AAPC CPC FINAL EXAM
Newest Version | 100 Questions & Verified Answers | 2026/2027 Aligned
Exam Instructions: This examination contains 100 multiple-choice questions across 16 content domains aligned with the AAPC
Certified Professional Coder (CPC) examination blueprint. Each question has ONE best answer. Total time allowed: 4 hours.
Closed-book except for CPT, ICD-10-CM, and HCPCS Level II code books approved by AAPC. A passing score requires 70% or
higher. Mark only one answer per question.
Section 1: Medical Terminology and Anatomy (Q1 - Q4)
Q1: A cardiologist documents that a patient has a stenosis of the mitral valve causing retrograde
blood flow from the left ventricle into the left atrium during systole. Which anatomical term BEST
describes this condition?
A. Mitral regurgitation resulting from incompetent valve leaflets [CORRECT]
B. Mitral stenosis producing impaired atrial emptying
C. Aortic regurgitation due to dilated annulus
D. Tricuspid prolapse with ventricular volume overload
Correct Answer: A
Rationale: Mitral regurgitation is the backward (retrograde) flow of blood from the left ventricle into the left atrium during
ventricular systole, caused by incompetent mitral valve leaflets. Stenosis means narrowing (forward obstruction), not
backward flow. The aortic and tricuspid valves are anatomically distinct from the mitral valve, making those options
incorrect by location.
Q2: During a thoracentesis, the physician enters the pleural cavity to drain excess fluid. Between
which two anatomical layers is the pleural space located?
A. Parietal pleura and the chest wall
B. Visceral pleura and the lung parenchyma
C. Visceral pleura and parietal pleura [CORRECT]
D. Pleura and the pericardium
Correct Answer: C
Rationale: The pleural cavity (potential space) lies between the visceral pleura (covering the lung surface) and the parietal
pleura (lining the chest wall, mediastinum, and diaphragm). The other options describe adjacent structures but not the actual
space entered during thoracentesis. Understanding this anatomy is essential because fluid, air, or blood accumulates within
this potential space.
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Q3: The medical record documents that a patient underwent an 'intravenous pyelogram' to
evaluate the urinary tract. Which root word combination correctly defines this procedure?
A. Intra- (within) + veno- (vein) + pyelo- (renal pelvis) + -gram (record) [CORRECT]
B. Inter- (between) + veno- (vessel) + pyelo- (kidney) + -gram (picture)
C. Intra- (within) + veno- (artery) + pyelo- (bladder) + -gram (record)
D. Intra- (within) + ventro- (belly) + pyelo- (pelvis) + -gram (study)
Correct Answer: A
Rationale: An intravenous pyelogram (IVP) is a radiographic study in which contrast is injected INTO a VEIN to produce a
RECORD of the RENAL PELVIS and urinary tract. The prefix 'intra-' means within, 'veno-' refers to vein, 'pyelo-' refers to
the renal pelvis (not the entire kidney or bladder), and '-gram' means a recorded image. The other options misuse the root
meanings.
Q4: A surgeon documents a procedure performed on the 'anterior-lateral aspect of the left
proximal femur.' Using standard anatomical planes and directional terminology, which description
is MOST accurate?
A. Front and outer side of the upper portion of the left thigh bone [CORRECT]
B. Back and inner side of the lower portion of the left thigh bone
C. Front and inner side of the lower portion of the left thigh bone
D. Back and outer side of the upper portion of the left thigh bone
Correct Answer: A
Rationale: Anterior means front (ventral), lateral means away from the midline (outer side), proximal means closer to the
trunk (upper portion of the femur), and the femur is the thigh bone. Therefore 'anterior-lateral aspect of the left proximal
femur' describes the front and outer side of the upper portion of the left thigh bone. The other options reverse one or more
directional terms.
Section 2: Coding Concepts and Guidelines (Q5 - Q11)
Q5: A patient is seen in the office for evaluation of a new thumb laceration. After a detailed history,
detailed exam, and low-complexity MDM, the physician performs a 2.5 cm intermediate repair. The
laceration was repaired the same day. Which CPT code(s) and modifier should be reported?
