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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 2
  • 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 3
  • 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 4
  • 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 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.
Topic 6
  • 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 7
  • 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 8
  • 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 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.
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
  • 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 13
  • 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 14
  • 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 15
  • 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 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.
Topic 17
  • 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.

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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q359-Q364):

NEW QUESTION # 359
Mr. Roland has difficulty breathing and congestion with a productive cough. The physician takes frontal and lateral view chest X-rays in the office (the equipment is owned by the physician group). The physician reads the X-rays and determines a diagnosis of walking pneumonia. The physician's interpretation is placed in the patient's chart.
How does the physician bill for the chest X-ray?

Answer: A

Explanation:
For a physician who owns the equipment and interprets the chest X-rays (both frontal and lateral views), code
71046 is used. This code includes both the technical and professional components, as the equipment is owned by the physician group and the physician also provides the interpretation.
References:
* AMA's CPT Professional Edition (current year)
* ICD-10-CM (current year)


NEW QUESTION # 360
Eric is buying his first life insurance policy from XYZ Life Insurance Company. The company requires Eric have a physical exam prior to issuance of the policy. Eric sees his primary care provider who completes the required documentation and forms provided by the insurance company.
How does the primary care provider report his services?

Answer: D


NEW QUESTION # 361
A cardiologist uses the hospital's equipment for a cardiac stress test as he doesn't own equipment for the test.
He supervises the test and provides the interpretation and report of the test.
What CPT codes are reported?

Answer: D

Explanation:
* Procedure: Cardiac stress test performed using hospital's equipment with the cardiologist providing supervision, interpretation, and report.
* CPT Codes:
* 93016: This code is for supervision only without provision of the equipment.
* 93018: This code is for interpretation and report only.
* Code Selection Justification: Since the cardiologist does not own the equipment, codes 93016 and
93018 correctly represent the supervision, interpretation, and report of the test.
References:
* AMA CPT Professional Edition (current year)


NEW QUESTION # 362
(Full Case:Pre/Post-op diagnosis:Grade 1 endometrial cancer.Procedure:Radical hysterectomy and pelvic lymph node sampling.Anesthesia:General.EBL:400 mL.Complications:None.Specimens:pelvic washings; uterus; tubes; ovaries; pelvic lymph nodes.Fluids:2 L crystalloid.Operative details:frog-leg position; perineum prepped sterile; Foley placed; midline vertical incision umbilicus to symphysis; exploration shows normal upper abdomen and bowel; no paraaortic adenopathy; pelvis/perineum normal; washings collected; round ligaments transected; retroperitoneal spaces opened; ureters visualized; ovarian vessels isolated/ligated; bladder flap taken down; uterine arteries, uterosacral and cardinal ligaments clamped/ligated; uterus removed; vagina closed; lymph node sampling left then right with removal of lymphatic tissue from external/internal iliac bifurcation to circumflex iliac vein and down to obturator nerve; tumor ~40% endometrial surface with
<50% myometrial invasion; closure in layers; patient tolerated well.Question:What CPT codes are reported?)

Answer: D

Explanation:
The operative note describes anopen radical hysterectomyfor endometrial cancer with removal of theuterus, tubes, and ovaries(specimens listed) and extensive dissection ofuterine arteries, uterosacral and cardinal ligaments, consistent with aradicalprocedure. The approach is clearlyabdominal/open(midline vertical incision and abdominal entry), not laparoscopic, so a laparoscopic radical hysterectomy code (such as 58548) is not appropriate. In the answer set,58210represents aradical abdominal hysterectomy(with appropriate extent for malignancy management). In addition, the surgeon performedpelvic lymph node samplingbilaterally, removing lymphatic tissue along the iliac vessels to the obturator nerve region. The correct code in the choices for pelvic lymphadenectomy/sampling is38770. Pelvic washings and extensive exploration are included in the primary surgical service and do not add separate CPT codes in this scenario. Therefore, the correct coding combination is58210 and 38770.


NEW QUESTION # 363
Patient is admitted in observation care on 12/2/20XX in the morning for acute asthma exacerbation. The ED physician requires the patient to stay overnight. Next day, 12/3/20XX the patient is discharged from observation care in the afternoon. Patient's total stay in observation was 16 hours.
What E/M categories and code ranges are appropriate to report?

Answer: A

Explanation:
1. E/M Code Category Selection:
The patient was placed in observation care on 12/2/20XX for an acute asthma exacerbation and stayed in observation for a total of 16 hours, with discharge occurring on 12/3/20XX.
The appropriate E/M category for patients in observation care for a period that includes both admission and discharge on separate calendar dates is "Hospital Inpatient or Observation Care Services", with specific codes for admission and discharge on different dates.
2. Code Range and Specific Codes:
Code Range 99234-99236 applies to cases where observation care includes both admission and discharge, particularly when they occur on different calendar days and the total duration of care is under 24 hours.
For discharge on the subsequent day, 99238-99239 (Hospital Inpatient or Observation Discharge Services) applies, depending on the time spent on discharge.
3. Rationale for Excluding Other Options:
Option B and Option D include Initial Hospital Inpatient or Observation Care codes (99221-99223), which are typically used for admissions to inpatient care rather than for observation care scenarios as presented here.
Option C incorrectly combines Subsequent Inpatient or Observation Care codes (99231-99233), which are used for follow-up days rather than discharge services.
4. AAPC and CPT Coding Guidelines:
According to CPT guidelines, the 99234-99236 code range is used when observation care requires both admission and discharge on different dates, and 99238-99239 is appropriate for discharge services.
Therefore, the correct answer is A. Hospital Inpatient or Observation Care Services (Including Admission and Discharge Services) (99234-99236) and Hospital Inpatient or Observation Discharge services (99238-99239).


NEW QUESTION # 364
......

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