AAPC CPC FINAL EXAM 2023-2024 REAL EXAM 100 QUESTIONS AND CORRECT ANSWERS(VERIFIED ANSWERS, Exams of Nursing

Download AAPC CPC FINAL EXAM 2023-2024 REAL EXAM 100 QUESTIONS AND CORRECT ANSWERS(VERIFIED ANSWERS and more Exams Nursing in PDF only on Docsity!

AAPC CPC FINAL EXAM 2023 - 2024

REAL EXAM 100 QUESTIONS AND

CORRECT ANSWERS(VERIFIED

ANSWERS)|AGARDE

(The correct answer has been verified, selected and highlighted in yellow for all of the questions below.)

1 What form is used to submit a provider’s charge to the insurance carrier? a. ABN b. UB-^04 c. CMS-^1500 d. Provider^ reimbursement^ form 2 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

3 When coding an operative report, what action would NOT be recommended?

a. Coding^ from^ the^ header^ without reading^ the^ body^ of the^ report. b. Reading^ the^ body^ of^ the^ report. c. Highlighting^ unfamiliar^ words. d. Starting^ with^ the^ procedure^ listed.

4 When are providers responsible for obtaining an ABN for a service NOT considered

medically necessary? a. During^ a^ procedure^ or^ service. b. After^ a^ denial^ has^ been^ received^ from^ Medicare. c. After^ providing^ a^ service^ or^ item^ to^ a^ beneficiary. d. Prior^ to^ providing^ a^ service^ or^ item^ to^ a^ beneficiary.

5 Evaluation and management services are often provided in a standard format such as

SOAP notes. What does the acronym SOAP stand for? a. Subjective, Objective,^ Assessment, Plan b. Standard,^ Objective,^ Activity,^ Period

c. Source,^ Opinion,^ Advice,^ Provider d. Scope,^ Observation,^ Action,^ Plan

6 What is a myocardial infarction?

a. Malfunction^ in^ one^ of^ the^ valves^ in^ the^ heart,^ disrupting^ blood^ flow b. Lack of^ oxygen^ to^ the^ heart^ tissue,^ resulting^ in^ tissue^ death

c. Abnormal^ heart^ beats^ causing^ pain,^ nausea^ and^ discomfort d. Overgrowth^ of^ muscle^ tissue,^ affecting^ the^ heart’s^ ability^ to^ pump

7 Which of the following is true about the function of the cochlea?

a. It^ helps^ with^ balance^ only b. It^ helps^ with^ balance^ and^ sound^ transmission c. Its^ function^ is^ to^ excrete^ cerumen^ (wax)^ to^ help^ keep^ the ear^ clean d. It^ transmits^ sound^ only

8 Which of the following best describes psoriasis?

a. An^ inflammatory^ condition^ characterized^ by^ redness^ pustular^ and^ vesicular^ lesions, crusts, and scales. b. An^ allergic^ reaction^ characterized^ by^ wheals^ and^ generally^ accompanied^ by^ pruritus. c. A^ chronic^ condition^ characterized^ by red, dry,^ elevated^ lesions,^ covered^ by^ silvery scales. d. A^ contagious^ infection^ of^ skin^ generally^ caused^ by^ staphylococcus^ bacterium.

9 A thin membrane lining the chambers of the heart and valves is called the:

a. Epicardium b. Endocardium c. Pericardium d. Myocardium

10 The dome-shaped muscle under the lungs flattening during inspiration is the:

a. Diaphragm b. Pleura c. Mediastinum d. Bronchus

11 When a patient has a condition that is both acute and chronic and there are separate

entries for both, how is it reported? a. Code^ only^ the^ chronic^ code b. Code^ only^ the^ acute^ code c. Code^ both^ sequencing^ the^ acute^ first d. Code^ both^ sequencing^ the^ chronic^ first

12 Which diagnosis code(s) below reports pain in the left and right ears?

a. H92. b. H92.

c. H93.8X d. H92.01,^ H92.

13 What is the ICD- 10 - CM code for nausea?

a. T75.3XXA b. R11. c. R11. d. R11.

14 A patient presents to the Emergency Department with nausea and vomiting, abdominal

pain and fever. The provider suspects appendicitis. The test results are pending. What ICD - 10 - CM code(s) is/are reported? a. R11.2,^ R10.9,^ R50.9,^ K b. R11.2,^ R10.9,^ R50. c. K d. R11.0,^ R11.10,^ R10.9,^ R50.

15 A 10 month-old comes into the pediatrician’s office for a harsh, bark-like cough. She is

diagnosed with croup. The mother also wants the pediatrician to look at a rash that has developed on her leg. The pediatrician prescribes over the counter medication of acetaminophen for the croup and hydrocortisone cream for the rash on the leg. She is to follow up in five days or return earlier if the conditions worsen. What ICD- 10 - CM code(s) should be reported for this visit? a. J05.0,^ R b. J05. c. J05.0,^ R05,^ R d. R

16 What does MRSA stand for?

a. Methicillin^ Resistant^ Streptococcus^ Aureus b. Moderate^ Resistance^ Susceptible^ Aureus c. Methicillin^ Resistant^ Staphylococcus^ Aureus d. Mild^ Resistance^ Streptococcus^ Aureus

17 A 32 year-old patient with hyperthyroidism has an ultrasound to determine why her neck

is enlarged. The results of the ultrasound reveal a uninodular goiter. What ICD- 10 - CM code is reported? a. E04. b. E05.

c. E05. d. E05.

