AAPC AAPC-CPC Online Practice Questions and Exam Preparation

AAPC AAPC-CPC Online Questions & Answers

• Question 331:

  A physician excises a 3.5 cm malignant lesion including margins from the back. Then a destruction of a 2.0 cm benign lesion on the right cheek of the face with cryosurgery.

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

  A. 11604, 11442, C76.8, C76.0
  B. 11404, 11442, C44.509, D23.39
  C. 11604, 17110, C44.509, D23.39
  D. 11604, 11642, C76.8, C76.0
  C. 11604, 17110, C44.509, D23.39

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  Explanation

  1. CPT(R) code 11604:

  This code is used for the excision of a malignant lesion on the back, with a size of 3.5 cm including margins. The 11600 series covers excision of malignant skin lesions, with 11604 being the correct code for a lesion size over 3.0 cm but not exceeding 4.0 cm.

  2. CPT(R) code 17110:

  This code is appropriate for the destruction of a benign lesion on the face (right cheek) via cryosurgery. 17110 covers destruction of benign lesions, up to 14 lesions.

  3. ICD-10-CM Code C44.509:

  This code represents unspecified malignant neoplasm of skin of trunk, which includes the back.

  4. ICD-10-CM Code D23.39:

  This code is used for a benign neoplasm of skin of other parts of the face, including the right cheek.

  Review of other options:

  Option A: 11604, 11442, C76.8,

  C76.0: Incorrect because 11442 is for excision of a benign lesion, not destruction of a benign lesion.

  Option B: 11404, 11442, C44.509,

  D23.39: Incorrect because 11404 is used for benign lesion excision, not malignant lesion excision.

  Option D: 11604, 11642, C76.8,

  C76.0: Incorrect because 11642 would indicate a second malignant excision rather than benign lesion destruction.

  Thus, the correct answer is Option C, 11604, 17110, C44.509, D23.39.

• Question 332:

  Full Case:

  Chief complaint: Syncope.

  HPI: A 68-year-old male arrives at the ED in respiratory distress after sudden syncope/collapse while shopping. He is unresponsive. EMS reports a weak pulse, labored respirations, and unresponsiveness.

  History: CABG 5 years ago, no chest pain since.

  ROS: Unobtainable because the patient is unconscious.

  Allergies: None.

  Medications: Coumadin.

  PMH: Hypertension.

  Social: Lives with wife.

  Exam/Vitals: BP 82/62, pulse 79, RR 12 and shallow, O2 saturation 90% on high-flow oxygen. The monitor shows right bundle branch block.

  Neuro: Initially, eyes are closed. The patient opens his eyes to questions and responds to some questions, then later becomes unresponsive.

  HEENT: Pupils sluggish and equal; unable to assess EOM/fundus.

  Neck: Supple, no JVD or bruits.

  Lungs: Mild rhonchi.

  Heart: Regular rhythm without murmurs.

  Abdomen: Benign.

  Extremities: Symmetric, no edema or cyanosis.

  Skin: No rash.

  Neuro: No focal deficits.

  Hospital course: IV x 2; NS 1000 cc bolus with little response; dopamine drip 10-20 mcg/kg/min; O2 saturation drops; respirations slow; patient becomes unresponsive and progresses to cardiac arrest. CPR is performed, with multiple doses of adrenaline and atropine, defibrillation, ABG showing pH 7.1, bicarbonate x 2, with no effect. The patient is pronounced dead at 13:32.

  Critical care time: 77 minutes continuous.

  Diagnosis: Cardiorespiratory arrest.

  What E/M coding is reported for this encounter?

  A. 99291, 99285
  B. 99285
  C. 99291
  D. 99291, 99292
  D. 99291, 99292

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  Explanation

  The patient was critically ill with hemodynamic instability, respiratory failure progression, and cardiac arrest, requiring intensive interventions, including multiple IVs, a large bolus, vasopressor infusion, resuscitation with CPR, defibrillation, medications, and ABG management.

  The provider documents 77 minutes of continuous critical care time. Critical care is reported with 99291 for the first 30-74 minutes on a date of service, and 99292 for each additional 30 minutes beyond that threshold.

  Because 77 minutes exceeds 74 minutes, report 99291 plus 99292. One unit of 99292 covers the additional time beyond the initial critical care window.

  Do not additionally report an ED E/M code, such as 99285, on the same date for the same provider when critical care encompasses the ED evaluation and management during that time period. The critical care service is the appropriate E/M reporting.

  The scenario supports that critical care criteria are met: high probability of life-threatening deterioration and active physician management.

  Therefore, the correct E/M coding is 99291, 99292.

• Question 333:

  Which statement is FALSE in reporting a personal history ICD-10-CM code?

  A. A personal history code can be reported as a first-listed code when the reason for encounter is for a screening.
  B. A personal history code can be reported with follow-up codes.
  C. A personal history code is acceptable on any medical record regardless of the reason for the visit.
  D. A personal history code is reported when the patient's condition is no longer present or being treated.
  C. A personal history code is acceptable on any medical record regardless of the reason for the visit.

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  Explanation

  In ICD-10-CM coding, personal history codes are used to indicate a patient's past medical conditions that no longer exist and are not receiving active treatment, but that may influence current care or require continued monitoring. Option A is correct because a personal history code can be reported as a first-listed code if the encounter is specifically for screening due to a past condition. Option B is correct because personal history codes can be reported with follow-up codes to indicate that the patient is being monitored for recurrence of the past condition. Option D is correct because a personal history code is used when the patient no longer has or is being treated for that condition, but it remains relevant to the patient's health history. Option C is false because a personal history code is not used indiscriminately on any medical record; it is only appropriate when the past condition is relevant to the current encounter or impacts current patient care. Therefore, the correct answer is Option C. A personal history code is acceptable on any medical record regardless of the reason for the visit.

