Download AAPC CPC Practice Questions and more Exams Health psychology in PDF only on Docsity!
AAPC CPC Practice Questions
A 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 8 cm lesion. Layered closure was performed after the removal. The specimen was sent for permanent histopathologic examination. What are the CPT® code(s) for this procedure? A. 11626 B. 11626, 12004- C. 11626, 12044- D. 11626, 13132-51, 13133 C. 11626, 12044- A 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 C. 11044 A 64-year-old female who has multiple sclerosis fell from her walker and landed on a glass table. She lacerated her forehead, cheek and chin and the total length of these lacerations was 6 cm. Her right arm and left leg had deep cuts measuring 5 cm on each extremity. Her right hand and right foot had a total of 3 cm lacerations. The ED physician repaired the lacerations as follows: The forehead, cheek, and chin had debridement and cleaning of glass debris with the lacerations being closed with one layer closure, 6- Prolene sutures. The arm and leg were repaired by layered closure, 6-0 Vicryl subcutaneous sutures and Prolene sutures on the skin. The hand and foot
were closed with adhesive strips. Select the appropriate procedure codes for this visit. A. 99283-25, 12014, 12034-59, 12002-59, 11042- B. 99283-25, 12053, 12034-59, 12002- C. 99283-25, 12014, 12034-59, 11042- D. 99283-25, 12053, 12034- D. 99283-25, 12053, 12034- A 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® and ICD-10-CM codes are reported? A. 21932, D17. B. 21935, D17. C. 21931, D17. D. 21925, D17. C. 21931, D17. Question 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 proximal pole of the scaphoid distal ward. The guidewire was positioned appropriately and then measured. A 25-mm Acutrak® drill bit was drilled to 25 mm. A 22.5-mm screw was selected and inserted and rigid internal fixation was accomplished in this fashion. This was visualized under the OEC imaging device in multiple
C. 36561, 77001-
D. 36571
C. 36561, 77001-
Question 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 guidewire under ultrasound guidance. A pigtail catheter is then inserted at the length of the guidewire and secured by stitches. The catheter will remain in the chest and is connected to drainage system to drain the accumulated fluid. The CPT® code is: A. 32557 B. 32555 C. 32556 D. 32550 A. 32557 The patient is a 59-year-old white male who underwent carotid endarterectomy for symptomatic left carotid stenosis a year ago. A carotid CT angiogram showed a recurrent 90% left internal carotid artery stenosis extending into the common carotid artery. He is taken to the operating room for re-do left carotid endarterectomy. The left neck was prepped and the previous incision was carefully reopened. Using sharp dissection, the common carotid artery and its branches were dissected free. The patient was systematically heparinized and after a few minutes, clamps were applied to the common carotid artery and its branches. A longitudinal arteriotomy was carried out with findings of extensive layering of intimal hyperplasia with no evidence of recurrent atherosclerosis. A silastic balloon-tip shunt was inserted first proximally and then distally, with restoration of flow. Several layers of intima were removed and the endarterectomized surfaces irrigated with heparinized saline. An oval Dacron patch was then sewn into place with running 6-0 Prolene. Which CPT® code(s) is/are reported? A. 35301 B. 35301, 35390 C. 35302 D. 35311, 35390 B. 35301, 35390
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-10-CM codes are reported? A. 47564, K81. B. 47562, K81. C. 47610, K81. D. 47600, K81. B. 47562, K81. 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) is (are) reported? A. 49560, 49568 B. 49652 C. 49653 D. 49652, 49568 B. 49652 The patient is a 50-year-old gentleman who presented to the emergency room with signs and symptoms of acute appendicitis with possible rupture. He has been brought to the operating room. An infraumbilical incision was made which a 5-mm VersaStep™ trocar was inserted. A 5-mm 0- degree laparoscope was introduced. A second 5-mm trocar was placed
the foreskin. Foreskin was pulled back and the excess foreskin was taken off and the two raw skin surfaces were sutured together to create a circumferential anastomosis. Select the appropriate code for this surgery: A. 54150 B. 54160 C. 54163 D. 54164 C. 54163 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 in a 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 D. 56441 The patient is a 64 year-old female who is undergoing a removal of a previously implanted Medtronic pain pump and catheter due to a 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, T85.898A, Z46. B. 62360, 62355-51, T85.79XA C. 62365, 62355-51, T85.79XA D. 36590, I97.42, T85.898A C. 62365, 62355-51, T85.79XA The patient is a 73 year-old gentleman who was noted to have progressive gait instability over the past several months. Magnetic resonance imaging
