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AAPC CPC Final Exam 2020: Practice Questions and Answers, Exams of Nursing

A collection of practice questions and answers for the aapc cpc final exam. It covers various topics related to medical coding, including evaluation and management services, icd-10-cm coding, hcpcs level ii codes, and cpt® coding. The questions are designed to test knowledge of medical terminology, coding guidelines, and procedures.

Typology: Exams

2024/2025

Available from 11/07/2024

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Evaluation and management services are often provided in a standard format such as SOAP notes. What does the acronym SOAP stand for? a. Scope, Observation, Action, Plan b. Standard, Objective, Activity, Period c. Source, Opinion, Advice, Provider d. Subjective, Objective, Assessment, Plan - ANSWER Subjective, Objective, Assessment, Plan What will the scope of a compliance program depend on? a. The number of insurance carriers the provider is contracted with. b. The size and resources of the provider's practice. c. The specific guidelines set forth in the OIG compliance plan. d. How many patients are seen in the office on a daily basis. - ANSWER The size and resources of the provider's practice. The Medicare program is made up of several parts. Which part covers provider fees without the use of a private insurer? a.Part Db.Part Bc.Part Cd.Part A - ANSWER Part b Which of the following is true about the tympanic membrane?

a.It separates the middle ear from the inner earb.It sits within the inner earc.It sits within the middle eard.It separates the external ear from the middle ear - ANSWER It separates the middle ear from the inner ear What is affected by myasthenia gravis? a.Muscle bellyb.Bonec.Neuromuscular junctiond.Muscle/bone connection - ANSWER Neuromuscular junction Which of the following is true of the stratum germinativum? a.It is the surface layer of the epidermis.b.It is composed of dense fibrous connective tissue.c.It lies on top of the dermis and has access to a rich supply of blood.d.It is composed of about 30 layers of dead, flattened, keratinized cells. - ANSWER It lies on top of the dermis and has access to a rich supply of blood. What is the Rinne's test? a.Test using music as the focal pointb.Test for hearing loss using a vibrating tuning fork placed at the center of the headc.Test using a two-syllable word with equal stress on each syllabled.Test measuring hearing using bone conduction and air conduction - ANSWER Test measuring hearing using bone conduction and air conduction Sialography is an X-ray of: a.Ventricles of the brainb.Sinusesc.Liverd.Salivary glands - ANSWER Salivary glands Which of the following statements is TRUE in reference to reporting body mass index (BMI) codes? a.BMI codes should never be reported in ICD- 10 - CM.b.BMI codes should be reported as a secondary code only.c.BMI codes are only reported with the ICD- 10 - CM code E66.3 for overweight.d.BMI

codes should be reported as primary codes only. - ANSWER BMI codes should be reported as a secondary code only. What is the ICD- 10 - CM code for keloid scar on the foot? a.Q81.0b.I51.89c.L91.0d.M35.4 - ANSWER L91. What do brackets [] indicate in the ICD- 10 - CM Alphabetic Index? a. Use the code(s) in brackets in addition to the disease or condition to identity an associated manifestation. b. Do not assign the code in brackets. c. Use the code(s) in brackets as the only code. d. Use the code(s) in brackets first. - ANSWER Use the code(s) in brackets in addition to the disease or condition to identity an associated manifestation. What ICD- 10 - CM code(s) is/are reported for enlargement of the prostate with a symptom of urinary retention? a.N40.1b.N40.1, R33.8c.N40.3, R33.8d.N40.0 - ANSWER N40. What surgical status indicator represents the Global Surgical Package for endoscopic procedures (without an incision) where there is no postoperative period after the day of the surgery?? - ANSWER 000 HCPCS Level II includes code ranges that consist of what type of codes? a.Permanent national codes, miscellaneous codes and temporary national codesb.Dental codes, morphology codes, miscellaneous codes and permanent national codesc.Permanent national codes,

dental codes and category II codesd.Category II codes, temporary national codes and miscellaneous codes - ANSWER a What is the correct HCPCS Level II code for parenteral nutrition solution amino acid, 3.5%? - ANSWER B What is the correct diagnosis code to report initial treatment of an infected post procedural stitch abscess of the right leg from a previous excision of a squamous cell carcinoma? a. T81.9XXA b. C44. c. T81.31XA d. T81.41XA - ANSWER d maybe 14 year-old boy was thrown against the window of the car on impact. The resulting injury was a star-shaped pattern cut to the top of his head. In the ED, the MD on call for plastic surgery was asked to evaluate the injury and repair it. The total length of the intermediate repair was 5+4+4+5 cm (18 cm total). The star-like shape allowed the surgeon to pull the wound edges together nicely in a natural Y- plasty in two spots. What CPT® code is reported for the repair? a.12035b.14041c.14040d.13121 - ANSWER a A 45 year-old male with a previous biopsy positive for malignant melanoma presents for definitive excision of the lesion. After induction of general anesthesia, the patient is placed supine on the OR table, the left knee prepped and draped in the usual sterile fashion. IV antibiotics are given as the patient had previous MRSA infection. The previous excisional biopsy site on the left knee measured approximately 4 cm and was widely ellipsed with a 1.5 cm

