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AAPC CPC Final Exam 2024 Questions And Answers, Exams of Nursing

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

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AAPC CPC Final Exam 2024 Questions

And Answers

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. What is the ICD-10-CM code for swine flu? a. J10. b. A08. c. J11. d. J09.X2 - correct answer --d. J09.X What ICD-10-CM code(s) is/are reported for enlargement of the prostate with a symptom of urinary retention? a. N40. b. N40.3, R33. c. N40. d. N40.1, R33.8 - correct answer --d. N40.1, R33. What diagnosis code(s) is/are reported for behavioral disturbances in a patient with early onset Alzheimer's? a. G30.8, F02. b. F02. c. F02.81, G30. d. G30.0, F02.81 - correct answer --d. G30.0, F02. What is the ICD-10-CM code for a patient with postoperative anemia due to acute blood loss during the surgery who needs a blood transfusion? a. D64. b. D53. c. D50. d. D62 - correct answer --d. D A 54-year-old male goes to his primary care provider with dizziness. On physical exam his blood pressure is 200/130. After a complete work-up, including laboratory tests, the provider makes a diagnosis of end stage renal disease and hypertension. What are the appropriate diagnosis codes for this encounter? a. I12.0, N18. b. I10, N18. c. I10, N18. d. I12.0 - correct answer --a. I12.0, N18.

A 32-year-old male was seen in the ambulatory surgery center ASC for removal of two lipomas. One was located on his back and the other was located on the right forearm. Both involved subcutaneous tissue. What ICD-10-CM code(s) is/are reported? 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 c. 70552 d. 70551 - correct answer --b. 70553 How are ambulance modifiers used? a. They identify the time elements of the ambulance service. b. They identify the mileage traveled during the encounter. c. They identify ambulance place of origin and destination. d. they identify emergency or non-emergency transport types. - correct answer --c. They identify ambulance place of origin and destination. What is the correct CPT® code for the wedge excision of a nail fold of an ingrown toenail? - correct answer -- Rationale: In the CPT® Index, look for Excision/Nail Fold referring you to 11765. 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. C44. b. C44. c. D79. d. C79.2 - correct answer --a. C44. In ICD-10-CM, what type of burn is considered corrosion? - correct answer --Burns due to chemicals 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. 11720 b. 11730 c. 11750 d. 11765 - correct answer --c. 11750 The patient is seen 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. 15877, 15878-50- b. 15877, 15879-50- c. 15830, 15839-50-51, 15847 d. 15830, 15832-50-51 - correct answer --b. 15877, 15879-50- 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 established immediately. The ED provider performs an emergency transtracheal tracheostomy. What CPT® and ICD-10-CM codes are reported? a. 31603, T17.220A b. 31603, T17.290A c. 31601, J34.9, T17.298A d. 31601, 31603, T17.228A - correct answer --b. 31603, T17.290A What ICD-10-CM code is reported for pyopneumothorax with fistula? - correct answer --J86. 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. 32560, J93. b. 32650, 32560, J93. c. 32650, J95. d. 32601, 32560, J95.811 - correct answer --a. 32560, J93. Response Feedback: Rationale:Chemopleurodesis is represented by codes 32560-32562. In the CPT® Index look for Pleurodesis/Instillation of Agent. Code 32560 is appropriate for the described actions taken to instill the talc used to treat recurrent pneumothorax. Look in the ICD-10-CM Alphabetic Index for Pneumothorax NOS/chronic which directs you to code J93.81. Verification in the Tabular List confirms code selection. A 25-year-old male presents with a deviated nasal septum. The patient undergoes a nasal septum repair and submucous resection. Cartilage from the bony septum was detached and the nasoseptum was realigned and removed in a piecemeal fashion. Thereafter, 4-0 chronic was used to approximate mucous membranes. Next, submucous resection of the turbinates was handled in the usual fashion by removing the anterior third of the bony turbinate and lateral mucosa followed by bipolar cauterization. What CPT® codes are reported? a. 30450, 30999-

