What Does It Take To Get A Medical Coding CPC Certification From AAPC

medical-black-female-40According to AAPC, this is the description of the CPC (certified professional coder) certification and what it takes to qualify for it.

AAPC’s Certified Professional Coder (CPC®) credential is the gold standard for medical coding in physician office settings and held by more than 80,000 coding professionals. CPC®’s are critical to compliant and profitable medical practices and typically earn 20% more than non-certified coders.*

The CPC® increases your chances of being hired and retained in a competitive job market.

A Certified Professional Coder has proven by rigorous examination and experience that they know how to read a medical chart and assign the correct diagnosis (ICD-9), procedure (CPT®), and supply (HCPCS Level II) code for a wide variety of clinical cases and services.
The CPC®’s abilities include:

1) Expertise in reviewing and assigning accurate medical codes for diagnoses, procedures, and services performed by physicians and other qualified health care providers
2) Proficiency across a wide range of services, including evaluation and management, anesthesia, surgical services, radiology, pathology and medicine
3) A sound knowledge of medical coding rules and regulations including compliance and reimbursement – allowing a CPC® to better handle issues such as medical necessity, claims denials, bundling issues and charge capture
4) Knowing how to integrate medical coding and reimbursement rule changes into a practice’s reimbursement processes
5) Knowledge of anatomy, physiology and medical terminology necessary to correctly code provider diagnosis and services

The CPC® Exam

  • 150 multiple choice questions (proctored)
  • 5 hours and 40 minutes to finish the exam
  • 1 free retake
  • $300.00 ($260.00 AAPC Students)
  • Open code book (manuals)

The CPC® examination consists of questions regarding the correct application of CPT®, HCPCS Level II procedure and supply codes and ICD-9-CM diagnosis codes used for billing professional medical services to insurance companies. It is designed to evaluate a physician practice coder’s knowledge of the following:

  • Anesthesia
  • Radiology
  • Medicine
  • Nervous
  • Endocrine
  • Digestive
  • Urinary
  • Musculoskeletal
  • Evaluation and Management
  • Anatomy and Physiology
  • Mediastinum & Diaphragm
  • Practice Management
  • Male/Female Genital
  • Hemic & Lymphatic
  • Maternity & Delivery
  • Eye & Ocular Adnexa
  • ICD-9-CM
  • HCPCS Level II
  • Coding Guidelines
  • Medical Terminology
  • Pathology
  • Integumentary
  • Respiratory
  • Laboratory

Medical Coding Certification Requirements

  1. We recommend having an associate’s degree.
  2. Pay examination fee at the time of application submission.
  3. Maintain current membership with the AAPC.
    1. New members must submit membership payment with examination application.
    2. Renewing members must have a current membership at the time of submission and when exam results are released.
  4. All exams will be reported with exact scores and areas of study (65% or less).

A CPC® must have at least two years medical coding experience (member’s with an apprentice designation are not required to have two years medical coding experience.) 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.

Note:
Each examination is separate and distinct from one another. To obtain all certifications, each examination must be taken separately and passed. Continuing Education Unit (CEU) submissions are required for all certifications. For CEU requirements please see our CEU Information page.

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. In addition to passing the certification exam, coders will also be required to demonstrate on-the-job coding experience. Those who pass the CPC®, CPC-H® and/or CPC-P® exams but have not yet met this requirement will be designated as an Apprentice (CPC-A®, CPC-H-A® and/or CPC-P-A®) on their certificate.

CPC-A®, CPC-H-A®, or CPC-P-A® Status: Members with an Apprentice designation are required to submit annual CEUs while completing the coding job requirement.

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-9-CM, or HCPCS Level II code sets. One letter must be on letterhead from your employer*, the other may be from a co-worker. Both letters are required to be signed and will need to outline your coding experience and amount of time in that capacity. Download our Apprentice Removal Template for easier submission. Letterhead and signatures are still required when using this template.

OR

Submit proof showing completion of at least 80 contact hours of coding education AND one letter, on letterhead, signed from your employer verifying one year of on-the-job experience (externships accepted) using the CPT, ICD-9-CM, or HCPCS Level II code sets.

Send proof of education in the form of a letter from an instructor on school letterhead stating the 80 contact hour course has been completed, a certificate/diploma stating at least 80 contact hours, or a school transcript.

Once ALL apprentice removal requirements have been met, you may submit them via fax, mail, or scanned email. Please allow 2-4 weeks for processing.

*Employers can only verify time spent coding with their organization.

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