Certified Professional Coder (CPC)^® certification

The Certified Professional Coder (CPC) is the gold standard for medical coding in a physician office setting. The CPC certification exam tests the competencies required to perform the job of a professional coder who specializes in coding for services performed by physicians and non-physician providers (eg, nurse practitioners and physician assistants).

Individuals who earn the CPC credential have proven expertise in physician/non-physician provider documentation review, abstract professional provider encounters, coding proficiency with CPT^®, HCPCS Level II, ICD-10-CM, and compliance and regulatory requirements for physician services.

Competencies proven with CPC credential include

• Expertise in assigning accurate CPT^®, HCPCS Level II, and ICD-10-CM medical codes for diagnoses and procedures.

• Solid understanding of anatomy, physiology, and medical terminology required to correctly code professional provider services and diagnoses.

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

• A sound knowledge of medical coding guidelines and regulations including compliance and reimbursement – allowing a CPC to better handle issues such as medical necessity, claims denials, bundling issues, and charge capture.

• Understanding of how to integrate medical coding and payment policy changes into a practice’s reimbursement processes.

About the CPC exam

The CPC exam is a test of medical coding proficiency consisting of 100 multiple-choice questions that assess 18 areas of knowledge.

Most questions present a coding scenario to test proper application of CPT^® procedure codes, HCPCS Level II supply codes, and ICD-10-CM diagnosis codes — all of which medical providers use to submit claims to payers.

Whether you take the exam online or in-person, you must complete the CPC exam within four hours and answer 70% of the questions correctly to pass.