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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 2
  • 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 3
  • 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 4
  • 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 5
  • 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 6
  • 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 7
  • 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 8
  • 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 9
  • 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 10
  • 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 11
  • 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 (Q403-Q408):

NEW QUESTION # 403
(A provider states that all of their office visits should be reported asmoderate levelsbecause they treat patients with high-complexity problems. Would this be considered a compliance problem?)

Answer: C

Explanation:
Systematically billing all office visits at a predetermined level-without documentation supporting the requiredmedical decision making (MDM)ortime-is a classic compliance red flag and is generally treated asabuse(often described as upcoding when higher levels are billed than supported). E/M levels must reflect what was actually performed and documented for that encounter, using the E/M rules (MDM elements or total time, depending on code selection). Even if a provider treats complex patients, not every visit will meet the same level; stable follow-ups may be lower complexity than acute exacerbations or new problems. "Waste" generally refers to inefficient or unnecessary use of resources without intent to misrepresent; a blanket instruction to code moderate levels suggestssystematic misbillingrather than inefficiency. Option D is incorrect because providers cannot select any level at will-coding must be supported by documentation. This type of pattern is exactly what audits target, and it can trigger overpayment recoupment, penalties, and corrective action plans.


NEW QUESTION # 404
A patient with three thyroid nodules is seen for an FNA biopsy. Using ultrasonic guidance, the provider inserts a 25-gauge needle into each nodule. Nodular tissue is aspirated and sent to pathology.
What CPT coding reported?

Answer: A

Explanation:
The CPT code 10005 is for fine needle aspiration biopsy, including ultrasound guidance, for the first lesion.
CPT code 10006 is for each additional lesion with ultrasound guidance. Since the provider aspirated tissue from three nodules, the coding should be 10005 for the first nodule and 10006 x 2 for the additional two nodules.
AMA's CPT Professional Edition (current year)


NEW QUESTION # 405
(A 40-year-old woman with progressive sensorineural hearing loss in the right ear has acochlear implantplaced for the right ear. Anesthesia is provided by aCRNAwithmedical directionby an anesthesiologist who is concurrently directing 5 CRNAs. Physical status is3. What anesthesia CPT and ICD-10-CM codes are reported by theanesthesiologist?)

Answer: A

Explanation:
Cochlear implant surgery is anearprocedure and maps to anesthesia code00120in this question's option framework. The anesthesiologist ismedically directingCRNAs and is concurrently directing5CRNAs. Under anesthesia modifier rules, when an anesthesiologist is directingmore than fourconcurrent anesthesia procedures, the correct modifier isAD(medical supervision by a physician: more than four concurrent anesthesia procedures). Physical status is given asP3(severe systemic disease), so append-P3. The diagnosis is progressive sensorineural hearing loss in the right ear; in the options,H90.41represents unilateral sensorineural hearing loss (right ear) as provided. Options usingAAwould indicate the anesthesiologist personally performed anesthesia (not true here), andQY/QXrepresent medical direction structures but do not match the
"more than four" concurrency described (which specifically triggersADin these exam-style choices).
Therefore, the correct reporting by the anesthesiologist is00120-AD-P3, H90.41.


NEW QUESTION # 406
(What CPT coding is reported for the insertion ofHeyman capsulesfor clinical brachytherapy?)

Answer: C

Explanation:
Heyman capsules are applicators used ingynecologic brachytherapy, classically forintracavitary uterineplacement as part of internal radiation therapy. CPT distinguishes between prostate brachytherapy services and gynecologic applicator placements.55875is associated with prostate brachytherapy procedures, and57155is for insertion of uterine tandem and/or vaginal ovoids (a different applicator system). The code that specifically aligns withinsertion of Heyman capsulesis58346. CPC exam strategy: when a question names a specific device/apparatus (like Heyman capsules), it is usually pointing to avery specific CPT code. Also, keep the anatomic system straight-Heyman capsules are not a prostate service and not simply a generic
"radiation therapy" code; they are a named gynecologic brachytherapy applicator insertion. Therefore, among the given options,58346is the correct report.


NEW QUESTION # 407
A 45-year-old patient comes In with chronic sinusitis that has not responded to medication. The physician decides to use a sinus stent implant to help alleviate the patients symptoms.
The physician inserts the implant into the ethmoid sinus using a delivery system. This implant is designed to keep the surgical opening clear, prop open the sinus, and gradually release a corticosteroid with anti-inflammatory properties directly to the sinus lining. The implant is not permanent and will dissolve over time.
What HCPCS Level II code is reported?

Answer: B

Explanation:
C2617 - Sinus implant, drug-eluting
Described implant:
Ethmoid sinus
Drug-eluting (corticosteroid)
Absorbable
Why others are incorrect:
C1877 - Vascular stent
S1091 - Temporary code
C9600 - Coronary intervention


NEW QUESTION # 408
......

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