AAPC AAPC-CPC Online Practice Questions and Exam Preparation

AAPC AAPC-CPC Online Questions & Answers

• Question 391:

  A 62-year-old with ventricular fibrillation comes to the outpatient surgery department for the replacement of a pacing cardioverter-defibrillator. The procedure is performed under MAC anesthesia. The Certified Registered Nurse Anesthetist (CRNA) is working independently without medical direction.

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

  A. 00534-QZ-QS, I49.01
  B. 00520-QZ-QS, I49.01
  C. 00520-QY, I48.91
  D. 00534-QY, I48.91
  A. 00534-QZ-QS, I49.01

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  Explanation

  00534 reports anesthesia for procedures on a pacemaker or cardioverter-defibrillator. Modifier QZ is reported when the CRNA service is performed without medical direction by a physician. Modifier QS indicates monitored anesthesia care.

  ICD-10-CM code I49.01 reports ventricular fibrillation.

  Why others are incorrect: 00520 is for anesthesia for closed chest procedures, not replacement of a pacemaker/cardioverter-defibrillator.

  Modifier QY indicates medical direction of one CRNA by an anesthesiologist, which is not documented.

  I48.91 reports unspecified atrial fibrillation, not ventricular fibrillation.

• Question 392:

  A provider performs a mastoidectomy and complete labyrinthectomy for right-sided peripheral vertigo.

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

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

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  Explanation

  69905 = Transmastoid labyrinthectomy.

  69990 = Operating microscope, separately reportable.

  H81.391 = Peripheral vertigo, right ear.

  R42, dizziness, is not reported when a definitive diagnosis exists.

• Question 393:

  What is done when a surgeon performs a bilateral oophorectomy?

  A. Removal of both fallopian tubes
  B. A sling procedure for vaginal prolapse
  C. Laparoscopic removal of the uterus
  D. Removal of both ovaries
  D. Removal of both ovaries

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  Explanation

  Break the term into parts: "oophor-" refers to the ovary, and "-ectomy" means surgical removal/excision.

  The modifier "bilateral" means both sides, right and left. Put together, bilateral oophorectomy means surgical removal of both ovaries. This is commonly confused with salpingectomy, removal of fallopian tube (s), and hysterectomy, removal of the uterus. CPC terminology questions often use these closely related female reproductive terms as distractors, so the safest approach is to anchor on the root: "oophor" = ovary, "salping" = fallopian tube, "hyster/uter" = uterus. If it were removal of both tubes, it would be bilateral salpingectomy; removal of the uterus, open or laparoscopic, is still a hysterectomy, not an oophorectomy.

  The "bilateral" part is critical. Without it, an oophorectomy could be unilateral, involving one ovary.

• Question 394:

  Which of the following is classified as coronary arteries?

  A. Circumflex, Posterior Descending, Left Anterior Descending
  B. Aortic, Internal Carotid, Circumflex
  C. Renal, Internal Carotid, Interosseous
  D. Pulmonary, Internal Carotid, Interosseous
  A. Circumflex, Posterior Descending, Left Anterior Descending

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  Explanation

  Coronary arteries are the arteries that supply blood directly to the heart muscle, or myocardium. The major coronary vessels include the left anterior descending (LAD) artery and the left circumflex artery, which are branches of the left coronary system, and the right coronary artery system, which commonly gives rise to the posterior descending artery (PDA) in right-dominant circulation.

  Option A lists vessels that are recognized as coronary arteries or named coronary branches seen in cardiology and coding contexts: LAD, circumflex, and PDA.

  The other options mix coronary with non-coronary vessels. The aorta is the main outflow artery from the heart but is not itself a coronary artery. The internal carotid supplies the brain. The renal artery supplies the kidneys. The interosseous artery supplies forearm regions. The pulmonary arteries carry blood from the right ventricle to the lungs.

  CPC exam strategy: If the list includes classic coronary names such as LAD and circumflex, it is almost certainly the coronary set, especially when distractors include arteries from unrelated organ systems.

• Question 395:

  A provider orders liquid chromatography mass spectrometry (LC-MS) definitive drug testing for a patient suspected of acetaminophen (analgesic) overdose.

