AAPC CPC-M Practice Exam 2026–2027
Build confidence with 120 original, scenario-based practice questions covering advanced professional-fee coding, auditing, compliance, complex surgical coding, radiology, laboratory, medicine, anesthesia, NCCI edits, and advanced case studies.
Focused CPC-M Practice for Advanced Coding Decisions
This independent practice resource is designed for experienced medical coders preparing for the AAPC Certified Professional Coder – Master (CPC-M) certification exam. It emphasizes scenario-based decision-making rather than simple memorization.
What You Receive
- 120 multiple-choice CPC-M practice questions.
- Scenario-based questions designed to strengthen practical coding reasoning.
- Detailed explanations for every correct answer.
- High-yield review notes for focused revision.
- Coverage across E/M and auditing, complex surgery, specialty procedure coding, radiology/pathology/laboratory/medicine/anesthesia, compliance, NCCI edits, and advanced case studies.
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FREE SAMPLE — 10 CPC-M Practice Questions
Try 10 representative questions selected from the complete e-book. They are renumbered 1–10 for this free sample and cover multiple domains from the full practice book. Click each answer section to review the correct answer, explanation, and high-yield note.
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?
View Answer & Explanation
Correct Answer: C. 99214
Explanation: The encounter supports Moderate MDM. The physician addresses two chronic conditions, including inadequately controlled diabetes, and adjusts prescription drug therapy. Although 18 minutes would not support 99214 by time, the code may be selected based on MDM when the documented MDM supports the higher level.
High-Yield Review Note: Office/outpatient E/M code selection may be based on either MDM or total time on the date of the encounter. Prescription drug management supports Moderate Risk.
A 72-year-old Medicare beneficiary returns for an Annual Wellness Visit. The record shows that the initial Medicare AWV was completed 18 months earlier. During today’s appointment, the patient also reports severe right lower-quadrant abdominal pain and nausea that began the previous day. The physician performs a distinct problem-oriented evaluation, orders laboratory testing and an abdominal CT, and directs the patient to the emergency department. The separately documented acute service supports moderate medical decision making. Which coding combination is most appropriate?
View Answer & Explanation
Correct Answer: D. G0439 and 99214-25
Explanation: Because the beneficiary previously received the initial Medicare Annual Wellness Visit, the current AWV is reported with G0439. The significant, separately identifiable acute abdominal-pain evaluation supports 99214 based on Moderate MDM, with modifier 25 appended to the E/M service.
High-Yield Review Note: G0438 is used for the initial Medicare AWV and G0439 for a subsequent AWV. When a medically necessary problem-oriented E/M service is performed beyond the AWV requirements, append modifier 25 to the E/M code.
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?
View Answer & Explanation
Correct Answer: B. 14040
Explanation: CPT 14040 is selected because the adjacent tissue transfer involves the cheek and the documented combined primary and secondary defect area is 9.5 sq cm. The lesion-excision work for the same lesion is included in the adjacent tissue transfer service and is not separately reported.
High-Yield Review Note: Adjacent tissue transfer codes are selected by anatomical location and total defect area. Add the primary and secondary defect areas when determining the appropriate size range.
A plastic surgeon performs a delayed left breast reconstruction on a post-mastectomy patient using a single-pedicle Transverse Rectus Abdominis Myocutaneous (TRAM) flap. To ensure adequate vascularity, the surgeon performs a microvascular anastomosis (supercharging). What is the correct CPT code?
View Answer & Explanation
Correct Answer: C. 19368
Explanation: The procedure is a single-pedicle TRAM flap with microvascular supercharging. CPT 19368 describes this configuration. The presence of the microvascular anastomosis distinguishes it from a single-pedicle TRAM flap without supercharging.
High-Yield Review Note: For TRAM flap reconstruction, pay close attention to pedicle count and whether microvascular supercharging is performed.
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?
View Answer & Explanation
Correct Answer: B. 43251, 43239-59
Explanation: CPT 43251 reports removal of the gastric polyp by snare, while 43239 reports the biopsy. Because the biopsy was performed on a separate lesion/site from the snare removal, modifier 59 (or an appropriate X{EPSU} modifier when applicable) identifies the distinct service.
High-Yield Review Note: When biopsy and snare removal are performed on different lesions during the same EGD session, documentation must clearly support the separate sites.
An ophthalmologist treats pediatric esotropia by performing surgical recession of the medial rectus muscle and resection of the lateral rectus muscle in the left eye during a single operative session. What is the correct coding?
View Answer & Explanation
Correct Answer: C. 67312-LT
Explanation: CPT 67312 describes strabismus surgery involving two horizontal muscles in one eye. Because both the medial rectus and lateral rectus muscles are treated in the left eye, 67312-LT is the appropriate coding.
High-Yield Review Note: Strabismus surgery on two horizontal muscles in a single eye is reported with CPT 67312.
A complete abdominal ultrasound is performed, documenting liver, gallbladder, common bile duct, pancreas, spleen, kidneys, upper abdominal aorta, and IVC. What is the CPT code?
View Answer & Explanation
Correct Answer: C. 76700
Explanation: CPT 76700 describes a complete real-time abdominal ultrasound with image documentation. The documented study includes the structures required for a complete abdominal examination.
High-Yield Review Note: Differentiate a complete abdominal ultrasound from a limited study by checking whether the required upper-abdominal organs and structures are documented.
An anesthesiologist provides anesthesia for an EGD on a 65-year-old patient with mild, well-controlled hypertension. What CPT code and physical status modifier apply?
View Answer & Explanation
Correct Answer: B. 00731-P2
Explanation: CPT 00731 applies to anesthesia for upper gastrointestinal endoscopic procedures. P2 is appropriate for a patient with mild systemic disease, such as well-controlled hypertension.
High-Yield Review Note: For anesthesia questions, identify both the procedure-specific anesthesia code and the patient's physical-status modifier.
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?
View Answer & Explanation
Correct Answer: C. The Stark Law
Explanation: The Stark Law addresses physician self-referrals for designated health services when the physician or an immediate family member has a financial relationship with the entity, unless a specific exception applies. Diagnostic imaging is among the designated health services covered by the law.
High-Yield Review Note: The Stark Law is a physician self-referral law and is commonly tested in scenarios involving financial relationships and designated health services.
Twenty days following an open cholecystectomy (90-day global period), a patient returns to the operating room with the original surgeon for drainage of an intra-abdominal abscess that developed as a complication. Which modifier must be appended to the reoperation code?
View Answer & Explanation
Correct Answer: B. 78
Explanation: Modifier 78 is used when the same physician performs an unplanned return to the operating/procedure room for a related procedure during the postoperative period. Here, the abscess is a complication of the original surgery and requires an unplanned return to the OR.
High-Yield Review Note: Use modifier 78 for an unplanned return to the operating room for a related procedure during the postoperative global period.
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AAPC CPC-M Practice Exam 2026–2027
120 practice questions • detailed explanations • high-yield review notes
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