A certified professional coder is a medical coding specialist who works in a health care specialist’s office for the purpose of billing the appropriate entities after medical services are rendered. More than 60,000 coding specialists are certified. Those who have passed the CPC (certified professional coder) exam have demonstrated proficiency in the practices and procedures in the field of medical coding.
The CPC exam is prepared by the AAPC, or the American Academy of Professional Coders. Upon passing the exam successfully, candidate is awarded the Certified Professional Coder credential. While formal training is not required to take the CPC exam, it is recommended the exam candidates have an Associate’s Degree. Exam candidates are required to have 2 years of medical coding experience, unless the candidates have served in an apprenticeship program.
In order to sit for the CPC exam, the exam candidate must be a member in good standing with the AAPC. Membership is obtained by filling out the required application and sending in the necessary fee. AAPC members are eligible for coding book discounts and educational seminars and a one year subscription for the medical coding trade magazine, which is worth 1 CEU (continuing education unit) per issue. AAPC members will also receive the bi-weekly email called “Edge Blast” worth ½ a CEU. The CEU’s are important as a requirement to renew certification requires each member to accumulate 18 CEU’s per year.
The CPC examination contains 150 multi choice questions.
- Evaluation & Management (12)
- Anesthesia (6)
- Radiology 70,000 series (9)
- Pathology 80,000 series (10)
- Medicine 90,000 series (10)
- Medical Terminology (13)
- Anatomy (9)
- ICD-9-CM (11)
- HCPCS (5)
- Coding Concepts (5)
- 10,000 series (9)
- 20,000 series (10)
- 30,000 series (10)
- 40,000 series (10)
- 50,000 series (11)
- 60,000 series (10)
The examinee will have 5 hours and 40 minutes for exam completion. This gives the examinee about 2 minutes to answer each question. The examinee is allowed to take breaks, but break time is included in the 5 hours and 40 minutes. The examinee that does not pass the exam will have the opportunity to retake the exam at no additional cost.
The exam is an open manual test and those taking the exam are urged to bring well annotated manuals to the exam. The exam questions are based on applying the correct coding standards for supply and medical diagnosis for billing to insurance companies, Medicare and if necessary, the patient.
The CPC exam is divided into 3 parts, including surgery and modifiers, medical concepts and all other remaining CPT codes. The 3 categories are then divided into classifications more specific to the codes and billing procedures for that category.
On the day of the CPC exam, the examinee must bring a current form of photo identification, the membership card from AAPC, the current CPT book as published by the AMA, the current ICD-9-CM books, volumes one and two, the current HCPCS Level II National Code book for Medicare, several number two pencils and a calculator, but not a calculator connected to any device such as a cell phone.
The books and manuals can be annotated and tabbed for easier reference. Additional references are not allowed to be used during the exam. The examinee must receive a score of 70% or higher to pass the exam.