The Certified Professional Coder (CPC) Exam is a prestigious certification designed to validate the expertise of medical coders.
Purpose: The exam assesses your ability to accurately translate healthcare procedures, services, and diagnoses into universal medical codes, which is vital for efficient healthcare operations and insurance billing.
Skills Measured: The exam evaluates proficiency in CPT, ICD-10-CM, and HCPCS Level II codes, alongside a strong grasp of medical terminology, anatomy, and regulatory compliance. It tests practical application skills through scenario-based questions that mimic real-world coding challenges.
Format: The CPC Exam consists of 100 multiple-choice questions, covering diverse coding-related topics including surgical procedures, E/M services, anesthesia, radiology, pathology, and more. You have 4 hours to complete the exam, emphasizing the importance of time management and accuracy under pressure.
Validity: Recognized as a gold standard in medical coding certification, the CPC credential is highly esteemed by employers, leading to better job prospects, higher salaries, and increased job security. It signifies that a coder is well-versed in the essential aspects of medical coding, ensuring high standards of documentation and billing practices.
The CPC Exam is a crucial step for anyone aiming to excel in medical coding, providing a robust foundation for professional growth and excellence in the healthcare industry.
Did you know?
The CPC Exam, with its 100-question format, covers 17 coding sections, including anesthesia and radiology. Successful test takers often have practical experience and rigorous preparation. Administered online or in-person, the exam uses a strict scoring system where 70% is the passing mark. Employers highly value the results, using them to gauge a candidate’s coding proficiency and reliability. Can you handle the pressure and precision required?
CPC Navigation Pad
Question Types Explained
The CPC Exam uses mostly multiple-choice questions to assess your knowledge across 17 different areas related to medical coding. Here’s a breakdown of the question types:
Coding Knowledge:
- CPT® Codes (Specific Ranges): These questions test your understanding of Current Procedural Terminology codes within specific ranges (e.g., 10000 series for Integumentary system). You’ll need to know the appropriate code based on the procedure description (6 questions per range, spread across the exam).
- Evaluation and Management (E/M): These questions assess your ability to choose the correct E/M code based on the level of service provided during an encounter (e.g., history, examination, medical decision-making). Understanding coding guidelines for E/M services is crucial (6 questions).
- Other Coding Systems: Similar to CPT®, you’ll encounter questions on ICD-10-CM diagnosis codes (5 questions), HCPCS Level II codes for procedures and supplies (3 questions), and Radiology and Pathology/Laboratory codes (6 questions each). Each requires knowledge of the specific coding system’s structure and application.
Foundational Knowledge:
- Medical Terminology (4 questions): These questions test your understanding of medical terms used in diagnoses and procedures. A strong vocabulary base is essential.
- Anatomy (4 questions): Understanding body structures is crucial for accurate coding. You’ll encounter questions that require knowledge of anatomy to choose the correct code.
Coding Practices:
- Coding Guidelines (7 questions): Demonstrate your ability to apply official coding guidelines from different coding systems (e.g., CPT®, ICD-10-CM) to select the most appropriate code.
- Compliance and Regulatory (3 questions): These questions assess your knowledge of regulations and compliance requirements surrounding medical coding.
Scenario-Based Questions:
- Cases (10 questions): These are the most comprehensive questions. They present a patient case with medical records and ask you to choose the correct combination of diagnosis and procedure codes. This format tests your ability to analyze medical documentation and apply your coding knowledge to a real-world scenario.
Overall Skills for Success:
To perform well on all these question types, you’ll need a strong foundation in medical terminology, anatomy, and coding guidelines. Practice applying your knowledge to various coding scenarios using resources like practice exams will also be crucial. Remember, the CPC exam emphasizes understanding and applying coding principles, not just memorizing codes.
