AAPC AAPC-CPC Online Practice Questions and Exam Preparation

AAPC AAPC-CPC Online Questions & Answers

• Question 431:

  A patient presents to the emergency room with a nosebleed that is controlled by limited anterior nasal packing.

  What CPT(R) code is reported?

  A. 30903
  B. 30905
  C. 30901
  D. 30906
  C. 30901

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  Explanation

  30901 = Control of anterior epistaxis, limited, any method. 30903, 30905, and 30906 are for extensive packing or posterior epistaxis.

• Question 432:

  Preoperative diagnosis: Right thigh benign congenital hairy nevus.

  Postoperative diagnosis: Right thigh benign congenital hairy nevus.

  Operation performed: Excision of right thigh benign congenital nevus, excision size with margins 4.5 cm and closure size 5 cm.

  Anesthesia: General.

  Intraoperative antibiotics: Ancef.

  Indications: The patient is a 5-year-old girl who presented with her parents for evaluation of her right thigh congenital nevus. It has been followed by pediatrics and thought to have changed over the past year.

  Family requested excision. They understood the risks involved, which included but were not limited to risks of general anesthesia, infection, bleeding, wound dehiscence, and poor scar formation. They understood the scar would likely widen as the child grows because of the location of it and because of the age of the patient. They consented to proceed.

  Description of procedure: The patient was seen preoperatively in the holding area, identified, and then brought to the operating room. Once adequate general anesthesia had been induced, the patient's right thigh was prepped and draped in standard surgical fashion. An elliptical excision measuring 6 x 1.8 cm had been marked. This was injected with Lidocaine with epinephrine, total of 6 cc of 1% with 1:100,000. After

  an adequate amount of time, a #15 blade was used to sharply excise this full thickness. This was passed

  to pathology for review. The wound required limited undermining in the deep subcutaneous plane on both sides for approximately 1.5 cm in order to allow mobilization of the skin for closure. The skin was then closed in a layered fashion using 3-0 Vicryl on the dermis and then 4-0 Monocryl running subcuticular in the skin. The wound was cleaned and dressed with Dermabond and Steri-Strips. The patient was then cleaned and turned over to anesthesia for extubation. She was extubated successfully in the operating room and taken to the recovery room in stable condition. There were no complications.

  What CPT(R) coding is reported?

  A. 12002, 11406-51
  B. 12002, 11606-51
  C. 12032, 11406-51
  D. 12032, 11606-51
  B. 12002, 11606-51

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  Explanation

  The lesion is a benign congenital hairy nevus; therefore, benign lesion excision codes are used.

  Location: Right thigh, coded under trunk, arms, or legs.

  Excision size with margins = 4.5 cm, which supports 11406 for excision of a benign lesion of the trunk, arms, or legs, excised diameter over 4.0 cm.

  Closure length = 5 cm.

  The documentation states layered closure with limited undermining, which supports intermediate repair. 12032 = Intermediate repair, trunk and/or extremities, 2.6 cm to 7.5 cm.

  Modifier -51 applies to the secondary procedure when required by payer reporting rules.

  Therefore, the correct answer is C. 12032, 11406-51.

• Question 433:

  A patient has a 5 cm tumor in the left lower quadrant abdominal wall, excised through the dermis and subcutaneous tissue. Pathology is pending to rule out cancer.

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

  A. 22901, D49.2
  B. 22903, D49.2
  C. 22903, R19.04
  B. 22903, D49.2

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  Explanation

  22903 = Excision of soft tissue tumor, abdominal wall, subcutaneous, 3 cm or greater.

  D49.2 = Neoplasm of unspecified behavior of soft tissue.

  R codes are not used when a neoplasm is documented.

• Question 434:

  A patient's left eye is damaged beyond repair due to a work injury. The provider fabricates a prosthesis from silicone materials and makes modifications to restore the patient's cosmetic appearance.

  What CPT(R) code is reported?

  A. 21077
  B. 21080
  C. 21088
  D. 21086
  C. 21088

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  Explanation

  Procedure and CPT(R) code

  Selection: The scenario describes the fabrication of an ocular prosthesis due to a severe injury to the left eye. A prosthesis made from silicone materials was created and customized to restore cosmetic appearance.

  Code 21088 is the correct CPT(R) code for fabrication of an ocular prosthesis. This code accurately reflects the custom fabrication of a prosthesis to replace or augment damaged eye structures for aesthetic purposes.

  Ruling Out Other Options:

  Code 21077 applies to prosthetic augmentation or replacement of mandibular or maxillary structures, not ocular prostheses, so it does not apply here. Code 21080 covers impression and custom preparation of facial or oral prostheses but is not specific to the ocular prosthesis described here. Code 21086 pertains to an orbital prosthesis, which is used for the orbital area surrounding the eye, not specifically an ocular prosthesis. Since this scenario involves an ocular prosthesis, 21088 is the most precise choice.

  AAPC and CPT(R)Guidelines: According to AAPC and CPT(R) coding principles, using codes for facial prosthetics requires matching the specific anatomical site and purpose of the prosthesis. CPT(R)21088 is directly applicable to prosthetic replacement within the ocular region, making it the best fit.

