How to get CPC certified

The Certified Professional Coder (CPC) credential is the most recognized medical coding certification in the healthcare industry. Employers value individuals who demonstrate proficiency and commitment to excellence through professional certification.

To earn the CPC^® credential, you must demonstrate:

• Proficiency across a range of services (including evaluation and management, anesthesia, surgery, radiology, pathology, and medicine)

• A sound knowledge of medical coding guidelines and regulations

• Mastery of anatomy, physiology, and medical terminology necessary to code diagnosis and services correctly

• An understanding of how to integrate medical coding and payment policy changes into reimbursement processes

Your checklist to becoming a Certified Professional Coder

1. Prepare for the exam

2. Become an AAPC member & schedule your CPC exam

3. Pass the CPC exam

4. Upgrade your CPC-A (apprentice) to CPC — Verifying your experience

5. Maintain certification through continuing education units (CEUs)

Step 1: Prepare for the exam

To prepare for the CPC exam, you can choose classroom training or our online CPC training. When choosing the online CPC course, you can further customize your training.

• Select the self-paced option if you prefer working at your convenience with no set schedule.

• If you learn better in a structured and interactive setting, choose our instructor-led online CPC training course. This option is live, meets on specified days, and provides one-on-one time with your instructor.

Prerequisite courses for CPC training

Because medical coders work with clinical documentation, they need to understand anatomy, pathophysiology, and medical terminology. These three courses — or the 3-in-1 course, Foundations in Medicine — are prerequisites for new CPC students.

Exemption for healthcare experience: If your educational or employment background have provided you with working knowledge of medical terminology, anatomy, and pathophysiology, you are exempt from these prerequisites.

Exemptions for experienced medical coders: If you have been working in healthcare, grandfathered into a medical coding role in a physician practice before certifications became an industry standard, you may register directly for the CPC exam.

Step 2: Become an AAPC member & schedule your CPC exam

If you haven’t become an AAPC member, you must do so prior to scheduling your CPC exam. Renewing AAPC members are also required to have a current membership to sit for a certification exam.

To schedule your exam, log into your account.

Step 3: Pass the CPC exam

The CPC examination tests your ability to correctly apply CPT^®, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis codes used to report professional medical services. You also must demonstrate knowledge of proper modifier use, coding guidelines, and regulatory rules.

AAPC has developed study tools to help students prepare for the CPC exam.

• The study guide offers a review of ICD-10-CM, CPT^®, and HCPCS Level II coding, as well as exam tips and practice questions (with answers and rationales).

• The online practice exams are developed by the creators of the CPC exam and simulate the format, difficulty level, and time constraints of the actual exam.

Exam format: Know what to expect

The proctored exam consists of 100 multiple-choice questions, which you must complete within 4 hours. You must correctly answer at least 70% of the exam questions to pass.

The test is open book, and you may use approved CPT^®, ICD-10-CM, and HCPCS Level II code books, Electronic devices with an on/off switch (cell phones, smart phones, tablets, etc.) are not allowed into the examination room.

Step 4: Upgrade your CPC-A (apprentice) to CPC — Verifying your experience

When you pass the CPC exam, you receive your CPC-A credential, which signifies apprenticeship standing. You remain an apprentice until you fulfill the 2-year experience requirement, at which time you will submit proof of meeting the requirement, and your “A” will be removed.

Options for meeting the 2-year experience required for full CPC standing include:

• Two years of on-the-job experience using the CPT^®, ICD-10-CM, or HCPCS Level II code sets.

  • To show proof, you must obtain and submit two letters of recommendation verifying two years of on-the-job experience using the specified code sets.

    • One of the two letters must be from your employer on company letterhead.

    • The second letter may come from a colleague or a previous employer.

    • Your experience, as well, can include time you have coded for a previous employer, or prior to certification.

• Completion of at least 80 contact hours of a coding preparation course equates with one year of coding experience.

  • Submitting proof of your participation in an 80-hour medical coding course deducts one year from the two years of experience required to graduate from CPC-A to CPC.

• Completion of the CPC-A Practicode online program — which consists of three modules, each containing 200 cases — equates with one year of coding experience.

  • Submitting proof of completing the CPC-A Practicode module deducts one year from the two years of experience required to graduate from CPC-A to CPC. This program may be completed while training for your certification exam or after.

  • Proof of 80 contact hours of a medical coding preparation course may be combined with the completion of CPC-A Practicode to fulfill the two years of experience required to graduate to CPC. As well, either of these may be combined with one year of on-the-job experience, verified by one signed letter from your employer on letterhead.

Step 5: Maintain certification through continuing education units (CEUs)

Medical codes and healthcare regulation changes rapidly, and it’s crucial for medical coders to stay on top of these changes. This requires continuing education.

To demonstrate current knowledge and expertise, a CPC must fulfill (and submit) 36 CEUs every two years. CEUs are available through AAPC, often at low or no cost, and through approved vendors.