18 A 45 year-old patient is scheduled to have an INFUSAID pump installed. He has primary

liver cancer and the pump is being inserted for continuous administration of 5 - FU. A pocket is created just under the skin and the pump is placed in the pocket. A catheter is attached to the pump and to the subclavian vein. The pump is filled with a chemotherapy agent provided by the hospital and the patient is observed for adverse reaction and discharged to home. What ICD- 10 - CM codes are reported? a. Z51.11,^ C22. b. C22.9,^ Z51. c. Z51.11,^ C22. d. C22.8,^ Z51.

19 A patient with type 2 diabetes presents with diabetic macular edema and proliferative

diabetic retinopathy in the right eye. What ICD- 10 - CM code(s) is/are reported? a. E11. b. E11.311,^ E11. c. E11. d. E11.9,^ E11.311,^ E11.

20 A patient is coming in for follow up of his essential hypertension and cardiomegaly. Both

conditions are stable and he is told to continue with his medications. The two conditions are unrelated. What ICD- 10 - CM code(s) is/are reported? a. I11.0,^ I51. b. I51. c. I11.9,^ I51. d. I10,^ I51.

21 What would be considered an adverse effect?

a. Rash^ developing^ when^ taking^ penicillin. b. Hemorrhaging^ after^ a^ vaginal^ delivery. c. Shortness^ of^ breath^ when^ running. d. Wound^ infection^ after^ surgery.

22 An X-ray is performed for pain in the left little finger. This is the initial encounter for this

visit. The X-ray report shows a fractured distal phalanx that is dislocated. What ICD- 10 - CM code(s) is/are reported? a. S62.637A,^ S63.257A

b. S62.637B, S63.257B c. S62.637A d. S62.635A

23 A 6 month-old patient is seen at the clinic for a routine well-child visit and vaccinations.

During the examination the provider finds that the child has a fever and a diagnosis of acute otitis media in the right ear is documented. Vaccinations are not given at this time. What ICD- 10 - CM code(s) is/are reported? a. H66.90,^ Z00. b. Z00. c. Z00.121,^ H66.91,^ Z28. d. Z00.121,^ H66.90,^ Z

24 A 14 year-old male patient was injured while skateboarding. The injuries included a

displaced transverse fracture of the right femur shaft with multiple significant abrasions of the right thigh. What ICD- 10 - CM codes are reported? a. S72.321A,^ V00.138A,^ Y93. b. S72.321A,^ S70.311A,^ V00.138A,^ Y93. c. S72.91XA,^ S70.311A,^ V00.138A d. S72.91XA,^ S70.311A,^ Y93.

25 The patient is admitted for radiation therapy for metastatic bone cancer, unknown

primary. She developed severe vomiting secondary to the radiation. What ICD- 10 - CM code(s) is/are reported? a. Z51.0,^ C79.51,^ C80.1,^ R11. b. C79.51,^ C80. c. R11. d. C79.51,^ C80.1,^ R11.10,^ Z51.

26 CPT® Category III codes reimburse at what level?

a. Reimbursement,^ if^ any,^ is^ determined^ by^ the^ payer b. 10 percent c. 85 percent d. 100 percent

27 When procedures are “mandated” by third party payers, what modifier would you use?

a. 52 b. 32

c. 76 d. 26

28 What is the correct code for the application of a short arm cast?

a. 29075 b. 29065 c. 29280 d. 29125

29 What codes are voluntarily reported to payers, provide evidence-based performance-

measure data? a. CPT®^ Category^ III^ codes b. CPT®^ Category^ I^ codes c. CPT®^ Category^ II^ codes d. HCPCS^ Level^ II^ codes

30 What chapter in the HCPCS Level II codebook lists the code for Wheelchairs?

a. Durable^ Medical^ Equipment^ (E0100-E8002) b. Orthotic^ Procedures^ and^ Services^ (L0112-L4631) c. Prosthetic^ Procedures^ (L5000-L9900) d. Transportation^ Services^ including^ Ambulance^ (A0021-A0999)

31 Which statement is TRUE regarding the Table of Neoplasms in ICD- 10 - CM?

a. The^ Table^ of^ Neoplasms^ is^ found^ by^ looking^ for^ Neoplasm^ in^ the^ ICD-^10 - CM^ Alphabetic Index. b. There^ are^ six^ columns^ in^ the^ Table^ of^ Neoplasms;^ Malignant^ Primary,^ Malignant Secondary, Ca in situ, Benign, Uncertain Behavior and Unspecified Behavior. c. The^ Table^ of^ Neoplasms^ is^ found^ in^ the^ Tabular^ List. d. There^ is not^ a Table^ of^ Neoplasms^ in ICD-^10 - CM.

32 The patient is here to see us about some skin tags on her neck and both underarms. She

has had these lesions for some time; they are irritated by her clothing, itch, and at times have a burning sensation to them. We discussed treatment options along with risks. Informed consent was obtained and we proceeded. We removed 16 skin tags from the right axilla, 16 skin tags from the left axilla, 10 from the right side of the neck and 17 from the left side of the neck. What CPT® and ICD- 10 - CM codes are reported? a. 11200,^11201 x^ 4,^11201 - 52,^ L91. b. 11200,^11201 x^ 5,^ L91. c. 11057,^ D23.5,^ D23. d. 11200,^11201 -^51 x^ 5,^ D23.5,^ D23.

