AAPC AAPC-CPC Online Practice Questions and Exam Preparation

AAPC AAPC-CPC Online Questions & Answers

• Question 71:

  Refer to the supplemental information when answering this question: View MR 903096.

  What CPT(R) and ICD-10-CM coding is reported?

  A. 62290, M54.50
  B. 62292, M54.50
  C. 62292, M48.07, M54.50
  D. 62290, M48.061, M54.50
  A. 62290, M54.50

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  Explanation

  CPT code 62290: Discography, lumbar, single or multiple levels, radiological supervision and interpretation.

  This code accurately describes the procedure performed. The documentation indicates that a lumbar discography was performed at a single level, L3-4, with radiological supervision, C-arm visualization.

  ICD-10-CM code M54.50: Low back pain, unspecified.

  This code is the most appropriate diagnosis based on the documentation. The preoperative diagnosis states, "Low back pain, possible spinal stenosis L3-4." While spinal stenosis was considered, it was not confirmed. The postoperative diagnosis indicates no evidence of spinal stenosis or discogenic pathology.

  Therefore, the definitive diagnosis is low back pain.

  Why other options are incorrect: 62292: This code is for discography with injection of contrast and/or medication for therapeutic purposes.

  The documentation does not indicate any therapeutic injection was performed.

  M48.061 and M48.07: These codes represent spinal stenosis, which was not confirmed in the postoperative diagnosis.

  References:

  CPT code 62290: Discography, lumbar, single or multiple levels, radiological supervision and interpretation.

  ICD-10-CM code M54.50: Low back pain, unspecified.

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

• Question 72:

  Eric is buying his first life insurance policy from XYZ Life Insurance Company. The company requires Eric have a physical exam prior to issuance of the policy. Eric sees his primary care provider who completes the required documentation and forms provided by the insurance company.

  How does the primary care provider report his services?

  A. 99499
  B. 99455
  C. 99456
  D. 99450
  D. 99450

• Question 73:

  A 42-year-old female is in the operating room to repair a zone 2 flexor digitorum profundus (FDP) tendon laceration involving her index finger with an associated radial digital nerve injury. The dorsal side of the FDP tendon was sutured. Next, the microscope was brought into place and the radial digital nerve was repaired using epineural sutures.

  What CPT(R) codes are reported?

  A. 26356, 64831-51, 69990
  B. 26356, 64831-51
  C. 26350, 64831-51
  D. 26350, 64831-51, 69990-51
  A. 26356, 64831-51, 69990

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  Explanation

  26356 = Zone 2 flexor tendon repair

  64831 = Digital nerve repair 69990 = Operating microscope (add-on, no modifier -51)

• Question 74:

  An otolaryngologist performs a tympanoplasty with mastoidectomy, reconstruction of the posterior ear canal wall, and ossicular chain reconstruction.

  What CPT(R) code is reported?

  A. 69644
  B. 69646
  C. 69642
  D. 69645
  C. 69642

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  Explanation

  69642 = Tympanoplasty with mastoidectomy and ossicular chain reconstruction.

  The procedure includes tympanoplasty, mastoidectomy, and ossicular chain reconstruction. Other codes represent variations that do not match the documented ossicular reconstruction.

• Question 75:

  

  Refer to the supplemental information when answering this question: View MR 004813.

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

  A. 43246, K94.29, Z93.1
  B. 43752, K94.29, Z93.1
  C. 43752-52, K94.29, K44.9
  D. 43246-52, K94.29, K44.9
  D. 43246-52, K94.29, K44.9

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  Explanation

  CPT Code 43246: Esophagogastroduodenoscopy, with directed placement of percutaneous gastrostomy tube.

  This code describes the attempted PEG tube placement.

  Modifier -52: Reduced services. This modifier is appended because the procedure was aborted and the PEG tube was not successfully placed.

  ICD-10-CM Code K94.29: Other complications of gastrostomy.

  This code captures the gastrostomy-related complication or failed PEG tube issue, based on the supplemental information.

  ICD-10-CM Code K44.9: Diaphragmatic hernia without obstruction or gangrene.

  This code reports the small hiatal hernia that was found during the procedure.

  References:

  CPT Code 43246: Esophagogastroduodenoscopy, with directed placement of percutaneous gastrostomy tube Modifier 52: Reduced services ICD-10-CM Code K94.29: Other complications of gastrostomy ICD-10-CM Code K44.9: Diaphragmatic hernia without obstruction or gangrene

• Question 76:

  An air bag deployed when a driver lost control of the car and crashed into a guardrail on the side of the highway. The driver suffers partial impact resulting in a skull fracture of the anterior cranial base. The fracture is diagnosed using an MRI scanner, and cerebrospinal fluid is noted dripping via the sphenoid sinus into the right nasal passage. The patient requires surgical nasal sinus endoscopy to assess and repair the injury.

  What is the correct procedure and diagnosis coding combination to report this service?

  A. 31287, S02.19XA, V47.5XXA, Y92.411
  B. 31291, S02.19XA, V47.5XXA, Y92.411
  C. 31235, S02.91XA, V47.5XXA, Y92.411
  D. 31291, 31231-59, S02.109A, V47.5XXA, Y92.411
  B. 31291, S02.19XA, V47.5XXA, Y92.411

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  Explanation

  Procedure and CPT(R) code

  Selection: The patient requires surgical nasal sinus endoscopy to repair a cerebrospinal fluid (CSF) leak caused by a skull fracture that resulted in CSF draining into the nasal passage.

