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AAPC CPC Prüfungsplan:

ThemaEinzelheiten
Thema 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.
Thema 2
  • 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.
Thema 3
  • 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.
Thema 4
  • 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.
Thema 5
  • 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.
Thema 6
  • 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.
Thema 7
  • 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.
Thema 8
  • 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.:
Thema 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.
Thema 10
  • 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.
Thema 11
  • 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.
Thema 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.
Thema 13
  • 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.
Thema 14
  • 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.
Thema 15
  • 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.
Thema 16
  • 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.

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AAPC Certified Professional Coder (CPC) Exam CPC Prüfungsfragen mit Lösungen (Q139-Q144):

139. Frage
View MR 003396
MR 003396
Operative Report
Preoperative Diagnosis: Acute MI, severe left main arteriosclerotic coronary artery disease Postoperative Diagnosis: Acute MI, severe left main arteriosclerotic coronary artery disease Procedure Performed: Placement of an intra-aortic balloon pump (IABP) right common femoral artery Description of Procedure: Patient's right groin was prepped and draped in the usual sterile fashion. Right common femoral artery is found, and an incision is made over the artery exposing it. The artery is opened transversely, and the tip of the balloon catheter was placed in the right common femoral artery. The balloon pump had good waveform. The balloon pump catheter is secured to his skin after local anesthesia of 2 cc of 1% Xylocaine is used to numb the area. The balloon pump is secured with a 0-silk suture. The patient has sterile dressing placed. The patient tolerated the procedure. There were no complications.
What CPT coding is reported for this case?

Antwort: B

Begründung:
The procedure involved the placement of an intra-aortic balloon pump (IABP) through the right common femoral artery for a patient with acute MI and severe left main arteriosclerotic coronary artery disease.
Procedure Description:
Placement of an intra-aortic balloon pump (IABP).
Right common femoral artery approach.
Confirmation of good waveform and securement of the catheter.
CPT Coding:
33975: Insertion of intra-aortic balloon assist device, percutaneous.
AMA's CPT Professional Edition (current year).
CPT Assistant for detailed coding guidelines on cardiac procedures.


140. Frage
Which one of the following is an example of a case in which a diabetes-related problem exists and the code for diabetes is never sequenced first?

Antwort: D

Begründung:
When a patient experiences an underdose of insulin due to an insulin pump malfunction, the primary reason for the encounter would be the malfunction itself, which is coded first. The resulting hyperglycemia or hypoglycemia due to the pump failure is a secondary condition. According to ICD-10-CM guidelines, the code for the mechanical complication of the pump (T85.633-) is sequenced first, followed by a code for the diabetes with complication (E11.65 for type 2 diabetes with hyperglycemia).References: ICD-10-CM (current year), Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88), ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.4.


141. Frage
The provider orders a bilirubin test for a patient with bowel flora disturbance. The lab determines the presence of bilirubin in a fecal sample.
What CPTcode is reported for the test?

Antwort: D


142. Frage
A complete cardiac MRI for morphology and function without contrast, followed by contrast with four additional sequences and stress imaging, is performed on a patient with systolic left ventricular congestive heart failure and premature ventricular contractions.
What CPT and ICD-10-CM codes are reported?

Antwort: C

Begründung:
* Procedure: Complete cardiac MRI for morphology and function without contrast, followed by contrast with four additional sequences and stress imaging.
* CPT Codes:
* 75561: Cardiac MRI for morphology and function without contrast material.
* 75563: Cardiac MRI with contrast and further sequences.
* ICD-10-CM Codes:
* I50.1: Left ventricular failure.
* I49.1: Premature ventricular contractions.
* Code Selection Justification: The CPT codes accurately capture the MRI procedures performed. The ICD-10-CM codes represent the diagnoses of left ventricular failure and premature ventricular contractions.
References:
* AMA CPT Professional Edition (current year)
* ICD-10-CM (current year)
* HCPCS Level II (current year)


143. Frage

Refer to the supplemental information when answering this question:
View MR 903096
What CPTand ICD-10-CM coding is reported?

Antwort: C

Begründung:
* CPT Code 62290: Discography, lumbar, single or multiple levels, radiological supervision and interpretation
* This code accurately describes the procedure performed. The documentation indicates a lumbar discography was performed at a single level (L3-4) with radiological supervision (C-arm visualization).
* ICD-10-CM Code M54.50: Low back pain, unspecified
* This code is the most appropriate diagnosis based on the documentation. The preoperative diagnosis states "Low back pain possible spinal stenosis L3-4." While spinal stenosis was considered, it was not confirmed. The postoperative diagnosis indicates no evidence of spinal stenosis or discogenic pathology. Therefore, the definitive diagnosis is low back pain.
Why other options are incorrect:
* 62292: This code is for a discography with injection of contrast and/or medication for therapeutic purposes. The documentation doesn't indicate any therapeutic injection was performed.
* M48.061 and M48.07: These codes represent spinal stenosis, which was not confirmed in the postoperative diagnosis.
References:
* CPT Code 62290: Discography, lumbar, single or multiple levels, radiological supervision and interpretation
* ICD-10-CM Code M54.50: Low back pain, unspecified
* AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.


144. Frage
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