5.14: CPC Exam: Practice Management
In this video, we'll discuss practice management as it relates to the CPC exam.
Section 5.01
What is the CPC Exam?
Section 5.02
General Preparation and Test Strategies for the CPC Exam
Section 5.03
CPC Exam: Anesthesia
Section 5.04
CPC Exam: Radiology
Section 5.05
CPC Exam: Medicine
Section 5.06
CPC Exam: The Nervous System
Section 5.07
CPC Exam: The Endocrine System
Section 5.08
CPC Exam: The Digestive System
Section 5.09
CPC Exam: The Urinary System
Section 5.10
CPC Exam: The Musculoskeletal System
Section 5.11
CPC Exam: Evaluation and Management
Section 5.12
CPC Exam: Anatomy and Physiology
Section 5.13
CPC Exam: Mediastinum and Diaphragm
Section 5.14
CPC Exam: Practice Management
Section 5.15
CPC Exam: Male and Female Genital System
Section 5.16
CPC Exam: Hemic and Lymphatic System
Section 5.17
CPC Exam: Maternity and Delivery
Section 5.18
CPC Exam: Eye and Ocular Adnexa
Section 5.20
CPC Exam: HCPCS Level II
Section 5.21
CPC Exam: Coding Guidelines
Section 5.22
CPC Exam: Medical Terminology
Section 5.23
CPC Exam: Pathology and Laboratory
Section 5.24
CPC Exam: Integumentary
Section 5.25
CPC Exam: Respiratory System
Section 5.26
CPC Exam: Cardiovascular System
Section 5.27
CPC Exam: Where to Take an Exam
Section 5.28
The CPC Apprentice Program
Section 5.29
The CPB Exam
The CPC exam does not limit its coverage explicitly to coding. On the exam, you should expect to see at least a few general practice management questions.
You won't find practice management in your ICD-10-CM or CPT manuals, because it's actually more closely related to the billing side of medical coding. Since coding is such an important part of the reimbursement cycle, however, it makes sense for the AAPC to test you on the basics of practice management.
When preparing for the test, you'll need to know about the basic types of payer, including Medicare, Medicaid, and other third party payers. You should be familiar with the different types of managed care and the basic building blocks of the payer-patient relationship, including deductibles, co-pays, and co-insurances. You'll find more detailed information about all of this in Section 3's Courses on medical billing.
As part of the patient management portion of the CPC, you'll also need to know about medical necessity. This is a relatively basic concept for coders, as you should be familiar with using ICD codes to demonstrate medical necessity on the superbill.
Test-takers should also be familiar with Relative Value Units, or RVUs. RVUs help determine the cost of physician services for Medicare. Each CPT (or, in the case of Medicare, HCPCS) code has an RVU attached to it, which helps determine the value or cost of the procedure. Each RVU is composed of three aspects: the physician work, the practice expense, and the malpractice premium. In order to determine the cost of a procedure, each of these values is multiplied by a unique geographic price index and added up. That number is then multiplied by the Medicare conversion factor (CV), which is the dollar amount Medicare will pay for one RVU. This sum is the cost of the procedure.
You should be aware of HIPAA and how it affects privacy, security, and the coding standards in use today. You can find more information about HIPAA and its effects on medical billing and practice management in Course 3-8.
It's a safe bet that you will not see very many questions on practice management, and those that you do will probably be relatively general. Still, it pays off to have a picture of the entire reimbursement process, as opposed to a confined expertise in coding, so be sure you know at least a little bit about practice management.