  Code 31291 is the correct CPT(R) code for endoscopic repair of a cerebrospinal fluid leak in the sphenoid sinus. This procedure code is appropriate because it specifically addresses surgical endoscopy for CSF leak repair in the sinus region.

  Other codes provided, such as 31287 and 31235, do not match the description for surgical repair of a CSF leak and are therefore inappropriate for this case.

  Diagnosis and ICD-10-CM Code Selection: ICD-10-CM Code S02.19XA is used to describe a fracture of the base of the skull, other specified skull fracture, initial encounter, which fits the described injury of the skull with cerebrospinal fluid leakage.

  External cause code V47.5XXA is used for a car driver injured in collision with a fixed or stationary object in a traffic accident.

  Y92.411 is the appropriate place-of-occurrence code to describe the location of the accident as a highway.

  Exclusion of Additional Procedure Codes: There is no need for a second endoscopy code or a modifier, as 31291 fully describes the endoscopic repair procedure for the CSF leak.

  AAPC and CPT(R) coding

  Guidelines: Per AAPC and CPT(R) coding guidelines, procedure codes for sinus endoscopy are chosen based on the specific type of intervention, such as CSF leak repair. ICD-10-CM guidelines support including external cause codes and place-of-occurrence codes for trauma cases related to motor vehicle accidents when reported.

  Thus, the correct answer based on CPT(R) and ICD-10-CM coding standards is B. 31291, S02.19XA, V47.5XXA, Y92.411.

• Question 77:

  Day 1: A provider admits the patient to observation care for type 2 diabetes mellitus with hyperglycemia.

  The provider orders an HbA1c, urine microalbumin, and kidney function laboratory tests. Blood sugar is high and poorly controlled. The provider discusses the case with the patient's endocrinologist. The provider prescribes an IV insulin drip along with SQ insulin and keeps the patient in observation overnight.

  Day 2: The patient remains in observation care, and the provider orders a blood glucose test. The patient's glucose levels have improved. The provider places an order for the dietitian to see the patient. The provider documents spending a total time of 25 minutes with the patient.

  Day 3: The patient has a blood glucose test. The patient's glucose level is back to normal. The provider documents spending 15 minutes with the patient. The provider discharges the patient.

  What E/M coding is reported by the physician for the patient in observation care?

  A. 99221, 99232, 99239
  B. 99222, 99231, 99238
  C. 99235, 99231, 99238
  D. 99235, 99238
  B. 99222, 99231, 99238

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  Explanation

  For observation care spanning more than one calendar date, report initial hospital inpatient or observation care for the first day, subsequent hospital inpatient or observation care for the next day, and hospital inpatient or observation discharge day management for the discharge date.

  Day 1: The patient is admitted to observation care for type 2 diabetes mellitus with hyperglycemia. The provider orders multiple tests, discusses the case with the endocrinologist, and manages the patient with IV insulin and SQ insulin. This supports 99222.

  Day 2: The patient remains in observation care. The provider documents 25 minutes with the patient. This supports 99231.

  Day 3: The provider documents 15 minutes and discharges the patient. Discharge time is 30 minutes or less, so 99238 is reported.Code 99235 is not appropriate because it is used when the patient is admitted and discharged on the same date.

  Therefore, the correct answer is Option B. 99222, 99231, 99238.

• Question 78:

  A patient with suspected gynecologic malignancy undergoes laparoscopic staging including bilateral pelvic lymphadenectomy, periaortic lymph node sampling, peritoneal washings, peritoneal and diaphragmatic biopsies, and omentectomy.

  What CPT(R) coding is reported?

  A. 38573
  B. 38571, 38573
  C. 38572-50, 38573-50
  D. 38573-50
  A. 38573

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  Explanation

  38573 includes comprehensive laparoscopic staging with bilateral pelvic lymphadenectomy and paraaortic sampling.

  All listed components are bundled into this code.

• Question 79:

  Which statement regarding lesion excision is TRUE?

  A. Lesion excision codes include removal of a lesion, with margins, and simple (nonlayered) closure when performed
  B. Lesion excision codes are selected by measuring the greatest clinical diameter of a lesion excluding the margins required to complete the excision
  C. Lesion excision codes include removal of a lesion, with margins, and intermediate closure when performed
  D. Lesion excision codes include removal of a lesion with margins, and complex closure when performed
  A. Lesion excision codes include removal of a lesion, with margins, and simple (nonlayered) closure when performed

• Question 80:

  A patient is in her dermatologist's office for treatment of recurring psoriatic plaques on the upper back and neck resistant to topical therapy. The dermatologist performs Excimer laser therapy on the upper back (300 sq cm) and neck (100 sq cm), total surface area 400 sq cm.

  What CPT(R) codes are reported?

  A. 96920 x 2
  B. 96921 x 2
  C. 96921
  D. 96921, 96920
  B. 96921 x 2

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  Explanation

  Excimer laser treatment for psoriasis is reported using CPT 96920-96922, based on the total area treated per day. Code 96920 covers treatment for less than 250 sq cm, 96921 covers 250 to 500 sq cm, and 96922 covers over 500 sq cm. Here, the provider treats 300 sq cm on the upper back plus 100 sq cm on the neck, for a total of 400 sq cm, which falls within the 250-500 sq cm range. Therefore, 96921 is the correct code for the day's treatment. The treatment should not be split into separate codes by body area.

  Under CPT(R), you code the total treated area per session/day, not separate body regions with multiple base codes.

  Therefore, 96921 is correct.