AAPC Proctor Confirmation 8y signing my name and checking each box listed below, | arn acknowledging the task indicated was completed and APC Guidelines were folowed during the examination, Index # Exar Date: ¥ Proctor, Date: 2 Proctor: Date: In case of emergency ot questions on Saturday please contact 801-836-4813 Pre Exam: 1 The Proctor-to-Coder instructions were personally read one week before the day of the exam. Exam: 1 The Proctor-to-Coder instructions were read aloud to the examinees after the Photo ID was checked, member ID confirmed, book check was conducted and exarn packets distributed. 1 Each examinee was tole the specific exam start time and notifi d when 30 minutes of test tine remained. CO Each examinee wrote their exam end time and signed their name on the time sheet. D1 Absolutely no talking between proctors or examinees during the examination, 1 Allcell chones must be powered off or put on sient (without vibration mode) including proctors. 1 Except for restroom breaks, both proctors remained nth the examinees during the entre examination Post Exam: 1 Allexam booklets have been collected and counted. 1 Each step of the Exam Return Instructions were read and followed. O the Did you assist with an ADA accommodation for this examn? FFyes, do you have any comments or sugge: process? exam package will be dropped off ata FedEx shiopina center within two business days of the exarn being held jons with AAPC’s ADA Please st any cornments o' gestions regarding the APC exarn pInstructions for AAPC Exam Proctors Thank you for supporting AAPC and your coding profession by serving asa proctor. AS a proctor, you are responsible for providing the best possible exam environment and ensuring the integrity of each exam acirinistered, Strict adherence to the following examination guidelines and attached Proctor-io-Coder Instructions is critical to accomalishing these goals, Please re the following instructions carefully and familarize yourself wh them at least one week prior to the exam date. Failure to folly all instructions could result in the disqualification of an examination and/or decertfication ofthe involved proctors 1. The contact information for each exarninee is includes at the bottom of your shipping confirmation email sent two to three weeks efore the exam date. AAPC requests the fist proctor verify the website has the correct book check time, ‘exam address, (including spectic driving directions) and any additonal helpful information at least one week before the ‘exam date. Itis important for you to keep the member ID#'s confidential, The ID#’s must not be copied or used for purposes other than this examination. Ifthe member needs assistance with their ID# to complete the answer grid itis ‘only located on the white adhesive label that is on each exam booklet showing who the booklet is assigned to. 2. Allexams adrrinistered by the AAPC have an exam length of 5 hours and 40 minutes Fifective January 1, 2010 ail exams willbe reported with the exact test score and areas of study in each area the examinee did not receive a passing score, Beginning June 1, 2010 new exam shipping instructions will be implemented for RETURNING ‘the exam package to APC. Please familiarize yoursel with these instructions to ensure the security ofthe test grids, With each examination the AAPC sends adeitional CPC exams to ONLY be used at the discretion ofthe National A office and should never be opened or used without prior approval. If you have any questions or concerns with the following information, contact the AAPC Exam Depariment weekdays at (800) 626-2633, option 3. you are proctoring con a Friday afternoon, Saturday, or Sunday when office is closed, you ray call Wendy Willes at (801) 836-4813, 3, Itis very important to explain how to accurately mark the exam grid. Included is an example grid on the last page of these instructions which may be used in order to help explain the correct method to filling out ‘the examination grid. Failure to correctly mark the grids may negatively impact the exam score. Also sealed with each exam is the Important Grid Marking Instructions form. Take a few minutes prior to beginning the ‘examination and allow the examinees to complete this form. You may use this time to answer any questions regarding how to fill out the grid correctly. Prior to starting the examination please collect all the forms and prepare them to be returned with the examination booklets. The exams are graded equally and to ensure fairness the AAPC will not be hand grading examinations. you are assisting an examinee with an ADA accornrnodation(), please revi been included in the exam package. the ADA Accorimodiation form that has 5. Providing @ comfortable exam environment is essential. Please follow the examination guidelines listed below: * Ifyou or the second proctor brings @ compute for personal use, make sure the sound is turned off * Use wise judgment ifyou decide to allow a late entrance. You have the right to not allow late entrances, a distracts the other test takers. * AllCell phones must be powered off or put on sient {without vibration mode) inckiding proctor. Advise