Error-Free AAPC CPC Exam Questions PDF Format

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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.:
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| Topic 2 | - 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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| Topic 3 | - 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.
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| Topic 4 | - 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.
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| Topic 5 | - 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 6 | - 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 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 | - 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 | - 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 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 | - 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.
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| Topic 12 | - 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.
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| Topic 13 | - 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 14 | - 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 15 | - 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 16 | - 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 17 | - 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.
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| Topic 18 | - Introduction to CPTยฎ, HCPCS Level II, and Modifiers: This section of the exam measures the skills of coding specialists and introduces candidates to CPTยฎ 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 19 | - 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.
|
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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q198-Q203):
NEW QUESTION # 198
Four malignant peritoneal tumors are excised, the largest measuring 15 cm.
What CPT and ICD-10-CM coding is reported?
- A. 49190, C48.2
- B. 49190, C76.2
- C. 49187, K66.8
- D. 49190, K66.9, R10.0
Answer: A
Explanation:
49190 = Excision of peritoneal tumor greater than 10 cm
C48.2 = Malignant neoplasm of peritoneum
NEW QUESTION # 199
The evisceration of ocular contents was performed using a surgical microscope for enhanced visualization. The procedure was performed on the left eye and an implant was not placed in the ocular cavity.
What CPT coding is reported?
- A. 65093-LT, 69990
- B. 65091-LT
- C. 65091-LT, 69990-51
- D. 65093-LT
Answer: B
Explanation:
1. Procedure and CPT Code Selection:
The procedure performed was an evisceration of ocular contents without the placement of an implant. The surgical microscope was used for enhanced visualization, but this does not require a separate code if the primary procedure code includes it inherently.
CPT Code 65091 is used for an evisceration of the ocular contents without implant placement. This code correctly describes the procedure performed on the left eye.
2. Modifier:
Modifier LT is added to indicate that the procedure was performed on the left eye.
3. Exclusion of Code 69990:
Code 69990 is for the use of an operating microscope, but it should not be billed separately when it is used as part of a procedure where enhanced visualization is typical or expected, such as an evisceration procedure. According to CPT guidelines, 69990 is not separately reported when the microscope is used for visualization in procedures where its use is considered part of the standard of care.
4. Rationale for Excluding Other Options:
Code 65093 is for an evisceration with implant placement, which does not apply since no implant was used.
Options B and C incorrectly include 69990, which is not separately reportable in this scenario.
5. AAPC and CPT Coding Guidelines:
According to AAPC and CPT coding guidelines, 65091 is sufficient to capture the procedure without the need to add code 69990 for the microscope.
Therefore, the correct answer is D. 65091-LT.
NEW QUESTION # 200
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?
- A. A0429-QM-HP
- B. A0429-QM-PH
- C. A0428-QM-HP
- D. A0428-QM-PH
Answer: D
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 # 201
Dr. Burns sees newborn baby James at the birthing center on the same day after the cesarean delivery. Dr.
Burns examined baby James, the maternal and newborn history, ordered appropriate blood test tests and hearing screening. He met with the family at the end of the exam.
How would Dr. Bums report his services?
Answer: A
Explanation:
Dr. Burns is providing initial hospital or birthing center care for the evaluation and management of a normal newborn infant. CPT code 99460 is used to report initial hospital or birthing center care, per day, for evaluation and management of a normal newborn infant. This includes a comprehensive history, examination, and medical decision-making. The description of the service provided fits this CPT code accurately.
References: CPT Professional Edition (current year), AMA.
NEW QUESTION # 202
A patient is having a thyroidectomy for malignancy on the right lobe. During the procedure, a lesion was found on the left lower side of the parathyroid gland and is suspected for malignancy.
The total right lobe of the thyroid and the parathyroid gland are removed.
What is the CPTcodes are reported for this encounter?
- A. 60505, 60220-59
- B. 60505,60240-59
- C. 60500, 60210-59
- D. 60500, 60220-59
Answer: A
Explanation:
1. Procedure and CPTCode Selection:
The patient underwent a thyroidectomy for malignancy in the right lobe, as well as the removal of the parathyroid gland due to a suspected malignant lesion.
CPTCode 60505 is for the parathyroidectomy with exploration of parathyroid glands and is appropriate for the removal of the parathyroid gland due to a suspected malignancy.
CPTCode 60220 represents a thyroid lobectomy (total removal of one lobe of the thyroid), which applies to the removal of the right thyroid lobe in this case.
2. Modifier 59:
Modifier 59 is added to 60220 to indicate that the thyroid lobectomy is a distinct procedure from the parathyroidectomy, performed in a separate anatomical site during the same surgical session.
3. Rationale for Excluding Other Options:
Code 60500 (in options A and C) is for a parathyroid exploration only, not including the actual removal of the parathyroid gland, so it does not apply here.
Code 60240 (in option D) is for a total thyroidectomy, which involves removal of the entire thyroid gland.
Since only the right lobe was removed, 60220 (thyroid lobectomy) is correct.
4. AAPC and CPTCoding Guidelines:
Per AAPC guidelines, 60505 is the appropriate code for parathyroidectomy procedures involving exploration or suspected malignancy, and 60220 with Modifier 59 accurately reflects the separate and distinct thyroid lobectomy procedure.
Thus, the correct answer is B. 60505, 60220-59.
NEW QUESTION # 203
......
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