Question Type | Skills Assessed | # of Questions |
---|---|---|
CPT® Codes (Specific Ranges) | Knowledge of specific Current Procedural Terminology codes | Varies (spread across exam to cover all ranges) |
Evaluation and Management (E/M) | Ability to assign E/M codes based on service level | 6 |
ICD-10-CM Codes | Understanding of International Classification of Diseases codes | 5 |
HCPCS Level II Codes | Knowledge of Healthcare Common Procedure Coding System codes | 3 |
Radiology & Pathology/Laboratory Codes | Familiarity with coding for radiology and lab tests | 6 each |
Medical Terminology | Comprehension of medical terms | 4 |
Anatomy | Knowledge of body structures | 4 |
Coding Guidelines | Ability to apply official coding guidelines | 7 |
Compliance and Regulatory | Understanding of coding regulations | 3 |
Cases | Skill in analyzing medical records and applying coding knowledge | 10 |
Total | Overall Coding Knowledge & Skills | 100 |
“The CPC Exam was tougher than I expected. The questions were very detailed, and they really tested my ability to apply coding principles in different scenarios. Time management was crucial because I almost ran out of time. I appreciated that it was open book, but you need to know where to find information quickly. Overall, it was a challenging but fair assessment of my coding skills.”
Sandra Liang, Medical Coder. Source: Reddit
Preparation Strategies
- Understand the Exam Format: Familiarize yourself with the exam structure, including the number of questions, the types of questions, and the subjects covered.
- Study the Official Manuals: Focus on the CPT, ICD-10-CM, and HCPCS Level II coding manuals. These are the primary sources for exam questions.
- Take Practice Exams: Use practice tests to identify areas where you need improvement and to get comfortable with the exam’s timing and format.
- Attend a Review Course: Consider enrolling in a CPC review course, which can provide structured guidance and expert insights.
- Join Study Groups: Collaborate with peers who are also preparing for the CPC Exam. Group study can offer support, different perspectives, and shared resources.
- Use Flashcards: Create flashcards for medical terminology, anatomy, and key coding concepts. This can help reinforce your memory through active recall.
- Focus on Weak Areas: Identify and concentrate on the areas where you are weakest. Use targeted study materials to improve these skills.
- Stay Updated: Keep abreast of any updates or changes in coding guidelines and practices. The healthcare field is constantly evolving, and so do the coding standards.
- Utilize Online Resources: Make use of online forums, webinars, and other resources.
- Practice Time Management: Develop a strategy to efficiently manage your time during the exam. Practice answering questions under timed conditions to improve your speed and accuracy.
Test Features
The CPC Exam is designed to assess the proficiency and knowledge of medical coders. Purpose: It ensures that candidates have a thorough understanding of medical coding standards and can accurately translate medical services into standardized codes.
Comprehensive Content: The exam covers a wide range of topics, including CPT, ICD-10-CM, and HCPCS Level II codes, and various medical specialties such as anesthesia, surgery, radiology, and pathology.
Real-World Application: Questions are designed to mimic real-life coding scenarios, requiring candidates to apply their knowledge to practical situations.
Flexible Format: The CPC Exam is available both online and in-person, accommodating different preferences and schedules of test-takers.
Common names for the CPC Exam
- CPC Certification Exam
- Certified Professional Coder Exam
- AAPC CPC Exam
- Medical Coding Certification Exam
“What worked best for me was taking multiple practice exams. They helped me get used to the exam format and identify my weak areas. I also joined a study group, which provided support and different perspectives on difficult topics. These strategies were instrumental in helping me pass the exam.”
David Mendez, Billing Specialist. Source: Reddit
Technical Facts
Test Fast Facts (tl;dr)
- 100 questions
- 4-hour duration
- Multiple-choice format
- Available online and in-person
- Requires 70% to pass
- Covers CPT, ICD-10-CM, HCPCS
- Scenario-based questions
- Medical specialties included
- Proctored environment
- Open book
Purpose: It aims to ensure that candidates have a deep understanding of coding principles and can accurately assign codes for medical diagnoses and procedures.
Comprehensive Coverage: The exam encompasses various coding systems, including CPT, ICD-10-CM, and HCPCS Level II, and spans multiple medical specialties such as surgery, radiology, and pathology.
