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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
  • 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 3
  • 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 4
  • 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 5
  • 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 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
  • 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
  • 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 9
  • 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 10
  • 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 11
  • 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 12
  • 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 13
  • 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 14
  • 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 15
  • 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 16
  • 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 17
  • 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.

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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q27-Q32):

NEW QUESTION # 27
(The physician performs adiagnostic ERCPof the common bile duct with insertion of astentinto the biliary duct. What CPT coding is reported?)

Answer: B

Explanation:
For ERCP, CPT coding follows the rule that thetherapeutic ERCP code includes the diagnostic ERCP workperformed during the same session. In this case, the key performed service isstent insertion into the biliary duct, which is captured by43274(ERCP with placement of endoscopic stent into biliary or pancreatic duct). You donotseparately report the diagnostic ERCP code43260when the therapeutic service (stent placement) is performed, because the diagnostic component is considered part of the overall ERCP service.
Code43276is used forstent removal and/or exchange, which is not described here. Option D is incorrect because it pairs another ERCP service with stent placement, and the scenario does not support multiple distinct ERCP therapeutic services beyond stenting. CPC exam tip: when a single ERCP session includes diagnostic evaluation plus a therapeutic intervention, report themost definitive therapeutic ERCP code-here,
43274.


NEW QUESTION # 28
A patient presents with 26 skin tags on the neck and shoulder. The provider removes all using a scissoring technique.
What CPT coding is reported?

Answer: A

Explanation:
11200 = removal of up to 15 skin tags
11201 = each additional 10 lesions or part thereof
26 lesions = 15 + 11 # 11201 ×2


NEW QUESTION # 29
A witness of a traffic accident called 911. An ambulance with emergency basic life support arrived at the scene of the accident. The injured party was stabilized and taken to the hospital. What HCPCS Level II coding is reported for the ambulance's service?

Answer: B

Explanation:
The scenario describes an emergency basic life support (BLS) ambulance service. The appropriate HCPCS Level II code for BLS emergency transport is A0429.
Modifier QN indicates that the service was provided by an ambulance supplier, and SH indicates the services were provided in an emergency situation.
HCPCS Level II, current year


NEW QUESTION # 30
A patient presents with recurrent spontaneous episodes of dizziness of unclear etiology. Caloric vestibular testing is performed irrigating both ears with warm and cold water while evaluating the patient's eye movements. There is a total of three irrigations.
What CPT coding is reported?

Answer: B

Explanation:
* Procedure: Caloric vestibular testing performed on both ears with three irrigations.
* CPT Code:
* 92537: Caloric vestibular test with recording, bilateral; bithermal (i.e., one warm and one cool irrigation in each ear).
* Modifier -50: Bilateral procedure.
* Code Selection Justification: The procedure performed was bilateral caloric vestibular testing with bithermal irrigation, appropriately coded with 92537 and modifier -50 for bilateral procedures.
References:
* AMA CPT Professional Edition (current year)


NEW QUESTION # 31
A Medicare patient is scheduled for a screening colonoscopy.
What code is reported for Medicare?

Answer: D


NEW QUESTION # 32
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