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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 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
  • 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 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.
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
  • 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 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
  • 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 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
  • 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 11
  • 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 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
  • 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 14
  • 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 15
  • 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 16
  • 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.

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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q432-Q437):

NEW QUESTION # 432
A patient presents with fever, cough, SOB, and a recent history of COVID-19. A PCR test was positive for COVID-19. The provider documents a final diagnosis of "pneumonia with history of COVID-19." What ICD-10-CM coding is reported?

Answer: C

Explanation:
The provider documents history of COVID-19, not active COVID-19.
Z86.16 = Personal history of COVID-19
J18.9 = Pneumonia, unspecified organism
Codes U07.1 and U09.9 are for current or post-COVID conditions, which are not documented here.
Therefore, A is correct.


NEW QUESTION # 433
A three-year-old patient is in the operative suite for stage 2 of treatment for double right outlet syndrome. The patient previously had the pulmonary artery banded and is returning for removal of the pulmonary band and transposition repair of the great vessels via aortic pulmonary reconstruction.
The surgeon performs a time-out and pre-incision review of respiration and BP then the previous sternal incision site is inspected and lightly painted with povidone. Next, reopens the sternal cavity and inserts central cannulae in the IVC, SVC and ascending aorta for extra corporeal membrane oxygenation (ECMO) bypass, chemical cardioplegia is initiated, stopping the heart and ECMO is initiated. A physician assistant monitors vitals and oxygenation until heart function resumes. The surgeon carefully incised and removes the Dacron band encircling the pulmonary artery, with nominal need for dilation. A section of coronary ostia is removed and sutured to the root of the pulmonary trunk. The pulmonary trunk and aortic root are then transected and transposed to allow for ideal cardiac circulation. Once structural integrity is visually confirmed, the physician assistant is permitted to administer the cardioplegia reversal solution and the surgeon removes the central cannulae after heart function safely resumes. The sternotomy is closed and the patient is transported to the NICU.
What CPT codes are reported for the surgery today?

Answer: D

Explanation:
1. Procedure Details and CPT Code Selection:
The patient is undergoing stage 2 treatment for double outlet right ventricle (DORV) with a removal of the pulmonary artery band and transposition repair of the great vessels.
Code 33779 is specific for correction of a double outlet right ventricle, with transposition of the great arteries. This code accurately reflects the procedure performed, including the complex repair involving the transposition of the pulmonary trunk and aortic root.
Code 33953 is used to report the initiation of extracorporeal membrane oxygenation (ECMO), which was used to maintain oxygenation during the procedure.
Code 33985 is for the termination of ECMO following the surgical repair once heart function has resumed. Both 33953 and 33985 accurately document the initiation and termination of ECMO during this complex heart repair.
2. Modifier Selection:
Modifier 78 (unplanned return to the operating room for a related procedure during the postoperative period) is appropriate here. This is a subsequent stage in the treatment plan, but due to the complexity and specific surgical intervention required, it is treated as a return to the OR for related procedure coding.
Modifier 58 (staged or related procedure during the postoperative period) would not be as suitable here because the procedure involves a new return to the OR.
3. AAPC and CPT Coding Guidelines:
AAPC guidelines support the use of specific modifiers (78 for unplanned return) and appropriate ECMO codes (33953 and 33985) in complex cardiac cases requiring bypass and staged treatment.
Thus, the correct CPT codes based on CPT and AAPC coding standards are C. 33779-78, 33953-78, 33985-78.


NEW QUESTION # 434
A diagnostic mammogram is performed on the left and right breasts. Computer-aided detection is also used to further analyze the image for possible lesions.
What CPT coding is reported for this radiology service?

Answer: B


NEW QUESTION # 435
A patient with empyema requires a Schede thoracoplasty.
What CPT code is reported for this procedure?

Answer: C


NEW QUESTION # 436
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.
What CPT and ICD-10-CM codes are reported?

Answer: D

Explanation:
45540 = Repair of rectal prolapse, abdominal approach
52332 = Cystourethroscopy with ureteral stent
K62.3 = Rectal prolapse


NEW QUESTION # 437
......

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