AAPC AAPC-CPC Online Practice Questions and Exam Preparation

AAPC AAPC-CPC Online Questions & Answers

• Question 141:

  A 35-year-old is coming in for trigger point injections for right-sided thoracic spine pain. Four points are injected with Depo-Medrol 40 mg/mL on the rhomboid major and rhomboid minor muscles under ultrasonic guidance.

  Which CPT coding is reported for the injections?

  A. 20552, 76942
  B. 20552 x 4, 76942
  C. 20606
  D. 20553
  B. 20552 x 4, 76942

• Question 142:

  A patient undergoes an MRI of the lumbar spine without and with contrast for left-sided low back pain with sciatica.

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

  A. 72148, 72149, M54.42, M54.50
  B. 72148, 72149, M54.42
  C. 72158, M54.42, M54.50
  D. 72158, M54.42
  D. 72158, M54.42

  ---

  Explanation

  72158 = MRI lumbar spine without and with contrast.

  M54.42 = Lumbago with sciatica, left side.

  Do not code redundant unspecified low back pain.

• Question 143:

  Which HCPCS Level II codes identify temporary services that would not be assigned a CPT(R) code but are needed for claims processing purposes?

  A. K codes
  B. T codes
  C. G codes
  D. Q codes
  D. Q codes

  ---

  Explanation

  Q codes are temporary HCPCS Level II codes used to identify services, procedures, or supplies that do not have permanent CPT(R) codes but are needed for claims processing purposes.

• Question 144:

  A 14-month-old male with a unilateral complete cleft lip and alveolar cleft palate had prior repair of the cleft lip. He now presents for reconstruction of the palate with closing the fissure in the soft tissue of the alveolar ridge with bone graft.

  What CPT(R) coding is reported?

  A. 42200, 20900
  B. 42210, 20900
  C. 42205
  D. 42210
  D. 42210

  ---

  Explanation

  This scenario describes a palatoplasty, repair of cleft palate, with closure of the alveolar ridge using a bone graft. CPT code 42210 is the code that captures palatoplasty with closure of the alveolar ridge and associated bone grafting work as part of the reconstructive procedure described. Because the bone graft is part of the defined palatoplasty service in this code concept, you do not separately report a generic bone graft harvesting code such as 20900 in the way the answer options suggest. The distractor 42200 is associated with a more limited palate repair, not matching the alveolar ridge closure with graft detail, and 42205 does not reflect the specific alveolar ridge closure with bone grafting described in the question stem.

  CPC exam strategy: identify the most comprehensive cleft palate repair that matches the documentation;

  when a CPT code description includes the specific additional work, like alveolar ridge closure with graft, code that single comprehensive service.

• Question 145:

  Patient has a 5 cm tumor in the left lower quadrant abdominal wall. A horizontal skin incision is made directly over the tumor in the patient's left lower quadrant, and dissection is carried down through the dermis and subcutaneous tissue. The tumor is located and completely excised using electrocautery. The specimen is sent immediately to pathology to rule out cancer.

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

  A. 22901, C76.2
  B. 22902, D49.2
  C. 22901, D49.2
  D. 22903, R19.04
  B. 22902, D49.2

  ---

  Explanation

  Procedure and CPT(R) code

  Selection: The scenario describes the excision of a 5 cm tumor located in the left lower quadrant of the abdominal wall. The tumor was excised through the dermis and subcutaneous tissue and removed using electrocautery.

  Code 22902 is appropriate for the excision of a soft tissue tumor of the abdominal wall, subcutaneous, 3 cm or greater.

  Code 22901 is for radical resection of a tumor of the abdominal wall and is not supported by the documentation.

  Code 22903 applies to excision of a soft tissue tumor of the abdominal wall, subfascial, less than 5 cm, which does not apply because this tumor is documented in the subcutaneous tissue.

  Code 22904 would apply to subfascial abdominal wall tumors 5 cm or greater, but subfascial location is not documented.

  Diagnosis and ICD-10-CM Code Selection: ICD-10-CM Code D49.2 is used for a neoplasm of unspecified behavior of bone, soft tissue, and skin, reflecting that the pathology report is pending to determine if the tumor is malignant.

  Code C76.2 would be incorrect because it is for malignant neoplasm of abdomen, which cannot be confirmed based on the initial excision. R19.04 is a symptom/sign code for left lower quadrant abdominal swelling, mass, and lump and is not appropriate when a neoplasm code is available.

  AAPC and CPT(R) coding

  Guidelines: Per AAPC coding guidelines, the size and depth of the tumor are critical in selecting the correct excision code for abdominal wall neoplasms. Additionally, if the tumor's pathology is not confirmed as malignant, it is coded as a neoplasm of unspecified behavior until further details are known.

  Therefore, based on CPT(R) and ICD-10-CM coding guidelines, the verified answer is B. 22902, D49.2.

