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AAPC CPC Prüfungsplan:

ThemaEinzelheiten
Thema 1
  • 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.:
Thema 2
  • 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.
Thema 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.
Thema 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.
Thema 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.
Thema 6
  • 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.
Thema 7
  • 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.
Thema 8
  • 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.
Thema 9
  • 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.
Thema 10
  • 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.
Thema 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.
Thema 12
  • 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.
Thema 13
  • 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.
Thema 14
  • 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 CPC Prüfungsfragen mit Lösungen (Q73-Q78):

73. Frage
An ED provider evaluates a patient with NSTEMI, consults cardiology, and the patient is admitted for PCI.
What E/M service and ICD-10-CM coding is reported by the ED provider?

Antwort: A

Begründung:
99285 = High-complexity ED visit
I21.4 = NSTEMI
Chest pain symptoms are not coded once MI is diagnosed


74. Frage
Eric is buying his first life insurance policy from XYZ Life Insurance Company. The company requires Eric have a physical exam prior to issuance of the policy. Eric sees his primary care provider who completes the required documentation and forms provided by the insurance company.
How does the primary care provider report his services?

Antwort: C

Begründung:
CPT code 99450 is used for the examination of a patient for the purpose of establishing medical baseline information or for insurance purposes. Since Eric's primary care provider completed the required physical exam documentation for his life insurance policy, this is appropriately reported with code 99450. Reference: CPT Professional Edition (current year), AMA.


75. Frage
According to the ICD-10-CM Guidelines, what code is reported as an additional code when the blood pressure of a patient with hypertension remains above goal in spite of the use of antihypertensive medications?

Antwort: C

Begründung:
According to ICD-10-CM Guidelines, I11A.0 (Resistant hypertension) is used to indicate hypertension that remains uncontrolled despite the use of multiple antihypertensive medications. Resistant hypertension is coded to highlight the severity of the patient's condition and the difficulty in managing their blood pressure.
This code is added as a secondary code to reflect the persistent elevation of blood pressure despite medication.
A: I10 (Essential hypertension) is a general code for primary hypertension but does not specify resistance to treatment.
B: A code from category I27 is related to pulmonary heart diseases, not directly related to hypertension management issues.
D: A code from category I16 (Hypertensive crisis) is used for hypertensive emergencies or urgencies, which are acute episodes, not persistent uncontrolled hypertension despite treatment.
Thus, the correct answer is C. I11A.0, Resistant hypertension.


76. Frage
A physician orders an obstetric panel that includes syphilis screening using the non-treponemal antibody approach, an automated CBC with manual differential WBC count, HBsAg, rubella antibody, a serum antibody screen, and ABO and Rh blood typing.
What CPTcoding is reported?

Antwort: D

Begründung:
1. Procedure and CPTCode Selection:
The obstetric panel ordered includes the following tests: syphilis screening (non-treponemal), automated CBC with manual differential WBC count, HBsAg, rubella antibody, serum antibody screen, and ABO/Rh blood typing.
CPTCode 80055 is for a comprehensive obstetric panel that includes all these components. This code is intended to report the entire panel of tests as a bundled service rather than itemizing each individual test.
2. Rationale for Excluding Other Options:
Option B lists the individual component codes for each test in the obstetric panel (e.g., 85027, 85007, 87340, etc.), but using 80055 is more appropriate because it provides a single code to report the full obstetric panel and follows CPTbundling guidelines.
Option C also lists the individual tests separately, which is unnecessary when 80055 includes all these components.
Option D lists 80081, which is for an obstetric panel that includes HIV testing. Since HIV testing is not part of the tests described in this scenario, 80081 is incorrect.
3. AAPC and CPTCoding Guidelines:
AAPC guidelines recommend using the single code 80055 when all components of an obstetric panel are ordered together, as itemizing each test individually is not necessary.
Therefore, the correct answer is A. 80055.


77. Frage
A 5-year-old patient has a fractured radius. The orthopedist provides moderate sedation and the reduction. The time is documented as 21 minutes.
What CPT code is reported for the moderate sedation?

Antwort: D

Begründung:
99152 - Moderate sedation, same physician, patient under 5 years, initial 15 minutes Time documented: 21 minutes First 15 minutes = 99152 Additional 15 minutes (99153) not reported separately in CPT exam context Why others are incorrect:
99151 - Minimal sedation
99155 / 99156 - Different age/provider scenarios


78. Frage
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