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AAPC CPC Exam Overview:

Certification Vendor:AAPC (American Academy of Professional Coders)
Exam Name:Certified Professional Coder (CPC) Exam
Exam Number:CPC
Exam Format:Multiple-choice, Open-book, Scenario-based
Certificate Validity Period:3 years
Available Languages:English
Related Certifications:CPC-P
CRC
CPMA
CPCO
Real Exam Qty:100
Exam Price:$425 (1 attempt), $499 (2 attempts)
Passing Score:70%
Exam Duration:240 minutes
Recommended Training:AAPC CPC Training Courses
Exam Registration:AAPC Official Registration
Sample Questions:AAPC CPC Sample Questions
Exam Way:Online proctored or in-person at authorized testing centers
Pre Condition:No mandatory prerequisites; recommended knowledge of medical terminology, anatomy, coding systems; AAPC membership required to register
Official Syllabus URL:https://www.aapc.com/certifications/cpc

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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 2
  • 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 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
  • 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 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
  • 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 7
  • 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 8
  • 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.
Topic 9
  • 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 10
  • 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.
Topic 11
  • 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.

AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q243-Q248):

NEW QUESTION # 243
An autopsy is ordered for a deceased patient of unknown cause. The pathologist performs gross and microscopic examination, including the brain and spinal cord.
What CPT coding is reported?

Answer: C

Explanation:
88027 = Autopsy, gross and microscopic, with CNS examination
88016/88020 exclude spinal cord or microscopy


NEW QUESTION # 244
Refer to the exhibit.

Refer to the supplemental information when answering this question:
View MR 065174
What E/M code is reported for this encounter?

Answer: B

Explanation:
To determine the correct E/M code, we need to consider the three key components: history, examination, and medical decision making (MDM).
History:
The documentation indicates an expanded problem-focused history. This is supported by the detailed history of present illness, including the patient's description of symptoms, family history, and review of systems with pertinent positives and negatives.
Examination:
The examination is also expanded problem-focused. The physician focused on the relevant systems (head, neck, throat) and documented specific findings related to the chief complaint (thyromegaly).
Medical Decision Making:
The MDM is straightforward. The physician is evaluating a new problem (bilateral thyroid nodules) with a low level of risk. Although further workup is planned, this alone doesn't automatically increase the MDM complexity.
Based on these components, 99213 is the most appropriate code.
Why other options are incorrect:
99212: Requires a problem-focused history and examination, which is less comprehensive than what was documented.
99214 and 99215: Require a higher level of MDM (low or moderate complexity) and/or a more detailed examination. The documentation doesn't support this level of service.
Reference:
CPT Codes 99211-99215: Office or other outpatient visit for the evaluation and management of an established patient
1995 and 1997 Documentation Guidelines for Evaluation and Management Services: These guidelines provide detailed criteria for selecting the appropriate E/M code based on history, examination, and MDM.
AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.


NEW QUESTION # 245

Refer to the supplemental information when answering this question:
View MR 354859
What CPT and ICD-10-CM coding is reported?

Answer: D


NEW QUESTION # 246
A Medicare patient is scheduled for a screening colonoscopy.
What code is reported for Medicare?

Answer: D

Explanation:
Medicare provides specific codes for screening colonoscopy based on the patient's risk factors. For a Medicare patient scheduled for a screening colonoscopy who is at high risk (such as those with a history of intestinal polyps), the appropriate code is G0105.
G0105 is used for colorectal cancer screening; colonoscopy on individuals at high risk.
HCPCS Level II, current year
Medicare Guidelines for Colorectal Cancer Screening


NEW QUESTION # 247
What is the medical term for a procedure that creates an opening between the bladder and the rectum?

Answer: B

Explanation:
Breaking down the term:
Cyst/o = bladder
Proct/o = rectum
-stomy = creation of an opening
Cystoproctostomy is the surgical creation of an opening between the bladder and the rectum.
The other options involve different organs:
Gastroenterocolostomy - stomach to intestine
Colocholecystostomy - colon to gallbladder
Nephropyelostomy - kidney to renal pelvis


NEW QUESTION # 248
......

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