AAPC AAPC-CPC Online Practice Questions and Exam Preparation

AAPC AAPC-CPC Online Questions & Answers

• Question 411:

  Which punctuation is used in the ICD-10-CM Tabular List to denote synonyms, alternative wording, or explanatory phrases?

  A. Colons
  B. Semicolon
  C. Parentheses
  D. Brackets
  C. Parentheses

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  Explanation

  In the ICD-10-CM Tabular List, parentheses ( ) are used to enclose nonessential modifiers, also described as supplementary words. These are words that may be present or absent in the diagnostic statement without affecting code assignment.

  This is why parentheses are associated with synonyms, alternative wording, or explanatory phrases. If the provider documents the core diagnosis and the parenthetical term is missing, the code can still be correct;

  if the parenthetical term is present, it still points to the same code.

  By contrast, a colon (:) is used after an incomplete term that needs one or more additional terms to make it assignable. Brackets [ ] have other specific functions, such as identifying manifestation codes in the Alphabetic Index and enclosing synonyms or alternative wording in the Tabular List in certain contexts.

  However, the standard CPC-tested definition for synonyms, alternative wording, or explanatory phrases in the Tabular List points to parentheses as nonessential modifiers.

  Knowing this distinction supports accurate code selection and reduces errors when provider wording varies.

• Question 412:

  A Medicare patient is scheduled for a screening colonoscopy.

  What code is reported for Medicare?

  A. G0106
  B. G0121
  C. 45378
  D. G0105
  D. G0105

• Question 413:

  A 58-year-old patient undergoes diagnostic facet joint injections. The physician performs bilateral paravertebral facet joint injections at the T2-T3, T3-T4, and T4-T5 levels, using fluoroscopic guidance at each site.

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

  A. 64490-50, 64491 x 2, 64492 x 2
  B. 64493, 64494
  C. 64493-50, 64494-50, 64495-50, 76000
  D. 64490-50, 64491-50, 64492-50
  D. 64490-50, 64491-50, 64492-50

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  Explanation

  Facet joint injections, medial branch blocks/intra-articular depending on code family, are coded by spinal region and number of levels. Thoracic facet injections use 64490 for the first level, 64491 for the second level, and 64492 for the third and each additional level within the thoracic region. This case includes three thoracic levels: T2-T3, first; T3-T4, second; and T4-T5, third. Because the injections are bilateral, you apply modifier -50 to each of the level codes per the answer set's style. Fluoroscopic guidance is built into these injection codes under current CPT(R) rules, so you do not separately report a fluoroscopy code, such as 76000. Options B and C are for lumbar/sacral facet injection families, not thoracic. Option A incorrectly doubles units rather than using the correct third-level add-on coding structure. Therefore, 64490-50, 64491-50, 64492-50 is correct.

• Question 414:

  View MR 099405

  MR 099405

  CC: Shortness of breath

  HPI: 16-year-old female comes into the ED for shortness of breath for the last two days.

  She is an asthmatic.

  Current medications being used to treat symptoms is Advair, which is not working and breathing is getting worse. Does not feel that Advair has been helping. Patient tried Albuterol for persistent coughing, is not helping. Coughing 10-15 minutes at a time. Patient has used the Albuterol 3x in the last 16 hrs. ED physician admits her to observation status.

  ROS: No fever, no headache. No purulent discharge from the eyes. No earache. No nasal discharge or

  sore throat. No swollen glands in the neck. No palpitations. Dyspnea and cough. Some chest pain. No nausea or vomiting. No abdominal pain, diarrhea, or constipation.

  PMH: Asthma

  SH: Lives with both parents.

  FH: Family hx of asthma, paternal side

  ALLERGIES: PCN-200 CAPS. Allergies have been reviewed with child's family and no changes reported.

  PE: General appearance: normal, alert. Talks in sentences. Pink lips and cheeks. Oriented.

  Well developed. Well nourished. Well hydrated.

  Eyes: normal. External eye: no hyperemia of the conjunctiva. No discharge from the conjunctiva

  Ears: general/bilateral. TM: normal. Nose: rhinorrhea. Pharynx/Oropharynx: normal. Neck: normal.

  Lymph nodes: normal.

  Lungs: before Albuterol neb, mode air entry b/l. No rales, rhonchi or wheezes. After Albuterol neb. improvement of air entry b/l. Respiratory movements were normal. No intercostals inspiratory retraction was observed.

  Cardiovascular system: normal. Heart rate and rhythm normal. Heart sounds normal. No murmurs were heard.

  GI: abdomen normal with no tenderness or masses. Normal bowel sounds. No hepatosplenomegaly

  Skin: normal warm and dry. Pink well perfused

  Musculoskeletal system patient indicates lower to mid back pain when she lies down on her back and when she rolls over. No CVA tenderness.

  Assessment: Asthma, acute exacerbation

  Plan: Will keep her in observation overnight. Will administer oral steroids and breathing treatment. CXR ordered and to be taken in the morning.

  What E/M code is reported?

