AAPC CPC Final Exam 2024-2025: Practice Questions and Answers, Exams of Advanced Education

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AAPC CPC Final Exam 2024-2025 With

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The minimum necessary rule is based on sound current practice that protected health information should NOT be used or disclosed when it is not necessary to satisfy a particular purpose or carry out a function. What does this mean? a. Staff members are allowed to access any medical record without restriction b. Providers should develop safeguards to prevent unauthorized access to protected health information. c. Practices should only provide minimum necessary information to patients. d. All of the above. - Correct Answer-b. Providers should develop safeguards to prevent unauthorized access to protected health information. EHR stands for: a. Electronic health record b. Extended health record c. Electronic health response d. Established health record - Correct Answer-a. Electronic health record The AAPC offers over 500 local chapters across the country for the purpose of a. Continuing education and networking b. Membership dues c. Regulations and bylaws d. Financial management - Correct Answer-a. Continuing education and networking What does the abbreviation MAC stand for? a. Medicaid Alert Contractor b. Medicare Advisory Contractor c. Medicare Administrative Contractor d. Medicaid Administrative Contractor - Correct Answer-c. Medicare Administrative Contractor The OIG recommends that provider practices enforce disciplinary actions through well publicized compliance guidelines to ensure actions that are ______. a. Permanent b. Consistent and appropriate c. Frequent d. Swift and enforceable - Correct Answer-b. Consistent and appropriate

Through which vessel is oxygenated blood returned to the heart from the lungs? a. Pulmonary vein b. Bronchial vein c. Pulmonary artery d. Bronchial artery - Correct Answer-a. Pulmonary vein Muscle is attached to bone by what method? a. Tendons, ligaments, and directly to bone b. Tendons, aponeurosis, and directly to bone c. Ligaments, aponeurosis, and directly to bone d. Tendons and cartilage - Correct Answer-b. Tendons, aponeurosis, and directly to bone Lacrimal glands are responsible for which of the following? a. Production of tears b. Production of vitreous c. Production of mydriatic agents d. Production of zonules - Correct Answer-a. Production of tears Melasma is defined as: a. Lines where the skin has been stretched b. A discharge of mucus and blood c. A dark vertical line appearing on the abdomen d. Brownish pigmentation appearing on the face - Correct Answer-d. Brownish pigmentation appearing on the face A gonioscopy is an examination of what part of the eye: a. Anterior chamber of the eye b. Lacrimal duct c. Interior surface of the eye d. Posterior segment - Correct Answer-a. Anterior chamber of the eye What type of code is assigned when the provider documents the reason for a patient seeking healthcare services that is not for an injury or disease? a. Non-specific code b. External cause code (V00-Y99) c. Z code (Z00-Z99) d. ICD-10-PCS - Correct Answer-c. Z code (Z00-Z99) What is the ICD-10-CM code for hay fever? - Correct Answer-J30.

a. D17. b. D17. c. D17.1, D17. d. D17.21, D17.1 - Correct Answer-d. D17.21, D17. A 33-year-old patient visits his primary care provider to discuss a lap band procedure for his morbid obesity. His caloric intake is in excess of 4,000 calories per day and his BMI is currently 45. What ICD-10-CM code(s) is/are reported? a. E66.01, Z68. b. E66.3, Z68. c. E66. d. E66.01, Z68.45 - Correct Answer-a. E66.01, Z68. A 58-year-old patient sees the provider for confusion and loss of memory. The provider diagnoses the patient with early onset stages of Alzheimer's disease with dementia. What ICD-10-CM codes are reported? a. F02.80, G30.0, F29, F41. b. G30.0, F02. c. F02.80, G30. d. G30.0, F02.80, F29, R41.3 - Correct Answer-b. G30.0, F02. What would be considered an adverse effect? a. Shortness of breath when running b. Rash developing when taking penicillin c. Hemorrhaging after a vaginal delivery d. Wound infection after surgery - Correct Answer-b. Rash developing when taking penicillin What is a TRUE statement in reporting pressure ulcers? a. When a pressure ulcer is at on stage and progresses to the higher stage, report the lowest stage for that site. b. Two codes are assigned when a patient is admitted with a pressure ulcer that evolves to another stage during the admission. c. When documentation does not provide the stage of the pressure ulcer, report the unstageable pressure ulcer code(L89.95). d. The site of the ulcer and the stage of the ulcer are reported with two separate codes.

