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AAPC CPC Exam Syllabus Topics:

Topic
Details

Topic 1

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 2

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 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

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 5

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 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

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 8

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 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

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 11

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 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

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 (Q348-Q353):

NEW QUESTION # 348
(A patient is in her otolaryngologist's office to receive therapeutic treatment forasthmatic bronchitis with status asthmaticus. A subcutaneous injection ofomalizumab (150 mg)is given in her left upper arm. What is the CPT and ICD-10-CM coding?)

A. 90460, J2357 × 30, J45.52
B. 90471, J2357 × 30, J45.902
C. 96369, J2357 × 30, J45.52
D. 96372, J2357 × 30, J45.902

Answer: D

Explanation:
Omalizumab is a drug reported withHCPCS J2357, and the dose is converted into billable units based on the code's unit definition. In CPC-style questions,150 mgis commonly represented asJ2357 × 30 units(i.e., 5 mg per unit # 150/5 = 30). Administration is atherapeutic subcutaneous injection, reported with96372(therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular). Vaccine administration codes (90460
/90471) are not appropriate because omalizumab is not a vaccine. For diagnosis, the statement includesstatus asthmaticusbut does not specify severity category (mild/moderate/severe persistent). In the options provided, J45.902is the "unspecified asthma with status asthmaticus" concept, whereas J45.52 requires severe persistent asthma with status asthmaticus (not documented). Therefore, the correct pairing is96372 + J2357 × 30 + J45.
902. CPC exam tip: match administration code type (therapeutic injection vs immunization) and choose the most specific ICD-10-CM supported by documentation.

NEW QUESTION # 349
A patient underwent a cystourethroscopy with a pyeloscopy using lithotripsy to break up the ureteral calculus.
An indwelling stent was also inserted during the same operative session on the same side. This service was performed in the outpatient hospital surgery center.
What CPT coding reported?

A. 52325, 52332-51
B. 0
C. 52352, 52332-51
D. 52353, 52332-51

Answer: B

NEW QUESTION # 350
(Full Case:Location:ABC Outpatient Clinic.Patient:60-year-old menopausal female.Independent radiologist (not employed by hospital):Dr. Q.Chief complaint:Uterine cramping.Procedure:Transvaginal ultrasound.
Findings:Ovaries normal; measurements given (note: left ovary listed twice with different dimensions); uterus
5.2 × 5.1 × 4.0; endometrial stripe 0.8 cm; uterus without focal hypoechoic mass; ovoid anechoic foci in lower uterus/cervix due to Nabothian cysts; no adnexal fluid or mass; cervix thickness/length normal; true sagittal thickest portion measured.Question:What CPT and ICD-10-CM codes are reported for the independent radiologist that provided the interpretation of the ultrasound?)

A. 76830-26, N94.89
B. 76817, N94.89
C. 76830, N94.9
D. 76817-26, N94.9

Answer: A

Explanation:
The documented study is atransvaginal pelvic ultrasound, which is coded with76830(ultrasound, transvaginal). Because the service is billed by anindependent radiologist providing only the interpretation, the correct reporting is theprofessional componentwith modifier-26(interpretation and report), not the global code. That makes76830-26the correct CPT selection. Code76817is fortransvaginal ultrasound in pregnancy
/obstetric contexts, which is not supported here (the patient is menopausal and no pregnancy evaluation is described). For diagnosis, the chief complaint isuterine cramping, and the options provide pelvic pain codes; N94.89(other specified conditions associated with female genital organs and menstrual cycle) is the best match among the choices provided for uterine cramping/pelvic symptom documentation.N94.9is less specific ("unspecified"), so when a more specific option is available in the answer set, selectN94.89. Therefore, the correct combination for the interpreting independent radiologist is76830-26, N94.89.

NEW QUESTION # 351
Adenoids, tonsils, appendix, and spleen belong to which organ system?

A. Nervous
B. Cardiovascular
C. Gastrointestinal
D. Lymphatic

Answer: D

Explanation:
The adenoids, tonsils, appendix, and spleen are all part of the lymphatic system, which plays a crucial role in immune function and the filtration of pathogens. These organs contribute to the body's defense by trapping and eliminating bacteria and other pathogens.
Adenoids and tonsils are lymphatic tissues located in the throat and help prevent infection by filtering pathogens from inhaled or ingested particles.
The appendix contains lymphoid tissue and is thought to play a role in gut immunity.
The spleen filters blood, removing old or damaged blood cells and producing lymphocytes for immune response.
The other options are unrelated:
B: Gastrointestinal: Involved in digestion, but not specifically immune response.
C: Cardiovascular: Involved in blood circulation, not immune response.
D: Nervous: Coordinates sensory and motor functions, unrelated to lymphatic tissue.
Therefore, the correct answer is A. Lymphatic.

NEW QUESTION # 352
A CRNA independently administers MAC anesthesia for ICD replacement.
What CPT and ICD-10-CM codes are reported?

A. 00534-QY, I48.91
B. 00520-QY, I48.91
C. 00534-QZ-QS, I49.01
D. 00520-QZ-QS, I49.01

Answer: C

Explanation:
00534 = Anesthesia for pacemaker/defibrillator procedures
QZ = CRNA without medical direction
QS = MAC anesthesia
I49.01 = Ventricular fibrillation

NEW QUESTION # 353
......

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