access to the CEU catalog number assigned to the recorded event. No additional questions are required beyond 30 to earn CEUs for recordings of duration beyond three hours.

Supplemental Post-test CEU Requirements: AAPC allows for limited CEUs for testing as a supplement to curriculum for live or recorded live products. A vendor can opt to include rationales with each question on its mandatory test for recorded curriculum to earn 1.0 supplemental CEU per hour of approved education. Supplemental post-tests require the following in addition to the formatting guidelines listed above:

• Test questions submitted for supplemental CEUs must be followed with information-rich rationale.
• The maximum of 1.0 CEU for a post-test can be awarded as a supplement to a one-hour live or recorded training, excluding post secondary school courses.
• The tests must be submitted at the time the curriculum is submitted and must follow AAPC test guidelines

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Rationale as Curriculum

Requirements: Questions must be followed by rationales that include a detailed narrative telling the story of how to come to the correct answer.. Students do not learn effectively with rationales that simply state that the wrong answer was chosen; it’s important to understand how to find the right answer. Rationales should enrich the established curriculum not copy it exactly. What follows are examples of acceptable rationales:

• Shortness of breath is documented. However, SOB is a common symptom associated with pneumothorax, and ICD-9-CM Official Coding Guidelines state, "Signs and symptoms that are integral to the disease process should not be assigned as additional codes, unless otherwise instructed by the classification."

• Total knee arthroplasty is reported with anesthesia code 01402 Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty. General anesthesia was provided by a personally performing anesthesiologist, which is identified with an "AA" modifier. The patient was healthy, which is reported with P1. The anesthesia diagnosis code should be the same as the surgeon’s post operative diagnosis. More specific diagnosis information was provided in the operative report (localized, primary). The knee is identified as "lower leg." Therefore, the correct diagnosis is 715.16 Osteoarthrosis, localized primary, lower leg. Anesthesia start time was 8:21 and end time was 11:00, for a total of two hours and 39 minutes. Exact start and stop times are necessary to determine the precise time. Surgery times are not considered when reporting anesthesia time.

Unacceptable Rationales:

• B is the right answer.
• The patient has sarcoidosis, reported with ICD-9-CM code 135.zz

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In-Service Approvals

In-service education is intended to provide CEUs for employers who provide free of charge education to employees only. If the session is open to the general public or if a fee is charged, the application will be denied under the in-service guidelines and a new application will be required under the "regular" designation.

Recurring In-services: Complete application as an in-service; indicate in the application by selecting the frequency of the sessions: weekly, twice monthly, monthly, every other month, or quarterly. AAPC will give a "block" of approved index numbers with a single application.

Required Information: Approximate information is required for processing purposes regarding the topic(s), the presenter(s), or sometimes even the date(s) of the in-service at the time of application submission if exact information is not available. It is understood that these approximations may cause the date, content, and presenter to change. If changes include ICD-10 content that wasn’t previously approved, follow the ICD-10 Content guidelines, if the new presenter is not certified or is a CPC-A follow the Presenter/Post-Secondary Instructor guidelines. If the change is to the date of the session, you do not need to receive a new approval for the change, unless the date is outside the approval timeframe.

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Educational Publications

(Textbooks, Newsletters/Magazines, PDF or Online)
Qualifying curriculum: Educational publications commonly include narrative, illustrations, and graphs or charts are taken into consideration during review. Excluded from word/page count are indexes, reference material and educational exercises (puzzles, quizzes, or other work).

Requirements: A copy of the publication and post-test without rationales are required to ensure the written curriculum has been completed; CEUs are not awarded for these tests. The test must follow AAPC test guidelines.

CEU Calculation for Publications: The following guideline is used to calculate CEUs for Educational Publications and Self Study Guides*:

• 50 pages of quality curriculum plus a post-test of 10 questions equals 1.0 CEU
• 100 pages of quality curriculum plus a post-test of 20 questions equals 2.0 CEUs
• 150 pages of quality curriculum plus a post-test of 30 questions equals 3.0 CEUs
• 200 + pages of quality curriculum plus a post-test of 40 questions equal 4.0 CEUs

The following guideline is used to calculate CEUs for monthly publications (i.e. newsletters, magazines, emailed PDF articles, etc.)*:

• 8–24 pages of education with a 5 question post-test may receive 0.5 CEUs.
• 25 pages or greater of education with a 10 question post-test may receive 1.0 CEU.