• Correct Answer-b. Two codes are assigned when a patient is admitted with a pressure ulcer that evolves to another stage during the admission. A child has a splinter under the right middle fingernail. What ICD-10-CM code is reported?

a. S61.222A b. S61.227A c. S61.242A d. S60.452A - Correct Answer-d. S60.452A A 16-year-old male is brought to the ED by his mother. He was riding his bicycle in the park when he fell off the bike. The patient's right arm is painful to touch, discolored, and swollen. The X-ray shows a closed fracture of the ulna. What ICD-10-CM codes are reported? a. S52.201A, V19.9XXA, Y92. b. S52.201A, V18.4XXA, Y92. c. S52.201A, V18.0XXA, Y92. d. S52.209A, V18.4XXA, Y92.830 - Correct Answer-c. S52.201A, V18.0XXA, Y92. A 12-month-old receives the following vaccinations: Hepatitis B, Hib, Varicella, and Mumps-measles-rubella. What ICD-10-CM code(s) is/are reported for the vaccinations? a. B19.10, B01.9, B26.9, B05.9, B06.9, Z b. Z23, B19.10, B01.9, B26.9, B05.9, B06. c. Z d. B19.10, B01.9, B26.9, B05.9, B06.9 - Correct Answer-c. Z The Table of Drugs in the HCPCS Level II book indicates various medication routes of administration. What abbreviation represents the route where a drug is introduced into the subdural space of the spinal cord? a. IT b. SC c. IM d. INH - Correct Answer-a. IT A patient is in the OR for an arthroscopy of the medial compartment of his left knee. A meniscectomy is performed. What is the correct code used to report for the anesthesia services? a. 01400 b. 01402 c. 29880-LT d. 29870-LT - Correct Answer-a. 01400 What is the correct CPT® code for a MRI performed on the brain first without contrast and then with contrast? a. 70554 b. 70553

The patient is seen in follow-up for excision of the basal cell carcinoma of his nose. I examined his nose noting the wound has healed well. His pathology showed the margins were clear. He has a mass on his forehead; he says it is from a fragment of sheet metal from an injury to his forehead. He has an X-ray showing a foreign body, and we have offered to remove it. After obtaining consent we proceeded. The area was infiltrated with local anesthetic. I had drawn for him how I would incise over the foreign body. He observed this in the mirror so he could understand the surgery and agree on the location. I incised a thin ellipse over the mass to give better access to it; the mass was removed. There was a granuloma capsule around this, containing what appeared to be a black-colored piece of stained metal; I felt it could potentially cause a permanent black mark on his forehead. I offered to excise the metal. He wanted me - Correct Answer-a. 10121, L92.3, Z18.10, Z85. In ICD-10-CM, what classification system is used to report open fracture classifications? a. Gustilo classification for open fractures b. PHF classification of fractures c. Danis-Weber classification d. Muller AO classification of fractures - Correct Answer-a. Gustilo classification for open fractures A patient presented with a right ankle fracture. After induction of general anesthesia, the right leg was elevated and draped in the usual manner for surgery. A longitudinal incision was made parallel and posterior to the fibula. It was curved anteriorly to its distal end. The skin flap was developed and retracted anteriorly. The distal fibula fracture was then reduced and held with reduction forceps. A lag screw was inserted from anterior to posterior across the fracture. A 5-hole 1/3 tubular plate was then applied to the lateral contours of the fibula with cortical and cancellous bone screws. Final radiographs showed restoration of the fibula. The wound was irrigated and closed with suture and staples on the skin. Sterile dressing was applied followed by a posterior splint. What CPT® code is reported? a. 27823-RT b. 27792-RT c. 27814-RT d. 27787-RT - Correct Answer-b. 27792-RT A 49-year-old female presented with chronic deQuervain's disease and has been unresponsive to physical therapy, bracing or cortisone injection. She has opted for more definitive treatment. After induction of anesthesia, the patient's left arm was prepared and draped in the normal sterile fashion. Local anesthetic was injected using a combination 2% lidocaine and 0.25% Marcaine. A transverse incision was made over the central area of the first dorsal compartment. The subcutaneous tissues were gently spread to protect the neural and venous structures. The retractors were placed. The fascial sheath of the first dorsal compartment was then incised and opened carefully.

