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AAPC CPC FINAL EXAM REAL EXAM 3 LATEST VERSIONS EACH VERSION
CONTAINS 200 QUESTIONS AND CORRECT ANSWERS.
Section 1: Evaluation & Management (E/M) Coding (Questions 1-30) Q1. A 37-year-old female is seen in the clinic for follow-up of lower extremity swelling. HPI: Patient here for follow-up of bilateral lower extremity swelling. The swelling responded to hydrochlorothiazide. DATA REVIEW: I reviewed her CBC lab. EXAM: Patient is in no acute distress. ASSESSMENT: 1. Bilateral lower extremity swelling. This has resolved with diuretics. PLAN: Will order an echocardiogram and kidney function lab test. Refill prescription. Return in 2 months. What E/M code is reported? A. 99212 B. 99213 C. 99214 D. 99215 Correct Answer: A. 99212 *Rationale: This follow-up visit involves a straightforward medical decision making (MDM) level. The patient has one stable chronic problem (swelling
resolved with diuretics). The data reviewed includes a single lab test (CBC). The prescription refill is not considered a new prescription but a continuation. The MDM level is straightforward, corresponding to 99212. According to E/M guidelines, 99212 is appropriate for straightforward MDM with a low level of history and exam .* Q2. In order to use the critical care codes (99291, 99292), which statement is TRUE? A. Critical care services can be provided in an internist's office B. Critical care services provided for more than 15 minutes but less than 30 minutes should be billed with 99291 and modifier 52 C. Time spent reviewing laboratory test results cannot be included in critical care time D. Critical care services are never reported with endotracheal intubation Correct Answer: A. Critical care services can be provided in an internist's office *Rationale: Critical care services can be provided at any site where the patient is critically ill. A minimum of 30 minutes of critical care must be performed to report
- If less than 30 minutes, select the appropriate E/M code. Time spent reviewing lab results, discussing care with staff, and documenting can be included
Q4. A 16-year-old male is brought to the ED after falling off his bicycle. X-ray shows a closed fracture of the ulna. What ICD- 10 - CM codes are reported? A. S52.209A, V18.4XXA, Y92. B. S52.201A, V19.9XXA, Y92. C. S52.201A, V18.0XXA, Y92. D. S52.201A, V18.4XXA, Y92. Correct Answer: C. S52.201A, V18.0XXA, Y92. Rationale: S52.201A is for closed fracture of upper end of right ulna (7th character A for initial encounter). V18.0XXA is for pedal cycle driver injured in noncollision transport accident. Y92.830 is for park as the place of occurrence. The external cause codes are reported for the length of treatment per ICD- 10 - CM guideline I.C.20.a.2 . Q5. A 50-year-old female presents with symptoms of insomnia and upset stomach. The provider suspects she is premenopausal and diagnoses impending menopause. What diagnosis code(s) should be reported? A. E28.
B. G47.00, K
C. N95.9, G47.00, K
D. N95.
Correct Answer: B. G47.00, K Rationale: ICD- 10 - CM guideline I.B.11 states to reference the Alphabetic Index to determine if a condition has a subentry for "impending" or "threatened." If subterms are not listed, code the condition. Impending menopause is not a specific code, so code the symptoms (insomnia G47.00 and upset stomach K30). The symptoms are the reason for the visit . Q6. A 60-year-old patient sustained a comminuted left calcaneal fracture after falling from a ladder. Initial ED treatment consisted of diagnostic radiology and ORIF 9 days later. The patient now presents for cast change. The fracture is healing normally. What ICD- 10 - CM code(s) is/are reported? A. S92.002A B. S92.002A, W11.XXA C. S92.002D D. S92.002D, W11.XXD
(used when pathology is not available). C codes are for malignant neoplasms. The chest mass location is trunk, so D36.7 is appropriate. Q8. A 17-year-old female has a bone marrow biopsy as a potential stem cell donor for her mother who has acute monocytic leukemia (AML). What diagnosis code(s) is/are used for the typing of the stem cell specimens? A. C93.00, Z52. B. Z00. C. Z52.3, C93. D. C93. Correct Answer: B. Z00. Rationale: Z00.6 is for encounter for examination for normal comparison and control in clinical research programs. The patient is a potential donor; she does not have leukemia. The testing is for donor compatibility screening. Z52.3 is for donor of bone marrow, but this code is used when the donor is the actual source (after matching).
