CPC Medical Coding study materials
CPC Medical Coding study resources

CPC Medical Coding study guide

CPC Medical Coding · Work through your exam, one topic at a time.

The Certified Professional Coder (CPC®) is AAPC's credential for outpatient and physician-based medical coding. It validates comprehensive knowledge of ICD-10-CM diagnosis coding, CPT® and HCPCS Level II procedure and supply coding, and the guidelines, conventions, and sequencing rules that connect them. As the entry benchmark for the field, it fits people launching a coding career, experienced but uncertified professionals validating their skills, and healthcare staff moving from administrative or clinical support roles into coding. The exam tests three areas: core coding knowledge; outpatient and physician services, including evaluation and management visits, procedures in physician practices, outpatient clinics, and same-day surgical centers; and compliance and payer requirements covering Medicare, Medicaid, and commercial rules, modifier use, and fraud, abuse, and compliance standards. Topics on this exam: Core Coding Knowledge (ICD-10-CM, CPT, HCPCS Level II, guidelines and sequencing), Outpatient and Physician Services (E/M services, procedures in physician practices, outpatient clinics, and same-day surgical centers), and Compliance and Payer Requirements (Medicare/Medicaid/commercial payer guidelines, modifiers, fraud, abuse, and compliance standards). The CPC Medical Coding study guide has 3 sections and about 1,104 words.

01

Core Coding Knowledge: ICD-10-CM, CPT, and HCPCS Level II

ICD-10-CM answers "what is wrong with the patient"; CPT and HCPCS Level II answer "what did the provider do." Candidates lose points by mixing the missions - assigning a procedure code to describe a symptom, or an ICD-10-CM code to describe a service. Read the tabular notes, not just the alphabetic index.

388 words, about 2 min
02

Outpatient and Physician Services: E/M, Procedures, and Same-Day Surgical Care

Office/outpatient E/M codes 99202–99215 are selected by either medical decision making (MDM) or total time on the date of the encounter - not both, and not a blend. MDM has three elements: number and complexity of problems, amount and complexity of data reviewed, and risk of morbidity/mortality.

358 words, about 2 min
03

Compliance and Payer Requirements: Medical Necessity, Modifiers, and Fraud Risk

Documentation must support the diagnosis, the service, and the level billed. Coverage rules come from NCDs (national) and LCDs (local).

358 words, about 2 min