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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 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
  • 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 4
  • 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 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
  • 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 8
  • 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 9
  • 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 10
  • 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 11
  • 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 12
  • 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 13
  • 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 14
  • 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 15
  • 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 16
  • 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 (Q48-Q53):

NEW QUESTION # 48
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: B

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 # 49
A surgeon removes the right and left fallopian tubes and the left ovary via an abdominal incision. How is this reported?

Answer: D

Explanation:
Bilateral salpingo-oophorectomy: This involves the removal of both fallopian tubes and ovaries.
Right and left fallopian tubes: Both fallopian tubes are removed.
Left ovary: Only the left ovary is removed.
Abdominal incision: The procedure is performed via an abdominal approach.
58720: Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure).
The procedure involves the removal of both fallopian tubes and one ovary, making 58720 the appropriate code.
Reference:
AMA's CPT Professional Edition (current year)
ICD-10-CM (current year), HCPCS Level II (current year)


NEW QUESTION # 50
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 # 51
Miranda is in her provider's office for follow up of her diabetes. Her blood sugars remain at goal with continuing her prescribed medications.
When referring to the MDM Table in the CPTcode book for number and complexity of problems addressed at the encounter, what type of problem is this considered?

Answer: C

Explanation:
1. Problem Type Selection:
Miranda is following up on her diabetes, which is a chronic condition. Her blood sugars are controlled, indicating that the condition is stable with her current medication regimen.
Stable, chronic illness is defined in the CPTMDM (Medical Decision Making) Table as a chronic condition that is under control and not currently worsening, even if ongoing management is required. This aligns with the patient's diabetes being well-managed with her prescribed medications.
2. Rationale for Excluding Other Options:
A: Acute, uncomplicated illness or injury is not applicable as diabetes is a chronic condition, not an acute issue.
B: Minimal problem refers to conditions that are minor or self-limited and typically require little to no treatment, which does not apply to chronic conditions like diabetes.
D: Stable, acute illness would refer to an acute condition that has stabilized, whereas diabetes is a chronic condition, not acute.
3. AAPC and CPTCoding Guidelines:
According to the CPTMDM Table, a "Stable, chronic illness" is the correct classification for a follow-up encounter on a controlled chronic condition like diabetes.
Therefore, the correct answer is C. Stable, chronic illness.


NEW QUESTION # 52
(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: C

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 # 53
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