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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 2
  • 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 3
  • 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 4
  • 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 5
  • 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 6
  • 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 7
  • 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 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
  • 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 10
  • 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 11
  • 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 12
  • 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 13
  • 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 14
  • 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 (Q49-Q54):

NEW QUESTION # 49
A catheter was placed into the abdominal aorta via the right common femoral artery access. An abdominal aortography was performed. The right and left renal artery were adequately visualized. The catheter was used to selectively catheterize the right and left renal artery. Selective right and left renal angiography were then performed, demonstrating a widely patent right and left renal artery.
What CPT coding is reported?

Answer: D

Explanation:
CPT code 36252 describes selective catheter placement of the main renal artery with angiography of both kidneys, which matches the procedure of selectively catheterizing the right and left renal arteries and performing angiography. Additionally, CPT code 75625-26 is for an abdominal aortography with interpretation and report. The -26 modifier indicates that the professional component of the service was performed.
References:
* AMA's CPT Professional Edition (current year), Codes 36252, 75625-26


NEW QUESTION # 50
A patient complains of tarry, black stool, and epigastric tightness. An esophagogastroduodenoscopy is recommended to evaluate the source of the bleeding. The endoscope is inserted orally. The esophagus appears normal on scope insertion. No evidence of bleeding in the stomach. The scope is then passed into the duodenum, where a polyp is found and removed with hot biopsy forceps. No evidence of bleeding post procedure.
What CPT code is reported?

Answer: C

Explanation:
An esophagogastroduodenoscopy (EGD) was performed with the removal of a polyp using hot biopsy forceps.
Procedure Description:
An EGD was performed.
A polyp was found in the duodenum and removed with hot biopsy forceps.
CPT Coding:
43250: Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps.
AMA's CPT Professional Edition (current year).
CPT Assistant for detailed coding guidelines on endoscopic procedures.


NEW QUESTION # 51

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

Answer: A

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.
References:
* 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 # 52
A 52-year-old woman has been experiencing discomfort and itching In the vulvar area for several months. She has a history of abnormal Pap smears and a recent biopsy revealed vulvar intraepithelial neoplasia (VIN III). Decision has been made to perform a vulvectomy.
Procedure: Under general anesthesia, the surgeon made an incision in the vulvar area and removed the vulva (more than 80%), including the affected skin and deep subcutaneous tissue.
What CPT and ICD-10-CM codes are reported?

Answer: B

Explanation:
Procedure Coding:
56633 - Radical vulvectomy (removal of >80%), including deep subcutaneous tissue Documentation supports greater than 80% vulvar removal Deep tissue involvement confirms radical procedure Diagnosis Coding:
D07.1 - Carcinoma in situ of vulva
VIN III = high-grade squamous intraepithelial lesion
Classified as carcinoma in situ, not benign dysplasia
Why Other Options Are Incorrect:
56620 / 56625 / 56630 - Partial or simple vulvectomy
N90.1 - Mild vulvar dysplasia (incorrect severity)
ICD-10-CM Official Guideline:
VIN III is coded as D07.1, not N90.x.


NEW QUESTION # 53
A 5-year-old is brought to the QuickCare in the ED to repair two lacerations: a 3 cm laceration on her right arm and 2 cm laceration on her nose. Her arm is repaired with a simple one-layer closure with sutures. Her nose is repaired with a simple repair using tissue adhesive, 2-cyanoacrylate.
How are the repairs reported?

Answer: C


NEW QUESTION # 54
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