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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 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
  • 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 4
  • 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 5
  • 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 6
  • 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.
Topic 7
  • 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 8
  • 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 9
  • 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 10
  • 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 11
  • 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 12
  • 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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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q212-Q217):

NEW QUESTION # 212
A couple presents to the freestanding fertility clinic to start in vitro fertilization. Under radiologic guidance, an aspiration needle is inserted (by aid of a superimposed guiding-line) puncturing the ovary and preovulatory follicle and withdrawing fluid from the follicle containing the egg.
What is the correct CPT code for this procedure?

Answer: C

Explanation:
The procedure involves the aspiration of fluid from an ovarian follicle to retrieve the egg under radiologic guidance.
* Procedure Description:
* Aspiration needle insertion.
* Puncture of the ovary and preovulatory follicle.
* Withdrawal of fluid containing the egg.
* Radiologic guidance was used.
* CPT Coding:
* 58976: Aspiration of ovarian follicle(s) with ultrasound guidance.
References:
* AMA's CPT Professional Edition (current year).
* CPT Assistant for detailed coding guidelines on reproductive procedures.


NEW QUESTION # 213
A surgeon performs midface LeFort I reconstruction on a patient's facial bones to correct a congenital deformity. The reconstruction is performed in two pieces in moving the upper jawbone forward and repositioning the teeth of the maxilla of the mid face.
What CPT code is reported?

Answer: C

Explanation:
The procedure described involves a LeFort I reconstruction, which is a type of orthognathic surgery performed to correct deformities of the midface. In this scenario, the surgeon performed the reconstruction in two pieces, moving the upper jawbone forward and repositioning the teeth of the maxilla. According to the CPT guidelines, CPT code 21146 describes a LeFort I (maxilla only) osteotomy, two-piece segment, including bone grafts (includes obtaining autografts). This code matches the description provided.
References:
* AMA's CPT Professional Edition (current year), Code 21146


NEW QUESTION # 214
A 47-year-old female presents to the operating room for a partial corpectomy on one upper thoracic vertebral body, T3. Two surgeons are performing the surgery. One surgeon performs the transthoracic approach and excises the damaged portion of the vertebral body. The second surgeon inserts a bone graft into the vertebral gap, closing the gap, and inserts a metal plate. Both surgeons work together, each as a primary surgeon.
How does each surgeon report their portion of the surgery?

Answer: C

Explanation:
For this scenario, two surgeons are working together, each as a primary surgeon. Therefore, the correct coding requires the use of the modifier -62, which indicates co-surgeons.
The transthoracic approach to excise the damaged portion of the vertebral body is coded with 63087.
The insertion of the bone graft and metal plate is coded with 63088.
Both codes are appended with modifier -62 to indicate that two surgeons worked together as primary surgeons on this case.
Reference:
AMA's CPT Professional Edition (current year)
ICD-10-CM (current year)
HCPCS Level II (current year)


NEW QUESTION # 215
Which is a malignant neoplasm originating in the skin?

Answer: D

Explanation:
Melanoma is a malignant neoplasm of melanocytes, which are pigment-producing cells found primarily in the skin. It is one of the most serious forms of skin cancer and is classified under ICD-10-CM category C43.- (Malignant melanoma of skin).
Osteosarcoma is a malignant tumor of bone, not skin (ICD-10-CM C40-C41).
Hemangioma is a benign tumor of blood vessels and is not malignant (often coded under D18.-).
Lymphoma is a malignancy of the lymphatic system, not a primary skin neoplasm (ICD-10-CM C81-C85), though rare cutaneous lymphomas exist, they are not the standard CPC exam answer here.


NEW QUESTION # 216
A patient has nausea with several episodes of emesis along with severe stomach pain due to dehydration.
Normal saline is infused in the same bag with 2 mg ondansetron to help with the nausea. Then a dose of 15 mg ketorolac tromethamine was given for the stomach pain.
What J codes are reported for these services?

Answer: D

Explanation:
The correct J codes are selected based on the specific medications administered and their quantities:
J2405 represents "ondansetron, 1 mg," and since the patient received a 2 mg dose, J2405 is reported once with a quantity of 2 mg.
J1885 represents "ketorolac tromethamine, 15 mg," which matches the single 15 mg dose administered to the patient, so J1885 is reported once.
Each J code is billed according to the precise dosage given, as no multipliers are required beyond the single- unit codes provided in choice A, making it the correct answer.


NEW QUESTION # 217
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