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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 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
  • 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 4
  • 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 5
  • 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 6
  • 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 7
  • 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 8
  • 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 9
  • 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 10
  • 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 11
  • 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.

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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q120-Q125):

NEW QUESTION # 120
A 7-year-old boy is brought to the pediatric clinic by his mother. She reported that her son is complaining of discomfort in both ears and loss of hearing in the left ear for the past two days. The pediatrician diagnosis is impacted cerumen. Pediatrician with the mother's consent removes impacted cerumen using water irrigation In the right ear. For the left ear the cerumen impaction is removed using instrumentation.
What CPT coding is reported'

Answer: B

Explanation:
69209-RT - Removal of impacted cerumen using irrigation
69210-LT - Removal of impacted cerumen using instrumentation
Coding Rules Applied:
Different techniques → different CPT codes
Different ears → RT/LT modifiers, not modifier -50
Why Other Options Are Incorrect:
A - Modifiers reversed
B / D - Modifier -50 inappropriate when different CPT codes are used


NEW QUESTION # 121
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 # 122
A male patient passes out while jogging in the park. Upon examination at the hospital, he is found to have a wide complex tachycardia and undergoes an electrophysiologic study and radiofrequency ablation. For this procedure he is placed under general anesthesia.
What is the anesthesia coding for this otherwise healthy 35-year-old?

Answer: B

Explanation:
00537 - Anesthesia for electrophysiologic procedures including ablation Patient is otherwise healthy # P1 Why others are incorrect:
00532 - Pacemaker insertion
01922 - MRI
01026 - Lower extremity procedures


NEW QUESTION # 123
In rhinoplasty:

Answer: C

Explanation:
Rhinoplasty is a surgical procedure performed to reconstruct or reshape the nose. It can be done for cosmetic reasons or to improve breathing function. The term "rhino" refers to the nose, and "plasty" refers to the surgical molding or forming of a part of the body.References: AMA's CPT Professional Edition, medical dictionaries


NEW QUESTION # 124
View MR 099407
MR 099407
Emergency Department Visit
Chief Complaint: VOMITING.
This started just prior to arrival and is still present. He has had nausea and vomiting. No diarrhea, black stools, bloody stools or abdominal pain. Pt is diabetic and has been having elevated blood sugars (320 mg/dL).
REVIEW OF SYSTEMS: Unobtainable due to patient's altered mental status.
PAST HISTORY: Poorly controlled diabetes mellitus, with history of poor compliance.
Medications: See Nurses Notes.
Allergies: PCN.
SOCIAL HISTORY: Nonsmoker. No alcohol use or drug use.
ADDITIONAL NOTES: The nursing notes have been reviewed.
PHYSICAL EXAM
Appearance: Lethargic. Patient in mild distress.
Vital Signs: Have been reviewed-tachycardic.
Eyes: Pupils equal, round and reactive to light.
ENT: Dry mucous membranes present.
Neck: Normal inspection. Neck supple.
CVS: Tachycardia. Heart sounds normal. Pulses normal.
E D. Course: Insulin IV drip per protocol, at 10 units/hr.
Zofran 8 mg 01:33 Jul 13 2008 IVP.
Phenergan 25 mg IVP. 07:52. Discussed case with physician. Dr. X. Reviewed test results. Agreed upon treatment plan. Physician will see patient in hospital.
Total critical care time: 45 min.
Disposition: Admitted to Intensive Care Unit. Condition: stable.
Admit decision based on need for monitoring and IV hydration and medications.
CLINICAL IMPRESSION: Vomiting, diabetic ketoacidosis, probable diabetes insipidus.
What E/M code is reported for this encounter?

Answer: D

Explanation:
99291: This code is used for the first 30-74 minutes of critical care, evaluation, and management of the critically ill or critically injured patient.
99292: This code is used for each additional 30 minutes of critical care service beyond the first 74 minutes.
The documentation indicates that the patient received a total of 45 minutes of critical care, which involves continuous IV insulin for diabetic ketoacidosis, administration of antiemetics, and admission to the ICU. The critical care time documented justifies the use of 99291 for the first 30-74 minutes and 99292 for each additional 30 minutes.
CPT Professional Edition, AMA


NEW QUESTION # 125
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