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AAPC CPC Exam Overview:
| Certification Vendor: | AAPC (American Academy of Professional Coders) |
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| Exam Name: | Certified Professional Coder (CPC) Exam |
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| Exam Number: | CPC |
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| Available Languages: | English |
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| Passing Score: | 70% |
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| Exam Price: | $425 (1 attempt), $499 (2 attempts) |
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| Related Certifications: | CPCO CPC-P CPMA CRC |
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| Exam Duration: | 240 minutes |
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| Real Exam Qty: | 100 |
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| Certificate Validity Period: | 3 years |
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| Exam Format: | Open-book, Scenario-based, Multiple-choice |
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| Recommended Training: | AAPC CPC Training Courses |
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| Exam Registration: | AAPC Official Registration |
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| Sample Questions: | AAPC CPC Sample Questions |
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| Exam Way: | Online proctored or in-person at authorized testing centers |
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| Pre Condition: | No mandatory prerequisites; recommended knowledge of medical terminology, anatomy, coding systems; AAPC membership required to register |
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| Official Syllabus URL: | https://www.aapc.com/certifications/cpc |
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| Topic | Details |
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| 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.
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| Topic 2 | - 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 3 | - 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 4 | - 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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| Topic 5 | - 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.
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| 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.
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| 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.
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| Topic 8 | - 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 9 | - 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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| Topic 10 | - 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.:
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| Topic 11 | - 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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| Topic 12 | - 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 13 | - 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 14 | - 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.
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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q410-Q415):
NEW QUESTION # 410
Preoperative diagnosis: Right thigh benign congenital hairy nevus. *1
Postoperative diagnosis: Right thigh benign congenital hairy 0 nevus.
Operation performed: Excision of right thigh benign congenital>1
nevus, excision size with margins 4.5 cm and closure size 5 cm.
Anesthesia: General.0
Intraoperative antibiotics: Ancef.0
Indications: The patient is a 5-year-old girl who presented with her parents for evaluation of her right thigh congenital nevus. It has been followed by pediatrics and thought to have changed over the past year. Family requested excision. They understood the risks involved, which included but were not limited to risks of general anesthesia, infection, bleeding, wound dehiscence, and poor scar formation. They understood the scar would likely widen as the child grows because of the location of it and because of the age of the patient. They consented to proceed.
Description of procedure: The patient was seen preoperatively in > I the holding area, identified, and then brought to the operating room. Once adequate general anesthesia had been induced, the patient's right thigh was prepped and draped in standard surgical fashion. An elliptical excision measuring 6 x 1.8 cm had been marked. This was injected with Lidocaine with epinephrine, total of 6 cc of 1% with 1:100,000. After an adequate amount of time, a #15 blade was used to sharply excise this full thickness.
This was passed to pathology for review. The wound required # limited undermining in the deep subcutaneous plane on both sides for approximately 1.5 cm in order to allow mobilization of the skin for closure. The skin was then closed in a layered fashion using 3-0 Vicryl on the dermis and then 4-0 Monocryl running subcuticular in the skin, the wound was cleaned and dressed with Dermabond and Steri-Strips.
The patient was then cleaned and turned over to anesthesia for S extubation.
She was extubated successfully in the operating room and taken S to the recovery room in stable condition.
There were no complications.
What CPT coding is reported?
- A. 52356-RT
- B. 52320-RT, 52332-RT
- C. 52353-RT, 52332-RT
- D. 52356-RT, 52332-RT
Answer: A
Explanation:
52356 = Cystourethroscopy with ureteroscopy, lithotripsy and stent placement Combination code # do not report components separately
NEW QUESTION # 411
A diagnostic mammogram is performed on the left and right breasts. Computer-aided detection is also used to further analyze the image for possible lesions.
What CPT coding is reported for this radiology service?
- A. 77066-50
- B. 0
- C. 77067-50
- D. 77065-LT, 77065-RT
Answer: B
NEW QUESTION # 412
A patient presents to the ER with a large sacral pressure ulcer measuring 7 cm. The provider excised the ulcer with 3 mm margins, removed muscle and segmental bone, and performed a layered skin flap closure.
What CPT and ICD-10-CM coding is reported?
- A. 15931, L89.153
- B. 15935, L89.156
- C. 15933, L89.153
- D. 15937, L89.156
Answer: D
Explanation:
Pressure ulcer excision with bone involvement → CPT 15937 (sacral, with ostectomy) Stage 4 pressure ulcer → L89.156 (sacral region with necrosis of bone)
NEW QUESTION # 413
(When a provider's documentation refers touse, abuse, and dependenceof the same substance (e.g., alcohol), which statement is correct?)
- A. If use, abuse, and dependence are documented, report all three codes separately.
- B. If both use and abuse are documented, assign abuse as the first code and use as the additional code.
- C. If both use and dependence are documented, assign only the code for dependence.
- D. If both abuse and dependence are documented, assign only the code for abuse.
Answer: C
Explanation:
ICD-10-CM has a clear hierarchy when the same substance is documented with multiple levels of severity.
Dependencerepresents a higher severity classification thanabuse, andabuseis higher thanuse. When two or more of these are documented for the same substance, you generally assignonly one code, selecting thehighest level of severitysupported: dependence over abuse, and abuse over use. Therefore, if bothuse and dependenceare documented, you assigndependence only(Option D). Option A is incorrect because you do not code both use and abuse for the same substance; you choose the higher severity (abuse). Option B is incorrect because if abuse and dependence are both documented, you would codedependence, not abuse. Option C is incorrect because ICD-10-CM does not support reporting all three separately for the same substance; doing so would be duplicative and noncompliant. CPC exam tip: remember the mnemonicD-A-U#Dependence > Abuse > Use(pick the highest).
NEW QUESTION # 414
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?
- A. L89.624
- B. L89.629
- C. L89.609
- D. L89.626
Answer: A
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 # 415
......
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