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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 2
  • 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 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
  • 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 5
  • 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 6
  • 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 7
  • 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 8
  • 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 9
  • 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 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
  • 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 12
  • 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 13
  • 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 14
  • 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 15
  • 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 16
  • 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 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 Sample Questions (Q307-Q312):

NEW QUESTION # 307
A patient with empyema requires a Schede thoracoplasty.
What CPT code is reported for this procedure?

Answer: D

Explanation:
The Schede thoracoplasty for empyema is accurately described by CPT code 32905, which covers the radical procedure involving the resection of multiple ribs and often the obliteration of the pleural cavity to treat chronic empyema.
Reference:
AMA's CPT Professional Edition (current year)


NEW QUESTION # 308
A patient with compression fractures of L5 and the sacrum undergoes vertebroplasty, with cement injected into two vertebral bodies, performed bilaterally.
What CPT coding is reported?

Answer: B

Explanation:
22514 = Vertebroplasty, lumbar (L5)
22515 = Each additional vertebral body (sacrum)
Vertebroplasty codes are inherently bilateral, so modifier -50 is not used


NEW QUESTION # 309
A patient with three thyroid nodules is seen for an FNA biopsy. Using ultrasonic guidance, the provider inserts a 25-gauge needle into each nodule. Nodular tissue is aspirated and sent to pathology.
What CPT coding reported?

Answer: D

Explanation:
The CPT code 10005 is for fine needle aspiration biopsy, including ultrasound guidance, for the first lesion. CPT code 10006 is for each additional lesion with ultrasound guidance. Since the provider aspirated tissue from three nodules, the coding should be 10005 for the first nodule and 10006 x 2 for the additional two nodules.
AMA's CPT Professional Edition (current year)


NEW QUESTION # 310
A 56-year-old female patient with a history of degenerative disc disease at levels T2-T3 and T4-T5 underwent a surgical repair procedure. Two surgeons will be working together as primary surgeons Surgeon X: Carried out the anterior exposure of the spine and mobilized the great vessels, assisted Dr. Z. and performed the closure.
Surgeon Z: Performed a minimal anterior discectomy and fusion at T2-T3 and T4-T5 levels using an anterior interbody technique and solely performed utilizing a structural allograft.
What is the CPT coding for the two surgeons?

Answer: D

Explanation:
The case describes two primary surgeons working together, which supports modifier 62 (co-surgeons) on the spine fusion/discectomy codes.
22556 = primary level anterior thoracic discectomy and fusion (T2-T3)
22585 = each additional thoracic level (T4-T5)
20931 = structural allograft (reported by the surgeon who solely performed/placed the structural allograft, per the statement-Surgeon Z) Why D fits best:
Surgeon X performed the approach/exposure and closure and assisted the primary surgeon → reports the co-surgeon spine procedure codes (22556-62, 22585-62).
Surgeon Z performed the discectomy/fusion and solely performed utilizing a structural allograft → reports 22556-62, 22585-62, plus 20931.
Options with -51 are not correct here (and add-on/related reporting logic in CPT does not support the way -51 is applied in those options).


NEW QUESTION # 311
An air bag deployed when a driver lost control of the car and crashed into a guardrail on the side of the highway. The driver suffers partial impact resulting in a skull fracture of the anterior cranial base. The fracture is diagnosed using the MRI scanner and cerebrospinal fluid is noted dripping via the sphenoid sinus into the right nasal passage. The patient requires a surgical nasal sinus endoscopy to assess and repair the injury.
What is the correct procedure and diagnosis coding combination to report this service?

Answer: D

Explanation:
1. Procedure and CPTCode Selection:
The patient requires a surgical nasal sinus endoscopy to repair a cerebrospinal fluid (CSF) leak caused by a skull fracture that resulted in CSF draining into the nasal passage.
Code 31291 is the correct CPTcode for an endoscopic repair of a cerebrospinal fluid leak in the sphenoid sinus. This procedure code is appropriate because it specifically addresses surgical endoscopy for CSF leak repair in the sinus region.
Other codes provided, such as 31287 (nasal/sinus endoscopy with balloon dilation) and 31235 (nasal endoscopy with biopsy), do not match the description for surgical repair of a CSF leak and are therefore inappropriate for this case.
2. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code S02.19XA is used to describe a fracture of the anterior cranial base, which fits the described injury of the skull with cerebrospinal fluid leakage.
External cause code V47.5XXA is used for motor vehicle accidents involving a car hitting a stationary object.
Y92.411 is the appropriate code to describe the location of the accident as a highway.
3. Exclusion of Additional Procedure Codes:
There is no need for a second endoscopy code or a modifier, as 31291 fully describes the endoscopic repair procedure for the CSF leak.
4. AAPC and CPTCoding Guidelines:
Per AAPC guidelines, procedure codes for sinus endoscopy are chosen based on the specific type of intervention (e.g., CSF leak repair). The guidelines for ICD-10-CM stress including external cause codes and location codes for trauma cases related to motor vehicle accidents.
Thus, the correct answer based on CPTand ICD-10-CM coding standards is B. 31291, S02.19XA, V47.
5XXA, Y92.411.


NEW QUESTION # 312
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