The underlying thumb abductor and extensor tendons were identified. The tissues were dissected and the extensor retinaculum of the first extensor compartment was incised. The fibrotic tissue was incised and the tendons gently released. The tendons were fre - Correct Answer-d. 25000-LT Rationale: The report states the extensor retinaculum of the first extensor compartment was incised. Look in CPT index for Incision/Wrist/Tendon Sheath 25000-25001. Code 25000 shows deQuervain's disease in the description. Modifier LT is appended to inciate procedure is performed on the left side. 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. 20553-F6, 20610-51-LT b. 20552-F6, 20605-52-LT c. 26055-F6, 20610-76-LT d. 26055-F6, 20610-51-LT - Correct Answer-d. 26055-F6, 20610-51-LT A 3-year-old is brought into the ED crying. He cannot bend his left arm after his older brother twisted it. X-ray is performed and the ED physician diagnoses the patient has a dislocated nursemaid elbow. The ED physician reduces the elbow successfully. The patient is able to move his arm again. The patient is referred to an orthopedist for follow- up care. What CPT® and ICD-10-CM codes are reported? a. 24640-54-LT, S53.091A, W50.2XXA b. 24600-54-LT, S53.002A, W49.9XXA c. 24640-54-LT, S53.032A, W50.2XXA d.24565-54-LT, S53.194S, Y33.XXXA - Correct Answer-c. 24640-54-LT, S53.032A, W50.2XXA What CPT® code is reported for an emergency endotracheal intubation to save the patient's life? - Correct Answer- Rationale: In the CPT® Index, look for Intubation/Endotracheal Tube. This directs you to code 31500, which is for an emergency endotracheal intubation. An 18-month-old patient is seen in the ED unable to breathe due to a toy he swallowed which had lodged in his throat. Soon brain death will occur if an airway is not

b. Right c. Inverted d. Superficial - Correct Answer-a. Left In the cath lab a physician places a catheter in the aortic arch from a right femoral artery puncture to perform an angiography. Fluoroscopic imaging is performed by the physician. What CPT® code(s) is/are reported? a. 36222 b. 36200, 75605- c. 36215, 75605- d. 36221 - Correct Answer-d. 36211 Rationale: The aorta is the trunk of the system, so this is a non-selective catheterization. Look in CPT Index for Angiography/Cervicocerebral Arch. Only one code is reported for the catheterization and fluoroscopic imaging which is code 36221 Which statement is TRUE regarding codes for hypertension and heart disease in ICD- 10-CM? A) Only one code is required to report hypertension and heart failure. B) Hypertension and heart disease have an assumed causal relationship. C) Hypertension and heart disease without a stated causal relationship must be coded separately. D) Hypertension with heart disease is always coded to heart failure. - Correct Answer-B) Hypertension and heart disease have an assumed causal relationship. Rationale: ICD-10-CM Coding Guidelines I.C.9.a states a causal relationship is presumed between hypertension and heart involvement. Only if the documentation specifically states they are unrelated, are they to be coded separately. ICD-10-CM guideline I.C.9.a.1 indicates two codes are required to report hypertension and heart failure. A patient presents for extremity venous study. Complete noninvasive physiologic studies of both lower extremities were performed. Which CPT® code is reported? - Correct Answer- Rationale: Code 93970 reports a complete bilateral noninvasive physiologic study of extremity veins. This study is found in the CPT® Index by looking for Vascular Studies/Venous Studies/Extremity which directs you to 93970-93971. Modifier 50 is not appended because the term bilateral is included in the code description for 93970. When reporting an encounter for screening of malignant neoplasms of the intestinal tract, what does the 5th character indicate? A) History of malignancy in the intestinal tract

