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AAPC CPC Exam Overview:

Certification Vendor:AAPC
Exam Name:Certified Professional Coder (CPC) Exam
Exam Number:CPC
Exam Price:USD 499
Exam Duration:240 minutes
Available Languages:English
Exam Format:Multiple Choice
Passing Score:70%
Real Exam Qty:100
Related Certifications:CPC-A
Certificate Validity Period:2 Years (requires continuing education to maintain)
Sample Questions:AAPC CPC Sample Questions
Exam Way:Online (Online Proctored or In-Person at Testing Centers)
Pre Condition:None required for exam (though AAPC recommends medical terminology/anatomy 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
  • 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 3
  • 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 4
  • 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 5
  • 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 6
  • 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 7
  • 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 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
  • 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 10
  • 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 11
  • 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 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
  • 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 15
  • 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 16
  • 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 17
  • 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.

AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q439-Q444):

NEW QUESTION # 439
A patient has chronic cholesteatoma in the right middle ear. The otolaryngologist performed a tympanoplasty with a radical mastoidectomy, removing the middle ear cholesteatoma. Grafting technique was used to repair the eardrum without ossicular chain reconstruction.
What CPT code is reported for this surgery?

Answer: A


NEW QUESTION # 440
What does the term "manipulation" refer to in the context of fracture or dislocation treatment?

Answer: B

Explanation:
In CPT fracture and dislocation care, manipulation refers to the application of force or traction to restore a bone or joint to its normal anatomic position.
This is a key distinction between with manipulation and without manipulation, which directly affects CPT code selection (e.g., 23505 vs. 23500).
Manipulation may be performed closed (no incision) or open (with incision).


NEW QUESTION # 441
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?

Answer: B

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 # 442
A 55-year-old patient with suspected liver cancer was seen by the physician to obtain a biopsy. The special biopsy needle was placed using ultrasonic guidance. The physician obtained a small tissue sample from the liver, which was then sent to pathology.
What CPT codes are reported?

Answer: A

Explanation:
Procedure: The physician performed a liver biopsy using ultrasonic guidance.
CPT Codes:
47000: This code is for the liver biopsy.
76942-26: This code is for ultrasonic guidance for needle placement, with modifier -26 indicating the professional component.
Code Selection Justification: The CPT code 47000 specifically captures the liver biopsy, and 76942-26 accurately represents the ultrasonic guidance utilized during the procedure.
AMA CPT Professional Edition (current year)
ICD-10-CM (current year)
HCPCS Level II (current year)


NEW QUESTION # 443
Refer to the exhibit.

Refer to the supplemental information when answering this question:
View MR 065174
What E/M code is reported for this encounter?

Answer: A

Explanation:
To determine the correct E/M code, we need to consider the three key components: history, examination, and medical decision making (MDM).
History:
The documentation indicates an expanded problem-focused history. This is supported by the detailed history of present illness, including the patient's description of symptoms, family history, and review of systems with pertinent positives and negatives.
Examination:
The examination is also expanded problem-focused. The physician focused on the relevant systems (head, neck, throat) and documented specific findings related to the chief complaint (thyromegaly).
Medical Decision Making:
The MDM is straightforward. The physician is evaluating a new problem (bilateral thyroid nodules) with a low level of risk. Although further workup is planned, this alone doesn't automatically increase the MDM complexity.
Based on these components, 99213 is the most appropriate code.
Why other options are incorrect:
99212: Requires a problem-focused history and examination, which is less comprehensive than what was documented.
99214 and 99215: Require a higher level of MDM (low or moderate complexity) and/or a more detailed examination. The documentation doesn't support this level of service.
Reference:
CPT Codes 99211-99215: Office or other outpatient visit for the evaluation and management of an established patient
1995 and 1997 Documentation Guidelines for Evaluation and Management Services: These guidelines provide detailed criteria for selecting the appropriate E/M code based on history, examination, and MDM.
AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.


NEW QUESTION # 444
......

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