b. 30520, 30140- c. 30420, 30140- d. 30620, 30999-51 - correct answer --b. 30520, 30140- Which main coronary artery bifurcates into two smaller ones? a. Left 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 Rationale: CPT 52630 is reported for a transurethral resection of residual or regrowth of the prostatic tissue. In the the CPT index look for Transurethral Procedure/Prostate/Resection. CPT 52500 is a separate procedure and considered an integral part of the prostate resection. CPT 52640 is used for the transurethral resection of a postoperative bladder neck contracture. A 63-year-old male presents for the insertion of an artificial inflatable urinary sphincter for urinary incontinence. A 4.5 cm cuff, 22 ml balloon, 61-70 mmHg artificial inflatable urinary sphincter was inserted. What CPT® code is reported for this service? - correct answer -- Rationale: In the CPT® Index look for Insertion/Prosthesis/Urethral Sphincter. You're directed to 53444-53445. Codes 53446-53448 are for the removal or removal/replacement of the inflatable sphincter. CPT® 53445 describes the insertion of an inflatable urethra/bladder neck sphincter, including placement of pump, reservoir and cuff. The patient has significant morbid obesity and her pannus has been retracted to help with dissection. The planned procedure is to place a catheter/tube to drain the bladder. It is apparent she has quite a bit of scarring from her previous surgeries and appears to have an old sinus tract just above the symphysis. A midline incision is made following her old scar from just above the symphysis for a length of about 4-6cm. The sinus tract was excised, as this was also in the midline, and carefully dissected down to the level of the fascia. It does not appear to be an actual hernia, as there are no ventral contents within it. Again, there is quite a bit of distortion from previous scarring because of the obesity, but staying in the midline, the fascia is incised just above the symphysis of a length of about 2cm. The fat and scar are incised above the fascia more superiorly and with palpation, mesh from a previous hernia r - correct answer --a. 51040- What does the abbreviation VBAC mean? - correct answer --Vaginal Birth After Cesarean A patient is seen for three extra visits during the third trimester of her 30-week pregnancy because of her history of pre-eclampsia during her previous pregnancy which puts her at risk for a recurrence of the problem during this pregnancy. No problems develop. What diagnosis code(s) is/are reported for these three extra visits?

a. O09.893, Z3A. b. O14.03, Z3A. c. Z34. d. Z34.83, O09.893, Z3A.30 - correct answer --a. O09.893, Z3A. A pregnant patient presents to the ED with bleeding, cramping, and concerns of loss of tissue and material per vagina. On examination, the physician discovers an open 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 Rationale: During the procedure, a tympanoplasty is performed. There is no mention of a mastoidectomy or ossicular chain reconstruction being performed. From the CPT® Index look for Tympanoplasty/without Mastoidectomy then verify the code in the numeric section. Modifier LT is used to indicate the procedure was performed on the left ear. What are the three classifications of anesthesia? a. General, regional, and epidural b. General, regional, and monitored anesthesia care c. General, regional, and moderate sedation d. General, MAC, and conscious sedation - correct answer --b. General, regional, and monitored anesthesia care What is the ICD-10-CM coding for personal history of colonic polyps? a. Z83. b. K51. c. K63. d. Z86.010 - correct answer --d. Z86. A patient undergoes heart surgery for angina decubitus and coronary artery disease (CAD). What ICD-10-CM coding is reported? a. I25. b. I25. c. I20. d. I25.119 - correct answer --a. I25. A patient presents to the OR for a craniotomy with evacuation of a hematoma. What CPT® coding is reported for the anesthesiologist's services? a. 00210 b. 61312 c. 61314 d. 00211 - correct answer --d. 00211 An anesthesiologist is medically supervising six cases concurrently. What modifier is reported for the anesthesiologist's service?

