AAPC CPC Exam Pattern | Simulation CPC Questions

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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • Anesthesia: This section of the exam measures the skills of medical coders and involves coding anesthesia services based on surgical site, complexity, and time. It tests the understanding of anesthesia modifiers and the importance of linking anesthesia codes with the correct primary procedures.
Topic 2
  • Evaluation & Management Services: This section of the exam measures the skills of coding specialists and covers office visits, hospital care, consultations, and other E
  • M services. It tests the understanding of time-based coding, medical decision-making, and history
  • exam components per current CMS guidelines.
Topic 3
  • The Business of Medicine: This section of the exam measures the skills of medical coders and covers foundational knowledge regarding the healthcare system, reimbursement models, insurance payers, HIPAA compliance, and the ethical responsibilities coders hold within clinical and billing environments. It establishes the context in which coding decisions directly affect healthcare operations and financial outcomes.
Topic 4
  • Integumentary System: This section of the exam measures the skills of medical coders and covers procedures related to the skin and related structures. Topics include excisions, biopsies, repairs, and destruction services, focusing on accurate code selection and modifier usage for integumentary interventions.
Topic 5
  • Digestive System: This section of the exam measures the skills of coding specialists and evaluates the coding of surgeries and procedures involving the oral cavity, pharynx, esophagus, stomach, intestines, liver, pancreas, and related organs. Understanding endoscopic procedures is particularly critical here.
Topic 6
  • Urinary System and Male Genital System: This section of the exam measures the skills of medical coders and assesses understanding of procedures on kidneys, bladder, ureters, prostate, and male reproductive organs. Proper use of CPT codes for surgical and diagnostic interventions is tested.
Topic 7
  • Respiratory System: This section of the exam measures the skills of medical coders and evaluates the ability to code procedures involving the nose, sinuses, larynx, trachea, bronchi, and lungs. Attention is given to services like endoscopies, excisions, and resections within the respiratory tract.
Topic 8
  • Applying the ICD-10-CM Guidelines: This section of the exam measures the skills of coding specialists and covers how to apply official ICD-10-CM guidelines to real-world coding scenarios. It emphasizes the hierarchy of instructional notes, general and chapter-specific rules, and how to make judgment calls within compliant coding frameworks.
Topic 9
  • Special Senses (Ocular and Auditory): This section of the exam measures the skills of coding specialists and covers the coding of procedures related to the eyes and ears. Topics include surgeries on the cornea, retina, and middle
  • inner ear, as well as related diagnostic procedures.
Topic 10
  • Hemic & Lymphatic Systems, Mediastinum, Diaphragm: This section of the exam measures the skills of medical coders and includes procedures related to the spleen, lymph nodes, bone marrow, as well as surgical interventions in the mediastinum and diaphragm. Coders must differentiate procedures by region and system accurately.
Topic 11
  • Endocrine System and Nervous System: This section of the exam measures the skills of medical coders and assesses the ability to assign codes for surgeries involving glands, the brain, spinal cord, and peripheral nerves. Procedures like resections and electrical stimulation are part of the evaluated content.
Topic 12
  • Pathology & Laboratory: This section of the exam measures the skills of medical coders and includes lab tests, specimen analysis, and pathological examination procedures. It ensures that coders understand how to apply codes for chemistry panels, cultures, and histopathological diagnostics.

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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q280-Q285):

NEW QUESTION # 280
According to the Repair (Closure) CPT guidelines, what type of repair is reported when a single layer closure includes copious irrigation and extensive cleaning to remove particulate matter?

Answer: C


NEW QUESTION # 281
A patient arrives for a PEG placement. The patient requires tube feeds for nutrition but frequently pulls out the dobhoffs tube. An EGD was performed. Several attempts were made to place the PEG tube without success so the procedure was aborted. During the withdraw of the scope, a small hiatal hernia was noted in the stomach. The scope was removed the the patient transferred to recovery.
What CPT and ICD-10-CM coding is reported?

Answer: B


NEW QUESTION # 282
(A patient presents for surgery due to recurrent lumbar radiculopathy at a previously operated spinal level.
The surgeon performs arepeat exploration laminotomywithbilateral foraminotomyto decompress nerve roots at theL1-L2 interspace. No additional spinal levels are treated. What CPT coding is reported?)

Answer: A

Explanation:
This is arepeatdecompression at apreviously operatedlumbar level, described as "repeat exploration laminotomy," which aligns with there-explorationcode family rather than a primary discectomy code. The procedure includesbilateral foraminotomyat a single lumbar interspace (L1-L2), meaning it is performed onboth sidesat the same level. In the answer choices,63042represents re-exploration/decompression (repeat procedure) and is appropriately markedbilateralwith-50. The foraminotomy component at the lumbar level is represented by63044, also performed bilaterally, so63044-50is appropriate when the code is unilateral by descriptor and the work was done on both sides. Options C and D reference63030/63035, which are associated with lumbar discectomy/decompression primary coding patterns, not the "repeat exploration laminotomy" scenario presented. Option A incorrectly lists 63044 twice rather than using bilateral reporting.
Therefore,63042-50, 63044-50is the best match within the provided options.


NEW QUESTION # 283
A 35-year-old female has cancer in her left breast. The surgeon performs a mastectomy, removing the breast tissue, skin, pectoral muscles, and surrounding tissue, including the axillary and internal mammary lymph nodes.
Which mastectomy code is reported?

Answer: A


NEW QUESTION # 284
A 47-year-old male with a history of peripheral artery disease presents with worsening claudication of the left leg. A diagnostic angiography confirms stenosis in the left iliac artery. To restore blood flow to the left leg, the vascular surgeon plans to perform angioplasty, using a balloon to dilate the vessel lumen followed by placement of an expandable stent in the left iliac artery.
What CPT coding is reported for the procedure?

Answer: D

Explanation:
The clinical scenario involves a diagnostic angiography (not separately reportable in this case as the therapeutic intervention occurs in the same session and the diagnosis is already known) and a percutaneous transluminal angioplasty (PTA) with stent placement in the left iliac artery.
To code this correctly:
CPT Code 37267: Transluminal stent placement(s), includes angioplasty within the same vessel, when performed; iliac artery.
This code includes the angioplasty if it is performed in the same vessel as the stent (which is true here - both procedures are done in the left iliac artery).
Since angioplasty is inherent to the stenting (to open the narrowed vessel before stent placement), only the stent code is reported.
No need to report angioplasty separately (e.g., 37263) when performed in the same vessel as the stent.
Other options explained:
A . 37267, 37263 - Incorrect. 37263 (angioplasty in the iliac artery) would only be reported if angioplasty was done in a separate iliac artery segment without stenting. Reporting both codes for the same vessel would be unbundling and against CPT/NCCI guidelines.
B . 37258, 37254 - Incorrect. These codes relate to renal artery procedures, not iliac artery.
C . 37258 - Also incorrect, as this refers to renal stent placement, not iliac.
Official CPT Guideline Reference:
In the CPT manual (Category I codes, 37220-37235), specific instructions state that angioplasty is included when performed in the same vessel as a stent and should not be reported separately.


NEW QUESTION # 285
......

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