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Exam Code: AAPC CPC
Exam Name: AAPC Certified Professional Coder
Format: 100 multiple-choice questions, including 10 case studies with multiple-choice answers.
Duration: 4 hours.
Passing Score: 70% (70 correct answers out of 100).
Type: Open-book exam, allowing candidates to use current editions of CPT®, ICD-10-CM, and HCPCS Level II code manuals.

- 10,000 Series
- Focus: Surgical procedures on the integumentary system (skin, subcutaneous tissue, nails, breast).
- Excision of benign and malignant lesions.
- Wound repair (simple, intermediate, complex).
- Skin grafts and flaps.
- Breast procedures (e.g., mastectomy, reconstruction).
- Debridement and incision/drainage.
- Lesion
- excision
- biopsy
- debridement
- closure
- graft
- flap
- Mohs surgery
- layered closure
- mastectomy
- lumpectomy

- 20,000 Series CPT
- Focus: Surgical procedures on the musculoskeletal system (bones, joints, muscles, tendons).
- Fracture and dislocation treatment.
- Arthroscopy and arthrodesis.
- Tendon and ligament repairs.
- Spinal procedures (e.g., laminectomy, fusion).
- Application of casts and strapping.

- Arthroscopy
- arthrodesis
- osteotomy
- fracture reduction
- fixation
- laminectomy
- kyphoplasty
- tendon repair
- synovial joint

- 30,000 Series CPT
- Focus: Surgical procedures on the respiratory, cardiovascular, hemic/lymphatic, and mediastinum/diaphragm systems.
- Nasal and sinus procedures (e.g., turbinate reduction).
- Laryngoscopy and bronchoscopy.
- Cardiac procedures (e.g., CABG, valve repair).
- Vascular procedures (e.g., bypass grafts, aneurysm repair).
- Lymph node excision and splenectomy.

- Turbinectomy
- septoplasty
- bronchoscopy
- coronary artery bypass graft (CABG)
- angioplasty
- stent
- lymphadenectomy
- splenectomy
- mediastinum

- 40,000 Series CPT
- Focus: Surgical procedures on the digestive system.
- Gastrointestinal endoscopy (e.g., EGD, colonoscopy).
- Hernia repairs (e.g., inguinal, ventral).
- Appendectomy and cholecystectomy.
- Bariatric surgery.
- Hemorrhoidectomy and fistula repair.

- Endoscopy
- colonoscopy
- esophagogastroduodenoscopy (EGD)
- hernia
- cholecystectomy
- anastomosis
- colostomy
- polypectomy.

- 50,000 Series CPT
- Focus: Surgical procedures on the urinary, male/female reproductive systems, and maternity/delivery.
- Cystoscopy and ureteroscopy.
- Prostate procedures (e.g., TURP).
- Hysterectomy and tubal ligation.
- Cesarean section and vaginal delivery.
- Fetal monitoring.

- Cystoscopy
- nephrectomy
- transurethral resection of the prostate (TURP)
- hysterectomy
- oophorectomy
- salpingectomy
- cesarean
- tocolysis.

- 60,000 Series CPT
- Focus: Surgical procedures on the nervous system, eye, and auditory system.
- Craniotomy and spinal procedures.
- Cataract extraction and glaucoma surgery.
- Tympanostomy and cochlear implant.
- Nerve blocks and neurostimulator placement.

- Craniotomy
- laminectomy
- discectomy
- cataract
- trabeculectomy
- vitrectomy
- tympanostomy
- neurostimulator
- nerve block.

- Evaluation and Management (E/M)
- Focus: Coding for office visits, hospital visits, consultations, and other E/M services.
- Levels of E/M services (e.g., new vs. established patient).
- History, examination, and medical decision-making (MDM).
- Time-based coding.
- Prolonged services and critical care.

- E/M
- history of present illness (HPI)
- review of systems (ROS)
- medical decision-making (MDM)
- consultation
- critical care
- prolonged services.

- Anesthesia
- Focus: Coding for anesthesia services.
- Anesthesia time reporting.
- Qualifying circumstances (e.g., extreme age, emergency).
- Physical status modifiers (P1–P6).
- Anesthesia for surgical, diagnostic, and obstetric procedures.