a. QX b. QK c. AA d. AD - correct answer --d. AD 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 32-year-old patient sees Dr. Smith for a consult at the request of his PCP, Dr. Long, for an ongoing problem with allergies. The patient has failed Claritin and Alavert and feels his symptoms continue to worsen. Dr. Smith performs an expanded problem focused history and exam and discusses options with the patient on allergy management. The MDM is straightforward. The patient agrees he would like to be tested to possibly gain better control of his allergies. Dr. Smith sends a report to Dr. Long thanking him for the referral and includes the date the patient is scheduled for allergy testing. Dr. Smith also includes his findings from the encounter. What E/M code is reported? a. 99203 b. 99242 c. 99243 d. 99214 - correct answer --b. 99242 A 75-year-old established patient sees his regular primary care provider for a physical screening prior to joining a group home. He has no new complaints. The patient has an established diagnosis of cerebral palsy and type 2 diabetes and is currently on his meds. A comprehensive history and examination is performed. The provider counsels the patient on the importance of taking his medication and gives him a prescription for refills. Blood work was ordered. PPD was done and flu vaccine given. Patient already had a vision exam. No abnormal historical facts or finding are noted. What CPT® code is reported? a. 99387 b. 99214 c. 99215 d. 99397 - correct answer --d. 99397 A 28-year-old female patient is returning to her provider's office with complaints of RLQ pain and heartburn with a temperature of 100.2. The provider performs a medically appropriate history and exam. Abdominal ultrasound is ordered and the patient has mild appendicitis. The provider prescribes antibiotics to treat the appendicitis in hopes of avoiding an appendectomy. What are the correct CPT® and ICD-10-CM codes for this encounter? a. 99213, K37, R b. 99202, R10.31, K c. 99203, K d. 99203, R50.9, R12, R10.31, K37 - correct answer --a. 99213, K37, R

A child with suspected sleep apnea was given an apnea monitoring device to use over the next month. The device was capable of recording and storing data relative to heart and respiratory rate and pattern. The pediatric pulmonologist reviewed the data and reported to the child's primary pediatrician. What CPT® code(s) is/are reported for the monitor attachment, download of data, provider review, interpretation and report? 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 Description of procedure: The patient was placed on the operating room table in a sitting position and spinal anesthesia induced. He was placed in the lithotomy position, prepped and draped appropriately. Resection began at the posterior bladder neck and extended to the verumontanum (a crest near the wall of the urethra). Posterior tissue was resected first from the left lateral lobe, then right lateral lobe, then anterior. Depth of resection was carried to the level of the circular fibers. Bleeding vessels were electrocauterized as encountered. Care was taken to not resect distal to the verumontanum, thus protecting the external sphincter. At the end of the procedure, prostatic chips were evacuated from the bladder. Final inspection showed good hemostasis and intact verumontanum. The instruments were removed, Foley - correct answer --d. 52601 Rationale: TURP is a Transurethral Resection of the Prostate and reported with 52601. In the CPT index TURP directs you to see Prostatectomy, Transurethral 52601, 52630. A TURP is not a bilateral procedure and is not reported with modifier 50. Code 52630 is reported when it is done for residual growth of the obstructive prostate tissue. Operative Report PROCEDURE: Left L3-L4 peri-articular paravertebral facet joint injection.PATIENT HISTORY: The patient is a 67-year-old woman referred by Dr. X for repeat diagnostic/therapeutic spinal injection procedure. She is about 1 1/2 years status post lumbar decompression for stenosis. Two weeks ago she underwent an interarticular left L4-L5 paravertebral facet joint injection. She had no relief of symptoms from that injection.TECHNIQUE: The patient was positioned prone and the skin was prepped and draped in the usual sterile fashion. The skin and underlying soft tissues were anesthetized with 3 cc of 1% lidocaine. Due to the advanced degenerative changes, the left L3-L4 paravertebral facet joint could not be distinctly visualized fluoroscopically, despite trying numerous angles. This was explained to the patient who wished to proceed with the injection. A 22-gauge 6-inch spinal needle was advanced toward the - correct answer --d. 64493 Rationale: Nerve block injections are selected based on location and number of levels. Code 64493 is described as a paravertebral facet joint of lumbar spine, single level. This code descriptor includes imaging guidance, and it is not reported separately. In CPT index look for Injections/Paravertebral Facet Joint/Nerve/with image guidance. A patient with a long history of endometriosis has an open surgical approach to perform 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. 49203, 58611, N80.1, N80.2, N80.3, Z30.2 b. 58662, 58600-51, N80.1, N80.2, N80.3, Z30.2 c. 49203, 58671-51, N80.8 d. 49000, 58662-51, 58925-51, 58671-51, N80.1, N80.2, N80.3, Z30.2 - correct answer --a. 49203, 58611, N80.1, N80.2, N80.3, Z30.2 Preoperative Diagnosis: Left orbital cyst, hemangioma versus lymphangioma Postoperative Diagnosis: Left orbital cyst, hemangioma versus lymphangioma Procedures Performed: Aspiration of left orbital cyst with injection of Kenalog Anesthesia: General Complications: None Estimated Blood Loss: Minimal Indications for Procedure: The patient presents with a small cyst of the superior medial left orbit felt to be suggestive for hemangioma versus lymphangioma. Risks, benefits, and alternatives of steroid injection to inactivate the cyst were reviewed. These risks included failure to work and significant visual loss. After discussion, they elected to proceed. Description of Procedure: After informed operative consent was obtained, the patient was brought to the operating room and laid in the supine position. General anesthetic was administered per the anesthesiologist. A 25-gauge needle on a 5-cc syringe was placed within the - correct answer --d. 67415-LT, H05.812 Rationale: The provider aspirated a cyst that was in the left orbit. In the CPT index look for Aspiration/Orbital Contents referring you to code 67415. Code 67500 is reported when there is an injection of a therapeutic or local anesthetic behind the eyeball(retrobulbar). Diagnoses documented as versus are not definitive diagnosis codes and are not coded. The postoperative header indicates and orbital cyst. In the ICD-10-CM alphabetical index look for Cyst/orbit referring you to code H05.81. Verify code in the Tabular List. A 6th character is required to indicate which eye; 2 is reported for the left eye. PROCEDURES PERFORMED:

