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2025 AAPC CPC FINAL PRACTICE TEST
A covered entity does NOT include a. Healthcare providers b. Health plans c. Patients d. Clearinghouses - ✅c. Patients What does MAC stands for? a. Medicare Administrative Contractor b. Medicare Advisory Contractor c. Medicaid Administrative Contractor d. Medicaid Alert Contractor - ✅a. Medicare Administrative Contractor When are providers responsible for obtaining an ABN for a service NOT considered medically necessary? a. After providing a service or item to a beneficiary. b. Prior to providing a service or item to a beneficiary. c. After a denial has been received from Medicare. d. During a procedure or service. - ✅b. Prior to providing a service or item to a beneficiary AAPC credentialed coders have proven mastery of what information? a. Code sets b. Evaluation and management principles c. Documentation guidelines d. All of the above - ✅d. All of the above
Local Coverage Determinations are administered by whom? a. LMRPs b. NCDs c. State Law d. Each regional MAC - ✅d. Each regional MAC Rationale: Each Medicare Administrative Contractor (MAC) is then responsible for interpreting national policies into regional policies Which of the following best describes constituent components of the human lymphatic system? a. Lymph nodes, lymphatic vessels, spleen, thoracic duct b. Lymph nodes, lymphatic vessels, thymus gland, pancreas c. Lymph nodes, lymphatic vessels, tonsils, liver d. Lymph nodes, lymphatic vessels, bone marrow, kidneys - ✅a. Lymph nodes, lymphatic vessels, spleen, thoracic duct The term hemic specifically refers to what bodily fluid? a. Bile interstitial fluid b. Interstitial fluid c. Blood d. Lymph - ✅c. Blood Which part of the brain controls blood pressure, heart rate and respiration? a. Cerebellum b. Cerebrum c. Cortex d. Medulla - ✅d. Medulla
c. F48. d. R53.83 - ✅d. R53. A patient sees his primary care provider for chest pain and regurgitation. The provider's diagnosis for the patient is gastroesophageal reflux. What diagnosis code(s) should be reported? a. K21. b. K21.9, R07.9, K21. c. R07.9, R11. d. R07.9, R11.10, K21.9 - ✅a. K21. A 45 year-old female with malignant Mullerian duct cancer is receiving her first treatment of chemotherapy. What diagnosis codes are reported? a. C79.82, Z51. b. C57.7, Z51. c. Z51.11, D28. d. Z51.11, C57.7 - ✅d. Z51.11, C57. According to ICD-10-CM guidelines, when a patient is seen for management of anemia due to malignancy, how is it reported? a. Anemia is the only condition reported. b. The malignancy is the only condition reported. c. Anemia is reported first, followed by the code for the malignancy. d. The malignancy is reported first, followed by the code for the anemia. - ✅d. The malignancy is reported first, followed by the code for the anemia. What ICD-10-CM code is reported for a patient who is a habitual abuser of cannabis? a. F12. b. F12. c. F12.
d. F12.10 - ✅d. F12. A patient presents to the ED with weakness on the left side and aphasia. Tests are ordered and the patient is admitted with a cerebrovascular accident (CVA). What ICD-10-CM code(s) is/are reported? a. I67. b. R53.1, R47. c. I63. d. I63.9 - ✅d. A patient is admitted after being found unresponsive at home. The patient had right-sided hemiplegia and aphasia from a previous CVA. The provider documents a current cerebral infarction due to occlusion of the right middle cerebral artery as the final diagnosis and the patient is transferred for rehabilitation. What ICD-10-CM code(s) is/are reported? a. I67.89, I69.959, I69. b. I65. c. I67.89, I69.954, R47. d. I63.511, I69.351, I69.320 - ✅d. I63.511, I69.351, I69. Response Feedback: Rationale: Refer to ICD-10-CM guideline I.C.9.d.2. Look in the ICD-10-CM Alphabetic Index for Infarct, infarction/cerebral/due to/occlusion NEC/cerebral arteries directing you to code I63.5-. Report I63.511 Cerebral infarct due to unspecified occlusion or stenosis of right middle cerebral artery. This patient has a history of CVA with right-sided hemiplegia and aphasia. Look in the Alphabetic Index for Sequelae (of)/infarction/cerebral/hemiplegia which directs the coder to I69.35-. Also look for Sequelae/infarction/cerebral/aphasia I69.320. Verify in the Tabular List I69.351 Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side.Per ICD-10-CM guideline I.C.9.d.1 because the right side was affected and we do not know the dominant side, the default for dominance is right Four years post hepatic transplant, the patient is diagnosed with combined hepatocellular carcinoma and cholangiocarcinoma of the liver. What ICD-10-CM codes are reported? a. T86.49, C80.2, C22.0, C22.1, Z94. b. C80.2, C22. c. C80.2, C22.0, C22.1, Z94.
