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AAPC CPC Exam Syllabus Topics:

Topic
Details

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

• 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

• 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

• 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 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

• 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 8

• 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 9

• 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 10

• 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 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

• 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.

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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q96-Q101):

NEW QUESTION # 96
A Medicare patient is scheduled for a screening colonoscopy.
What code is reported for Medicare?

• A. G0121
• B. 0
• C. G0105
• D. G0106

Answer: C

NEW QUESTION # 97
A woman at 36-weeks gestation goes into labor with twins. Fetus 1 is an oblique position, and the decision is made to perform a cesarean section to deliver the twins. The obstetrician who delivered the twins, provided the antepartum care, and will provide the postpartum care.
What CPT coding is reported for the twin delivery?

• A. 59510, 59515
• B. 59510 x 2
• C. 0
• D. 59510, 59514, 59515

Answer: D

NEW QUESTION # 98
The evisceration of ocular contents was performed using a surgical microscope for enhanced visualization.
The procedure was performed on the left eye and an implant was not placed in the ocular cavity.
What CPTcoding is reported?

• A. 65093-LT
• B. 65091-LT, 69990-51
• C. 65091-LT
• D. 65093-LT, 69990

Answer: C

Explanation:
1. Procedure and CPTCode Selection:
The procedure performed was an evisceration of ocular contents without the placement of an implant. The surgical microscope was used for enhanced visualization, but this does not require a separate code if the primary procedure code includes it inherently.
CPTCode 65091 is used for an evisceration of the ocular contents without implant placement. This code correctly describes the procedure performed on the left eye.
2. Modifier:
Modifier LT is added to indicate that the procedure was performed on the left eye.
3. Exclusion of Code 69990:
Code 69990 is for the use of an operating microscope, but it should not be billed separately when it is used as part of a procedure where enhanced visualization is typical or expected, such as an evisceration procedure.
According to CPTguidelines, 69990 is not separately reported when the microscope is used for visualization in procedures where its use is considered part of the standard of care.
4. Rationale for Excluding Other Options:
Code 65093 is for an evisceration with implant placement, which does not apply since no implant was used.
Options B and C incorrectly include 69990, which is not separately reportable in this scenario.
5. AAPC and CPTCoding Guidelines:
According to AAPC and CPTcoding guidelines, 65091 is sufficient to capture the procedure without the need to add code 69990 for the microscope.
Therefore, the correct answer is D. 65091-LT.

NEW QUESTION # 99
Which place of service code is submitted on the claim for a service that is performed in a skilled nursing facility?

• A. 0
• B. 1
• C. 2
• D. 3

Answer: B

Explanation:
In medical billing, Place of Service (POS) code 31 is used to indicate that a service was performed in a skilled nursing facility (SNF). POS codes are standardized by the Centers for Medicare & Medicaid Services (CMS) to specify the location where services are provided.
A: 32 refers to a nursing facility (NF), which is different from a skilled nursing facility in terms of the level of care provided.
B: 20 indicates urgent care facility.
C: 22 is used for outpatient hospital services.
Thus, the correct answer is D. 31 for a skilled nursing facility.

NEW QUESTION # 100
A Medicare patient that is on dialysis for ESRD is seen by the nurse for a Hep B vaccination. This patient is given a dialysis patient dosage as part of a three-dose schedule. The nurse administers the Hep B vaccine in the right deltoid. The physician reviews the chart and signs off on the nurse's note.
What procedure and diagnosis codes are reported for the scheduled vaccine injection for this Medicare patient?

• A. G0010, 90740, Z23, N18.6, Z99.2
• B. 90471, 90746, Z23, N18.6, Z99.2
• C. 90471, 90746, Z23, B19.10, N18.6, Z99.2
• D. 99211-25, G0010, 90740, B19.10, N18.6, Z99.2

Answer: A

NEW QUESTION # 101
......

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