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AAPC CPC Exam Syllabus Topics:
Topic
Details
Topic 1
- 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 2
- 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 3
- 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 4
- 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 5
- 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 6
- 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 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
- 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 9
- 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 10
- 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 11
- 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 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.
Topic 13
- 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 14
- 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 15
- 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 16
- 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 17
- 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.
AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q175-Q180):
NEW QUESTION # 175
A patient with three thyroid nodules is seen for an FNA biopsy. Using ultrasonic guidance, the provider inserts a 25-gauge needle into each nodule. Nodular tissue is aspirated and sent to pathology.
What CPT coding reported?
- A. 10005, 10006 x 2
- B. 10006 x 3
- C. 10021, 10004 x 2, 76942
- D. 10005, 10006 x 2, 76942
Answer: A
NEW QUESTION # 176
The gastroenterologist performs a simple excision of three external hemorrhoids and one internal hemorrhoid, each lying along the left lateral column. The operative report indicates that the internal hemorrhoid is not prolapsed and is outside of the anal canal.
What CPTand ICD-10CM codes are reported?
- A. 46250, 46945, K64.0, K64.4
- B. 46320, 46945, K64.0, K64.9
- C. 46255, K64.0, K64.4
- D. 46250, K64.0, K64.9
Answer: C
Explanation:
CPTcode 46255 describes the excision of both internal and external hemorrhoids, which matches the procedure described. The ICD-10-CM codes K64.0 (First degree hemorrhoids) and K64.4 (Residual hemorrhoids) describe the conditions treated.
References:
* AMA's CPTProfessional Edition (current year), Code 46255
* ICD-10-CM (current year), Codes K64.0, K64.4
NEW QUESTION # 177
A 67-year-old male presents with DJD and spondylolisthesis at L4-L5 The patient is placed prone on the operating table and, after induction of general anesthesia, the lower back is sterilely prepped and draped. One incision was made over L1-L5. This was confirmed with a probe under fluoroscopy. Laminectomies are done at vertebral segments L4 and L5 with facetectomies to relieve pressure to the nerve roots. Allograft was packed in the gutters from L1-L5 for a posterior arthrodesis. Pedicle screws were placed at L2, L3, and L4.
The construct was copiously irrigated and muscle; fascia and skin were closed in layers.
Select the procedure codes for this scenario.
- A. 63047, 63048, 22612, 22614 x 3, 22842
- B. 63042, 63043, 22808, 22841 x 3
- C. 63005 x 2, 22612, 22614 x 3, 22842
- D. 63017, 63048, 22612, 22808, 22842 x 3
Answer: A
Explanation:
* Laminectomy and Facetectomy (63047 and 63048): The laminectomies at L4 and L5 with facetectomies fall under CPT codes 63047 (for the initial segment) and 63048 (for each additional segment).
* Posterior Arthrodesis (22612 and 22614 x 3): The posterior arthrodesis from L1-L5 is coded with
22612 for the primary segment (L4-L5) and 22614 for each additional segment (L1-L4).
* Placement of Pedicle Screws (22842): The placement of pedicle screws at L2, L3, and L4 is captured under CPT code 22842 for segmental instrumentation.
References:
* AMA's CPT Professional Edition (current year)
* ICD-10-CM (current year)
* HCPCS Level II (current year)
NEW QUESTION # 178
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 # 179
A patient presents with keratosis lesions on her left cheek, above the left eyebrow, and on the chin area. The dermatologist treats those areas by lightly sanding the surface of a total of 5 lesions.
What CPTcoding is reported?
- A. 15787 x 5
- B. 15786, 15787 x 4
- C. 15786 x 5
- D. 15786, 15787
Answer: C
Explanation:
CPTcode 15786 is used for abrasion treatment of a single lesion (e.g., for keratosis) through techniques like dermabrasion (lightly sanding the skin's surface). When treating multiple lesions in this manner, each lesion treated should be coded individually.
Since the patient has 5 keratosis lesions treated through sanding, 15786 x 5 accurately represents the procedure for each lesion.
Explanation of other options:
A: 15787 x 5: Incorrect because 15787 is designated for dermabrasion of "additional lesions" and would be used in conjunction with 15786, not alone.
B: 15786, 15787: Incorrect, as it does not account for all five lesions treated.
C: 15786, 15787 x 4: Incorrect, as 15787 is used only when performed in addition to 15786, not as a replacement for each additional lesion.
Therefore, the correct answer is D. 15786 x 5, which accurately reports the treatment of all five lesions.
NEW QUESTION # 180
......
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