33 Joe has a terrible problem with ingrown toenails. He goes to the podiatrist to have a nail

permanently removed along with the nail matrix. What CPT® code is reported? a. 11765 b. 11720 c. 11730 d. 11750

34 PREOPERATIVE & POSTOPERATIVE DIAGNOSES:

1. Macromastia.
2. Back pain.
3. Neck pain.
4. Shoulder pain.
5. Shoulder grooving.
6. Intertrigo. NAME OF PROCEDURE:
7. Right breast reduction of 1950 g.
8. Right free-nipple graft.
9. Left breast reduction of 1915 g.
10. Left free-nipple graft. INDICATIONS FOR SURGERY: The patient is a 43 year-old female with macromastia and associated back pain, neck pain, shoulder pain, shoulder grooving and intertrigo. She desired a breast reduction. Because of the extreme ptotic nature of her breasts, we felt she would need a free-nipple graft technique. In the preoperative holding area, we marked her for this free-nipple graft technique of breast reduction. The patient observed these markings so she could understand the surgery and agree on the location, and we proceeded. The patient also was morbidly obese with a body mass index of 54. Because of this, we felt she met the criteria for DVT prophylaxis, which included Lovenox injection. The patient understood this would increase her risk of bleeding. She also made it known she is a Jehovah's Witness and refused blood products, but she did understand her risk of bleeding would significantly increase and we proceeded. DESCRIPTION OF PROCEDURE: The patient was given 40 mg of subcutaneous Lovenox in the preoperative holding area. She was then taken to the operating room. Bilateral thigh-high TED hose, in addition to bilateral pneumatic compression stockings were used throughout the procedure. IV Ancef 1 g was given. Anesthesia was induced. Both arms were secured on padded arm boards using Kerlix rolls. A similar body Bair Hugger was placed. The chest and abdomen were prepped and draped in sterile fashion. I began by circumscribing around each nipple-areolar complex using a 42-mm areolar marker. On each side the free-nipple grafts were harvested. They were marked to be side specific and were stored on the back table in moistened lap sponges. Meticulous hemostasis was achieved using Bovie cautery. The tail of the apex of each breast was de-epithelialized using the scalpel. I amputated the inferior portion of the breast from the right side. Again, meticulous hemostasis was achieved using the Bovie cautery. There were also large feeder vessels divided and ligated using either a medium Ligaclip or 3 - 0 silk tie sutures. I then moved to the left and again amputated the

inferior portion of the breast. Meticulous hemostasis was achieved using the Bovie cautery. Each of these wounds were temporarily closed using the skin stapler. The patient was then sat up. I felt we had achieved a very symmetrical result. The new positions for the nipple - areolar complexes were marked with a 42 - mm areolar marker and methylene blue. The patient was then placed in the supine position and the new positions for the nipple-areolar complexes were de-epithelialized using the scalpel. Meticulous hemostasis was then achieved again using the Bovie cautery. The free-nipple grafts were then retrieved from the back table. They were each defatted using scissors and were placed in an on-lay fashion on the appropriate side, and each was inset using 5 - 0 plain sutures. Vents were made in the skin graft to allow for the egress of fluid on each side. A vertical mattress suture was used, tied over a piece of Xeroform in critical areas of each of the nipple-areolar complexes. A Xeroform bolster wrapped over a mineral oil-moistened sponge was affixed to each of the nipple-areolar complexes using 5 - 0 nylon suture. The vertical and transverse incisions were closed using 3 - 0 Monocryl, both interrupted and running suture, and 5 - 0 Prolene. The patient tolerated the procedure well. Again, meticulous hemostasis was achieved using the Bovie cautery. She was given another 1 g of Ancef at the 2 - hour mark by our anesthesiologist, and was taken to the recovery room in good condition. What CPT® code is reported? a. 19325 -^50 b. 19324 -^50 c. 19318 -^50 d. 19366 -^50

35 The patient is coming in for removal of fatty tissue of the posterior iliac crest, abdomen,

and the medial and lateral thighs. Suction-assisted lipectomy was undertaken in the left posterior iliac crest area and was continued on the right and the lateral trochanteric and posterior aspect of the medial thighs. The medial right and left thighs were suctioned followed by the abdomen. The total amount infused was 2300 cc and the total amount removed was 2400 cc. The incisions were closed and a compression garment was applied. What CPT® codes are reported? a. 15830,^15832 -^50 -^51 b. 15877,^15878 -^50 -^51 c. 15877,^15879 -^50 -^51 d. 15830,^15839 -^50 - 51,^15847

36 Hallux rigidus is a condition affecting what part of the body?

a. Foot b. Knee c. Spine d. Ankle

37 A 49 year-old presents with an abscess of the right thumb. The physician incises the

abscess and purulent sanguineous fluid is drained. The wound is packed with iodoform packing. What CPT® code is reported? a. 26011 - F b. 10061 - F c. 10060 - F d. 26010 - F

38 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. 23075 - RT b. 23030 - RT c. 23066 - RT d. 23076 - RT