all exarr- inees to be respectful of each other during the exam (making as litle noise as possible when opening snacks and when exiting/entering the room for a break) * Please explain if a any time during the exam a test take is cistracted they may elect not to take the exarn. tis the examinees responsibilty to contact APC to reschedule. f any portion of the examination has atthe time it was stopped, the examinee rust contact AAPC to request a review. Once AAPC has reviewed the reason the exam was not completed, APC may or may not choose to grace the exarn, * The examination time sheet isto be signed at the end of the exam, when the exam booklet is collected from each examinee. sunfaityThe CFT* (only AMA Standard or Professional editions) and the examinee’s choice ofthe ICD-9-CM and HCPCS Level li manuals Expert editions ate allowed for the ICD-9-CM and HCPCS Level Il manuals) ftom any qualified publisher may be used as reference manuals during the exam. Ary officially published errata sheets with corrections may be used. All manuals sted 0” the back of the AAPC Examination Instructions may be used. A Medical Dictionary may. be used only for Specialty credentials, Tabs can be inserted, ted, pasted, glued, o” stapled in the manual, ifthe ‘obvious intent isto earmark a page with words or numbers and not add supplemental information, No other material ‘of any kind may be taped, stapled, or glued into the manuals to be used during the examination. Handwritten notes in coding books (as nose commonly seen in dally work coding activites) are permitted. Manuals will not be ciscualfied due to writing contained therein, 7. Office super bils, charge tickets, scrap paper, AAPC’s study guides, CPT* Assistant or other CPT* books may not be used as reference material curing the exam, 8, Breaks are allowed as needed during the exam however the exarn clock will not stop when an exarrinee elects to take a break, Only one examinee may take a break and leave the examination ‘oom at atime, Removal of any test material from the exam site i strictly prohibited, Any attempt to rernove exam mateta will disgualy the examinee for certification and result in automatic falute of the examination. 9. The attached Proctor-to-Coder instructions are required to be read aloud on the day of the exam to the examinees (after the book check has been held and prior to the beginning of the examination) If an examinee has a question and you are unsure of the answer, or an unexpected situation occurs during the exam Please call the APC Exam Department Weekdays at (800) 626-2633, option 3. fyou ate proctoring on a Friday afternoon, Saturday or Sunday, olease call Wendy Willes at (801) 836-4813. This sa timed test; remember to notify the examinees when they have 30 minutes of test time remaining. You must read the following Proctor-to-Coder Instructions aloud to the examinees after the book check has been held, exam packets distributed and prior to the beginning of the examination: onWelcome to the AAPC Certification Coding Exam. My name i [state your name] and this is [state second proctor’s name] We are the prociors for your exarnina- tion today 2. Fach of you has been given a copy ofthe ProctorTo- oder Instructions along with an exam packel. Your exam packet contains a test atid, marking instructions for gid, ‘gold seals and exam booklet. Please open only your exam packet saving the white achesive abel on the plastic shrink wrap. Set aside the gold seas and very you have the correct type of examination boost forthe exam you ae taking (CPC®, CPCH®, CPGP®, CIRCC*, CPMA™: or Specialy) and then seit aside with the gold seals (do not break the siver seals on your exarn booklet yet) Locate the Important Grid Marking Instruction form. Please read carefully, and using a #2 pencil ‘complete form. Once the form is completed it will, be collected prior to beginning the exam. If there are any questions regarding how to fill out the grid correctly please inquire now. 3, Using a #2 pencil, please fill out sections A, B and C of ‘the examination answer grid at this time, For Section B, the Index Number is located on the white adhesive abe of your exam packet, Please make sure you are filling in «each bubble on your test grid completely relerence the upper right hand corner ofthe test rid for an example 4, Now complete Section D of the test arid, Please refer to the back of the exam booklet for the exam type, version and exarn number For assistance with your member ID refer to the white adhesive label, which is located ‘on the exam plastic shrink wrap, Please sign your first and last name on the exam booklet undemeath the ‘exam type, version and exarn number. 