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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 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
  • 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
  • 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 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.
Topic 6
  • 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 7
  • 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 8
  • 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 9
  • 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 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
  • 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 (Q401-Q406):

NEW QUESTION # 401
A woman at 36-weeks gestation goes into labor with twins. Fetus 1 is an oblique position, and the decision is made to perform a cesarean section to deliver the twins. The obstetrician who delivered the twins, provided the antepartum care, and will provide the postpartum care.
What CPT coding is reported for the twin delivery?

Answer: B

Explanation:
* Cesarean Delivery with Antepartum and Postpartum Care: The procedure involved the cesarean section delivery of twins, including antepartum and postpartum care.
* CPT Code 59510: This code is used for routine obstetric care including antepartum care, cesarean delivery, and postpartum care. The code is not reported per fetus but per delivery, even when delivering multiples.
References:
* AMA's CPT Professional Edition (current year)


NEW QUESTION # 402
(A patient has nausea with several episodes of emesis and severe stomach pain due to dehydration. Normal saline is infused in the same bag with2 mg ondansetron. Then15 mg ketorolac tromethamineis given for stomach pain. What J codes are reported for these services?)

Answer: C

Explanation:
HCPCS J-codes for medications are reported based on the drug and the code's definedbilling unit(e.g., mg per unit).Ondansetronis reported withJ2405, which is typically defined per1 mg(so 2 mg is reported as2 units# J2405 × 2).Ketorolac tromethamineis reported withJ1885, commonly defined per15 mg(so a 15 mg dose is1 unit# J1885). Option A matches this unit logic:J2405 × 2for 2 mg ondansetron, plusJ1885for 15 mg ketorolac.
Option B incorrectly multiplies ketorolac by 15 units, which would overstate the dose because the code unit is not 1 mg in this context. Option C underreports ondansetron units if the unit is 1 mg. Option D uses an incorrect J-code for ketorolac. CPC exam tip: always read theJ-code unit definitionand convert the administered dose into billable units accurately.


NEW QUESTION # 403
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: A

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 # 404
(A 28-year-old woman who is 36 weeks pregnant withdichorionic/diamniotic twinsdeliveredboth babies vaginally. The same OB provider who delivered the babies provided theantepartum careand will provide thepostpartum care. What CPT and ICD-10-CM codes are reported on the maternal record?)

Answer: B

Explanation:
Formultiple gestation vaginal deliveries, CPT global obstetric care is generally reported as the global code for thefirst fetus(here59400: antepartum + vaginal delivery + postpartum), and an additionaldelivery-onlycode for each additional fetus (here59409) with an appropriate modifier (commonly-51in exam-style choices). You donotreport59400 twicebecause the global package is not duplicated for each baby; only the additional delivery service is added for the additional fetus. Diagnosis coding: this is atwin pregnancy, dichorionic
/diamniotic, third trimester#O30.043. Delivery outcome for twins #Z37.2, and weeks of gestation #Z3A.36.
Because delivery occurred at36 weeks(preterm threshold is <37 weeks), and the options use thepreterm labor with preterm deliverycategory with fetus identifiers, the correct pairing shown isO60.14X1 and O60.14X2 (fetus 1 and fetus 2). Option D is the only one matching correct CPT multiple-delivery structure and appropriate diagnosis set.


NEW QUESTION # 405
Refer to the exhibit.

Refer to the supplemental information when answering this question:
View MR 003264
What is the procedural coding?

Answer: B

Explanation:
The patient had a post-operative complication (cardiac tamponade) following a previous CABG surgery, requiring a return to the operating room for exploration and evacuation of a blood clot. This is coded using CPT code 32658 (Exploration, mediastinum, with or without drainage; for postoperative hemorrhage, drainage of abscess, or to locate foreign body). Modifier 78 is appended to indicate an unplanned return to the operating room by the same physician following the initial procedure for a related procedure during the postoperative period.
Reference:
CPT Code 32658: Exploration, mediastinum, with or without drainage; for postoperative hemorrhage, drainage of abscess, or to locate foreign body Modifier 78: Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.


NEW QUESTION # 406
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