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CPC Minimum Pass Score & Test CPC Sample Questions

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AAPC CPC Exam Syllabus Topics:TopicDetailsTopic 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

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 3

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 4

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 5

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 6

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 7

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 8

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 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

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 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

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 13

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 14

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.:

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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q191-Q196):

NEW QUESTION # 191
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: A

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 # 192
An established patient presents with fever and sore throat. Rapid strep test is positive.
What CPT and ICD-10-CM codes are reported?

A. 99212-25, 87880, J02.0, R50.9, J02.9
B. 99213-25, 87880, J02.0, R50.9, J02.9
C. 99212-25, 87880, R50.9, J02.9
D. 99213-25, 87880, J02.0

Answer: D

Explanation:
99213-25 = E/M with separate procedure
87880 = Rapid strep test
J02.0 = Streptococcal pharyngitis
Symptoms are not reported with definitive diagnosis

NEW QUESTION # 193
Preoperative diagnosis: Right thigh benign congenital hairy nevus. *1
Postoperative diagnosis: Right thigh benign congenital hairy 0 nevus.
Operation performed: Excision of right thigh benign congenital>1
nevus, excision size with margins 4.5 cm and closure size 5 cm.
Anesthesia: General.0
Intraoperative antibiotics: Ancef.0
Indications: The patient is a 5-year-old girl who presented with her parents for evaluation of her right thigh congenital nevus. It has been followed by pediatrics and thought to have changed over the past year. Family requested excision. They understood the risks involved, which included but were not limited to risks of general anesthesia, infection, bleeding, wound dehiscence, and poor scar formation. They understood the scar would likely widen as the child grows because of the location of it and because of the age of the patient. They consented to proceed.
Description of procedure: The patient was seen preoperatively in > I the holding area, identified, and then brought to the operating room. Once adequate general anesthesia had been induced, the patient's right thigh was prepped and draped in standard surgical fashion. An elliptical excision measuring 6 x 1.8 cm had been marked. This was injected with Lidocaine with epinephrine, total of 6 cc of 1% with 1:100,000. After an adequate amount of time, a #15 blade was used to sharply excise this full thickness.
This was passed to pathology for review. The wound required limited undermining in the deep subcutaneous plane on both sides for approximately 1.5 cm in order to allow mobilization of the skin for closure. The skin was then closed in a layered fashion using 3-0 Vicryl on the dermis and then 4-0 Monocryl running subcuticular in the skin, the wound was cleaned and dressed with Dermabond and Steri-Strips.
The patient was then cleaned and turned over to anesthesia for S extubation.
She was extubated successfully in the operating room and taken S to the recovery room in stable condition. There were no complications.
What E/M code is reported for this encounter?

A. 0
B. 1
C. 2
D. 3

Answer: C

Explanation:
Established patient with moderate MDM
99214 aligns with CPC exam standards

NEW QUESTION # 194
In rhinoplasty:

A. The chin is reconstructed
B. The nose is reconstructed
C. The brow is reconstructed
D. The lips are reconstructed

Answer: B

NEW QUESTION # 195
Refer to the exhibit.

Refer to the supplemental information when answering this question:
View MR 354859
What CPT and ICD-10-CM coding is reported?

A. 28820-T2, 170.262, L97.528
B. 28810-T2, L97.528, 170.262
C. 28820-T2, L97.528, 170.262
D. 28810-T2, 170.262, L97.528

Answer: C

NEW QUESTION # 196
......

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