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AAPC CPC Prüfungsplan:

ThemaEinzelheiten
Thema 1
  • 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 2
  • 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 3
  • 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 4
  • 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.:
Thema 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.
Thema 6
  • 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 7
  • 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 8
  • 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 9
  • 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 10
  • 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 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.
Thema 12
  • 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.
Thema 13
  • 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 14
  • 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 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.
Thema 16
  • 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.
Thema 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.
Thema 18
  • 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 19
  • 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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AAPC Certified Professional Coder (CPC) Exam CPC Prüfungsfragen mit Lösungen (Q209-Q214):

209. Frage
A 35-year-old female has cancer in her left breast. The surgeon performs a mastectomy, removing the breast tissue, skin, pectoral muscles, and surrounding tissue, including the axillary and internal mammary lymph nodes.
Which mastectomy code is reported?

Antwort: C


210. Frage
Dr. Carter sees Mrs. White at the Spring Valley Nursing Facility. He saw her last month after she was admitted to the facility. Today is a follow up visit. She is doing well. He documented a medically appropriate history and exam. The patient has osteoporosis, hypertension, dementia. CAD, CHF, and type 2 diabetes (moderate number and complexity of problems). He reviews 4 labs and a telemetry (Moderate data). He adds a Cardizem prescription for better control of her blood pressure which is a moderate risk. What CPT code does Dr. Carter report for the visit?

Antwort: C

Begründung:
This is a subsequent nursing facility care visit.
MDM Analysis (2021+ E/M Guidelines):
Problems: Multiple chronic conditions → Moderate
Data: 4 labs + telemetry → Moderate
Risk: Prescription drug management → Moderate
99309 - Subsequent nursing facility care, moderate MDM
Why others are incorrect:
99307 / 99308 - Low complexity
99305 - Initial nursing facility care


211. Frage
A patient presents with fever, cough, SOB, and a recent history of COVID-19. A PCR test was positive for COVID-19. The provider documents a final diagnosis of "pneumonia with history of COVID-19." What ICD-10-CM coding is reported?

Antwort: C

Begründung:
The provider documents history of COVID-19, not active COVID-19.
Z86.16 = Personal history of COVID-19
J18.9 = Pneumonia, unspecified organism
Codes U07.1 and U09.9 are for current or post-COVID conditions, which are not documented here. Therefore, A is correct.


212. Frage
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?

Antwort: A

Begründung:
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)


213. Frage
A physician orders an obstetric panel that includes syphilis screening using the non-treponemal antibody approach, an automated CBC with manual differential WBC count, HBsAg, rubella antibody, a serum antibody screen, and ABO and Rh blood typing.
What CPTcoding is reported?

Antwort: C

Begründung:
1. Procedure and CPTCode Selection:
The obstetric panel ordered includes the following tests: syphilis screening (non-treponemal), automated CBC with manual differential WBC count, HBsAg, rubella antibody, serum antibody screen, and ABO/Rh blood typing.
CPTCode 80055 is for a comprehensive obstetric panel that includes all these components. This code is intended to report the entire panel of tests as a bundled service rather than itemizing each individual test.
2. Rationale for Excluding Other Options:
Option B lists the individual component codes for each test in the obstetric panel (e.g., 85027, 85007, 87340, etc.), but using 80055 is more appropriate because it provides a single code to report the full obstetric panel and follows CPTbundling guidelines.
Option C also lists the individual tests separately, which is unnecessary when 80055 includes all these components.
Option D lists 80081, which is for an obstetric panel that includes HIV testing. Since HIV testing is not part of the tests described in this scenario, 80081 is incorrect.
3. AAPC and CPTCoding Guidelines:
AAPC guidelines recommend using the single code 80055 when all components of an obstetric panel are ordered together, as itemizing each test individually is not necessary.
Therefore, the correct answer is A. 80055.


214. Frage
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