demonstrated a ventriculomegaly. It was recommended that the patient proceed forward with right frontal ventriculoperitoneal shunt placement with Codman® programmable valve. What is the correct code for this surgery? A. 62220 B. 62223 C. 62190 D. 62192 B. 62223 What is the CPT® code for the decompression of the median nerve found in the space in the wrist on the palmar side? A. 64704 B. 64713 C. 64721 D. 64719 C. 64721 A 2-year-old male has a chalazion on both upper and lower lid of the right eye. He was placed under general anesthesia. With a #11 blade the chalazion was incised and a small curette was then used to retrieve any granulomatous material on both lids. What CPT® code should be used for this procedure? A. 67801 B. 67805 C. 67800 D. 67808 D. 67808 An 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 pessary replaced. For F/U in 4 months. What CPT® and ICD-10-CM codes are reported for this service? A. 99201, Z46. B. 99211, Z46. C. 99202, Z46. D. 99212, Z46. B. 99211, Z46. 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
A 10-month-old child is taken to the operating room for removal of a laryngeal mass. What is (are) the appropriate anesthesia code(s) to report? A. 00320 B. 00326 C. 00320, 99100 D. 00326, 99100 B. 00326 A catheter is placed in the left common femoral artery which was directed into the right the external iliac (antegrade). Dye was injected and a right lower extremity angiogram was performed which revealed patency of the common femoral and profunda femoris. The catheter was then manipulated into the superficial femoral artery (retrograde) in which a lower extremity angiogram was performed which revealed occlusion from the popliteal to the tibioperoneal artery. What are the procedure codes that describe this procedure? A. 36217, 75736- B. 36247, 75716- C. 36217, 75756- D. 36247, 75710- D. 36247, 75710- 56-year-old female is having a bilateral mammogram with computer aid detection conducted as a screening because the patient has a family history of breast cancer. She does not presently have signs or symptoms of breast disease. What radiological services are reported? A. 77065 x 2 B. 77065, 77066 C. 77067 D. 77066 C. 77067 A 63-year-old patient with bilateral ureteral obstruction presents to an outpatient facility for placement of a right and left ureteral stent along with an interpretation of a retrograde pyelogram. What codes should be reported? A. 52332, 74425 B. 52332-50, 74420- C. 52005, 74420 D. 52005-50, 74425-
B. 52332-50, 74420-
Patient is coming in for a pathological examination for ischemia in the left leg. The first specimen is 1.5 cm of a single portion of arterial plaque taken from the left common femoral artery. The second specimen is 8.5 x 2.7 cm across x 1.5 cm in thickness of a cutaneous ulceration with fibropurulent material on the left leg. What surgical pathology codes should be reported for the pathologist? A. 88304-26, 88302- B. 88305-26, 88304- C. 88307-26, 88305- D. 88309-26, 88307- B. 88305-26, 88304- During a craniectomy the surgeon asked for a consult and sent a frozen section of a large piece of tumor and sent it to pathology. The pathologist received a rubbery pinkish tan tissue measuring in aggregate 3 x 0.8 x 0. cm. The entire specimen is submitted in one block and also a gross and microscopic examination was performed on the tissue. The frozen section and the pathology report are sent back to the surgeon indicating that the tumor was a medulloblastoma. What CPT® code(s) will the pathologist report? A. 80500 B. 88331-26, 88307- C. 80502 D. 88331-26, 88332-26, 88304- B. 88331-26, 88307- Physician orders a basic (80047) and comprehensive metabolic (80053) panels. Select the code(s) on how this is reported. A. 80053, 80047 B. 80053 C. 80047, 82040, 82247, 82310, 84075, 84155, 84460, 84450 D. 80053, 82330 D. 80053, 82330 A 4-year-old is getting over his cold and will be getting three immunizations in the pediatrician's office by the nurse. The first vaccination administered is the Polio vaccine intramuscularly. The next vaccination is the live influenza (LAIV3) administered in the nose. The last vaccination is the Varicella (live)
C. 92520-
What is the difference between entropion and ectropion? A. Entropion is the inward turning of the eyelid and ectropion is the outward turning of the eyelid. B. Entropion is facial droop and ectropion is a facial spasm. C. Entropion is the outward turning of the hands and ectropion is the inward turning of the hands. D. Entropion inward turning of the feet and ectropion is the outward turning of the feet due to muscle disorder. A. Entropion is the inward turning of the eyelid and ectropion is the outward turning of the eyelid. What is the full CPT® code description for 00846? A. Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy B. Radical hysterectomy C. Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified radical hysterectomy D. Radical hysterectomy not otherwise specified A. Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy Ventral, umbilical, spigelian and incisional are types of: A. Surgical approaches B. Hernias C. Organs found in the digestive system D. Cardiac catheterizations B. Hernias Fracturing the acetabulum involves what area? A. Skull B. Shoulder C. Pelvis D. Leg C. Pelvis When a patient is having a tenotomy performed on the abductor hallucis muscle, where is this muscle located? A. Foot
