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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 2
  • 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 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
  • 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 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
  • 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
  • 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 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
  • 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 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
  • 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 13
  • 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 14
  • 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 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.
Topic 16
  • 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 17
  • 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.

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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q197-Q202):

NEW QUESTION # 197
A surgeon performs midface LeFort I reconstruction on a patient's facial bones to correct a congenital deformity. The reconstruction is performed in two pieces in moving the upper jawbone forward and repositioning the teeth of the maxilla of the mid face.
What CPT code is reported?

Answer: C

Explanation:
The procedure described involves a LeFort I reconstruction, which is a type of orthognathic surgery performed to correct deformities of the midface. In this scenario, the surgeon performed the reconstruction in two pieces, moving the upper jawbone forward and repositioning the teeth of the maxilla. According to the CPT guidelines, CPT code 21146 describes a LeFort I (maxilla only) osteotomy, two-piece segment, including bone grafts (includes obtaining autografts). This code matches the description provided.
References:
* AMA's CPT Professional Edition (current year), Code 21146


NEW QUESTION # 198
A 53-year-old male arrived at the ER due to severe ocular trauma to the right eye. He was at work on a metal drilling machine and a metallic item penetrates his right eyeball. A foreign body is in the posterior segment of the eye and corneal laceration with multiple posterior perforated sites were noted. He is brought back to the surgical suite. The surgeon removes the metallic foreign body using large retinal forceps. The laceration of the cornea is sutured and the provider also performs a pars plana lensectomy.
What is the CPTand ICD-10-CM codes are reported?

Answer: B

Explanation:
1. Procedure and CPTCode Selection:
The patient required surgical intervention for severe ocular trauma involving removal of a foreign body from the posterior segment of the eye, suturing of the corneal laceration, and a pars plana lensectomy.
CPTCode 65265 is for removal of a foreign body from the posterior segment of the eye without the use of a magnet. This code is appropriate for the removal of the metallic foreign body using retinal forceps.
CPTCode 66852 covers the pars plana lensectomy, which was performed as part of the surgical treatment.
CPTCode 65280 is used for repairing a corneal laceration with multiple perforations, which applies to the corneal suturing.
2. Modifiers:
Modifier RT is used to indicate that the procedures were performed on the right eye.
Modifier 51 is added to indicate multiple procedures performed during the same surgical session.
3. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code S05.51XA is appropriate for penetrating wound of the right eyeball with a foreign body in the posterior segment.
ICD-10-CM Code W31.1XXA is used to indicate that the injury was caused by contact with a metalworking and woodworking machine.
4. Rationale for Excluding Other Options:
Codes 65235 and 65275 in options B, C, and D refer to foreign body removal from the anterior chamber and the anterior segment, respectively, which are not appropriate since the foreign body was located in the posterior segment.
Codes S05.31XA and W31.0XXA in options C and D represent different eye injuries and types of machines, which do not match the scenario described.
5. AAPC and CPTCoding Guidelines:
According to AAPC guidelines, codes should be selected based on the specific location (posterior segment) and the type of foreign body removal. Each procedure, including the corneal repair, should be coded to capture the full extent of the treatment.
Therefore, the correct answer is A. 65265-RT, 66852-51-RT, 65280-51-RT, S05.51XA, W31.1XXA.


NEW QUESTION # 199
(A 6-month-old child was brought to the hospital with severe breathing difficulties. After testing, the child was diagnosed withtracheal stenosis present from birth. The pediatric surgeon performed atracheoplasty (surgical widening of the trachea). What CPT and ICD-10-CM codes are reported?)

Answer: D

Explanation:
The diagnosis "tracheal stenosis present from birth" is acongenital malformation, which is coded withQ32.1 (congenital stenosis of trachea) rather than an acquired tracheal disorder code. For anesthesia coding, tracheoplasty is a major airway/tracheal surgical procedure and maps to the appropriateairway/trachea anesthesiacategory represented by00320in the answer set. Because the patient is aninfant (6 months old), anesthesia qualifies for the extreme age add-on99100(anesthesia for patient of extreme age, under 1 year or over 70 years). Options includingJ39.8reflect an acquired/other tracheal disorder category rather than congenital stenosis, which conflicts with "from birth." Options that omit 99100 miss the age-related qualifying circumstance. CPC exam strategy: always code congenital conditions withQ-codeswhen documented as present from birth, and remember99100for patients<1 yearwhen anesthesia qualifying circumstances are reported. Therefore,00320, 99100, Q32.1is correct.


NEW QUESTION # 200
A 78-year-old patient experiencing intermittent asthma with exacerbation is in her pulmonologist's office for a pulmonary function test. The pulmonologist tests for spirometry, vital capacity, breathing capacity, and flow volume capturing the measurements before and after administering a bronchodilator.
What CPTand ICD-10-CM codes are reported?

Answer: C

Explanation:
1. Procedure and CPTCode Selection:
The patient underwent a pulmonary function test that included spirometry, vital capacity, breathing capacity, and flow volume measurements before and after bronchodilator administration.
CPTCode 94060 is for spirometry, including the bronchodilator responsiveness testing, which involves capturing pre- and post-bronchodilator measurements. This code accurately reflects the testing performed.
CPTCode 94010 is for spirometry testing without bronchodilator, which might be considered redundant in this case since 94060 encompasses spirometry testing with and without bronchodilator. However, some practices may code both, but generally, 94060 alone should suffice.
2. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code J45.901 is used for unspecified asthma with acute exacerbation. This code is appropriate given that the diagnosis indicates intermittent asthma with exacerbation.
J45.21 represents mild intermittent asthma without the specification of exacerbation, making it less accurate than J45.901 in this context.
3. Rationale for Excluding Other Options:
Code 94070 (options B and C) is for bronchospasm provocation testing, which does not apply to standard pulmonary function testing with bronchodilator responsiveness.
Option D includes J45.21, which does not capture the exacerbation aspect and is therefore incorrect.
4. AAPC and CPTCoding Guidelines:
According to AAPC guidelines, 94060 should be used when pre- and post-bronchodilator spirometry is performed, and J45.901 is appropriate for asthma with exacerbation.
Therefore, the correct answer is A. 94060, 94010, J45.901.


NEW QUESTION # 201
A 65-year-old man had a right axillary block by the anesthesiologist. When the arm was totally numb, the arm was prepped and draped, and the surgeon performed tendon repairs of the right first, second, and third fingers. The anesthesiologist monitored the patient throughout the case.
What anesthesia code is reported?

Answer: D


NEW QUESTION # 202
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