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Each format specializes in a specific study style and offers unique benefits, each of which is crucial to good Certified Professional Coder (CPC) Exam (CPC) exam preparation. The specs of each AAPC CPC Exam Questions format are listed below, you may select any of them as per your requirements.
| Topic | Details |
|---|
| Topic 1 | - 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 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 | - 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 4 | - 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 5 | - 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 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 | - 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 8 | - 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 9 | - 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 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 | - 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 12 | - 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 13 | - 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.
|
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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q120-Q125):
NEW QUESTION # 120
(Miranda is in her provider's office for follow up of her diabetes. Her blood sugars remain at goal with continuing her prescribed medications. When referring to the MDM Table for number and complexity of problems addressed, what type of problem is this considered?)
- A. Stable, chronic illness
- B. Acute, uncomplicated illness or injury
- C. Stable, acute illness
- D. Minimal problem
Answer: A
Explanation:
Diabetes mellitus is achronic illness. In the MDM framework, the "number and complexity of problems addressed" considers whether a chronic condition isstable, whether it isexacerbated, and whether it requires significant management changes. The vignette says this is afollow-upfor diabetes with blood sugarsat goaland continuing current medications-this describes astable chronic illnessbeing managed. It is not an acute illness or injury, and it is not "minimal problem," because diabetes generally requires ongoing monitoring and management and is not considered trivial. "Stable, acute illness" is internally inconsistent; "acute uncomplicated illness/injury" is also incorrect because diabetes is not acute in this context. CPC exam tip:
"stable on meds" + chronic disease follow-up #stable chronic illness(often supporting at least a low-to- moderate problem complexity depending on other MDM elements). Therefore, the correct selection isStable, chronic illness.
NEW QUESTION # 121
Which place of service code is submitted on the claim for a service that is performed in a skilled nursing facility?
Answer: C
Explanation:
In medical billing, Place of Service (POS) code 31 is used to indicate that a service was performed in a skilled nursing facility (SNF). POS codes are standardized by the Centers for Medicare & Medicaid Services (CMS) to specify the location where services are provided.
A: 32 refers to a nursing facility (NF), which is different from a skilled nursing facility in terms of the level of care provided.
B: 20 indicates urgent care facility.
C: 22 is used for outpatient hospital services.
Thus, the correct answer is D. 31 for a skilled nursing facility.
NEW QUESTION # 122
Which government office is responsible for overseeing and investigating cases of healthcare fraud and abuse?
- A. Department of Health and Human Services (HHS)
- B. Centers for Medicare & Medicaid Services (CMS)
- C. Office of Inspector General (OIG)
- D. American Medical Association (AMA)
Answer: C
Explanation:
The Office of Inspector General (OIG) operates under the Department of Health and Human Services (HHS) and is specifically responsible for detecting, investigating, and preventing fraud, waste, and abuse in federal healthcare programs such as Medicare and Medicaid.
This is a key compliance and regulatory topic on the CPC exam.
NEW QUESTION # 123
A 6-French sheath and catheter is placed into the coronary artery and is advanced to the left side of the heart into the ventricle. Ventriculography is performed using power injection of contrast agent. Pressures in the left heart are obtained. The coronary arteries are also selected and imaged.
What CPT code is reported?
Answer: D
NEW QUESTION # 124
View MR 006399
MR 006399
Operative Report
Preoperative Diagnosis: Chronic otitis media in the right ear
Postoperative Diagnosis: Chronic otitis media in the right ear
Procedure: Eustachian tube inflation
Anesthesia: General
Blood Loss: Minimal
Findings: Serous mucoid fluid
Complications: None
Indications: The patient is a 2-year-old who presented to the office with chronic otitis media refractory to medical management. The treatment will be eustachian tube inflation to remove the fluid. Risks, benefits, and alternatives were reviewed with the family, which include general anesthetic, bleeding, infection, tympanic membrane perforation, routine tubes, and need for additional surgery. The family understood these risks and signed the appropriate consent form.
Procedure in Detail: After the patient was properly identified, he was brought into the operating room and placed supine. The patient was prepped and draped in the usual fashion. General anesthesia was administered via inhalation mask, and after adequate sedation was achieved, a medium-sized speculum was placed in the right ear and cerumen was removed atraumatically using instrument with operative microscope. The tube is dilated, an incision is made to the tympanum and thick mucoid fluid was suctioned. The patient was awakened after having tolerated the procedure well and taken to the recovery room in stable condition.
What CPT coding is reported for this case?
- A. 69421-RT
- B. 69433-RT
- C. 69436-RT
- D. 69420-RT
Answer: A
Explanation:
The procedure involves eustachian tube inflation to remove serous mucoid fluid in the right ear of a 2-year-old patient with chronic otitis media.
Procedure Description:
Eustachian tube inflation to remove fluid.
General anesthesia.
Incision to the tympanum and suctioning of thick mucoid fluid.
CPT Coding:
69421-RT: Eustachian tube inflation, transnasal or transoral; with catheterization, including general anesthesia. The modifier -RT indicates the right ear.
AMA's CPT Professional Edition (current year).
CPT Assistant for detailed coding guidelines on eustachian tube procedures.
NEW QUESTION # 125
......
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