AAPC CPC FINAL EXAM REAL EXAM 3 LATEST VERSIONS 2024-2025, Exams of Information Technology

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AAPC CPC FINAL EXAM REAL EXAM 3 LATEST

VERSIONS 2024 - 2025

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. Staf f 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 clients. d. All of the above. - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - ANSWER>a. Anterior chamber of the eye What type of code is assigned when the provider documents the reason for a client 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 - ANSWER>c. Z code (Z00-Z99)

What is the ICD- 10 - CM code for hay fever? - ANSWER>J 30. 1 What is the ICD- 10 - CM code for swine flu? a. J10. b. A08. c. J11. d. J09.X2 - 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 - ANSWER>d. N40.1, R33. What diagnosis code(s) is/are reported for behavioral disturbances in a client with early onset Alzheimer's? a. G30.8, F02. b. F02. c. F02.81, G30. d. G30.0, F02.81 - ANSWER>d. G30.0, F02. What is the ICD- 10 - CM code for a client with postoperative anemia due to acute blood loss during the surgery who needs a blood transfusion? a. D64. b. D53. c. D50. d. D62 - 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 stagerenal disease and hypertension. What are the appropriate diagnosis codesfor this encounter? a. I12.0, N18. b. I10, N18. c. I10, N18. d. I12.0 - 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 - ANSWER>d. D17.21, D17. 1 A 33 - year-old client visits his primary care provider to discuss a lap band procedure for his morbid obesity. His caloric intake is in excess of 4, 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 - ANSWER>a. E66.01, Z68. A 58 - year-old client sees the provider for confusion and loss of memory. The provider diagnoses the client 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 - 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 - 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 client 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.

• ANSWER>b. Two codes are assigned when a client 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 - 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 of f the bike. The client'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 - 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 - 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 - ANSWER>a. IT A client 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 - 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 - 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. - 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? - ANSWER> 11765 Rationale: In the CPT® Index, look for Excision/Nail Fold referring you to

A client 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 - ANSWER>a. C44. In ICD- 10 - CM, what type of burn is considered corrosion? - 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 - ANSWER>c. 11750 The client 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 - 51 b. 15877, 15879 - 50 - 51 c. 15830, 15839 - 50 - 51, 15847 d. 15830, 15832 - 50 - 51 - ANSWER>b. 15877, 15879 - 50 - 51

The client 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 - 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 - ANSWER>a. Gustilo classification for open fractures A client 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 - 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 client'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 - 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 - 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 client has a dislocated nursemaid elbow. The ED physician reduces the elbow successfully. The client is able to move his arm again. The client 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. 5 - 54 - LT, S53.194S, Y33.XXXA - ANSWER>c. 24640 - 54 - LT, S53.032A, W50.2XXA What CPT® code is reported for an emergency endotracheal intubation to save the client's life? - ANSWER> 31500 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 client 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 - ANSWER>b. 31603, T17.290A What ICD- 10 - CM code is reported for pyopneumothorax with fistula? - ANSWER>J 86. 0 A client 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 - 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 client 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 - 51 b. 30520, 30140 - 51 c. 30420, 30140 - 51 d. 30620, 30999 - 51 - ANSWER>b. 30520, 30140 - 51 Which main coronary artery bifurcates into two smaller ones?