Scenario-Based Questions: The exam includes questions that mimic real-life coding situations, requiring candidates to apply their knowledge in practical contexts.
Flexible Testing Options: The CPC Exam can be taken either online or in-person, providing flexibility to suit different candidates’ preferences and schedules.
Results Scale and Interpretations
Earning your Certified Physician Coder (CPC) credential demonstrates your expertise in medical coding. But how do you interpret your score report? While details might be limited, let’s explore what we know about CPC exam scoring and how it can inform your path forward.
Decoding the Score Report
Unfortunately, the CPC exam score report is primarily a pass/fail notification. You’ll receive electronic results within 7-10 business days indicating whether you achieved the required passing score (typically 70%).
There is no detailed score report with components like:
- Raw Score: The total number of correct answers out of 100 questions.
- Percentile Ranking: How your score compares to other test-takers (e.g., scoring higher than 80% of examinees).
- Sub-Scores: Performance breakdowns by specific coding sections (e.g., surgery, radiology).
Limited Details, Focused Goal
While the lack of a detailed report might seem like a drawback, remember the primary goal is to achieve a passing score. This signifies you possess the fundamental medical coding knowledge and skills necessary for the profession.
The AAPC does not provide detailed score reports, not even upon request or for a fee.
“Flashcards were incredibly helpful for memorizing key terms and codes. I also made sure to review the coding manuals thoroughly and focused on the sections where I felt least confident. Practice exams were key to improving my time management and familiarizing myself with the question style.”
Lucas Thompson, Certified Professional Coder. Source: Reddit
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FAQs
The CPC Exam is a certification test for medical coders to validate their knowledge and skills in coding using CPT, ICD-10-CM, and HCPCS Level II codes.
The exam measures proficiency in medical terminology, anatomy, coding guidelines, and the practical application of coding principles to real-world scenarios.
The CPC Exam consists of 100 multiple-choice questions, covering various medical coding topics and requiring application of coding guidelines.
A minimum score of 70% is required to pass the CPC Exam.
The exam is 4 hours long, designed to test both knowledge and time management skills.
Yes, the CPC Exam is available both online and in-person, providing flexibility for test-takers.
Yes, the CPC Exam is an open-book test, allowing you to use the CPT, ICD-10-CM, and HCPCS Level II coding manuals during the exam.
Employers use CPC Exam results to assess a candidate’s coding proficiency and readiness for medical coding roles, often influencing hiring decisions and career advancement.
Exam results are typically available within a few days for online exams and a few weeks for in-person exams.
If you don’t pass, you can retake the exam. AAPC offers options for retakes to help you achieve certification.
No, AAPC does not provide detailed score reports, not even upon request or for a fee.
Test Tips
- Arrive Early: Ensure you arrive at the testing center at least 30 minutes early to avoid any last-minute stress or delays.
- Bring Necessary Materials: Don’t forget your coding manuals, photo ID, and any other required items. Being prepared will keep you focused.
- Read Questions Carefully: Take your time to read each question thoroughly before answering to avoid mistakes due to misinterpretation.
- Manage Your Time: Allocate your time wisely, spending no more than 2 minutes per question. If a question is too difficult, move on and return to it later.
- Use Process of Elimination: If you’re unsure of an answer, eliminate the clearly incorrect options first to improve your chances of selecting the right one.
- Stay Calm and Focused: Keep a clear mind, take deep breaths if you feel anxious, and maintain your concentration throughout the exam.
- Double-Check Your Answers: If time permits, review your answers, especially the ones you were uncertain about, to correct any mistakes.
“The CPC Exam’s scenario-based questions really tested my practical knowledge. Some cases were very detailed, requiring careful analysis to determine the correct codes. The open-book format was helpful, but only if you know your manuals well. My advice is to practice navigating the books quickly.”
Rita Johnson, Outpatient Coder. Source: reddit
Administration
- Test Location: The CPC Exam can be taken at various approved locations or online.
- Test Schedule: Exams are scheduled regularly; check AAPC’s website for specific dates and times.
- Test Format: The exam is computerized, with 100 multiple-choice questions.
