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| Topic | Details |
|---|
| 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 | - 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 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 | - 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 5 | - 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 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 | - 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 8 | - 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 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 | - 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 11 | - 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 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 | - 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.
|
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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q338-Q343):
NEW QUESTION # 338
(ESTABLISHED PATIENT VISIT: A 37-year-old woman presents with coughing, congestion, upper respiratory symptoms, and headache for two days. Complete ROS negative except as noted. No significant past/family history. Exam: stable vitals, nasal congestion, normal TMs, occasional rhonchi, no wheezing, normal heart, soft abdomen. Assessment/Plan:Acute upper respiratory infection, fluids,amoxicillinfor 5-7 days, return precautions. What CPT code is reported?)
Answer: C
Explanation:
This is anestablished patient office visitcoded byMDM(or time, but time is not provided). Problems:one acute, uncomplicated illness(URI) # supportslowproblem complexity. Data: no labs/imaging ordered or reviewed
#minimal/nonedata. Risk: although a prescription is given, MDM level is determined by2 of 3elements (Problems, Data, Risk). Here, only the risk might approach moderate due to prescription management, butproblems and data remain low/minimal, so the overall MDM doesnotmeet moderate. Therefore, the visit is best supported atlow MDM, which corresponds to99213for an established patient. It is more than minimal (99212) because a focused exam and management plan are documented, but it does not meet the higher complexity required for 99214/99215 (multiple problems, significant data review, or high-risk management).
CPC exam focus: don't let a single element (like antibiotics) automatically "force" a higher code-MDM requires meeting the level intwo elements.
NEW QUESTION # 339
The patient, who is at 32 weeks pregnant, has been hospitalized due to an infection of COVID-19.
What ICD-10-CM codes are reported?
- A. O98.513, U07.1, Z3A.32
- B. O98.513, U07.1, R06.02, R50.81, Z3A.32
- C. U07.1, R06.02, R50.81, Z33.1, Z3A.32
- D. U07.1, O98.513, Z3A.32
Answer: A
Explanation:
Pregnancy guidelines require O codes first.
O98.513 = COVID-19 infection complicating pregnancy, third trimester
U07.1 = COVID-19
Z3A.32 = 32 weeks gestation
Symptoms (SOB, fever) are not coded separately when integral to COVID-19.
Correct sequencing makes A correct.
NEW QUESTION # 340
A patient who is 37 weeks' gestation is admitted to labor and delivery for a cesarean delivery. An external cephalic version was performed successfully several days ago and she now presents in labor, fully dilated, and the fetus has returned to a footling presentation.
What anesthesia code is reported?
- A. 01960
- B. 01961
- C. 01958
- D. 01967
Answer: B
Explanation:
To determine the correct anesthesia code for a cesarean delivery with specific conditions, we review the following codes:
01961 is defined as "Anesthesia for cesarean delivery only," which aligns with this scenario, as the patient is admitted for a cesarean section.
01960 refers to anesthesia for a vaginal delivery, which does not apply here as the delivery is via cesarean.
01967 is for "Anesthesia for planned vaginal delivery," which also does not apply due to the cesarean route.
01958 is used for planned vaginal delivery that may involve a complicated scenario, but since the procedure is a cesarean section, this code is not appropriate.
Given that the patient is in labor for a cesarean section and has had a previous external cephalic version, 01961 is the correct answer.
NEW QUESTION # 341
(What is the ICD-10-CM code for amedial meniscus tearof theleft kneedue to arecent football injury?)
- A. M23.204
- B. S83.232A
- C. S83.242A
- D. M23.202
Answer: B
Explanation:
A "recent football injury" indicates anacute traumaticinjury rather than a chronic/old derangement. Acute meniscus tears are coded from theS83.2-category (tear of meniscus, current injury), not theM23.-category (derangement of meniscus due to old tear or injury). The question specifiesmedial meniscus,left knee, and implies aninitial encounterfor the acute injury, so the correct code must include laterality and the 7th characterAfor initial encounter.S83.232Acorresponds to acurrent tear of the medial meniscus, left knee, initial encounter.S83.242Ais a different meniscus specification (not medial).M23.202/M23.204are derangement codes typically used forold tearsor chronic conditions, not an acute recent sports injury. CPC exam tip:
"recent injury" #S-codes, "old tear/derangement" #M23. Mnemonic:S = Sudden (acute),M = Mature (old
/chronic).
NEW QUESTION # 342
A couple presents to the freestanding fertility clinic to start in vitro fertilization. Under radiologic guidance, an aspiration needle is inserted (by aid of a superimposed guiding-line) puncturing the ovary and preovulatory follicle and withdrawing fluid from the follicle containing the egg.
What is the correct CPT code for this procedure?
Answer: D
Explanation:
The procedure involves the aspiration of fluid from an ovarian follicle to retrieve the egg under radiologic guidance.
* Procedure Description:
* Aspiration needle insertion.
* Puncture of the ovary and preovulatory follicle.
* Withdrawal of fluid containing the egg.
* Radiologic guidance was used.
* CPT Coding:
* 58976: Aspiration of ovarian follicle(s) with ultrasound guidance.
References:
* AMA's CPT Professional Edition (current year).
* CPT Assistant for detailed coding guidelines on reproductive procedures.
NEW QUESTION # 343
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