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Advanced practice for experienced medical coders

AAPC CPC-M Practice Exam 2026–2027: 120 Questions & Answers

The AAPC Certified Professional Coder – Master (CPC-M) practice exam e-book is an independently published resource for experienced medical coding professionals preparing for the CPC-M certification examination. It contains 120 original CPC-M practice questions with answers, detailed explanations, and high-yield review notes for structured certification exam preparation.

Independently published by MedicalBillingTips. This product is not official AAPC study material and is not affiliated with or endorsed by AAPC.

120 Practice Questions
A–D Multiple-Choice Options
5 Book Knowledge Areas
₹299 India Price

What You Receive

120 Original Practice Questions

The book provides scenario-based multiple-choice questions designed to develop advanced coding reasoning and decision-making.

Detailed Answer Explanations

Each correct answer is supported by an explanation that reviews the coding principle or reasoning used to reach the most appropriate answer.

High-Yield Review Notes

Focused review notes reinforce important concepts and highlight details worth remembering during further study.

Advanced Scenario Practice

Questions emphasize documentation analysis, E/M decision-making, surgical coding, modifiers, compliance and other advanced professional-fee coding situations.

Knowledge Areas Covered in the Book

The manuscript is organized into five major study sections. These are the book's learning categories and should not be interpreted as the current official AAPC CPC-M examination-domain list.

  • Advanced Evaluation and Management (E/M) and Auditing
  • Complex Surgical Coding
  • Advanced Surgical Coding involving digestive, urinary, genital, nervous, eye and ear services
  • Specialized Radiology, Pathology, Laboratory, Medicine and Anesthesia
  • Regulatory Compliance, NCCI Edits and Advanced Case Studies
Important: Official certification examination formats, content outlines, code sets, policies and permitted reference materials can change. Candidates should always compare their preparation materials with current information published by AAPC.

Who Is This Practice E-Book For?

Experienced Medical Coders

The material is intended for coders who already understand core CPT, ICD-10-CM, HCPCS Level II, documentation and professional-fee coding concepts.

CPC-M Candidates

It can be used as supplementary question practice by experienced professionals preparing for the Certified Professional Coder – Master examination.

Advanced Coding Review

Readers can use the explanations and review notes to identify knowledge gaps and revisit difficult coding concepts.

Not an Introductory Coding Course

This practice bank assumes prior medical coding knowledge and should not replace foundational coding education, current official references or current codebooks.

Free preview

10 Free CPC-M Practice Questions

The following questions are selected from the complete e-book and represent several of its knowledge areas. They are original educational practice questions and are not actual certification examination questions.

Sample Question 1

A 68-year-old established patient visits the outpatient clinic for a routine follow-up of type 2 diabetes mellitus and essential hypertension. Clinical evaluation reveals that the patient's hypertension is stable under the current regimen, but the diabetes is inadequately controlled. The physician orders a comprehensive metabolic panel, a lipid profile, and a hemoglobin A1c, adjusts the dosage of the patient's oral hypoglycemic prescription, and schedules a return visit in four weeks. Total documentation reflects 18 minutes of physician time on the date of the encounter. Based on Medical Decision Making (MDM), which evaluation and management (E/M) code should be reported?

  • A. 99212
  • B. 99213
  • C. 99214
  • D. 99215
Sample Question 2

A general surgeon evaluates a patient in the office on post-operative day 10 following an uncomplicated open appendectomy, a procedure subject to a 90-day global period. The patient reports a new, highly painful, tender mass on the right thigh. The surgeon evaluates the thigh lesion, diagnoses a subcutaneous abscess, and performs an office-based incision and drainage. What modifier(s) must be appended to the E/M code for proper billing?

  • A. 24
  • B. 25
  • C. 24, 25
  • D. 57
Sample Question 3

A surgeon removes a malignant melanoma from the right cheek and closes the surgical defect by designing and rotating a rhomboid flap. The operative report documents a combined primary and secondary defect area of 9.5 sq cm. Which CPT coding is most appropriate?

  • A. 11646-51 and 14040
  • B. 14040
  • C. 14041
  • D. 14301
Sample Question 4

An orthopedic surgeon performs an arthroscopic ACL reconstruction on a patient's right knee. Through a separate portal, the surgeon performs a medically indicated partial medial meniscectomy in a separate compartment. NCCI guidelines permit separate reporting when distinct compartments are documented. How should these procedures be coded?

  • A. 29888-RT and 29881-59-RT
  • B. 29888-RT only
  • C. 29888-RT and 29881-51-RT
  • D. 29881-RT and 29882-59-RT
Sample Question 5

During an esophagogastroduodenoscopy (EGD) performed on a Medicare beneficiary, a gastroenterologist removes a 1.5 cm gastric polyp using a snare technique and performs a cold forceps biopsy on a separate suspicious esophageal lesion. How should these services be billed?

