AAPC AAPC-CPC Online Practice Questions and Exam Preparation

AAPC AAPC-CPC Online Questions & Answers

• Question 301:

  A provider documents "pericarditis with effusion" in the assessment.

  Based on medical terminology, which structure is inflamed?

  A. The heart muscle
  B. The sac surrounding the heart
  C. The blood vessels supplying the heart
  D. The inner lining of the heart chambers
  B. The sac surrounding the heart

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  Explanation

  Medical terms here are very literal. Peri-means around, cardi refers to the heart, and -itis means inflammation. Therefore, pericarditis is inflammation of the pericardium, the fibrous sac surrounding the heart. "With effusion" indicates fluid accumulation in that pericardial space (pericardial effusion), which can be clinically important because significant effusion may impair heart filling and create tamponade risk, but the question is strictly asking which structure is inflamed. Distractors map to other "card-" terms: myocardium (heart muscle) would be "myocarditis," endocardium (inner lining of chambers/valves) would be "endocarditis," and blood vessels supplying the heart are coronary arteries. Inflammation of the coronary arteries would not be termed pericarditis. On CPC exams, identifying prefix + root + suffix is the fastest method: peri (around) + cardi (heart) + itis (inflammation) = pericardium inflamed.

• Question 302:

  A patient is having a thyroidectomy for malignancy on the right lobe. During the procedure, a lesion is found on the left lower side of the parathyroid gland and is suspected to be malignant. The total right lobe of the thyroid and the parathyroid gland are removed.

  What CPT(R) codes are reported for this encounter?

  A. 60500, 60210-59
  B. 60505, 60220-59
  C. 60500, 60220-59
  D. 60505, 60240-59
  C. 60500, 60220-59

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  Explanation

  CPT(R) code 60500 is reported for parathyroidectomy or exploration of parathyroid gland(s).

  CPT(R) code 60220 is reported for total thyroid lobectomy, unilateral, with or without isthmusectomy.

  Only the right thyroid lobe is removed, so 60220 is appropriate. A total thyroidectomy code is not reported.

  Modifier 59 is appended to 60220 to indicate that the thyroid lobectomy is a distinct procedure from the parathyroidectomy.

  Therefore, the correct answer is C. 60500, 60220-59.

• Question 303:

  What CPT code is reported for an excision of a sacral pressure ulcer with a primary closure?

  A. 15934
  B. 15931
  C. 15933
  D. 15920
  C. 15933

• Question 304:

  The pulmonologist performs a bronchoscopy with fluoroscopic guidance. The scope is introduced into the right nostril and advanced to the vocal cords and into the trachea. The scope is advanced to the right upper lobe and a lung nodule is noted. An endobronchial biopsy is performed.

  What CPT code is reported for the procedure?

  A. 31624
  B. 31625
  C. 31628
  D. 31622
  B. 31625

• Question 305:

  A 58-year-old male suffered an acute STEMI of the inferolateral wall while running a marathon on June 15 and received treatment. Three weeks later, the patient presents to the ED complaining of SOB and left arm pain. An EKG is performed as well as blood tests. The patient is admitted for continued evaluation and care related to the recent STEMI.

  What diagnosis code is reported for this encounter?

  A. I22.2
  B. I21.29
  C. I21.29
  D. I21.29
  B. I21.29

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  Explanation

  For this encounter, ICD-10-CM guidelines indicate that a myocardial infarction occurring within four weeks, or 28 days, of onset is still considered to be in the acute phase. Therefore, the patient's condition is still coded as an acute MI because it is within the four-week period since the initial STEMI.

  I21.29 is the correct code for acute STEMI involving other sites, including the inferolateral wall.

  I22.2 is used for a subsequent non-ST elevation myocardial infarction, which is not documented here.

  I21.19 and I21.3 do not specify the documented inferolateral wall STEMI.

  Therefore, the correct answer is B. I21.29.

• Question 306:

  The gastroenterologist performs a simple excision of three external hemorrhoids and one internal hemorrhoid, each lying along the left lateral column. The operative report indicates that the internal hemorrhoid is not prolapsed and is outside of the anal canal.

  What CPT and ICD-10CM codes are reported?