A. 12001 only; the E/M is bundled into the procedure
B. 99213-25, 12001-F6
C. 99203-25, 12001 [CORRECT]
D. 99213, 12001-57
Correct Answer: C
Rationale: This is a new patient (no prior face-to-face service within 3 years) so the E/M code falls in the 9920x series:
99203 requires detailed history, detailed exam, and low-complexity MDM. Modifier -25 is appended because a significant,
separately identifiable E/M was performed on the same day as a minor procedure (intermediate repair). 12001 is the correct
code for a 2.5 cm intermediate repair of the extremity. Modifier -57 is for decision for surgery on major procedures, not
minor repairs; modifier -F6 applies to HCPCS hand modifiers but is not required here.
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Q6: A physician performs a unilateral thyroid lobectomy (60100) followed by a separate, distinct
biopsy of a contralateral neck lymph node (38500) during the same operative session. Both
procedures are performed at separate anatomic sites through separate incisions. How should
these services be reported?
A. 60100; 38500-51
B. 60100; 38500-59 [CORRECT]
C. 60100-50; 38500
D. 60100; 38500
Correct Answer: B
Rationale: Modifier -59 (or the appropriate X{EPSU} modifier) indicates a distinct procedural service performed at a
separate anatomic site, separate session, or separate incision. Because the lymph node biopsy is on the contralateral side
through a separate incision, modifier -59 appropriately overrides the NCCI edit. Modifier -51 is for multiple procedures in
the same anatomic area and may reduce payment, while -50 is for bilateral procedures on paired organs only. Reporting
38500 without a modifier would likely be denied as bundled.
Q7: Which statement BEST describes the global surgical package for a major procedure with a
90-day global period?
A. Includes all postoperative visits, complications, and unrelated E/M services for 90 days
B. Includes intraoperative service, all E/M visits related to the procedure on the day of surgery, and
postoperative visits for 90 days [CORRECT]
C. Includes only the surgical procedure itself with no follow-up included
D. Includes preoperative visits beginning 30 days before surgery and 90 days postoperatively
Correct Answer: B
Rationale: The global surgical package for a major procedure includes the intraoperative service, all E/M services related to
the procedure on the day of surgery, and all routine postoperative visits during the 90-day postoperative period. Preoperative
visits are NOT included for the initial consultation but only those related to the decision for surgery are excluded. Treatment
of complications requiring return to the OR is separately reportable. Minor procedures (0- or 10-day global) have different
rules.
Q8: A procedure requires significantly increased complexity and effort due to extensive
adhesions, increasing the operative time by 50% over the usual work. Which modifier should be
appended to the procedure code?
A. Modifier -22 (Increased procedural services) [CORRECT]
B. Modifier -52 (Reduced services)
C. Modifier -23 (Unusual anesthesia)
D. Modifier -80 (Assistant surgeon)
Correct Answer: A
Rationale: Modifier -22 is appended when the procedural service required substantially greater effort than typically
required, such as significant additional time or complexity due to factors like extensive adhesions. Documentation must
clearly support the increased work. Modifier -52 is for reduced services, -23 is for unusual anesthesia, and -80 is for an
assistant surgeon. Modifier -22 requires supporting operative note documentation to justify additional reimbursement.
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Q9: Which of the following is an example of an NCCI Procedure-to-Procedure (PTP) edit?
A. Code A cannot be reported with Code B under any circumstances; modifier -59 is NEVER allowed
B. Code A and Code B cannot be reported together, but a modifier -59 may be used if the services are distinct
[CORRECT]
C. Code A may only be reported once per patient per day regardless of medical necessity
D. Code A requires a specific diagnosis code in order to be reimbursed
Correct Answer: B
Rationale: NCCI PTP edits identify code pairs that should not be reported together because they are mutually exclusive or
one is inherent to the other. Most PTP edits have a modifier indicator of '1,' meaning a modifier (typically -59 or X{EPSU})
may be appended when the services are truly distinct (separate site, session, or procedure). A modifier indicator of '0' means
no modifier is ever allowed. The third option describes a Medically Unlikely Edits (MUE) concept, and the fourth describes
a Local Coverage Determination (LCD) requirement.