- Base units
- time units
- modifier
- physical status
- qualifying circumstances
- monitored anesthesia care (MAC)
- general anesthesia.

- Radiology
- Focus: Diagnostic and interventional radiology procedures.
- X-rays, CT, MRI, and ultrasound.
- Mammography and bone density studies.
- Interventional radiology (e.g., angioplasty, embolization).
- Nuclear medicine.

- Modality
- contrast
- non-contrast
- mammography
- DEXA scan
- embolization
- angiogram
- fluoroscopy
- nuclear medicine.

- Laboratory/Pathology
- Focus: Laboratory and pathology procedures.
- Organ and disease panels.
- Drug testing and therapeutic drug assays.
- Urinalysis and molecular pathology.
- Surgical pathology and cytopathology.
- Panel
- assay
- urinalysis
- molecular pathology
- cytopathology
- surgical pathology
- immunohistochemistry
- flow cytometry.

- Medicine
- Focus: Non-surgical medical procedures and services.
- Immunizations and therapeutic injections.
- Cardiology procedures (e.g., ECG, stress testing).
- Dialysis and chemotherapy.
- Physical therapy and psychiatric services.
- Electrocardiogram (ECG)
- stress test
- dialysis
- chemotherapy
- infusion
- vaccine
- psychotherapy
- biofeedback.

- Medical Terminology
- Focus: Understanding medical terms related to body systems, diseases, and procedures.
- Prefixes, suffixes, and root words.
- Terminology for circulatory, skeletal, nervous, and other systems.
- Common surgical and diagnostic terms.
- ectomy
- otomy
- oscopy
- cardio
- neuro
- osteo
- myo
- hemo
- patho
- benign
- malignant
- acute
- chronic

- Anatomy and Physiology
- Focus: Knowledge of human anatomy and physiological processes.
- Structure and function of body systems (e.g., cardiovascular, respiratory, musculoskeletal).
- Anatomical landmarks and planes.
- Pathophysiology of common conditions.
- Proximal
- distal
- medial
- lateral
- anterior
- posterior
- sagittal
- coronary
- alveoli
- neuron
- tendon
- ligament
- ischemia

- ICD-10-CM Coding
- Focus: Application of ICD-10-CM diagnosis codes.
- Official guidelines for coding and reporting.
- Coding for diseases, injuries, and external causes.
- Sequencing of primary and secondary diagnoses.
- Z codes and V codes (supplementary classifications).
- Principal diagnosis
- secondary diagnosis
- comorbidity
- complication
- external cause
- Z code
- placeholder
- combination code.

- HCPCS Level II Coding
- Focus: Coding for supplies, medications, and professional services.
- Durable medical equipment (DME).
- Drugs and biologicals (e.g., J codes).
- Modifiers for Medicare services.
- Ambulance and orthotic/prosthetic services.
- DME
- J code
- A code
- modifier
- orthotic
- prosthetic
- enteral
- parenteral.

- Coding Guidelines
- Focus: Application of CPT, ICD-10-CM, and HCPCS coding guidelines.
- CPT parenthetical notes and EXCLUDES notes.
- ICD-10-CM conventions (e.g., “code first,” “use additional code”).
- Modifier usage.
- National Correct Coding Initiative (NCCI) edits.
- Modifier
- bundling
- unbundling
- NCCI
- EXCLUDES1
- EXCLUDES2
- code first
- sequenced diagnosis.

- Compliance and Regulatory
- Focus: Knowledge of healthcare regulations and compliance.
- HIPAA regulations.
- Medicare Parts A, B, C, and D.
- Fraud, waste, and abuse prevention.
- Documentation guidelines for reimbursement.
- HIPAA
- upcoding
- downcoding
- fraud
- abuse
- compliance
- medical necessity
- OIG
- CMS.

- Cases
- Focus: Practical application of coding skills through clinical scenarios.
- Coding from medical record documentation (e.g., operative reports, physician notes).
- Scenarios covering surgery, E/M, radiology, pathology, and medicine.
- Integration of medical terminology, anatomy, and regulatory knowledge.
- Operative report
- encounter
- documentation
- medical necessity
- clinical scenario
- code linkage.