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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 2
  • 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 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
  • 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 5
  • 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 6
  • 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 7
  • 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 8
  • 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 9
  • 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 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.
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
  • 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.

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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q394-Q399):

NEW QUESTION # 394
(Full Case:Pre/Post-op diagnosis:Grade 1 endometrial cancer.Procedure:Radical hysterectomy and pelvic lymph node sampling.Anesthesia:General.EBL:400 mL.Complications:None.Specimens:pelvic washings; uterus; tubes; ovaries; pelvic lymph nodes.Fluids:2 L crystalloid.Operative details:frog-leg position; perineum prepped sterile; Foley placed; midline vertical incision umbilicus to symphysis; exploration shows normal upper abdomen and bowel; no paraaortic adenopathy; pelvis/perineum normal; washings collected; round ligaments transected; retroperitoneal spaces opened; ureters visualized; ovarian vessels isolated/ligated; bladder flap taken down; uterine arteries, uterosacral and cardinal ligaments clamped/ligated; uterus removed; vagina closed; lymph node sampling left then right with removal of lymphatic tissue from external/internal iliac bifurcation to circumflex iliac vein and down to obturator nerve; tumor ~40% endometrial surface with
<50% myometrial invasion; closure in layers; patient tolerated well.Question:What CPT codes are reported?)

Answer: D

Explanation:
The operative note describes anopen radical hysterectomyfor endometrial cancer with removal of theuterus, tubes, and ovaries(specimens listed) and extensive dissection ofuterine arteries, uterosacral and cardinal ligaments, consistent with aradicalprocedure. The approach is clearlyabdominal/open(midline vertical incision and abdominal entry), not laparoscopic, so a laparoscopic radical hysterectomy code (such as 58548) is not appropriate. In the answer set,58210represents aradical abdominal hysterectomy(with appropriate extent for malignancy management). In addition, the surgeon performedpelvic lymph node samplingbilaterally, removing lymphatic tissue along the iliac vessels to the obturator nerve region. The correct code in the choices for pelvic lymphadenectomy/sampling is38770. Pelvic washings and extensive exploration are included in the primary surgical service and do not add separate CPT codes in this scenario. Therefore, the correct coding combination is58210 and 38770.


NEW QUESTION # 395

Refer to the supplemental information when answering this question:
View MR 000281
What anesthesia and diagnosis codes are reported for this case?

Answer: B

Explanation:
* CPT Code 00811: Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to the splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing
* This code is reported for anesthesia services provided during a colonoscopy that is diagnostic in nature.
* ICD-10-CM Code D62: Acute posthemorrhagic anemia
* This is the most accurate postoperative diagnosis. The operative report states "Anemia due to acute blood loss."
* ICD-10-CM Code N18.6: End stage renal disease
* This code captures the patient's documented history of ESRD.
* ICD-10-CM Code Z99.2: Dependence on renal dialysis
* This code is necessary to report the patient's dialysis status, as it affects the overall risk of the procedure.
Why other options are incorrect:
* 00812: This code is for therapeutic colonoscopies, not diagnostic.
* D64.9: This code is for anemia, unspecified. D62 is more specific to the patient's condition.
* K62.5: This code is for lower gastrointestinal bleeding, but the anemia is the primary diagnosis in this case.
References:
* CPT Code 00811: Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to the splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing
* ICD-10-CM Code D62: Acute posthemorrhagic anemia
* ICD-10-CM Code N18.6: End stage renal disease
* ICD-10-CM Code Z99.2: Dependence on renal dialysis
* AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.


NEW QUESTION # 396
(Dr. Winston sees a patient with abdominal pain in the observation unit in the hospital. This is hisfirst visitwith this patient during this stay. He spent a total time of85 minuteson that patient on that date of service, including review of the observation admission, labs, X-rays, and EKG results, and examining the patient with amoderate level of medical decision making. What CPT coding is reported?)

Answer: A

Explanation:
This is aninitial hospital/observation evaluation(first visit during the stay), so the correct code family is theinitial observation/inpatient E/Mlevel. The stem providestotal time = 85 minutesand also statesmoderate MDM. Under current E/M rules, you can select the code based oneither MDM or total time(when time is used, it includes the physician's qualifying time on that date). The time of85 minutesfits the time range for99223(the highest initial hospital/observation level by time) even if MDM is described as moderate. The prolonged service add-on99418requires meeting the threshold beyond the primary code's time before it can be added; with 85 minutes, you do not reach the additional increment needed to report 99418. Therefore, you report99223 only. CPC exam tip: when time is explicitly provided and is high, it often drives the level; do not add prolonged time unless the documented time clearly exceeds the primary code's requirement by the necessary increment.


NEW QUESTION # 397
Which punctuation is used in the ICD-10-CM Tabular List to denote synonyms, alternative wording, or explanatory phrases?

Answer: C

Explanation:
In the ICD-10-CM Tabular List, square brackets [ ] (Brackets) are used to enclose synonyms, alternative wording, or explanatory phrases. This is a punctuation convention taught for ICD-10-CM and is tested on CPC.
To avoid confusion with other punctuation:
Parentheses ( ) indicate nonessential modifiers (supplementary words that may be present or absent without affecting the code selection).
A semicolon ( ; ) is used in the Tabular List to show that additional modifying words (that follow the semicolon) are required to complete the diagnostic statement.
Colons ( : ) are used after an incomplete term that needs one or more modifying terms to make it assignable.


NEW QUESTION # 398
(A patient is in her otolaryngologist's office to receive therapeutic treatment forasthmatic bronchitis with status asthmaticus. A subcutaneous injection ofomalizumab (150 mg)is given in her left upper arm. What is the CPT and ICD-10-CM coding?)

Answer: B

Explanation:
Omalizumab is a drug reported withHCPCS J2357, and the dose is converted into billable units based on the code's unit definition. In CPC-style questions,150 mgis commonly represented asJ2357 × 30 units(i.e., 5 mg per unit # 150/5 = 30). Administration is atherapeutic subcutaneous injection, reported with96372(therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular). Vaccine administration codes (90460
/90471) are not appropriate because omalizumab is not a vaccine. For diagnosis, the statement includesstatus asthmaticusbut does not specify severity category (mild/moderate/severe persistent). In the options provided, J45.902is the "unspecified asthma with status asthmaticus" concept, whereas J45.52 requires severe persistent asthma with status asthmaticus (not documented). Therefore, the correct pairing is96372 + J2357 × 30 + J45.
902. CPC exam tip: match administration code type (therapeutic injection vs immunization) and choose the most specific ICD-10-CM supported by documentation.


NEW QUESTION # 399
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