The CPC exam takes five hours and 40 minutes and it is open book.
The American Academy of Professional Coders (AAPC) awards the Certified Professional Coder (CPC) credential to those who meet the eligibility requirements and pass the CPC exam. The exam includes 150 multiple choice questions that cover medical coding methods, coding systems and associated topics involved in coding procedures. The exam deals with a range of subjects, so it's wise to divide the materials into groups and review it so you can identify the areas to which you need to devote more time. To take the CPC exam, you must meet the eligibility requirements, register and schedule a test date. As of June 2010, the exam costs $300 or $260 if you are an AAPC student). Visit the association's website or call AAPC at 800-626-2633 to set your exam date.
Medical Terminology & Anatomy and Physiology
Both medical terminology as well as anatomy and physiology play a critical role in the coding process; you'll need to be proficient in both to accurately identify and code a provider's diagnosis and services. The exam is intended to assess a physician practice coder's knowledge of the body's structures and the following systems: cardiovascular, digestive, endocrine, hemic and lymphatic, musculoskeletal, nervous, male/female genital/reproductive, respiratory, skeletal and urinary.
Review the key components (root, prefix, suffix and combining vowel) and linguistic structure that medical terminology adheres to and learn how different parts of the body are connected and their relationships with each other. As an exercise, write an assortment of root words, prefixes and suffixes on index cards and separate them by category. Draw a card from each of the piles to practice formulating terms and see how familiar you are with their meanings.
Prepare for the anatomy and physiology questions by trying to identify the part or system of the body to which your medical terms correspond. You can also print (or draw) a diagram of the body (unlabeled) and write the name of the body system's structures on labels. Attach the labels to their correct locations to see how many parts you can identify.
Coding Systems
As noted on the AAPC website, the CPC test contains questions concerning the correct application of medical coding for diagnoses, procedures and services within physician-based settings, and for billing professional medical services to insurance companies. These systems covered are: HCPCS Level II procedure and supply codes (Healthcare Common Procedure Coding System); CPT (Current Procedural Terminology); and ICD-9-CM (International Statistical Classification of Diseases and Related Health Problems).
Study the methods for each system, why the different systems are used, and the broad range of services for which they're used. In addition, review the guidelines and divisions (evaluation and management, anesthesia, surgery, radiology, pathology and laboratory, and medicine) surrounding each of the systems.
Coding, Regulations, Compliance and Reimbursement
All codes must adhere to specific federal and legal guidelines, and they must comply with the regulations set forth by insurance agencies and providers. That being said, review the standards instituted by the American Medical Association (AMA), the Center for Medicare and Medicaid Services (CMS), Institute for Safe Medication Practices and Joint Commission on Accreditation of Healthcare.
The CPC exam also tests a coder's ability to locate and correct any inaccurate claims and deal with other insurance-related matters such as claim denials. Make a list of some of the vocabulary and terms that you may encounter during this process. For example: Eligible Payment Amount, HCFA 1500 Billing Form (CMS), Submitter ID, Medical Necessity, Internal Control Number (ICN), Bundling, Prospective Payment System (PPS), Revenue Code and Charge Capture.
Additionally, review the types of insurance policies and the difference between indemnity and managed care plans. "The Coding Education Program Approval Manual," published by the American Health Information Management Association (AHIMA) provides an inclusive summary of these terms along with others on the CPC exam.
General Resources
The AAPC offers the following resources to help prepare for the exam (they can be accessed via the association's website): Medical Terminology Course/Anatomy Course, CPC Preparation Course, CPC Study Guide, CPC Workbook, CPC Review Class and CPC Practice Exam. Purchase review books or study guides, such as "Coding Review for National Certification: Passing the CPC and CCS-P Exams" by Mary Harmon or "CPC Coding Exam Review 2010: The Certification Step" (CPC Coding Exam Review: Certification Step) by Carol J. Buck.
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