  1. Bilateral facet joint injections, L4-L5
  2. Bilateral facet joint injections, L5-S1.
  3. Fluoroscopy. TECHNIQUE: The AP view was aligned with the proper tilt so that the end plates for the desired levels were perpendicular. The AP image showed the sacrum and the L5 spinous process. Manual palpation located the sacral hiatus. The 6-inch, 20-gauge needle with a slight volar bend was inserted using fluoroscopy into each facet joint under AP image. The bilateral L4-L5, and L5-S1 facet joints were injected in a systematic fashion from caudal to cranial. A sterile dressing was applied. The patient

tolerated the procedure well with no complications and was transferred to recovery in good condition. What CPT® codes are reported? a. 64493-50 x 2 b. 64493-50, 64494-50-51, 77002-26 c. 64493-50, 64494 x 2, 77002-26 d. 64493-50, 64494 x 2 - correct answer --d. 64493-50, 64494 x 2 A 65-year-old was admitted in the hospital two days ago and is being examined today by his primary care physician, who has been seeing him since he has been admitted. Primary care physician is checking for any improvements or if the condition is worsening. CHIEF COMPLAINT: CHF INTERVAL HISTORY: CHF symptoms worsened since yesterday. Now has some resting dyspnea. HTN remains poorly controlled with systolic pressure running in the 160s. Also, I'm concerned about his CKD, which has worsened, most likely due to cardio-renal syndrome. REVIEW OF SYSTEMS: Positive for orthopnea and one episode of PND. Negative for flank pain, obstructive symptoms or documented exposure to nephrotoxins. PHYSICAL EXAMINATION: GENERAL: Mild respiratory distress at rest VITAL SIGNS: BP 168/84, HR 58, temperature 98.1. LUNGS: Worsening bibasilar crackles CARDIOVASCULAR: RRR, no MRGs. EXTREMITIES: Show worsening lower extremity edema. LABS: BUN 5 - correct answer --d. Subsequent Hospital Visit (99231-99233) Operative Report: Pre-Operative Diagnoses: Basal Cell Carcinoma, forehead Basal Cell Carcinoma, right cheek Suspicious lesion, left nose Suspicious lesion, left forehead Post-Operative Diagnoses: Basal Cell Carcinoma, forehead with clear margins Basal Cell Carcinoma, right cheek with clear margins Compound nevus, left nose with clear margins Epidermal nevus, left forehead with clear margins INDICATIONS FOR SURGERY: The patient is a 47-year-old white man with a biopsy proven basal cell carcinoma of his forehead and a biopsy proven basal cell carcinoma of his right cheek. We were not quite sure of the patient's location of the basal cell carcinoma of the forehead whether it was a midline lesion or lesion to the left. We felt stronger about the midline lesion, so we marked the area for elliptical excision in relaxed skin tension lines of his forehead with gross normal margins of 1-2 mm and I marked the lesion of the le - correct answer --c. C44.319, D22.39

