By Jacqueline Thelian, CPC, CPC-I, CHCA, CPMA
I am sure by now you have been diligently studying your coding manuals. So right now, you are the best you can be.
The examination is an open-book exam; therefore, you have all the answers! If you prepared your three Coding Manuals (CPT, ICD-10-CM, and HCPCS) properly, you will know where to look to find the answers.
Your coding manuals should be prepared in the following ways:
• Have key sections of the coding guidelines highlighted. Remember guidelines include Dos and Don’ts, so use different color highlighters to distinguish the difference.
• There are many blank pages in the books. Use them wisely. You can utilize blank pages by writing terminology, definitions, and acronyms you are not familiar with on these pages.
• Tabs may be inserted, taped, pasted, glued, or stapled into your coding books as long as the intent of the tab is to bookmark a page. Tabs or sticky notes may not contain any supplemental information.
• Notes handwritten directly in the manuals are permissible.
Be sure to use approved versions of coding manuals for the examination. The AAPC allows the American Medical Association CPT professional edition and your choice of ICD-10-CM and HCPCS manuals.
The examination spans five hours and forty minutes. This is a considerable amount of time to spend at one sitting, so come prepared to make yourself comfortable. Dress in layers; some people will tend to become hot or cold at different times during the exam, so dressing in layers helps you control your body temperature for maximum comfort.
You are allowed to eat and drink during the exam. Bring plenty of water and snacks to keep your brain powered and your body hydrated. You are also allowed breaks during the exam; however, the exam clock will not stop during your break. You will be more comfortable if you take a few minutes to use the restroom, clear your mind, and rest your eyes.
The exam consists of 150 multiple choice questions, encompassing all sections of the CPT manual, ICD-10-CM, and HCPCS coding.
Because the test is time based, you do not have to complete it in any particular order. It is strongly recommended you first go through the test and quickly answer the questions to which you know the answer. This will allow you more time for questions requiring more time.
Use the process of elimination when applicable. If your strong point is ICD-10-CM, focus on eliminating the answers with the incorrect ICD-10-CM codes; by the same token, if your strong point is CPT or modifiers, you can use the process of elimination in the same manner. You will usually be able to quickly narrow down the selection to two potential answers that will require further investigation.
Highlight key words and terms to help identify the services provided (CPT), the reason for the service (ICD-10-CM), supplies utilized (HCPCS), and any modifying factors (modifiers). Be mindful of words such as “not” and “except”—they are critical to selecting the correct answer.
Sequencing is also a consideration—some answers may appear to be similar. However, sequencing rules apply.
It is important to remember that the exam is based on the coding guidelines, rules, and regulations within the CPT, ICD-10-CM, and HCPCS books and not on specific insurance requirements.
Remember to read the guidelines above the codes and the parentheticals and guidance below the codes before selecting your answer. Key information can be found in those spots.
Other Things to Consider
When taking the exam at a physical location, make sure you completely fill in the bubbles on the answer grid with a number 2 pencil, not in the question booklet. Never leave any question unanswered. If time is running out and you are still unsure of an answer, guess. This is the time to trust your gut instincts, which will usually guide you to the correct answer.
The best advice is to make sure you get a good night’s sleep before the exam and stay relaxed and confident. Remember, you are allowed to retake the exam, so there is no need to put unnecessary pressure on yourself.
Remember the following:
• You are at the top of your game and in the best possible position to take the exam.
• It’s an open-book exam and you have all the answers!
• Answer all the questions you know first, then go back to answer those you have left blank.
• Use all the time allotted.
• Never leave a question unanswered; guess if you are unsure.
• Be mindful of sequencing and words such as “not” and “except.”
• Coding for the exam is based on CPT, ICD-10-CM, and HCPCS coding rules and regulations and not those of a specific insurance carrier.
• When applicable, use the process of elimination.
• Highlight key words and terms.
• Enter your answers on the answer grid and do not make any stray marks there.
• Come prepared with a few sharpened number 2 pencils.
• Dress comfortably, bring drinks and snacks, and take breaks as needed.
• Get a good night’s rest the night before the exam.
Believe in yourself and in your skills and remember you fail only when your faith in yourself falters.
— Jacqueline Thelian, CPC, CPC-I, CHCA, CPMA, is a nationally recognized consultant, auditor, ICD-10 trainer, subject matter expert, author, and sought-after speaker and educator at Medco Consultants with more than three decades of experience in medical coding and practice management.