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| Topic | Details |
|---|
| Topic 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.:
|
| Topic 2 | - 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 3 | - 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 4 | - 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 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 | - 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 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 | - 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 9 | - 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 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.
|
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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q249-Q254):
NEW QUESTION # 249
According to the Repair (Closure) CPT guidelines, what type of repair is reported when a single layer closure includes copious irrigation and extensive cleaning to remove particulate matter?
- A. Intermediate repair
- B. Complex repair
- C. Simple repair plus a code for irrigation
- D. Simple repair
Answer: A
Explanation:
According to the CPT guidelines for Repair (Closure), an intermediate repair includes the closure of a wound with one or more layers of subcutaneous tissue and superficial fascia in addition to the skin (epidermal and dermal) closure. It also involves extensive cleaning of the wound, which includes copious irrigation and the removal of particulate matter. This description fits the scenario provided in the question.
AMA's CPT Professional Edition, Repair (Closure) guidelines.
NEW QUESTION # 250
A patient presents to the ER with a large sacral pressure ulcer measuring 7 cm. The provider excised the ulcer with 3 mm margins, removed muscle and segmental bone, and performed a layered skin flap closure.
What CPT and ICD-10-CM coding is reported?
- A. 15937, L89.156
- B. 15931, L89.153
- C. 15935, L89.156
- D. 15933, L89.153
Answer: A
Explanation:
Pressure ulcer excision with bone involvement → CPT 15937 (sacral, with ostectomy) Stage 4 pressure ulcer → L89.156 (sacral region with necrosis of bone)
NEW QUESTION # 251
A driver loses control of a vehicle and crashes into a guardrail on the side of the highway. The patient sustains a fracture of the anterior fossa cranial base. Imaging confirms Involvement of the sphenoid sinus, but no cerebrospinal fluid (CSF) leak is identified. The patient undergoes a surgical nasal sinus endoscopy with sphenoidotomy lo evaluate and treat the sinus injury. No CSF leak repair is performed.
What is the correct procedure and diagnosis coding combination to report this service?
- A. 31291, S02.19XA
- B. 31267.S02.19XA
- C. 31287.31231-59, S02.109A
- D. 31287, 31231-59, S02.109A
Answer: C
Explanation:
Procedure Coding (CPT):
31287 - Nasal/sinus endoscopy, surgical; with sphenoidotomy
Correct because the surgeon performed a surgical endoscopic sphenoidotomy to evaluate and treat sphenoid sinus injury.
No CSF leak repair was performed, so codes 31290-31291 are not appropriate.
31231-59 - Nasal endoscopy, diagnostic
Diagnostic endoscopy is separately reportable because:
It was performed to evaluate traumatic injury
It is not bundled into the surgical service when it provides distinct diagnostic information Modifier -59 indicates a separate and distinct service per NCCI edits.
Diagnosis Coding (ICD-10-CM):
S02.109A - Unspecified fracture of base of skull, initial encounter for closed fracture The anterior cranial fossa fracture with sphenoid sinus involvement qualifies as a skull base fracture No CSF leak is documented Correct 7th character "A" for initial encounter Why Other Options Are Incorrect:
A - Incorrect format and duplicated CPT logic
B - 31267 = maxillary sinus, wrong sinus
D - 31291 includes CSF leak repair, which was not performed
NEW QUESTION # 252
Patient has cervical spondylosis with myelopathy. The surgeon performed a bilateral posterior laminectomy with facetectomies at each level and foraminotomies performed between interspaces C5-C6 and C6-C7.
Bilateral decompression of the nerve roots is achieved.
What CPT coding is reported?
- A. 0
- B. 63040-50, 63043, 63043
- C. 63050-50
- D. 63045, 63048
Answer: D
Explanation:
* Cervical spondylosis with myelopathy: Condition requiring decompressive surgery.
* Bilateral posterior laminectomy, facetectomies, foraminotomies: Procedures performed to decompress nerve roots.
* Interspaces C5-C6 and C6-C7: Specific levels where the procedures were performed.
CPT code 63045 is used for the initial cervical laminectomy, and 63048 is for each additional segment. The combination covers the decompression across two interspaces.
References: AMA's CPT Professional Edition (current year)
NEW QUESTION # 253
The gastroenterologist performs a simple excision of three external hemorrhoids and one internal hemorrhoid, each lying along the left lateral column. The operative report indicates that the internal hemorrhoid is not prolapsed and is outside of the anal canal.
What CPT and ICD-10CM codes are reported?
- A. 46320, 46945, K64.0, K64.9
- B. 46250, 46945, K64.0, K64.4
- C. 46250, K64.0, K64.9
- D. 46255, K64.0, K64.4
Answer: C
NEW QUESTION # 254
......
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