B) Laterality of the intestinal tract C) Anatomic location being screened in the intestinal tract D) Screening codes for malignant neoplasms of the intestinal tract are only reported with four characters. - Correct Answer-C) Anatomic location being screened in the intestinal tract Bile empties into the duodenum through what structure? A) Pyloric sphincter B) Biliary artery C) Common bile duct D) Common hepatic duct - Correct Answer-C) Common Bile Duct What ICD-10-CM code is reported for non-erosive duodenitis? a. K29. b. K29. c. K29. d. K29.91 - Correct Answer-a. K29. A 57-year-old patient with chronic pancreatitis presents to the operating room for a pancreatic duct-jejunum anastomosis by the Puestow-type operation. What CPT® and ICD-10-CM codes are reported for the encounter? a. 48548, K85. b. 48520, K86. c. 48520, K85. d. 48548, K86.1 - Correct Answer-d. 48548, K86. The urologist is called to the operating room to repair a kidney laceration status post MVA. The urologist examines the kidney and repairs a small 2 cm laceration of the kidney. What CPT® code is reported for this service? a. 50525 b. 50520 c. 50500 d. 50526 - Correct Answer-c. 50500 Transurethral resection of bladder neck and nodular prostatic regrowth. What CPT® code is reported for this service? a. 55801 b. 52630 c. 52500 d. 52640 - Correct Answer-b. 52630

cervical os with no products of conception seen. He tells the patient she has had an abortion. What type of abortion has she had? a. Missed b. Induced c. Spontaneous d. None of the above - Correct Answer-c. Spontaneous Mrs. Smith is visiting her mother and is 150 miles away from home. She is in the 26th week of pregnancy. In the late afternoon she suddenly feels a gush of fluids followed by strong uterine contractions. She is rushed to the hospital but the baby is born before they arrive. In the ED she and the baby are examined and the retained placenta is delivered. The baby is in the neonatal nursery doing okay. Mrs. Smith has a 2nd degree perineal laceration secondary to precipitous delivery which was repaired by the ED physician. She will return home for her postpartum care. What ICD-10-CM and CPT® codes are reported by the ED physician? a. 59409, O80, Z3A.26, Z37. b. 59409, 59414-51, 59300-51, O62.3, O70.1, Z3A.26, Z37. c. 59414, 59300-51, O62.3, O70.9, Z3A.26, Z37. d. 59414, 59300-51, O73.0, O70.1, Z3A.26, Z37.0 - Correct Answer-d. 59414, 59300- 51, O73.0, O70.1, Z3A.26, Z37. Migraines are reported from what category in ICD-10-CM? a) F b) G c) G d) G43 - Correct Answer-d) G A patient with a status post (after or following) lumbar puncture headache receives an epidural blood patch. The patient's venous blood is injected into the lumbar epidural space; this blood forms a clot sealing the leak of CSF from the lumbar puncture. What CPT® and ICD-10-CM codes are reported? a. 62273, G97. b. 62281, G44. c. 62282, G97. d. 62273, G44.1 - Correct Answer-a. 62273, G97. What ICD-10-CM code is used for spinal meningitis? a. G03. b. A87. c. G04. d. A39.9 - Correct Answer-a. G03.

A 47-year-old male presents with chronic back pain and lower left leg radiculitis. A laminectomy is performed on the inferior end of L5. The microscope is used to perform microdissection. There was a large extradural cystic structure on the right side underneath the nerve root as well as the left. The entire intraspinal lesion was evacuated. What CPT® code(s) is/are reported for this procedure? a. 63252, 69990 b. 63267, 69990 c. 63277 d. 63272 - Correct Answer-b. 63267, 69990 What ICD-10-CM code is reported for mild nonproliferative diabetic retinopathy with macular edema? a. E11. b. E11. c. E11. d. E11.3199 - Correct Answer-c. E11. The provider makes an incision in the patient's left tympanic membrane in order to inflate eustachian tubes and aspirate fluid in a patient with acute eustachian salpingitis. The procedure is completed without anesthesia. What CPT® and ICD-10-CM codes are reported? a. 69421, H68. b. 69420, H68. c. 69421, H68. d. 69420, H68.022 - Correct Answer-b. 69420, H68. A patient with a cyst like mass on his left external auditory canal was visualized under the microscope and a microcup forceps was used to obtain a biopsy of tissue along the posterior superior canal wall. What CPT® code is reported? a. 69105-LT b. 69140-RT c. 69145-LT d. 69100-RT - Correct Answer-a. 69105-LT 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? - Correct Answer-69631-LT

