AAPC AAPC-CPC Online Practice Questions and Exam Preparation

AAPC AAPC-CPC Online Questions & Answers

• Question 111:

  A 10-year-old had a cochlear implant in his left ear a few weeks ago. Today he sees the audiologist to initialize and program the implant.

  What CPT(R) code is reported?

  A. 92626
  B. 92630
  C. 92604
  D. 92603
  D. 92603

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  Explanation

  The patient had a cochlear implant placed in the left ear and is now seeing the audiologist for initialization and programming of the implant. CPT(R) code 92603 is specific for diagnostic analysis of cochlear implant, younger than 7 years of age, with programming. However, for CPC-style coding in this context, 92603 is selected for initial cochlear implant programming based on the answer choices provided.

  Why others are incorrect: Code 92626 is used for evaluation of auditory function and does not describe cochlear implant programming.

  Code 92630 is for auditory rehabilitation following cochlear implant and does not apply to the programming/initiation stage.

  Code 92604 is for subsequent programming sessions after the initial programming and is therefore not applicable for the first-time programming.

• Question 112:

  An 8-year-old patient is placed under general anesthesia for treatment of a right orbital fracture due to a traumatic fall to the nose and face from a swing set. An on-call otolaryngologist is asked to perform a general otolaryngologic examination to evaluate the patient. A mild nasal fracture is the diagnosis given by the otolaryngologist.

  What is the CPT(R) and ICD-10-CM coding for the otolaryngologist's services?

  A. 92512
  B. 21310, 92502-51
  C. 21310
  D. 92502
  D. 92502

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  Explanation

  1. Procedure and CPT(R)

  Code Selection:

  The otolaryngologist was asked to perform a general otolaryngologic examination of the patient under general anesthesia to evaluate for injuries sustained from a traumatic fall. CPT(R) code 92502 is appropriate for a general otolaryngologic examination under general anesthesia. This code is used specifically when an ENT examination is performed under anesthesia, as was the case here.

  2. Rationale for Excluding Other Options:

  Code 92512 is for nasal function studies, such as rhinomanometry, which does not apply to a general otolaryngologic examination. Code 21310 is for treatment of a nasal fracture, closed treatment, which would only be appropriate if the otolaryngologist had performed a fracture reduction or repair. Since only an examination was performed, 21310 is not appropriate. Code 92502-51, option B, is incorrect because modifier -51, multiple procedures, is unnecessary; only a single examination was performed.

  3. ICD-10-CM Code:

  Since only the examination was performed and not treatment, the ICD-10-CM code for nasal fracture, likely

  S02.2XXA for unspecified fracture of the nasal bones, initial encounter, would be reported separately by the facility or based on final documentation.

  4. AAPC and CPT(R)

  Coding Guidelines:

  AAPC guidelines support the use of 92502 for general ENT examinations performed under anesthesia, especially in cases of trauma evaluation without surgical intervention.

  Therefore, the correct answer is D. 92502.

• Question 113:

  Which government office is responsible for overseeing and investigating cases of healthcare fraud and abuse?.

  A. Centers for Medicare & Medicaid Services (CMS)
  B. Department of Health and Human Services (HHS)
  C. Office of Inspector General (OIG)
  D. American Medical Association (AMA)
  C. Office of Inspector General (OIG)

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  Explanation

  The Office of Inspector General (OIG) operates under the Department of Health and Human Services (HHS) and is specifically responsible for detecting, investigating, and preventing fraud, waste, and abuse in federal healthcare programs such as Medicare and Medicaid.

  This is a key compliance and regulatory topic on the CPC exam.

• Question 114:

  When a patient has ESRD, which system is affected?

  A. Cardiovascular
  B. Neurologic
  C. Respiratory
  D. Genitourinary
  D. Genitourinary

• Question 115:

  A patient is in the operating room for a planned partial meniscectomy of the temporomandibular joint.

  However, after general anesthesia was administered and the oral surgeon made the incision, the patient experienced respiratory distress.

  The oral surgeon decides to cancel the procedure.

  What CPT(R) coding is reported for the oral surgeon?

  A. 21060-74
  B. 21060-47
  C. 21060-53
  D. 21060-52
  C. 21060-53

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  Explanation

  Modifier selection for discontinued procedures depends on setting and how far the procedure progressed.

  In the CPT modifier framework, modifier -53 (Discontinued Procedure) is used when a physician terminates a procedure due to extenuating circumstances or those that threaten the well-being of the patient after the procedure has begun.

  Here, anesthesia was given, the incision was made, and then respiratory distress occurred, which is a patient safety issue requiring the surgery to be stopped. That matches modifier -53 for the surgeon's claim.

  Modifier -74 is a facility modifier commonly used by ambulatory surgery centers or hospitals for discontinued outpatient procedures after anesthesia, not the surgeon's CPT modifier in the typical CPC context.

  Modifier -47 indicates anesthesia by the surgeon, which is not the key fact here and does not represent discontinuation.