  What CPT(R) code is reported for the test?

  A. 80143
  B. 80329
  C. 80299
  D. 80324
  B. 80329

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  Explanation

  80329 = Definitive drug testing for one or two nonopioid analgesics.

  Acetaminophen is a nonopioid analgesic, and the test is described as definitive drug testing by LC-MS. 80143 is a therapeutic drug assay for acetaminophen and is not the definitive drug testing code in this question. 80299 is an unlisted therapeutic drug assay. 80324 is for a different definitive drug class.

  Therefore, the correct answer is B. 80329.

• Question 396:

  A 2-year-old male presents with a single ventricular septal defect (VSD) and is in current heart failure. The decision is made to use a patch for the closure. Under general anesthesia, the skin incision is made via median sternotomy. Cardiopulmonary bypass is initiated. Under epicardial guidance, the muscular VSD is located. The guidewire is placed transmyocardially through the VSD. A patch is then delivered over guidance to close the VSD. After successful closure, the guidewire is removed, and the site is repaired. A chest tube is placed in the sternum.

  What is the correct code for this procedure?

  A. 33645
  B. 33681
  C. 33675
  D. 33647
  B. 33681

• Question 397:

  A male patient passes out while jogging in the park. Upon examination at the hospital, he is found to have a wide complex tachycardia and undergoes an electrophysiologic study and radiofrequency ablation. For this procedure, he is placed under general anesthesia.

  What is the anesthesia coding for this otherwise healthy 35-year-old?

  A. 00532-P2
  B. 01922-P2
  C. 01026-P1
  D. 00537-P1
  D. 00537-P1

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  Explanation

  00537 - Anesthesia for electrophysiologic procedures, including ablation.

  Patient is otherwise healthy = P1.

  Why others are incorrect:

  00532 - Pacemaker insertion.

  01922 - MRI.

  01026 - Lower extremity procedures.

• Question 398:

  A 55-year-old female with severe coronary arteriosclerosis with angina is admitted for elective coronary artery bypass. The surgeon performed a coronary artery bypass using a saphenous vein harvested endoscopically. The vein graft was anastomosed to the obtuse marginal and the left circumflex.

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

  A. 33534, 33508
  B. 33511, 33508
  C. 33534
  D. 33511
  B. 33511, 33508

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  Explanation

  CABG coding depends on (1) the number of coronary venous grafts and (2) the conduit type, venous vs. arterial. This case uses a saphenous vein graft, a venous conduit, to bypass two coronary targets: the obtuse marginal and the left circumflex. The CPT(R) code for CABG with two venous grafts is 33511. The separate code 33508 is reported for endoscopic harvest of vein when performed for CABG, which is specifically documented here, "harvested endoscopically." 33534 is for an arterial graft, such as an internal mammary artery, and does not match a saphenous vein-only description. Option D omits the separately reportable endoscopic harvest service documented. CPC exam approach: identify conduit, vein = 33510- 33516 family, count distal anastomoses, two = 33511, and add endoscopic harvest, 33508, when documented.

• Question 399:

  A patient presents for planned sterilization via bilateral excisional vasectomy.

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

  A. 55250, Z30.2
  B. 55250, Z30.012
  C. 55250-50, Z30.012
  D. 55250-50, Z30.2
  A. 55250, Z30.2

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  Explanation

  55250 = Vasectomy, unilateral or bilateral, including postoperative semen examination(s).

  The bilateral procedure is inherent in the code description, so modifier -50 is not appended.

  Z30.2 = Encounter for sterilization.

  Z30.012 is for emergency contraception counseling and prescription, not planned sterilization.

• Question 400:

  A patient is diagnosed with a healing pressure ulcer on her left heel that is currently being treated.

  What ICD-10-CM coding is reported?

  A. L89.609
  B. L89.624
  C. L89.626
  D. L89.629
  B. L89.624

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  Explanation

  ICD-10-CM guidelines state that healing pressure ulcers are coded as the stage documented.

  The question does not document a specific stage for the healing pressure ulcer.

  L89.629 = Pressure ulcer of left heel, unspecified stage.

  Unspecified stage is appropriate when the stage is not documented.