a. Left b. Right c. Inverted d. Superficial - 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 - 26 c. 36215, 75605 - 26 d. 36221 - 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. - 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 client presents for extremity venous study. Complete noninvasive physiologic studies of both lower extremities were performed. Which CPT®code is reported? - ANSWER> 93970 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. - 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 - 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 - ANSWER>a. K29. A 57 - year-old client 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 - 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 - 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 - 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? - ANSWER> 53445 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 client 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 - ANSWER>a. 51040 - 53 What does the abbreviation VBAC mean? - ANSWER>Vaginal Birth After Cesarean A client 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 - ANSWER>a. O09.893, Z3A. A pregnant client 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 client she has had an abortion. What type of abortion has she had? a. Missed b. Induced c. Spontaneous d. None of the above - 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 - 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 - ANSWER>d) G A client with a status post (after or following) lumbar puncture headache receives an epidural blood patch. The client'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 - ANSWER>a. 62273, G97. What ICD- 10 - CM code is used for spinal meningitis? a. G03. b. A87. c. G04. d. A39.9 - 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 - 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 - ANSWER>c. E11. The provider makes an incision in the client's left tympanic membrane in order to inflate eustachian tubes and aspirate fluid in a client with acute eustachian salpingitis. The procedure is completed without anesthesia. WhatCPT® and ICD- 10 - CM codes are reported? a. 69421, H68. b. 69420, H68. c. 69421, H68. d. 69420, H68.022 - ANSWER>b. 69420, H68. A client 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 - 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 client wished to proceed with surgery. Withuse of the operating microscope, the surgeon performs a left lateral graft tympanoplasty. What CPT® code is reported? - 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 - 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 - ANSWER>d. Z86. A client 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 - ANSWER>a. I25. A client 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 - 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 - ANSWER>d. AD

A client 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 client has a fractured ankle. What CPT® code(s) is/are reported? a. 73600 X 2 b. 73610 c. 73600, 73610 d. 73600 - ANSWER>d. 73600 A 32-year-old client with cervical cancer is in an outclient 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? - ANSWER> 77762 - 26 Response Feedback: Rationale: Client 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 client who may have a stricture of the artery is undergoing an aortogram in which the left femoral artery was cannulated with a catheteradvanced 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 appearnormal. What CPT® codes are reported for the professional component? a. 36200, 75625 - 26 b. 36200, 75805 - 26 c. 36200, 75630 - 26 d. 36200, 75635 - 26 - ANSWER>c. 36200, 75630 - 26 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 - 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 - 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 - 52 b. 85025, 84443, 82040, 82247, 82310, 82374, 82435, 82947, 84075, 84132, 84155, 84295, 84460, 84450, 84520 c. 80050 d. 80050 - 22 - 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 - 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 - 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 - ANSWER>c. Review the code descriptors and examples for the category or subcategory selected.

A 32 - year-old client sees Dr. Smith for a consult at the request of his PCP, Dr. Long, for an ongoing problem with allergies. The client 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 client on allergy management. The MDM is straightforward. The client 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 client 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 - ANSWER>b. 99242 A 75 - year-old established client sees his regular primary care provider for a physical screening prior to joining a group home. He has no new complaints. The client 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 client 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. Client 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 - ANSWER>d. 99397 A 28-year-old female client 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 client 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 - 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 - 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 client 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 - 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 inclient 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 - ANSWER>b. 90870, F43. A client with hypertensive end stage renal failure, stage 5, and secondary hyperparathyroidism is evaluated by the provider and receives peritoneal dialysis. The provider evaluates the client 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 - 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 1.6 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 - ANSWER>a. 33235, 33208 - 51, 33233 - 51 Operative Report PREOPERATIVE DIAGNOSIS:Prolapsed vitreous in anterior chamber with corneal edema POSTOPERATIVE DIAGNOSIS:Same OPERATION PERFORMED:Anterior vitrectomy The client 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 client 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 client is admitted for anterior vitrectomy.PROCEDURE: The client 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, - ANSWER>c. 67010 Operative Report Indications: This is a third follow-up EGD dilation on this 40-year-old client 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 client 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 t - ANSWER>d. 43245, 43239 - 51, K31.1, Z87.11 Benign prostatic hypertrophy with outlet obstruction and hematuria. Operation: TURP Anesthesia: Spinal Description of procedure: The client 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 - 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
52631. 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.CLIENT HISTORY: The client 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 weeksago she underwent an interarticular left L4-L5 paravertebral facet joint injection. She had no relief of symptoms from that injection.TECHNIQUE: Theclient 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 client who wished to proceed with the injection. A 22-gauge 6-inch spinal needle was advanced toward the - 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 client 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 client 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 - 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 client 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 client 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 - 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 client 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