Q10: A patient is seen by the surgeon in the office on Monday for evaluation of right inguinal
hernia, and the decision is made to perform surgery on Wednesday. Which modifier should be
appended to the E/M service on Monday?
A. Modifier -25 (Significant, separately identifiable E/M)
B. Modifier -57 (Decision for surgery) [CORRECT]
C. Modifier -24 (Unrelated E/M during postoperative period)
D. No modifier is needed because the E/M was the initial consultation
Correct Answer: B
Rationale: Modifier -57 is appended to an E/M service when the visit results in the decision to perform a MAJOR surgery
(90-day global) either the same day or the next day. The hernia repair is a major procedure with a 90-day global period, so
modifier -57 correctly identifies that this E/M led to the surgical decision and is not bundled into the global package.
Modifier -25 is used for E/M on the same day as a MINOR procedure. Modifier -24 applies to unrelated E/M during a
postoperative period.
Q11: Which of the following statements regarding the use of modifier -50 (Bilateral procedure) is
CORRECT?
A. Modifier -50 is reported on code pairs such as 10000-LT and 10000-RT
B. Modifier -50 is reported on a single line item with one unit of service [CORRECT]
C. Modifier -50 is reported with two units of service on one line
D. Modifier -50 may be used on any procedure code regardless of anatomic location
Correct Answer: B
Rationale: Modifier -50 (Bilateral procedure) is reported on a single line item with one unit of service, appended to the
procedure code for a procedure performed on both sides of a paired organ (e.g., eyes, ears, kidneys). It is NOT used with
two separate lines with -LT/-RT, and it is NOT reported with two units. The procedure must be inherently unilateral and
performed bilaterally during the same operative session. Payment is typically 150% of the fee schedule amount.
Section 3: ICD-10-CM Diagnosis Coding (Q12 - Q16)
AAPC CPC Final Exam - 2026/2027 Newest Version | Verified A+ Grade Answers
Newest Version | 100 Questions & Verified Answers | 2026/2027 Aligned
Exam Instructions: This examination contains 100 multiple-choice questions across 16 content domains aligned with the AAPC
Certified Professional Coder (CPC) examination blueprint. Each question has ONE best answer. Total time allowed: 4 hours.
Closed-book except for CPT, ICD-10-CM, and HCPCS Level II code books approved by AAPC. A passing score requires 70% or
higher. Mark only one answer per question.
Section 1: Medical Terminology and Anatomy (Q1 - Q4)
Q1: A cardiologist documents that a patient has a stenosis of the mitral valve causing retrograde
blood flow from the left ventricle into the left atrium during systole. Which anatomical term BEST
describes this condition?
A. Mitral regurgitation resulting from incompetent valve leaflets [CORRECT]
B. Mitral stenosis producing impaired atrial emptying
C. Aortic regurgitation due to dilated annulus
D. Tricuspid prolapse with ventricular volume overload
Correct Answer: A
Rationale: Mitral regurgitation is the backward (retrograde) flow of blood from the left ventricle into the left atrium during
ventricular systole, caused by incompetent mitral valve leaflets. Stenosis means narrowing (forward obstruction), not
backward flow. The aortic and tricuspid valves are anatomically distinct from the mitral valve, making those options
incorrect by location.
Q2: During a thoracentesis, the physician enters the pleural cavity to drain excess fluid. Between
which two anatomical layers is the pleural space located?
A. Parietal pleura and the chest wall
B. Visceral pleura and the lung parenchyma
C. Visceral pleura and parietal pleura [CORRECT]
D. Pleura and the pericardium
Correct Answer: C
Rationale: The pleural cavity (potential space) lies between the visceral pleura (covering the lung surface) and the parietal
pleura (lining the chest wall, mediastinum, and diaphragm). The other options describe adjacent structures but not the actual
space entered during thoracentesis. Understanding this anatomy is essential because fluid, air, or blood accumulates within
this potential space.