  • A. 43251, 43239
  • B. 43251, 43239-59
  • C. 43251
  • D. 43239, 43251-51

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Sample Question 6

A urologist treats a 1.2 cm mid-ureteral calculus using cystourethroscopy with ureteroscopy and holmium laser lithotripsy. Following fragmentation, a double-J indwelling ureteral stent is placed. Which CPT code configuration represents this encounter?

  • A. 52353, 52332-51
  • B. 52356, 52332-59
  • C. 52352
  • D. 52356
Sample Question 7

A patient with lung cancer presents with acute headaches. The radiologist performs a brain MRI without intravenous contrast, followed by intravenous gadolinium administration and further contrast sequences. What is the CPT code?

  • A. 70551, 70552
  • B. 70553
  • C. 70551, 70552-59
  • D. 70552
Sample Question 8

A patient receives intravenous chemotherapy infusion for colon cancer lasting 2 hours and 15 minutes. How should the facility report the chemotherapy administration?

  • A. 96413, 96415
  • B. 96413, 96415 x 2
  • C. 96365, 96366
  • D. 96413
Sample Question 9

A physician owns a 40% financial interest in an independent imaging center and routinely refers Medicare beneficiaries to this facility for MRI scans. Which federal statute does this arrangement directly violate?

  • A. The Anti-Kickback Statute
  • B. The False Claims Act
  • C. The Stark Law
  • D. The HIPAA Privacy Rule
Sample Question 10

A billing claim is denied because two procedures performed on different anatomical sites are flagged as mutually exclusive under NCCI edits. The NCCI modifier indicator for the code pair is "1". What is the correct corrective action?

  • A. Write off the code.
  • B. Resubmit the claim with modifier 59, or an appropriate X{EPSU} modifier, attached to the Column 2 code.
  • C. Append modifier 51.
  • D. Appeal without modifiers.

Sample Answer Key

1. C
2. C
3. B
4. A
5. B
6. D
7. B
8. A
9. C
10. B

Answers and Explanations

Sample Question 1

Correct Answer: C. 99214

Moderate MDM is supported because the encounter includes an inadequately controlled chronic condition together with prescription drug management. When MDM supports the service level, the lower documented time does not prevent selection of 99214 based on MDM.

High-Yield Note: Office and outpatient E/M selection may be based on either MDM or total time. Prescription drug management supports moderate risk.

Sample Question 2

Correct Answer: C. Modifiers 24 and 25

Modifier 24 identifies an unrelated E/M service occurring during the postoperative period of the earlier surgery. Modifier 25 identifies the significant, separately identifiable E/M service performed on the same day as the minor incision-and-drainage procedure.

High-Yield Note: When documentation supports both circumstances, modifier 24 can identify the unrelated postoperative E/M service while modifier 25 distinguishes the same-day E/M service from the minor procedure.

Sample Question 3

Correct Answer: B. 14040

The adjacent tissue transfer involves the cheek and has a combined primary and secondary defect area of 9.5 sq cm, placing it within the applicable 14040 size range. The lesion excision associated with creating the defect is included in the adjacent tissue transfer service.

High-Yield Note: Adjacent tissue transfer coding is determined by anatomical location and the combined area of the primary and secondary defects.

Sample Question 4

Correct Answer: A. 29888-RT and 29881-59-RT

The ACL reconstruction is represented by 29888. The medically necessary partial meniscectomy is separately reportable in the scenario because the documentation establishes work in a distinct compartment, supporting modifier 59 on the secondary service.

High-Yield Note: Separate reporting of otherwise edited arthroscopic procedures requires documentation supporting a genuinely distinct service, such as a separate anatomical compartment.

Sample Question 5

Correct Answer: B. 43251 and 43239-59

Code 43251 represents removal by snare technique, while 43239 represents biopsy. Because the biopsy is performed on a separate esophageal lesion rather than the gastric polyp removed by snare, modifier 59 identifies the distinct biopsy service.

High-Yield Note: When different endoscopic techniques are performed on separate lesions, clearly documented separate sites can support distinct procedural reporting.

Sample Question 6

Correct Answer: D. 52356

Code 52356 describes ureteroscopy with lithotripsy and insertion of an indwelling ureteral stent. Because both services occur in the same ureter, separate reporting of the stent insertion is not appropriate.

High-Yield Note: Look for comprehensive CPT codes that already incorporate associated services before adding separate procedure codes.

Sample Question 7

Correct Answer: B. 70553

The MRI includes images obtained without contrast followed by contrast administration and additional sequences. Code 70553 represents the combined without-and-with-contrast brain MRI service.

High-Yield Note: When both pre-contrast and post-contrast brain MRI sequences are documented, identify the comprehensive combination code rather than separately reporting the component studies.

