AAPC-CPC Exam Information and Guideline
Certified Professional Coder - 2025
Below are complete topics detail with latest syllabus and course outline, that will help you good knowledge about exam objectives and topics that you have to prepare. These contents are covered in questions and answers pool of exam.
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.