margin. The excision was taken down to the underlying patellar fascia. Hemostasis was achieved via electrocautery. The resulting defect was 11cm x 5cm. Wide advancement flaps were created inferiorly and superiorly using electrocautery. This allowed skin edges to come together without tension. The wound was closed using interrupted 2-0 Monocryl and 2 retention sutures were placed using #1 Prolene. Skin was closed with a stapler. What CPT® code(s) is/are reported? a. 14 - ANSWER a The patient is here because the cyst in her chest has come to a head and is still painful even though she has been on antibiotics for a week. I offered to drain it for her. After obtaining consent, we infiltrated the area with 1 cc of 1% lidocaine with epinephrine, prepped the area with Betadine and incised and opened the cyst in the relaxed skin tension lines of her chest, and removed the cystic material. There was no obvious purulence. We are going to have her clean this with a Q-tip. We will let it heal on its own and eventually excise it. I will have her come back a week from Tuesday to reschedule surgery. What CPT® and ICD- 10 - CM codes are reported? a.10061, L72.9b.10140, L70.1c.10160, R22.2d.10060, L72.9 - ANSWER d The acronym BKA means? - ANSWER below knee amputation A young female patient was taken to the operative suite and was placed under appropriate anesthesia. She has been suffering from pain and a potential rotator cuff tear of the right shoulder. The right arm was sterilely draped and prepped. Arthroscopic portals were created anteriorly-posteriorly. The joint line was carefully examined. The biceps insertion was noted to be normal. The middle and inferior glenohumeral ligaments were visualized and noted to be normal. The undersurface of the rotator cuff was clearly

visualized and also noted to be normal. There was a large anterior spur formation. The burr was introduced through a lateral portal and the anterior lip of the acromion was resected. The undersurface of the clavicle was noted to be quite prominent and part of the impinging process. There was intense bursitis and a bursectomy was performed, allowing for acromial decompression and release. Spurs were removed fro - ANSWER 29822-RT, 29826-RT A 66 year-old sustained a left proximal humerus fracture. Standard deltopectoral approach was used and dissection was carried down to the fracture site. The fracture site was identified and fragments were mobilized and the humeral head fragments removed. Once this was done, the stem was prepared up to a size 10. A trial reduction was carried out with the DePuy trial stem and implant head. Sutures were placed in key positions for closure of the tuberosities down to the shaft including sutures through the shaft. The shaft was then prepared and cement was injected into the shaft. The implant was placed. Once the cement was hardened, the head was placed on Morse taper and reduced. A bone graft was placed around the area where the tuberosities were being brought down. The tuberosities were then tied down with a suture previously positioned. This gave excellent closure and coverage of the significant motion at the repair s - ANSWER 23616-LT 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? 24565 - 54 - RT, 24605- 54 - 51 - RTRationale: In the CPT® Index look for Fracture/Humerus/Epicondyle/Closed Treatment. You are referred to code 24560-24565. Review the codes to choose the

appropriate service. 24565 is the correct code to report the alignment of an epicondyle fracture with manipulation (reduced) without a surgical incision. In the CPT® Index, look for Dislocation/Elbow/Closed Treatment. You are referred to 24600,

  1. Review the codes to choose appr - ANSWER The patient is a 17 year-old male who was struck on the elbow by another player's stick while playing hockey. He is found to have a fracture of the olecranon process. The patient was brought to the OR, anesthetized and intubated. The right upper extremity was prepped with Betadine scrub and draped free in the usual sterile orthopedic manner. The arm was then elevated and exsanguinated and the tourniquet inflated to 250 mm/Hg. A five-inch incision was made with the scalpel on the extensor side of the elbow, beginning distally and proceeding in an oblique fashion up the proximal forearm. Dissection was carried through subcutaneous tissue and fascia, and bleeding was controlled with electrocautery. We then subperiosteally exposed the proximal ulna and olecranon to visualize the fracture site. The fracture could be seen at the base of the olecranon process. We irrigated the site thoroughly and reduced the fracture fragme - ANSWER A final diagnosis for a patient in the ER is COPD with acute bronchitis due to echovirus. How is this diagnosis coded? - ANSWER J44.0, J20. Which statement is TRUE regarding coding COPD with asthma in ICD- 10 - CM? - ANSWER The type of asthma is reported along with the COPD. A patient is seen in the endoscopy suite for a diagnostic maxillary sinusotomy. During the sinusotomy, the provider observes some diseased tissue which needs to be removed. The provider decides to perform a maxillary antrostomy with tissue removal. Bleeding is