Sample Question 8

Correct Answer: A. 96413 and 96415

Code 96413 represents the initial chemotherapy infusion period. A 2-hour-and-15-minute infusion supports one additional-hour unit of 96415, but the documented time does not support a second additional-hour unit.

High-Yield Note: Infusion coding requires careful application of the applicable time thresholds rather than automatically counting every partial hour as another unit.

Sample Question 9

Correct Answer: C. The Stark Law

The scenario describes a physician financial relationship with an imaging entity combined with referrals of Medicare patients for designated health services. In the absence of an applicable exception, this is the type of physician self-referral addressed by the Stark Law.

High-Yield Note: In compliance scenarios, distinguish physician self-referral restrictions from kickback, false-claim and privacy rules.

Sample Question 10

Correct Answer: B. Modifier 59 or an appropriate X{EPSU} modifier

An NCCI modifier indicator of "1" means an appropriate modifier may be used to bypass the edit when documentation establishes circumstances such as separate anatomical sites or separate encounters. The modifier is applied to the Column 2 code when the distinct service is properly supported.

High-Yield Note: A modifier indicator of "1" does not automatically authorize unbundling. Documentation must still demonstrate a valid distinct-service circumstance.

Continue with the Complete 120-Question Practice E-Book

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Pricing and Purchase Information

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₹299

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Frequently Asked Questions

1. Is this an official certification-organization product?

No. This is an independently published educational resource from MedicalBillingTips. It is not affiliated with, sponsored by, approved by, licensed by or endorsed by AAPC or any other examination or certification organization.

2. Does the e-book contain actual examination questions?

No. The questions are original educational practice questions. They are not actual CPC-M examination questions, recalled examination content or confidential certification material.

3. What does the e-book include?

The manuscript contains 120 scenario-based multiple-choice practice questions, answer explanations and high-yield review notes covering advanced E/M, surgical coding, specialty coding, compliance, NCCI and related advanced coding situations.

4. What format will I receive?

This product is offered as a digital e-book. Please review the Gumroad product page before purchase for the exact downloadable file format and files currently included with the international product, because the delivery file type could not be independently verified from the supplied manuscript alone.

5. Is this book suitable for beginners or experienced candidates?

It is primarily designed for experienced medical coders. The questions assume familiarity with medical coding concepts, documentation analysis, CPT, ICD-10-CM, HCPCS Level II, modifiers and compliance principles. It is not intended to replace introductory coding education.

6. Are official codebooks, textbooks or reference manuals included?

No official CPT, ICD-10-CM, HCPCS Level II codebooks, textbooks or certification-organization reference manuals are represented as being included. Candidates should obtain and use the appropriate current official references separately.

7. Does purchasing the e-book guarantee a passing score?

No. Purchasing, reading or completing the practice questions does not guarantee a passing examination score, certification, employment, promotion or any other specific result.

8. How do international customers purchase the e-book?

International customers can open the public Gumroad product page using the purchase buttons on this page and review the current price and checkout information displayed there.

9. How do customers in India purchase the e-book?

The India price is ₹299. Because a dedicated India payment URL was not supplied for this sales page, India customers should contact MedicalBillingTips for the current payment and delivery instructions rather than assuming that the Gumroad checkout uses the same ₹299 price.

10. What should a buyer do if there is a payment or download problem?

For a Gumroad order, use the purchase receipt, order page and support options associated with the Gumroad transaction and contact the seller if necessary. For an India purchase, contact MedicalBillingTips through the website's Contact Us page and provide the relevant order or payment information.

11. What is the refund policy for a downloaded digital product?

For Gumroad purchases, review the refund information displayed by the seller or Gumroad for the applicable transaction before purchasing. No separate direct-India refund policy was supplied for this page, so India buyers should contact MedicalBillingTips and confirm the applicable policy before completing payment.

For the current CPC-M examination format, eligibility information, policies, permitted materials and certification terminology, consult the official AAPC CPC-M certification page.

Independent-Publication Disclaimer

This independently published educational resource is not affiliated with, sponsored by, approved by, licensed by, or endorsed by AAPC or any other examination or certification organization. All organization names, examination names, abbreviations and trademarks belong to their respective owners and are used only to identify the examination for which this independent educational resource may be relevant.

The practice questions are original educational content and are not actual examination questions, recalled examination questions or confidential examination content. Examination formats, policies, code sets, standards, guidelines and requirements may change. Readers should consult current official examination information and current authoritative coding resources.

Purchasing, reading or studying this e-book does not guarantee a passing score, certification, employment, promotion, increased income or any other specific result.

Ready for More CPC-M Practice?

Review the 10 free samples above first. If the question style and difficulty match your preparation needs, continue with the complete 120-question independent practice e-book.

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