Q9. A 5-year-old patient with atrial fibrillation requires insertion of a nontunneled central venous catheter. What CPT® code is reported? A. 36557 B. 36555 C. 36556 D. 00400 Correct Answer: C. 36556 Rationale: 36556 is for insertion of nontunneled centrally inserted central venous catheter, age 5 years or older. Code 36555 is for patients under 5 years. The patient is 5 years old, so 36556 is correct. The anesthesia code (00400) would be reported by the anesthesiologist, not the surgeon. Q10. A patient is having a laparoscopic cholecystectomy with intraoperative cholangiogram. The surgeon includes a separate report with interpretation indicating normal flow with no filling defects. What CPT® codes are reported for the professional services of the surgeon? A. 47562, 74300
Correct Answer: B. 35301, 35390 Rationale: 35301 is for carotid endarterectomy with patch graft. 35390 is for reoperation, carotid, more than 1 month after original operation. The reoperation code is an add-on code to report the increased complexity of a re-do procedure. The patient had a previous endarterectomy one year ago, making this a reoperation . Q12. A 52-year-old female has a 4 cm lipoma excised from her right flank. What CPT® and ICD- 10 - CM codes are reported? A. 21932, D17. B. 21935, D17. C. 21931, D17. D. 21925, D17. Correct Answer: C. 21931, D17. *Rationale: 21931 is for excision of a subcutaneous tumor, trunk, 3-5 cm. The lipoma was 4 cm and located on the flank (trunk). D17.1 is for benign lipomatous
neoplasm of skin and subcutaneous tissue of trunk. D17.9 is unspecified site, which is not appropriate since the site is known .* Q13. A 67-year-old patient with metastatic colon cancer and a brain metastasis is having an Infuse-A-Port placed for chemotherapy. What CPT® code(s) is/are reported? A. 36556, 77001- 26 B. 36560 C. 36561, 77001- 26 D. 36571 Correct Answer: C. 36561, 77001- 26 Rationale: 36561 is for insertion of a tunneled centrally inserted central venous access device with subcutaneous port (port-a-cath) in patients age 5 years or older. 77001-26 is for fluoroscopic guidance for central venous access device placement with professional component. The fluoroscopic guidance is separately reportable when performed .
C. 51990
D. 57287
Correct Answer: A. 57288 Rationale: 57288 is for sling operation for stress incontinence (eg, fascia or synthetic). The procedure described is a mid-urethral sling placement performed via vaginal approach. The cystoscopy is included in the procedure and not separately reported . Q16. An infant with genu valgum undergoes bilateral medial distal femur hemiepiphysiodesis. What CPT® code is reported? A. 27475 B. 27485 C. 27450 D. 27485- 50 Correct Answer: D. 27485- 50
*Rationale: 27485 is for hemiepiphysiodesis, distal femur. Modifier - 50 is added for bilateral procedure. The procedure was performed on both knees, so modifier
- 50 indicates the bilateral nature. The bilateral surgery modifier is appropriate when the same procedure is performed on both sides during the same operative session .* Q17. A 52-year-old patient with chronic cholecystitis undergoes laparoscopic cholecystectomy. What CPT® code is reported? A. 47562 B. 47563 C. 47564 D. 47600 Correct Answer: A. 47562 Rationale: 47562 is for laparoscopic cholecystectomy. Code 47563 includes cholangiography, which was not performed. Code 47564 is for laparoscopic cholecystectomy with exploration of common duct. Code 47600 is for open cholecystectomy. Since no cholangiogram was mentioned and no common duct exploration, 47562 is correct.
A. 32557
B. 32421
C. 32550
D. 32555
Correct Answer: A. 32557 Rationale: 32557 is for pleural drainage, percutaneous, with insertion of indwelling catheter. The procedure described involves a pigtail catheter that remains in the chest connected to a drainage system. This is a tunneled pleural catheter placement for drainage of recurrent effusion. Q20. A patient is admitted for laparoscopic cholecystectomy. The surgeon uses a Vesi-Port and three other ports. The gallbladder is removed without complication. What CPT® code is reported? A. 47562 B. 47563 C. 47564 D. 47605
Correct Answer: A. 47562 Rationale: 47562 is for laparoscopic cholecystectomy. The use of multiple ports is standard for laparoscopic cholecystectomy and not separately coded. No cholangiogram or common duct exploration was performed, so codes 47563 and 47564 are not appropriate. Q21. A patient presents with a blowout fracture of the orbit sustained while playing softball. What is the anatomical location of a blowout fracture? A. Orbit B. Clavicle C. Patella D. Femur Correct Answer: A. Orbit Rationale: A blowout fracture is a fracture of the walls or floor of the orbit. The orbit is the cavity or socket of the skull in which the eye and its appendages are
A. Spine B. Hand C. Male genitalia D. Nasal sinus Correct Answer: A. Spine Rationale: Lordosis is a spinal deformity in which the anterior curvature of the lumbar spine is excessive, also called a "sway back." Lordosis may be caused by tight lower back muscles, obesity, or pregnancy. In ICD- 10 - CM, lordosis is coded to M40.50 under deforming dorsopathies . Q24. A 49-year-old presents with an abscess of the right thumb. The physician incises the abscess and purulent sanguineous fluid is drained. The wound is packed with iodoform packing. What CPT® code is reported? A. 10060-F B. 10061-F C. 26010-F D. 26011-F
Correct Answer: C. 26010-F Rationale: 26010 is for drainage of finger abscess (simple). The documentation indicates a simple incision and drainage (I&D) without mention of complex or extensive undermining. Modifier - F5 is for right hand, thumb. Code 10060 is for I&D of abscess on skin, but finger-specific codes (26010) are more specific and should be used when available . Q25. A 15-year-old underwent placement of a cochlear implant 1 year ago. It now needs to be reprogrammed. What CPT® code is reported for the reprogramming? A. 92602 B. 92604 C. 92603 D. 92601 Correct Answer: B. 92604 *Rationale: In the CPT® Index, look for Cochlear Device/Programming. Code selection is based on the age of the patient and whether it is initial programming