39 Under general anesthesia, a 45 year-old patient was sterilely prepped. The wrist joint was

injected with Marcaine and epinephrine. Three arthroscopic portals were created. The articulating surface between the scaphoid and the lunate clearly showed disruption of the ligamentous structures. We could see soft tissue pouching out into the joint; this was debrided. There was abnormal motion noted within the scapholunate articulation. At this point the C-arm was brought in. Arthroscopic instruments were placed in the joint and confirmed the location of the shaver as a probe in the scapholunate ligament. There was a significant gap between the capitate and lunate. K-wire was utilized from the dorsal surface into the lunate, restoring the space. Further examination revealed gross instability between the capitate and lunate. With the wrist in neutral position, a K-wire was passed through the scaphoid, through the capitate and into the hamate. This provided stabilization of the wrist joint. Stitches were placed, and a thumb spica cast was applied. What CPT® code(s) is/are reported? a. 29847 b. 29847,^29840 -^51 c. 29846 d. 29840

40 A 45 year-old presents to the operating room with a right index trigger finger and left

shoulder bursitis. The left shoulder was injected with 1 cc of Xylocaine, 1 cc of Celestone and 1 cc of Marcaine. An approximately 1 - inch incision was made over the A1 pulley in the distal transverse palmar crease. This incision was taken through skin and subcutaneous tissue. The A1 pulley was identified and released in its entirety. The wound was irrigated with antibiotic saline solution. The subcutaneous tissue was injected with Marcaine without epinephrine. The skin was closed with 4 - 0 Ethilon suture. Clean dressing was applied. What CPT® codes are reported? a. 20552 - F6,^20605 -^52 - LT b. 20553 - F6,^20610 -^51 - LT c. 26055 - F6,^20610 -^51 - LT d. 26055 - F6,^20610 -^76 - LT

41 What CPT® code is reported for open decortication and parietal pleurectomy?

a. 32652 b. 32320 c. 32220 d. 32225

42 Which statement is TRUE regarding coding COPD with asthma in ICD- 10 - CM?

a. Only the COPD^ is reported. b. The^ type^ of^ asthma^ is^ reported along^ with^ the^ COPD. c. Only^ the^ asthma^ is^ reported. d. COPD^ with bronchitis is^ reported for COPD^ with^ asthma.

43 What ICD- 10 - CM code is reported for pyopneumothorax with fistula?

a. J86. b. J86. c. J93. d. J95.

44 The pulmonologist in a multispecialty group refers a patient to the otolaryngologist

because he thinks that the shortness of breath that the patient is experiencing may be due to sinusitis and laryngopharyngeal reflux (LPR). The otolaryngologist decides to perform a rigid bilateral nasal endoscopy to get a better look at what is going on in the sinuses and a flexible laryngoscopy to determine if (LPR) is contributing to the problems because he could not get adequate visualization on manual exam. First the bilateral nasal endoscopy is performed and the otolaryngologist diagnosis chronic pansinusitis. Next a flexible fiberoptic laryngoscope is introduced nasally and the larynx and trachea are inspected. The diagnosis is chronic laryngitis/tracheitis and LPR. He prescribes Singulair and Nexium and proposes endoscopic surgery will be considered in the future if the current treatment does not fully

take care of the problems experienced by the patient. What CPT® and ICD- 10 - CM codes are reported for the procedure? a. 31575,^31231 - 59,^ J32.4,^ J37. b. 31576,^31231 - 51,^ J32.4,^ J02.9,^ J41. c. 31576,^31237 -^50 - 59,^ J32.4,^ J37.0,^ J41. d. 31575,^31231 -^50 - 59,^ J32.4,^ J37.

45 A patient with a diagnosis of chronic sphenoidal sinusitis undergoes a bilateral

sinusotomy. While the provider examines the diseased sphenoid sinus, she takes a biopsy of the sphenoidal masses and removes the mucosa with several polyps. Transseptal sutures are placed and the intraoral incision is closed in a single layer. The nose is packed and external nasal dressings are placed. What CPT® and ICD- 10 - CM codes are reported? a. 31090,^30115 -^50 - 51,^ J32. b. 31288 - 50,^ J32. c. 31237 - 50,^ J32. d. 31051 - 50,^ J32.3,^ J33.

46 Which main coronary artery bifurcates into two smaller ones?

a. Left b. Inverted c. Right d. Superficial

47 A patient presents to the outpatient surgery department for revision to his autogenous

radiocephalic fistula so he can continue his hemodialysis. What is the correct CPT® code? a. 36832 b. 36904 c. 36825 d. 36831

48 Physician replaces a single chamber permanent pacemaker with a dual chamber

permanent pacemaker. What CPT® code(s) is/are reported? a. 33212,^33233 -^51 b. 33213,^33233 - 51,^33235 -^51 c. 33213,^33233 -^51 d. 33214

49 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 Maverick balloon was used for dilatation of the diagonal artery ostium with inflation pressure up to 8 atmospheres applied. Final angiographic documentation was carried out after the patient received 200 mcg of intracoronary nitroglycerine. The guiding catheter was then pulled, the sheath secured in place. The patient is now being transferred to telemetry for post coronary intervention observation and care. RESULTS: The initial guiding picture of the left coronary system demonstrates the high-grade ostial stenosis of the diagonal artery taking off within the LAD. Following the coronary intervention with balloon angioplasty there is complete resolution of the stenosis with less than 10 percent residual narrowing observed, no evidence for intimal disruption, no intraluminal filling defect, and good antegrade TIMI III flow preserved. CONCLUSION: Successful coronary intervention with balloon angioplasty to the ostial/proximal segment of the second diagonal vessel. a. 92937 - LD b. 92921 - LD c. 92924 - LD d. 92920 - LD

