AAPC AAPC-CPC Online Practice Questions and Exam Preparation

AAPC AAPC-CPC Online Questions & Answers

• Question 21:

  According to the ICD-10-CM coding guidelines, when coding hypertension with heart conditions classified to I50.

  - or I51.4-I51.7, I51.89, I51.9, what category should be used?

  A. Category I11, Hypertensive heart disease
  B. Category I13, Hypertensive heart and chronic kidney disease
  C. Category I12, Hypertensive chronic kidney disease
  D. Category I10, Essential (primary) hypertension
  A. Category I11, Hypertensive heart disease

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  Explanation

  When hypertension and heart disease are documented together, a cause-and-effect relationship is presumed unless stated otherwise.

  Category I11 (Hypertensive heart disease) is used.

  Additional codes from I50.- (heart failure) are assigned if applicable.

  This follows ICD-10-CM Official Coding Guidelines.

• Question 22:

  A patient with compression fractures of L5 and the sacrum undergoes vertebroplasty, with cement injected into two vertebral bodies, performed bilaterally.

  What CPT(R) coding is reported?

  A. 22514-50, 22515-50
  B. 22511, 22512
  C. 22514, 22515
  D. 22511-50, 22512-50
  C. 22514, 22515

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  Explanation

  22514 = Vertebroplasty, lumbar (L5) 22515 = Each additional vertebral body (sacrum)

  Vertebroplasty codes are reported per vertebral body level; modifier -50 is not applicable.

• Question 23:

  A 60-year-old man presents for examination of the entire rectum and sigmoid colon. Two polyps are found in the sigmoid colon and removed using ablation.

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

  A. 45346 x 2, K62.1
  B. 45320 x 2, K63.5
  C. 45320, K62.1
  D. 45346, K63.5
  D. 45346, K63.5

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  Explanation

  The described scope reaches the sigmoid colon, which is consistent with a flexible sigmoidoscopy rather than a full colonoscopy. The key therapeutic action is that the polyps were treated by ablation (destruction), not snare excision or biopsy. CPT 45346 represents flexible sigmoidoscopy with ablation of tumor(s), polyp (s), or other lesion(s). You report the sigmoidoscopy ablation code once for the session; you do not multiply it by the number of polyps unless CPT instructions explicitly direct unit reporting, which is not the standard approach for these endoscopic therapeutic codes.

  For diagnosis, polyps in the sigmoid colon are coded as K63.5 (polyp of colon). K62.1 is a rectal polyp code and does not fit because the polyps are in the sigmoid colon.

  Therefore, 45346 with K63.5 is correct.

  CPC exam tip: Match the scope extent (sigmoid) and the removal method (ablation).

• Question 24:

  An incision is made in the scalp, a craniectomy is performed to access the area where electrodes are present. The electrodes are removed. The surgical wound is closed.

  What procedure code is reported?

  A. 61850
  B. 61880
  C. 61535
  D. 61860
  B. 61880

• Question 25:

  A 13-year-old established patient is seen for an annual preventive exam. Last visit was two years ago.

  What CPT(R) code is reported?

  A. 99393
  B. 99383
  C. 99382
  D. 99394
  A. 99393

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  Explanation

  99394 = Preventive visit, established patient, age 12-17.

  Preventive codes are based on age and patient status, not time since last visit.

• Question 26:

  A patient is brought to the operating room with right-sided peripheral vertigo. The provider makes a postauricular incision and uses an operating microscope to perform a mastoidectomy using a burr. He next destroys the semicircular canals, the utricle, and the saccule, completely removing the diseased labyrinth structures. The provider sutures the incision.

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

  A. 69910, 69990-51, R42
  B. 69905, 69990-51, R42
  C. 69905, 69990, H81.391
  D. 69910, 69990, H81.391
  D. 69910, 69990, H81.391

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  Explanation

  Procedure Coding (CPT(R)):

  69910 - Labyrinthectomy, complete; transmastoid approach.

  The provider performed a mastoidectomy and complete destruction/removal of the semicircular canals, utricle, and saccule. This is a complete labyrinthectomy, not a partial labyrinthectomy.

  69990 - Microsurgical techniques, requiring use of operating microscope.

  The use of the operating microscope is documented. Modifier -51 is not required because 69990 is an add-on code.

  Diagnosis Coding (ICD-10-CM):

  H81.391 - Peripheral vertigo, right ear.

  This code reflects the documented right-sided peripheral vertigo.

  Why Other Options Are Incorrect:

  69905 - Partial labyrinthectomy.

  R42 - Dizziness and giddiness; this is a symptom code and is not used when a definitive diagnosis is documented.

