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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 2
  • 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 3
  • 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 4
  • 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 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
  • 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 8
  • 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 9
  • 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 10
  • 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 11
  • 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 12
  • 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.

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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q345-Q350):

NEW QUESTION # 345
Mr. Roland has difficulty breathing and congestion with a productive cough. The physician takes frontal and lateral view chest X-rays in the office (the equipment is owned by the physician group). The physician reads the X-rays and determines a diagnosis of walking pneumonia. The physician's interpretation is placed in the patient's chart.
How does the physician bill for the chest X-ray?

Answer: B

Explanation:
For a physician who owns the equipment and interprets the chest X-rays (both frontal and lateral views), code 71046 is used. This code includes both the technical and professional components, as the equipment is owned by the physician group and the physician also provides the interpretation.
Reference:
AMA's CPT Professional Edition (current year)
ICD-10-CM (current year)


NEW QUESTION # 346
A patient has a 5 cm tumor in the left lower quadrant abdominal wall, excised through dermis and subcutaneous tissue. Pathology is pending to rule out cancer.
What CPT and ICD-10-CM codes are reported?

Answer: A

Explanation:
22903 = Excision of soft tissue tumor, abdominal wall, subcutaneous, 3 cm or greater D49.2 = Neoplasm of unspecified behavior of soft tissue R codes are not used when a neoplasm is documented


NEW QUESTION # 347
The mediastinum is:

Answer: A

Explanation:
The mediastinum is an anatomical region located in the thoracic cavity. It is bounded by the sternum in front, the vertebral column at the back, and is situated between the lungs. It contains the heart, trachea, esophagus, thymus, and other structures, but it is not itself an organ. Therefore, the correct answer is that it is a location in the chest.
ICD-10-CM, Medical Anatomy and Physiology textbooks


NEW QUESTION # 348
56-year-old female is postmenopausal with abnormal vaginal bleeding. Ob-gyn provider performs a hysteroscopy to examine the uterine cavity.
What CPTcode is reported?

Answer: B

Explanation:
1. Procedure and CPTCode Selection:
The procedure performed was a hysteroscopy to examine the uterine cavity due to abnormal vaginal bleeding.
This is a diagnostic hysteroscopy.
CPTCode 58555 is specifically for a diagnostic hysteroscopy to examine the uterine cavity, which aligns with the procedure performed in this case.
2. Rationale for Excluding Other Options:
Code 58558 is for a hysteroscopy with a surgical procedure, such as biopsy or removal of a lesion or polyp, which was not performed in this case.
Code 58579 is an unlisted procedure code for the female genital system and is unnecessary here because there is a specific code (58555) for diagnostic hysteroscopy.
Code 58578 is also an unlisted hysteroscopic procedure code and is not appropriate when a specific diagnostic code exists.
3. AAPC and CPTCoding Guidelines:
AAPC guidelines indicate that 58555 should be used for diagnostic hysteroscopy procedures without any surgical intervention.
Therefore, the correct answer, following CPTguidelines, is C. 58555.


NEW QUESTION # 349
A 45-year-old female presents to the ED with chest pain. The provider has an Albumin Cobalt Binding Test to determine if the chest pain is ischemic in nature.
That lab test is reported?

Answer: A

Explanation:
Procedure: Albumin Cobalt Binding (ACB) test to determine ischemic nature of chest pain.
CPT Code:
83857: This code is used for the Albumin Cobalt Binding test.
Code Selection Justification: The ACB test specifically measures ischemia-modified albumin, making 83857 the appropriate code for this laboratory test.
AMA CPT Professional Edition (current year)
ICD-10-CM (current year)
HCPCS Level II (current year)


NEW QUESTION # 350
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