5, The exam length is 5 hours and 40 minutes. Eating or drinking is permitted during the exam, but make sure ‘examination grids remain dry and clean, Breaks are allowed (es needed) during the exarn; however the ‘exam clock wil nt stop when an examinee elects to take @ break. Only one examinee may take a break and leave the examination room ata time. Removal of any test material from the exam sites stvctly prohibited Aniy attempt fo remove exam materials wil disqualify the examinee or cerification and result in automatic falue ofthe examination, 6. Because thisis a timed test, there is no requirement for the examination to be completed in a particular order. Itis recommended that you complete all questions thet can be done quickly and then go back to those that Proctor-to-Coder Instructions Please Read Aloud To Examinees require more time. AAPC does advise that eaminces shoulé not leave any questions unanswered, You wl be notfied when 30 minutes of test time i remaining 7. Upon completion of your exam, locate your gold seals and put them on the top, right side anc bottom of your ‘exam booklet (but do NOT seal your test ard in the bbookle) Fill ou sections F and G on the answer grid and return your exam booklet test arid (and E/M Aut Sheets, f applicable) to us before exiting the room. Kyou finish your exam before the 5 hours and 40 minutes are up, you may eave, When exiting the exam room, please be quiet and courteous of other test takers 8. Any collaborative or disruptive behavior detected during the examination is cause for immediate action (disqualification, etc) by the proctors. Electronic devices capable of storing and retrieving text, audio books, ete may not be brought into the examination room, Please tum off and put away al cell phones andfor pagers. Examination contents confidential therefore, copying questions and/or discussing the questions with others during or following the examination will disqualify you from certification Removal of any test material from the exam site is strictly prohibited. Any attempt to remove exam materials will disqualify the examinee for certification and result in automatic failure ofthe ‘examination. Proctors may not cari test questions during the examination. 8. Ifatany time you feel the exam environment is distracting, you may elect to not take the exam, It's, your responsibilty to contact APC to reschedule I ary portion ofthe exarination has been completed at the time you stop the test, you must contact AAPC for a review Once AAPC has reviewed the reason you decided not to continue with your exzmination, APC may or may not choose to grade the exam, 10, Exam results are usually released within § to 7 business days after APC receives the exam package back from the proctor, Results willbe accessible in your member area on the AAPC web site (www.aapc.cor) and official result documents will be mailed within 2 weeks of their receipt at the national office Please do not call AAPC. for your test results. Exam results are prohibited from being released over the telephone. \We are now ready to begin the examination, you make break the silver seals and open your test booklet. Use only a #2 pencil to mark your answers and please correctly bubble in each answer on your test grid. You have 5 hours and 40 minutes to complete the examination, the current time is, [state the time} [he exarn wil enc at [state the time]Allowed Reference Material Required References © CPT®(AMA Standard or Professional edition ONLY) eietaghe Brom im Your choice of ICD-9-CM (expert editions are allowed) ™ Your choice of HCPCS Level Il (expert editions are allowe Note: Any offically published corrections or errata belonging to these three references are also permitted. AAPC's study guides, CPT® Assistant or other CPT* books may not be used as reference material during the exarn. The APC uses only the Current calendar year codes on all exams. Second attempt exams occurring in the next calendar year will not be permit take the previous year's exam. AAPC strongly recommends using current year coding manuals. References manuals for Specialty exams must be published (a Medical Dictionary is allowed as a reference book for Specialty Exams Only) ‘igh Recommended In addition to Highly Recommended ‘references, also permitted [optional ore: Profesional oct __None. None Core: Out Patient Fai ‘OCH? None. None Core: Payer ‘COCP* None None Core: Profesional Medical Coding Intucter CPCI" None. None Core: Interventional Radiology ‘CIRC Anatomical charts Tabeled with catheter selecivily None 10-9 not required Core: Cried Professional Medical Auditor CPMAY Both CMS Documentation Guidelines (995 61997) Audit Sheet/Toal alowed Core: Cerified Professional Compliance _CPCO™ Any references allowed, except study guide and None Officer HCCA's Compliance Reference Guide ‘nesineva Pan Nanagemen CNP ASAAVG + One efeence your hake + CPT crosswalk * EMM Aue Worksheets of your chalce + Both CWS Documentation Guidelines (1995 & 1997) Timah Soper Cane TE + Opa teence Tyo ake Cilesy “tere chaser pices a thevasculriee__¥ One eerece afyourenaice| Both C¥S Documentation Guicenes (985 & 1997) F/M uct Worksheet of your choice [yeiovacubNTTRGREC TIC + Anaromicl ents the ascubrinee __» Onereerence o youre Bath CMS Documentation Gigees (985 & E/N Aut Noses) of your chic Creacke TPC» FM Adit Worksheet of your choce 7 One tence your aR Bath CMS Documentation Guicenes (995 & 1997) Desmaalooy FD> G/M Ad Worsheets of your choce Bath CMS Documentation Guicelnes (1985 & 1997) Tergency Depatinent TD = F/M Aud Worsheets of your choce Both CMS Cocumentation Guidelines (1995 & 1997) Traliaion nd Manager TENE + EIN Aut Woresneet] of your choice Both CMS Documentation Gueles (1885 61967 WP GPC + FMA Worksheets of your chow . you ake Both CNS Documentation Guiles (095 & 1997 Gasroeni@obay CER™ = F/M Asdt Worksheet) of your cho . ence your ake Both chs Doeumenaton Guidelines (195 & Geveasugey THE * EM Aut Noreen ye + Ore efeence ofyour ace Both CRS Documentation Guielies 1985 & TematalogyOaclogy CHEN + Ona leaner your ake Treat iedcne He + One teence your cake uit 1985 & 982 © One te TE ut orsheet oF Both chs Documentation Guidelines (195 & 1997 Bath volumes a he coe iM uct orsheet aapneaie Sue + Ona eteence Trou ake 1 oh CW'S Documentation Gunes (995 & 198 ‘Giehngor ay TINT © EMA Worksheet. + Ona eteence youn hake 1 fh cS Socumentaion Guidelines 1985 & Peaatie TRDC™ = EM Ault Woresneet) of your choice © One wteence youn ake sh ews Guidelines 1995 & 987 Phsic and Racarsiuaive GE TA + EN Alt Worksheet) of your choice + Ora efeence your ake Both CRS Documentation Guiles (1095 & 1997 Treat RHC™ = E/M Audit Worsheet of your choce + One teence your hake Both CMS Documentation Guidelines (195 & 1987 Traeay THE + Aut Worseneeis oF your 1 oth cS Documentation Guanes 95 & 1997 7 Ore wleence olyour aeProctor Procedures upon Completion of Exam itis very important all return steps are followed. Please carefully read and follow the Return Instructions listed below to ensure the securicy ofthe tes gids inside the return exarn envelope/box. You may use the prepaid FedEx return address label (hich has been inclided in your exarn package) to send the exam package back to the AAPC. The exam package is required to be retumed to the address listed below within 2 business days of the exam being held. Contact the APC Exarn Departmnent if you have any questions regarding the arocess of returning your exam package weekdays at (800) 626.2633, option 3. Fyou are proctoring on a Friday afternoon, Saturday, or Sunday, call Wendy Wills at (@01) 836-483. ARC 2480 S, 3850 W, Suite 8 Salt Lake Cir, UT 2412 Exam Return Instructions: Step one: Place the answer grids into the FedEx Small Pak envelope which has been provided and securely seal, Step two: Bundle the stall pak envelope which contains the answer grids along with the exam booklets (and any additional ‘exam documents; E/M audit sheets, etc) inside the return Fedex Large Pak erwelope or reuse the box the exams were sent in itis extremely important you put the envelope with the exam arids into the Fee Large Pak envelope or box with the exam booklets when shipping Items back, DO NOT ship the envelope with exarn gris separately. They wil get lost and wil resul in examinees retaking the exam Step three: Apply the FedEx adhesive return label to the return envelope/ocx. (Is important to remove the old shipping label or apply the return label directly over the old label on the ervelope/box) Step four: Secure and seal the envelope/box Stop five: Return package to ary FedEx Shipping Center To find a FedEx drop-off location go to hetpu/wwwfedex.com//Dropoftistart or call 1-800-463-3339 (1-800-GoFedEx)Section A Fit Name it Name Ho Adavese Cay Sate: Zip [ fale) Section B eG l l Fes City Text Date Index Number | 1M OT Section C (to be completed prior to testing) YES 1. Thave completed the following coding education Distance Leatning/AAPC online course o AAPC Profesional Medical Coding Curriculum ° [AAPC Saudy Guide S ‘AAPC online practice exams ° Exam Review Class/ Workshop ° NAMAS/Doctor’s Management auditing workshop So ‘Community College Coding Courses © “Tech Trade School ° Other ° 2. Thave the following yeas coding experience: 0-1 ° 25 years ° 6-9 years ° 10+ years ° 3. Other courses completed ‘Anatomy ° “Terminology ° Section G (to be completed after testing) YES NO 1. [signed in, photo ID and books were checked. ° 2. Twas allowed all required manuials for use during examination as stated on confirmation. ° 3. The Proctor-to-Coder instructions were rea aloud to the examinees ° 4, Tae RE HM Rand to a etisfyng examination experience oS 5. My cst booklet was appropriately sealed with che silver seals before che examination began. 6. Excepe for restroom breaks, both proctors remained with the examinees during the entire examination, ee 7. Twas given a fll five hours and 40 minutes to complete the examination, oO Comments:2480 South 3850 West, SuieeB Examination Answer Grid Salt Lake City, UT 84120 Cncnintgieiatnianarn 1-800-626-2633 Section D (Please Use No.2 Pencill >» Exam Type Ver Exam Number Member ID RIGHT bat forte bata] B seas cose | |@aee 2 eae “Use @ No. 2 pencil only ce ee -Fill in bubble completely -Erase completely to change -Do not fold or staple 8880 68 @@oOoE DO 121 QOH 2 ODOBO oo OD [oy BeeeaE 0 MDOOD gE 41 OOOwE 2 DOOOD 8 ODODE AOHOOG #4 @BOBO 4 OOO@i HOODD, 7 DOOD #8 ODODD 9 DOOBD: OHooe OHooe DODD OOone Ononw i OOOo@ 85 DOHOOD ODOD® 6 DHOO DOOQDw 8 DO 88 OE 149 150 OODOE Section F ‘At the end of the testing period, I certify that I will seal my test booklet with gold seals. Further, I will not remove any parts of this test, nor any materials included within the test packet, from the testing site, (Signature)