Taking the CPCO^® exam

The CPCO exam is a test of compliance proficiency consisting of 100 multiple-choice questions that assess several areas of knowledge, including the ever-growing compliance requirements of government laws, regulations, rules, and guidelines.

By passing the CPCO exam, you demonstrate an understanding of the key requirements necessary to effectively develop, implement, and monitor a healthcare compliance program for your practice based on governmental regulatory guidelines — including internal compliance reviews, audits, risk assessments, and staff education and training.

Who should take the CPCO exam?

You should register for the CPCO exam if you’ve completed certification training and/or have experience in compliance and are able to demonstrate an understanding of compliance requirements of government laws, regulations, rules, and guidelines.

What to expect on exam day

The exam has a total of 100 questions to be answered in four hours. People often wonder if the CPCO exam is hard. We'll say this: If you have taken the training course, studied, and are familiar with your CPCO resources, the test will be demanding, but not difficult.

Here's a quick overview of what you can expect:

Before you begin the test, take a moment and breathe. You have prepared for this. This is your opportunity to demonstrate your compliance expertise.

You'll have four hours to finish the exam, giving you approximately 2.4 minutes to answer each of the 100 multiple-choice questions. You can save time by reading the answer choices before reading each question and by saving the more difficult questions for last. It’s important to answer every question, even if you aren’t sure. Your best guess is better than no answer at all.

The questions assess several areas of knowledge, many of which are presented as scenarios to test application of knowledge about compliance requirements of government laws, regulations, rules, and guidelines.

Passing grades

An overall score of 70% or higher is required to pass the certification exam. For a passing score of 70%, you must get at least 70 questions correct. If you incorrectly answer more than 30 questions, you will not pass. If you don’t pass, you will be notified of the categories/areas of study with sub-scores of 65% or less to help you prepare for retesting.

All AAPC certification exams exclusively measure proficiencies relating to the one credential named in the exam. To earn additional medical coding credentials, you will be required to pass additional certification exams.

Your results will be shared with you online in your My AAPC Account Dashboard under My Exams. You can expect the results within 7-10 business days after taking the exam. Once you have passed, your certificate will be sent to you in the mail.

Materials allowed on the day of the exam

Breakdown of the 100-question CPCO exam

Passing the CPCO exam requires you to correctly answer a minimum of 70 questions from the domains below. The CPCO test will rely on a level of understanding that enables you to identify the domain.

Healthcare compliance program history (5 questions)
These questions will assess your knowledge of the history of healthcare laws in the United States, past healthcare industry investigations, federal sentencing guidelines, the implementation of compliance program guidance, key agencies involved in healthcare compliance, current statistics related to CERT reports and national healthcare expenditures, and the OIG five-principle strategy.

OIG compliance program guidance for physicians and small group practices (22 questions)
These questions will address general guidance information and the seven “steps” — standards of conduct and operational policies, oversight requirements, compliance training, monitoring and auditing, communications, disciplinary actions, and responding to detected offenses.

Compliance program guidance for third-party billing companies and clinical laboratories (3 questions)
This section will test your knowledge of lab orders and billing, the Balanced Budget Act of 1997 and diagnoses, and the use of outside billing companies.

OIG compliance program guidance for hospitals (3 questions)
This section will address supplemental hospital guidance.

Key and other risk areas (19 questions)
This section will test your knowledge of physician compliance program guidance risks, documentation, conflict of interest, gifts/gratuities, medical necessity, advance beneficiary notices, incident to, overpayments/credit balances, certificates of medical necessity, certifications for home health and therapy services, billing of non-covered services as if covered, teaching physicians, gainsharing arrangements, joint ventures, limiting charges for par and non-par practices, professional courtesy/discounts/adjustments, rental of office space, unlawful advertising, and state escheat laws.

Fraud and abuse laws (12 questions)
In this section of the exam, you will be tested on the difference between fraud and abuse, civil monetary penalties, the False Claim Act, the anti-kickback statute, Stark laws, the Fraud Enforcement and Recovery Act (FERA), and the Patient Protection and Affordable Care Act (PPACA/health reform).

Other laws and regulations (24 questions)
These questions will assess your knowledge of HIPAA, EMTALA, CLIA, OSHA, RICO, and mail/wire fraud.

Investigation process/audits (9 questions)
In this section of the exam, you will be tested on subpoenas and search warrants, use of legal counsel, self-disclosure protocol, qui tam and whistleblowers, corporate integrity agreements (CIAs), certification of compliance agreements (CCAs), excluded parties (OIG and GSA), and RACs, UPICs, MICs, PSCs, and MFCUs.

References/resources (3 questions)
These questions will assess your knowledge of federal regulations/citations/references, the Office of Inspector General, the Centers for Medicare & Medicaid Services, and Medicaid and workers’ compensation.