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AAPC CPC Exam Overview:

Certification Vendor:AAPC (American Academy of Professional Coders)
Exam Name:Certified Professional Coder (CPC) Exam
Exam Number:CPC
Exam Duration:240 minutes
Related Certifications:CPMA
CRC
CPC-P
CPCO
Available Languages:English
Exam Price:$425 (1 attempt), $499 (2 attempts)
Certificate Validity Period:3 years
Exam Format:Scenario-based, Open-book, Multiple-choice
Passing Score:70%
Real Exam Qty:100
Recommended Training:AAPC CPC Training Courses
Exam Registration:AAPC Official Registration
Sample Questions:AAPC CPC Sample Questions
Exam Way:Online proctored or in-person at authorized testing centers
Pre Condition:No mandatory prerequisites; recommended knowledge of medical terminology, anatomy, coding systems; AAPC membership required to register
Official Syllabus URL:https://www.aapc.com/certifications/cpc

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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 2
  • 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 3
  • 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 4
  • 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 5
  • 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 6
  • 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 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.
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
  • 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 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
  • 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.

AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q452-Q457):

NEW QUESTION # 452
A patient is seen at the doctor's office for nausea, vomiting, and sharp right lower abdominal pain. CT scan of the abdomen is ordered. Labs come back indicating an increased WBC count with review of the abdominal CT scan. The physician determines the patient has chronic appendicitis. The physician schedules an appendectomy and takes the patient to the operating room. The appendix is severed from the intestines and removed via scope inserted through an umbilical incision. What CPT and diagnosis codes are reported?

Answer: C

Explanation:
1. Procedure and CPT Code Selection:
The patient underwent an appendectomy performed via laparoscopic approach. The procedure involved removal of the appendix using a scope inserted through an umbilical incision.
CPT Code 44970 is specific for a laparoscopic appendectomy, which is the correct code for this procedure.
Code 44950 would be used for an open appendectomy, but since this case was performed laparoscopically, 44970 is appropriate.
2. Diagnosis and ICD-10-CM Code Selection:
The diagnosis given by the physician is chronic appendicitis.
ICD-10-CM Code K36 is used to report chronic appendicitis, which is the definitive diagnosis in this case.
Additional codes for symptoms such as nausea (R11.2) and right lower quadrant pain (R10.31) are not necessary because the primary diagnosis of chronic appendicitis (K36) fully explains the symptoms, according to ICD-10-CM guidelines on coding symptoms when a definitive diagnosis is available.
3. AAPC and CPT Coding Guidelines:
AAPC guidelines indicate that when a definitive diagnosis is established, symptom codes should not be reported separately. The use of 44970 for laparoscopic appendectomy and K36 for chronic appendicitis is fully supported by these coding standards.
Therefore, the correct answer is C. 44970, K36.


NEW QUESTION # 453
Mr. Woolridge has had a suspicious lesion on his left shoulder for approximately eight weeks that is not healing. On the dermatologist's exam of left shoulder blade, there is excoriation and scabbing and the lesion not healing. Patient agrees and wishes to proceed with a punch biopsy of the lesion. A punch biopsy is taken of the lesion and sent to pathology. A simple repair is performed at the biopsy site.
What CPT and ICD-10-CM codes are reported?

Answer: B

Explanation:
CPT code 11102 is for punch biopsy of skin, including simple closure. CPT code 12001-51 is for simple repair of superficial wounds, with modifier 51 indicating multiple procedures. ICD-10-CM code D49.2 is used for a neoplasm of unspecified behavior of the bone, soft tissue, and skin. This coding accurately reflects the punch biopsy and simple repair performed on the lesion.
AMA's CPT Professional Edition (current year), ICD-10-CM (current year)


NEW QUESTION # 454
Patient has esotropia of the right eye and presents to operating suite for strabismus surgery. The physician resects the medial rectus horizontal and lateral rectus muscles of the eye and secures them with adjustable sutures. Extensive scar tissue is noted, due to a previous surgery involving an extraocular muscle. Extraocular muscle is isolated, and the muscle is freed from surrounding scar tissues.
What CPT codes are reported for this surgery?

Answer: C


NEW QUESTION # 455
A 7-year-old boy was brought 10 the ED by his mother after he had been playing with small beads and one got lodged in his right external ear canal. After examination, the physician decided to remove the foreign body from the external auditory canal using alligator forceps without anesthesia.
What CPT code is reported?

Answer: B

Explanation:
69200 - Removal of foreign body from external auditory canal; without anesthesia Correct for simple removal using forceps Patient tolerated procedure without anesthesia Why Other Options Are Incorrect:
69110 / 69105 - Middle ear procedures
69205 - Removal with general anesthesia


NEW QUESTION # 456
(A 58-year-old patient undergoes diagnostic facet joint injections. The physician performsbilateral paravertebral facet joint injectionsat theT2-T3, T3-T4, and T4-T5levels, usingfluoroscopic guidanceat each site. What CPT coding is reported for this encounter?)

Answer: D

Explanation:
Facet joint injections (medial branch blocks/intra-articular depending on code family) are coded byspinal regionandnumber of levels. Thoracic facet injections use64490for thefirst level,64491for thesecond level, and64492for thethird and each additional level(within the thoracic region). This case includesthree thoracic levels: T2-T3 (1st), T3-T4 (2nd), and T4-T5 (3rd). Because the injections arebilateral, you applymodifier -50 to each of the level codes per the answer set's style. Fluoroscopic guidance isbuilt intothese injection codes under current CPT rules, so you donotseparately report a fluoroscopy code (such as 76000). Options B and C are forlumbar/sacralfacet injection families, not thoracic. Option A incorrectly doubles units rather than using the correct third-level add-on coding structure. Therefore,64490-50, 64491-50, 64492-50is correct.


NEW QUESTION # 457
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