  Thus, based on CPT(R)guidelines and coding standards, the verified answer is C. 21088.

• Question 435:

  A patient presents for evaluation of suspicious skin lesions. During the encounter, the provider performs:

  1. Incisional biopsy of a deep inflammatory lesion on the upper arm.

  2. Punch biopsy of a separate lesion on the forearm.

  3. Shave biopsy of a superficial lesion on the shoulder.

  Each biopsy is performed on a separate lesion for diagnostic purposes, and all specimens are submitted to pathology.

  What CPT(R) coding is reported?

  A. 11106, 11104-51, 11102-51
  B. 11106, 11104, 11102
  C. 11106, 11105, 11103
  D. 11106, 11105-51, 11103-51
  B. 11106, 11104, 11102

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  Explanation

  CPT biopsy codes for the skin are selected by technique and whether the biopsy is tangential (shave), punch, or incisional.In this scenario, three different biopsy techniques are performed on three separate lesions: an incisional biopsy of a deep lesion on the upper arm, a punch biopsy of a separate lesion on the forearm, and a shave biopsy of a superficial lesion on the shoulder.The first biopsy is reported with the appropriate primary code:11106 = Incisional biopsy of skin, single lesion.Additional biopsies are reported with the appropriate add-on codes based on technique:11105 = Each separate/additional punch biopsy lesion.11103 = Each separate/additional tangential/shave biopsy lesion.Modifier -51 is not appended to add-on codes.Therefore, the correct coding is 11106, 11105, 11103.

• Question 436:

  Patient with erectile dysfunction is presenting for same day surgery in removal and replacement of an inflatable penile prosthesis.

  What CPT(R) code is reported for this service?

  A. 54401
  B. 54400
  C. 4417
  D. 54416
  B. 54400

• Question 437:

  A patient visits her provider's office because she is experiencing persistent headaches. Her provider sends her to a radiology facility to do a CT scan of the brain without contrast. The images are sent to the provider, and the provider reads and interprets the scan.

  What CPT(R) coding of the radiology service is reported by the provider?

  A. 70450-26
  B. 70450
  C. 70450-TC
  D. 70450-26-TC
  A. 70450-26

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  Explanation

  CPT 70450 describes a CT of the head/brain without contrast. When a radiology facility performs the technical portion, including scanner, technologist, and supplies, and the provider only interprets and reports the study, the provider bills the professional component using modifier -26. That is exactly what the vignette describes: the radiology facility performed the scan, and the provider received images and provided the interpretation. Therefore, the provider reports 70450-26. Reporting 70450 alone would imply billing the global service, professional plus technical, which would be incorrect because the provider did not supply the equipment or technical resources. Modifier -TC is used to bill the technical component, which would be reported by the facility, not the interpreting provider in this scenario.

  Modifier -26 and -TC together are not appropriate because they represent opposite components of the same radiology service.

  CPC exam tip: Always determine who performed the technical work and who interpreted; then use -26 for interpretation-only billing.

• Question 438:

  A healthy 35-year-old patient undergoes an EP study and ablation under general anesthesia.

  What anesthesia coding is correct?

  A. 01922-P2
  B. 00537-P1
  C. 01926-P1
  D. 00532-P2
  B. 00537-P1

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  Explanation

  00537 = Anesthesia for EP procedures.

  P1 = Normal healthy patient.

• Question 439:

  A wheelchair-bound resident of a skilled nursing facility is seen in the physician's office. The physician's office makes arrangements with a social worker to take the patient back to the skilled nursing facility.

  What is the HCPCS Level II transportation service code?

  A. A0100
  B. A0130
  C. A0120
  D. A0160
  B. A0130

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  Explanation

  This scenario describes non-emergency transportation arranged for a patient who is wheelchair-bound, traveling between a physician's office and a skilled nursing facility. HCPCS Level II includes specific "A" codes for non-emergency transport categories. The code that corresponds to non-emergency transportation by wheelchair van, transport appropriate for a wheelchair-bound patient not requiring an ambulance, is A0130 in CPC-style code selection questions. By contrast, A0428/A0429 would be ambulance codes, which are not offered here, and other A-codes in this option set represent different non-emergency transport circumstances, such as general transportation, litter van, or transportation that does not specify wheelchair accommodation. The presence of a social worker arranging transport and the patient's wheelchair-bound status strongly cues a wheelchair van level of service rather than ambulance.

  On the CPC exam, pay close attention to transport level: ambulance implies medical monitoring/medical necessity; wheelchair van implies mobility needs without ambulance-level clinical support. Therefore, the correct HCPCS Level II transportation code is A0130.

• Question 440:

  An 8-day old newborn, weighing 3 kilograms, is seen for a circumcision. The infant is placed on a restraining board and a dorsal penile block is given as the anesthetic. A dorsal slit is made at the top of the penis, the Gomco circumcision clamp is applied, and the foreskin was excised with a scalpel.

  What CPT coding is reported?

  A. 54610
  B. 54150
  C. 54160-63
  D. 54150-52-63
  B. 54150