controlled. The patient tolerated the procedure well. What CPT® code(s) is/are reported? - ANSWER 31267 An ICU diabetic patient who has been in a coma for weeks as the result of a head injury becomes conscious and begins to improve. The physician performs a tracheostomy closure and since the scar tissue is minimal, the plastic surgeon is not needed. What CPT® and ICD- 10 - CM codes are reported for this procedure? 31820, Z43.0, S06.9X9D, E11.9:Rationale: In the CPT® Index look for Tracheostomy/Surgical Closure/without Plastic Repair. This directs you to code 31820.In the ICD- 10 - CM Alphabetic Index look for Attention (to)/tracheostomy which directs you to Z43.0. It is reported as a primary code because the closure of the tracheostomy is the reason for the procedure performed. Diabetic coma (E11.641) is not reported because the coma resulted from a head injury not diabetes. Coma would not be reported because it is resolved and the patient no longer has it. In the Alphabetic Index look for Injury/head directing you to S09.90 - ANSWER A surgeon performs a high thoracotomy with resection of a single lung segment on a 57-year-old who is currently a heavy smoker who had presented with a six-month history of right shoulder pain that radiates to the chest. An apical lung biopsy had confirmed lung cancer. What CPT® and ICD- 10 - CM codes are reported? 32484, C34.10, F17.210:Rationale: A segment of the lung is removed. In the CPT® Index look for Removal/Lung/Single Segment. This directs you to code 32484.We have a confirmed diagnosis of apical lung cancer, a cancer in an upper lobe, which is code C34.10 (no indication of right or left lung). The term apical means the tip of a pyramidal or rounded structure, so apical lung cancer means the tumor/cancer is located at the top or upper lobe of the lung. We find this by looking in the Table of Neoplasms for Neoplasm, neoplastic/lung/upper lobe and select from the Primary Malignant column which directs you to cod - ANSWER

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? - ANSWER 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? Z51.89, I25.9Rationale: Because it is past four weeks since the myocardial infarction and the patient is still symptomatic, ICD- 10 - CM guideline, I.C.9.e.1, indicates that the appropriate aftercare code is assigned rather than a code from category I21. Look in the ICD- 10 - CM Alphabetic Index for Aftercare which directs the coder to Z51.89. Verify code selection in the Tabular List. The instructional note under category Z51 indicates to code also condition requiring care. Look in the Alphabetic Index for Disease/heart/ischemic (chronic or with a stated duration of over 4 weeks) directing you to I25.9. Verify in the Tabular List. - ANSWER a patient presented to the ED and was found to have a ruptured abdominal aortic aneurysm. he was taken to emergency surgery, a physician performed a direct repair. the physician documented the aneurysm involved the common iliac 35103 - ANSWER In the cath lab, from a right femoral artery access, the following procedures are performed: Catheter placed in the left renal, accessory renal superior to the left renal and one main right renal artery. Radiologic supervision and imaging is performed in all locations. What CPT® code(s) is/are reported? 36252Rationale: Look in the CPT® Index for Angiography/Renal Artery and you are directed to 36251-36254. This is a bilateral

procedure, with an accessory left renal artery. Code 36252 includes bilateral and accessory renal angiography, and radiologic supervision and imaging. - ANSWER What is included in all vascular injection procedures? - ANSWER Necessary local anesthesia, introduction of needles or catheters, injection of contrast media with or without automatic power injection and/or necessary pre-and post-injection care specifically related to the injection procedure. MAZE procedure is performed on a patient with atrial fibrillation. The physician isolates and ablates the electric paths of the pulmonary veins in the left atrium, the right atrium and the atrioventricular annulus while on cardiopulmonary bypass. - ANSWER What is the eponym for a pancreatoduodenectomy? - ANSWER Meckel's Procedure What is the CPT® code for a test used to diagnose lactase intolerance? It involves the patient ingesting lactose sample followed by collections of exhaled air at different time intervals to measure the hydrogen levels in the breath. - ANSWER 91065 What is the correct ICD- 10 - CM code for a patient with IBS? - ANSWER K58. A patient suffering from cirrhosis of the liver from alcohol abuse presents with a history of coffee ground emesis (bleeding). The surgeon diagnoses the patient with esophageal gastric varices. Two days later, in the hospital GI lab, the surgeon ligates the varices with bands via an UGI endoscopy. What CPT® and ICD- 10 - CM codes are reported? - ANSWER 43244, K70.30, I85.11, F10.

