What is the Difference between the CPC Exam and CPB Exam?

While the names may be similar and the industry the same, the CPC exam and CPB exam have several differences. The main difference between the CPC exam and CPB exam is their function. The CPC exam stands for Certified Professional Coder, while the CPB exam stands for Certified Professional Biller. Both billing and coding serve roles within the world of healthcare administration, but they handle different tasks.

In this article, you'll learn about the differences between the CPC exam and the CPB exam. We'll explain the unique elements and the different topics covered for each as we explore the following sections (jump to):

• Certified Professional Coder (CPC) Exam
• Certified Professional Biller (CPB) Exam
• Are the CPC and CPB Exams Required?
• How Hard are the CPC Exam and CPB Exam?
• How do I prepare for the CPC and CPB Exams?

According to the AAPC, the association that administers the exam, the CPC exam is an essential step toward earning CPC certification, which an important credential in the world of medical coding.

The exam consists of 150 multiple choice questions that touch on 17 separate knowledge areas. A majority of the questions deal with coding scenarios in which you must use coding databases, such as the ICD-10, to properly assign codes to procedures and submit claims.

During the exam, you are allowed to use coding books and manuals to help you answer the questions within the five hour and 40 minute time limit. In order to pass, you must answer at least 70% of the questions correctly.

Topics covered by the CPC exam include:

• Assigning accurate medical codes
• Coding guidelines and regulations
• E/M, anesthesia, surgery, radiology, pathology and medicine
• Anatomy, physiology and medical terminology

Passing the CPB exam is an important step on the way to becoming a Certified Professional Biller. This certification exam consists of 200 questions, and like the CPC exam, has a time limit of five hours and 40 minutes.

Most of the exam focuses on topics such as managed care and insurance, including Medicaid and Medicare. It also deals with how to create and send out claims while adhering to the established HIPAA laws and other regulatory agencies that have oversight on medical billing concerns.

Unlike the CPC exam, which focuses primarily on the coding of medical procedures, the CPB exam mostly covers billing. However, there are some coding questions on the CPB exam.

The AAPC, which administers the CPB exam as well, lists the following areas covered on the CPB exam:

• Types of Insurance
• Billing Regulations
• HIPAA & Compliance
• Reimbursement & Collections
• Billing
• Coding
• Case Analysis

Earning your CPC or CPB certification is not required to pursue a job in the medical billing and coding field, however many employers do require candidates to have passed the CPC certification exam or CPB certification exam.

While you may not need these certifications to pursue a medical billing and coding job, having them may impact which types of jobs that you’re able to consider, depending on individual employer requirements. Even in the case of jobs that don't require you to have a CPB or CPC certification, having may help you stand out to potential employers.

As with any exam, the level difficulty will depend on the individual. This is also true for the CPC and CPB exams and is also partially determined by how well you prepare for them. The more you prepare, the better your experience taking the CPB and CPC exams will likely be.

A productive way to study for the CPC and CPB exams may be to enroll in a preparation course. Another great way to prepare is to earn an Undergraduate Certificate in Medical Billing and Coding, which can help you develop a knowledge base that you can build upon while studying for the exam.

There are dozens of different ways that you can prepare for medical billing and coding exams. You can study by yourself, with a group or you can enroll in an exam prep course. Some people even choose to earn a degree or certificate to help them develop or brush up on foundational skills.