July 8, 2024

Prep your Medical Coding Manuals for AAPC CPC Exam

By Janine Mothershed

Prep Your Medical Coding Manuals for the AAPC CPC Exam

When preparing your manuals for the CPC exam, it’s crucial to include comprehensive notes that will help you navigate through various coding scenarios effectively.


Book notes

Handwritten notes are acceptable in the code books only if they pertain to daily coding activities. Long passages of information are not permitted on the blank pages. Questions from the study guides, practice exams, or the exam itself are prohibited. Altering, whiting out, painting, or printing over any pages within the code books (e.g., marketing pages, table of contents, reference pages, etc.) to supplement information is prohibited.

Approved code books

Current-year manuals are highly recommended as code sets are updated annually. You may choose to utilize books from the preceding year, the current year, or a combination of both; however, only one copy of each book is allowed.


AAPC has a social hour where Coding Clarified’s Lori Jaramillo asks what is allowed in manuals for an AAPC exam here:

Coding Clarified students get access to the instructor’s audio files for each chapter to implement notes into their manuals.



  • Circle category codes in the same group heading (a parent code with a child and add-on codes as appropriate).
  • Highlight the differences between codes in the same category groupings.
  • Make a note of a page or a guideline where a resource can be located in the manual pertaining to those codes in the manual
  • Make notes for things you want to remember or struggle with next to the codes they pertain to.
  •  The more you know your manuals, the better you can manage your time on exam day. 
  • Get your manuals organized with tabs.

    Book tabs

    Tabs may be inserted, taped, pasted, glued, or stapled in the code books so long as the obvious intent of the tab is to earmark a page with words or numbers, not supplement the information in the book.

The goal is to quickly locate anything and everything — codes, guidelines, tables, instructions, illustrations, appendices, etc. — so continue familiarizing yourself with all the parts of your manuals.

Section 1: Understanding CPT Coding Basics

  1. CPT Manual Structure
    • Explanation of sections (Evaluation and Management, Anesthesia, Surgery, etc.) and their organization.
    • Importance of knowing where to find specific codes quickly.
  2. Coding Guidelines
    • Overview of general coding guidelines applicable to all sections.
    • Emphasis on adherence to official instructions and conventions.
  3. Modifiers
    • Commonly used modifiers and their significance in altering payment and reimbursement.
    • Examples of when to use modifiers (e.g., -25, -59) and how to correctly apply them.

Please see our blog on CPT modifiers: https://codingclarified.com/cpt-medical-modifiers/

Section 2: Surgical Procedures

  1. Global Surgery Rules
    • Explanation of global periods (pre-operative, intra-operative, post-operative).
    • How to correctly code for services during the global period.
  2. Unlisted Procedures
    • Guidance on using unlisted procedure codes (e.g., 29999) when specific codes are not available.
    • Documentation requirements for using unlisted codes.
  3. Surgical Packages
    • Understanding what is included in surgical packages and when separate billing is appropriate.
    • Examples and scenarios to illustrate correct coding practices.

Section 3: Evaluation and Management (E/M) Services

  1. E/M Documentation Guidelines
    • Key components of E/M services (history, examination, medical decision making).
    • Tips on how to select the appropriate level of service based on documentation.
  2. Time-Based Coding
    • When and how to use time-based coding for E/M services.
    • Documentation requirements for time-based coding scenarios.
  3. Medical Necessity
    • Importance of documenting medical necessity for E/M services.
    • Examples of supporting documentation for different levels of service.

Include notes from AMA E/M: https://www.ama-assn.org/system/files/2023-e-m-descriptors-guidelines.pdf

Section 4: Anesthesia Services

  1. Anesthesia Coding Guidelines
    • Overview of base units, time units, and modifiers specific to anesthesia services.
    • Examples of how to calculate anesthesia services based on time and complexity.
  2. Qualifying Circumstances
    • Explanation of anesthesia services involving unusual or complex circumstances (modifiers -23, -47, etc.).
    • Documentation requirements for qualifying circumstances.

a structured approach to developing a CPT manual tailored for the CPC exam, focusing on key areas that candidates should master to enhance their coding skills and exam performance. Each section should delve into specifics with clear examples and practical tips to aid understanding and application.

Here are some key notes and tips to consider including:

  1. ICD-10-CM (Diagnosis Coding):
    • Documentation Requirements: Emphasize the importance of clear and detailed documentation to support accurate code assignment.
    • Specificity: Note the importance of coding to the highest level of specificity available in the documentation.
    • Seventh Characters: Include notes on how to correctly apply seventh characters for injury, poisoning, and certain other categories.
    • Excludes Notes and Notations: Highlight how to correctly interpret Excludes notes, Includes notes, and other similar annotations.

Please see our blog on ICD-10 sequencing: https://codingclarified.com/sequencing/

  1. CPT (Procedural Coding):
    • Modifiers: Provide a list of common modifiers and their appropriate use cases (e.g., -25 for significant, separately identifiable evaluation and management service).
    • Global Surgery: Explain global surgery rules and how to code for preoperative, intraoperative, and postoperative services.
    • Unlisted Procedures: Include guidance on how to use unlisted procedure codes and when to append modifier -22 (increased procedural services) if applicable.
  2. HCPCS Level II (Supply and DME Coding):
    • Documentation Requirements: Stress the importance of documenting medical necessity for durable medical equipment (DME) and supplies.
    • Billing Requirements: Include notes on when and how to use different HCPCS codes, such as those for injection and infusion drugs, and durable medical equipment.
    • Coverage Issues: Address coverage issues related to Medicare and Medicaid for certain HCPCS codes.
  3. Coding Guidelines and Conventions:
    • General Coding Guidelines: Summarize key coding guidelines such as sequencing procedures and diagnoses, use of parentheses, and conventions for symbols.
    • National Correct Coding Initiative (NCCI): Explain how to use NCCI edits and when modifier indicators apply.
    • Medicare Rules: Include notes on Medicare-specific rules, such as those related to coding for diagnostic tests, E/M services, and preventive services.

By incorporating these notes into your manuals, you’ll be better prepared to handle the breadth of topics covered in the CPC exam. Remember, clarity, completeness, and relevance are key when compiling your study materials.

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