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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • Introduction to CPTยฎ, HCPCS Level II, and Modifiers: This section of the exam measures the skills of coding specialists and introduces candidates to CPTยฎ 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 2
  • 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 3
  • 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 4
  • 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 5
  • 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 6
  • 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 7
  • 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 8
  • 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 9
  • 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 10
  • 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 11
  • 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 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 Certified Professional Coder (CPC) Exam Sample Questions (Q402-Q407):

NEW QUESTION # 402
(What CPT coding is reported for the insertion ofHeyman capsulesfor clinical brachytherapy?)

Answer: D

Explanation:
Heyman capsules are applicators used ingynecologic brachytherapy, classically forintracavitary uterineplacement as part of internal radiation therapy. CPT distinguishes between prostate brachytherapy services and gynecologic applicator placements.55875is associated with prostate brachytherapy procedures, and57155is for insertion of uterine tandem and/or vaginal ovoids (a different applicator system). The code that specifically aligns withinsertion of Heyman capsulesis58346. CPC exam strategy: when a question names a specific device/apparatus (like Heyman capsules), it is usually pointing to avery specific CPT code. Also, keep the anatomic system straight-Heyman capsules are not a prostate service and not simply a generic
"radiation therapy" code; they are a named gynecologic brachytherapy applicator insertion. Therefore, among the given options,58346is the correct report.


NEW QUESTION # 403
(A provider documents "pericarditis with effusion" in the assessment. Based on medical terminology, which structure is inflamed?)

Answer: A

Explanation:
Medical terms here are very literal.Peri-meansaround,cardirefers to theheart, and-itismeansinflammation.
Sopericarditisis inflammation of thepericardium, thefibrous sac surrounding the heart. "With effusion" indicatesfluid accumulationin that pericardial space (pericardial effusion), which can be clinically important because significant effusion may impair heart filling (tamponade risk), but the question is strictly asking which structure is inflamed. Distractors map to other "card-" terms:myocardium(heart muscle) would be
"myocarditis,"endocardium(inner lining of chambers/valves) would be "endocarditis," and blood vessels supplying the heart arecoronary arteries(inflammation would not be termed pericarditis). On CPC exams, identifyingprefix + root + suffixis the fastest method: peri (around) + cardi (heart) + itis (inflammation) # pericardium inflamed.


NEW QUESTION # 404
A physician conducts a 15-minute phone call discussing medication management.
How is this reported?

Answer: B

Explanation:
98012 = Telephone E/M, 11-20 minutes
99447 is for interprofessional consults, not patient calls
HCPCS LEVEL II


NEW QUESTION # 405
Which one of the following is an example of a case in which a diabetes-related problem exists and the code for diabetes is never sequenced first?

Answer: D


NEW QUESTION # 406

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.
References:
* 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 # 407
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