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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 Format:Scenario-based, Open-book, Multiple-choice
Available Languages:English
Real Exam Qty:100
Passing Score:70%
Related Certifications:CRC
CPMA
CPCO
CPC-P
Exam Duration:240 minutes
Certificate Validity Period:3 years
Exam Price:$425 (1 attempt), $499 (2 attempts)
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
  • 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 2
  • 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 3
  • 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 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.:
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
  • 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 7
  • Introduction to CPTยฎ, HCPCS Level II, and Modifiers: This section of the exam measures the skills of coding specialists and introduces candidates to CPTยฎ 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 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
  • 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 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
  • 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 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.
Topic 13
  • 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 14
  • 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.

AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q396-Q401):

NEW QUESTION # 396
A patient presents with recurrent spontaneous episodes of dizziness of unclear etiology. Caloric vestibular testing is performed irrigating both ears with warm and cold water while evaluating the patient's eye movements. There is a total of three irrigations.
What CPT coding is reported?

Answer: D


NEW QUESTION # 397
When a provider's documentation refers to use, abuse, and dependence of the same substance (e.g. alcohol), which statement is correct?

Answer: C

Explanation:
According to ICD-10-CM coding guidelines for substance use, abuse, and dependence, when multiple levels (use, abuse, and dependence) of the same substance are documented, only the highest level of severity is coded. The hierarchy is as follows: dependence > abuse > use.
D: If both use and dependence are documented, assign only the code for dependence is correct, as dependence represents the highest severity level and supersedes both use and abuse.
A: is incorrect because if both use and abuse are documented without dependence, only abuse would be coded as it is of a higher severity than use.
B: is incorrect because all three codes (use, abuse, dependence) should not be reported together; only the highest level should be coded.
C: is incorrect because if both abuse and dependence are documented, only dependence (the higher severity level) should be coded, not abuse.
Therefore, the correct answer is D. If both use and dependence are documented, assign only the code for dependence.


NEW QUESTION # 398
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: D

Explanation:
* Esotropia of the right eye: Indicates strabismus surgery is required.
* Resection of medial rectus horizontal and lateral rectus muscles: Specific muscles addressed during the surgery.
* Adjustable sutures: Used in securing the muscles, indicating specific techniques.
* Extensive scar tissue from previous surgery: Requires additional work and isolation.
CPT codes 67314 and 67334 are used to report the resection of two muscles with adjustable sutures (67314) and surgery on an extraocular muscle involving extensive scar tissue (67334).
References: AMA's CPT Professional Edition (current year)


NEW QUESTION # 399
According to the Application of Cast and Strapping CPTguidelines, what is reported when an orthopedic provider performs initial fracture care treatment for a closed scaphoid fracture of the wrist, applies a short arm cast, and the patient will be returning for subsequent fracture care?

Answer: B

Explanation:
For initial fracture care of a closed scaphoid fracture, code 25622 is used, which includes treatment and initial casting. The application of the cast is part of the fracture care and is not reported separately. CPTguidelines specify that casting or strapping performed as part of the fracture care is included in the fracture care code.
References: AMA's CPTProfessional Edition (current year), Surgery section, Musculoskeletal System.


NEW QUESTION # 400
Preoperative diagnosis: Right thigh benign congenital hairy nevus. *1
Postoperative diagnosis: Right thigh benign congenital hairy 0 nevus.
Operation performed: Excision of right thigh benign congenital>1
nevus, excision size with margins 4.5 cm and closure size 5 cm.
Anesthesia: General.0
Intraoperative antibiotics: Ancef.0
Indications: The patient is a 5-year-old girl who presented with her parents for evaluation of her right thigh congenital nevus. It has been followed by pediatrics and thought to have changed over the past year. Family requested excision. They understood the risks involved, which included but were not limited to risks of general anesthesia, infection, bleeding, wound dehiscence, and poor scar formation. They understood the scar would likely widen as the child grows because of the location of it and because of the age of the patient. They consented to proceed.
Description of procedure: The patient was seen preoperatively in > I the holding area, identified, and then brought to the operating room. Once adequate general anesthesia had been induced, the patient's right thigh was prepped and draped in standard surgical fashion. An elliptical excision measuring 6 x 1.8 cm had been marked. This was injected with Lidocaine with epinephrine, total of 6 cc of 1% with 1:100,000. After an adequate amount of time, a #15 blade was used to sharply excise this full thickness.
This was passed to pathology for review. The wound required # limited undermining in the deep subcutaneous plane on both sides for approximately 1.5 cm in order to allow mobilization of the skin for closure. The skin was then closed in a layered fashion using 3-0 Vicryl on the dermis and then 4-0 Monocryl running subcuticular in the skin, the wound was cleaned and dressed with Dermabond and Steri-Strips.
The patient was then cleaned and turned over to anesthesia for S extubation.
She was extubated successfully in the operating room and taken S to the recovery room in stable condition.
There were no complications.
What CPT coding is reported?

Answer: B

Explanation:
52356 = Cystourethroscopy with ureteroscopy, lithotripsy and stent placement Combination code # do not report components separately


NEW QUESTION # 401
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