Each publication can receive 1 CEU per month; weekly newsletters will be considered at 0.5 CEUs and would be approved only twice monthly. The vendor is required to submit issue numbers or the dates of the issues per CEU request.

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Online Education

To ensure that the appropriate CEU assignment is made for this type of curriculum, the guidelines for both printed publications and lecture-based education are applied. CEUs will be awarded for both aspects of the guidelines above. CEUs are for the vendor’s own curriculum, not for links to source documents coders can access on their own.

• Web-based curriculum requires a post-test to ensure materials were read and absorbed. The test should be based on the curriculum word count: 10 questions for each 7,000 words, with a maximum of 40 questions. Word count consideration may be given for any information-rich rationales that accompany the test questions or any quizzes along the way. These rationales must qualify as curriculum in order to be considered part of the word count. The post-test must follow AAPC guidelines for tests.

*Note: Font size and spacing will be taken into consideration in the page count. Online products may require word count calculation. See below "Word Count Consideration".

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Word Count Consideration

Time considerations are translated into word count when AAPC awards CEUs for online print products. AAPC bases its print - both hardcopy and online - requirements on the number of words spoken in the average coding education session. Our research shows that an average of 7,000 words is spoken in a one-hour session. Therefore, our calculation for written CEUs is 7,000 words for 1 CEU. This information may help vendors in their CEU application calculations. Keep in mind AAPC reserves the right to exclude any material from the word calculation (for example, lengthy operative notes or coding scenarios, while contributing to the curriculum, may not qualify as curriculum).

CEUs are based on education provided. Products containing exercises without curriculum are not eligible for CEUs (for example, a series of worksheets with scenarios or coding questions). Rationales provided with individual questions and answers may qualify as curriculum. See below for more information on rationales as curriculum.

If a Self Study Guide is composed of coding scenarios, as a practice tool, each scenario must have rationale provided. The rationale will be considered the educational component. A word count computation will be performed as a measurement of CEU value on the rationales. The coding scenarios must be checked and corrected if needed by the sponsoring organization, prior to the participant receiving a CEU certificate of completion. AAPC requires that the member pass with a 70 percent score or higher in order to be awarded the CEU.

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Required Materials, if Requested, for Review

Please refer to the chart below for required documents.

Media of Presentation	Required Materials for Review
Live Face to Face Presentation	Agenda or Outline **
Recorded Live-CD/DVD On Demand Product	Agenda or Outline**
Web Based Training – Live or Self Study	Agenda or Outline or Access to web based training via a ID and Password**
Teleconference	Handouts
Publication	Entire Publication

**Full handouts and/or Power Point presenations maybe requested at anytime during the review process to verify level of content to be presented**

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ICD-10 Content

Approvals that address ICD-10 Implementation will be awarded Core B CEUs. ICD-10 Guidelines and Code Set Training will be awarded Core A CEUs. AAPC does not accept CEUs from other entities that offer, "AHIMA approved" CEUs. Organizations must apply separately for AAPC CEUs and receive an AAPC index number and CEU value. Any event, presentation, publication, etc…that pertains to ICD-10 has to be submitted in its entirety for review to the CEU Vendor Department. Any trainings provided by AHIMA certified ICD-10 trainers using materials from AHIMA’s Train the Trainer program will not be accepted or approved.

Please refer to the Requirements tab on this page.

