Healthcare & Clinical

Open-Book Doesn't Mean Easy: How to Study for the CPC® Exam

By Kaplan CertPrep Editorial Team · Jun 05, 2026 · 2 min read

The CPC® exam is open-book, meaning you may bring your CPT®, ICD-10-CM, and HCPCS Level II codebooks into the testing room. What the open-book format does not change: 100 questions, 4 hours, and a 70% passing score. At roughly 2.4 minutes per question, candidates who rely on looking things up rather than navigating quickly and applying guidelines from memory will run out of time before they run out of questions.

Why 'Open-Book' Is the Most Misunderstood Thing About the CPC® Exam

Every year candidates underestimate the CPC® exam because they heard it was open-book. The exam isn't testing whether you can eventually locate a code. It's testing whether you can read a clinical scenario, identify what coding guideline applies, navigate to the right section of the right codebook, and select the correct code — accurately and fast enough to get through 100 questions before the clock stops.

What the Time Limit Actually Means for Your Codebook Strategy

100 questions. Four hours. That works out to 2.4 minutes per question — with no tolerance for inefficiency. If you average three minutes per question instead of two and a half, you exceed the time limit by fifty minutes. You don't get fifty extra minutes.

How to Build a Tabbed Codebook System Before Exam Day

Tab every major CPT® Surgery subsection, the ICD-10-CM Alphabetic Index vs. Tabular List dividing point, the major ICD-10-CM chapters, and the HCPCS Level II category ranges.

  • CPT® Surgery Subsections: Integumentary, Musculoskeletal, Respiratory, Cardiovascular, Digestive, Urinary, Reproductive, Nervous, Eye/Ocular
  • CPT® Non-Surgery: E/M, Anesthesia, Radiology, Pathology/Lab, Medicine
  • ICD-10-CM chapters: Neoplasms, Circulatory, Musculoskeletal, Pregnancy, Injury/Poisoning, Z codes
  • HCPCS Level II: A codes, E codes, J codes, L codes

What to Annotate (and What Not to)

Annotations worth making: E/M Decision Points for the 2021 MDM table, parenthetical notes in Surgery that restrict or expand use, ICD-10-CM sequencing flags, and Neoplasm Table navigation notes.

What not to annotate: information already clearly printed in the codebook. Annotations should supplement the printed content — flags, decision points, reminders of your own mistakes — not duplicate it.

How to Practice with Your Books the Way You'll Use Them

Use your actual exam codebooks when you practice. Set a 30-second benchmark for codebook navigation — any code should be locatable within 30 seconds. Practice scenario-based questions with codebooks open. Build section familiarity through targeted drilling.

The Role of Full-Length Timed Practice Tests

They expose your pacing reality. They surface your actual weak sections. They train your endurance — four hours of sustained focus is physically tiring.

Take at least two full-length timed practice tests before your exam date. The exam fee is $425 — the time investment in practice tests is the most direct way to protect it.

Frequently Asked Questions

You may bring CPT®, ICD-10-CM, and HCPCS Level II codebooks into the CPC® exam. AAPC specifies that codebooks must be from an approved publisher and must be the current or prior year edition. You may pre-tab and annotate your codebooks. You may not bring study guides, loose notes, or unauthorized materials.
AAPC does not publish a breakdown by lookup requirement, but most questions require at least some codebook reference — particularly in Surgery, ICD-10-CM, and HCPCS Level II. The most efficient candidates use codebooks selectively.
At minimum: each major Surgery subsection, E/M, Anesthesia, Radiology, Pathology/Lab, and Medicine. Also tab Appendix A (Modifiers) and Appendix B (Summary of changes). Your tabs should let you open directly to any section without scanning.
Start at the beginning of your study period, not the week before. You build familiarity with your tab system through repeated use during practice. A tab system set up the night before hasn’t been broken in and won’t save you time under pressure.
At minimum, two full-length timed practice tests before your exam date. Three is better. Each test should be completed under realistic conditions: timed (4 hours), with your actual exam codebooks open, without pausing.
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