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AAPC CPC Exam Overview:

Certification Vendor:AAPC
Exam Name:Certified Professional Coder (CPC) Exam
Exam Number:CPC
Exam Duration:240 minutes
Exam Format:Multiple Choice
Related Certifications:CPC-A
Available Languages:English
Real Exam Qty:100
Certificate Validity Period:2 Years (requires continuing education to maintain)
Exam Price:USD 499
Passing Score:70%
Sample Questions:AAPC CPC Sample Questions
Exam Way:Online (Online Proctored or In-Person at Testing Centers)
Pre Condition:None required for exam (though AAPC recommends medical terminology/anatomy training)
Official Syllabus URL:https://www.aapc.com/certification/cpc

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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 2
  • 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 3
  • 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 4
  • 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 5
  • 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 6
  • 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 7
  • 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 8
  • 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 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
  • 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 11
  • 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 12
  • 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.

AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q353-Q358):

NEW QUESTION # 353
Refer to the supplemental information when answering this question:
View MR 138093
What E/M coding is reported?

Answer: C

Explanation:
This patient presents to the ER with syncope, requiring a comprehensive evaluation and critical care. Here's the breakdown of the codes:
CPT Code 99291-25: Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes This code is appropriate because the patient's syncope and vital signs (low blood pressure, shallow respirations, low oxygen saturation) indicate a critical condition requiring immediate intervention.
Modifier -25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service. This modifier is appended because the critical care services were provided in addition to the separately reported procedures below.
CPT Code 92950: Cardiopulmonary resuscitation (eg, CPR, external cardiac massage, endotracheal intubation, ventilation) While the documentation doesn't explicitly mention CPR, it states the patient was unresponsive upon arrival but had spontaneous pulse and respirations. This suggests possible resuscitation efforts were performed by the paramedics before the physician's assessment.
CPT Code 31500: Intubation, endotracheal, emergency procedure
Although not explicitly stated, the documentation indicates the patient was placed on "high flow oxygen," which strongly suggests endotracheal intubation was performed to manage the patient's respiratory distress.
CPT Code 82803: Blood gases, arterial, pH, PCO2, PO2, with oxygen saturation; interpretation and report This code is likely reported based on the patient's respiratory distress and the need to monitor their oxygenation status.
Why other options are incorrect:
99285: This is a standard emergency department visit code and doesn't capture the critical nature of the patient's condition.
99285-25, 99291-25, 92950, 31500, 82803: This includes 99285, which is not necessary as 99291 encompasses the evaluation and management.
99291-25, 99292-25, 92950, 31500: This includes 99292, which is for subsequent critical care time. There's no indication in the documentation that the physician provided critical care beyond the initial 74 minutes.
Reference:
CPT Codes 99281-99285: Emergency department visits
CPT Codes 99291-99292: Critical care services
CPT Code 92950: Cardiopulmonary resuscitation
CPT Code 31500: Endotracheal intubation
CPT Code 82803: Arterial blood gases
AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.


NEW QUESTION # 354
A patient arrives with stridor and in respiratory distress. The provider performs a micro laryngoscopy using a Parson's laryngoscope and magnifying telescope. A bronchoscopy was also performed using a 2.5 Stortz bronchoscope. The findings include subglottic web and stenosis with laryngeal edema suggestive of reflux. There was also significant collapse of the trachea at the carina and into the main bronchi bilaterally.
What CPTcoding is reported?

Answer: A

Explanation:
1. Procedure and CPTCode Selection:
The provider performed both a bronchoscopy and a microlaryngoscopy to evaluate the patient's airway due to respiratory distress and stridor.
Code 31622 is used for a diagnostic bronchoscopy, which includes the inspection of the trachea, carina, and bronchial structures. Since the bronchoscopy was diagnostic and no additional therapeutic procedures were performed, this is the appropriate code.
Code 31526 is for direct laryngoscopy with the use of an operating microscope or telescope (microlaryngoscopy). This code is appropriate given the use of a Parson's laryngoscope and magnifying telescope to inspect the larynx.
2. Modifier 51:
Modifier 51 is added to 31526 to indicate that it was performed in conjunction with another procedure (31622, bronchoscopy). Modifier 51 denotes multiple procedures without the necessity of a separate incision.
3. Exclusion of Code 69990:
Code 69990 is used for the use of an operating microscope in microsurgery but is not coded separately when the procedure (such as microlaryngoscopy) already includes visualization with a microscope or telescope as part of the CPTdescriptor. Thus, 69990 is not separately reported in this scenario, per CPTguidelines.
4. AAPC and CPTCoding Guidelines:
The guidelines specify that when visualization or microlaryngoscopy is inherently part of the procedure (as in
31526), 69990 should not be billed separately. Also, the use of Modifier 51 for multiple procedures in the same session is appropriate.
Therefore, the verified answer, following the CPTand AAPC coding rules, is A. 31622, 31526-51.


NEW QUESTION # 355
The surgeon performs Roux-en-Y anastomosis of the extrahepatic biliary duct to the gastrointestinal tract on a
45-year-old patient.
What CPT code is reported?

Answer: D


NEW QUESTION # 356
A patient presents with keratosis lesions on her left cheek, above the left eyebrow, and on the chin area. The dermatologist treats those areas by lightly sanding the surface of a total of 5 lesions.
What CPTcoding is reported?

Answer: C

Explanation:
CPTcode 15786 is used for abrasion treatment of a single lesion (e.g., for keratosis) through techniques like dermabrasion (lightly sanding the skin's surface). When treating multiple lesions in this manner, each lesion treated should be coded individually.
Since the patient has 5 keratosis lesions treated through sanding, 15786 x 5 accurately represents the procedure for each lesion.
Explanation of other options:
A: 15787 x 5: Incorrect because 15787 is designated for dermabrasion of "additional lesions" and would be used in conjunction with 15786, not alone.
B: 15786, 15787: Incorrect, as it does not account for all five lesions treated.
C: 15786, 15787 x 4: Incorrect, as 15787 is used only when performed in addition to 15786, not as a replacement for each additional lesion.
Therefore, the correct answer is D. 15786 x 5, which accurately reports the treatment of all five lesions.


NEW QUESTION # 357
Patient is diagnosed with dacryocystitis, which is the inflammation of?

Answer: C

Explanation:
Dacryocystitis is the inflammation of the lacrimal sac, which is part of the tear drainage system located in the inner corner of the eye. The lacrimal sac is connected to the nasolacrimal duct, which drains tears into the nasal cavity. Inflammation in this area can cause pain, redness, and swelling near the inner corner of the eye.
References


NEW QUESTION # 358
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