• Question 27:

  An 8-year-old undergoes tonsillectomy with adenoidectomy for chronic tonsillitis and adenoiditis with hypertrophy.

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

  A. 42825, 42830, J35.03
  B. 42825, 42830, J35.03, J35.3
  C. 42820, J35.03, J35.3
  D. 42820, J35.03
  D. 42820, J35.03

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  Explanation

  42820 = Tonsillectomy and adenoidectomy, under age 12.

  J35.03 = Chronic tonsillitis and adenoiditis.

  J35.3 = Hypertrophy of tonsils with hypertrophy of adenoids.

  The documentation supports both chronic tonsillitis/adenoiditis and hypertrophy, so both diagnosis codes are reported.

  Therefore, the correct answer is C. 42820, J35.03, J35.3.

• Question 28:

  Full Case: Preoperative diagnosis: Low back pain; possible spinal stenosis L3-4. Postoperative diagnosis:

  No evidence of discogenic pathology or spinal stenosis at L3-4; normal discography L3-4. Procedure:

  Awake discography and injection, L3-4. Anesthesia: IV narcotic with reversal and local; propofol given

  transiently, then patient alert/responsive for pain response during injection. Technique: Patient to OR; right

  decubitus; sterile prep/drape; C-arm used to mark entry; local ethyl chloride + 1% Xylocaine; docking

  needle placed posterolateral at L3-4 under AP/lateral; inner needle advanced to disc nucleus center;

  contrast injected while monitoring patient response; normal bilocular pattern; 1.5 cc volume; no pain with

  pressurization. Documentation: No videotape; plain films available; post-discography CT planned/reviewed

  for other causes.

  What CPT(R) and ICD-10-CM coding is reported?

  A. 62292, M54.50
  B. 62290, M54.50
  C. 62290, M48.061, M54.50
  D. 62292, M48.07, M54.50
  B. 62290, M54.50

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  Explanation

  This service is a lumbar discography at a single level, L3-L4, with injection of contrast into the intervertebral disc under fluoroscopic (C-arm) guidance while the patient is awake/able to report symptoms, which is exactly what CPT(R) 62290 describes for diagnostic discography at a lumbar level.

  CPT(R) 62292 is used for discography in a different spinal region and is not supported by the "L3-4" lumbar level stated multiple times. The post-discography CT scan is referenced as planned/reviewed but is not clearly documented as performed/interpreted as part of this same physician service in the stem, and it is not part of the answer choices. For ICD-10-CM, the confirmed postoperative finding is "normal discography," but the reason for the study remains the patient's low back pain and suspected stenosis; in outpatient/procedural settings, you code the reason for the test when the definitive suspected condition is not confirmed. Here, the stenosis was ruled out, "no evidence," so do not code spinal stenosis; report

  M54.50 for low back pain. Therefore, 62290 with M54.50 is correct.

• Question 29:

  A patient arrives for a PEG placement. The patient requires tube feeds for nutrition but frequently pulls out the Dobhoff tube. An EGD was performed. Several attempts were made to place the PEG tube without success, so the procedure was aborted. During withdrawal of the scope, a small hiatal hernia was noted.

  The scope was removed and the patient was transferred to recovery.

  What CPT and ICD-10-CM coding is reported?

  A. 43830-52, Z43.1
  B. 43246-53, K94.29, K44.9
  C. 49450-53, K94.29, K44.9
  D. 43246, K94.29, Z93.1
  B. 43246-53, K94.29, K44.9

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  Explanation

  43246 describes esophagogastroduodenoscopy with directed placement of a percutaneous gastrostomy tube. Because several attempts were made and the PEG placement was unsuccessful, modifier -53 is appended to indicate a discontinued procedure.

  K94.29 reports other complications of gastrostomy, based on the gastrostomy-related problem requiring attention.

  K44.9 reports the small hiatal hernia noted during the procedure.

  Option A is incorrect because 43830 describes open gastrostomy, not endoscopic PEG placement.

  Option C is incorrect because 49450 describes replacement of a gastrostomy tube, not attempted PEG placement by EGD.

  Option D is incorrect because the procedure was not completed and modifier -53 is required.

  Therefore, the correct answer is B. 43246-53, K94.29, K44.9.

• Question 30:

  A surgeon performed Mohs micrographic surgery on a lesion on the right arm. This required one stage with six tissue blocks.

  What CPT(R) codes are reported for the Mohs surgery?

  A. 17313, 17314, 17315
  B. 17311, 17315
  C. 17313, 17315
  D. 17311, 17312, 17315
  B. 17311, 17315

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  Explanation

  17311 = First stage, trunk/arms/legs 17315 = Each additional block after 5 6 blocks add 17315