50 In the cardiac suite, an electrophysiologist performs an EP study. With programmed

electrical stimulation, the heart is stimulated to induce arrhythmia. Observed is right atrial and ventricular pacing, recording of the bundle of His, right atrial and ventricular recording and left atrial and ventricular pacing and recording from the left atrium. a. 93620, 93618,^93621 b. 93600,^ 93602,^ 93603,^ 93610,^ 93612,^ 93618,^ 93621,^93622 c. 93620, 93621,^93622 d. 93619,^93621

51 What ICD- 10 - CM code is reported for internal hemorrhoids?

a. K64. b. K64. c. K64.

d. K64.

52 What is the correct ICD- 10 - CM code for a patient with IBS?

a. K58. b. K59. c. K59. d. K58.

53 A 45 year-old woman underwent a cholecystectomy performed laparoscopically. The

procedure was performed for recurrent bouts of acute cholecystitis. What CPT® and ICD- 10 - CM codes are reported? a. 47600,^ K81. b. 47562,^ K81. c. 47605,^ K81. d. 47570,^ K81.

54 Margaret has a cholecystoenterostomy with a Roux-en-Y. Five hours later, she has an

enormous amount of pain, abdominal swelling and a spike in her temperature. She is returned to the OR for an exploratory laparotomy and subsequent removal of a sponge that remained behind from surgery earlier that day. The area had become inflamed and was demonstrating early signs of peritonitis. What is the correct coding for the subsequent services on this date of service? The same surgeon took her back to the OR as the one who performed the original operation. What CPT® code is reported? a. 49402 -^78 b. 49000 -^58 c. 49000 -^77 d. 49402 -^77

55 Operative Report

Indications: This is a third follow-up EGD dilation on this 40 year-old patient for a pyloric channel ulcer which has been slow to heal with resulting pyloric stricture. This is a repeat evaluation and dilation. Medications: Intravenous Versed 2 mg. Posterior pharyngeal Cetacaine spray. Procedure: With the patient in the left lateral decubitus position, the Olympus GIFXQ10 was inserted into the proximal esophagus and advanced to the Z-line. The esophageal mucosa was unremarkable. Stomach was entered revealing normal gastric mucosa. Mild erythema was seen in the antrum. The pyloric channel was again widened. The ulcer, as previously seen, was well healed with a scar. The pyloric stricture was still present. With some probing, the 11 mm endoscope could be introduced into the second portion of the duodenum, revealing normal mucosa. Marked deformity and scarring was seen in the proximal bulb. Following the diagnostic exam, a 15 mm balloon was placed across the stricture, dilated to maximum pressure, and withdrawn. There was minimal bleeding post-op. Much easier

access into the duodenum was accomplished after the dilation. Follow-up biopsies were also taken to evaluate Helicobacter noted on a previous exam. The patient tolerated the procedure well. Impressions: Pyloric stricture secondary to healed pyloric channel ulcer, dilated. Plan: Check on biopsy, continue Prilosec for at least another 30 days. At that time, a repeat endoscopy and final dilation will be accomplished. He will almost certainly need chronic H blocker therapy to avoid recurrence of this divesting complicated ulcer. What CPT® and ICD- 10 - CM codes are reported? a. 43245,^43239 - 51,^ K31.1,^ Z87. b. 43236,^43239 - 59,^ K31.1,^ Z87. c. 43235,^43239 - 51,^ K31.4,^ Z87. d. 43248,^43239 - 59,^ K31.5,^ Z87.

56 What is the correct CPT® code for a percutaneous pyelostolithotomy with dilation and

basket extraction measuring 1 cm? a. 50080 b. 50081 c. 50040 d. 50130

57 Vasectomy reversal is performed, bilaterally, using the operating microscope. Choose the

procedure code(s). a. 55400 - 50,^69990 b. 55250 c. 55450 - 50,^69990 d. 55400

58 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. 51595 b. 51596 c. 51590 d. 51580

59 Patient comes in today to the provider’s office for routine monthly Foley catheter change.

A two way Foley catheter is replaced in the usual sterile fashion. An abdominal urinary drainage bag and bedside bag are given to the patient. What is/are the correct code(s)?

a. 51701,^ A4338,^ A4357,^ A b. 51100 c. 51102 d. 51702,^ A4338,^ A4357,^ A

60 Dr. Smith is treating a 72 year-old female with a ureteral obstruction caused by a

postoperative stricture and post radiation scarring following treatment for transitional cell cancer. The patient requires removal and replacement of an internal indwelling ureteral stent. Dr. Smith advances a diagnostic catheter under conscious sedation into the bladder and injects contrast to opacity the bladder. A guide wire is advanced into the bladder and the diagnostic catheter is exchanged for a larger catheter to allow the use of a snare device. Under the fluoroscopic guidance the snare device is negotiated into the bladder through the sheath and used to grasp the pigtail portion of the double-J ureteral stent tube within the bladder and the indwelling stent tube is pulled out of the bladder and urethra far enough to allow retrograde introduction of a guide wire through the stent, directed into the renal pelvis. Using fluoroscopic guidance to negotiate the wire through the inner lumen of the ureteral stent tube rather than through side holes, a diagnostic catheter is positioned over the wire into the renal pelvis, allowing opacification and visualization of the renal pelvis. The guide wire is repositioned into the renal pelvis and the diagnostic catheter removed. A new double- J ureteral stent tube is introduced and positioned. The guide, sheath and safety wire are removed after appropriate position is confirmed with fluoroscopy and a permanent image is obtained for the medical record. What code is used to describe the exchange? a. 50386 -^26 b. 50384 c. 50385 -^26 d. 50385

