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AAPC CPC Exam Overview:
| Certification Vendor: | AAPC |
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| Exam Name: | Certified Professional Coder (CPC) Exam |
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| Exam Number: | CPC |
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| Exam Format: | Multiple Choice |
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| Certificate Validity Period: | 2 Years (requires continuing education to maintain) |
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| Available Languages: | English |
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| Exam Price: | USD 499 |
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| Real Exam Qty: | 100 |
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| Related Certifications: | CPC-A |
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| Passing Score: | 70% |
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| Exam Duration: | 240 minutes |
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| Sample Questions: | AAPC CPC Sample Questions |
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| Exam Way: | Online (Online Proctored or In-Person at Testing Centers) |
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| Pre Condition: | None required for exam (though AAPC recommends medical terminology/anatomy training) |
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| Official Syllabus URL: | https://www.aapc.com/certification/cpc |
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| Topic | Details |
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| Topic 1 | - 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.
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| 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.
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| Topic 3 | - 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.
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| Topic 4 | - 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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| 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.
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| Topic 6 | - 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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| Topic 7 | - 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.
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| Topic 8 | - 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.
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| Topic 9 | - 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.
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| Topic 10 | - 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.
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| Topic 11 | - 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.
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| Topic 12 | - 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.
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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q230-Q235):
NEW QUESTION # 230
Miranda is in her provider's office for follow up of her diabetes. Her blood sugars remain at goal with continuing her prescribed medications.
When referring to the MDM Table in the CPT code book for number and complexity of problems addressed at the encounter, what type of problem is this considered?
- A. Stable, chronic illness
- B. Minimal problem
- C. Stable, acute illness
- D. Acute, uncomplicated illness or injury
Answer: A
NEW QUESTION # 231
Which is a TRUE statement for Place of Service (POS) codes for professional claims?
- A. Place of service codes are three-digit alphanumeric codes.
- B. Place of service codes only denote if a patient is admitted to the intensive care unit in a hospital.
- C. Reporting an incorrect POS in where a physician's service was provided may result in a denial of a claim.
- D. Place of service codes are found in the Tabular List of the ICD-10-CM code book.
Answer: C
Explanation:
Place of Service (POS) codes are two-digit numeric codes used on professional claims to identify where a service was performed (e.g., office, inpatient hospital, outpatient hospital).
Reporting an incorrect POS can affect reimbursement and may result in claim denial # POS codes are not alphanumeric They describe many locations, not just ICU POS codes are maintained by CMS, not found in the ICD-10-CM code book
NEW QUESTION # 232
A patient has five biopsies performed on the duodenum.
What CPT coding is reported?
- A. 44020 ×5
- B. 0
- C. 1
- D. 44010 ×5
Answer: C
Explanation:
44010 = Biopsy of small intestine, single or multiple
Reported once only, regardless of number
NEW QUESTION # 233
A complete 7-view X-ray of the lumbosacral spine, including bending views, is performed.
What CPT code is reported?
Answer: C
Explanation:
72114 = Radiologic exam, lumbosacral spine, complete with bending views Other codes represent fewer views or different spine regions
NEW QUESTION # 234
A patient with abnormal growth had a suppression study that included five glucose tests and five human growth hormone tests.
What CPT@ coding is reported?
- A. 80430, 82947, 83003
- B. 80430, 82947 x 2, 83003
- C. 80430, 82947 x 5, 83003 x 5
- D. 82947 x 5, 83003 x 5
Answer: C
Explanation:
1. Procedure and CPTCode Selection:
The patient underwent a suppression study involving five glucose tests and five human growth hormone tests.
CPTCode 80430 represents a suppression panel specifically for growth hormone studies, which includes various assessments for diagnosing abnormal growth.
CPTCode 82947 is used for each glucose test performed, and since five glucose tests were conducted, it should be coded as 82947 x 5.
CPTCode 83003 is used for each human growth hormone test performed, and since five tests were conducted, it should be coded as 83003 x 5.
2. Rationale for Excluding Other Options:
Option A lists 82947 x 2 and 83003 without sufficient units to account for the five tests each, which does not match the actual number of tests performed.
Option B omits the suppression panel code 80430, which is necessary for documenting the overall suppression study.
Option D does not provide the correct quantity of glucose and growth hormone tests, which were each performed five times.
3. AAPC and CPTCoding Guidelines:
According to AAPC guidelines, when a suppression panel includes multiple components that are performed more than once, the specific panel code 80430 should be used along with the correct number of individual component codes.
Therefore, the correct answer is C. 80430, 82947 x 5, 83003 x 5.
NEW QUESTION # 235
......
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