What type of insurance is Medicare Part D? a. Hospital coverage available to all Medicare beneficiaries. b. A Medicare Advantage program managed by private insurers. c. Provider coverage requiring monthly premiums. d. Prescription drug coverage available to all Medicare beneficiaries - correct answer -- d. Prescription drug coverage available to all Medicare beneficiaries HITECH provides a ______ day window during which any violation not due to willful neglect may be corrected without penalty. a. 45 b. 60 c. 30 d. 40 - correct answer --c. 30 The Medicare program is made up of several parts. Which part covers provider fees without the use of a private insurer? a. Part D b. Part C c. Part A d. Part B - correct answer --b. Part C Which CMS product describes whether specific medical items, services, treatment procedures or technologies are considered medically necessary under Medicare? a. Medicare Physician Fee Schedule Final Rule b. Medicare Claims Processing Manual c. National Coverage Determinations Manual d. Relative Value Files - correct answer --c. National Coverage Determinations Manual If an NCD does not exist for a particular service/procedure performed on a Medicare patient, who determines coverage? a. Centers for Medicare & Medicaid Services (CMS) b. Current Procedural Terminology (CPT®) guidelines c. Medicare Administrative Contractor (MAC) d. The physician providing the service - correct answer --c. Medicare Administrative Contractor (MAC) Which does NOT contribute to refraction in the eye? a. Cornea b. Aqueous c. Macula d. Lens - correct answer --c. Macula

Which part of the brain controls blood pressure, heart rate and respiration? a. Cerebellum b. Medulla c. Cerebrum d. Cortex - correct answer --b. Medulla Upon leaving the stomach, nutrients move through the small intestine in what order? a. Duodenum, jejunum, ileum. b. Jejunum, ileum, duodenum c. Jejunum, duodenum, ileum d. Duodenum, ileum, jejunum - correct answer --a. Duodenum, jejunum, ileum. Bone marrow harvesting is a procedure to obtain bone marrow from a donor. Bone marrow collected from a close relative is: a. Autoinfusion b. Allogenic c. Alloplasty d. Autologous - correct answer --b. Allogenic A respiratory disease characterized by overexpansion and destruction of the alveoli is identified as: a. Respiratory distress syndrome b. Emphysema c. Pneumoconiosis d. Cystic fibrosis - correct answer --b. Emphysema The terms malignant, benign, in situ and uncertain behavior are all terms used when coding what? a. Seeds b. Lumps c. Skin rashes d. Neoplasms - correct answer --d. Neoplasms What do brackets [ ] indicate in the ICD-10-CM Alphabetic Index? a. Use the code(s) in brackets first. b. Use the code(s) in brackets in addition to the disease or condition to identity an associated manifestation. c. Use the code(s) in brackets as the only code. d. Do not assign the code in brackets. - correct answer --b. Use the code(s) in brackets in addition to the disease or condition to identity an associated manifestation. What is the ICD-10-CM code for nausea? a. R11.0 b. R11.11 c. T75.3XXA