d. S81.852A, Z23, W54.0XXA - ✅a. S81.852A, Z20.3, Z23, W54.0XXA A male patient is here for his chemotherapy for metastatic carcinoma of the liver secondary to cancer of the right areola. What ICD-10-CM codes are reported? a. C22.9, C50.019, Z51. b. Z51.11, C78.7, C50. c. Z51.11, C50.029, C78. d. C78.7, C50.021, Z51.11 - ✅b. Z51.11, C78.7, C50. Rationale: ICD-10-CM guideline I.C.2.e.2 states that if a patient admission/encounter is solely for the administration of chemotherapy, immunotherapy, or radiation therapy, assign code Z51.0 Encounter for antineoplastic radiation therapy, or Z51.11 Encounter for antineoplastic chemotherapy, or Z51. Encounter for antineoplastic immunotherapy as the first listed or principal diagnosis. In the ICD-10- CM Alphabetic Index look for Encounter (with health service) (for)/chemotherapy for neoplasm guiding you to code Z51.11. Next, look in the Alphabetic Index for Metastasis, metastatic/cancer/from specified site and you are directed to see Neoplasm, malignant, by site. In the ICD-10-CM Table of Neoplasms look for Neoplasm, neoplastic/liver and select the code from the Malignant Secondary column, guiding you to code C78.7. Next look for Neoplasm, neoplastic/areola and select the code from the Malignant Primary column or Neoplasm, neoplastic/breast/areola and select the code from the Malignant Primary column, guiding you to subcategory code C50.0-. In the Tabular List, the 5th character is reported for the sex of the patient. In this case the patient is a male resulting in a 5th character of 2. The 6th character is for laterality; 1 is for right. The complete code is C50.021 for primary cancer of the right male areola. When assigning breast cancer codes make sure to select for the correct sex of the patient. The secondary cancer is listed first because the chemotherapy is directed to the secondary site per ICD-10-CM guideline I.C.2.b. Verify code selection in the Tabular List. What is the correct CPT® code for a complete, four-view, chest X-ray? a. 71048 b. 71046 x 2 c. 71047 d. 71045 x 4 - ✅a. 71048
How many days does it take CMS to implement HCPCS Level II Temporary Codes that have been reported as added, changed or deleted? a. 90 b. 30 c. 60 d. 365 - ✅a. 90 What codes are voluntarily reported to payers, provide evidence-based performance-measure data? a. HCPCS Level II codes b. CPT® Category I codes c. CPT® Category III codes d. CPT® Category II codes - ✅d. CPT® Category II codes HCPCS Level II includes code ranges that consist of what type of codes? a. Permanent national codes, miscellaneous codes and temporary national codes b. Permanent national codes, dental codes and category II codes c. Category II codes, temporary national codes and miscellaneous codes d. Dental codes, morphology codes, miscellaneous codes and permanent national codes - ✅a. Permanent national codes, miscellaneous codes and temporary national codes When procedures are "mandated" by third party payers, what modifier would you use? a. 52 b. 26 c. 76 d. 32 - ✅d. 32 A patient is taken to surgery for removal of a squamous cell carcinoma of the right thigh. What is the correct diagnosis code for today's procedure? a. C79.