• Question 146:

  A 32-year-old is in the outpatient clinic for an esophagoscopy due to increased difficulty swallowing with his eosinophilic esophagitis. The flexible scope is inserted into the esophagus. Examination notes narrowing in the distal esophagus. Following an injection of Kenalog, a transendoscopic balloon dilation is performed in the area of stenosis, eventually reaching 18 mm.

  What CPT(R) coding is reported for this procedure?

  A. 43220, 43204
  B. 43214, 43201
  C. 43220, 43201
  D. 43220, 43200-59
  C. 43220, 43201

  ---

  Explanation

  This encounter includes two reportable endoscopic services: esophagoscopy with dilation and a submucosal injection performed via the endoscope. Balloon dilation of an esophageal stricture/stenosis performed transendoscopically is captured by 43220 (esophagoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus). The scenario also documents an injection of Kenalog delivered endoscopically to the stenotic area; endoscopic injection is reported with 43201 (esophagoscopy with directed submucosal injection[s]). These services are not mutually exclusive when both are performed and documented, and no separate diagnostic-only esophagoscopy code is reported because the therapeutic codes include the scope.

  Option D is incorrect because 43200 is the base diagnostic esophagoscopy and should not be reported in addition to the therapeutic dilation; modifier -59 does not override that bundling.

  Options A and B include codes that do not match the described esophagoscopy balloon dilation plus injection combination.

  Therefore, 43220 and 43201 are correct.

• Question 147:

  Patient had polyps removed on a previous colonoscopy. The patient returns three months later for a follow-up examination for another colonoscopy. No new polyps are seen.

  What diagnosis coding is reported for the second colonoscopy?

  A. Z09, Z86.010
  B. K63.5
  C. Z86.010, K63.5
  D. Z09, K63.5
  D. Z09, K63.5

• Question 148:

  A patient with jaundice was seen by the physician to obtain liver biopsies. A needle biopsy was taken using CT guidance for needle placement. The physician obtained two core biopsies, which were then sent to pathology.

  What CPT(R) codes are reported?

  A. 47001, 76942
  B. 47000, 77002
  C. 47000, 47001, 77012
  D. 47000,77012
  D. 47000,77012

  ---

  Explanation

  Procedure and Code Selection:

  The procedure performed is a percutaneous needle biopsy of the liver with CT guidance. CPT 47000 accurately represents a percutaneous liver biopsy and includes all biopsy passes performed during the same session; therefore, obtaining multiple core samples does not warrant additional biopsy codes.

  CT imaging guidance for needle placement is separately reportable using CPT 77012. This code specifically describes CT guidance for needle placement and is appropriate when CT is used to localize and guide the biopsy.

  Exclusion of Other Codes: CPT 47001 is an add-on code used only when a liver biopsy is performed in conjunction with another primary surgical procedure (e.g., open or laparoscopic surgery). It is not applicable to a standalone percutaneous biopsy.

  CPT 76942 represents ultrasound guidance for needle placement and is not appropriate when CT guidance is documented.

  CPT 77002 represents fluoroscopic guidance and is likewise incorrect when CT guidance is used.

  Coding Guidelines:

  According to CPT and AAPC guidelines, imaging guidance for needle placement may be reported separately when it is not inherently included in the primary procedure and when properly documented. CPT 47000 does not include imaging guidance; therefore, CPT 77012 is appropriately reported in addition.

  Final Answer:

  47000, 77012

• Question 149:

  An ED provider evaluates a patient with NSTEMI, consults cardiology, and the patient is admitted for PCI.

  What E/M service and ICD-10-CM coding is reported by the ED provider?

  A. 99284, I21.4, R07.9
  B. 99254, I21.4, R07.9
  C. 99285, I21.4
  D. 99255, I21.4
  C. 99285, I21.4

  ---

  Explanation

  99285 = High-complexity ED visit.

  I21.4 = NSTEMI.

  Chest pain symptoms are not coded once MI is diagnosed.

• Question 150:

  A 52-year-old male patient with known AIDS saw his orthopedic physician today for severe pain in the right knee. The physician documents that his knee pain is due to a flare-up of post-traumatic osteoarthritis, and he gives him a cortisone injection in the right knee joint. The osteoarthritis is not related to AIDS.

  What ICD-10-CM codes are reported for this encounter?

  A. B20, M17.31
  B. Z21, M08.861
  C. M17.11, B20
  D. M17.31, B20
  D. M17.31, B20

  ---

  Explanation

  The encounter is for severe right knee pain due to a flare-up of post-traumatic osteoarthritis. The osteoarthritis is documented as not related to AIDS.

  M17.31 = Unilateral post-traumatic osteoarthritis, right knee.

  B20 = Human immunodeficiency virus (HIV) disease.

  Because the condition treated during this encounter is the right knee osteoarthritis and it is not related to AIDS, M17.31 is sequenced first, followed by B20.

  Therefore, the correct answer is D. M17.31, B20.