  A. 46320, 46945, K64.0, K64.9
  B. 46250, K64.0, K64.9
  C. 46255, K64.0, K64.4
  D. 46250, 46945, K64.0, K64.4
  B. 46250, K64.0, K64.9

• Question 307:

  A patient presents with dysuria and lower abdominal pain. The physician suspects UTI. An automated urinalysis without microscopy is done in the office and is negative. UTI is ruled out for the final diagnosis.

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

  A. 81003, N39.0, R30.0, R10.30
  B. 81003, R30.0, R10.30
  C. 81001, N39.0, R30.0, R10.30
  D. 81001, N39.0
  B. 81003, R30.0, R10.30

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  Explanation

  The urinalysis performed is described as automated, without microscopy, which corresponds to CPT(R) code 81003, urinalysis, automated, without microscopy. CPT(R) code 81001 includes microscopy and is not supported because the question explicitly states "without microscopy." For diagnosis coding, the provider suspected a UTI, but the urinalysis is negative and UTI is ruled out as the final diagnosis. Under ICD-10-CM reporting principles, conditions documented as ruled out are not coded in the outpatient/office setting; instead, you code the signs and symptoms that prompted the visit and testing. The symptoms documented are dysuria and lower abdominal pain, which are coded as R30.0 and R10.30, as presented in the answer choices. Therefore, the correct combination is 81003 with R30.0 and R10.30 only. CPC exam tip: outpatient "rule out" = code symptoms, not the excluded diagnosis.

• Question 308:

  A Medicare patient in a partial hospitalization program received occupational therapy services from a qualified occupational therapist.

  What is the HCPCS Level II code for this service?

  A. G0128
  B. G0153
  C. G0152
  D. G0129
  B. G0153

• Question 309:

  A 1-year-old patient was born with two supernumerary digits. One on the left includes bone and joint and is amputated. The right is a soft tissue nubbin removed by simple excision.

  What CPT(R) coding is reported?

  A. 26910-50
  B. 26951-50, 11200-50
  C. 26910-LT, 11200-RT
  D. 26587-LT, 11200-RT
  C. 26910-LT, 11200-RT

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  Explanation

  Supernumerary digit removal coding depends on whether the extra digit has bone/joint involvement or is a soft-tissue tag/nubbin. The left-hand extra digit includes a metacarpal bone with a joint, so it is treated as removal of an accessory digit with bony involvement and is reported with 26910. Because it is the left side, append modifier -LT.

  The right-hand extra digit is described as a nubbin with no bony structure, removed by simple excision.

  This aligns with a skin-tag-like removal code, 11200, for removal of benign skin tags/lesions by simple excision, with modifier -RT for laterality.

  You should not bill both sides with a single modifier -50 because the procedures are not the same on each side: one is a bony digit and the other is a soft-tissue nubbin.

  Therefore, 26910-LT and 11200-RT are correct.

• Question 310:

  A patient is seen at the doctor's office for nausea, vomiting, and sharp right lower abdominal pain. 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 ruptured appendicitis. The physician schedules an appendectomy and takes the patient to the operating room. The appendix is severed from the intestines and removed via scope inserted through an umbilical incision.

  What CPT(R) and diagnosis codes are reported?

  A. 44970, K35.32
  B. 44970, K35.32, R11.2, R10.31
  C. 44960, K35.80, R11.2, R10.31
  D. 44950, K35.890
  A. 44970, K35.32

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  Explanation

  Procedure Coding:

  44970 - Laparoscopic appendectomy.

  The appendix was removed via scope through an umbilical incision, confirming a laparoscopic approach.

  Diagnosis Coding:

  K35.32 - Acute appendicitis with perforation and localized peritonitis, without abscess.

  Documentation supports ruptured (perforated) appendicitis.

  No abscess is documented.

  Why Other Options Are Incorrect: Option B - Signs/symptoms (R11.2, R10.31) are not coded once a definitive diagnosis is established.

  Option C - 44960 = Open appendectomy, not performed.

  Option D - 44950 = Open appendectomy, and the diagnosis code is incorrect.

  References:

  Do not code symptoms when a definitive diagnosis is confirmed.