A patient was seen in the provider's office and was diagnosed with influenza with pneumonia. The provider selected J18.9. Refer to the Tabular List to verify code J18.9. Is it correct to report code J18.9? Why? a. Yes, code J18.9 is a combination code assigned to influenza with pneumonia. b. No, the influenza code, J11.1 also needs to be reported on the claim. c. Yes, because the provider selected J18.9, it must be reported. d. No, there is a combination code J11.00 includes influenza with pneumonia. - ANSWER No, there is a combination code J11. includes influenza with pneumonia. a. Eight weeks b. One week c. Four weeks (28 days) d. Only at the time of occurrence - ANSWER c What ICD- 10 - CM code is used for the first episode of an acute myocardial infarction? a. I21. b. I c. I25.

d. I22 - ANSWER b A 70 year-old patient with decompensated COPD is admitted to the hospital with acute exacerbation of bronchial asthma. What diagnosis(es) code(s) is (are) reported? a. J44.1, J45. b. J44. c. J44. d. J45.9 - ANSWER a An elderly male patient presents to the ED complaining of a high fever the day prior to the encounter and of extreme lethargy. He has a history of benign hypertension which has been elevated. On arrival he was examined by his primary care physician and admitted, with possible septic urinary tract infection and concern for his elevated blood pressure. He was noted to have hematuria and a urine culture performed. Positive UTI and pseudomonas showed in the urine culture and IV antibiotics were administered. During the course of the day, his fever decreased and his lethargy improved. As the IV fluids were decreased, he resumed a benign hypertensive state. On the next hospital day, his primary care physician noted the urine was clear and he was discharged on oral antibiotics, with septicemia ruled out. What ICD- 10 - CM codes should be reported? a. A41.52, N39.0, I b. N39.0, B96.5, I c. A41.9, I10, R31.9, N39.

d. B96.5, - ANSWER b A 63 year-old came in to the ED with severe shortness of breath and goes into respiratory failure. He was intubated and admitted for acute respiratory failure. Chest X-ray shows he has pleural effusion. What ICD- 10 - CM code(s) is/are reported? a. J94.0, J96.00, R09. b. J96. c. J96.00, J d. J94.0, J96.01 - ANSWER J96.00, J According to the ICD- 10 - CM Official Guidelines for Coding and Reporting, Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A), codes in this range have sequencing priority over what codes? a.Chapter 15 codes do not have sequencing priority over other codes.b.All codes including Z33.1c.Codes from Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99).d.Codes from all other chapters. - ANSWER d A pregnant woman in her 40 th week has gestational diabetes which is controlled by diet. What ICD- 10 - CM code(s) is/are reported? a. O24.113, O24.410, Z3A. b. O24.410, O24. c. O24.410, Z3A. d.

O24.913 - ANSWER c A 45 year-old mother of three children is going into surgery to correct an anterior vaginal wall prolapse with an incomplete uterine prolapse. What ICD- 10 - CM code is reported? a.N81.4b.N81.3c.N81.2d.N81.10 - ANSWER c A patient is prescribed anticonvulsant medication for her seizures. She returns to her doctor three days later with nausea and rash due to taking the anticonvulsant medication. The provider notes that this is a drug reaction to an anticonvulsant and changes the medication. What ICD- 10 - CM codes are reported? a.L27.0, R11.0, T42.75XAb.L27.0, R11.2, T42.71XAc.R21, R11.2, T42.71XAd.R21, R11.0, T42.75XA - ANSWER a A patient had a spontaneous complete abortion three days ago. She returns to the ED and is bleeding. After the ED provider examines her, she still has retained products of conception (POC). What ICD- 10 - CM code is reported for this encounter? a.O03.6b.O03.1c.O02.1d.O04.6 - ANSWER b What codes are voluntarily reported to payers, provide evidence- based performance-measure data? a.CPT® Category II codesb.CPT® Category III codesc.HCPCS Level II codesd.CPT® Category I codes - ANSWER a What is the correct CPT® code to report a microscopic urinalysis? a.81015b.81003c.81000d.81001 - ANSWER c