✅c. 14060 Operative Report PREOPERATIVE DIAGNOSIS: Congenital left breast deformity. POSTOPERATIVE DIAGNOSIS: Congenital left breast deformity. PROCEDURE PERFORMED: Placement of left breast implant using mentor catalog #, lot #, serial #, 425 cc smooth round moderate profile implant filled with 475 cc of normal saline for breast reconstruction. INDICATIONS FOR SURGERY: The patient is a 34 year-old female who approximately 15 to 16 years ago had a left breast implant placed for breast reconstruction for her congenital deformity of the left breast. This implant ruptured and in late September 20XX, I performed a capsulectomy and exchanged her ruptured implant for a new implant. About a week after surgery the patient developed an infection. Due to the infection, her implant had to be removed. The patient's infection has completely resolved and she is now ready to have her implant replaced. In the preoperative holding area, I - ✅b. 19342-LT, Q83. In ICD-10-CM, what classification system is used to report open fracture classifications? a. Muller AO classification of fractures b. Danis-Weber classification c. Gustilo classification for open fractures d. PHF classification of fractures - ✅c. Gustilo classification for open fractures A patient is given Xylocaine, a local anesthetic, by injection in the thigh above the site to be biopsied. A small bore needle is then introduced into the muscle, about 3 inches deep, and a muscle biopsy is taken. What CPT® code is reported for this service? a. 20206 b. 27324 c. 20225 d. 20205 - ✅a. 20206
This 45 year-old male presents to the operating room with a painful mass of the right upper arm. Upon deep dissection a large mass in the soft tissue of the patient's shoulder was noted. The mass appeared to be benign in nature. With deep blunt dissection and electrocautery, the mass was removed and sent to pathology. What CPT® code is reported? a. 23030-RT b. 23075-RT c. 23076-RT d. 23066-RT - ✅d. 23066-RT A 22 year-old female sustained a dislocation of the right elbow with a medial epicondyle fracture while on vacation. The patient was given general anesthesia and the elbow was reduced and was stable. The medial epicondyle was held in the appropriate position and was reduced in acceptable position and elevated. A long arm splint was applied. The patient is referred to an orthopedist when she returns to her home state in a few days. What CPT® code(s) are reported? a. 24576-54-RT, 24620-54-51-RT b. 24565-54-RT, 24605-54-51-RT c. 24577-54-RT, 24600-54-51-RT d. 24575-54-RT, 24615-54-51-RT - ✅b. 24565-54-RT, 24605-54-51-RT A patient is seen in the hospital's outpatient surgical area with a diagnosis of a displaced fracture of the lateral condyle, right elbow. An ORIF (open reduction) procedure was performed and included the following techniques: An incision was made in the area of the lateral epicondyle. This was carried through subcutaneous tissue, and the fracture site was easily exposed. Inspection revealed the fragment to be rotated in two places about 90 degrees. It was possible to manually reduce this quite easily, and the manipulation resulted in an almost anatomic reduction. This was fixed with two pins driven across the humerus. The pins were cut off below skin level. The wound was closed with plain catgut subcutaneously and 5-0 nylon for the skin. Dressings and a long arm cast were applied. What CPT® and ICD-10-CM codes are reported? a. 24577-RT, S42.451A b. 24579-RT, S42.451A c. 24579-RT, 29065-51-RT, S42.434B d. 24575-R - ✅c. 24579-RT, 29065-51-RT, S42.434B
A returning 2 year-old child is seen in the pediatrician's office with stridor and a bark like cough. The pediatrician examines the child quickly and determines the child has stridulous croup. The child is given a nebulizer breathing treatment in the office to improve PO 2 levels. Medication used is breathable Epinephrine. What CPT® and ICD-10-CM codes are reported? a. 94644, J04. b. 94644, R06.1, R c. 94640, J38. d. 94642, J38.5, R05, R06.1 - ✅c. 94640, J38. A patient with chronic pneumothoraces presents for chemopleurodesis. Under local anesthesia a small incision is made between the ribs. A catheter is inserted into the pleural space between the parietal and pleural viscera. Subsequently, 5g of sterile asbestos free talc was introduced into the pleural space via the catheter. What CPT® and ICD-10-CM codes are reported? a. 32650, 32560, J93.11 b. 32601, 32560, J95. c. 32650, J95.811 d. 32560, J93.81 - ✅d. 32560, J93. Patient presents to her physician 10 weeks following a true posterior wall myocardial infarction. The patient is still symptomatic and is diagnosed with ischemic heart disease. What is (are) the correct ICD-10-CM code(s) for this condition? a. I22. b. I21. c. I25. d. Z51.89, I25.9 - ✅d. Z51.89, I25. What information is needed in order to accurately code hypertension retinopathy in ICD-10-CM? a. The affected eye(s). b. Whether the hypertension is malignant or benign. c. Which side of the heart is affected? d. The stage of retinopathy - ✅a. The affected eye(s).
