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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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| Available Languages: | English |
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| Passing Score: | Approximately 70% |
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| Certificate Validity Period: | 2 years (renewal via Continuing Education Units - CEUs) |
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| Exam Price: | $399–$499 USD (varies by membership and region) |
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| Exam Duration: | 340 minutes |
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| Exam Format: | Multiple Choice Questions, Open-book (CPT, ICD-10-CM, HCPCS manuals allowed) |
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| Real Exam Qty: | 150 multiple-choice questions |
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| Related Certifications: | Certified Inpatient Coder (CIC) Certified Coding Specialist (CCS) Certified Outpatient Coder (COC) |
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| Recommended Training: | AAPC CPC Training Course AAPC CPC Practice Exams |
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| Exam Registration: | AAPC CPC Certification Page AAPC Exam Registration Portal |
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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 | - 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 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 | - 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.
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| Topic 4 | - 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 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.
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| Topic 6 | - 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.
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| Topic 7 | - 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 8 | - 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 9 | - 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 10 | - 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 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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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q28-Q33):
NEW QUESTION # 28
(A patient is in her otolaryngologist's office to receive therapeutic treatment forasthmatic bronchitis with status asthmaticus. A subcutaneous injection ofomalizumab (150 mg)is given in her left upper arm. What is the CPT and ICD-10-CM coding?)
- A. 90460, J2357 × 30, J45.52
- B. 96369, J2357 × 30, J45.52
- C. 90471, J2357 × 30, J45.902
- D. 96372, J2357 × 30, J45.902
Answer: D
Explanation:
Omalizumab is a drug reported withHCPCS J2357, and the dose is converted into billable units based on the code's unit definition. In CPC-style questions,150 mgis commonly represented asJ2357 × 30 units(i.e., 5 mg per unit # 150/5 = 30). Administration is atherapeutic subcutaneous injection, reported with96372(therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular). Vaccine administration codes (90460
/90471) are not appropriate because omalizumab is not a vaccine. For diagnosis, the statement includesstatus asthmaticusbut does not specify severity category (mild/moderate/severe persistent). In the options provided, J45.902is the "unspecified asthma with status asthmaticus" concept, whereas J45.52 requires severe persistent asthma with status asthmaticus (not documented). Therefore, the correct pairing is96372 + J2357 × 30 + J45.
902. CPC exam tip: match administration code type (therapeutic injection vs immunization) and choose the most specific ICD-10-CM supported by documentation.
NEW QUESTION # 29
Day 1 - A provider admits the patient to observation care for type 2 diabetes mellitus with hyperglycemia. The provider orders a HbA1c, a urine (microalbumin), and kidney function lab tests.
Blood sugar is high and poorly controlled. The provider discusses the case with the patient's endocrinologist. The provider prescribes an IV insulin drip, along with SQ insulin and keeps the patient in observation overnight.
Day 2 - Patient is in observation care and the provider orders a blood glucose test. The patient's glucose levels have improved. The provider places an order for the dietitian to see the patient.
Provider
documents spending a total time of 25 minutes with the patient.
Day 3 - Patient has a blood glucose test. The patient's glucose level is back to normal. The provider documents spending 15 minutes with the patient. The provider discharges the patient.
What E/M coding is reported by the physician for the patient in observation care?
- A. 99222, 99231, 99238
- B. 99221, 99232, 99239
- C. 99235, 99238
- D. 99235, 99231, 99238
Answer: D
Explanation:
For a patient in observation care, selecting the correct E/M codes requires evaluating each day's service level and the provider's documentation.
Day 1: The patient was admitted for observation, and the physician prescribed IV and SQ insulin, noting diabetes with hyperglycemia requiring complex management. The CPT code 99235 is appropriate here because it represents an initial observation or inpatient care for patients with high-complexity medical decision-making (MDM), which aligns with the patient's unstable glucose and the management requirements.
Day 2: The patient's glucose levels improved, and the provider documented spending 25 minutes with the patient in continued observation care. Since this is an established patient with continued observation, 99231 applies here, indicating subsequent observation care with low MDM complexity.
Day 3: The provider documented spending 15 minutes with the patient, whose glucose levels normalized, and then discharged the patient from observation care. Code 99238 is used for a discharge from observation care and is selected based on discharge times under 30 minutes.
These codes were selected based on CPT guidelines for observation care and the provider's time-based documentation. This matches the medical decision complexity documented per the case and code descriptions available for observation care management.
NEW QUESTION # 30
A business requires drug testing for cocaine and methamphetamines prior to hiring a job candidate. A single analysis with direct optical observation is performed, followed by a confirmation for cocaine.
Which codes are used for reporting the testing and confirmation?
- A. 80305, 80353
- B. 80306, 80375
- C. 80306 x 2, 80353
- D. 80305 x 2, 80353
Answer: A
Explanation:
For drug testing for cocaine and methamphetamines with a single analysis using direct optical observation and a subsequent confirmation for cocaine, the appropriate codes are:
80305 for the initial drug test (presumptive).
80353 for the confirmation test of cocaine.
Reference:
AMA's CPT Professional Edition (current year)
NEW QUESTION # 31
The outermost protective layer of skin is called the:
- A. Dermis
- B. Epidermis
- C. Subcutaneous tissue
- D. Hypodermis
Answer: B
Explanation:
The outermost protective layer of the skin is called the epidermis. It serves as a barrier to protect the body against environmental elements, pathogens, and helps to retain moisture. The epidermis itself is composed of several sub-layers, with the stratum corneum being the outermost layer.
ICD-10-CM (current year), Chapter 12: Diseases of the Skin and Subcutaneous Tissue (L00-L99).
NEW QUESTION # 32
(Which one of the following is an anesthesiaphysical status modifier?)
Answer: D
Explanation:
Anesthesiaphysical status modifiersare the ASA modifiersP1-P6, which describe the patient's overall systemic health (e.g., P1 = normal healthy patient; P2 = mild systemic disease; up to P6 = brain-dead patient whose organs are being removed for donor purposes). Among the choices,P1is the only ASA physical status modifier.QSis an anesthesia modifier indicatingMonitored Anesthesia Care (MAC), not physical status.
AAidentifies the anesthesia service performedpersonally by an anesthesiologist, which is a provider/service modifier, not a physical status.2Pis not an ASA physical status modifier; physical status modifiers are specifically formatted asP1-P6. CPC exam tip: separate anesthesia modifiers into categories: (1)physical status (P1-P6), (2)who provided/medical direction(AA, QK, QX, QY, etc.), and (3)service circumstancemodifiers (like QS for MAC when applicable). Here, the question explicitly asks for physical status-soP1is correct.
NEW QUESTION # 33
......
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