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Promoting Your Approved Program

You may not state that CEU approval has been submitted to, or is pending from AAPC.
AAPC will allow the vendor the ability to use the AAPC CEU Approved Logo for purposes of promoting approved coding products. AAPC credential(s) can be used in the body of marketing materials but are not permitted to use any of the AAPC credential(s) in the title or on the cover of any product, or title or headline of any marketing materials.
The CEU Approved vendor logos are for approved CEU Vendors only, Vendors are not allowed to copy the AAPC logo from our website for use in anyway. Please contact the CEU Vendor department at 1-800-626-2633, ext.115 for the "NEW" prepared logo and text to be displayed when marketing your CEU approved status. Guidelines for promoting your educational programs both online and offline will also be given. These guidelines ensure your customers, and potential customers, are informed of the continuing education units approved by AAPC.
AAPC will not provide a mailing list of our members. Please do not ask.
As part of the approval process, AAPC randomly and routinely audits CEU approvals. Feel free to contact the CEU Vendor Department if you have any questions regarding marketing of your product within AAPC guidelines.

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Local Chapters and Vendors

Presenting at Local Chapter Meetings: Approved vendors are allowed to present at AAPC Local Chapter meetings at the discretion of the current chapter officers. Local Chapter education CEUs are awarded for education-not product or presenter promotion, limit presentation to education topics only. If an AAPC Local Chapter has requested that you present at a meeting, your CEU Index number is not valid for the Local Chapter meetings. The Chapter officers will request approval from AAPC’s Local Chapter Department.

Solicitation and Local Chapter Contact Guidelines: Solicitation of local chapters and local chapter officers is strictly prohibited. AAPC Local Chapters do not become affiliates with any other organizations, they do not resell products for vendors, and they do not need to be contacted about your products. Do not solicit chapter officers to promote your events or products; they are not obligated to talk to you or allow you into their meetings even for ‘a minute of their time’. You can leave your business card and flyers near the entry of the meeting place but not inside the meeting room itself. Members can then pick them up at their discretion. It is not allowed to use your vendor status as a tool to infiltrate AAPC Local Chapters. We approve educational content, not a company or organization.

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Reasons for Application Denial

• AAPC does not approve CEUs for auditors for the audits they perform or for exit education provided to physicians and their faculty.
• AAPC does not approve CEUs for a coder’s day to-day coding/billing responsibilities including providing education when it is a main responsibility of a job position such as "New Physician Training." This includes any education that considered "mandatory" to employment beyond the retention of a member’s credential.
• Applications submitted for approval for curriculum that has an exam to earn a credential after completing the curriculum and the exam is not available for separate registration and payment the application will be denied.

Example of mandatory training: annual compliance training (this includes anything that is employer specific regarding their compliance plan that is broad in its information covered and not specific to coding or documentation guidelines. This also includes New Hire Training, regardless if the education comes from internal or contracted sources.

• AAPC will not award CEUs for publications or software considered a tool that a coder would or could use at their desk to perform daily responsibilities. Examples would be CPT^®, ICD-9-CM, and HCPCS Level II, desk reference books and software containing reference material.
• Training on the benefits of particular software or how to use the software may be eligible for Core B CEUs for first time users only. Applications with the intent of refreshing user’s knowledge will not be approved. Portions of the training may be considered Coding/Billing knowledge, the CEU analyst will reflect back on the "purpose" of the training to make a decision.

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Reasons to Revoke Vendor Status

If an application has received prior approval and any of the following are found to be true, AAPC vendor status will be revoked without refund of any fees for violation of these policies.

• Misrepresentation by the sponsoring organization or presenter of programs, credentials, or intent.
• False or misleading information by the sponsoring organization or presenter.
• False claims of AAPC endorsement or unauthorized logo use by the sponsoring organization or presenter.
• Editing/Modifying certificates and/or code cards from the original PDF documents provided after approval. This includes the addition of a company logo, address, and/or signatures not on the original document.
• Discrimination by the sponsoring organization or presenter against race, creed, religion and/or gender.
• Representation by the sponsoring organization or presenter of AAPC and/or members in a negative manner.
• Negative or adversarial remarks against payers or providers by the sponsoring organization or presenter.
• Foul or vulgar language will not be tolerated and visual aids shall be free of inappropriate content or pictures per subject matter.
• Sharing or transferring an approved CEU for distribution by or through another entity.
• Findings that a credential and or an exam offering the credential are attached to approved curriculum.
• Using the approved time to promote products, services, or software for commercial or financial gain.
• Soliciting Local Chapters for products or services offered by the vendor.
• AAPC reserves the right to revoke CEUs for any vendor for any reason.