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AAPC CPC Exam Overview:

Certification Vendor:AAPC
Exam Name:AAPC Certified Professional Coder (CPC) Certification Exam
Exam Number:CPC
Related Certifications:Certified Inpatient Coder (CIC)
Certified Outpatient Coder (COC)
Certified Coding Specialist (CCS)
Exam Price:$399–$499 USD (varies by membership and region)
Available Languages:English
Passing Score:Approximately 70%
Exam Duration:340 minutes
Exam Format:Multiple Choice Questions, Open-book (CPT, ICD-10-CM, HCPCS manuals allowed)
Certificate Validity Period:2 years (renewal via Continuing Education Units - CEUs)
Real Exam Qty:150 multiple-choice questions
Recommended Training:AAPC CPC Practice Exams
AAPC CPC Training Course
Exam Registration:AAPC CPC Certification Page
AAPC Exam Registration Portal
Sample Questions:AAPC CPC Sample Questions
Exam Way:Available via online proctored exam or authorized testing centers (in-person).
Pre Condition:No formal prerequisite required. Recommended: 1–2 years of medical coding experience or completion of AAPC CPC training.
Official Syllabus URL:https://www.aapc.com/certification/cpc/

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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
  • 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 3
  • 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 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
  • 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 6
  • 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 7
  • 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 8
  • 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 9
  • 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 10
  • 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 11
  • 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 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
  • 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 14
  • 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 15
  • 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 16
  • 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.
Topic 17
  • 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 18
  • 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 19
  • 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.

AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q155-Q160):

NEW QUESTION # 155
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: C

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.
CPT Professional Edition (current year)
Surgery guidelines for mastectomy procedures


NEW QUESTION # 156
The documentation states:
He was then sterilely prepped and draped along the flank and abdomen in the usual sterile fashion. I first made a skin incision off the tip of the twelfth rib, extending medially along the banger's lines of the skin. This was approximately 3.5 cm in length. Once this incision was carried sharply, electrocautery was used to gain access through the external oblique, internal oblique, and transverse abdominis musculature and fascia.
What surgical approach was used for this procedure?

Answer: D

Explanation:
The documentation describes making a skin incision off the tip of the twelfth rib and extending medially along the banger's lines of the skin. The use of electrocautery to gain access through multiple layers of musculature and fascia indicates an open surgical approach. Open surgery involves making a large incision to expose and directly view the surgical site. This is distinct from percutaneous (which involves needles or catheters), laparoscopic (which uses small incisions and a camera), and other minimally invasive techniques.References:
AMA's CPT Professional Edition, ICD-10-CM, and HCPCS Level II (current year)


NEW QUESTION # 157
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 # 158
(Full Case:Preoperative diagnosis:Recurrent dysphagia.Postoperative diagnosis:Hiatal hernia with obstruction.
Procedure:EGD with dilation.Consent:PAR conference; informed consent signed; premedication given.
Position/monitoring:left lateral decubitus; monitored with BP cuff and pulse oximeter throughout.Topical:
Hurricaine spray to posterior pharynx.Scope passage:flexible endoscope passed under direct visualization through cricopharyngeus into esophagus; advanced with identification of EG junction into stomach; rugal folds visualized; advanced to antrum/pylorus; pylorus cannulated; duodenal bulb and second portion visualized; retroflexed views of cardia/fundus/lesser curvature.Dilation technique:guidewire placed in antrum; scope removed; wire positioned by markings;#14 French dilatorpassed into stomach area;esophageal dilation performed over guidewire.Findings:tortuous/shortened esophagus; large sliding hiatal hernia; EG junction
~30 cm; stomach abnormal with very large sliding hiatal hernia; duodenum normal.Question:What CPT coding is reported?)

Answer: C

Explanation:
The documented service is an upper GI endoscopy (EGD) withesophageal dilationperformed using aguidewireand a passed dilator ("dilation performed over the guidewire"). In CPT, when a therapeutic endoscopic service is performed, you report thetherapeutic EGD code, not the separate diagnostic EGD code, because diagnostic visualization is inherent in performing the therapeutic procedure. Therefore,43235 (diagnostic EGD) is not additionally reported. The key distinction between the dilation codes offered is the method:43248describes EGD withesophageal dilation using a guidewire technique(bougie/dilator passed over a guidewire), which matches the narrative: guidewire placed in the antrum, scope removed, and a dilator passedover the guidewireinto the stomach area. Code43249generally reflects balloon dilation of the esophagus performed endoscopically; the note does not describe balloon inflation, diameter, or balloon equipment. The hiatal hernia findings and dysphagia indication support medical necessity but do not change code selection. Thus, the correct CPT code is43248alone.


NEW QUESTION # 159
Dr. Carter sees Mrs. White at the Spring Valley Nursing Facility. He saw her last month after she was admitted to the facility. Today is a follow up visit. She is doing well. He documented a medically appropriate history and exam. The patient has osteoporosis, hypertension, dementia. CAD, CHF, and type 2 diabetes (moderate number and complexity of problems). He reviews 4 labs and a telemetry (Moderate data). He adds a Cardizem prescription for better control of her blood pressure which is a moderate risk. What CPT code does Dr. Carter report for the visit?

Answer: D

Explanation:
This is a subsequent nursing facility care visit.
MDM Analysis (2021+ E/M Guidelines):
Problems: Multiple chronic conditions # Moderate
Data: 4 labs + telemetry # Moderate
Risk: Prescription drug management # Moderate
99309 - Subsequent nursing facility care, moderate MDM
Why others are incorrect:
99307 / 99308 - Low complexity
99305 - Initial nursing facility care


NEW QUESTION # 160
......

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