The CPC Exam Breakdown
According to AAPC Guidelines, passing the CPC exam requires you to correctly answer a minimum of 70 questions from the series below. The exam questions, however, will not be identified or sorted by the series to which they pertain. The CPC test will rely on a level of understanding that enables you to identify the series.
Consists of six questions related to surgical procedures performed on the Integumentary system, which includes skin, subcutaneous, and accessory structures, as well as nails, pilonidal cysts, repairs, destruction, and breast.
Six questions in the 20000 Series will home in on surgical procedures performed on the musculoskeletal system from head to toe. Specifically, these areas include the head, neck, back and flank, spine, abdomen, shoulder, arm, hand and fingers, pelvis and hip, leg, foot and toes.
Six questions covering the 30000 Series focus on surgical procedures performed on the respiratory system, surgical procedures performed on the cardiovascular system, surgical procedures performed on the hemic and lymphatic systems, and surgical procedures performed on the mediastinum and diaphragm.
40000 Series will be tested with six questions targeting surgical procedures performed on the digestive system, which will focus on these areas: lips, mouth, palate and uvula, salivary gland and ducts, pharynx, adenoids, and tonsils, esophagus, stomach, intestines, appendix, rectum, anus, liver, biliary tract, pancreas, abdomen, peritoneum, and omentum.
Six questions pertaining to surgical procedures performed on the urinary system, surgical procedures performed on the male reproductive system, surgical procedures performed on the female reproductive system, including maternity and delivery, and surgical procedures performed on the endocrine system.
Six questions directed at the 60000 Series involve surgical procedures performed on the nervous system and will include codes pertaining to the skull, meninges, brain, spine, spinal cord, extracranial nerves, peripheral nerves, autonomic nervous system.
Evaluation and Management
Six E/M questions will assess your coding proficiency related to place and level of services, such as office/other outpatient, hospital observation, hospital inpatient, consultations, emergency department, critical care, nursing facility, domiciliary and rest homes, and home services. It will also include questions directed at preventive medicine, non-face-to-face services, neonatal and pediatric critical care, intensive care, prolonged services, chronic care, transitional care, case management, and care plan oversight.
Four questions related to anesthesia will pertain to time reporting, qualifying circumstances, physical status modifiers, anesthesia for surgical, diagnostic and obstetric services.
Six questions in this section of the CPC test will focus on both diagnostic and interventional radiology, including diagnostic ultrasound, radiologic guidance, mammography, bone and joint studies, radiation oncology, and nuclear medicine.
Laboratory / Pathology
Six path/lab questions will determine your knowledge of organ and disease panels, drug testing, therapeutic drug assays, evocation/suppression testing, consultations, urinalysis, molecular pathology,MAAA, chemistry, hematology and coagulation, immunology, transfusions, microbiology, anatomic pathology, cytopathology, cytogenetic studies, surgical pathology, in vivo and reproductive.
Six questions will cover numerous specialty-specific coding scenarios, as well as immunizations,biofeedback,dialysis, central nervous system assessments, health and behavior assessments, hydration, medical nutrition, therapeutic and diagnostic administration, chemotherapy administration,photodynamic therapy, osteopathic manipulative treatment, patient education and training, non-face-to-face nonphysician services, and moderate sedation.
Medical terminology for all systems in the human body will be assessed in four questions.
Anatomy for all systems in the human body will be assessed in four questions.
Five questions will require proficiency in diagnosis for all the chapters included in ICD-10-CM, as well as thorough knowledge of the ICD-10-CM Official Guidelines for Coding and Reporting. Additionally,diagnosis questions will appear in other sections of the exam from the categories.
HCPCS Level II
Three questions on the CPC exam will pertain to HCPCS Level II coding and include questions focusing on modifiers, supplies, medications, and professional services for Medicare patients.
Seven questions addressing the ICD-10-CM Official Guidelines for Coding and Reporting, coding guidelines and parenthetical notes, and modifier use.
Compliance and Regulatory
Three questions testing your knowledge of compliance and regulations will pertain to services covered under Medicare Parts A, B, C and D; applying coding to payment policy, place of service reporting, fraud and abuse, NCCI edits, NCD/LCD, HIPAA, ABNs, and RVUs.
(Note: New Section) Case Studies
Ten cases will test your ability accurately code medical record documentation using ICD-10-CM, and HCPCS Level II. The cases will cover 10000 series, 20000 series, 30000 series, 40000 series, 50000 series,60000 series, medicine, anesthesia, radiology, pathology and laboratory, and evaluation and management services. Medical terminology, anatomy, compliance, and regulatory information may also be tested in the cases.