61 If a woman is hospitalized with severe pre-eclampsia in the 30 th^ week of her pregnancy

what is the diagnosis code for her daily visits? a. O14.10,^ Z3A. b. O14.13,^ Z3A. c. O14.03,^ Z3A. d. O14.

62 Patient wishes permanent sterilization and elects laparoscopic tubal ligation with Falope

ring. What is the CPT® code reported for this service? a. 58600 b. 58671 c. 58615 d. 58670

63 What ICD- 10 - CM code is reported for an incomplete uterine prolapse?

a. N81. b. N81. c. N81. d. N81.

64 A patient with a long history of endometriosis has an exploratory laparotomy for an

enlarged right ovary seen on ultrasound with other possible masses on the uterus and in the peritoneum. Exploration reveals these masses to be endometriosis including a chocolate cyst (endometrioma) of the right ovary, right fallopian tube and peritoneum. The endometriomas are all small, less than 5 cm, and laser is used to ablate them, except the ovarian cyst, which is excised. During the procedure the patient also has a tubal ligation. What are the CPT® and ICD- 10 - CM codes reported for this service? a. 49000,^58662 - 51,^58925 - 51,^58671 - 51,^ N80.1,^ N80.2,^ N80.3,^ Z30. b. 58662,^58600 - 51,^ N80.1,^ N80.2,^ N80.3,^ Z30. c. 49203,^58671 - 51,^ N80. d. 49203,^ 58611,^ N80.1,^ N80.2,^ N80.3,^ Z30.

65 What is the code for ultrasound evaluation of a fetus and mother, usually performed early

in pregnancy (first trimester), to confirm fetal age, set an anticipated delivery date, for qualitative assessment of amniotic fluid volume/gestational sac shape and examination of the maternal uterus and adnexa? a. 76801 b. 76815 c. 76819 d. 59025

66 Looking in the CPT® manual the Nervous System is divided into what subheadings?

a. Skull,^ Meninges,^ and^ Brain;^ Spine^ and^ Spinal^ Cord;^ Extracranial^ Nerves,^ Peripheral Nerves, and Autonomic Nervous System. b. Brain,^ Central^ Nervous^ System,^ Autonomic^ Nervous^ System c. Skull,^ Spine,^ Peripheral^ Nervous^ System,^ Central^ Nervous^ System d. Central^ Nervous^ System^ and^ Peripheral^ Nervous^ System

67 A 50 year-old male is diagnosed with a tumor of the skull base just below the occipital

tonsils. The neurosurgeon performs a transpetrosal approach to the posterior cranial fossa. He then performs an intradural removal of the tumor of the posterior cranial fossa at the base of the skull. Dural repair is done and the area is closed with Neurolon. What CPT® code(s) is/are reported? a. 61521

b. 61597,^61616 -^51 c. 61598,^61616 -^51 d. 61524

68 What CPT® code is used to report neurorrhaphy with autogenous vein graft for one

nerve? a. 64910 b. 64885 c. 64911 d. 64892

69 A 41 year-old female has carpal tunnel syndrome in her left hand. The patient underwent

release of the carpal ligament with internal neurolysis. An incision was made directly over the carpal ligament through the skin to the carpal ligament. Under direct vision the carpal ligament was divided then internal neurolysis of the median nerve was performed using a magnifying loupes. What CPT® code is reported? a. 64722 b. 64719 c. 64721 d. 64704

70 A patient recently experienced muscle atrophy and noticed she did not have pain when

she cut herself on a piece of glass. The provider decides to obtain a needle biopsy of the spinal cord under ultrasound guidance in the outpatient setting. The biopsy results come back as syringomyelia. What CPT® and ICD- 10 - CM codes are reported for the biopsy procedure? a. 62270,^76942 - 26,^ G95. b. 62269,^ G12. c. 62270,^ G12. d. 62269,^76942 - 26,^ G95.

71 What is exophthalmos?

a. Enlargement^ of^ the^ thyroid^ gland. b. Excess^ sugar^ in^ the^ urine. c. Protrusion^ of^ the^ eyeballs. d. A condition resulting from^ an excess^ of^ hormones^ from the^ adrenal^ cortex.

72 To code for the operating microscope, what verbiage are you looking for in the medical

record?

a. Microdissection^ may^ be^ necessary. b. The^ operating^ microscope^ was^ sterilely^ draped and brought^ into^ the surgical^ field. c. “Due^ to^ the^ intricate^ dissection^ under^ magnification…” d. Loupes were^ donned^ for magnification.

