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AAPC CPC Exam Syllabus Topics:

TopicDetails
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.
Topic 2
  • 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.
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.
Topic 4
  • 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.
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.:
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.
Topic 7
  • 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 8
  • 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 9
  • 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 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.
Topic 11
  • 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 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.
Topic 13
  • 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 14
  • 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 15
  • 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 16
  • 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 17
  • 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.

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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q58-Q63):

NEW QUESTION # 58
A patient arrives at the clinic experiencing pain due to a chest injury caused by blunt force. The provider takes X-ray imaging with 6 views of the chest.
What CPT coding is reported?

Answer: A

Explanation:
71048 - Radiologic examination, chest; complete, minimum of 4 views
Includes 6 views
CPT codes are based on ranges, not per-view billing
Why Other Options Are Incorrect:
71047 - 2 views only
CPT does not allow "× view" reporting


NEW QUESTION # 59
Which entity offers compliance program guidance to form the basis of a voluntary compliance program for a provider practice?

Answer: B


NEW QUESTION # 60
A therapeutic colonoscopy is performed, where the scope goes beyond the splenic flexure, but not to the cecum. Using the Colonoscopy Decision Tree illustrated in the CPTcode book, what coding is reported?

Answer: B

Explanation:
When a therapeutic colonoscopy is attempted but does not reach the cecum, it is considered an incomplete procedure. According to the CPTColonoscopy Decision Tree, if the colonoscopy extends beyond the splenic flexure but does not reach the cecum, the appropriate way to code this incomplete colonoscopy is by appending modifier 53 to indicate a discontinued procedure due to extenuating circumstances or risk to the patient.
A: 45378-53 is the correct answer as it designates a diagnostic colonoscopy with modifier 53, signifying that the procedure was started but not completed.
B: 45330 is incorrect as it represents a sigmoidoscopy, which only goes up to the splenic flexure.
C: 45331-45347 refers to therapeutic colonoscopies that were completed to the cecum.
D: 45379-45398 with modifier 52 is incorrect because modifier 52 is used for reduced services, which does not accurately describe an incomplete colonoscopy.
Thus, the correct answer is A. 45378-53.


NEW QUESTION # 61

Refer to the supplemental information when answering this question:
View MR 623654
What CPTO coding is reported for this case?

Answer: D


NEW QUESTION # 62
A diagnostic mammogram is performed on the left and right breasts. Computer-aided detection is also used to further analyze the image for possible lesions.
What CPT coding is reported for this radiology service?

Answer: C


NEW QUESTION # 63
......

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