AAPC AAPC-CPC Online Practice Questions and Exam Preparation

AAPC AAPC-CPC Online Questions & Answers

• Question 261:

  A patient presents with increased intracranial pressure and is scheduled for a lumbar puncture. Under CT guidance, the physician inserts a needle at the L4 level and advances a catheter into the subarachnoid space to actively drain cerebrospinal fluid. CSF is collected and sent to the lab; the catheter is removed.

  What CPT(R) coding is reported?

  A. 62329
  B. 62328, 77012
  C. 62272, 77012
  D. 62270
  A. 62329

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  Explanation

  This procedure is therapeutic drainage of cerebrospinal fluid by needle or catheter under CT guidance.

  62329 = Spinal puncture, therapeutic, for drainage of cerebrospinal fluid by needle or catheter; with fluoroscopic or CT guidance.

  The CT guidance is included in 62329 and is not reported separately with 77012.

  Therefore, the correct answer is A. 62329.

• Question 262:

  A patient comes in complaining of pain in the lower left back, which is accompanied by a numbing sensation that extends into the leg. Attempts to alleviate the pain with home treatments have been unsuccessful. The provider orders an MRI of the lumbar spine initially without, and then with, contrast material. The images are interpreted by the physician. The final diagnosis is left-sided low back pain with sciatica.

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

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

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  Explanation

  Procedure Coding:

  72158 - MRI, lumbar spine; without contrast material, followed by contrast material and further sequences.

  This is reported with a single comprehensive code.

  Diagnosis Coding:

  M54.42 - Lumbago with sciatica, left side.

  Why Other Options Are Incorrect: Option B / C - Incorrectly unbundle MRI codes.

  Option D - Coding additional unspecified low back pain is inappropriate when the more specific diagnosis of low back pain with sciatica is reported.

• Question 263:

  A patient is seen at the doctor's office for nausea, vomiting, and sharp right lower abdominal pain. A CT scan of the abdomen is ordered. Labs come back indicating an increased WBC count, with review of the abdominal CT scan. The physician determines the patient has chronic appendicitis. The physician schedules an appendectomy and takes the patient to the operating room. The appendix is severed from the intestines and removed via a scope inserted through an umbilical incision.

  What CPT(R) and diagnosis codes are reported?

  A. 44970, K36, R11.2, R10.31
  B. 44950, K35.80
  C. 44970, K36
  D. 44950, K35.80, R11.2, R10.31
  C. 44970, K36

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  Explanation

  Procedure and CPT(R)

  Code Selection: The patient underwent an appendectomy performed via laparoscopic approach. The procedure involved removal of the appendix using a scope inserted through an umbilical incision.

  CPT(R) code 44970 is specific for a laparoscopic appendectomy, which is the correct code for this procedure.

  Code 44950 would be used for an open appendectomy, but since this case was performed laparoscopically, 44970 is appropriate.

  Diagnosis and ICD-10-CM Code Selection: The diagnosis given by the physician is chronic appendicitis.

  ICD-10-CM code K36 is used to report chronic appendicitis, which is the definitive diagnosis in this case.

  Additional codes for symptoms such as nausea (R11.2) and right lower quadrant pain (R10.31) are not necessary because the primary diagnosis of chronic appendicitis (K36) fully explains the symptoms, according to ICD-10-CM guidelines on coding symptoms when a definitive diagnosis is available.

  AAPC and CPT(R)

  Coding Guidelines: AAPC guidelines indicate that when a definitive diagnosis is established, symptom codes should not be reported separately. The use of 44970 for laparoscopic appendectomy and K36 for chronic appendicitis is fully supported by these coding standards.

  Therefore, the correct answer is C. 44970, K36.

• Question 264:

  An established patient is seen in the office for a headache and congestion. A medically appropriate history and exam are documented. The patient was told to take over-the-counter decongestants and Tylenol?

  What CPT code is reported?

  A. 99213
  B. 99214
  C. 99202
  D. 99203
  A. 99213

• Question 265:

  In the ICD-10-CM code book, which instructional note given in the Tabular List indicates when two conditions cannot be reported together?

  A. Excludes2
  B. Not elsewhere classifiable (NEC)
  C. Excludes1
  D. Not otherwise specified (NOS)
  C. Excludes1

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  Explanation

  An Excludes1 note means "NOT CODED HERE" and indicates that the two conditions cannot be reported together because they are either mutually exclusive or one condition is inherently included in the other in that context. In practical CPC exam terms, if an Excludes1 note applies between two codes, you generally do not assign both codes on the same encounter.

  This is different from Excludes2, which means the excluded condition is not part of the code, but the patient may have both conditions at the same time, so both codes may be reported if supported by documentation. NEC (Not Elsewhere Classifiable) points you to a more specific code when available; NOS (Not Otherwise Specified) reflects insufficient detail in documentation. The question is specifically about a note that prevents reporting two conditions together. This is the hallmark definition of Excludes1 under ICD-10-CM conventions and is heavily tested on CPC exams.

• Question 266:

  What does PHI stand for in healthcare privacy regulations?

  A. Protected Health Information
  B. Personal Hospital Insurance
  C. Private Health Index
  D. Patient Health Initiative
  A. Protected Health Information

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  Explanation

  Under HIPAA (Health Insurance Portability and Accountability Act), PHI stands for Protected Health Information. It includes any individually identifiable health information related to a patient's health status, provision of healthcare, or payment for healthcare. Protection of PHI is a key compliance topic on the CPC exam.