An arterial catheterization is performed by cutdown for transfusion. What CPT® code is reported? a. 36640 b. 36625 c. 36620 d. 36600 - ✅b. 36625 INDICATIONS FOR CORONARY INTERVENTION: Acute inferior myocardial infarction. Documented mildly occlusive plaque with much clot in the right coronary artery. PROCEDURE: Insertion of temporary pacemaker in the right femoral vein. Primary stenting of the right coronary artery with a 4.5 x 16 mm Express stent. Angio-Seal to the vessels of the right common femoral artery post procedure, and also Angio-Seal of the right common femoral vein. TECHNIQUE: Judkins percutaneous approach from the right groin with Perclose at the arterial puncture site post procedure. CATHETERS: 4 French Angio-Jet catheter device, insertion of a 5 French temporary pacing wire, a 4. x 16 mm Express stent. PRESSURES: Aortic Pressure: 107/ RESULTS: Coronary stenting procedure of the right coronary artery: The right coronary artery was primarily stented with a 4.5 x 16 mm Express stent. It was expanded to 12 atmospheres. There was no residual - ✅d. 92928-RC, 92929-LD, 33967, 92973-RC ??? CLINICAL SUMMARY: The patient is a 41 year-old female with known coronary disease and recent recurrent chest pain, cardiac catheterization demonstrated subtotal occlusion of the diagonal artery at its takeoff from the left anterior descending artery. PROCEDURE: With informed consent obtained, the patient was prepped and draped in the usual sterile fashion. With the right groin area infiltrated with 2% Xylocaine, the patient was given 2 mg of Versed and 50 mcg Fentanyl intravenously for conscious sedation and pain control. The right femoral artery was cannulated with a modified Seldinger technique and a 6 French catheter sheath placed. A 6 French JL3.5 catheter with no side holes was utilized as a guiding catheter. After the initial guiding picture had been obtained, the patient was given Angiomax per protocol, and a short Cross-it 100 wire was advanced to the LAD and then into the diagonal vessel. A 2.0. 15-mm-long - ✅c. 92920-LD ??? What ICD-10-CM code(s) is reported for ulcerative colitis with rectal bleeding?
