AAPC CPC Practice Exam A (Just Released), Exams of Medicine

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AAPC CPC Practice Exam A (Just Released)

AAPC CPC Practice Exam A (Just Released) 1: 46-year-old female had a previous biopsy that indicated positive malignant margins anteriorly on the right side of her neck. A 0.5 cm margin was drawn out and a 15 blade scalpel was used for full excision of an 8cm lesion. Layered closure was performed after the removal. The specimen was sent for permanent histopathologic examination. What are the code(s) for this procedure? A. 11626 B. 11626, 12004-51 C. 11626, 12044-51 D. 11626, 13132-51, 13133 2: 30-year-old female is having 15 sq cm debridement performed on an infected ulcer with eschar on the right foot. Using sharp dissection, the ulcer was debrided all the way to down to the bone of the foot. The bone had to be minimally trimmed because of a sharp point at the end of the metatarsal. After debriding the area, there was minimal bleeding because of very poor circulation of the foot. It seems that the toes next to the ulcer may have some involvement and cultures were taken. The area was dressed with sterile saline and dressings and then wrapped. What CPT® code should be reported? A. 11043 B. 11012 C. 11044 D. 11042 4: 52-year-old female has a mass growing on her right flank for several years. It has finally gotten significantly larger and is beginning to bother her. She is brought to the Operating Room for definitive excision. An incision was made directly overlying the mass. The mass was down into the subcutaneous tissue and the surgeon encountered a well encapsulated lipoma approximately 4 centimeters. This was excised primarily bluntly with a few attachments divided with electrocautery. What CPT® should be reported? A. 21932, D17.39 B. 21935, D171 C. 21931, D171 D. 21925, D179 5: PREOPERATIVE DIAGNOSIS: Right scaphoid fracture. TYPE OF PROCEDURE: Open reduction and internal fixation of right scaphoid fracture. DESCRIPTION OF PROCEDURE: The patient was brought to the operating room, anesthesia having been administered. The right upper extremity was prepped and draped in a sterile manner. The limb was elevated, exsanguinated, and a pneumatic arm tourniquet was elevated. An incision was made over the dorsal radial aspect of the right wrist. Skin flaps were elevated. Cutaneous nerve branches were identified and very gently retracted. The interval between the second and third dorsal compartment tendons was identified and entered. The respective tendons were retracted. A dorsal capsulotomy incision was made, and the fracture was visualized. There did not appear to be any type of significant defect at the fracture site. A 0.045 Kirschner wire was then used as a guidewire, extending from the proxi 7: The patient is a 67-year-old gentleman with metastatic colon cancer recently operated on fora brain metastasis, now for placement of an Infuse-A-Port for continued chemotherapy. The left subclavian vein was located with a needle anda guide wire placed. This was confirmed to be in the proper position fluoroscopically. A transverse incision was made just inferior to this and a subcutaneous pocket created just inferior to this. After tunneling, the introducer was placed over the guide wire and the power port line was placed with the introducer and the introducer was peeled away. The tip was placed in the appropriate position under fluoroscopic guidance and the catheter trimmed to the appropriate length and secured to the power port device. The locking mechanism was fully engaged. The port was placed in the subcutaneous pocket and everything sat very nicely fluoroscopically. It was secured to the underlying soft tis 8: A CT scan identified moderate- sized right pleural effusion in a 50- year-old male. This was estimated to be 800 cc in size and had an appearance of fluid on the CT Scan. A needle is used to puncture through the chest tissues and enter the pleural cavity to insert a guidwire. A pigtail catheter is then inserted at the length of the guidwire and fluid was drained under ultrasound guidance using 1% lidocaine as local anesthetic. What procedure code should be used? A. 32557 B: 32555 C. 32556 D. 32550 10: A 52-year-old patient is admitted to the hospital for chronic cholecystitis for which a laparoscopic cholecystectomy will be performed. A transverse infraumbilical incision was made sharply dissecting to the subcutaneous tissue down to the fascia using access under direct vision with a Vesi-Port and a scope was placed into the abdomen. Three other ports were inserted under direct vision. The fundus of the gallbladder was grasped through the lateral port, where multiple adhesions to the gallbladder were taken down sharply and bluntly: The gallbladder appeared chronically inflamed. Dissection was carried out to the right of this identifying a small cystic duct and artery, was clipped twice proximally, once distally