73 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. 67916 - E4,^67914 - E b. 67916 -^50 c. 67914 -^50 d. 67923 - E4,^67921 - E

74 What ICD- 10 - CM code is reported for bilateral chronic otitis media with effusion?

a. H65. b. H65. c. H65. d. H65.

75 A 26 year-old female with a one-year history of a left tympanic membrane perforation.

She has extensive tympanosclerosis with a nonhealing perforation. Her options, including observation with water precautions or surgery, were discussed. The patient wished to proceed with surgery. With use of the operating microscope, the surgeon performs a left lateral graft tympanoplasty. What CPT® code is reported? a. 69631 - LT b. 69641 - LT c. 69642 - LT d. 69632 - LT

76 Report the appropriate anesthesia code for an obstetric patient who had a planned

general anesthesia for cesarean hysterectomy. a. 01969 b. 01963 c. 01962 d. 01967

77 The patient had surgery to remove and replace an existing Hickman catheter. The

anesthesiologist reported a postoperative diagnosis of a catheter related bloodstream infection (CRBSI). What ICD- 10 - CM code(s) is/are reported?

a. Z45. b. Z45.2,^ T80.219A c. T80.219A d. T80.211A

78 The patient is receiving a cast change for a compound left trimalleolar fracture (ankle).

What ICD- 10 - CM code is reported? a. S82.892D b. S82.851S c. S89.302S d. S82.852D

79 Anesthesia start time is reported as 7:14 am, and the surgery began at 7:26 am. The

surgery finished at 8:18 am and the patient was turned over to PACU at 8:29 am, which was reported as the ending anesthesia time. What is the anesthesia time reported? a. 7:26^ am^ to^ 8:29^ am^ (63^ minutes) b. 7:26^ am^ to^ 8:18^ am^ (52^ minutes) c. 7:14^ am^ to^ 8:18^ am^ (64^ minutes) d. 7:14^ am^ to^ 8:29^ am^ (75^ minutes)

80 A 72 year-old patient is undergoing a corneal transplant. An anesthesiologist is personally

performing monitored anesthesia care. What CPT® code and modifier(s) are reported for anesthesia? a. 00144,^99100 b. 00144 - AA-QS,^99100 c. 00144 - QK-QS,^99100 d. 00144 - AA,^99100

81 Which anatomic position has the patient lying at an angle instead of lying flat or directly

on their side? a. Supine b. Lateral c. Prone d. Oblique

82 A 25 year-old female in her last trimester of her pregnancy comes into her obstetrician’s

office for a fetal biophysical profile (BPP). An ultrasound is used to first monitor the fetus’ movements showing three movements of the legs and arms (normal). There are two breathing movements lasting 30 seconds (normal). Non-stress test (NST) of 30 minutes showed the heartbeat at 120 beats per minute that increased with movement (normal or

reactive). Arms and legs were flexed with fetus’ head on its chest, opening and closing of a hand. Two pockets of amniotic fluid at 3cm were seen in the uterine cavity (normal). Biophysical profile scored 9 out of 10 points (normal or reassuring). What CPT® code is reported by the obstetrician? a. 76819 b. 76815 c. 59025,^76818 d. 76818

83 A patient with prostate cancer has his first dose of radiation treatment of a single area

that requires a single port and an energy level of 7 milli-electron volts (MeV). What CPT® code is reported? a. 77373 b. 77412 c. 77402 d. 77407

84 Magnetic resonance imaging of the chest is first done without contrast medium

enhancement and then is performed with an injection of contrast. What CPT® code(s) is/are reported for the radiological services? a. 71275 b. 71552 c. 71555 d. 71550,^71551

85 A young child is taken to the OR to reduce a meconium plug bowel obstruction. A

therapeutic enema is performed with fluoroscopy. The patient is in position and barium is instilled into the colon through the anus for the reduction. What CPT® code is reported by the independent radiologist for the radiological service? a. 74280 -^26 b. 74270 -^26 c. 74283 -^26 d. 74246 -^26

86 What is the code for gross and microscopic examination (surgical pathology) of breast

tissue from a simple mastectomy? a. 88307 b. 88300 c. 88309

d. 88305

87 A patient has a traumatic head injury and some cerebrospinal fluid (CSF) is removed to

limit potential damage from swelling of the brain. The CSF is sent to pathology for examination and the results show unusual cytological counts, although no specific findings. The patient has had no previous symptoms known to his family members. What is the ICD- 10 - CM code for this examination of CSF? a. A39.0 b. S06.1X0A c. Z00.01 d. R83.6

88 A physician orders a General Health Panel, all tests except a creatinine, including CBC

with automated differential. What CPT® code(s) is/are reported? a. 85025, 84443,^ 82040,^ 82247,^ 82310,^ 82374,^ 82435,^ 82947,^ 84075,^ 84132,^ 84155, 84295, 84460, 84450, 84520 b. 80050 -^22 c. 80050 -^52 d. 80050

89 Esther Glass has a primary cancer located in the intra-hepatic biliary tract and had a

cholecystectomy and biopsy of the duodenum done. Two separate specimens (gall bladder, biopsy of duodenum) were sent to the pathologist working at a hospital laboratory. The technician prepared the slides and the pathologist (self-employed) read them. Select the best code or codes for the pathologist’s services. a. 88304 -^26 x2 b. 88305 -^26 x2 c. 88304 - 26,^88305 -^26 d. 88304,^88305

