AAPC AAPC-CPC Online Practice Questions and Exam Preparation

AAPC AAPC-CPC Online Questions & Answers

• Question 211:

  An anesthesiologist medically directs two cases during EGD and colonoscopy in a P3 patient.

  What CPT(R) codes are reported?

  A. 00731-QX-P3
  B. 00813-AA-P3
  C. 00731-QY-P3
  D. 00813-QK-P3
  D. 00813-QK-P3

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  Explanation

  00813 = Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum.

  QK = Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals.

  P3 = A patient with severe systemic disease. 99100 is not reported because extreme age is not documented. 99140 is not reported because an emergency condition is not documented.

  Therefore, the correct answer is Option D. 00813-QK-P3.

• Question 212:

  A patient who has colon adenocarcinoma undergoes a laparoscopic partial colectomy. The surgeon removes the proximal colon and terminal ileum and reconnects the cut ends of the distal ileum and remaining colon.

  What procedure and diagnosis codes are reported?

  A. 44204, C18.2
  B. 44140, C18.9
  C. 44205, C18.9
  D. 44160, C18.2
  C. 44205, C18.9

• Question 213:

  Refer to the supplemental information when answering this question: View MR 138093

  What E/M coding is reported?

  A. 99285-25, 99291-25, 92950, 31500, 82803
  B. 99291-25, 92950, 31500, 82803
  C. 99285
  D. 99291-25, 99292-25, 92950, 31500
  B. 99291-25, 92950, 31500, 82803

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  Explanation

  This patient presents to the ER with syncope, requiring comprehensive evaluation and critical care.

  Here's the breakdown of the codes:

  CPT Code 99291-25:

  Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes.

  This code is appropriate because the patient's condition requires immediate critical care management.

  Modifier -25:

  Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service. This modifier is appended because the critical care services were provided in addition to the separately reported procedures below.

  CPT Code 92950:

  Cardiopulmonary resuscitation (CPR).

  CPT Code 31500:

  Intubation, endotracheal, emergency procedure.

  CPT Code 82803:

  Blood gases, arterial, pH, PCO2, PO2, with oxygen saturation.

  Why other options are incorrect: 99285: This is a standard emergency department visit code and does not capture the critical care service when critical care is documented. 99285-25, 99291-25, 92950, 31500, 82803: This includes 99285, which is not separately reported because 99291 represents the critical care E/M service. 99291-25, 99292-25, 92950, 31500: This includes 99292, which is for additional critical care time beyond the first 74 minutes.

  There is no indication in the documentation that the physician provided critical care beyond the initial 74 minutes.

  References:

  CPT Codes 99281-99285: Emergency department visits.

  CPT Codes 99291-99292: Critical care services.

  CPT Code 92950: Cardiopulmonary resuscitation.

  CPT Code 31500: Endotracheal intubation.

  CPT Code 82803: Arterial blood gases.

• Question 214:

  View MR 006399

  MR 006399

  Operative Report

  Preoperative Diagnosis: Chronic otitis media in the right ear

  Postoperative Diagnosis: Chronic otitis media in the right ear

  Procedure: Eustachian tube inflation Anesthesia: General

  Blood Loss: Minimal

  Findings: Serous mucoid fluid

  Complications: None

  Indications: The patient is a 2-year-old who presented to the office with chronic otitis media refractory to medical management. The treatment will be eustachian tube inflation to remove the fluid. Risks, benefits, and alternatives were reviewed with the family, which include general anesthetic, bleeding, infection, tympanic membrane perforation, routine tubes, and need for additional surgery. The family understood these risks and signed the appropriate consent form.

  Procedure in Detail: After the patient was properly identified, he was brought into the operating room and placed supine. The patient was prepped and draped in the usual fashion. General anesthesia was administered via inhalation mask, and after adequate sedation was achieved, a medium-sized speculum was placed in the right ear and cerumen was removed atraumatically using instrument with operative microscope. The tube is dilated, an incision is made to the tympanum and thick mucoid fluid was suctioned. The patient was awakened after having tolerated the procedure well and taken to the recovery room in stable condition.

  What CPT coding is reported for this case?

  A. 69420-RT
  B. 69436-RT
  C. 69433-RT
  D. 69421-RT
  D. 69421-RT

• Question 215:

  The documentation states: "A punch is placed and pushed downward to obtain a tissue sample for a biopsy of the lunula."

