AAPC CPC Course Notes

CASES = 10 questions. Treat each case as a mini coding audit: identify the setting and encounter purpose, read the full record, isolate reportable diagnoses and performed services, verify every candidate code in the correct code set, apply bundling/modifier rules, then reconcile the final answer against the documentation. Case questions reward disciplined sequencing more than memorized code numbers.

• Coding from the chief complaint alone instead of the final assessment/procedure documentation.

• Use CASE: Context → Anatomy → Service → Exclusions/bundles.

CODING GUIDELINES = 7 questions. This section tests rule hierarchy and code-book navigation. ICD-10-CM requires Index lookup followed by Tabular verification. CPT requires the code descriptor plus section guidelines, notes, symbols, and parenthetical instructions. A modifier communicates a documented circumstance; it does not create medical necessity, documentation, or a separately reportable service.

• Stopping at the ICD-10-CM Alphabetic Index.

• ICD: Index → Tabular → Instructions → Specificity.

CPT 10000 SERIES = 6 questions. Integumentary coding is driven by exactly what was done to skin/subcutaneous structures: lesion type, method, anatomic site, size, number, depth, repair complexity, and whether multiple services are separately reportable. Read the procedure note, not just the diagnosis.

• Using pathology diagnosis alone to choose the procedure code.

• Integumentary = METHOD + SITE + SIZE + NUMBER + DEPTH.

CPT 20000 SERIES = 6 questions. Musculoskeletal questions are anatomy-heavy. Identify bone/joint/soft-tissue structure, exact site and laterality, open versus percutaneous/closed approach, fracture/dislocation treatment method, manipulation, fixation/device work, and whether diagnostic or component services are bundled.

• Using fracture diagnosis terminology to infer the treatment approach.

• MSK = STRUCTURE → SIDE → APPROACH → MANIPULATION → EXTENT.

CPT 30000 SERIES = 6 questions. This series covers respiratory, cardiovascular, hemic, and lymphatic surgery. Separate anatomy and access from the intervention: airway/lung procedure, vessel/heart structure, catheter path, open vs. percutaneous approach, imaging guidance, device, and the extent of treatment.

• Coding every catheter path segment separately.

• 30000s = ANATOMY + ACCESS + INTERVENTION + EXTENT.

CPT 40000 SERIES = 6 questions. Digestive coding is dominated by exact organ/segment, approach, endoscopic reach, technique, lesion count, and bundling. The exam often gives several services in one endoscopy session; choose the most accurate combination after applying family-specific inclusion rules.

• Coding the diagnosis instead of the procedure technique.

• Digestive = ORGAN → EXTENT → APPROACH → TECHNIQUE → BUNDLE.

CPT 50000 SERIES = 6 questions. This section covers urinary, male genital, female genital, maternity care, and delivery. Code from organ/site, approach, laterality, diagnostic vs. therapeutic intent, device/stone work, and—when obstetric services are involved—whether the service is part of a global maternity package or separately reportable.

• Assuming all stone procedures use the same code because the diagnosis is the same.

• 50000s = ORGAN → SIDE → APPROACH → PROCEDURE → PACKAGE/BUNDLE.

CPT 60000 SERIES = 6 questions. AAPC's current exam description places endocrine, nervous, eye/ocular-adnexa, and auditory surgery in this series. High-yield variables are exact structure, level/side, approach, extent, decompression vs. excision/repair, device work, and whether guidance or diagnostic components are bundled.

• Studying only endocrine and nervous systems and skipping eye/auditory content.

• 60000s = STRUCTURE → LEVEL/SIDE → APPROACH → EXTENT → DEVICE.

RADIOLOGY = 6 questions. Code the complete imaging/interventional service by modality, body site, number/type of views or study, contrast when code-defining, professional vs. technical component, and whether imaging guidance is included in the intervention.

• Using modifier 26 on a service that is already professional-only.

• Radiology = MODALITY → SITE → VIEWS/EXTENT → CONTRAST → COMPONENT.

PATHOLOGY/LAB = 6 questions. This domain is test/specimen driven. Determine the exact laboratory service, panel requirements, specimen/pathology service, repeat-testing circumstances, and whether component tests are bundled into a panel.

• Reporting a panel when a required component was not performed.

• Lab = TEST + METHOD + SPECIMEN + UNITS.

MEDICINE = 6 questions. This section spans many specialties, so use service-family rules rather than one universal formula. High-yield CPC topics include immunizations, hydration/injections/infusions, chemotherapy administration, dialysis, rehabilitation/therapy-related services, OMT, education/training, cardiovascular/neurologic testing, and moderate sedation.

• Choosing an 'initial' infusion code simply because it happened first.

• Medicine = SERVICE FAMILY FIRST.

E/M = 6 questions. First choose the correct E/M category from the setting and patient/service type. Then select the level using that category's governing rules—commonly medical decision making (MDM) or total physician/QHP time on the date of encounter. History and exam must be medically appropriate but generally do not determine the modern office/outpatient level.

• Using physical-status anesthesia modifiers to select E/M level.

• E/M = CATEGORY → MDM or TIME.

ICD-10-CM = 5 questions. Code diagnoses to the highest specificity supported by documentation and the Official Guidelines. Always verify Index findings in the Tabular List, apply instructional notes/sequencing, and remember the CPC is professional/outpatient focused—uncertain diagnoses are not coded as confirmed.

• Coding directly from the Index.

• ICD = Index → Tabular → Notes → Specificity.

MEDICAL TERMINOLOGY = 4 questions. These are fast points if you break unfamiliar words into prefix + root/combining form + suffix and then confirm the meaning from the body-system context. The same abbreviation can mean different things in different specialties.

• Trying to memorize the whole term instead of decomposing it.

• Unknown word? Break it apart before reaching for the codebook.

ANATOMY = 4 questions. Treat anatomy as a coding-navigation skill. Know major organs, bones, vessels, nerves, cavities, directional terms, and common subdivisions well enough to distinguish neighboring structures and map documentation to the correct CPT/ICD family.

• Ignoring anatomy because there are only four dedicated questions—anatomy also drives many CPT questions.

• Anatomy is multiplied across the whole exam, not just four questions.

ANESTHESIA = 4 questions. Separate the anesthesia procedure code from anesthesia time, physical-status modifiers, qualifying circumstances, and payer-specific anesthesia modifiers. Physical status describes the patient's condition; it does not determine anesthesia time.

• Saying ASA physical status determines anesthesia time.

• Anesthesia = PROCEDURE + TIME + STATUS + PROVIDER ROLE.

COMPLIANCE/REGULATORY = 3 questions. These are high-value concept questions: Medicare Parts A–D, payment/coverage policy, place of service, NCDs/LCDs, medical necessity, ABNs, NCCI edits, RVUs, HIPAA, and fraud/abuse. The safest coding answer is always the one supported by documentation and the applicable rule—not the one that maximizes payment.

• Assuming an LCD overrides a national NCD.

• Coverage: NCD national, LCD local.

HCPCS LEVEL II = 3 questions. Use HCPCS Level II for many supplies, drugs/biologicals, DMEPOS, ambulance services, temporary/procedural services, and payer-specific items not represented by CPT. The fastest workflow is ITEM/SERVICE → code family → descriptor → unit definition → modifier/documentation.

• Treating all non-CPT services as generic 'supplies.'

• HCPCS = ITEM → DESCRIPTOR → UNIT → MODIFIER.