MEDICAL CODING WITH CONFIDENCE

CPC Exam Information

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The Certified Professional Coder (CPC) exam is an examination that consists of questions regarding the correct application of CPT®, HCPCS Level II procedure and supply codes and ICD-10-CM diagnosis codes used for coding and billing professional medical services to insurance companies. Examinees must also demonstrate knowledge on proper modifier use, coding guidelines and regulatory rules.

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The CPC exam is: 

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• 100 multiple choice & fill-in the blank questions (proctored)

• 4 hours (at a Meazure Testing Center, taken all within same day) / 2 parts: 2 hours each (in virtual environment, taken 2 consecutive days) 

• One free retake (only if taken in a live environment)

• Meazure Testing Center - $499 - two attempts (live proctor) / Virtual - $399 - only 1 attempt (virtual proctor) 

• Open code book (manuals)

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In order to successfully pass the CPC certification exam, 70% or higher is needed in each section of the exam. 

 

 

Approved Manuals for Use During Examination

• CPT® Books AMA professional edition No other publisher is allowed.

• Your choice of ICD-10-CM.

• Your choice of HCPCS Level II.

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Medical Coding Certification Requirements

• We recommend having an associate’s degree (not required).

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• Pay examination fee at the time of application submission.

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• Maintain current membership with the AAPC.

  • New members must submit membership payment with examination application.

  • Renewing members must have a current membership at the time of submission and when exam results are released.

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• A CPC designation must have at least two years medical coding experience. 

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• If you have not submitted proof of 2 years on the job experience, a CPC-A designation will be awarded.

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• Membership is required to be renewed annually and 36 Continuing Education Units (CEU's) must be submitted every two years for verification and authentication of expertise.

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CPC® Apprentice 

Proof of education or experience isn’t necessary to sit for these exams.However, due to the level of expertise required of medical coders, AAPC expects certified coders to be able to perform not only in an exam setting but also in the real world. Those who pass the CPC® exams but have not yet met this requirement will be designated as an Apprentice (CPC-A®) on their certificate.

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Requirements for Removal of Apprentice Designation

To remove your apprentice designation via on-the-job experience, you must obtain and submit two letters of recommendation verifying at least two years of on-the-job experience (externships accepted) using the CPT®, ICD-10-CM, or HCPCS Level II code sets. One letter must be on letterhead from your employer*, the other may be from a co-worker. Experience includes time coding for a previous employer and prior to certification. Both letters are required to be signed and will need to outline your coding experience and amount of time in that capacity. Download AAPC's Apprentice Removal Template for easier submission. Letterhead and signatures are still required when using this template.

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Submit proof showing completion of at least 80 contact hours of a coding preparation course (not CEUs) AND one letter, on letterhead, signed from your employer verifying one year of on-the-job experience (externships accepted) using the CPT®, ICD-10-CM, or HCPCS Level II code sets.

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Send proof of education in the form of a letter from an instructor on school letterhead stating you have completed 80 or more contact hours, a certificate/diploma stating at least 80 contact hours, or an unofficial school transcript.

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Proof of education or experience isn’t necessary to sit for the exam. It should only be submitted (via fax or as a scanned attachment to an email) once ALL apprentice removal requirements have been met.

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Please allow 2-4 weeks for processing.

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* Employers can only verify time spent coding with their organization. Proof of experience letters may be from previous employers, current employers, or a combination of both.

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Email: apprenticeremovals@aapc.com

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Tips for CPC

• It is all about the guidelines: In preparation for the exam, review all coding guidelines and understand how they are applied. This pertains to all codebooks (CPT®, ICD-10-CM, HCPCS Level II). Coding conventions and guidelines for ICD-10-CM are found in the front of the codebook. CPTT® guidelines are found in the introductory sections and throughout the codebook in selected subsections.​

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• Get your materials organized: Well-marked codebooks can be extremely helpful during the exam. Because coding guidelines contain instructions for what can be reported and what cannot be reported, use different colored highlighters to quickly distinguish between the two.

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• Sequencing matters: Follow sequencing rules in coding guidelines and coding conventions. Example: A urine culture confirms the patient’s diagnosis of a UTI caused by E coli. The correct codes and sequence are: 599.0, 041.49. There is a note instructing you to use an additional code to identify the organism, such as Escherichia coli (E.coli). If there are code options with the same codes in a different sequence, pay close attention to the coding conventions and guidelines to guide you in the right selection.

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• Parenthetical notes provide valuable information: Paying close attention to information in the CPT® parenthetical notes prevents you from making coding errors. Example: There is a parenthetical note following code 10030 which states "Do not report 10030 in conjunction with 75989, 76942, 77002, 77003, 77012, 77021. This alerts the coder that imaging guidance cannot be reported with the surgical procedure code.

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• Know your modifiers: Review the proper use for each modifier. Understand when each should be appended.
  Example: Modifier 26 is appended to codes with a professional and technical component to indicate the provider you are coding for only performed the professional component. If the question/scenario indicates the procedure is performed in the hospital setting, the coder will be alerted that modifier 26 should be appended to radiology procedures and medicine procedures that apply. If the code description includes professional component (eg 93010), you would not append modifier 26.

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