B. Upper Arm C. Upper Leg D. Hand A. Foot A 44-year-old had a history of adenocarcinoma of the cervix on a conization in March 20XX who has been followed with twice-yearly endocervical curettages and Pap smears that were all negative for two years, per the recommendation of a GYN oncologist. Her Pap smear results from the last visit noted atypical glandular cells. In light of this, she underwent a colposcopy and the biopsy of the normal-appearing cervix on colposcopy was benign. The endocervical curettage was benign endocervical glands, and the endometrial sampling was benign endometrium. In light of the fact that she had had previous atypical glandular cells that led to diagnosis of adenocarcinoma and the concerns that this may have recurred, she had been recommended for a cone biopsy and fractional dilatation and curettage, which she is undergoing today. What ICD-10-CM code(s) should be reported? A. R87.619, C53. B. C C. R87.619, Z85. D. Z12.4, Z85. C. R87.619, Z85. Patient comes into see her primary care physician for a productive cough and shortness of breath. The physician takes a chest X-ray which indicates the patient has double pneumonia. Select the ICD-10-CM code(s) for this visit. A. J18.9, R05, R06. B. R05, R06.2, J18. C. J18. D. J15. C. J18. What is the correct way to code a patient having bradycardia due to Demerol that was correctly prescribed and properly administered? A. T40.2X1A, R00. B. T40.2X3A, R00. C. R00.1, T40.2X5A D. R00.1, T40.2X2A C. R00.1, T40.2X5A
D. When assigning codes for diabetes and its associated condition(s), the code(s) from category E08-E13 are not reported as a primary code. A. If the type of diabetes mellitus is not documented in the medical record the default type is E11.- Type 2 diabetes mellitus. Which statement is TRUE for reporting external cause codes of morbidity (V00-Y99)? A. All external cause codes do not require a seventh character. B. Only report one external cause code to fully explain each cause. C. Report code Y92.9 if the place of occurrence is not stated. D. External cause codes should never be sequenced as a first-listed or primary code D. External cause codes should never be sequenced as a first-listed or primary code PRE OP DIAGNOSIS: Left Breast Abnormal MMG or Palpable Mass; Other Disorders of Breast PROCEDURE: Automated Stereotactic Biopsy Left Breast FINDINGS: Lesion is located in the lateral region, just at or below the level of the nipple on the 90 degree lateral view. There is a subglandular implant in place. I discussed the procedure with the patient today including risks, benefits and alternatives. Specifically discussed was the fact that the implant would be displaced out of the way during this biopsy procedure. Possibility of injury to the implant was discussed with the patient. Patient has signed the consent form and wishes to proceed with the biopsy. The patient was placed prone on the stereotactic table; the left breast was then imaged from the inferior approach. The lesion of interest is in the anterior portion of the breast away from the implant which was displaced back toward the chest wall. After imaging was obtained and stereotactic guidance used to target coordinates for the biopsy, the left breast was prepped with Betadine. 1% lidocaine was injected subcutaneously for local anesthetic. Additional lidocaine with epinephrine was then injected through the indwelling needle. The SenoRx needle was then placed into the area of interest. Under stereotactic guidance we obtained 9 core biopsy samples using vacuum and cutting technique. The specimen radiograph confirmed representative sample of calcification was removed. The tissue marking clip was deployed into the biopsy cavity successfully. This was confirmed by final stereotactic digital image and confirmed by post core biopsy mammogram left breast. The clip is visualized projecting over the lateral anterior left breast in satisfactory position. No obvious calcium is visible on the final post core biopsy image in the area of interest. The patient tolerated the procedure well. There were no apparent
