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AAPC CPC Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 2
  • 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 3
  • 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 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
  • 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 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
  • 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
  • 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
  • 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
  • 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 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
  • 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 13
  • 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 14
  • 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 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.

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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q332-Q337):

NEW QUESTION # 332
A patient has chronic cholesteatoma in the right middle ear. The otolaryngologist performed a tympanoplasty with a radical mastoidectomy, removing the middle ear cholesteatoma. Grafting technique was used to repair the eardrum with ossicular chain reconstruction.
What CPTcode is reported for this surgery?

Answer: A

Explanation:
1. Procedure and CPTCode Selection:
The procedure involves a tympanoplasty with a radical mastoidectomy to remove a cholesteatoma in the middle ear. Additionally, the procedure includes ossicular chain reconstruction and grafting to repair the eardrum.
CPTCode 69646 is appropriate for tympanoplasty with a radical mastoidectomy, including removal of the cholesteatoma and ossicular chain reconstruction. This code accurately describes the combination of tympanoplasty, radical mastoidectomy, and ossicular chain reconstruction, making it the correct choice.
2. Rationale for Excluding Other Options:
Code 69643 describes a tympanoplasty with a simple mastoidectomy, which is not appropriate since a radical mastoidectomy was performed.
Code 69645 covers a tympanoplasty with radical mastoidectomy but does not include ossicular chain reconstruction, which was part of this procedure.
Code 69641 is for a tympanoplasty without mastoidectomy, making it incorrect for this case.
3. AAPC and CPTCoding Guidelines:
According to AAPC and CPTguidelines, 69646 is the appropriate code when a tympanoplasty includes a radical mastoidectomy with ossicular chain reconstruction, as documented in this case.
Therefore, the correct answer based on CPTguidelines is D. 69646.


NEW QUESTION # 333
An incision is made in the scalp, a craniectomy is performed to access the area where electrodes are present. The electrodes are removed. The surgical wound is closed.
What procedure code is reported?

Answer: C

Explanation:
The procedure described involves the removal of electrodes from the cranial area after making an incision in the scalp and performing a craniectomy.
Procedure Description:
Incision in the scalp.
Craniectomy to access the area with electrodes.
Removal of electrodes.
Closure of the surgical wound.
CPT Coding:
61860: Removal of intracranial neurostimulator electrodes, including burr hole(s) or craniectomy.
AMA's CPT Professional Edition (current year).
CPT Assistant for detailed coding guidelines on neurostimulator procedures.


NEW QUESTION # 334
A patient had surgery a year ago to repair two flexor tendons in his forearm. He is in surgery for a secondary repair for the same two tendons.
Which CPT coding is reported?

Answer: C

Explanation:
The scenario involves a secondary repair of two flexor tendons in the forearm. CPT code 25272 describes the repair of a secondary flexor tendon injury, including a graft, in the forearm and/or wrist, which fits the description provided. This code should be reported once, as the procedure encompasses the repair of multiple tendons.
References:
* AMA's CPT Professional Edition (current year), Code 25272


NEW QUESTION # 335
A 16-year-old female just moved to the area and is living in a campground with her parents. She has several medical conditions and the parents are unable to take her to a physician's office. A physician sees the patient in the campground and documents a medical decision making of moderate complexity. After the visit, the physician spends an additional 25 minutes in a prolonged discussion with the patient's parents; he reviews complex and detailed medical records from her previous physicians and completes a comprehensive treatment plan. A care plan with the local hearth agency and a dietician is initiated.
What E/M coding is reported for this visit?

Answer: C

Explanation:
Service location = campground → domiciliary/home visit
Patient is new
99344 = New patient domiciliary visit, moderate MDM
Prolonged Services:
Additional 25 minutes beyond base time
99417 is used for prolonged services with office/home E/M codes
Why others are incorrect:
99349 - Established patient
99204 - Office visit (wrong location)


NEW QUESTION # 336
View MR 006399
MR 006399
Operative Report
Preoperative Diagnosis: Chronic otitis media in the right ear
Postoperative Diagnosis: Chronic otitis media in the right ear
Procedure: Eustachian tube inflation
Anesthesia: General
Blood Loss: Minimal
Findings: Serous mucoid fluid
Complications: None
Indications: The patient is a 2-year-old who presented to the office with chronic otitis media refractory to medical management. The treatment will be eustachian tube inflation to remove the fluid. Risks, benefits, and alternatives were reviewed with the family, which include general anesthetic, bleeding, infection, tympanic membrane perforation, routine tubes, and need for additional surgery. The family understood these risks and signed the appropriate consent form.
Procedure in Detail: After the patient was properly identified, he was brought into the operating room and placed supine. The patient was prepped and draped in the usual fashion. General anesthesia was administered via inhalation mask, and after adequate sedation was achieved, a medium-sized speculum was placed in the right ear and cerumen was removed atraumatically using instrument with operative microscope. The tube is dilated, an incision is made to the tympanum and thick mucoid fluid was suctioned. The patient was awakened after having tolerated the procedure well and taken to the recovery room in stable condition.
What CPT coding is reported for this case?

Answer: A

Explanation:
The procedure involves eustachian tube inflation to remove serous mucoid fluid in the right ear of a 2-year-old patient with chronic otitis media.
Procedure Description:
Eustachian tube inflation to remove fluid.
General anesthesia.
Incision to the tympanum and suctioning of thick mucoid fluid.
CPT Coding:
69421-RT: Eustachian tube inflation, transnasal or transoral; with catheterization, including general anesthesia. The modifier -RT indicates the right ear.
AMA's CPT Professional Edition (current year).
CPT Assistant for detailed coding guidelines on eustachian tube procedures.


NEW QUESTION # 337
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