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| Topic | Details |
|---|
| Topic 1 | - 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 2 | - 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 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 | - 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 5 | - 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 6 | - 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 7 | - 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 8 | - 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 9 | - 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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| Topic 10 | - 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.:
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| 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 | - 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 13 | - 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 14 | - 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 15 | - 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 16 | - 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 17 | - 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.
|
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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q32-Q37):
NEW QUESTION # 32
View MR 099401
MR 099401
Established Patient Office Visit
Chief Complaint: Patient presents with bilateral thyroid nodules.
History of present illness: A 54-year-old patient is here for evaluation of bilateral thyroid nodules. Thyroid ultrasound was done last week which showed multiple thyroid masses likely due to multinodular goiter. Patient stated that she can "feel" the nodules on the left side of her thyroid. Patient denies difficulty swallowing and she denies unexplained weight loss or gain. Patient does have a family history of thyroid cancer in her maternal grandmother. She gives no other problems at this time other than a palpable right-sided thyroid mass.
Review of Systems:
Constitutional: Negative for chills, fever, and unexpected weight change.
HENT: Negative for hearing loss, trouble swallowing and voice change.
Gastrointestinal: Negative for abdominal distention, abdominal pain, anal bleeding, blood in stool, constipation, diarrhea, nausea, rectal pain, and vomiting Endocrine: Negative for cold Intolerance and heat intolerance.
Physical Exam:
Vitals: BP: 140/72, Pulse: 96, Resp: 16, Temp: 97.6 °F (36.4 °C), Temporal SpO2: 97% Weight: 89.8 kg (198 lbs ), Height: 165.1 cm (65") General Appearance: Alert, cooperative, in no acute distress Head: Normocephalic, without obvious abnormality, atraumatic Throat: No oral lesions, no thrush, oral mucosa moist Neck: No adenopathy, supple, trachea midline, thyromegaly is present, no carotid bruit, no JVD Lungs: Clear to auscultation, respirations regular, even, and unlabored Heart: Regular rhythm and normal rate, normal S1 and S2, no murmur, no gallop, no rub, no click Lymph nodes: No palpable adenopathy ASSESSMENT/PLAN:
1) Multinodular goiter - the patient will have a percutaneous biopsy performed (minor procedure).
What E/M code is reported for this encounter?
Answer: A
Explanation:
The patient is an established patient presenting with bilateral thyroid nodules and has a detailed history and examination performed.
Procedure Description:
Detailed history and examination of bilateral thyroid nodules.
Review of systems and physical examination.
Assessment and plan for a percutaneous biopsy.
CPT Coding:
99214: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making.
AMA's CPT Professional Edition (current year).
CPT Assistant for detailed coding guidelines on evaluation and management services.
NEW QUESTION # 33
Patient has esotropia of the right eye and presents to operating suite for strabismus surgery. The physician resects the medial rectus horizontal and lateral rectus muscles of the eye and secures them with adjustable sutures. Extensive scar tissue is noted, due to a previous surgery involving an extraocular muscle. Extraocular muscle is isolated, and the muscle is freed from surrounding scar tissues.
What CPT codes are reported for this surgery?
- A. 67314, 67334
- B. 67311, 67334
- C. 67312, 67335
- D. 67316, 67335
Answer: A
Explanation:
* Esotropia of the right eye: Indicates strabismus surgery is required.
* Resection of medial rectus horizontal and lateral rectus muscles: Specific muscles addressed during the surgery.
* Adjustable sutures: Used in securing the muscles, indicating specific techniques.
* Extensive scar tissue from previous surgery: Requires additional work and isolation.
CPT codes 67314 and 67334 are used to report the resection of two muscles with adjustable sutures (67314) and surgery on an extraocular muscle involving extensive scar tissue (67334).
References: AMA's CPT Professional Edition (current year)
NEW QUESTION # 34
A 23-year-old receives MMR and Hepatitis B vaccines without counseling.
What CPT codes are reported?
- A. 90460 ×2, 90461 ×3, 90710, 90744
- B. 90471 ×2, 90472 ×3, 90707, 90746
- C. 90471, 90472, 90707, 90746
- D. 90460, 90461, 90710, 90744
Answer: C
Explanation:
90471/90472 = Administration without counseling
90707 = MMR
90746 = Hepatitis B, adult
NEW QUESTION # 35
(Regarding the CPT Surgery Guidelines for a surgical code designated as a"Separate Procedure,"which statement isFALSE?)
- A. Codes designated as "separate procedure" should not be reported in addition to the code for the total procedure or service of which it is an integral component.
- B. A service that is commonly carried out as an integral component of a total service or procedure is identified by the inclusion of the term "separate procedure."
- C. To identify a service designated as a "separate procedure" that is reported with an unrelated primary service, append modifier79to the code.
- D. When a procedure is designated as a separate procedure and carried out independently or considered unrelated from the total primary service, it may be reported.
Answer: C
Explanation:
In CPT, a code labeled"separate procedure"is typically a service that isnormally includedas part of a more comprehensive procedure andshould not be reported separatelywhen performed as an integral component.
However, itmaybe reported when performedindependentlyorunrelatedto the primary procedure-this supports options A, B, and C as true. The false statement isDbecause CPT doesnotinstruct that modifier79is specifically required to report a separate procedure with an unrelated primary service. Modifier selection depends on the actual circumstances and payer rules, and "separate procedure" logic is about whether the service isdistinct and not integral, often supported by documentation of a different site/session or separate clinical intent; when a modifier is needed, it is commonly adistinct procedural servicemodifier (e.g., 59 or X
{EPSU}) rather than automatically 79. Modifier79is a global surgery modifier used for anunrelated procedure during the postoperative period, which is a different concept than "separate procedure" designation.
NEW QUESTION # 36
The pulmonologist performs a bronchoscopy with fluoroscopic guidance. The scope is introduced into the right nostril and advanced to the vocal cords and into the trachea. The scope is advanced to the right upper lobe and a lung nodule is noted. An endobronchial biopsy is performed.
What CPT code is reported for the procedure?
Answer: B
Explanation:
The CPT code 31625 is used for bronchoscopy with a transbronchial lung biopsy. This includes the use of fluoroscopic guidance, as described in the scenario.
Reference:
AMA's CPT Professional Edition (current year)
NEW QUESTION # 37
......
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