- Test Materials: Bring your coding manuals. Pens, pencils, and paper are allowed for notes.
- Cost: Online Exam: $399 for one attempt or $499 for two attempts. In-Person Exam: $449 for one attempt or $499 for two attempts (includes the benefit of two attempts).
- Retake Policy: If you fail, you can retake the exam; specific retake policies and fees apply.
Test Provider
The American Academy of Professional Coders (AAPC) is the organization behind the CPC Exam. Established in 1988, AAPC provides training, certification, and resources for medical coders, billers, and other healthcare professionals. Their services aim to enhance the accuracy and efficiency of medical coding and billing, ensuring high standards in the healthcare industry.
AAPC has a global presence, offering certification exams, training programs, and professional development resources worldwide. Their top products include the Certified Professional Coder (CPC) certification, the Certified Outpatient Coder (COC) certification, and comprehensive training courses in medical coding, billing, auditing, and compliance.
Information Sources
- AAPC CPC Certification
- AAPC CPC Exam FAQs
- AAPC Taking the CPC Exam
- AAPC Official Blog
- AAPC Member Forums
Disclaimer –All the information and prep materials on iPREP are genuine and were created for tutoring purposes. iPREP is not affiliated with AAPC, which is the owner of the CPC Exam, or with any of the companies or organizations mentioned above.
Free CPC practice exam: Get to know what the CPC Exam will be like by practicing with these sample questions:
Question 1 of 20 (Surgery)
A patient undergoes a laparoscopic cholecystectomy. Which of the following CPT codes should be used?
- 47562
- 47563
- 47600
- 47610
Correct Answer: 47562
Explanation:
- 47562: Correct code for laparoscopic cholecystectomy.
- 47563: Incorrect; this code is for laparoscopic cholecystectomy with cholangiography.
- 47600: Incorrect; this code is for open cholecystectomy.
- 47610: Incorrect; this code is for cholecystectomy with exploration of the common duct.
Question 2 of 20 (Evaluation and Management)
What is the appropriate code for a new patient office visit with a comprehensive history, comprehensive exam, and medical decision making of moderate complexity?
- 99201
- 99202
- 99203
- 99204
Correct Answer: 99204
Explanation:
- 99201: Incorrect; this code is for a problem-focused visit.
- 99202: Incorrect; this code is for an expanded problem-focused visit.
- 99203: Incorrect; this code is for a detailed history and exam.
- 99204: Correct; this code includes comprehensive history, comprehensive exam, and moderate complexity medical decision making.
Question 3 of 20 (Anesthesia)
Which code represents anesthesia for a total knee arthroplasty?
- 01382
- 01402
- 01404
- 01400
Correct Answer: 01402
Explanation:
- 01382: Incorrect; this code is for anesthesia for knee arthroscopy.
- 01402: Correct; this code is for anesthesia for total knee arthroplasty.
- 01404: Incorrect; this code is for anesthesia for knee revision procedures.
- 01400: Incorrect; this code is for anesthesia for knee joint procedures.
Question 4 of 20 (Radiology)
What is the CPT code for a screening mammogram of both breasts?
- 77055
- 77056
- 77057
- 77067
Correct Answer: 77067
Explanation:
- 77055: Incorrect; this code is for diagnostic mammography of one breast.
- 77056: Incorrect; this code is for diagnostic mammography of both breasts.
- 77057: Incorrect; this code is for a screening mammography (older code replaced by 77067).
- 77067: Correct; this code is for a screening mammography of both breasts.
Question 5 of 20 (Pathology and Laboratory)
Which code represents a complete blood count (CBC) with automated differential WBC count?
- 85025
- 85027
- 85004
- 85007
Correct Answer: 85025
Explanation:
- 85025: Correct; this code is for CBC with automated differential WBC count.
- 85027: Incorrect; this code is for CBC without differential.
- 85004: Incorrect; this code is for manual differential WBC count.
- 85007: Incorrect; this code is for blood smear, microscopic examination with manual differential WBC count.