  A. 99221
  B. 99284
  C. 99285
  D. 99222
  B. 99284

• Question 415:

  A 45-year-old patient comes in with chronic sinusitis that has not responded to medication. The physician decides to use a sinus stent implant to help alleviate the patient's symptoms. The physician inserts the implant into the ethmoid sinus using a delivery system. This implant is designed to keep the surgical opening clear, prop open the sinus, and gradually release a corticosteroid with anti-inflammatory properties directly to the sinus lining. The implant is not permanent and will dissolve over time.

  What HCPCS Level II code is reported?

  A. C2617
  B. C1877
  C. SI091
  D. C9600
  A. C2617

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  Explanation

  C2617 - Sinus implant, drug-eluting.

  The described implant is placed in the ethmoid sinus, is drug-eluting, releases a corticosteroid, and is absorbable.

  Why others are incorrect: C1877 - Vascular stent.

  S1091 - Not the best match for the described drug-eluting sinus implant in this answer set.

  C9600 - Coronary intervention.

• Question 416:

  On examination, the physician notes a yellowish vaginal discharge with a foul odor. A gram stain is performed in the office by collecting a sample of the discharge and a thin layer is placed on a glass slide.

  The results show the patient has chlamydia. The lab test was performed in the office which is regulated by federal rules under the Clinical Laboratory Improvement Amendments (CLIA).

  How is this lab test reported?

  A. 87205-QW
  B. 87205-GA
  C. 87207-GA
  D. 87207-QW
  D. 87207-QW

• Question 417:

  A patient presents with fatigue and unexplained weight gain. To evaluate possible thyroid dysfunction, the provider orders a single laboratory test to measure thyroid-stimulating hormone (TSH). A routine venous blood sample is collected and sent to the laboratory.

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

  A. 84443, E07.9, R53.83, R63.5
  B. 84443, R53.83, R63.5
  C. 84445, E07.9, R53.83, R63.5
  D. 84445, R53.83, R63.5
  B. 84443, R53.83, R63.5

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  Explanation

  TSH testing is reported with CPT(R) code 84443.

  The scenario describes a workup for possible thyroid dysfunction, but there is no confirmed thyroid diagnosis provided, only symptoms of fatigue and weight gain.

  In outpatient coding, when a definitive diagnosis is not established, code the signs and symptoms that justify the test. Therefore, the correct ICD-10-CM codes are R53.83, other fatigue, and R63.5, abnormal weight gain.

  Do not assign a thyroid disorder code, such as E07.9, unspecified disorder of thyroid, unless the provider documents an actual thyroid disorder diagnosis. Suspicion alone does not support it in the outpatient setting.

  Options C and D list 84445, which is not the standard CPT(R) code for TSH measurement in CPC exam coding.

  This question tests both correct lab code selection and the outpatient guideline principle of coding symptoms when the diagnosis is not confirmed. Therefore, 84443 with R53.83 and R63.5 is correct.

• Question 418:

  A patient arrives at the clinic experiencing pain due to a chest injury caused by blunt force. The provider takes X-ray imaging with 6 views of the chest.

  What CPT(R) coding is reported?

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

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  Explanation

  71048 - Radiologic examination, chest; complete, minimum of 4 views.

  This includes 6 views.

  CPT codes are based on view ranges, not per-view billing.

  Why Other Options Are Incorrect:

  71047 - Chest X-ray, 3 views.

  CPT does not allow reporting the chest X-ray code per view.

• Question 419:

  A patient is diagnosed with sepsis due to enterococcus.

  What ICD-10-CM code is reported?

  A. A41.52
  B. A41.9, R65.20
  C. A41.81
  D. A41.9
  A. A41.52

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  Explanation

  A41.52 = Sepsis due to Enterococcus.

  When the organism is specified, a combination code is used.

  No additional code for severe sepsis is documented.

• Question 420:

  A dermatologist excises a basal cell lesion from an area of the scalp, measuring 3.7 cm. This is closed with a layered repair.

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

  A. 11424, 12032, D44.41
  B. 11624, C44.399
  C. 11624, 12032, C44.41
  D. 11424, D23.4
  C. 11624, 12032, C44.41

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  Explanation

  Basal cell carcinoma is a malignant skin neoplasm, so the excision is coded from 11600-11646 (malignant lesion excision), not 11400-11446 (benign lesion excision). The scalp is in the anatomic group that includes scalp/neck/hands/feet/ genitalia, and the excised diameter including margins determines the malignant excision code range. A size of 3.7 cm falls into the 3.1-4.0 cm category, which corresponds to 11624 for malignant excision in that location group. Closure is separately reportable when it is an intermediate (layered) repair, so you add 12032 (intermediate repair, scalp/axillae/trunk/extremities; 2.6-7.5

  cm) when documentation supports layered closure beyond simple repair. Diagnosis coding should reflect basal cell carcinoma of scalp/neck, which is C44.41. Options that use benign excision or benign diagnosis codes are incorrect for basal cell carcinoma.