• Question 334:

  A new patient presents to the ophthalmologist with a complaint of visual disturbances and decreased vision for one month. He has blind spots in his peripheral visual field. A comprehensive medical eye exam is performed, in addition to fundus photography and an extended visual field examination. The interpretation and report are in the medical record. Final diagnosis is primary open angle glaucoma, mild stage in both eyes.

  What CPT and ICD-10-CM codes are reported?

  A. 92004, 92250, 92081, H40.1111, H40.1121
  B. 92002, 92250, 92083, H40.1111, H40.1121
  C. 92004, 92250, 92083, H40.1131
  D. 92002, 92250, 92082, H40.1131
  A. 92004, 92250, 92081, H40.1111, H40.1121

• Question 335:

  A 78-year-old patient experiencing intermittent asthma with exacerbation is in her pulmonologist's office for a pulmonary function test. The pulmonologist performs spirometry and flow-volume measurements before and after administering a bronchodilator.

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

  A. 94060, J45.21
  B. 94070, J45.21
  C. 94070, J45.901
  D. 94060, J45.901
  A. 94060, J45.21

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  Explanation

  CPT(R) code 94060 is reported for bronchodilation responsiveness, spirometry as in 94010, with pre-and post-bronchodilator administration.

  Code 94010 is not reported separately because 94060 includes the spirometry performed before and after bronchodilator administration.

  Code 94070 is for bronchospasm provocation testing and does not apply to standard pre-and post-bronchodilator spirometry.

  For the diagnosis, the patient has intermittent asthma with exacerbation. ICD-10-CM code J45.21 reports mild intermittent asthma with acute exacerbation.

  Therefore, the correct answer is A. 94060, J45.21.

• Question 336:

  A patient arrives with pain due to a chest injury from blunt force. The provider performs X-ray imaging with 6 views of the chest.

  What CPT(R) coding is reported?

  A. 71048 x 6
  B. 71047 x 2
  C. 71047
  D. 71048
  D. 71048

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  Explanation

  Chest radiography codes are selected by the number of views performed. CPT(R) code 71047 is for a chest X-ray with 2 views, while 71048 is for a chest X-ray with 3 or more views.

  When the number of views exceeds a code's defined range, you generally do not report the code multiple times per extra view; instead, you select the CPT(R) code that best describes the service family and view count as structured by the code set and payer rules.

  view or per-unit reporting. Therefore, within the provided choices, the correct answer is 71048.

• Question 337:

  A 47-year-old patient previously had a right mastoidectomy and an implanted osseointegrated BAHA device. The patient now presents with chronic infection, implant migration, and osteomyelitis of the right temporal bone. The surgeon performs a revision mastoid procedure with debridement, removes the existing BAHA implant, and places a new osseointegrated BAHA in a new skull location.

  What CPT(R) codes are reported?

  A. 69502-RT, 69714-RT
  B. 69601-RT, 69717-RT
  C. 69502-RT, 69714-RT, 69990
  D. 69601-RT, 69717-RT, 69990
  A. 69502-RT, 69714-RT

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  Explanation

  This operative note describes two major components: (1) revision mastoid surgery to treat chronic infection/osteomyelitis and remove diseased tissue, and (2) replacement/placement of a BAHA osseointegrated implant in a new location. In the answer set, 69502-RT represents the revision mastoidectomy-type service, appropriate because this is not a first-time mastoidectomy and includes significant revision/debridement work. 69714-RT represents implantation of an osseointegrated skull device, such as a BAHA. The case uses magnifying loupes, not an operating microscope, so 69990 is not supported. CPT 69990 requires an operating microscope to be explicitly documented, and loupes alone do not meet that requirement. Options using 69717 do not match the described implant service in this question's choices. Therefore, the correct reporting per the options is 69502-RT and 69714-RT.

• Question 338:

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

  A. A service that is commonly carried out as an integral component of a total service is identified by the inclusion of the term "separate procedure."
  B. Codes designated as "separate procedure" should not be reported in addition to the code for the total procedure when integral.
  C. When a procedure is designated as a separate procedure and carried out independently or unrelated, it may be reported.
  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.

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  Explanation

  Modifier 79 is not automatically required for "separate procedure" designation.

  It applies only to unrelated procedures during the postoperative period.

  Separate procedure logic is based on whether the service is distinct and not integral.

• Question 339:

  What ICD-10-CM coding is reported for Type 1 diabetes with diabetic chronic kidney disease?

  A. E11.21
  B. E10.22, N18.9
  C. E10.21
  D. E10.22, N18.1
  B. E10.22, N18.9

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  Explanation

  E10.22 = Type 1 diabetes mellitus with diabetic chronic kidney disease.

  Add N18.- for CKD stage.

  Stage not specified N18.9.

• Question 340:

  A wedge excision of soft tissue at the lateral margin of an ingrown toenail on the left great toe is performed.

  What CPT(R) code is reported?

  A. 11750-TA
  B. 11765-TA
  C. 11755-TA
  D. 11730-TA
  B. 11765-TA

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  Explanation

  11765 = Excision of nail fold (wedge excision), ingrown toenail

  TA = Left great toe