AAPC AAPC-CPC Online Practice Questions and Exam Preparation

AAPC AAPC-CPC Online Questions & Answers

• Question 361:

  A patient undergoes lumbar puncture with catheter placement under CT guidance to drain CSF.

  What CPT(R) coding is reported?

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

  ---

  Explanation

  The procedure is a therapeutic spinal puncture for 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 imaging guidance is included in 62329 and is not separately reported with 77012.

  62270 is for diagnostic lumbar puncture without imaging guidance. 62272 is for therapeutic spinal puncture without fluoroscopic or CT guidance. 62328 is for diagnostic lumbar puncture with fluoroscopic or CT guidance.

  Therefore, the correct answer is Option D. 62329.

• Question 362:

  Refer to the supplemental information when answering this question: View MR 000281.

  What anesthesia and diagnosis codes are reported for this case?

  A. 00812, D62, N18.6, Z99.2
  B. 00811, D64.9, K62.5, N18.6, Z99.2
  C. 00812, D64.9, K62.5, N18.6, Z99.2
  D. 00811, D62, N18.6, Z99.2
  D. 00811, D62, N18.6, Z99.2

  ---

  Explanation

  CPT(R) code 00811: Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to the splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing.

  This code is reported for anesthesia services provided during a colonoscopy that is diagnostic in nature.

  ICD-10-CM code D62: Acute posthemorrhagic anemia.

  This is the most accurate postoperative diagnosis. The operative report states "Anemia due to acute blood loss."

  ICD-10-CM code N18.6: End stage renal disease.

  This code captures the patient's documented history of ESRD.

  ICD-10-CM code Z99.2: Dependence on renal dialysis.

  This code is necessary to report the patient's dialysis status, as it affects the overall risk of the procedure.

  Why the other options are incorrect: 00812: This code is for screening colonoscopy anesthesia, not diagnostic colonoscopy anesthesia.

  D64.9: This code is for anemia, unspecified. D62 is more specific to the patient's condition.

  K62.5: This code is for lower gastrointestinal bleeding, but the anemia is the primary diagnosis in this case.

  References:

  CPT(R) code 00811: Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to the splenic flexure

  diagnostic, with or without collection of specimen(s) by brushing or washing.

  ICD-10-CM code D62: Acute posthemorrhagic anemia.

  ICD-10-CM code N18.6: End stage renal disease.

  ICD-10-CM code Z99.2: Dependence on renal dialysis.

  AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.

• Question 363:

  A cardiologist performs and interprets a 12-lead ECG in the office.

  What CPT(R) coding is reported?

  A. 93000-26
  B. 93010
  C. 93010-26
  D. 93000
  D. 93000

  ---

  Explanation

  93000 = ECG with tracing, interpretation, and report.

  93010 = Interpretation only.

• Question 364:

  View MR 004397

  MR 004397

  Operative Report

  Preoperative Diagnosis: Calculi of the gallbladder

  Postoperative Diagnosis: Calculi of the gallbladder, chronic cholecystitis

  Procedure: Cholecystectomy

  Indications: The patient is a 50-year-old woman who has a history of RUQ pain, which ultrasound revealed to be multiple gallstones. She presents for removal of her gallbladder.

  Procedure: The patient was brought to the OR and prepped and draped in a normal sterile fashion. After adequate general endotracheal anesthesia was obtained, a trocar was placed and C02 was insufflated into the abdomen until an adequate pneumoperitoneum was achieved. A laparoscope was placed at the umbilicus and the gallbladder and liver bed were visualized. The gallbladder was enlarged and thickened, and there was evidence of chronic inflammatory changes. Two additional ports were placed and graspers were used to free the gallbladder from the liver bed with a combination of sharp dissection and electrocautery. Cystic artery and duct are clipped. Dye is injected in the gallbladder. Cholangiography revealed no intraluminal defect or obstruction. Gallbladder is dissected from the liver bed. The scope and trocars are removed.

  What CPT coding is reported for this case?

