AAPC AAPC-CPC Online Practice Questions and Exam Preparation

AAPC AAPC-CPC Online Questions & Answers

• Question 171:

  A patient is seen by her podiatrist to treat a painful left ingrown toenail on the big toe. The podiatrist performs a wedge excision of the skin of the nail fold at the lateral margin. Local anesthetic is administered, and an elliptical incision is made through the subcutaneous tissue of the affected nail groove. A wedge-shaped piece of soft tissue from the nail margin is removed.

  What CPT(R) code is reported?

  A. 11755-TA
  B. 11730-TA
  C. 11750-TA
  D. 11765-TA
  D. 11765-TA

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  Explanation

  The key phrase is "wedge excision of the skin of the nail fold," with removal of a wedge-shaped portion of soft tissue at the nail margin.

  CPT(R) code 11765 is used for wedge excision of the skin of the nail fold, the classic code for this approach.

  Code 11730 represents simple avulsion of the nail plate, which does not match wedge excision of the nail fold soft tissue.

  Code 11750 describes excision of the nail and nail matrix and is a common distractor; however, the vignette specifically emphasizes wedge excision of the nail fold.

  Code 11755 relates to a nail biopsy and does not match this scenario.

  The TA modifier indicates the left great toe for anatomical specificity on the claim.

• Question 172:

  Preoperative diagnosis: Bradycardia. Postoperative diagnosis: Bradycardia. Procedure performed: Dual-

  chamber pacemaker implantation. Brief history: 77-year-old female with recurrent syncope; evaluation

  revealed first-degree AV block, sinus bradycardia, bundle-branch block; bradyarrhythmia suspected; after

  discussion with her sister, dual-chamber pacemaker recommended; risks explained; consent obtained.

  Procedure details: Taken to the cardiac catheterization lab; positioned on the cath table; prepped and

  draped in standard fashion; procedure challenging due to agitation despite adequate sedation; left

  infraclavicular area anesthetized with 0.5 cc of Xylocaine; pacemaker pocket created; hemostasis

  achieved with cautery; a 9-French peel-away sheath was used to introduce an atrial and a ventricular lead;

  leads positioned with excellent thresholds; secured with 0-silk sutures over sleeves; pulse generator

  connected; pocket flushed with antibiotic solution; pacemaker and leads placed in pocket; incision closed

  in two layers; performed under fluoroscopic guidance. Complication: None. Plan: Return to recovery;

  discharge later this evening to nursing home with routine post-pacemaker care.

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

  A. 33208
  B. 33206
  C. 33207
  D. 33206, 33207
  A. 33208

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  Explanation

  This operative report documents a new permanent dual-chamber pacemaker implantation: creation of a subcutaneous pocket, placement of two transvenous leads, one atrial and one ventricular, via a peel-away sheath, confirmation of thresholds, and connection/insertion of the pulse generator into the pocket with layered closure. CPT pacemaker insertion coding is determined by the number of chambers/leads placed during the session. 33208 is the correct code for insertion of a dual-chamber permanent pacemaker system, atrial and ventricular leads with generator. 33206 is for a single-chamber ventricular system, and 33207 is for a single-chamber atrial system, so neither matches a dual-lead implantation. Reporting 33206 and 33207 together is not correct because CPT provides the single comprehensive dual-chamber code when both leads are placed. The fluoroscopic guidance and catheterization lab setting support how the leads were placed but do not change the CPT selection, and "challenging due to agitation" does not by itself create a separate reportable service. Therefore, report 33208.

• Question 173:

  Dr. Winston sees a patient with abdominal pain in the observation unit in the hospital. This is his first visit with this patient during this stay. He spent a total time of 85 minutes on that patient on that date of service, including review of the observation admission, labs, X-rays, and EKG results, and examining the patient with a moderate level of medical decision making.

  What CPT(R) coding is reported?

  A. 99222, 99418
  B. 99223, 99418
  C. 99223
  D. 99222
  C. 99223

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  Explanation

  This is an initial hospital/observation evaluation, first visit during the stay, so the correct code family is the initial observation/inpatient E/M level. The stem provides total time = 85 minutes and also states moderate MDM. Under current E/M rules, you can select the code based on either MDM or total time when time is used and includes the physician's qualifying time on that date. The time of 85 minutes fits the time range for 99223, the highest initial hospital/ observation level by time, even if MDM is described as moderate.

  The prolonged service add-on 99418 requires meeting the threshold beyond the primary code's time before it can be added; with 85 minutes, you do not reach the additional increment needed to report 99418.

  Therefore, you report 99223 only.

  CPC exam tip: When time is explicitly provided and is high, it often drives the level; do not add prolonged time unless the documented time clearly exceeds the primary code's requirement by the necessary increment.

• Question 174:

  From a left femoral access, the catheter is placed within the proper hepatic artery, dye is injected, and imaging is obtained. A stenosis within this artery is identified. A percutaneous transluminal angioplasty is performed on the proper hepatic (visceral) artery in the outpatient radiology department.

  What CPT coding is reported?

  A. 36247, 75736-26-59, 37248-51
  B. 36247, 75726-26-59, 37246-51
  C. 36253, 75726-26-59, 37246-51
  D. 36253, 75736-26-59, 37248-51
  D. 36253, 75736-26-59, 37248-51

• Question 175:

  The CPT(R) code book provides full descriptions of medical procedures, with some descriptions requiring the use of a semicolon (;) to distinguish among closely related procedures.

