AAPC Official CPC Certification EXAM
STUDY GUIDE 2026/2027 ACCURATE
QUESTIONS WITH CORRECT
DETAILED SOLUTIONS ||
100% GUARANTEED PASS
<NEWEST VERSION>
1. CPC Credential - ANSWER ✔ Certified Professional Coder credential
awarded by AAPC.
2. AAPC - ANSWER ✔ Primary organization for medical coding
professionals.
3. Medical Coding - ANSWER ✔ Process of translating healthcare diagnoses
into codes.
4. ICD-10-CM - ANSWER ✔ International Classification of Diseases, 10th
Revision, Clinical Modification.
5. CPT Coding - ANSWER ✔ Current Procedural Terminology used for
reporting medical services.
6. HCPCS Level II - ANSWER ✔ Healthcare Common Procedure Coding
System for non-physician services.
7. Compliance - ANSWER ✔ Adherence to federal and state medical billing
regulations.
8. Reimbursement - ANSWER ✔ Payment for medical services provided to
patients.
,9. Medical Terminology - ANSWER ✔ Language used to describe medical
conditions and procedures.
10.Anatomy - ANSWER ✔ Study of body structure relevant to medical
coding.
11.Physiology - ANSWER ✔ Study of body functions relevant to medical
coding.
12.Claims Denials - ANSWER ✔ Refusal by payers to reimburse for services
rendered.
13."hold harmless clause" - ANSWER ✔ * found in some non-Medicare
health plan contracts
• prohibits billing to patient for anything beyond deductibles and co-
pays.
14.A compliance plan may offer several benefits, including: - ANSWER ✔ *
more accurate payment of claims
• fewer billing mistakes
• improved documentation and more accurate coding
• less chance of violating self-referral and anti-kickback status
15.A healthcare clearing house is a - ANSWER ✔ entity that processes
nonstandard health information they receive from another entity into a
standard format
16.A key provision in HIPAA is the Minimum Necessary requirement. this
means - ANSWER ✔ only the minimum necessary protected health
information should be shared to satisfy a particular purpose.
17.A medically necessary service is the - ANSWER ✔ least radical
service/procedure that allows for effective treatment of the patients'
complaint or condition
18.A patient sustaining an injury to her great saphenous vein would have
sustained injury to which of anatomical site? - ANSWER ✔ Leg
,19.APC - ANSWER ✔ Ambulatory Payment Classification
20.ARRA - ANSWER ✔ American Recovery and Reinvestment Act (of
2009)
21.ASC - ANSWER ✔ Ambulatory Surgical Centers
22.Abuse consists of - ANSWER ✔ payment for items or services that are
billed by providers in error that should not be paid for by Medicare.
23.An ABN protects the provider's financial interest by - ANSWER ✔
creating a paper trail that CMS requires before a provider can bill the patient
for payment if Medicare denies coverage for the stated service or procedure.
24.An entity that processes nonstandard health information they receive from
another entity into a standard format is considered what? - ANSWER ✔
Clearinghouse
25.Resource costs for RBRVS are divided into three componentes: - ANSWER
✔ physican work
practice expense
professional liability insurance
26.Sebacious glands are a part of which anatomic system? - ANSWER ✔
Integumentary
27.The ABN form is entitled - ANSWER ✔ Revised ABN CMS-R-131 and is
available with instructions as a free download on the CMS website.
28.The ABN is a standardized form that - ANSWER ✔ explains to the patient
why Medicare may deny the particular service or procedure.
29.The OIG is mandated by public law to engage in activities to test -
ANSWER ✔ the efficiency and economy of government programs to
include investigation of suspected health care fraud or abuse.
, 30.The amount on an ABN should be within how much of the cost to the
patient? - ANSWER ✔ $100 or 25% of cost
31.RATIONALE: CMS instructions stipulate, "Notifires msut make a good
faith effort to insert a reasonable estimate....the estimate should be within
$100 or 25% of the actual costs, whichever is greater.
32.What anatomical or compartment contains all the thoracic viscera except the
lungs? - ANSWER ✔ Mediastinum
33.Who is responsible for enforcing the HIPAA security rule - ANSWER ✔
Office of Civil Rights (OCR)
34.ABN - ANSWER ✔ Advance Beneficiary Notice
35.According to the OIG, internal monitoring and auditing should be performed
by what means? - ANSWER ✔ Periodic audits
36.What does the abbreviation MAC stand for? - ANSWER ✔ Medicare
Administrative Contractor
37.How many lobes make up the RIGHT lung? - ANSWER ✔ the right has 3
lobes
the left has 2 lobes
38.Condition in which the endometrial tissue is found outside of the uterus. -
ANSWER ✔ Endometriosis
39.A thin membrane lining the chambers of the heart and valves is called the: -
ANSWER ✔ endocardium
40.PHI - ANSWER ✔ Protected Health Information
41.What is the TRUE statement in reporting pressure ulcers? - ANSWER ✔
Two codes are assigned when a patient is admitted with a pressure ulcer that
evolves to another stage during the admission.
