AAPC AAPC-CPC Online Practice Questions and Exam Preparation

AAPC AAPC-CPC Online Questions & Answers

• Question 231:

  A surgeon performs midface LeFort I reconstruction on a patient's facial bones to correct a congenital deformity. The reconstruction is performed in two pieces in moving the upper jawbone forward and repositioning the teeth of the maxilla of the mid face.

  What CPT code is reported?

  A. 21146
  B. 21141
  C. 21142
  D. 21145
  C. 21142

• Question 232:

  A patient complains of tarry, black stool, and epigastric tightness. An esophagogastroduodenoscopy is recommended to evaluate the source of the bleeding. The endoscope is inserted orally. The esophagus appears normal on scope insertion. No evidence of bleeding in the stomach. The scope is then passed into

  the duodenum, where a polyp is found and removed with hot biopsy forceps. No evidence of bleeding post procedure.

  What CPT code is reported?

  A. 43251
  B. 43250
  C. 43255
  D. 43270
  B. 43250

• Question 233:

  A patient with malignant lymphoma is administered the antineoplastic drug Rituximab 800 mg and then 100 mg of Benadryl.

  Which HCPCS Level II codes are reported for both drugs administered intravenously?

  A. J9312 x 80, J1200 x 2
  B. J9312, J1200
  C. J9312, Q0163
  D. J9312 x 80, 00163 x 2
  D. J9312 x 80, 00163 x 2

• Question 234:

  An emergency department (ED) physician preforms an immediate tracheostomy on a 1-year-old that has severe head and neck trauma that is obstructing her breathing.

  Which CPT code is reported?

  A. 31603
  B. 31500
  C. 31601
  D. 31600
  D. 31600

• Question 235:

  The patient, who is at 32 weeks pregnant, has been hospitalized due to COVID-19 infection.

  What ICD-10-CM codes are reported?

  A. O98.513, U07.1, Z3A.32
  B. U07.1, R06.02, R50.81, Z33.1, Z3A.32
  C. U07.1, O98.513, Z3A.32
  D. O98.513, U07.1, R06.02, R50.81, Z3A.32
  A. O98.513, U07.1, Z3A.32

  ---

  Explanation

  Pregnancy guidelines require O codes first.

  O98.513 = COVID-19 infection complicating pregnancy, third trimester

  U07.1 = COVID-19

  Z3A.32 = 32 weeks gestation

  Symptoms (SOB, fever) are not coded separately when integral to COVID-19.

  Correct sequencing makes A correct.

• Question 236:

  Day 1: Provider admits patient to observation care for type 2 diabetes with hyperglycemia, orders labs, consults endocrinologist, starts IV insulin drip, and keeps the patient overnight. Day 2: Provider orders a glucose test and dietitian consult, and documents total time of 25 minutes. Day 3: Glucose is normal, provider documents 15 minutes, and discharges the patient.

  What E/M coding is reported by the physician for the patient in observation care?

  A. 99222, 99231, 99238
  B. 99235, 99231, 99238
  C. 99221, 99232, 99239
  D. 99235, 99238
  B. 99235, 99231, 99238

  ---

  Explanation

  Observation E/M coding is selected by the type of service provided on each calendar date. Day 1 includes admission to observation care with significant work, including an IV insulin drip, multiple labs, and consultation with an endocrinologist. This supports an initial hospital inpatient or observation care code.

  Because the patient is not admitted and discharged on the same calendar date, 99235 is not appropriate.

  Code 99222 is the appropriate initial hospital inpatient or observation care code in the choices provided.

  Day 2 includes ongoing observation management with documented time of 25 minutes, supporting a subsequent hospital inpatient or observation care code, 99231, as provided in the answer choices. Day 3 is observation discharge. The provider documents 15 minutes, which supports 99238 for hospital inpatient or observation discharge day management of 30 minutes or less.

  Therefore, the correct answer is Option A. 99222, 99231, 99238.

• Question 237:

  The surgical preparation of a 25 sq cm wound on the right leg is performed along with a 25 sq cm wound on the left leg.

  What CPT code is reported?

  A. 15002
  B. 15004
  C. 15004 x 2
  D. 15002 x 2
  C. 15004 x 2

• Question 238:

  Regarding the CPT(R) Surgery Guidelines for a surgical code designated as a "Separate Procedure," which statement is FALSE?

