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AAPC CPC Prüfungsplan:

ThemaEinzelheiten
Thema 1
  • 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.
Thema 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.
Thema 3
  • 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.
Thema 4
  • 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.
Thema 5
  • 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.
Thema 6
  • 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.
Thema 7
  • 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.
Thema 8
  • 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.
Thema 9
  • 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.
Thema 10
  • 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.
Thema 11
  • 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.
Thema 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.
Thema 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.
Thema 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.
Thema 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.
Thema 16
  • 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.
Thema 17
  • 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.

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AAPC Certified Professional Coder (CPC) Exam CPC Prüfungsfragen mit Lösungen (Q35-Q40):

35. Frage
Which is a TRUE statement for Place of Service (POS) codes for professional claims?

Antwort: B

Begründung:
Place of Service (POS) codes are two-digit numeric codes used on professional claims to identify where a service was performed (e.g., office, inpatient hospital, outpatient hospital).
Reporting an incorrect POS can affect reimbursement and may result in claim denial ✔ POS codes are not alphanumeric They describe many locations, not just ICU POS codes are maintained by CMS, not found in the ICD-10-CM code book


36. Frage
(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?)

Antwort: A

Begründung:
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.


37. Frage
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 and ICD-10-CM codes are reported?

Antwort: B

Begründung:
27380 = Repair, quadriceps muscle
S76.311A = Strain of muscle, fascia, tendon of right thigh, initial encounter Code selection is based on specific muscle group and laterality


38. Frage
A surgeon performed Mohs micrographic surgery on a lesion on the right arm. This required one stage with six tissue blocks.
What CPT@ codes are reported for the Mohs surgery?

Antwort: C

Begründung:
For Mohs micrographic surgery, CPTcoding is based on the anatomic location of the lesion, the number of stages, and the number of tissue blocks per stage.
17311: This code is used for Mohs surgery on body areas such as the trunk, arms, or legs for the first stage.
17315: This is an add-on code used when more than five tissue blocks are examined in a single stage. Since this case involved six tissue blocks, 17315 is appropriate.
Explanation of incorrect answers:
A: 17313, 17314, 17315: Incorrect, as 17313 applies to the head, neck, hands, feet, or genitalia, not the arm.
C: 17313, 17315: Incorrect, as 17313 is not appropriate for the arm.
D: 17311, 17312, 17315: 17312 is used for additional stages beyond the first, which is not applicable here since only one stage was performed.
E: 85B2-335 is not a valid CPT code for Mohs surgery.
Thus, the correct answer is B. 17311, 17315, which accurately reflects a single-stage Mohs surgery with six tissue blocks on the arm.


39. Frage
(A 55-year-old female with severe coronary arteriosclerosis with angina is admitted for elective coronary artery bypass. The surgeon performed a coronary artery bypass using asaphenous vein harvested endoscopically. The vein graft was anastomosed to theobtuse marginaland theleft circumflex. What CPT coding is reported for this procedure?)

Antwort: D

Begründung:
CABG coding depends on(1) number of coronary venous graftsand(2) the conduit type(venous vs arterial).
This case uses asaphenous vein graft(a venous conduit) to bypasstwocoronary targets: theobtuse marginaland theleft circumflex. The CPT code for CABG withtwo venous graftsis33511. The separate code33508is reported forendoscopic harvest of veinwhen performed for CABG, which is specifically documented here ("harvested endoscopically").33534is for anarterial graft(e.g., internal mammary artery) and does not match a saphenous vein-only description. Option D omits the separately reportable endoscopic harvest service documented. CPC exam approach: identify conduit (vein = 33510-33516 family), count distal anastomoses (two = 33511), and add endoscopic harvest (33508) when documented.


40. Frage
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