CPC Exam Syllabus: Full 12-Module Content Blueprint

• Word roots, combining forms, prefixes, and surgical suffixes (-ectomy, -ostomy, -otomy, -plasty)
• Major organ systems: Integumentary, Musculoskeletal, Cardiovascular, Respiratory, Digestive, Nervous, Genitourinary
• Anatomical directional terminology: Anterior/Posterior, Proximal/Distal, Medial/Lateral, Superior/Inferior
• Cellular biology, neoplastic transformations, benign versus malignant behavior, and chronic systemic pathologies

Rapid operative report parsing and immediate surgical approach identification without consulting reference tables.

50-question flash drill targeting anatomical structures, pathological terms, and high-frequency surgical prefixes.

• General conventions: Excludes1 versus Excludes2 notes, Code Also, Code First, and In Diseases Classified Elsewhere
• Infectious diseases (Chapter 1), Neoplasms (Chapter 2), and Endocrine/Diabetes combination rules (Chapter 4)
• Circulatory and Hypertensive organ disease relationships (Chapter 9: I10, I11, I12, I13 combinations)
• Trauma and poisoning 7th character extensions: A (initial), D (subsequent), and S (sequela) across Chapters 19 and 20
• Social determinants of health (Z55-Z65) and clinical status/screening encounters (Chapter 21)

Diagnostic sequencing rules, manifestation pairing, causal assumptions, and lateralized fracture coding.

25 case-based diagnostic clinical chart scenarios requiring precise guideline citation and sequencing.

• Incision and drainage (I&D) simple versus complex (10060-10061, 10080-10081)
• Benign (11400-11446) versus malignant (11600-11646) lesion excision sizing calculations including surgical margins
• Wound repairs: Simple (12001-12018), Intermediate (12031-12057), and Complex (13100-13153) grouping and summing rules
• Adjacent tissue transfers/rearrangements (14000-14350) and full/split thickness skin replacement autografts (15002-15278)
• Destruction of premalignant/malignant lesions and Mohs micrographic surgery (17311-17315) stage/block allocation

Excised diameter plus margin math formulas, repair bundling exclusions, and Mohs surgical stage differentiation.

20 complex surgical operative report exercises covering simultaneous lesion excision with intermediate layered repair.

• General musculoskeletal rules: Deep versus superficial biopsies, muscle wound exploration, and foreign body extraction
• Fracture care: Closed treatment with/without manipulation, open treatment with internal fixation (ORIF), and external fixation
• Spine surgery: Arthrodesis approaches (anterior, posterior, lateral), spinal instrumentation add-on codes, and bone grafts
• Endoscopy/arthroscopy rules (29800-29999) versus open arthrotomy procedures and diagnostic-to-surgical conversions
• Application of casts, strapping, and splints (29000-29750) initial versus replacement guidelines

Fracture terminology analysis, approach-based code selection, and add-on spinal instrumentation pairing.

25 orthopedic and trauma operative report coding challenges covering fracture reduction and spinal arthrodesis.

• Endoscopic sinus surgery and diagnostic versus therapeutic bronchoscopy (31622-31654)
• Coronary artery bypass grafting (CABG): Combined venous and arterial graft rules (33510-33536)
• Pacemakers and implantable defibrillators: Insertion, revision, and lead replacement coding
• Vascular catheterization: First, second, and third-order branch hierarchy and non-selective access
• Central venous access devices: Tunneled versus non-tunneled, subcutaneous port versus pump, insertion by patient age

Vascular branching map navigation, order tracking, and CABG arterial/venous combination code assignment.

20 cardiovascular and pulmonary case studies with step-by-step vascular order hierarchy tracking.

• Upper GI endoscopy (EGD) diagnostic versus therapeutic (biopsy, dilation, stent placement, control of bleeding)
• Colonoscopy rules: Scope advancement to cecum, hot biopsy versus snare versus cold snare/forceps unbundling rules (45378-45398)
• Hernia repair coding: Inguinal, femoral, umbilical, incisional/ventral, reducible versus incarcerated/strangulated
• Laparoscopic versus open cholecystectomy with concurrent intraoperative cholangiography
• Bariatric surgeries: Laparoscopic sleeve gastrectomy, gastric bypass Roux-en-Y, and revision interventions

Multiple polyp removal technique differentiation, diagnostic-to-surgical endoscopy crosswalks, and hernia categorization.

