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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 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
  • 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 5
  • 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 6
  • 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 7
  • 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 8
  • 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 9
  • 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 10
  • 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 11
  • 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.

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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q433-Q438):

NEW QUESTION # 433
A comatose patient is seen in the ER. The patient has a history of depression. Drug testing confirm she overdosed on tricyclic antidepressant drugs doxepin, amoxapine, and clomipramine.
What CPT code is reported?

Answer: B

Explanation:
For a comatose patient who has overdosed on tricyclic antidepressant drugs (doxepin, amoxapine, and clomipramine), the correct CPT code is 80366. This code covers drug testing for tricyclic antidepressants, which includes the specific drugs mentioned in the scenario.
References:
* AMA's CPT Professional Edition (current year)


NEW QUESTION # 434
An incision is made in the scalp, a craniectomy is performed to access the area where electrodes are present.
The electrodes are removed. The surgical wound is closed.
What procedure code is reported?

Answer: C

Explanation:
The procedure described involves the removal of electrodes from the cranial area after making an incision in the scalp and performing a craniectomy.
* Procedure Description:
* Incision in the scalp.
* Craniectomy to access the area with electrodes.
* Removal of electrodes.
* Closure of the surgical wound.
* CPT Coding:
* 61860: Removal of intracranial neurostimulator electrodes, including burr hole(s) or craniectomy.
References:
* AMA's CPT Professional Edition (current year).
* CPT Assistant for detailed coding guidelines on neurostimulator procedures.


NEW QUESTION # 435
An incision is made in the scalp, a craniectomy is performed to access the area where electrodes are present. The electrodes are removed. The surgical wound is closed.
What procedure code is reported?

Answer: B


NEW QUESTION # 436
Two weeks after removal of a 4 cm subcutaneous lipoma, the patient presents with extensive internal wound dehiscence requiring multi-layer closure in the OR.
What CPT coding is reported by the surgeon?

Answer: D

Explanation:
Repair of wound dehiscence # CPT 13160 (complex repair, secondary closure) Occurs during global period and is unplanned # Modifier -78 Modifier -58 is for staged or planned procedures.


NEW QUESTION # 437
Refer to the supplemental information when answering this question:
View MR 005271
What CPT coding is reported?

Answer: D

Explanation:
CPT Code 55706: Biopsy, prostate; needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance.
This code accurately describes the procedure performed. The documentation clearly states that a stereotactic template was used to guide the biopsy needles, and multiple samples were taken (saturation biopsies). This code includes imaging guidance.
CPT Code 76942: Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation.
Although 55706 includes imaging guidance, code 76942 is also reported separately because the transrectal ultrasound provided initial diagnostic images and was then used for guidance during the biopsy. This is supported by the documentation which states "Using a B & K ultrasound probe, a transrectal ultrasound of the prostate was obtained. Once this was done...a biopsy needle is inserted into the prostate...under ultrasound guidance." This indicates distinct uses of the ultrasound.
Important Note: While some sources suggest that 76942 and the diagnostic transrectal ultrasound code (76872) are bundled, it's crucial to consult the latest National Correct Coding Initiative (NCCI) edits for the most up-to-date guidance.
References:
CPT Code 55706: Biopsy, prostate; needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance CPT Code 76942: Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.
NCCI Edits: Always check the most current NCCI edits to confirm coding combinations.


NEW QUESTION # 438
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