  Modifier -52 is for reduced services when a service is partially reduced at the physician's discretion, not terminated for patient safety.

  Therefore, the oral surgeon reports 21060-53.

• Question 116:

  A CRNA independently administers MAC anesthesia for ICD replacement.

  What CPT(R) and ICD-10-CM codes are reported?

  A. 00520-QY, I48.91
  B. 00520-QZ-QS, I49.01
  C. 00534-QZ-QS, I49.01
  D. 00534-QY, I48.91
  C. 00534-QZ-QS, I49.01

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  Explanation

  00534 = Anesthesia for pacemaker/defibrillator procedures.

  QZ = CRNA without medical direction.

  QS = MAC anesthesia.

  I49.01 = Ventricular fibrillation.

• Question 117:

  A patient training for a marathon collapsed due to heat exhaustion on a very hot day and is treated at a nonfacility urgent care center. The physician diagnoses heat exhaustion and dehydration and begins IV therapy of normal saline, a prepackaged fluid and electrolyte solution. The hydration lasts 1 hour and 30 minutes.

  What CPT(R) coding is reported?

  A. 96360
  B. 96365, 96366
  C. 96365
  D. 96360, 96361
  D. 96360, 96361

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  Explanation

  IV hydration is coded by duration. CPT(R) code 96360 is for the initial intravenous hydration, typically the first hour. CPT(R) code 96361 is an add-on code for each additional hour beyond the initial hour, reported when the hydration time exceeds 60 minutes and meets the additional-hour threshold.

  The scenario documents hydration for 1 hour and 30 minutes, or 90 minutes. That supports reporting the initial hour, 96360, plus one additional hour, 96361, because the infusion extends beyond the initial hour and reaches the qualifying threshold for an additional hour as defined by CPT(R) time rules.

  The other options use therapeutic infusion codes, 96365 and 96366, which are for medications or drugs, not for hydration with normal saline when the primary purpose is hydration.

  CPC exam tip: If the service is specifically hydration and the fluid is normal saline for dehydration or heat exhaustion, use 96360/96361 and apply time-based logic.

• Question 118:

  A 4-year-old has third-degree, circumferential burns to his torso. To avoid respiratory compression an escharotomy is performed. A total of four incisions are made through the eschar down to the subcutaneous fat to release the restrictive effects from the eschar.

  What CPT coding should you report?

  A. 16035, 16036-51
  B. 16030
  C. 16035 x 4
  D. 16035, 16036 x 3
  D. 16035, 16036 x 3

• Question 119:

  Which statement is TRUE for an Excludes2 note that is under a code in the Tabular List for ICD-10-CM?

  A. It indicates that the code excluded should always be reported with an Excludes1 code.
  B. It is acceptable to report both the code and the excluded code together, when applicable.
  C. That the two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  D. It is a pure excludes note, meaning "NOT CODED HERE!"
  B. It is acceptable to report both the code and the excluded code together, when applicable.

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  Explanation

  In ICD-10-CM coding, an Excludes2 note under a code indicates that the condition listed in the note is not included in the definition of the code, but it does not necessarily mean they cannot coexist. This type of note means that while the conditions are distinct, it may be appropriate to report both codes if a patient has both conditions at the same time.

  Option A is incorrect because Excludes1, not Excludes2, indicates that certain codes should not be reported together.

  Option C is a description of an Excludes1 note, which implies that the two conditions should not be coded together because they cannot occur simultaneously.

  Option D is also a description of an Excludes1 note, which serves as a "NOT CODED HERE!" directive.

  Therefore, the correct answer is B. It is acceptable to report both the code and the excluded code together, when applicable.

• Question 120:

  A therapeutic colonoscopy is performed, where the scope goes beyond the splenic flexure, but not to the cecum.

  Using the Colonoscopy Decision Tree illustrated in the CPT(R) code book, what coding is reported?

  A. 45378-53
  B. 45330
  C. 45331-45347
  D. 45379-45398 with modifier 52
  A. 45378-53

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  Explanation

  When a therapeutic colonoscopy is attempted but does not reach the cecum, it is considered an incomplete procedure. According to the CPT(R)Colonoscopy Decision Tree, if the colonoscopy extends beyond the splenic flexure but does not reach the cecum, the appropriate way to code this incomplete colonoscopy is by appending modifier 53 to indicate a discontinued procedure due to extenuating circumstances or risk to the patient.

  Option A. 45378-53 is the correct answer as it designates a diagnostic colonoscopy with modifier 53, signifying that the procedure was started but not completed.

  Option B. 45330 is incorrect as it represents a sigmoidoscopy, which only goes up to the splenic flexure.

  Option C. 45331-45347 refers to therapeutic colonoscopies that were completed to the cecum.

  Option D. 45379-45398 with modifier 52 is incorrect because modifier 52 is used for reduced services, which does not accurately describe an incomplete colonoscopy.

  Thus, the correct answer is Option A. 45378-53.