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AAPC CPC Exam Overview:

Certification Vendor:AAPC
Exam Name:AAPC Certified Professional Coder (CPC) Certification Exam
Exam Number:CPC
Exam Format:Open-book (CPT, ICD-10-CM, HCPCS manuals allowed), Multiple Choice Questions
Exam Duration:340 minutes
Passing Score:Approximately 70%
Certificate Validity Period:2 years (renewal via Continuing Education Units - CEUs)
Exam Price:$399โ€“$499 USD (varies by membership and region)
Related Certifications:Certified Inpatient Coder (CIC)
Certified Coding Specialist (CCS)
Certified Outpatient Coder (COC)
Available Languages:English
Real Exam Qty:150 multiple-choice questions
Recommended Training:AAPC CPC Training Course
AAPC CPC Practice Exams
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: 1โ€“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
  • 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 2
  • 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 3
  • Introduction to CPTยฎ, HCPCS Level II, and Modifiers: This section of the exam measures the skills of coding specialists and introduces candidates to CPTยฎ 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
  • 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 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
  • 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 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
  • 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 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.
Topic 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.:
Topic 12
  • 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 13
  • 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 14
  • 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 15
  • 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 16
  • 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.

AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q38-Q43):

NEW QUESTION # 38
(Full Case:Procedure:Excision of6.0 cm malignant lesionof theright forearmwithadjacent tissue transferusing arotation flap.Pre/Post-op Dx:Basal cell carcinoma, right forearm.Anesthesia:local (1% Xylocaine with epi).
Defect size:8 sq cm.Specimen:sent forfrozen section margin control; margins confirmed clear.Closure:rotation flap from adjacent healthy tissue,total area 8 sq cm, secured with layered closure (5-0 Vicryl/6-0 Prolene).
Question:What CPT coding is reported?)

Answer: A

Explanation:
The operative report documents amalignant lesion excision(basal cell carcinoma) on theright forearmfollowed by reconstruction with anadjacent tissue transfer (rotation flap)afterfrozen sectionconfirmed clear margins. In CPT, when a defect is repaired withadjacent tissue transfer/rearrangement, the flap code includes the work ofexcision (including necessary undermining and preparation of the recipient site)performed as part of creating and closing the defect; therefore the malignant excision code (e.g.,11606) isnot separately reportedin this same session when the excision is integral to the flap repair. Code selection for adjacent tissue transfer is based on theanatomic siteand thetotal defect area (primary + secondary defects). The documentedtotal area is
8 sq cm, and the site is theforearm (arm/leg grouping). For arms/legs,10 sq cm or lessis reported with14020.
Codes14040apply to a different anatomic region grouping and do not match the forearm. Frozen section pathology/margin control does not change the primary surgical coding here. Therefore, report14020 only.


NEW QUESTION # 39
A 25-year-old woman underwent percutaneous breast biopsy on the right breast with placement of a Gelmark clip. The procedure was performed using stereotactic imaging.
What CPT codes will be reported?

Answer: B

Explanation:
CPT code 19081 is used for percutaneous biopsy of breast(s) using stereotactic guidance, which includes the placement of a localization device and imaging of the biopsy specimen when performed. This accurately describes the procedure performed on the right breast with the placement of a Gelmark clip using stereotactic imaging. The other codes either describe open biopsies or separate procedures that are not applicable here.References: AMA's CPT Professional Edition (current year)


NEW QUESTION # 40

Refer to the supplemental information when answering this question:
View MR 003264
What is the procedural coding?

Answer: A

Explanation:
The patient had a post-operative complication (cardiac tamponade) following a previous CABG surgery, requiring a return to the operating room for exploration and evacuation of a blood clot. This is coded using CPT code 32658 (Exploration, mediastinum, with or without drainage; for postoperative hemorrhage, drainage of abscess, or to locate foreign body). Modifier 78 is appended to indicate an unplanned return to the operating room by the same physician following the initial procedure for a related procedure during the postoperative period.
References:
CPT Code 32658: Exploration, mediastinum, with or without drainage; for postoperative hemorrhage, drainage of abscess, or to locate foreign body Modifier 78: Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period AAPC Coder ' s Desk Reference: This resource provides detailed information on coding guidelines and procedures.


NEW QUESTION # 41
Preoperative diagnosis: Right thigh benign congenital hairy nevus. *1
Postoperative diagnosis: Right thigh benign congenital hairy 0 nevus.
Operation performed: Excision of right thigh benign congenital>1
nevus, excision size with margins 4.5 cm and closure size 5 cm.
Anesthesia: General.0
Intraoperative antibiotics: Ancef.0
Indications: The patient is a 5-year-old girl who presented with her parents for evaluation of her right thigh congenital nevus. It has been followed by pediatrics and thought to have changed over the past year. Family requested excision. They understood the risks involved, which included but were not limited to risks of general anesthesia, infection, bleeding, wound dehiscence, and poor scar formation. They understood the scar would likely widen as the child grows because of the location of it and because of the age of the patient. They consented to proceed.
Description of procedure: The patient was seen preoperatively in > I the holding area, identified, and then brought to the operating room. Once adequate general anesthesia had been induced, the patient's right thigh was prepped and draped in standard surgical fashion. An elliptical excision measuring 6 x 1.8 cm had been marked. This was injected with Lidocaine with epinephrine, total of 6 cc of 1% with 1:100,000. After an adequate amount of time, a #15 blade was used to sharply excise this full thickness.
This was passed to pathology for review. The wound required # limited undermining in the deep subcutaneous plane on both sides for approximately 1.5 cm in order to allow mobilization of the skin for closure. The skin was then closed in a layered fashion using 3-0 Vicryl on the dermis and then 4-0 Monocryl running subcuticular in the skin, the wound was cleaned and dressed with Dermabond and Steri-Strips.
The patient was then cleaned and turned over to anesthesia for S extubation.
She was extubated successfully in the operating room and taken S to the recovery room in stable condition.
There were no complications.
Which CPT and ICD-10-CM codes are reported for this procedure?

Answer: C

Explanation:
65420 = Excision or transposition of pterygium without graft
LT = Left eye
H11.002 = Pterygium of left eye


NEW QUESTION # 42
A patient underwent a cystourethroscopy with a pyeloscopy using lithotripsy to break up the ureteral calculus. An indwelling stent was also inserted during the same operative session on the same side. This service was performed in the outpatient hospital surgery center.
What CPT coding reported?

Answer: C

Explanation:
Cystourethroscopy: This is a procedure that involves the use of a cystoscope to look inside the urethra and bladder.
Pyeloscopy: Involves the examination of the upper urinary tract, typically done through the cystoscope.
Lithotripsy: A procedure that uses shock waves or a laser to break up stones in the kidney, bladder, or ureter.
Indwelling stent insertion: A procedure to place a stent in the ureter to help urine flow from the kidney to the bladder.
52356: Cystourethroscopy with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization and/or ureteral stent placement).
The code 52356 includes all components mentioned: cystourethroscopy, pyeloscopy, lithotripsy, and stent insertion performed in the same operative session.
Reference:
AMA's CPT Professional Edition (current year)
ICD-10-CM (current year), HCPCS Level II (current year)


NEW QUESTION # 43
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