AAPC CPC Final Exam - 2026/2027 Newest Version | Verified A+ Grade Answers
,AAPC CPC Final Exam - 100 Questions Page 2
Q3: The medical record documents that a patient underwent an 'intravenous pyelogram' to
evaluate the urinary tract. Which root word combination correctly defines this procedure?
A. Intra- (within) + veno- (vein) + pyelo- (renal pelvis) + -gram (record) [CORRECT]
B. Inter- (between) + veno- (vessel) + pyelo- (kidney) + -gram (picture)
C. Intra- (within) + veno- (artery) + pyelo- (bladder) + -gram (record)
D. Intra- (within) + ventro- (belly) + pyelo- (pelvis) + -gram (study)
Correct Answer: A
Rationale: An intravenous pyelogram (IVP) is a radiographic study in which contrast is injected INTO a VEIN to produce a
RECORD of the RENAL PELVIS and urinary tract. The prefix 'intra-' means within, 'veno-' refers to vein, 'pyelo-' refers to
the renal pelvis (not the entire kidney or bladder), and '-gram' means a recorded image. The other options misuse the root
meanings.
Q4: A surgeon documents a procedure performed on the 'anterior-lateral aspect of the left
proximal femur.' Using standard anatomical planes and directional terminology, which description
is MOST accurate?
A. Front and outer side of the upper portion of the left thigh bone [CORRECT]
B. Back and inner side of the lower portion of the left thigh bone
C. Front and inner side of the lower portion of the left thigh bone
D. Back and outer side of the upper portion of the left thigh bone
Correct Answer: A
Rationale: Anterior means front (ventral), lateral means away from the midline (outer side), proximal means closer to the
trunk (upper portion of the femur), and the femur is the thigh bone. Therefore 'anterior-lateral aspect of the left proximal
femur' describes the front and outer side of the upper portion of the left thigh bone. The other options reverse one or more
directional terms.
Section 2: Coding Concepts and Guidelines (Q5 - Q11)
Q5: A patient is seen in the office for evaluation of a new thumb laceration. After a detailed history,
detailed exam, and low-complexity MDM, the physician performs a 2.5 cm intermediate repair. The
laceration was repaired the same day. Which CPT code(s) and modifier should be reported?
A. 12001 only; the E/M is bundled into the procedure
B. 99213-25, 12001-F6
C. 99203-25, 12001 [CORRECT]
D. 99213, 12001-57
Correct Answer: C
Rationale: This is a new patient (no prior face-to-face service within 3 years) so the E/M code falls in the 9920x series:
99203 requires detailed history, detailed exam, and low-complexity MDM. Modifier -25 is appended because a significant,
separately identifiable E/M was performed on the same day as a minor procedure (intermediate repair). 12001 is the correct
code for a 2.5 cm intermediate repair of the extremity. Modifier -57 is for decision for surgery on major procedures, not
minor repairs; modifier -F6 applies to HCPCS hand modifiers but is not required here.
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,AAPC CPC Final Exam - 100 Questions Page 3
Q6: A physician performs a unilateral thyroid lobectomy (60100) followed by a separate, distinct
biopsy of a contralateral neck lymph node (38500) during the same operative session. Both
procedures are performed at separate anatomic sites through separate incisions. How should
these services be reported?
A. 60100; 38500-51
B. 60100; 38500-59 [CORRECT]
C. 60100-50; 38500
D. 60100; 38500
Correct Answer: B
Rationale: Modifier -59 (or the appropriate X{EPSU} modifier) indicates a distinct procedural service performed at a
separate anatomic site, separate session, or separate incision. Because the lymph node biopsy is on the contralateral side
through a separate incision, modifier -59 appropriately overrides the NCCI edit. Modifier -51 is for multiple procedures in
the same anatomic area and may reduce payment, while -50 is for bilateral procedures on paired organs only. Reporting
38500 without a modifier would likely be denied as bundled.
Q7: Which statement BEST describes the global surgical package for a major procedure with a
90-day global period?