Question 6 of 20 (Medicine)
What is the CPT code for an adult flu vaccination administration?
- 90471
- 90473
- 90658
- 90662
Correct Answer: 90471
Explanation:
- 90471: Correct; this code is for immunization administration (one vaccine).
- 90473: Incorrect; this code is for immunization administration by intranasal or oral route.
- 90658: Incorrect; this code is for the flu vaccine itself, not the administration.
- 90662: Incorrect; this code is for high-dose flu vaccine for adults 65 years or older.
Question 7 of 20 (Medical Terminology)
Which term describes inflammation of the liver?
- Hepatitis
- Nephritis
- Gastritis
- Dermatitis
Correct Answer: Hepatitis
Explanation:
- Hepatitis: Correct; it means inflammation of the liver.
- Nephritis: Incorrect; it means inflammation of the kidneys.
- Gastritis: Incorrect; it means inflammation of the stomach lining.
- Dermatitis: Incorrect; it means inflammation of the skin.
Question 8 of 20 (Anatomy)
Question: What is the anatomical term for the windpipe?
- Esophagus
- Trachea
- Bronchi
- Larynx
Correct Answer: Trachea
Explanation:
- Esophagus: Incorrect; it is the tube that carries food to the stomach.
- Trachea: Correct; it is the windpipe.
- Bronchi: Incorrect; these are the main passageways into the lungs.
- Larynx: Incorrect; it is the voice box.
Question 9 of 20 (ICD-10-CM)
What is the ICD-10-CM code for type 2 diabetes mellitus without complications?
- E10.9
- E11.9
- E13.9
- E14.9
Correct Answer: E11.9
Explanation:
- E10.9: Incorrect; this code is for type 1 diabetes mellitus without complications.
- E11.9: Correct; this code is for type 2 diabetes mellitus without complications.
- E13.9: Incorrect; this code is for other specified diabetes mellitus without complications.
- E14.9: Incorrect; this code is for unspecified diabetes mellitus without complications.
Question 10 of 20 (HCPCS Level II)
What is the HCPCS code for a standard power wheelchair?
- E1130
- E1135
- E1140
- E1150
Correct Answer: E1130
Explanation:
- E1130: Correct; this code is for a standard power wheelchair.
- E1135: Incorrect; this code is for a custom motorized/power wheelchair.
- E1140: Incorrect; this code is for a high strength, lightweight power wheelchair.
- E1150: Incorrect; this code is for a heavy-duty power wheelchair.
Question 11 of 20 (Coding Guidelines)
Which modifier indicates a bilateral procedure?
- -22
- -50
- -51
- -59
Correct Answer: -50
Explanation:
- -22: Incorrect; this modifier indicates increased procedural services.
- -50: Correct; this modifier indicates a bilateral procedure.
- -51: Incorrect; this modifier indicates multiple procedures.
- -59: Incorrect; this modifier indicates a distinct procedural service.
Question 12 of 20 (Surgery)
What is the CPT code for an appendectomy?
- 44950
- 44955
- 44960
- 44970
Correct Answer: 44950
Explanation:
- 44950: Correct; this code is for an open appendectomy.
- 44955: Incorrect; this code is for an appendectomy when performed for a reason other than appendicitis.
- 44960: Incorrect; this code is for an appendectomy for a ruptured appendix with abscess or generalized peritonitis.
- 44970: Incorrect; this code is for a laparoscopic appendectomy.
Question 13 of 20 (Evaluation and Management)
What is the appropriate code for a follow-up inpatient consultation with a detailed history and exam, and medical decision making of moderate complexity?
- 99231
- 99232
- 99233
- 99234
Correct Answer: 99232
Explanation:
- 99231: Incorrect; this code is for subsequent hospital care with a problem-focused history and exam.
- 99232: Correct; this code is for subsequent hospital care with a detailed history and exam, and moderate complexity medical decision making.
- 99233: Incorrect; this code is for subsequent hospital care with a comprehensive history and exam.
- 99234: Incorrect; this code is for observation or inpatient care services.
