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AAPC CPC 認定試験の出題範囲:
| トピック | 出題範囲 |
|---|
| トピック 1 | - 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.
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| トピック 2 | - 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.
|
| トピック 3 | - 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.
|
| トピック 4 | - 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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| トピック 5 | - 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.
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| トピック 6 | - 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.
|
| トピック 7 | - 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.
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| トピック 8 | - 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.
|
| トピック 9 | - 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.
|
| トピック 10 | - 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.
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| トピック 11 | - 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.:
|
| トピック 12 | - 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.
|
| トピック 13 | - 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.
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| トピック 14 | - 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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| トピック 15 | - 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.
|
| トピック 16 | - 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.
|
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AAPC Certified Professional Coder (CPC) Exam 認定 CPC 試験問題 (Q313-Q318):
質問 # 313
Patient is admitted in observation care on 12/2/20XX in the morning for acute asthma exacerbation. The ED physician requires the patient to stay overnight. Next day, 12/3/20XX the patient is discharged from observation care in the afternoon. Patient's total stay in observation was 16 hours.
What E/M categories and code ranges are appropriate to report?
- A. Initial Hospital Inpatient or Observation Care (99221-99223) and Hospital Inpatient or Observation Discharge services (99238-99239)
- B. Initial Hospital Inpatient or Observation Care (99221-99223) and Subsequent Hospital Inpatient or Observation Care (99231-99233)
- C. Hospital Inpatient or Observation Care Services (Including Admission and Discharge Services) (99234-99236) and Hospital Inpatient or Observation Discharge services (99238-99239)
- D. Hospital Inpatient or Observation Care Services (Including Admission and Discharge Services) (99234-99236) and Subsequent Inpatient or Observation Care (99231-99233)
正解:C
解説:
1. E/M Code Category Selection:
The patient was placed in observation care on 12/2/20XX for an acute asthma exacerbation and stayed in observation for a total of 16 hours, with discharge occurring on 12/3/20XX.
The appropriate E/M category for patients in observation care for a period that includes both admission and discharge on separate calendar dates is "Hospital Inpatient or Observation Care Services", with specific codes for admission and discharge on different dates.
2. Code Range and Specific Codes:
Code Range 99234-99236 applies to cases where observation care includes both admission and discharge, particularly when they occur on different calendar days and the total duration of care is under 24 hours.
For discharge on the subsequent day, 99238-99239 (Hospital Inpatient or Observation Discharge Services) applies, depending on the time spent on discharge.
3. Rationale for Excluding Other Options:
Option B and Option D include Initial Hospital Inpatient or Observation Care codes (99221-99223), which are typically used for admissions to inpatient care rather than for observation care scenarios as presented here.
Option C incorrectly combines Subsequent Inpatient or Observation Care codes (99231-99233), which are used for follow-up days rather than discharge services.
4. AAPC and CPT Coding Guidelines:
According to CPT guidelines, the 99234-99236 code range is used when observation care requires both admission and discharge on different dates, and 99238-99239 is appropriate for discharge services.
Therefore, the correct answer is A. Hospital Inpatient or Observation Care Services (Including Admission and Discharge Services) (99234-99236) and Hospital Inpatient or Observation Discharge services (99238-99239).
質問 # 314
Patient has cervical spondylosis with myelopathy. The surgeon performed a bilateral posterior laminectomy with facetectomies at each level and foraminotomies performed between interspaces C5-C6 and C6-C7. Bilateral decompression of the nerve roots is achieved.
What CPT coding is reported?
- A. 63045, 63048
- B. 63040-50, 63043, 63043
- C. 0
- D. 63050-50
正解:A
解説:
Cervical spondylosis with myelopathy: Condition requiring decompressive surgery.
Bilateral posterior laminectomy, facetectomies, foraminotomies: Procedures performed to decompress nerve roots.
Interspaces C5-C6 and C6-C7: Specific levels where the procedures were performed.
CPT code 63045 is used for the initial cervical laminectomy, and 63048 is for each additional segment. The combination covers the decompression across two interspaces.
質問 # 315
A 47-year-old male recently injured as a passenger in a car accident sustained multiple fractures. The patient now has physical restraints due to pulling out foley catheter, IV catheters and attempted to pull out NG tube. Emergency department physician is asked to come see patient and injects 0.5 lidocaine into lumbar region of the spine. An indwelling catheter is placed into the lumbar region for continuous infusion with fluoroscopy for pain management.
What CPTis reported for the Emergency department physician?
- A. 62327,77003
- B. 0
- C. 1
- D. 62326,77003
正解:A
解説:
1. Procedure and CPTCode Selection:
The emergency department physician placed an indwelling catheter into the lumbar region for continuous infusion for pain management with fluoroscopic guidance.
CPTCode 62327 is appropriate for injection or catheter placement for continuous infusion of anesthetic or analgesic in the lumbar or sacral region using imaging guidance.
CPTCode 77003 represents the fluoroscopic guidance used during the catheter placement, which is separately reportable in this case.
2. Rationale for Excluding Other Options:
Code 62326 (in options B and D) is for the injection or catheter placement without imaging guidance. Since fluoroscopic guidance was specifically mentioned, 62327 is the appropriate choice.
Code 77003 must be reported separately when fluoroscopy is used in conjunction with 62327 for pain management catheter placement.
3. AAPC and CPTCoding Guidelines:
According to AAPC guidelines, the combination of 62327 and 77003 is correct when catheter placement for continuous infusion is performed with fluoroscopic guidance.
Therefore, the correct answer is C. 62327, 77003.
質問 # 316
A cardiologist attempted to perform a percutaneous transluminal coronary angioplasty of a totally occluded blood vessel. The surgeon stopped the procedure because of an anatomical problem creating risk for the patient and preventing performance of the catheterization.
What modifier is appended to the procedure code?
正解:A
質問 # 317
A 67-year-old male presents with DJD and spondylolisthesis at L4-L5 The patient is placed prone on the operating table and, after induction of general anesthesia, the lower back is sterilely prepped and draped. One incision was made over L1-L5. This was confirmed with a probe under fluoroscopy. Laminectomies are done at vertebral segments L4 and L5 with facetectomies to relieve pressure to the nerve roots. Allograft was packed in the gutters from L1-L5 for a posterior arthrodesis. Pedicle screws were placed at L2, L3, and L4.
The construct was copiously irrigated and muscle; fascia and skin were closed in layers.
Select the procedure codes for this scenario.
- A. 63017, 63048, 22612, 22808, 22842 x 3
- B. 63005 x 2, 22612, 22614 x 3, 22842
- C. 63047, 63048, 22612, 22614 x 3, 22842
- D. 63042, 63043, 22808, 22841 x 3
正解:C
解説:
Laminectomy and Facetectomy (63047 and 63048): The laminectomies at L4 and L5 with facetectomies fall under CPT codes 63047 (for the initial segment) and 63048 (for each additional segment).
Posterior Arthrodesis (22612 and 22614 x 3): The posterior arthrodesis from L1-L5 is coded with 22612 for the primary segment (L4-L5) and 22614 for each additional segment (L1-L4).
Placement of Pedicle Screws (22842): The placement of pedicle screws at L2, L3, and L4 is captured under CPT code 22842 for segmental instrumentation.
References:
AMA's CPT Professional Edition (current year)
ICD-10-CM (current year)
HCPCS Level II (current year)
質問 # 318
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