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AAPC CPC Exam Overview:
| Certification Vendor: | AAPC |
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| Exam Name: | AAPC Certified Professional Coder (CPC) Certification Exam |
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| Exam Number: | CPC |
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| Related Certifications: | Certified Coding Specialist (CCS) Certified Outpatient Coder (COC) Certified Inpatient Coder (CIC) |
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| Exam Format: | Multiple Choice Questions, Open-book (CPT, ICD-10-CM, HCPCS manuals allowed) |
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| Available Languages: | English |
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| Exam Price: | $399–$499 USD (varies by membership and region) |
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| Passing Score: | Approximately 70% |
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| Exam Duration: | 340 minutes |
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| Certificate Validity Period: | 2 years (renewal via Continuing Education Units - CEUs) |
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| Real Exam Qty: | 150 multiple-choice questions |
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| Recommended Training: | AAPC CPC Training Course AAPC CPC Practice Exams |
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| Exam Registration: | AAPC Exam Registration Portal AAPC CPC Certification Page |
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| Sample Questions: | AAPC CPC Sample Questions |
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| Exam Way: | Available via online proctored exam or authorized testing centers (in-person). |
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| Pre Condition: | No formal prerequisite required. Recommended: 1–2 years of medical coding experience or completion of AAPC CPC training. |
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| Official Syllabus URL: | https://www.aapc.com/certification/cpc/ |
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| Topic | Details |
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| 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.
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| Topic 2 | - 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 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.
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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 | - 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 6 | - 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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| Topic 7 | - 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.
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| Topic 8 | - 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 9 | - 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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| Topic 10 | - 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.
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| Topic 11 | - 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.
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| Topic 12 | - 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.
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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q220-Q225):
NEW QUESTION # 220
(What ICD-10-CM coding is reported forType 1 diabeteswithdiabetic chronic kidney disease?)
- A. E11.21
- B. E10.22, N18.1
- C. E10.22, N18.9
- D. E10.21
Answer: C
Explanation:
For diabetes coding, you must first select the diabetes category that matches the type:Type 1 diabetesisE10.- (not E11, which is Type 2). "Diabetic chronic kidney disease" maps toE10.22(Type 1 diabetes mellitus with diabetic chronic kidney disease). ICD-10-CM guidelines then require anadditional codeto identify thestage of CKDfromN18.-. Because the question does not specify the CKD stage, you assignN18.9(chronic kidney disease, unspecified). That makesE10.22, N18.9correct (Option B). Option D would only be correct if the stage were specifically documented asCKD stage 1 (N18.1). Option C (E10.21) is diabetes with diabetic nephropathy, which is not the same as "diabetic CKD" in this question. CPC exam tip:E10.22 always needs an N18.- stage codewhen stage is known; if not known, useN18.9.
NEW QUESTION # 221
Preoperative diagnosis: Right thigh benign congenital hairy nevus. *1
Postoperative diagnosis: Right thigh benign congenital hairy 0 nevus.
Operation performed: Excision of right thigh benign congenital>1
nevus, excision size with margins 4.5 cm and closure size 5 cm.
Anesthesia: General.0
Intraoperative antibiotics: Ancef.0
Indications: The patient is a 5-year-old girl who presented with her parents for evaluation of her right thigh congenital nevus. It has been followed by pediatrics and thought to have changed over the past year. Family requested excision. They understood the risks involved, which included but were not limited to risks of general anesthesia, infection, bleeding, wound dehiscence, and poor scar formation. They understood the scar would likely widen as the child grows because of the location of it and because of the age of the patient. They consented to proceed.
Description of procedure: The patient was seen preoperatively in > I the holding area, identified, and then brought to the operating room. Once adequate general anesthesia had been induced, the patient's right thigh was prepped and draped in standard surgical fashion. An elliptical excision measuring 6 x 1.8 cm had been marked. This was injected with Lidocaine with epinephrine, total of 6 cc of 1% with 1:100,000. After an adequate amount of time, a #15 blade was used to sharply excise this full thickness.
This was passed to pathology for review. The wound required limited undermining in the deep subcutaneous plane on both sides for approximately 1.5 cm in order to allow mobilization of the skin for closure. The skin was then closed in a layered fashion using 3-0 Vicryl on the dermis and then 4-0 Monocryl running subcuticular in the skin, the wound was cleaned and dressed with Dermabond and Steri-Strips.
The patient was then cleaned and turned over to anesthesia for S extubation.
She was extubated successfully in the operating room and taken S to the recovery room in stable condition. There were no complications.
What is the radiology coding for this encounter?
- A. 73560-26-LT
- B. 73562-26
- C. 0
- D. 73560-LT
Answer: B
Explanation:
73562 = Knee X-ray, 3 views
-26 = Professional component only
NEW QUESTION # 222
A patient with malignant lymphoma is administered the antineoplastic drug Rituximab 800 mg and then 100 mg of Benadryl.
Which HCPCS Level II codes are reported for both drugs administered intravenously?
- A. J9312 x 80, J1200 x 2
- B. J9312, J1200
- C. J9312 x 80, 00163 x 2
- D. J9312, Q0163
Answer: C
NEW QUESTION # 223
A comatose patient is seen in the ER. The patient has a history of depression. Drug testing confirm she overdosed on tricyclic antidepressant drugs doxepin, amoxapine, and clomipramine.
What CPT code is reported?
Answer: C
Explanation:
For a comatose patient who has overdosed on tricyclic antidepressant drugs (doxepin, amoxapine, and clomipramine), the correct CPT code is 80366. This code covers drug testing for tricyclic antidepressants, which includes the specific drugs mentioned in the scenario.
References:
* AMA's CPT Professional Edition (current year)
NEW QUESTION # 224
A physician prescribes carbamazepine to treat a patient with epileptic seizures. After six months, the physician performs a therapeutic drug test to monitor the total level of the drug in the patient.
What CPTand ICD-10-CM coding is used for the six month-evaluation?
- A. 80156, R56.9
- B. 80157, R56.9
- C. 80156, G40.909
- D. 80157, G40.909
Answer: C
Explanation:
The correct CPTcode for a therapeutic drug test to monitor the total level of carbamazepine is 80156. The ICD-10-CM code G40.909 is used for epileptic seizures, not otherwise specified, which aligns with the patient
' s condition being treated for seizures.
References:
AMA ' s CPTProfessional Edition (current year)
ICD-10-CM (current year)
NEW QUESTION # 225
......
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