Question 14 of 20 (Anesthesia)
Which code represents anesthesia for cesarean delivery only?
- 01961
- 01967
- 01968
- 01969
Correct Answer: 01961
Explanation:
- 01961: Correct; this code is for anesthesia for cesarean delivery only.
- 01967: Incorrect; this code is for neuraxial labor analgesia/anesthesia for planned vaginal delivery.
- 01968: Incorrect; this code is for anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia.
- 01969: Incorrect; this code is for anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia.
Question 15 of 20 (Radiology)
What is the CPT code for a bone density study using dual-energy X-ray absorptiometry (DEXA) for the spine?
- 77080
- 77081
- 77085
- 77086
Correct Answer: 77080
Explanation:
- 77080: Correct; this code is for a DEXA bone density study of the spine.
- 77081: Incorrect; this code is for a DEXA bone density study of the appendicular skeleton.
- 77085: Incorrect; this code is for a DEXA bone density study with vertebral fracture assessment.
- 77086: Incorrect; this code is for vertebral fracture assessment### Mock Question 16: Pathology and Laboratory
Question 16 of 20 (Medicine)
What is the CPT code for a routine electrocardiogram (ECG) with at least 12 leads, with interpretation and report?
- 93000
- 93005
- 93010
- 93015
Correct Answer: 93000
Explanation:
- 93000: Correct; this code is for a routine ECG with interpretation and report.
- 93005: Incorrect; this code is for ECG tracing only, without interpretation and report.
- 93010: Incorrect; this code is for ECG interpretation and report only.
- 93015: Incorrect; this code is for cardiovascular stress test using ECG monitoring.
Question 17 of 20 (Medical Terminology)
Which medical term describes the surgical removal of the gallbladder?
- Cholecystectomy
- Cholecystitis
- Cholelithiasis
- Cholangiography
Correct Answer: Cholecystectomy
Explanation:
- Cholecystectomy: Correct; it means the surgical removal of the gallbladder.
- Cholecystitis: Incorrect; it means inflammation of the gallbladder.
- Cholelithiasis: Incorrect; it means the presence of gallstones.
- Cholangiography: Incorrect; it is an imaging test of the bile ducts.
Question 18 of 20 (Anatomy)
What is the anatomical term for the collarbone?
- Scapula
- Clavicle
- Sternum
- Humerus
Correct Answer: Clavicle
Explanation:
- Scapula: Incorrect; it is the shoulder blade.
- Clavicle: Correct; it is the collarbone.
- Sternum: Incorrect; it is the breastbone.
- Humerus: Incorrect; it is the upper arm bone.
Question 19 of 20 (ICD-10-CM)
What is the ICD-10-CM code for acute bronchitis due to Mycoplasma pneumoniae?
- J20.0
- J20.1
- J20.2
- J20.3
Correct Answer: J20.0
Explanation:
- J20.0: Correct; this code is for acute bronchitis due to Mycoplasma pneumoniae.
- J20.1: Incorrect; this code is for acute bronchitis due to Hemophilus influenzae.
- J20.2: Incorrect; this code is for acute bronchitis due to streptococcus.
- J20.3: Incorrect; this code is for acute bronchitis due to coxsackievirus.
Question 20 of 20 (Scenario-Based)
A 55-year-old male patient presents with chest pain and shortness of breath. The physician performs a detailed history, a detailed examination, and medical decision making of high complexity. The patient is diagnosed with acute myocardial infarction (MI). The physician decides to admit the patient to the hospital. Which CPT code should be used for the initial hospital care?
- 99221
- 99222
- 99223
- 99231
Correct Answer: 99223
Explanation:
- 99221: Incorrect; this code is for initial hospital care with a detailed history, detailed examination, and medical decision making of low complexity.
- 99222: Incorrect; this code is for initial hospital care with a comprehensive history, comprehensive examination, and medical decision making of moderate complexity.
- 99223: Correct; this code is for initial hospital care with a comprehensive history, comprehensive examination, and medical decision making of high complexity.
- 99231: Incorrect; this code is for subsequent hospital care.
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