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Certified Professional Coder-Hospital® (CPC-H®)
A Certified Professional Coder-Hospital® (CPC-H®) is an individual of high professional integrity who has passed a medical coding certification examination sponsored by the American Academy of Professional Coders (AAPC). The examination consists of questions regarding the correct application of CPT®, HCPCS procedure and supply codes and ICD-9-CM diagnosis codes used for coding and billing outpatient facility services to insurance companies.
A CPC-H® is an individual who in addition to on the job experience as a medical coder has achieved a measurable level of knowledge and expertise in coding of services, procedures and diagnoses for outpatient facilities
- 150 multiple choice questions (proctored)
- 5 1/2 hours
- 1 free retake
- $300 ($260 AAPC Students)
- Open book (manuals)
The CPC-H®'s abilities in regard to outpatient facility services may include:
- Demonstration of proficiency in assigning accurate medical codes for diagnoses, procedures and services performed in the outpatient setting.
- Proficiency is required across a wide range of services, which include:
- Evaluation and management
- Anesthesia
- Surgical services
- Radiology
- Pathology
- Medicine
- A sound knowledge of coding rules and regulations go hand in hand with keeping current on issues regarding medical compliance, and reimbursement under outpatient grouping systems. A trained coding professional can best handle issues such as medical necessity, claims denials, bundling issues and charge capture.
- A CPC-H® will be able to integrate coding and reimbursement rule changes in a timely manner to include updating the Charge Description Master (CDM), fee updates and the Field Locators (FL) on the UB92.
- A CPC-H® will have a demonstrated a working knowledge of AHA Coding Clinic guidelines in the assignment of ICD-9-CM codes from Volumes 1 & 2.
- The CPC-H® can correctly complete a UB92, including the appropriate application of modifiers.
- A CPC–H® has demonstrated knowledge of anatomy, physiology and medical terminology commensurate with ability to correctly code provider services and diagnosis.
The CPC-H® examination is designed to evaluate a
hospital outpatient coder’s knowledge of:
Section 1: Medical Concepts
Medical Terminology (10), Anatomy (10), Coding
Guidelines (10), Payment Methodologies (15),
Compliance (5)
Section 2:
Code Assignment ICD-9-CM Vols 1 & 2 (30),
CPT® (20), HCPCS (10)
Section 3: Coding Applications
Surgery and Modifiers (40)
A CPC-H® must have at least two years medical coding experience and maintain yearly renewal as well as submit Continuing Education Units (CEUs) every two years for verification and authentication of expertise.