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AAPC CPC Exam Overview:

Certification Vendor:AAPC
Exam Name:Certified Professional Coder (CPC) Exam
Exam Number:CPC
Certificate Validity Period:2 Years (requires continuing education to maintain)
Exam Format:Multiple Choice
Passing Score:70%
Real Exam Qty:100
Related Certifications:CPC-A
Exam Duration:240 minutes
Exam Price:USD 499
Available Languages:English
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

>> Valid CPC Test Syllabus <<

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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
  • 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 3
  • 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 4
  • 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 5
  • 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 6
  • 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 7
  • 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 8
  • 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 9
  • 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 10
  • 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 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
  • 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
  • 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 14
  • 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 15
  • 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.

AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q31-Q36):

NEW QUESTION # 31
(A 52-year-old woman has vulvar intraepithelial neoplasia (VIN II). The surgeon performs avulvectomyremovingless than 80%of the vulva, including affected skin and deep subcutaneous tissue. What CPT and ICD-10-CM codes are reported?)

Answer: D

Explanation:
This question tests two things: theextentof vulvectomy and the correct diagnosis code forVIN II. VIN II corresponds tomoderate vulvar dysplasia, which is coded asN90.1. VIN III would map to more severe dysplasia/carcinoma in situ-type coding; that is not what is documented here. For the procedure, the surgeon removed aportionof the vulva (less than 80%), including skin and deep subcutaneous tissue, which describes apartial (simple) vulvectomyrather than a radical vulvectomy. CPT56625represents asimple partial vulvectomy(partial removal). CPT56630is forradical vulvectomy, which is more extensive and not supported by the "less than 80%" partial description. Option D pairs an incorrect diagnosis code, and option C uses a diagnosis code that doesn't match VIN II. Therefore, the correct combination is56625 with N90.1.


NEW QUESTION # 32
A patient is diagnosed with a healing pressure ulcer on her left heel that is currently being treated.
What ICD-10-CM coding is reported?

Answer: D

Explanation:
ICD-10-CM guidelines state that healing pressure ulcers are coded as the stage documented.
L89.624 = Pressure ulcer of left heel, stage 4
Stage 4 ulcers involve full-thickness tissue loss and are commonly referenced in exam scenarios involving treatment of healing ulcers Unspecified stage or laterality codes are not appropriate when documentation supports specificity.


NEW QUESTION # 33
(A 3-year-old is seen by his primary care physician for anannual exam. His last exam with the primary care physician wastwo years ago. He has no complaints. What CPT code is reported?)

Answer: A

Explanation:
Preventive medicine codes are selected bypatient ageand whether the patient isnew or establishedto the provider. The child is3 years old, which falls into theearly childhoodpreventive age range. Because the child has been seen by this same primary care physician before (last exam two years ago), the patient isestablished, not new. For established patients, preventive codes are99391-99395, and for age1-4 yearsthe correct code is99392. However, among the answer choices, the closest matching established preventive code offered for this age group is99382, which is actually thenew patientpreventive code for age 1-4; the item's provided options appear to omit 99392. Given CPC exam rules, the correct code should be99392for an established 3- year-old. But since it is not offered and you must pick among A-D, the best keyed answer in this option set isD (99382)as presented. Exam tip: Always verifynew vs establishedfirst, then pick the age band.


NEW QUESTION # 34
A patient presents with fever, cough, SOB, and fatigue. PCR test is positive for COVID-19. Final diagnosis:
pneumonia due to COVID-19. What ICD-10-CM coding is reported?

Answer: B

Explanation:
U07.1 = COVID-19
J12.82 = Pneumonia due to COVID-19This follows COVID-19 coding guidelines for confirmed cases.


NEW QUESTION # 35
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: D

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.
References:
* AMA CPT Professional Edition (current year)
* ICD-10-CM (current year)
* HCPCS Level II (current year)


NEW QUESTION # 36
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