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AAPC CPC Exam Overview:

Certification Vendor:AAPC
Exam Name:AAPC Certified Professional Coder (CPC) Certification Exam
Exam Number:CPC
Certificate Validity Period:2 years (renewal via Continuing Education Units - CEUs)
Available Languages:English
Passing Score:Approximately 70%
Related Certifications:Certified Outpatient Coder (COC)
Certified Coding Specialist (CCS)
Certified Inpatient Coder (CIC)
Exam Duration:340 minutes
Real Exam Qty:150 multiple-choice questions
Exam Price:$399–$499 USD (varies by membership and region)
Exam Format:Multiple Choice Questions, Open-book (CPT, ICD-10-CM, HCPCS manuals allowed)
Recommended Training:AAPC CPC Practice Exams
AAPC CPC Training Course
Exam Registration:AAPC CPC Certification Page
AAPC Exam Registration Portal
Sample Questions:AAPC CPC Sample Questions
Exam Way:Available via online proctored exam or authorized testing centers (in-person).
Pre Condition:No formal prerequisite required. Recommended: 1–2 years of medical coding experience or completion of AAPC CPC training.
Official Syllabus URL:https://www.aapc.com/certification/cpc/

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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 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.
Topic 3
  • 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 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
  • 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 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
  • 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 8
  • 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 9
  • 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 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
  • 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 12
  • 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 13
  • 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.
Topic 14
  • 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 15
  • 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 16
  • Female Reproductive System and Maternity Care & Delivery: This section of the exam measures the skills of coding specialists and evaluates coding accuracy for gynecological and obstetric procedures. It includes deliveries, antepartum care, cesarean sections, and surgical procedures involving female reproductive anatomy.
Topic 17
  • 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 18
  • 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.

AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q248-Q253):

NEW QUESTION # 248

Refer to the supplemental information when answering this question:
View MR 000281
What anesthesia and diagnosis codes are reported for this case?

Answer: A

Explanation:
* CPT Code 00811: Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to the splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing
* This code is reported for anesthesia services provided during a colonoscopy that is diagnostic in nature.
* ICD-10-CM Code D62: Acute posthemorrhagic anemia
* This is the most accurate postoperative diagnosis. The operative report states "Anemia due to acute blood loss."
* ICD-10-CM Code N18.6: End stage renal disease
* This code captures the patient's documented history of ESRD.
* ICD-10-CM Code Z99.2: Dependence on renal dialysis
* This code is necessary to report the patient's dialysis status, as it affects the overall risk of the procedure.
Why other options are incorrect:
* 00812: This code is for therapeutic colonoscopies, not diagnostic.
* D64.9: This code is for anemia, unspecified. D62 is more specific to the patient's condition.
* K62.5: This code is for lower gastrointestinal bleeding, but the anemia is the primary diagnosis in this case.
References:
* CPT Code 00811: Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to the splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing
* ICD-10-CM Code D62: Acute posthemorrhagic anemia
* ICD-10-CM Code N18.6: End stage renal disease
* ICD-10-CM Code Z99.2: Dependence on renal dialysis
* AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.


NEW QUESTION # 249
Which is an anesthesia physical status modifier?

Answer: C

Explanation:
P1-P6 = ASA Physical Status modifiers
AA, QS are anesthesia service modifiers


NEW QUESTION # 250
911 is called by the physician for an ambulance with non-emergency basic life support to pick up a patient from his office that had fainted. The patient was taken to the hospital. What HCPCS Level II coding is reported for the ambulance's service?

Answer: A

Explanation:
To select the correct HCPCS Level II code for a non-emergency ambulance service, we focus on the following components:
A0428 represents "Ambulance service, Basic Life Support (BLS), non-emergency transport," which is appropriate here as the patient was transported with non-emergency BLS following a fainting episode. This eliminates options B and D, which indicate "emergency" (A0429).
QM Modifier indicates "Ambulance service provided under arrangement by a provider of services," relevant when a physician arranges the ambulance transport.
PH Modifier specifies "Physician's office to hospital" transport, matching the scenario where the patient was taken from the physician's office to the hospital.
Thus, A0428-QM-PH accurately describes a non-emergency BLS transport arranged by a provider from a physician's office to the hospital, aligning with choice A.


NEW QUESTION # 251
A patient suffering from idiopathic dystonia is seen today and receives the following Botulinum injections:
three muscle injections in both upper extremities and seven injections in six paraspinal muscles.
How are these injections reported according to the CPT guidelines?

Answer: D

Explanation:
For the injections, CPT code 64642 is used for chemodenervation of one extremity; 64643 for each additional extremity, and 64647 for chemodenervation of muscles in the paraspinal region. The modifier -50 is added to 64642 and 64643 to indicate bilateral procedures. According to CPT guidelines, when multiple sites are treated, each site is coded separately, and appropriate modifiers are used.References: AMA's CPT Professional Edition (current year), Surgery section, Nervous System.


NEW QUESTION # 252
A 44-year-old female patient came in for a planned laparoscopic total abdominal hysterectomy for endometriosis of the uterus. The surgeon attached the trocars, a scope is inserted examining the uterus, abdominal wall, bilateral ovaries, and fallopian tubes. The surgeon decided to convert the laparoscopic procedure to an open total hysterectomy because of the extensive amount of adhesions that need to be removed. A total hysterectomy was performed and due to removal of the extensive adhesions the surgery took longer than normal of 2 hours.
What CPT and diagnosis codes are reported?

Answer: A

Explanation:
1. Procedure and CPT Code Selection:
The patient initially underwent a laparoscopic total abdominal hysterectomy for endometriosis of the uterus. However, due to extensive adhesions, the surgeon converted the procedure to an open total abdominal hysterectomy to complete the surgery.
CPT Code 58150 is appropriate for a total abdominal hysterectomy, including removal of the uterus and cervix, via an open approach. Since the procedure was converted to an open approach, 58150 is the correct code.
The -22 modifier is added to indicate increased procedural services due to the extensive adhesiolysis (removal of adhesions), which extended the surgery duration.
2. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code N80.00 is used for endometriosis of the uterus, which is the primary condition that prompted the hysterectomy.
ICD-10-CM Code N73.6 is appropriate for female pelvic peritoneal adhesions, reflecting the extensive adhesions that necessitated the conversion to open surgery.
3. Rationale for Excluding Other Options:
Code 58571 (in options B and C) is for a laparoscopic approach, which is incorrect because the procedure was converted to an open approach.
The -78 modifier is incorrect in this context because the conversion to open surgery was part of the same operative session and not an unplanned return to the OR.
Diagnosis code N99.4 (in options B and D) pertains to postprocedural pelvic adhesions, which does not apply here as the adhesions were not due to a prior procedure.
4. AAPC and CPT Coding Guidelines:
AAPC guidelines specify using 58150 for an open total abdominal hysterectomy and adding the -22 modifier for increased complexity or time due to factors like extensive adhesiolysis.
Therefore, the correct answer based on CPT and ICD-10-CM guidelines is A. 58150-22, N80.00, N73.6.


NEW QUESTION # 253
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