90 A patient has partial removal of his lung which is sent in for gross and microscopic

examination. The pathologist also did gross and microscopic exam on biopsies for several lymph nodes in the patient’s chest which are placed in one container. A consultation is performed on a tissue block of a single specimen intraoperatively by frozen section. The pathologist also performs a trichrome stain. What CPT® codes are reported for the lab tests performed? a. 88307,^ 88305 x^ 2,^88332 b. 88309,^ 88305,^ 88313,^88331 c. 88309 x 2,^88307 x 2,^ 88313, 88331, 88332 d. 88309 x^ 2,^ 88313, 88329

91 If the pain is sharp, stabbing or dull, what is the component of the History of Present

Illness (HPI)? a. Quality b. Modifying^ Factor c. Timing d. Duration

92 Dr. Howitzer sees Mrs. Jones in Clinic Eight for sudden loss of consciousness while

watching the Olympic Torch go by. He is a new provider to the neurology department. Dr. Drake Rinaldi, a prominent member of the neurology faculty at the university saw Mrs. Jones last month. Dr. Howitzer performs a history including 3 HPI elements and 2 ROS, a detailed exam and has medical decision making of high complexity. The final diagnosis given is transient loss of consciousness. The patient makes a follow-up appointment to see Dr. Rinaldi in one week. What is the appropriate diagnosis and E/M code for this visit? a. 99203,^ R55 b. 99202,^ R40.1 c. 99214,^ R55 d. 99215,^ R40.1

93 After moving across country, Ms. Robbins took her 2 year-old daughter to a new pediatric

clinic for an annual physical. The provider completed an age / gender appropriate history, exam, and provided anticipatory guidance. He ordered no additional tests or immunizations. What CPT® code is reported? a. 99392 b. 99391 c. 99381 d. 99382

94 The physician was called to the hospital floor for the medical management of a 56 year-

old patient admitted one day ago with aspiration pneumonia and COPD. No chest pain at present, but still SOB and some swelling in his lower extremities. Patient was tachypneic yesterday; lungs reveal course crackles in both bases, right worse than left. The physician writes instructions to continue with intravenous antibiotic treatment and respiratory support with ventilator management. He reviewed chest X-ray and labs. Patient is improving and a pulmonary consultation has been requested. What CPT® code is reported? a. 99232 b. 99231 c. 99218 d. 99221

95 An established 47 year-old patient presents to the provider’s office after falling last night

in her apartment when she slipped in water on the kitchen floor. She is complaining of low back pain and no tingling or numbness. Provider documents that she has full range motion of the spine, with discomfort. Her gait is within normal limits. Straight leg raising is negative. She requested no medication. It is recommended to use heat, such as a hot water bottle. Provider’s Assessment: Lower Back Muscle Strain. What E/M and ICD- 10 - CM codes are reported for this service? a. 99213,^ S39.012A,^ W01.0XXA,^ Y92.030 b. 99212,^ S39.012A,^ W18.30XA,^ Y92.030 c. 99213,^ S33.9XXA,^ W18.40XD,^ Y92.030 d. 99212,^ S39.012A,^ W19.XXXD,^ Y92.030

96 A new patient with cystic fibrosis underwent evaluation of lung function, including

percussion, vibration and cupping to the chest wall to facilitate his lung function. What CPT® code(s) is/are reported for this service? a. 99201 - 25,^94668 b. 94667 c. 94664 d. 94662

97 A patient with hypertensive cardiovascular disease is admitted by his primary care

provider. What is/are the correct ICD- 10 - CM code(s) for this encounter? a. I11.9 b. I11.0 c. I10,^ I25.10 d. I11.9,^ I25.10

98 A 30 year-old male cut his right hand on a nail repairing the gutter on his house. Six days

later it became infected. He went to the intermediate care center in his neighborhood, his first visit there. The wound was very red and warm with purulent material present. The wound was irrigated extensively with sterile water and covered with a clean sterile dressing. An injection of Bicillin CR, 1,200,000 units was given. The patient was instructed to return in three to four days. The provider diagnosed open wound of the hand with cellulitis. A problem focused history and examination with a low MDM were performed. What are the codes? a. 96372,^ S61.411A,^ L03.114,^ W45.0XXA,^ Y93.H9 b. 99201,^ 96372,^ J0558^ x^ 12,^ S61.411A,^ L03.113,^ W45.0XXA,^ Y93.H9 c. 99284,^ S41.009A,^ L03.113 d. 99201,^ J0558^ x^ 4,^ S52.009A,^ W31.81XA

99 A qualified genetics counselor is working with a child who has been diagnosed with fragile

X syndrome. After extensive research about the condition, she meets with the parents to discuss the features of the disease and the child’s prognosis. The session lasted 45 minutes. What CPT® and ICD- 10 - CM codes are reported? a. 96040,^ Q99.9 b. 96040,^ Q99.2 c. 96040 x^ 2,^ Q99.2 d. 96040 x^ 2,^ Q99.8

100 A patient with bilateral sensory hearing loss is fitted with a digital, binaural, behind the

ear hearing aid. What HCPCS Level II and ICD- 10 - CM codes are reported? a. V5261,^ Z46.1,^ H90.3 b. V5261,^ Z01.110,^ H90.3 c. V5140,^ H90.6 d. V5140,^ H90.3,^ Z46.1