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AAPC CPC Exam Overview:

Certification Vendor:AAPC (American Academy of Professional Coders)
Exam Name:Certified Professional Coder (CPC) Exam
Exam Number:CPC
Related Certifications:CPMA
CRC
CPC-P
CPCO
Exam Duration:240 minutes
Exam Format:Scenario-based, Open-book, Multiple-choice
Certificate Validity Period:3 years
Available Languages:English
Passing Score:70%
Exam Price:$425 (1 attempt), $499 (2 attempts)
Real Exam Qty:100
Recommended Training:AAPC CPC Training Courses
Exam Registration:AAPC Official Registration
Sample Questions:AAPC CPC Sample Questions
Exam Way:Online proctored or in-person at authorized testing centers
Pre Condition:No mandatory prerequisites; recommended knowledge of medical terminology, anatomy, coding systems; AAPC membership required to register
Official Syllabus URL:https://www.aapc.com/certifications/cpc

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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • Radiology: This section of the exam measures the skills of coding specialists and focuses on diagnostic imaging procedures including X-rays, CT scans, MRIs, ultrasounds, and nuclear medicine. It emphasizes proper selection of codes based on anatomical site and modality used.
Topic 2
  • Overview of ICD-10-CM: This section of the exam measures the skills of medical coders and introduces the structure, format, and usage of the ICD-10-CM coding system. It reviews the purpose of ICD-10-CM in diagnosis reporting and prepares candidates to interpret chapters, code ranges, and conventions embedded in the system.
Topic 3
  • Female Reproductive System and Maternity Care & Delivery: This section of the exam measures the skills of coding specialists and evaluates coding accuracy for gynecological and obstetric procedures. It includes deliveries, antepartum care, cesarean sections, and surgical procedures involving female reproductive anatomy.
Topic 4
  • 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 5
  • 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 6
  • 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.
Topic 7
  • Accurate ICD-10-CM Coding: This section of the exam measures the skills of medical coders and focuses on the precise assignment of diagnosis codes using the ICD-10-CM system. The goal is to ensure accurate representation of patient conditions, proper sequencing, and a clear linkage between diagnoses and services.
Topic 8
  • Introduction to CPT®, HCPCS Level II, and Modifiers: This section of the exam measures the skills of coding specialists and introduces candidates to CPT® coding for procedures, HCPCS Level II for supplies and services, and the correct use of modifiers. It helps learners distinguish between different code sets and understand their place in medical billing.
Topic 9
  • Review of Anatomy: This section of the exam measures the skills of coding specialists and covers a high-level understanding of human anatomy. It includes organs, systems, directional terminology, and anatomical locations, enabling coders to link procedures and diagnoses to the correct bodily structures with accuracy and consistency.
Topic 10
  • Musculoskeletal System: This section of the exam measures the skills of coding specialists and focuses on coding procedures involving bones, joints, muscles, and tendons. It covers surgeries, reductions, arthroscopies, and fracture treatments, emphasizing accurate mapping of procedures to anatomical areas.
Topic 11
  • 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 12
  • 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 13
  • 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 14
  • 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 15
  • 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 16
  • Cardiovascular System: This section of the exam measures the skills of coding specialists and addresses services related to the heart, arteries, and veins. It involves the coding of diagnostic and therapeutic procedures, including catheterizations, bypasses, and repairs.:
Topic 17
  • 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.

AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q430-Q435):

NEW QUESTION # 430
A patient presents to the surgical suite for a planned sterilization procedure via a bilateral excisional vasectomy.
What is the correct CPTcode and diagnosis code for the service?

Answer: D

Explanation:
1. Procedure and CPTCode Selection:
The patient underwent a bilateral excisional vasectomy for sterilization.
CPTCode 55250 represents a bilateral vasectomy with excision, which includes postoperative care. The code already implies a bilateral procedure, so it is not necessary to add the -50 modifier for bilateral designation.
2. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code Z30.2 is used for encounter for sterilization and is the correct code to report for a planned sterilization procedure such as a vasectomy.
Code Z30.012 is specific to encounter for sterilization of a female patient, which does not apply in this male patient scenario.
3. Rationale for Excluding Other Options:
55250-50 (in options C and D) is unnecessary because the CPTcode 55250 inherently covers a bilateral vasectomy, and applying the -50 modifier is redundant.
Z30.012 (options B and D) is incorrect as it pertains to female sterilization procedures, not male.
4. AAPC and CPTCoding Guidelines:
According to AAPC guidelines, 55250 is reported without a bilateral modifier, as the procedure inherently covers both sides. Additionally, Z30.2 is the correct ICD-10-CM code for male sterilization procedures.
Thus, the correct answer based on CPTand ICD-10-CM guidelines is A. 55250, Z30.2.