complications. The biopsy site was dressed with Steri-Strips, bandage and ice pack in the usual manner. The patient did receive written and verbal post- biopsy instructions. The patient left our department in good condition. IMPRESSION: 1. SUCCESSFUL STEREOTACTIC CORE BIOPSY OF LEFT BREAST CALCIFICATIONS. 2. SUCCESSFUL DEPLOYMENT OF THE TISSUE MARKING CLIP INTO THE BIOPSY CAVITY 3. PATIENT LEFT OUR DEPARTMENT IN GOOD CONDITION TODAY WITH POST-BIOPSY INSTRUCTIONS. 4. PATHOLOGY REPORT IS PENDING; AN ADDENDUM WILL BE ISSUED AFTER WE RECEIVE THE PATHOLOGY REPORT. What is (are) the CPT® code(s)? A. 19081 B. 19283 C. 19081, 19283 D. 19100, 19283 A. 19081 A 53-year-old male is in the dermatologist's office for removal of 2 lesions located on his lower lip and nose. Lesions were identified and marked. The lower lip lesion of 4 mm in size was shaved to the level of the superficial dermis. Utilizing a 3-mm punch, a biopsy was taken of the left supratip nasal area. What are the CPT® codes for these procedures? A. 40490, 11104- B. 11310, 11104- C. 17000, 17003 D. 11440, 11105- B. 11310, 11104- A 76-year-old has dermatochalasis on bilateral upper eyelids. A blepharoplasty will be performed on the eyelids. A lower incision line was marked at approximately 5 mm above the lid margin along the crease. Then using a pinch test with forceps the amount of skin to be resected was determined and marked. An elliptical incision was performed on the left eyelid and the skin was excised. In a similar fashion the same procedure was performed on the right eye. The wounds were closed with sutures. The correct CPT® code(s) is/are? A. 15822, 15823- B. 15823- C. 15822- D. 15820-LT, 15820-RT
C. 22630, 22632 x 2, 22842, 20938, 20930 PREOPERATIVE DIAGNOSIS: Displaced impacted Colles fracture, left distal radius and ulna. POSTOPERATIVE DIAGNOSIS: Displaced impacted Colles fracture, left distal radius and ulna. OPERATIVE PROCEDURE: Reduction with application of an external fixation system, left wrist fracture FINDINGS: The patient is a 46 year-old right-hand-dominant female who fell off stairs 4 to 5 days ago sustaining an impacted distal radius fracture with possible intraarticular component and an associated ulnar styloid fracture. Today in surgery, fracture was reduced anatomically and an external fixation system was applied. PROCEDURE: Under satisfactory general anesthesia, the fracture was manipulated and C-arm images were checked. The left upper extremity was prepped and draped in the usual sterile orthopedic fashion. Two small incisions were made over the second metacarpal and after removing soft tissues including tendinous structures out of the way, drawing was carried out and blunt-tipped pins were placed for the EBI external fixator. The frame was next placed and the site for the proximal pins was chosen. Small incision was made. Subcutaneous tissues were carried out of the way. The pin guide was placed and 2 holes were drilled and blunt-tipped pins placed. Fixator was assembled. C-arm images were checked. Fracture reduction appeared to be anatomic. Suturing was carried out where needed with 4-0 Vicryl interrupted subcutaneous and 4-0 nylon interrupted sutures. Sterile dressings were applied. Vascular supply was noted to be satisfactory. Final frame tightening was carried out. What CPT® code(s) is/are reported? A. 25600-LT, 20692- B. 25605- LT, 20690- C. 25606-LT D. 25607-LT B. 25605- LT, 20690- A 79-year-old male with symptomatic bradycardia and syncope is taken to the Operating Suite where an insertion of a DDD pacemaker will be performed. After the anesthesiologist provided moderate sedation, the cardiologist performed a left subclavian venipuncture was carried out. A guide wire was passed through the needle, and the needle was withdrawn. A second subclavian venipuncture was performed, a second guide wire was passed and the second needle was withdrawn. An oblique incision in the deltopectoral area incorporating the wire exit sites. A subcutaneous pocket was created with the cautery on the pectoralis fascia. An introducer dilator was passed over the first wire and the wire and dilator were withdrawn. A
ventricular lead was passed through the introducer, and the introducer was broken away in the routine fashion. A second introducer dilator was passed over the second guide wire and the wire and dilator were withdrawn. An atrial lead was passed through the introducer and the introducer was broken away in the routine fashion. Each of the leads were sutured down to the chest wall with two 2-0 silk sutures each, connected the leads to the generator, curled the leads, and the generator was placed in the pocket. We assured hemostasis. We assured good position with the fluoroscopy. What CPT® code(s) is (are) reported by the cardiologist? A. 33208 B. 33212 C. 33226 D. 33235, 71090- A. 33208 Patient has lung cancer in his upper right and middle lobes. Patient is in the operating suite to have a video-assisted thorascopy surgery (VATS). A 10- mm-zero-degree thoracoscope is inserted in the right pleural cavity through a port site placed in the ninth and seventh intercostal spaces. Lung was deflated. The tumor is in the right pleural. Both lobes were removed thorascopically. Port site closed. A chest tube was placed to suction and patient was sent to recovery in stable condition. Which CPT® code is reported for this procedure? A. 32482 B. 32484 C. 32670 D. 32671 C. 32670 The patient is a 58-year-old white male, one month status post pneumonectomy. He had a post pneumonectomy empyema treated with a tunneled cuffed pleural catheter which has been draining the cavity for one month with clear drainage. He has had no evidence of a block or pleural fistula. Therefore a planned return to surgery results in the removal of the catheter. The correct CPT® code is: A. 32440- B. 32035-