  What anatomical structure is being biopsied?

  A. Eye
  B. Brain
  C. Skin
  D. Nail
  D. Nail

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  Explanation

  The lunula is the pale, crescent-shaped area visible at the base of some fingernails and toenails, most commonly the thumb. It is part of the nail unit and is associated with the nail matrix, where nail formation occurs. Because the lunula is a nail structure, a biopsy "of the lunula" is a nail biopsy, even though a punch tool is also commonly used in skin biopsies. CPC exam questions frequently test precise anatomical vocabulary, especially for integumentary structures, including skin, nails, and hair.

  The distractors "eye" and "brain" are unrelated. "Skin" is tempting because punch biopsies are typically skin procedures; however, the question specifically identifies the lunula, which is not a skin landmark.

  Coding and documentation accuracy depend on knowing these terms because nail procedures often have different code families and clinical considerations than routine skin biopsies.

  Correct identification starts by mapping the term to its anatomical system: lunula = nail apparatus.

• Question 216:

  A patient had surgery a year ago to repair two extensor tendons in his wrist. He is in surgery for a secondary repair for the same two tendons with free graft.

  What CPT(R) coding is reported?

  A. 25270
  B. 25274 x 2
  C. 25270 x 2
  D. 25272
  B. 25274 x 2

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  Explanation

  1. Procedure Type:

  This scenario describes a secondary repair of two extensor tendons in the wrist with a free graft. According to CPT(R) coding guidelines, secondary repair with a free graft suggests a more complex repair than primary closure.

  2. CPT(R) code Selection:

  Code 25270 is used for primary repair of an extensor tendon in the forearm or wrist. Since this is a secondary repair, 25270 does not apply, ruling out Options A and

  C. Code 25272 represents repair of an extensor tendon in the forearm or wrist, but it does not describe secondary repair with free graft, ruling out Option

  D. Code 25274 specifically addresses secondary repair of an extensor tendon with free graft in the forearm or wrist, which is the correct scenario described in the question.

  3. Applying the Code for Multiple Tendons:

  Since the procedure involves two tendons, 25274 should be reported twice (25274 x 2) to account for the secondary repair on each tendon.

  4. Reference from AAPC CPC Guidelines:

  In AAPC CPC and CPT(R) coding principles, tendon repair codes require careful distinction between primary repairs and secondary repairs with grafts. Multiple tendons should be coded with individual codes when performed on separate anatomical structures, hence the use of 25274 twice for both tendons.

  Therefore, the verified and precise answer based on CPT(R)guidelines and AAPC coding standards is Option B. 25274 x 2.

• Question 217:

  Which CPT code is reported for a knee arthrocentesis without ultrasound guidance?

  A. 20615
  B. 20611
  C. 27369
  D. 20610
  D. 20610

• Question 218:

  The Medicare program has multiple parts covering different services.

  Which part provides coverage for outpatient physician charges?

  A. Part C
  B. Part B
  C. Part A
  D. Part D
  B. Part B

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  Explanation

  Medicare Part B provides coverage for outpatient services, including physician services, preventive care, outpatient procedures, diagnostic tests, and durable medical equipment. Part B is a key component of Medicare, covering medically necessary services and some preventive services.

  Option A: Part C (Medicare Advantage) includes all benefits and services covered under Parts A and B and often additional services, but it is provided through private insurance companies.

  Option C: Part A covers inpatient hospital care, skilled nursing facility care, hospice, and some home health services.

  Option D: Part D provides coverage for prescription drugs.

  Therefore, the correct answer is Option B, Part B.

• Question 219:

  Repeat three-view imaging of both hips and pelvis is performed on the same day due to a new fall, interpreted by the same radiologist.

  What CPT(R) coding is reported?

  A. 73523-76, 73523
  B. 73522-76, 73522
  C. 73522, 73522-76
  D. 73523, 73523-77
  C. 73522, 73522-76

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  Explanation

  73522 = Radiologic examination, hips, bilateral, with pelvis, 3-4 views.

  Modifier -76 = Repeat procedure by the same physician or other qualified health care professional.

  Because the same radiologist interpreted the repeat study on the same day, report the original study and the repeated study with modifier -76.

• Question 220:

  Where is a Warthin's tumor found?

  A. Ovary
  B. Bone
  C. Salivary gland
  D. Back of eye
  C. Salivary gland