What kind of certification exam is required of a Medical Billing and Coding Specialist?

Certified medical billing and coding specialists prevent invoicing discrepancies and ensures that the medical providers receive their payments in a timely manner. Upon graduation from your medical billing and coding program, your next step is to pass the Certified Professional Coder (CPC) exam from the American Academy of Professional Coders (AAPC). The CPC certification ensures that medical providers are in compliance with regulatory procedures.

The CPC exam consists of 150 questions primarily in the form of multiple choice. The test must be completed within the time frame of five hours and 40 minutes, including two breaks. The entrance exam fee is payable at the time of application submission. You must be a member of the AAPC, which then should be renewed annually. To take the exam, your cost will be approximately $380.

Although a fairly difficult exam, the intent is to thoroughly test the coder’s knowledge of the coding process covering 24 subjects ranging from medical coding and terminology to anatomy and physiology. You must be prepared with knowledge of all code sets including CPT, ICD-10-CM, HCPCS Level II, in addition to, surgical coding. A strong knowledge in medical vocabulary will help you exponentially. Also, a portion of the test will provide you with medical reports and you will be asked to select the proper codes.

The AAPC’s practice exams will be a great way to help you prepare, therefore, you should attempt to pass by 80 percent on your practice test before you attempt to take the real CPC exam. It is also advisable to manage your time spent on each question or section wisely. Don’t spend too much time on one question; if you don’t know an answer just go back to it as time permits.

To pass the CPC exam, you must depend on your prior knowledge of coding sets, in addition to, medical terms and procedures. A score of 70 percent or better is considered a passing grade for the CPC exam, however, you get one free retake if you should fail the exam the first time.

Upon passing your exam with flying colors, you will receive your certification after you have worked in the coding field professionally for two years. Please note that some people choose to work in medical billing and coding for two years before they take their exam. It is your choice.

The AAPC also offers certifications in other areas, too. The Certified Professional Coder-Hospital Outpatient (CPC-H) specializes in the outpatient facility of hospitals. The Certified Inpatient Coder (CIC) pertains to services within an inpatient hospital setting. The Certified Professional Coder-Payes (CPC-P) works within the health plan industry and Specialty Medical Coding Certifications are stand alone certificates primarily designed for the experienced coder.

Although certification is not required in all states, most employers are looking for the distinction on prospective employee applications. It shows that you have put forth the effort and that you are knowledgeable, as well. We have compiled a list of the Top 20 Accredited Online Schools offering Medical Billing and Coding Programs to help you along your education journey.