CPC Medical Coding Practice Test
Free CPC medical coding practice questions in English, Chinese, and Spanish — ICD-10-CM guidelines, E/M level selection, surgical coding rules, modifiers and HCPCS Level II, and compliance, each with a full explanation.
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Practice questions based on the ICD-10-CM Official Guidelines for Coding and Reporting, the AMA CPT guidelines, the CMS HCPCS Level II system, and federal healthcare compliance law. CPC is a mark of the AAPC and CPT is a mark of the American Medical Association; this site is not affiliated with or endorsed by either. ICD-10-CM, CPT, and HCPCS Level II are revised every year, so these questions test coding rules and conventions rather than code values — always verify actual code selection against the current code books and your payer's published policy. Nothing here is medical, legal, or billing advice.
About the CPC medical coding exam
The Certified Professional Coder (CPC) credential is the AAPC's certification for coding in the physician-office and outpatient setting: you read a provider's documentation and translate it into diagnosis codes, procedure codes, and modifiers that a payer will accept. The exam is open-book against the current ICD-10-CM, CPT, and HCPCS Level II manuals, which tells you what it is really testing — not whether you memorized codes, but whether you can navigate the guidelines, apply the conventions, and defend the choice you made. These practice questions are built around that durable layer: index-then-tabular verification, Excludes1 versus Excludes2, sequencing, the surgical package, medical decision making, modifier meaning, and the compliance rules that make a claim honest.
How to study for the CPC
Start with the guidelines, not the codes. The ICD-10-CM Official Guidelines for Coding and Reporting sit at the front of the manual and are the single highest-yield thing you can read, because almost every diagnosis question on the exam is really a guidelines question wearing a clinical costume. Learn the two-step discipline — find a candidate in the Alphabetic Index, then always verify it in the Tabular List — and learn what the conventions instruct you to do: Excludes1 and Excludes2, "code first" and "use additional code" pairs and the order they force, the "with" convention that presumes a causal link, the placeholder X, and the seventh character that says whether this is an initial encounter, a subsequent one, or a sequela.
Treat the CPT side as a set of bundling questions. The exam rewards coders who can say what is already included in something else: the surgical package, the diagnostic endoscopy folded into a surgical endoscopy of the same site, the "separate procedure" that disappears when it is a component of the larger operation through the same approach, the add-on code that never stands alone and never takes the multiple-procedure modifier. Learn the measurement conventions in the same spirit — excised diameter is the lesion plus the narrowest margin counted twice, measured before excision; repairs of the same classification in the same anatomic grouping are summed while different classifications are reported separately.
Drill modifiers until their meanings are reflexes, because modifier questions are scenario questions in disguise. The distinction that trips people up most is the postoperative trio: a staged or related procedure that was planned, an unplanned return to the operating room for a related problem, and an entirely unrelated procedure during the same postoperative period each get a different modifier, and the scenario tells you which by describing whether it was planned and whether it was related. The same discipline applies to reporting a significant, separately identifiable visit on the day of a procedure versus the decision for major surgery, and to the distinct-procedural-service modifier, which is the option of last resort once no more specific modifier fits.
Finally, give the compliance material real study time instead of skimming it at the end. It is a substantial part of the exam and it is the part that follows you into the job: the difference between fraud and abuse turning on intent, the False Claims Act reaching reckless disregard and not only knowing falsity, the Anti-Kickback Statute requiring intent while Stark imposes strict liability on physician self-referral, minimum necessary and the treatment exception, and medical necessity as something entirely separate from coding accuracy — a perfectly coded claim can still be denied as not reasonable and necessary. Since the code sets change every year, build the habit now of checking the current manuals and the payer's published policy rather than trusting a number you remember.
FAQ
Do I need to memorize CPT and ICD-10-CM codes to pass the CPC?
No — the exam is open-book and you bring your code manuals. What you have to know cold is how to get to the right code fast and how to justify it: the Alphabetic Index leads you to a candidate, the Tabular List confirms it, and the guidelines and conventions decide the rest. That is also why these practice questions test rules rather than code values. The code sets are revised every year, so a memorized code number is the most perishable thing you could carry into the exam, while the conventions behind it barely move.
What is the difference between Excludes1 and Excludes2?
An Excludes1 note means "not coded here" — the two conditions are mutually exclusive and cannot be reported together, because the excluded code and the code you are looking at could not occur in the same patient at the same time. An Excludes2 note means "not included here" — the excluded condition is not part of the code you are looking at, but the patient may well have both, so you may report both codes together when the documentation supports it. Reading an Excludes2 as if it were an Excludes1 is one of the most common ways coders lose legitimate reimbursement.
How is an office visit level chosen now that history and exam no longer count?
For office and outpatient visits you select the level either by medical decision making or by the total time the provider personally spent on the date of the encounter — whichever the documentation supports. History and examination are still performed and documented as medically appropriate, but they no longer drive the level. Medical decision making is judged on three elements — the number and complexity of problems addressed, the amount and complexity of data reviewed and analyzed, and the risk of complications or morbidity from patient management — and two of those three must be met or exceeded at a given level.
When should a coder query the provider instead of choosing a code?
Whenever the documentation is ambiguous, incomplete, conflicting, or clinically implausible on its face. A coder codes from what the treating provider documented and never infers a diagnosis, a laterality, or a level of service that is not there. The query itself must be non-leading: it presents the documentation and asks for clarification rather than suggesting the answer that pays better. If an employer pressures you to report a service the record does not support, that is not a coding judgment call — it is a compliance problem, and reporting services not rendered or upcoding a visit can expose both the coder and the practice to False Claims Act liability.
What is the CPT surgical package, and what falls outside it?
The surgical package is the set of services CPT considers part of the operation itself and therefore not separately reportable: the procedure, local or digital-block anesthesia, one related preoperative evaluation after the decision for surgery was made, immediate postoperative care and orders, evaluating the patient in recovery, and typical follow-up care. Outside it are the visit at which the decision for surgery was made, unrelated services, and complications that require a return to the operating room. Note that a payer's global period is a separate concept layered on top of the CPT package, which is why the same scenario can be handled differently by different payers.