A Certified Professional Coder (CPC) is an individual of high professional integrity who has passed a coding certification examination sponsored by the American Academy of Professional Coders (the Academy). The examination consists of questions regarding the correct application of CPT®, HCPCS procedure and supply codes and ICD-9-CM diagnosis codes used for billing professional medical services to insurance companies. A CPC must have at least two years coding experience and maintain yearly CEU requirements.  
  A CPC is an individual who has achieved a certain level of knowledge and expertise in coding of services, procedures and diagnoses for physician practices. The Certified Professional Coder's responsibilities may include:  
  Determining accurate codes for diagnoses, procedures and services performed by physicians and recognized, licensed nonphysician providers in physician-based settings (These services may include evaluation and management services as well as reviewing operative notes)  
  Keeping current with medical compliance and reimbursement policies, such as medical necessity issues and correct coding issues.  
  Performing various auditing duties related to physician practice management and coding to maintain compliance with payor reimbursement policies and governmental regulations as well as Medicare/CMS guidelines. Monitoring progress resulting from periodic internal audits.  
  Providing training in coding and compliance issues to physicians, nonphysician providers and staff on an ongoing basis.  
  Providing physicians and staff with up-to-date coding information from reliable, accurate sources, such as specific payors, the AMA, AHA's Coding Clinic, and CMS, to name a few sources.  
  Providing orientation training to include medical practice guidelines for new physicians and non-providers to the practice.  
  Implementing of new coding guidelines in a timely manner within the practice.
Updating encounter forms/superbills on an annual basis with respect to diagnostic, procedural and supply code changes. 		 
  Updating other patient information forms as necessary from time to time.
Updating the clinic's fee schedule based on Relative Value Unit (RVU) updates that come out annually and based on additions and deletions to codes for procedures, services, and supplies. 		 
  Preparing and/or submitting completed HCFA-1500 forms for services and procedures performed by the practice's physicians and nonphysician providers, such as CRNAs, nurse practitioners and physician assistants. Reviewing explanations of benefits from payors, evaluating denied claims and filing appeals for denied claims.