NEW QUESTION # 431
A 52-year-old male patient with known AIDS saw his orthopedic physician today for severe pain in the right knee. The physician documents that his knee pain is due to a flare up of posttraumatic osteoarthritis and he gives him a cortisone injection in the right knee joint. The osteoarthritis is not related to AIDS.
What ICD-10-CM codes are reported for this encounter?

Answer: A

Explanation:
In this encounter, the correct coding order follows ICD-10-CM guidelines for coding multiple conditions when AIDS (B20) is documented, as it takes precedence. The patient's diagnosis of AIDS, documented with code B20, is reported as the primary diagnosis since it is a chronic condition. The M17.31 code is used to document unilateral primary osteoarthritis of the right knee, unrelated to AIDS but causing the patient's knee pain.
Explanation of each answer choice:
A: B20, M17.31: Correctly lists AIDS (B20) as the primary diagnosis and osteoarthritis of the right knee (M17.31) as the secondary diagnosis.
B: Z21, M08.861: Z21 represents asymptomatic HIV, not AIDS, which is incorrect here, and M08.861 is the code for juvenile idiopathic arthritis, not relevant in this case.
C: M17.11, B20: Incorrect as M17.11 is for unilateral primary osteoarthritis of the right knee, not left, and does not prioritize B20 as required.
D: M17.31, B20: Incorrect because it does not list B20 as the primary diagnosis, which is necessary per coding guidelines when AIDS is documented.
Thus, the correct answer is A. B20, M17.31.


NEW QUESTION # 432
A 44-year-old female patient came in for a planned laparoscopic total abdominal hysterectomy for endometriosis of the uterus. The surgeon attached the trocars, a scope is inserted examining the uterus, abdominal wall, bilateral ovaries, and fallopian tubes. The surgeon decided to convert the laparoscopic procedure to an open total hysterectomy because of the extensive amount of adhesions that need to be removed. A total hysterectomy was performed and due to removal of the extensive adhesions the surgery took longer than normal of 2 hours.
What CPT and diagnosis codes are reported?

Answer: C

Explanation:
1. Procedure and CPT Code Selection:
The patient initially underwent a laparoscopic total abdominal hysterectomy for endometriosis of the uterus. However, due to extensive adhesions, the surgeon converted the procedure to an open total abdominal hysterectomy to complete the surgery.
CPT Code 58150 is appropriate for a total abdominal hysterectomy, including removal of the uterus and cervix, via an open approach. Since the procedure was converted to an open approach, 58150 is the correct code.
The -22 modifier is added to indicate increased procedural services due to the extensive adhesiolysis (removal of adhesions), which extended the surgery duration.
2. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code N80.00 is used for endometriosis of the uterus, which is the primary condition that prompted the hysterectomy.
ICD-10-CM Code N73.6 is appropriate for female pelvic peritoneal adhesions, reflecting the extensive adhesions that necessitated the conversion to open surgery.
3. Rationale for Excluding Other Options:
Code 58571 (in options B and C) is for a laparoscopic approach, which is incorrect because the procedure was converted to an open approach.
The -78 modifier is incorrect in this context because the conversion to open surgery was part of the same operative session and not an unplanned return to the OR.
Diagnosis code N99.4 (in options B and D) pertains to postprocedural pelvic adhesions, which does not apply here as the adhesions were not due to a prior procedure.
4. AAPC and CPT Coding Guidelines:
AAPC guidelines specify using 58150 for an open total abdominal hysterectomy and adding the -22 modifier for increased complexity or time due to factors like extensive adhesiolysis.
Therefore, the correct answer based on CPT and ICD-10-CM guidelines is A. 58150-22, N80.00, N73.6.


NEW QUESTION # 433
A 49-year-old patient arrives with hearing loss in his left ear. Impedance testing via tympanometry is performed.
What CPT code is reported?

Answer: A

Explanation:
* Procedure: Impedance testing via tympanometry is performed to assess hearing loss in the left ear.
* CPT Code:
* 92567: This code is for tympanometry (impedance testing) without reflex threshold measurements.
* Code Selection Justification: The procedure involved tympanometry without reflex threshold, which is specifically coded as 92567.
References:
* AMA CPT Professional Edition (current year)


NEW QUESTION # 434
A patient with a history of chronic venous embolism in the inferior vena cava has a radiographic study to visualize any abnormalities. In outpatient surgery the physician accesses the subclavian vein and the catheter is advanced to the inferior vena cava for injection and imaging. The supervision and interpretation of the images is performed by the physician.
What codes are reported for this procedure?

Answer: C

Explanation:
For the procedure involving access to the subclavian vein and advancing a catheter to the inferior vena cava for injection and imaging, the following codes are used:
* 36010 for the catheter placement.
* 75825-26 for the supervision and interpretation of the imaging.
Modifier -26 indicates the professional component of the radiological supervision and interpretation.
References:
* AMA's CPT Professional Edition (current year)
* ICD-10-CM (current year)


NEW QUESTION # 435
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