• Question 267:

  Which one of the following is NOT a cardiac valve?

  A. Mitral valve
  B. Femoral valve
  C. Aortic valve
  D. Tricuspid valve
  B. Femoral valve

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  Explanation

  The human heart has four cardiac valves: tricuspid, pulmonic, mitral (bicuspid), and aortic. These valves regulate one-way blood flow through the heart's chambers and into the great vessels. The mitral valve lies between the left atrium and left ventricle; the tricuspid valve lies between the right atrium and right ventricle; the aortic valve controls flow from the left ventricle to the aorta. "Femoral" refers to the femur (thigh bone) and the femoral artery/vein in the groin/thigh region, not a structure of the heart. While veins can contain valves, such as in the legs, the term "femoral valve" is not recognized as a standard named cardiac valve. On CPC-style anatomy questions, distractors often use real anatomical words from other body regions to test whether you know the specific list of true cardiac valves.

• Question 268:

  A patient suffering from lateral epicondylitis in the left elbow is sent to the operating room to manipulate the elbow. The patient is placed under general anesthesia by the anesthesiologist. The physician manipulates the elbow through stretching and rotation to restore motion.

  What CPT(R) coding is reported for the physician?

  A. 24300, 01710
  B. 24605
  C. 24300
  D. 24605, 01710
  C. 24300

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  Explanation

  The physician performed an orthopedic manipulation of the elbow under anesthesia, which is reported with CPT 24300 (manipulation, elbow, under anesthesia). The anesthesia service is separately reported by the anesthesia provider, the anesthesiologist/CRNA, using an anesthesia CPT code, but the question asks specifically what is reported for the physician performing the manipulation, not the anesthesiologist.

  Therefore, you do not assign the anesthesia code, such as 01710, to the manipulating physician. Option A is incorrect because it includes anesthesia coding under the physician. Options B and D include 24605, which represents a different service, not the correct manipulation-under-anesthesia code for this vignette.

  CPC exam strategy: Identify who is billing, surgeon vs. anesthesiologist, and select the CPT code that describes the physician's operative service. Here, the physician's work is the manipulation itself, accurately captured by 24300 alone.

• Question 269:

  Which is a malignant neoplasm originating in the skin?

  A. Osteosarcoma
  B. Hemangioma
  C. Melanoma
  D. Lymphoma
  C. Melanoma

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  Explanation

  Melanoma is a malignant neoplasm of melanocytes, which are pigment-producing cells found primarily in the skin. It is one of the most serious forms of skin cancer and is classified under ICD-10-CM category

  C43.-, malignant melanoma of skin.

  Osteosarcoma is a malignant tumor of bone, not skin (ICD-10-CM C40-C41). Hemangioma is a benign tumor of blood vessels and is not malignant, often coded under D18.-.

  Lymphoma is a malignancy of the lymphatic system, not a primary skin neoplasm (ICD-10-CM C81-C85).

  Although rare cutaneous lymphomas exist, they are not the standard CPC exam answer here.

• Question 270:

  Preoperative diagnosis: Right thigh benign congenital hairy nevus.

  Postoperative diagnosis: Right thigh benign congenital hairy nevus.

  Operation performed: Excision of right thigh benign congenital hairy nevus, excision size with margins 4.5 cm and closure size 5 cm.

  Anesthesia: General.

  Intraoperative antibiotics: Ancef.

  Indications: The patient is a 5-year-old girl who presented with her parents for evaluation of her right thigh congenital nevus. It has been followed by pediatrics and was thought to have changed over the past year.

  The family requested excision. They understood the risks involved, including but not limited to the risks of general anesthesia, infection, bleeding, wound dehiscence, and poor scar formation. They understood the scar would likely widen as the child grows because of the location and age of the patient. They consented to proceed.

  Description of procedure: The patient was seen preoperatively in the holding area, identified, and then brought to the operating room. Once adequate general anesthesia had been induced, the patient's right thigh was prepped and draped in standard surgical fashion. An elliptical excision measuring 6 x 1.8 cm had been marked. This was injected with lidocaine with epinephrine, total of 6 cc of 1% with 1:100,000. After an

  adequate amount of time, a #15 blade was used to sharply excise this full thickness. This was passed to

  pathology for review. The wound required limited undermining in the deep subcutaneous plane on both sides for approximately 1.5 cm in order to allow mobilization of the skin for closure. The skin was then closed in a layered fashion using 3-0 Vicryl on the dermis and then 4-0 Monocryl running subcuticular in the skin. The wound was cleaned and dressed with Dermabond and Steri-Strips. The patient was then cleaned and turned over to anesthesia for extubation. She was extubated successfully in the operating room and taken to the recovery room in stable condition. There were no complications.

  Which CPT(R) and ICD-10-CM codes are reported for this procedure?

  A. 11406, 12032, D22.71
  B. 11404, 12032, D22.71
  C. 11606, 12032, D48.5
  D. 11406, D22.71
  A. 11406, 12032, D22.71

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  Explanation

  11406 = Excision of benign lesion, trunk, arms, or legs; excised diameter over 4.0 cm.

  12032 = Intermediate repair, trunk and/or extremities; 2.6 cm to 7.5 cm.

  D22.71 = Melanocytic nevi of right lower limb, including hip.

  The lesion is documented as benign, so a malignant lesion excision code is not reported. The closure is layered, supporting intermediate repair.