20 gastroenterology operative records with multiple polyp removals and concomitant hernia repair.

• Cystourethroscopy rules: Fulguration, biopsy, ureteral catheterization, and TURBT tumor size measurement tiers
• Male genital: Prostate biopsy (needle versus needle core), transurethral resection (TURP), and vasectomy
• Female genital: Colposcopy, cervical conization/LEEP, and hysterectomy coding by approach (vaginal, abdominal, laparoscopic)
• Maternity care and delivery: Global package (59400, 59510, 59610) versus split antepartum, delivery, and postpartum components

Global obstetric package component splitting and TURBT lesion size classification.

20 urology and obstetrics case reports with split maternity billing scenarios.

• Spinal puncture, epidural and subarachnoid injections, and transforaminal nerve blocks with image guidance
• Neurostimulator pulse generator and lead insertion/programming (63650-63688)
• Eye and ocular adnexa: Cataract extraction with intraocular lens (66982 versus 66984 complex versus standard)
• Strabismus surgery and retinal detachment repair (cryotherapy, vitrectomy, scleral buckle)
• Auditory: Myringotomy, tympanostomy tube insertion (local versus general anesthesia), and tympanoplasty

Image guidance unbundling rules for spinal injections and complex versus standard cataract criteria.

15 neurology and ophthalmology surgical operative records.

• The 3 Medical Decision Making elements: Number/complexity of problems, amount/complexity of data, and risk of complications
• Office and other outpatient visits (99202-99215) new versus established patient criteria
• Total physician time calculation rules: Countable versus non-countable activities on the date of encounter
• Hospital inpatient and observation care services (99221-99223, 99231-99233, 99238-99239)
• Emergency department services (99281-99285), critical care (99291-99292), and nursing facility services

Rapid 2-out-of-3 MDM level determination and time threshold calculation.

30 comprehensive E/M clinical charts with full MDM scoring worksheets.

• Anesthesia formula: (Base Units + Time Units + Qualifying Circumstances) x Conversion Factor + Physical Status (P1-P6)
• Radiology: Diagnostic X-ray view counting, CT and MRI with/without contrast coding rules
• Interventional radiology: Complete component coding (surgical code + radiological supervision and interpretation)
• Pathology and Laboratory: Automated organ/disease panels (80048, 80053, 80076) unbundling prohibitions
• Surgical pathology levels (88300-88309) specimen identification rules

Anesthesia unit calculation and radiological supervision/interpretation modifier usage.

20 anesthesia and interventional radiology multi-code clinical cases.

• HCPCS Level II letter classifications: J-codes (drugs), A-codes (medical supplies), E-codes (DME), G-codes (CMS temporary)
• DMEPOS coding, dosage calculation units for chemotherapy and biologic injections
• Evaluation and Management modifiers: Modifier 24 (unrelated E/M during global period), Modifier 25 (significant separate E/M)
• Procedural unbundling modifiers: Modifier 59 versus Medicare X{EPSU} subsets (XE, XP, XS, XU)
• Surgical modifier nuances: Modifier 22 (increased services), 50 (bilateral), 51 (multiple), 52 (reduced), 53 (discontinued)

Medication unit math and NCCI edit modifier justification.

25 modifier application case scenarios with correct modifier selection.

• HIPAA Privacy, Security, and Breach Notification rules: Protected Health Information (PHI) definition
• Healthcare fraud and abuse statutes: False Claims Act, Anti-Kickback Statute (AKS), and Stark Law physician self-referral
• OIG Work Plan, compliance program elements, and Advance Beneficiary Notice (ABN) rules
• CMS National Correct Coding Initiative (NCCI): Procedure-to-Procedure (PTP) edits and Medically Unlikely Edits (MUE)
• The 240-Minute Exam Blueprint: 3-pass question triage strategy, book marking conventions, and speed algorithms

NCCI column 1/column 2 edit navigation and high-speed exam question elimination.

Final 100-Question Comprehensive Timed AAPC CPC Mock Exam with full analytics.