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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 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
  • 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 4
  • 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 5
  • 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 6
  • 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 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
  • 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 9
  • 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 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.:
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
  • 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 13
  • 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 14
  • 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 15
  • 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 16
  • 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.

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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q44-Q49):

NEW QUESTION # 44
(What ICD-10-CM coding is reported forType 1 diabeteswithdiabetic chronic kidney disease?)

Answer: C

Explanation:
For diabetes coding, you must first select the diabetes category that matches the type:Type 1 diabetesisE10.- (not E11, which is Type 2). "Diabetic chronic kidney disease" maps toE10.22(Type 1 diabetes mellitus with diabetic chronic kidney disease). ICD-10-CM guidelines then require anadditional codeto identify thestage of CKDfromN18.-. Because the question does not specify the CKD stage, you assignN18.9(chronic kidney disease, unspecified). That makesE10.22, N18.9correct (Option B). Option D would only be correct if the stage were specifically documented asCKD stage 1 (N18.1). Option C (E10.21) is diabetes with diabetic nephropathy, which is not the same as "diabetic CKD" in this question. CPC exam tip:E10.22 always needs an N18.- stage codewhen stage is known; if not known, useN18.9.


NEW QUESTION # 45
A 60-year-old male suffering from degenerative disc disease at the L3-L4 and L5-S1 levels was placed under general anesthesia. Using an anterior approach, the L3-L4 disc space was exposed. Using blunt dissection, the disc space was cleaned. The disc space was then sized and trialed. Excellent placement and insertion of the artificial disc at L3-L4 was noted. The area was inspected and there was no compression of any nerve roots. Same procedure was performed on L5-S1 level. Peritoneum was then allowed to return to normal anatomic position and entire area was copiously irrigated. The wound was closed in a layered fashion. The patient tolerated the discectomy and arthroplasty well and was returned to recovery in good condition. What CPT coding is reported for this procedure?

Answer: D

Explanation:
This scenario describes an anterior discectomy and arthroplasty at two levels (L3-L4 and L5-S1) using artificial discs. CPT code 22857 describes total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), single interspace, lumbar. Since the procedure was performed at two levels, the code should be reported twice.
Reference:
AMA's CPT Professional Edition (current year), Code 22857


NEW QUESTION # 46
(A three-year-old patient returns forstage 2treatment for double right outlet syndrome. The surgeon removes apulmonary artery bandand performstransposition repair of the great vesselsvia aortic pulmonary reconstruction. Central cannulae are inserted forECMO bypass, chemical cardioplegia is initiated, and a physician assistant monitors vitals and oxygenation until heart function resumes. What CPT codes are reported for the surgery today?)

Answer: D

Explanation:
This is aplanned stagedcongenital cardiac repair following prior pulmonary artery banding, so the correct postoperative modifier concept isstaged/related(modifier-58), not an unplanned return-to-OR modifier (-78).
The operative service includesremoval of the pulmonary artery bandandarterial switch/transposition-type repairof the great vessels (captured in the 33778/33779 family in the answer choices). The case also describes use ofECMOwith central cannulation and management during the procedure, which is reported with the appropriate ECMO initiation/management codes shown as33955and the monitoring/assistant-related component represented by33985in the choices. Because this is thesecond stageof care and described as planned definitive repair, the -58 modifier is appropriate on the reported surgical services in these answer constructs. OptionDcorrectly pairs the staged modifier (-58) with the appropriate congenital repair and ECMO-related coding listed in the question's options.


NEW QUESTION # 47
View MR 002395
MR 002395
Operative Report
Pre-operative Diagnosis: Acute rotator cuff tear
Post-operative Diagnosis: Acute rotator cuff tear, synovitis
Procedures:
1) Rotator cuff repair
2) Biceps Tenodesis
3) Claviculectomy
4) Coracoacromial ligament release
Indication: Rotator cuff injury of a 32-year-old male, sustained while playing soccer.
Findings: Complete tear of the right rotator cuff, synovitis, impingement.
Procedure: The patient was prepared for surgery and placed in left lateral decubitus position. Standard posterior arthroscopy portals were made followed by an anterior-superior portal. Diagnostic arthroscopy was performed. Significant synovitis was carefully debrided. There was a full-thickness upper 3rd subscapularis tear, which was repaired. The lesser tuberosity was debrided back to bleeding healthy bone and a Mitek 4.5 mm helix anchor was placed in the lesser tuberosity. Sutures were passed through the subcapulans in a combination of horizontal mattress and simple interrupted fashion and then tied. There was a partial-thickness tearing of the long head of the biceps. The biceps were released and then anchored in the intertubercular groove with a screw. There was a large anterior acromial spur with subacromial impingement. A CA ligament was released and acromioplasty was performed. Attention was then directed to the supraspinatus tendon tear. The tear was V-shaped and measured approximately 2.5 cm from anterior to posterior. Two Smith & Nephew PEEK anchors were used for the medial row utilizing Healicoil anchors.
Side-to-side stitches were placed. One set of suture tape from each of the medial anchors was then placed through a laterally placed Mitek helix PEEK knotless anchor which was fully inserted after tensioning the tapes. A solid repair was obtained. Next there were severe degenerative changes at the AC joint of approximately 8 to 10 mm. The distal clavicle was resected taking care to preserve the superior AC joint capsule. The shoulder was thoroughly lavaged. The instruments were removed and the incisions were closed in routine fashion. Sterile dressing was applied. The patient was transferred to recovery in stable condition.
What CPT coding is reported for this case?

Answer: A

Explanation:
29827: Arthroscopic rotator cuff repair is correctly coded as 29827.
29828: Arthroscopic biceps tenodesis is an additional procedure and should be coded as 29828 with modifier
-51 (Multiple Procedures).
29824: Arthroscopic claviculectomy (partial resection of the distal clavicle) is coded as 29824 with modifier
-51.
29826: Arthroscopic subacromial decompression, including coracoacromial ligament release, is coded as
29826.
All these procedures were performed arthroscopically and documented in the operative report, justifying the use of these codes and the use of modifier -51 for multiple procedures.
CPT Professional Edition, AMA


NEW QUESTION # 48
(Which CPT code can append modifier50?)

Answer: A

Explanation:
Modifier50indicates abilateral procedureperformed during the same session when the CPT code describes aunilateralservice and there isno specific bilateral codethat must be used instead. Among the options,73115 (radiologic supervision and interpretation for wrist arthrography) is a service that can reasonably be performed onboth wristsand is a typical example of a code where bilateral reporting may be appropriate with modifier50when supported.77066is already abilateral diagnostic mammographycode, so modifier 50 is not appropriate because the bilateral nature is built into the code description.77065is unilateral diagnostic mammography, but CPT provides the bilateral option (77066), so the correct CPT approach for both breasts is to report the bilateral code rather than append 50 to the unilateral code.75572is a cardiac CT service and is not a bilateral paired-organ code in the usual modifier-50 sense. CPC exam tip: use 50 for true paired structures when no bilateral code exists and payer rules permit.


NEW QUESTION # 49
......

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