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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 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.
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.
Topic 4
  • 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 5
  • 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 6
  • 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 7
  • 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 8
  • 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 9
  • 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.:
Topic 10
  • 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.
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.
Topic 12
  • 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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AAPC - CPC - Certified Professional Coder (CPC) Exam –Updated Online Test

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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q423-Q428):

NEW QUESTION # 423
During a laparoscopic hemicolectomy, the left kidney is accidentally perforated. A nephrologist performs open repair of the kidney laceration and places a JP drain.
What CPT and ICD-10-CM coding is reported by the nephrologist?

Answer: A

Explanation:
50500 = Repair of kidney laceration
N99.72 = Accidental puncture/laceration of genitourinary system during a procedure S37.062A (traumatic kidney injury) is not used for intraoperative complications The nephrologist does not report the colectomy, nor modifier -80


NEW QUESTION # 424
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?

Answer: C

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 # 425
A patient is diagnosed with diabetic polyneuropathy.
Using ICD-10-CM coding guidelines, what ICD-10-CM coding is reported?

Answer: A

Explanation:
Diabetic polyneuropathy is coded as E11.42, which indicates type 2 diabetes mellitus with diabetic polyneuropathy. The ICD-10-CM guidelines direct that when a patient has both diabetes and polyneuropathy, a single combination code is used to capture both conditions.
ICD-10-CM (current year), Chapter 4: Endocrine, Nutritional, and Metabolic Diseases (E00-E89), ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.4.a.6.


NEW QUESTION # 426
(A driver crashes into a guardrail and sustains a fracture of the anterior fossa cranial base with involvement of thesphenoid sinus, withno CSF leak. The patient undergoessurgical nasal sinus endoscopy with sphenoidotomyto evaluate and treat the sinus injury. No CSF leak repair is performed. What is the correct procedure and diagnosis coding combination to report this service?)

Answer: A

Explanation:
Asphenoidotomyperformed vianasal/sinus endoscopyis specifically reported withCPT 31287(endoscopic sinus surgery, sphenoidotomy). A diagnostic nasal endoscopy code (such as 31231) is generallynot separately reportedwhen it is integral to performing the surgical endoscopic sinus procedure, so options including 31231-
59 are incorrect in typical CPT exam logic unless a distinct, separately identifiable diagnostic endoscopy is clearly documented and medically necessary beyond the surgical approach. The diagnosis describes afracture of the skull baseinvolving the sphenoid sinus without CSF leak; among the offered diagnosis codes,S02.
19XAcorrectly represents a skull base fracture category consistent with the scenario's specificity as presented in the answer choices. Code31291represents a different sinus procedure (not sphenoidotomy). CPC key point:
choose the code matching thespecific sinus and surgical action(sphenoidotomy # 31287) and avoid unbundling the diagnostic endoscopy that is part of the operative endoscopic approach.


NEW QUESTION # 427
A patient presents to the labor and delivery department for a planned cesarean section for triplets. She is at 37 weeks gestation. She is given a continuous epidural for the delivery.
What anesthesia coding is reported?

Answer: A

Explanation:
The patient presents for a planned cesarean section for triplets and receives continuous epidural anesthesia.
CPT code 01967 is used for neuraxial labor analgesia/anesthesia for planned vaginal delivery, and code 01968 is an add-on code for cesarean delivery following neuraxial labor analgesia/anesthesia. Since this is a planned cesarean section with triplets, both codes 01967 and 01968 are applicable.
References: CPT Professional Edition (current year), AMA.


NEW QUESTION # 428
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