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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
  • 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 3
  • 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 4
  • 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 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
  • 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.
Topic 7
  • 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 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
  • 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 10
  • Endocrine System and Nervous System: This section of the exam measures the skills of medical coders and assesses the ability to assign codes for surgeries involving glands, the brain, spinal cord, and peripheral nerves. Procedures like resections and electrical stimulation are part of the evaluated content.

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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q18-Q23):

NEW QUESTION # 18
A provider orders LC-MS definitive drug testing for suspected acetaminophen overdose.
What CPT code is reported?

Answer: B

Explanation:
80143 = Acetaminophen level
80324/80329 = Drug classes, not specific analytes
80299 = Unlisted therapeutic drug assay


NEW QUESTION # 19
A patient who was training for a marathon collapsed due to heat exhaustion on a very hot day. The patient is driven by his wife to a non-facility urgent care center for him to be treated. On examination, the physician diagnoses heat exhaustion and dehydration. The physician began IV therapy of normal saline that consists of pre-packaged fluid and electrolytes. The hydration lasts for 1 and 30 minutes.
What CPTcoding is reported?

Answer: C

Explanation:
1. Procedure and CPTCode Selection:
The patient received IV hydration therapy with normal saline, which lasted for 1 hour and 30 minutes.
CPTCode 96360 is used for initial IV hydration for the first hour. This code applies to the first 31-60 minutes of hydration therapy.
CPTCode 96361 is used for each additional hour of IV hydration. Since the hydration lasted 1 hour and 30 minutes, 96361 should be reported once to cover the additional 30 minutes after the initial hour.
2. Rationale for Excluding Other Options:
Code 96365 is for initial IV infusion for therapeutic, prophylactic, or diagnostic purposes, rather than hydration, and is not applicable in this case.
Code 96366 is used for additional therapeutic, prophylactic, or diagnostic infusions and does not apply to hydration services.
Option A (96360) would only cover the initial hour of hydration, missing the additional 30 minutes, which is appropriately coded with 96361.
3. AAPC and CPTCoding Guidelines:
According to AAPC and CPTguidelines, 96360 should be used for the first hour of IV hydration, and
96361 should be used for each additional hour or portion of an hour beyond the initial 60 minutes.
Therefore, the correct answer is D. 96360, 96361.


NEW QUESTION # 20
Which punctuation is used in the ICD-10-CM Tabular List to denote synonyms, alternative wording, or explanatory phrases?

Answer: A

Explanation:
In the ICD-10-CM Tabular List, square brackets [ ] (Brackets) are used to enclose synonyms, alternative wording, or explanatory phrases. This is a punctuation convention taught for ICD-10-CM and is tested on CPC.
To avoid confusion with other punctuation:
Parentheses ( ) indicate nonessential modifiers (supplementary words that may be present or absent without affecting the code selection).
A semicolon ( ; ) is used in the Tabular List to show that additional modifying words (that follow the semicolon) are required to complete the diagnostic statement.
Colons ( : ) are used after an incomplete term that needs one or more modifying terms to make it assignable.


NEW QUESTION # 21

Refer to the supplemental information when answering this question:
View MR 065174
What E/M code is reported for this encounter?

Answer: A

Explanation:
To determine the correct E/M code, we need to consider the three key components: history, examination, and medical decision making (MDM).
* History:
* The documentation indicates an expanded problem-focused history. This is supported by the detailed history of present illness, including the patient's description of symptoms, family history, and review of systems with pertinent positives and negatives.
* Examination:
* The examination is also expanded problem-focused. The physician focused on the relevant systems (head, neck, throat) and documented specific findings related to the chief complaint (thyromegaly).
* Medical Decision Making:
* The MDM is straightforward. The physician is evaluating a new problem (bilateral thyroid nodules) with a low level of risk. Although further workup is planned, this alone doesn't automatically increase the MDM complexity.
Based on these components, 99213 is the most appropriate code.
Why other options are incorrect:
* 99212: Requires a problem-focused history and examination, which is less comprehensive than what was documented.
* 99214 and 99215: Require a higher level of MDM (low or moderate complexity) and/or a more detailed examination. The documentation doesn't support this level of service.
References:
* CPT Codes 99211-99215: Office or other outpatient visit for the evaluation and management of an established patient
* 1995 and 1997 Documentation Guidelines for Evaluation and Management Services: These guidelines provide detailed criteria for selecting the appropriate E/M code based on history, examination, and MDM.
* AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.


NEW QUESTION # 22
Multiple laceration repairs were performed:
Simple: cheek (2.5 cm), nose (3 cm)
Intermediate: left leg (9 cm), right leg (11.5 cm)
Complex: left upper arm (4 cm)
What CPT codes are reported?

Answer: B

Explanation:
Complex (arm, 4 cm) β†’ 13121
Intermediate legs total = 20.5 cm β†’ 12036
Simple face closures coded separately:
12013 (cheek)
12011 (nose)
Modifiers allow separate anatomical reporting.
Correct answer: A


NEW QUESTION # 23
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