A. Includes all postoperative visits, complications, and unrelated E/M services for 90 days
B. Includes intraoperative service, all E/M visits related to the procedure on the day of surgery, and
postoperative visits for 90 days [CORRECT]
C. Includes only the surgical procedure itself with no follow-up included
D. Includes preoperative visits beginning 30 days before surgery and 90 days postoperatively
Correct Answer: B
Rationale: The global surgical package for a major procedure includes the intraoperative service, all E/M services related to
the procedure on the day of surgery, and all routine postoperative visits during the 90-day postoperative period. Preoperative
visits are NOT included for the initial consultation but only those related to the decision for surgery are excluded. Treatment
of complications requiring return to the OR is separately reportable. Minor procedures (0- or 10-day global) have different
rules.
Q8: A procedure requires significantly increased complexity and effort due to extensive
adhesions, increasing the operative time by 50% over the usual work. Which modifier should be
appended to the procedure code?
A. Modifier -22 (Increased procedural services) [CORRECT]
B. Modifier -52 (Reduced services)
C. Modifier -23 (Unusual anesthesia)
D. Modifier -80 (Assistant surgeon)
Correct Answer: A
Rationale: Modifier -22 is appended when the procedural service required substantially greater effort than typically
required, such as significant additional time or complexity due to factors like extensive adhesions. Documentation must
clearly support the increased work. Modifier -52 is for reduced services, -23 is for unusual anesthesia, and -80 is for an
assistant surgeon. Modifier -22 requires supporting operative note documentation to justify additional reimbursement.
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Q9: Which of the following is an example of an NCCI Procedure-to-Procedure (PTP) edit?
A. Code A cannot be reported with Code B under any circumstances; modifier -59 is NEVER allowed
B. Code A and Code B cannot be reported together, but a modifier -59 may be used if the services are distinct
[CORRECT]
C. Code A may only be reported once per patient per day regardless of medical necessity
D. Code A requires a specific diagnosis code in order to be reimbursed
Correct Answer: B
Rationale: NCCI PTP edits identify code pairs that should not be reported together because they are mutually exclusive or
one is inherent to the other. Most PTP edits have a modifier indicator of '1,' meaning a modifier (typically -59 or X{EPSU})
may be appended when the services are truly distinct (separate site, session, or procedure). A modifier indicator of '0' means
no modifier is ever allowed. The third option describes a Medically Unlikely Edits (MUE) concept, and the fourth describes
a Local Coverage Determination (LCD) requirement.
Q10: A patient is seen by the surgeon in the office on Monday for evaluation of right inguinal
hernia, and the decision is made to perform surgery on Wednesday. Which modifier should be
appended to the E/M service on Monday?
A. Modifier -25 (Significant, separately identifiable E/M)
B. Modifier -57 (Decision for surgery) [CORRECT]
C. Modifier -24 (Unrelated E/M during postoperative period)
D. No modifier is needed because the E/M was the initial consultation
Correct Answer: B
Rationale: Modifier -57 is appended to an E/M service when the visit results in the decision to perform a MAJOR surgery
(90-day global) either the same day or the next day. The hernia repair is a major procedure with a 90-day global period, so
modifier -57 correctly identifies that this E/M led to the surgical decision and is not bundled into the global package.
Modifier -25 is used for E/M on the same day as a MINOR procedure. Modifier -24 applies to unrelated E/M during a
postoperative period.
Q11: Which of the following statements regarding the use of modifier -50 (Bilateral procedure) is
CORRECT?
A. Modifier -50 is reported on code pairs such as 10000-LT and 10000-RT
B. Modifier -50 is reported on a single line item with one unit of service [CORRECT]
C. Modifier -50 is reported with two units of service on one line
D. Modifier -50 may be used on any procedure code regardless of anatomic location
Correct Answer: B
Rationale: Modifier -50 (Bilateral procedure) is reported on a single line item with one unit of service, appended to the
procedure code for a procedure performed on both sides of a paired organ (e.g., eyes, ears, kidneys). It is NOT used with
two separate lines with -LT/-RT, and it is NOT reported with two units. The procedure must be inherently unilateral and
performed bilaterally during the same operative session. Payment is typically 150% of the fee schedule amount.
Section 3: ICD-10-CM Diagnosis Coding (Q12 - Q16)
AAPC CPC Final Exam - 2026/2027 Newest Version | Verified A+ Grade Answers