A 56 year-old patient complains of occasional rectal bleeding. His physician decides to perform a rigid proctosigmoidoscopy. During the procedure, two polyps are found in the rectum. The polyps are removed by a snare. What CPT® and ICD-10-CM codes are reported? a. 45320, K62. b. 45309, 45309, K63. c. 45385, K63. d. 45315, K62.1 - ✅d. 45315, K62. What ICD-10 -CM code is reported for carcinoma of the bladder dome? a. C67. b. C67. c. C67. d. C67.1 - ✅d. C67. Vasectomy reversal is performed, bilaterally, using the operating microscope. Choose the procedure code(s). a. 55400-50, 69990 b. 55250-50, 69990 c. 55400 d. 55250 - ✅a. 55400-50, 69990 When a cystectomy is performed, there are various means of diverting the urine. One method is to create a neobladder which allows the patient to void through his or her urethra. Which code describes this procedure? a. 51590 b. 51595 c. 51596 d. 51580 - ✅c. 51596
A 58 year-old man with an enlarging right hydrocele is here for surgical repair. He is taken to the operating room where the hydrocele was enucleated from the skin in dartos fashion and delivered into the wound. It was skeletonized at the equator and then was opened and drained. Excess hydrocele sac tissue was excised with electrocautery. It was then wrapped backward around the spermatic cord and sewn there so it would not reform. There were a few pockets also opened up and skeletonized. The testicle was replaced in the scrotum. What CPT® code is reported for this service? a. 55041-RT b. 55000-RT c. 55040-RT d. 55100-RT - ✅c. 55040-RT The patient presents to the office for cystometrogram (CMG). Complex CMG with voiding pressure studies is done. Intraabdominal voiding pressure studies and complex uroflowmetry are also performed. What CPT® code(s) is/are reported for this service? a. 51726 b. 51728-26, 51797-26, 51741-51- c. 51728, 51797, 51741- d. 51726, 51728-51, 51797 - ✅c. 51728, 51797, 51741- What ICD-10-CM code is reported for VIN III? a. N90. b. D07. c. D07. d. N87.1 - ✅b A diabetic woman delivered her child and now returns to obstetrician's office for follow up. She has had type 1 diabetes controlled with insulin for most of her life. Her obstetrician will monitor her closely for several weeks to be sure her pregnancy does not cause her permanent problems. What diagnosis code is used for her visit 2 weeks after her delivery? a. O24. b. O24.019, E10.
c. Craniectomy d. Trephine - ✅a. Burr hole A patient is having a decompression of the nerve root involving two segments of the lumbar spine via transpedicular approach. What CPT® code(s) is/are reported? a. 63056, 63057 b. 63030, 63035 c. 63030 d. 63056 - ✅a. 63056, 63057 A patient with MEN1 (Multiple Endocrine Neoplasia 1) has surgery to remove three of her parathyroid glands and part of the fourth parathyroid gland. What CPT® and ICD-10-CM codes are reported? a. 60502, E31. b. 60500, E31. c. 60505, E31. d. 60505, E31.21 - ✅b. 60500, E31. A patient with a malignant neoplasm of the spinal meninges is receiving a programmable pump implantation for chemotherapy. The patient is placed in the prone position where the provider made a midline incision overlying the area of the spinal cord. The reservoir was placed in the subcutaneous tissues and attached to the previously placed catheter. Layered sutures were used to close the incision. The patient tolerated the procedure well and was released in good condition. What CPT® and ICD-10-CM codes are reported for this procedure? a. 62360, C70. b. 62367, C70. c. 62350, C70. d. 62362, C70.1 - ✅d. 62362, C70.
A 47 year-old female presents to the OR for a partial corpectomy to three thoracic vertebrae. One surgeon performs the transthoracic approach while another surgeon performs the three vertebral nerve root decompressions necessary. How should each provider involved code their portion of the surgery? a. 63085, 63086-82 x 2 b. 63087-80, 63088-80 x 2 c. 63085-62, 63086-62 x 2 d. 63087-52, 63088-52 x 2 - ✅c. 63085-62, 63086-62 x 2 Which option best describes what is being done during strabismus surgery? a. Corrects the condition in which the refractive surfaces of the eye are unequal. b. Is a repair of the cornea. c. Removes the opaque covering on or in the lens. d. Corrects the muscle misalignment. - ✅d. Corrects the muscle misalignment. A 65 year-old patient presents with an ectropion of the right lower eyelid. Repair with tarsal wedge excision is performed for correction. Attention was then directed to the left eye. The patient also has an ectropion of the left lower eyelid which is repaired by suture repair. What CPT® code(s) is/are reported? a. 67914- b. 67916-E4, 67914-E c. 67916- d. 67923-E4, 67921-E2 - ✅b. 67916-E4, 67914-E A patient with right and left prominent ears presents for an otoplasty. What CPT® and ICD-10-CM codes are reported? a. 69320, H61. b. 69300-50, Q17. c. 69310, H61. d. 69300, Q17.5 -