and transected. The gallbladder was then taken down from the bed using electrocautery, delivering it into an endo-bag and removing it from the abdominal cavity with the umbilical port. What CPT® and ICD- Il: A 70-year-old female who has a history of symptomatic ventral hernia was advised to undergo laparoscopic evaluation and repair. An incision was made in the epigastrium and dissection was carried down through the subcutaneous tissue. Two 5-mm trocars were placed, one in the left upper quadrant and one in the left lower quadrant and the laparoscope was inserted. Dissection was carried down to the area of the hernia where a small defect was clearly visualized. There was some omentum, which was adhered to the hernia and this was delivered back into the peritoneal cavity. The mesh was tacked on to cover the defect. What procedure code(s) should be used? A. 49560, 49568 B. 49652 C. 49653 D. 49652, 49568 13: 45-year-old male is going to donate his kidney to his son. Operating ports where placed in standard position and the scope was inserted. Dissection of the renal artery and vein was performed isolating the kidney. The kidney was suspended only by the renal artery and vein as well as the ureter. A stapler was used to divide the vein just above the aorta and three clips across the ureter, extracting the kidney. This was placed on ice and sent to the recipient room. The correct CPT °code is: A. 50543 B. 50547 C. 50300 D. 50320 14: 67-year-old female having urinary incontinence with intrinsic sphincter deficiency is having a cystoscopy performed with a placement of a sling. An incision was made over the mid urethra dissected laterally to urethropelvic ligament. Cystoscopy revealed no penetration of the bladder. The edges of the sling were weaved around the junction of the urethra and brought up to the suprapubic incision. A hemostat was then placed between the sling and the urethra, ensuring no tension. What CPT® code(s) should be reported? A. 57288 B. 57287 C. 57288, 52000-51 D. 51992, 52000-51 16: 5-year-old female has a history of post void dribbling. She was found to have extensive labial adhesions, which have been unresponsive to topical medical management. She is brought to the operating suite ina supine position. Under general anesthesia the labia majora is retracted and the granulating chronic adhesions were incised midline both anteriorly and posteriorly. The adherent granulation tissue was excised on either side. What code should be used for this procedure? A. 58660 B. 58740 C. 57061 D. 56441 17: The patient is a 64-year-old female who is undergoing a removal of a previously implanted Medtronic pain pump and catheter due toa possible infection. The back was incised; dissection was carried down to the previously placed catheter. There was evidence of infection with some fat necrosis in which cultures were taken. The intrathecal portion of the catheter was removed. Next the pump pocket was incised and the pump was dissected from the anterior fascia. A 7-mm Blake drain was placed in the pump pocket through a stab incision and secured to the skin with interrupted Prolene. The pump pocket was copiously irrigated with saline and closed in two layers. What are the CPT® and ICD-10-CM codes for this procedure? A. 62365, 62350-51, T85.89XA, Z46.2 B. 62360, 62355-51, T85.79XA C. 62365, 62355-51, T85.79XA D. 36590, 197.42, T85.89XA 20: 2-year-old Hispanic male has a chalazion on both upper and lower lid of the right eye. He was placed under general anesthesia. With an #11 blade the chalazion was incised and a small curette was then used to retrieve any granulomatous material on both lids. A. 67801 B. 67805 C. 67800 D. 67808 21: 80-year-old patient is returning to the gynecologist's office for pessary cleaning. Patient offers no complaints. The nurse removes and cleans the pessary, vagina is swabbed with betadine, and pessory replaced. For F/U in 4 months. What CPT® and ICD-10-CM codes? A. 99201, Z46.89 B. 99211, Z46.89 C. 99202, Z46.9 D. 99212, Z469 22: Patient was in the ER complaining of constipation with nausea and vomiting when taking Zovirax for his herpes zoster and Percocet for pain. His primary care physician came to the ER and admitted him to the hospital for intravenous therapy and management of this problem. His physician documented a detailed history, comprehensive examination and a medical decision making of moderate complexity. Which E/M? A. 99285 B. 99284 C. 99221 D. 99222 23: 20-day-old infant was seen in the ER by the neonatologist admitting the baby to NICU for cyanosis and rapid breathing. The neonatologist performed intubation, ventilation management and a complete echocardiogram in the NICU and provided a report for the echocardiography which did indicate congenital heart disease. Select the correct codes for the physician service. A. 99468-25, 93303-26 B. 99471-25, 31500, 94002, 93303-26 C. 99460-25, 31500, 94002, 93303-26 D. 99291-25, 93303-26