  A. When a procedure is designated as a separate procedure and carried out independently or considered to be unrelated to the total primary service, it may be reported.
  B. The codes designated as "separate procedure" should not be reported in addition to the code for the total procedure or service of which it is an integral component.
  C. A service that is commonly carried out as an integral component of a total service or procedure is identified by the inclusion of the term "separate procedure."
  D. To identify a service designated as a "separate procedure" that is reported with an unrelated primary service, append modifier 79 to the code.
  D. To identify a service designated as a "separate procedure" that is reported with an unrelated primary service, append modifier 79 to the code.

  ---

  Explanation

  In CPT(R) Surgery Guidelines, a "separate procedure" code is used to identify a service that is typically performed as part of a larger procedure and should not be coded separately when it is an integral component of that primary service.

  However, it may be reported independently if it is performed alone or is unrelated to the primary procedure.

  Option

  A. is true because a separate procedure may be reported if it is performed independently or is unrelated to the primary procedure. Option

  B. is true, as "separate procedure" codes are not reported in addition to the code for the primary procedure when they are part of the total procedure. Option

  C. is correct because the "separate procedure" designation indicates that the service is often part of a more comprehensive procedure but can be reported separately when performed alone. Option

  D. is false because modifier 79 is not used for unrelated "separate procedures." Instead, modifier 59 is typically used to indicate a "distinct procedural service" when reporting a separate procedure that is unrelated to the primary service.

  Therefore, the correct answer is D. To identify a service designated as a "separate procedure" that is reported with an unrelated primary service, append modifier 79 to the code.

• Question 239:

  A 42-year-old with chronic left trochanteric bursitis is scheduled to receive an injection at the Pain Clinic. A 22-gauge spinal needle is introduced into the trochanteric bursa under ultrasonic guidance, and a total volume of 8 cc of normal saline and 40 mg of Kenalog was injected.

  What CPT code should be reported for the surgical procedure?

  A. 20610-LT
  B. 20611-LT, 76942
  C. 20611-LT
  D. 20610-LT, 76942
  C. 20611-LT

• Question 240:

  A 44-year-old female patient came in for a planned laparoscopic total abdominal hysterectomy for endometriosis of the uterus. The surgeon attached the trocars, and a scope was inserted to examine the uterus, abdominal wall, bilateral ovaries, and fallopian tubes. The surgeon decided to convert the laparoscopic procedure to an open total hysterectomy because of the extensive amount of adhesions that needed to be removed. A total hysterectomy was performed, and due to removal of the extensive adhesions, the surgery took longer than normal by 2 hours.

  What CPT(R) and diagnosis codes are reported?

  A. 58150-22, N80.00, N73.6
  B. 58571-22, N80.00, N99.4
  C. 58571-78, N80.9, N73.6
  D. 58150-78, N80.9, N99.4
  A. 58150-22, N80.00, N73.6

  ---

  Explanation

  1. Procedure and CPT(R) code

  Selection:

  The patient initially underwent a laparoscopic total abdominal hysterectomy for endometriosis of the uterus.

  However, due to extensive adhesions, the surgeon converted the procedure to an open total abdominal hysterectomy to complete the surgery.

  CPT(R) code 58150 is appropriate for a total abdominal hysterectomy, including removal of the uterus and cervix, via an open approach. Since the procedure was converted to an open approach, 58150 is the correct code.

  Modifier -22 is added to indicate increased procedural services due to the extensive adhesiolysis, which extended the surgery duration.

  2. Diagnosis and ICD-10-CM Code Selection:

  ICD-10-CM Code N80.00 is used for endometriosis of the uterus, which is the primary condition that prompted the hysterectomy.

  ICD-10-CM Code N73.6 is appropriate for female pelvic peritoneal adhesions, reflecting the extensive adhesions that necessitated the conversion to open surgery.

  3. Rationale for Excluding Other Options:

  Code 58571 is for a laparoscopic approach, which is incorrect because the procedure was converted to an open approach.

  Modifier -78 is incorrect because the conversion to open surgery was part of the same operative session and not an unplanned return to the operating room.

  Diagnosis code N99.4 pertains to postprocedural pelvic adhesions, which does not apply here because the adhesions were not documented as postprocedural.

  4. AAPC and CPT(R) coding

  Guidelines:

  AAPC and CPT(R)guidelines support reporting the completed open procedure when a laparoscopic procedure is converted to an open procedure. Modifier -22 may be appended when documentation supports substantially increased procedural complexity or time, such as extensive adhesiolysis.

  Therefore, the correct answer is A. 58150-22, N80.00, N73.6.