  A. 47562, 74300-26
  B. 47563, 74300-26
  C. 47605, 74300-26
  D. 47600, 74300-26
  B. 47563, 74300-26

• Question 365:

  

  Refer to the supplemental information when answering this question: View MR 623654

  What CPT(R) coding is reported for this case?

  A. 14001, 11606-51, 12034-51
  B. 14001
  C. 14001, 11606-51
  D. 15271
  B. 14001

  ---

  Explanation

  When adjacent tissue transfer or rearrangement is performed, the excision of the lesion and the closure of the defect are included in the adjacent tissue transfer code. The malignant lesion excision code and separate repair code are not reported separately when the excision and closure are integral to the adjacent tissue transfer.

  Therefore, the correct code is 14001.

• Question 366:

  A pediatrician is requested to attend a high-risk delivery and performs initial stabilization of the newborn after cesarean delivery.

  What E/M service is reported?

  A. 99464
  B. 99465
  C. 99464, 99465
  D. 99460
  A. 99464

  ---

  Explanation

  99464 = Attendance at delivery with initial stabilization. 99465 is used when resuscitation is required. 99460 is for normal newborn care after birth.

• Question 367:

  Which one of the following is an example of a case in which a diabetes-related problem exists and the code for diabetes is never sequenced first?

  A. If the patient has hyperglycemia that Is not responding to medication
  B. If the patient has an underdose of insulin due to an insulin pump malfunction
  C. If the patient is being treated for secondary diabetes
  D. If the patient is being treated for type 2 diabetes
  B. If the patient has an underdose of insulin due to an insulin pump malfunction

• Question 368:

  The outermost protective layer of skin is called the:

  A. Epidermis
  B. Hypodermis
  C. Subcutaneous tissue
  D. Dermis
  A. Epidermis

• Question 369:

  A 45-year-old male, with no prior history of heart disease, has been diagnosed with atherosclerotic heart disease with unstable angina. He is in the cardiologist's office for a cardiac MRI test to determine the morphology and function of his heart under stress. First, images obtained are without contrast, and then contrast is administered for the next set of images. Then the physician injects medicine to increase the heart rate and checks the coronary arteries for narrowing or blockage. The physician interprets the test, and the results and images are in the medical record.

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

  A. 75563-26, 125.118
  B. 75559-26, 125.118
  C. 75563, 125.110
  D. 75557, 75559, 125.110
  A. 75563-26, 125.118

  ---

  Explanation

  1. Procedure and CPT(R)

  Code Selection:

  The patient underwent a cardiac MRI to assess the morphology and function of the heart under stress, involving both non-contrast and contrast-enhanced imaging. Additionally, pharmacological stress testing was performed to evaluate the coronary arteries.

  CPT(R) code 75563 is appropriate for a cardiac MRI with both stress and rest imaging, including morphology and function studies with contrast and pharmacologic stress testing. This code accurately captures the entire scope of the MRI study described in this case. Modifier 26 is applied to indicate the professional component of the service if the cardiologist is providing only the interpretation and not the technical component.

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

  ICD-10-CM code I25.118 is used for atherosclerotic heart disease with other forms of angina pectoris. This code accurately reflects the diagnosis provided in the scenario.

  3. Rationale for Excluding Other Options:

  Code 75559, option B, represents a cardiac MRI without the pharmacologic stress component performed here.

  Code 75557, in option D, is for a limited cardiac MRI that does not include both stress and non-stress imaging, so it is incorrect for this comprehensive test. ICD-10-CM code I25.110, in options C and D, is for atherosclerosis with unspecified angina pectoris, making I25.118 more appropriate given the diagnosis of unstable angina in the answer set.

  4. AAPC and CPT(R)

  Coding Guidelines:

  AAPC and CPT(R) guidelines support the use of 75563 for comprehensive cardiac MRI studies with stress testing, both with and without contrast.

  Therefore, the correct answer is A. 75563-26, I25.118.

• Question 370:

  Patient is diagnosed with dacryocystitis, which is the inflammation of?

  A. Cornea
  B. Fingernail
  C. Eardrum
  D. Lacrimal sac
  D. Lacrimal sac