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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 2
  • 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 3
  • 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 4
  • 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 5
  • 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 6
  • 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 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
  • 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
  • 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
  • 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 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.
Topic 13
  • 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 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
  • 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 16
  • 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 17
  • 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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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q193-Q198):

NEW QUESTION # 193
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

Explanation:
For a mastectomy that involves removing the breast tissue, skin, pectoral muscles, and surrounding tissue, including the axillary and internal mammary lymph nodes, the appropriate CPT code is:
* 19306: Mastectomy, radical, including pectoral muscles, axillary lymph nodes.
This code captures the extent of the surgery, including the removal of the breast tissue, skin, pectoral muscles, and lymph nodes.
References:
* CPT Professional Edition (current year)
* Surgery guidelines for mastectomy procedures


NEW QUESTION # 194
This 27-year-old male has morbid obesity with a BMI of 45 due to a high calorie diet. He has decided to have an open Roux-en-Y gastric bypass. The patient is brought to the operating room and placed in supine position. A midline abdominal incision is made. The stomach is mobilized, and the proximal stomach is divided and stapled creating a small proximal pouch in continuity with the esophagus. A short limb of the proximal bowel of 155 cm is divided. It is brought up and anastomosed to the gastric pouch. The other end of the divided bowel is connected back into the distal small bowel to the short limb's gastric anastomosis to restore intestinal continuity. The abdominal incision is closed.
What are the procedure and diagnosis codes for this encounter?

Answer: B

Explanation:
Open Roux-en-Y Gastric Bypass: The procedure involves creating a small gastric pouch and anastomosing it to the jejunum.
CPT Code 43847: This code describes a surgical gastric restrictive procedure with gastric bypass for morbid obesity, open.
ICD-10-CM Code E66.01: This code represents morbid (severe) obesity due to excess calories.
ICD-10-CM Code Z68.42: This code indicates a BMI of 45.
Reference:
AMA's CPT Professional Edition (current year)
ICD-10-CM (current year)


NEW QUESTION # 195
A patient returns for embryo transfer. The lab thaws cryopreserved embryos and cultures them for two additional days.
What CPT coding is reported?

Answer: A

Explanation:
89258 = Thawing of cryopreserved embryos
89250 = Culture of embryos, per day (reported once per encounter)


NEW QUESTION # 196
(What modifier is appended to indicate that during thepostoperative period, a procedure is performed that wasplanned,more extensivethan the original procedure, or done fortherapeutic reasons?)

Answer: C

Explanation:
Modifier58is used when a subsequent procedure during the postoperative period isstaged or relatedto the original procedure and meets one of these classic criteria:(1) planned/prospective (staged), (2) more extensive than the original, or (3) therapeutic following a diagnostic procedure. It signals that the later procedure is not an unplanned complication but part of a planned course of care or an escalation of treatment. This is different from modifier78, which is for anunplanned returnto the operating room/procedure room during the postoperative period for arelated procedure(often due to complications) and typically doesnotrestart the global period. Modifier26is theprofessional componentmodifier for certain diagnostic services, not a global surgical modifier. Modifier56is not the appropriate postoperative modifier for staged/related surgical services. For CPC exam accuracy, associate58with staged/planned/more extensive/therapeutic-after-diagnostic, and78with unplanned return to OR.


NEW QUESTION # 197
(A three-year-old patient returns forstage 2treatment for double right outlet syndrome. The surgeon removes apulmonary artery bandand performstransposition repair of the great vesselsvia aortic pulmonary reconstruction. Central cannulae are inserted forECMO bypass, chemical cardioplegia is initiated, and a physician assistant monitors vitals and oxygenation until heart function resumes. What CPT codes are reported for the surgery today?)

Answer: A

Explanation:
This is aplanned stagedcongenital cardiac repair following prior pulmonary artery banding, so the correct postoperative modifier concept isstaged/related(modifier-58), not an unplanned return-to-OR modifier (-78).
The operative service includesremoval of the pulmonary artery bandandarterial switch/transposition-type repairof the great vessels (captured in the 33778/33779 family in the answer choices). The case also describes use ofECMOwith central cannulation and management during the procedure, which is reported with the appropriate ECMO initiation/management codes shown as33955and the monitoring/assistant-related component represented by33985in the choices. Because this is thesecond stageof care and described as planned definitive repair, the -58 modifier is appropriate on the reported surgical services in these answer constructs. OptionDcorrectly pairs the staged modifier (-58) with the appropriate congenital repair and ECMO-related coding listed in the question's options.


NEW QUESTION # 198
......

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