A patient arrives at the urgent care facility with a swollen ankle. Anteroposterior and lateral view X-rays of the ankle are taken to determine whether the patient has a fractured ankle. What CPT® code(s) is/are reported? a. 73600 X 2 b. 73610 c. 73600, 73610 d. 73600 - Correct Answer-d. 73600 A 32-year-old patient with cervical cancer is in an outpatient facility to have HDR brachytherapy. The cervix is dilated and under ultrasound guidance six applicators are inserted with iridium via the vagina to release its radiation dose. The placement is in the cervical cavity (intracavitary). What CPT® code is reported for the physician service? - Correct Answer-77762- Response Feedback: Rationale: Patient is receiving a type of internal radiation therapy delivering a high dose of radiation (HDR) from implants (applicators with the iridium) placed via the vaginal cavity (intracavitary). This is found in the CPT® Index by looking for Brachytherapy/Intracavitary Application directing you to 0395T, 77761-77763. The CPT® subsection guidelines under the heading Clinical Brachytherapy, definitions are given to differentiate simple, intermediate and complex brachytherapy. Code 77762 is reported for the intracavitary application of five to 10 sources (intermediate); six applicators were used for this procedure making 77762 the correct code. A patient who may have a stricture of the artery is undergoing an aortogram in which the left femoral artery was cannulated with a catheter advanced into the infrarenal abdominal aorta. Contrast medium was injected, and films taken by serialography showing the aortoiliac inflow vessels were widely patent. The bilateral common femoral arteries appear normal. What CPT® codes are reported for the professional component? a. 36200, 75625- b. 36200, 75805- c. 36200, 75630- d. 36200, 75635-26 - Correct Answer-c. 36200, 75630- Myocardial Perfusion Imaging (MPI)—Office Based TestIndications: Chest pain.Procedure: Resting tomographic myocardial perfusion images were obtained following injection of 10 mCi of intravenous Cardiolite. At peak exercise, 30 mCi of intravenous Cardiolite was injected, and post-stress tomographic myocardial perfusion images were obtained. Post stress gated images of the left ventricle were also acquired. Myocardial perfusion images were compared in the standard fashion.Findings: This is a technically fair study. There was no stress induced electrocardiographic changes noted. There were no significant reversible or fixed perfusion defects noted. Gated images of the left ventricle reveal normal left ventricular volumes, normal left ventricular wall

motion, and an estimated left ventricular ejection fraction of 50%.Impression: No evidence of myocardial ischemia or infarction. Normal left ventricular ejection fraction. - Correct Answer-b. 78452 HCPCS Level II codes specifically for Pathology and Laboratory services all start with what letter? a. G b. A c. P d. Q - Correct Answer-c. P 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. 80050- b. 85025, 84443, 82040, 82247, 82310, 82374, 82435, 82947, 84075, 84132, 84155, 84295, 84460, 84450, 84520 c. 80050 d. 80050-22 - Correct Answer-b. 85025, 84443, 82040, 82247, 82310, 82374, 82435, 82947, 84075, 84132, 84155, 84295, 84460, 84450, 84520 What diagnosis codes are reported for metastatic adenocarcinoma to the lungs from an unknown primary location? a. D49.1, D49. b. D02.21, D02.22, C34. c. C78.01, C78.02, C80. d. C34.90, C80.1 - Correct Answer-c. C78.01, C78.02, C80. Flow cytometry is performed for DNA analysis. What CPT® code is reported? a. 88184 b. 88182 c. 88187 d. 88189 - Correct Answer-b. 88182 According to CPT® guidelines, what is the first step in selecting an evaluation and management code for an E/M service provided in a hospital? a. Determine if time is the determining component b. Determine the level of history c. Review the code descriptors and examples for the category or subcategory selected. d. Determine the level of medical decision making - Correct Answer-c. Review the code descriptors and examples for the category or subcategory selected.