STUDY GUIDE 2026/2027 ACCURATE
QUESTIONS WITH CORRECT
DETAILED SOLUTIONS ||
100% GUARANTEED PASS
<NEWEST VERSION>
1. CPC Credential - ANSWER ✔ Certified Professional Coder credential
awarded by AAPC.
2. AAPC - ANSWER ✔ Primary organization for medical coding
professionals.
3. Medical Coding - ANSWER ✔ Process of translating healthcare diagnoses
into codes.
4. ICD-10-CM - ANSWER ✔ International Classification of Diseases, 10th
Revision, Clinical Modification.
5. CPT Coding - ANSWER ✔ Current Procedural Terminology used for
reporting medical services.
6. HCPCS Level II - ANSWER ✔ Healthcare Common Procedure Coding
System for non-physician services.
7. Compliance - ANSWER ✔ Adherence to federal and state medical billing
regulations.
8. Reimbursement - ANSWER ✔ Payment for medical services provided to
patients.
,9. Medical Terminology - ANSWER ✔ Language used to describe medical
conditions and procedures.
10.Anatomy - ANSWER ✔ Study of body structure relevant to medical
coding.
11.Physiology - ANSWER ✔ Study of body functions relevant to medical
coding.
12.Claims Denials - ANSWER ✔ Refusal by payers to reimburse for services
rendered.
13."hold harmless clause" - ANSWER ✔ * found in some non-Medicare
health plan contracts
• prohibits billing to patient for anything beyond deductibles and co-
pays.
14.A compliance plan may offer several benefits, including: - ANSWER ✔ *
more accurate payment of claims
• fewer billing mistakes
• improved documentation and more accurate coding
• less chance of violating self-referral and anti-kickback status
15.A healthcare clearing house is a - ANSWER ✔ entity that processes
nonstandard health information they receive from another entity into a
standard format
16.A key provision in HIPAA is the Minimum Necessary requirement. this
means - ANSWER ✔ only the minimum necessary protected health
information should be shared to satisfy a particular purpose.
17.A medically necessary service is the - ANSWER ✔ least radical
service/procedure that allows for effective treatment of the patients'
complaint or condition
18.A patient sustaining an injury to her great saphenous vein would have
sustained injury to which of anatomical site? - ANSWER ✔ Leg
,19.APC - ANSWER ✔ Ambulatory Payment Classification
20.ARRA - ANSWER ✔ American Recovery and Reinvestment Act (of
2009)
21.ASC - ANSWER ✔ Ambulatory Surgical Centers
22.Abuse consists of - ANSWER ✔ payment for items or services that are
billed by providers in error that should not be paid for by Medicare.
23.An ABN protects the provider's financial interest by - ANSWER ✔
creating a paper trail that CMS requires before a provider can bill the patient
for payment if Medicare denies coverage for the stated service or procedure.
24.An entity that processes nonstandard health information they receive from
another entity into a standard format is considered what? - ANSWER ✔
Clearinghouse
25.Resource costs for RBRVS are divided into three componentes: - ANSWER
✔ physican work
practice expense
professional liability insurance
26.Sebacious glands are a part of which anatomic system? - ANSWER ✔
Integumentary
27.The ABN form is entitled - ANSWER ✔ Revised ABN CMS-R-131 and is
available with instructions as a free download on the CMS website.
28.The ABN is a standardized form that - ANSWER ✔ explains to the patient
why Medicare may deny the particular service or procedure.
29.The OIG is mandated by public law to engage in activities to test -
ANSWER ✔ the efficiency and economy of government programs to
include investigation of suspected health care fraud or abuse.
, 30.The amount on an ABN should be within how much of the cost to the
patient? - ANSWER ✔ $100 or 25% of cost
31.RATIONALE: CMS instructions stipulate, "Notifires msut make a good
faith effort to insert a reasonable estimate....the estimate should be within
$100 or 25% of the actual costs, whichever is greater.
32.What anatomical or compartment contains all the thoracic viscera except the
lungs? - ANSWER ✔ Mediastinum
33.Who is responsible for enforcing the HIPAA security rule - ANSWER ✔
Office of Civil Rights (OCR)
34.ABN - ANSWER ✔ Advance Beneficiary Notice
35.According to the OIG, internal monitoring and auditing should be performed
by what means? - ANSWER ✔ Periodic audits
36.What does the abbreviation MAC stand for? - ANSWER ✔ Medicare
Administrative Contractor
37.How many lobes make up the RIGHT lung? - ANSWER ✔ the right has 3
lobes
the left has 2 lobes
38.Condition in which the endometrial tissue is found outside of the uterus. -
ANSWER ✔ Endometriosis
39.A thin membrane lining the chambers of the heart and valves is called the: -
ANSWER ✔ endocardium
40.PHI - ANSWER ✔ Protected Health Information
41.What is the TRUE statement in reporting pressure ulcers? - ANSWER ✔
Two codes are assigned when a patient is admitted with a pressure ulcer that
evolves to another stage during the admission.