  What is the full description of CPT(R) code 35860?

  A. Exploration for postoperative hemorrhage, thrombosis, or infection; neck, chest, abdomen, and/or extremity
  B. Exploration for postoperative hemorrhage, thrombosis, or infection; excluding extremity
  C. Exploration for postoperative hemorrhage, thrombosis, or infection; extremity
  D. Exploration for postoperative hemorrhage, thrombosis, or infection; neck and/or extremity
  A. Exploration for postoperative hemorrhage, thrombosis, or infection; neck, chest, abdomen, and/or extremity

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  Explanation

  In the CPT(R) code book, code 35860 describes "Exploration for postoperative hemorrhage, thrombosis, or infection" in multiple areas, specifically including the neck, chest, abdomen, and/or extremity. This code is used when a surgeon explores these areas postoperatively to locate and address complications such as bleeding, clots, or infections.

  Options B, C, and D are incorrect because they do not fully encompass all the areas listed in the actual description of CPT(R) code 35860, which includes all four regions: neck, chest, abdomen, and extremity.

  Thus, the correct answer is A. Exploration for postoperative hemorrhage, thrombosis, or infection; neck, chest, abdomen, and/or extremity.

• Question 176:

  A physician prescribes carbamazepine to treat a patient with epileptic seizures. After six months, the physician performs a therapeutic drug test to monitor the total level of the drug in the patient.

  What CPT and ICD-10-CM coding is used for the six month-evaluation?

  A. 80156, R56.9
  B. 80157, R56.9
  C. 80157, G40.909
  D. 80156, G40.909
  D. 80156, G40.909

• Question 177:

  An otolaryngologist removes a 3 cm deep facial tumor within muscle.

  What CPT(R) code is reported?

  A. 21015
  B. 21016
  C. 21012
  D. 21014
  A. 21015

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  Explanation

  21015 = Excision of facial tumor, deep, subfascial or intramuscular, 3 cm or less. 21016 is for a deep facial tumor greater than 3 cm.

  The tumor is exactly 3 cm, making 21015 correct.

• Question 178:

  A patient in a radiology facility has an X-ray examination of her lumbosacral spine due to pain while playing golf. The radiologist takes a complete 7-view study of the lumbosacral spine, including bending views.

  What CPT(R) code is reported?

  A. 72020
  B. 72080
  C. 72114
  D. 72084
  C. 72114

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  Explanation

  Procedure and CPT(R) code selection: The patient underwent a 7-view X-ray of the lumbosacral spine, which included bending views. A complete set of views was captured.

  CPT(R) code 72114 is appropriate for a complete lumbosacral spine X-ray with a minimum of six views.

  This code includes comprehensive imaging, such as bending and other specialized views, which were taken in this scenario.

  Rationale for excluding other options: Code 72020 is for a single-view X-ray of the spine, which is not adequate to describe a 7-view series.

  Code 72080 is for a two-or three-view X-ray of the thoracolumbar spine, which does not cover the full set of seven views described in this scenario. Code 72084 represents a complete thoracic spine study with multiple views but does not specifically cover the lumbosacral spine, which is the focus of this X-ray examination.

  AAPC and CPT(R) coding guidelines: According to AAPC and CPT(R) guidelines, 72114 is the correct choice for a complete lumbosacral spine study involving multiple views, including specialized views such as bending.

  Therefore, the correct answer is C. 72114.

• Question 179:

  When a provider's documentation refers to use, abuse, and dependence of the same substance, such as alcohol, which statement is correct?

  A. If both use and abuse are documented, assign abuse first and use as an additional code.
  B. If both abuse and dependence are documented, assign only the code for abuse.
  C. If both use and dependence are documented, assign only the code for dependence.
  D. If use, abuse, and dependence are documented, report all three codes separately.
  C. If both use and dependence are documented, assign only the code for dependence.

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  Explanation

  Per ICD-10-CM guidelines, when dependence is documented with either use or abuse, only the dependence code is assigned because dependence takes precedence.

• Question 180:

  Which one of the following is correct to report an intermediate repair code (12031-12037)?

  A. A scalp laceration that involves extensive undermining and is closed in a single layer with staples.
  B. A right leg laceration that involves extensive cleaning with removal of debris and is closed in a single layer with sutures.
  C. A traumatic laceration involving the upper left arm that requires deep layered closure with debridement of wound edges.
  D. A chest laceration that involves the epidermis skin layer and is repaired with adhesive strips and medical glue.
  B. A right leg laceration that involves extensive cleaning with removal of debris and is closed in a single layer with sutures.

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  Explanation

  Intermediate repair includes single-layer closure with extensive cleaning, debridement, or removal of debris, or layered closure of one or more deeper layers.

  Option B meets the definition due to extensive cleaning and debris removal.

  Option C also describes elements that may support intermediate repair; however, based on the answer choices provided, option B is the intended best answer because it specifically describes single-layer closure with extensive cleaning and debris removal.

  Option D is a simple repair.

  Extensive undermining alone may support a more complex repair depending on documentation and extent.