a. 94775, 94776, 94777 b. 95800 c. 95806 d. 94774 - Correct Answer-d. 94774 A 5 week old infant shows signs of fatigue after eating and has poor weight gain. He is suspected to have a congenital heart defect. The neonatologist ordered a transthoracic echocardiogram (TTE). TTE is showing a shunt between the right and left ventricles. The neonatologist read and interpreted the study and indicated the patient has a ventricular septal defect (VSD). What are the CPT® and ICD-10-CM codes for the TTE read? a. 93303-26, Q21. b. 93312-26, Q21. c. 93312, I51. d. 93303, I51.0 - Correct Answer-a. 93303-26, Q21. A teenager has been chronically depressed since the separation of her parents 1 year ago and moving to a new city. Her school grades continued to slip and she has not made new friends. She has frequent crying episodes and is no longer interested in her appearance. She has attended the community mental health center and participates in group sessions. Recently her depression exacerbated to the point inpatient admission was required. The provider diagnosed adjustment disorder with emotional and conduct disturbances. Due to the length of the depression and no real improvement, the provider discussed electroconvulsive therapy with her mother. After discussing benefits and risks, the mother consented to the procedure. What CPT® and ICD-10-CM codes are reported for the electroconvulsive therapy? a. 90882, F43. b. 90870, F43. c. 90870, F43.24, F43. d. 90867, F43.24, F43.25 - Correct Answer-b. 90870, F43. A patient with hypertensive end stage renal failure, stage 5, and secondary hyperparathyroidism is evaluated by the provider and receives peritoneal dialysis. The provider evaluates the patient once before dialysis begins. What CPT® and ICD-10-CM codes are reported? a. 90947, I12.0, N25. b. 90945, I10, N18.5, Z99.2, N25. c. 90945, I12.0, N18.6, Z99.2, N25. d. 90947, I12.0, N18.5, Z99.2 - Correct Answer-c. 90945, I12.0, N18.6, Z99.2, N25. PREOPERATIVE DIAGNOSIS : Heart BlockPOSTOPERATIVE DIAGNOSIS: Heart BlockANESTHESIA: Local anesthesiaNAME OF PROCEDURE: Reimplantation of dual

chamber pacemakerDESCRIPTION: The chest was prepped with Betadine and draped in the usual sterile fashion. Local anesthesia was obtained by infiltration of 1% Xylocaine. A subfascial incision was made about 2.5 cm below the clavicle, and the old pulse generator was removed. Using the Seldinger technique, the subclavian vein was cannulated and through this, the old atrial lead was removed, and a new atrial lead (serial # 6662458) was placed in the right atrium and to the atrial septum. Thresholds were obtained as follows: The P-wave was 1.4 millivolts, atrial threshold was 1. millivolts with a resultant current of 3.5 mA and resistance of 467 ohms.Using a second subclavian stick in the Seldinger technique, the old ventricular lead was removed and a new ventricular lead (serial - Correct Answer-a. 33235, 33208-51, 33233- Operative Report PREOPERATIVE DIAGNOSIS:Prolapsed vitreous in anterior chamber with corneal edema POSTOPERATIVE DIAGNOSIS:Same OPERATION PERFORMED:Anterior vitrectomy The patient is a 72-year-old woman who approximately 10 months ago underwent cataract surgery with a YAG laser capsulotomy, developed corneal edema and required a corneal transplant. The patient has done well. Over the last few weeks, she developed posterior vitreous detachment with vitreous prolapse to the opening in the posterior capsule with vitreous into the anterior chamber with corneal touch and adhesion to the graft host junction and early corneal edema. The patient is admitted for anterior vitrectomy.PROCEDURE: The patient was prepped and draped in the usual manner after first undergoing retrobulbar anesthetic. A lid speculum was inserted. An incision was made at approximately the 10 o'clock meridian 3 mm in length, 2 mm posterior to the limbus, - Correct Answer-c. 67010 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 GIFXQ 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 t - Correct Answer-d. 43245, 43239-51, K31.1, Z87. Benign prostatic hypertrophy with outlet obstruction and hematuria. Operation: TURP Anesthesia: Spinal