Free AAPC Certified Professional Coder (CPC) exam Practice Questions

Sample Practice Questions

Try these 10 sample questions from the AAPC Certified Professional Coder (CPC) exam practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1In a clinical term, what does the root cardi- identify?

   1. A.The heartCorrect answer: A
   2. B.A blood vessel
   3. C.A joint
   4. D.The head

   Explanation: MedlinePlus pairs "cardi-, cardio- heart" in its word-parts table. Thus cardi- identifies the heart, while the other choices name different structures.

   Reference: MedlinePlus Appendix A: Word Parts and What They Mean — Body Parts and Disorders, cardi- entry

2. 2For a Medicare NCCI procedure-to-procedure edit pair on the same date of service, which code is ordinarily denied when both are reported without an allowable modifier?

   1. A.The Column One code
   2. B.The Column Two codeCorrect answer: B
   3. C.Both paired codes
   4. D.Neither paired code

   Explanation: CMS states that the "Column One code is eligible for payment, but the Column Two code is denied" absent an allowed, clinically appropriate modifier. The denied member is therefore Column Two.

   Reference: CMS Medicare NCCI FAQ Library — Procedure-to-Procedure (PTP) Edits, question 1

3. 3An outpatient record documents diabetes mellitus but does not identify its type. What type does the FY 2027 ICD-10-CM guideline use as the default?

   1. A.Type 1 diabetes mellitus
   2. B.Type 2 diabetes mellitusCorrect answer: B
   3. C.Secondary diabetes mellitus
   4. D.Gestational diabetes mellitus

   Explanation: The guideline says, "If the type of diabetes mellitus is not documented in the medical record the default is E11.-, Type 2 diabetes mellitus." The coder cannot infer another type from the absence of documentation.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 — FY 2027, PDF page 40

4. 4Under Medicare NCCI, an abscess is incised and drained only to gain access for excision at the same site during the same encounter. How is the drainage reported?

   1. A.Included in the excision without a separate I&D code.Correct answer: A
   2. B.Report both excision and separate I&D codes.
   3. C.Report separate I&D with modifier 59 for access.
   4. D.Report I&D instead of the completed excision.

   Explanation: The manual says an incision or drainage done "to gain access to an area for another procedure" is not separately reportable at the same encounter. This is the access step described.

   Reference: Medicare NCCI Policy Manual 2026, Chapter III: Integumentary System — Chapter III.D, Incision and Drainage

5. 5Under Medicare NCCI, a biopsy is taken during a more extensive nasal/sinus operation, but its result did not determine whether the operation would proceed. How is the biopsy coded?

   1. A.Include the biopsy in the more extensive operation.Correct answer: A
   2. B.Report a separate diagnostic biopsy because tissue was sampled.
   3. C.Report the biopsy with modifier 59 because pathology was ordered.
   4. D.Report the biopsy separately because pathology resulted later.

   Explanation: CMS states, "A biopsy performed in conjunction with a more extensive nasal/sinus procedure is not separately reportable unless the biopsy is examined pathologically before the more extensive procedure and the decision to proceed with the more extensive procedure is based on the result of the pathologic examination." The stated biopsy did not determine the decision to operate, so it remains included.

   Reference: Medicare NCCI Policy Manual 2026, Chapter V: Respiratory and Cardiovascular Surgery — PDF page V-5

6. 6A physician performs the same endoscopic polypectomy multiple times in one CPT-defined digestive region during one encounter. What unit rule does Medicare NCCI apply?

   1. A.One unit for that same endoscopic procedureCorrect answer: A
   2. B.One unit for every polyp
   3. C.One unit for every instrument pass
   4. D.One unit for every specimen container

   Explanation: CMS says when the same endoscopic procedure is repeated in a single defined region and encounter, "only one CPT code may be reported with one unit of service." Separate polyps do not independently raise units.

   Reference: Medicare NCCI Policy Manual 2026, Chapter VI: Digestive System — PDF page VI-5

7. 7A burr hole is created solely to access the same intracranial site for a craniotomy. Under Medicare NCCI, is the burr-hole code separately reported?

   1. A.No, the access burr hole is integral to craniotomy.Correct answer: A
   2. B.Yes, report each burr hole as an added procedure.
   3. C.Yes, report the access burr hole before craniotomy.
   4. D.Yes, report the burr hole if it enlarges cranial access.

   Explanation: CMS says a burr hole used as an integral step of another intracranial service is "not separately reportable" at the same encounter. The stem describes access at the same site.

   Reference: Medicare NCCI Policy Manual 2026, Chapter VIII: Nervous System — Chapter VIII.C.1, Burr hole

8. 8An abnormal laboratory result is retested solely to verify that result. Under Medicare NCCI policy, how many units of that test are reported?

   1. A.One unit.Correct answer: A
   2. B.Two units.
   3. C.One unit per methodology.
   4. D.One unit per aliquot tested.

   Explanation: CMS says repeat performance solely to verify an abnormal result "is reported as 1 unit of service rather than 2."

   Reference: Medicare NCCI Policy Manual 2026, Chapter X: Pathology and Laboratory Services — Chapter X.A, verification testing

9. 9For Medicare billing, a physician performs a consultation in an office. Which E/M reporting approach follows CMS policy?

   1. A.Bill a consultation code from 99242-99255.
   2. B.Bill an appropriate E/M level for the office site.Correct answer: B
   3. C.Bill a hospital consultation code.
   4. D.Bill a critical care code.

   Explanation: CMS states "Medicare does not recognize consultation E&M CPT codes 99242–99255 for billing and payment purposes." It directs the appropriate site-of-service E/M level.

   Reference: Medicare NCCI Policy Manual 2026, Chapter XI: Medicine and E/M Services — Chapter XI.U, consultation codes

10. 10The psychiatrist's record documents a diagnostic psychiatric evaluation that includes medical evaluation and management. No psychotherapy occurs. Which CPT code represents the diagnostic visit?

    1. A.90791.
    2. B.90792.Correct answer: B
    3. C.90832.
    4. D.99213.

    Explanation: CMS states "CPT code 90791 is psychiatric evaluation without medical E&M, and CPT code 90792 is psychiatric evaluation with medical E&M." The chart documents the latter.

    Reference: Medicare NCCI Policy Manual 2026, Chapter XI: Medicine and E/M Services — Chapter XI.C, psychiatric diagnostic evaluation