review for AAPC CPC exam Actual Exam

review for AAPC CPC exam Actual Exam Latest Update - 190 Questions and 100% Verified Correct Answers Guaranteed A+ 15-year-old male is seen by the pediatrician in his office for having excessive thirst and frequent urination. A urine dip is performed showing +3 sugar and with some ketones.Glucometer reading is done showing a blood sugar range of 500-600. Physician sends the patient with his father to the hospital for emergency admission and insulin drip. The pediatrician meets the patient at the hospital and performs a medically appropriate history andexam continuing treatment for the patient. How should the pediatrician code the E/M service for this visit?

• Office visit E/M code only
• Initial Hospital Inpatient E/M code and Office Visit E/M code with modifier 25
• Initial Hospital Inpatient E/M code only

D. Subsequent Hospital Inpatient E/M code - CORRECT ANSWER: b. Initial hospital

inpatient E/M code and office visit E/M coe with modifier 25 According to CPT® subsection guidelines for Initial Hospital Care: When the patient is admitted to the hospital as an inpatient or to observation status in the course of an encounter in another site of service (eg, hospital emergency department, office, nursing facility), the services in the initial site may be separately reported. Modifier 25 may be added to the other evaluation and management service to indicate a significant, separately identifiable service by the same physician or other qualified health care professional was performed on the same date.

A 2-year-old male requires a central venous catheter. Using xylocaine local anesthesia a percutaneous approach is used in the neck and venous access is achieved. A subcutaneous tunnel is created from the anterior chest wall to the venotomy site and the catheter passed through the tunnel. The CV catheter is then placed at the superior vena cava and sutured in position. Which procedure code is reported?

A. 36568

B. 36555

C. 36557

D. 36560 - CORRECT ANSWER: c. 36557

The selection of the central venous codes are based on the technique of placement, if there is a use of port or pump, and the age of the patient. Procedure performed is for placement of a central venous catheter eliminating multiple choice A. An access device is not inserted eliminating multiple choice D. The documentation supports that a subcutaneous tunnel is created to place the catheter guiding you to code 36557.

A 7-year-old riding his bike struck a tree stump throwing him off his bike. He received multiple lacerations. He had a 3 cm dermis laceration on his scalp with two 0.5 cm lacerations on his face. His right arm had a 5 cm laceration and right leg has a 5 cm laceration. The physician stapled the laceration for the scalp. Physician used steri-strips (adhesive strips) to close the wounds on the face. The legs and arms were cleaned by 1 / 4

heavily irrigating them with normal saline and removal of embedded debris performed on both wounds, followed with a single-layer closure. Select the repair codes to report.

A. 12032, 12032-59, 12011-59, 12002-59

B. 12002, 12002-59, 12011-59, 12002-59

C. 12005, 11042-59

D. 12034, 12002-59 - CORRECT ANSWER: d. 12034, 12002-59

The two face lacerations were closed with steri-strips (adhesive strips). When adhesive strips are the only repair material used to close an open wound a repair code is not reported. According to CPT® subsection guidelines for Repair (Closure), when wound closure uses adhesive strips as the only repair material it should be coded using the appropriate E/M service. Code 12011 is inappropriate to report for this scenario, eliminating multiple choices A and B. The repairs for the wounds on the arm and leg are intermediate closures. According to CPT® subsection guidelines for Repair (Closure), single-layer closure of heavily contaminated wounds that have required extensive cleaning or removal of particulate matter also constitutes intermediate repair. This eliminates multiple choice C. To report multiple wounds that are repaired in the same classification and from the anatomic sites that are grouped together into the same code descriptor, add the length of the wounds. The subsection guidelines also indicates when more than one classification of wounds is repaired, append modifier 59 to the least complicated repair(s).

A 22 year old is in an outpatient facility for an inguinal hernia repair. Just before surgery, the surgeon discovers the patient is positive for MRSA and the surgery is canceled.Which ICD-10-CM code(s) shoudl be reported for the outpatient service?

• A49.02
• A49.01, K40.90, Z53.09
• Z53.09

d. K40.90, A49.02, Z53.09 - CORRECT ANSWER: d. K40.90, A49.02, Z53.09

ICD-10-CM guideline for outpatient services IV.A.1 states to report reason for the surgery as the first listed diagnosis even if the surgery is canceled due to a contraindication.

A 24 year old woman developed a keloid scar as a result of a third degree burn son the LEFT upper arm. What ICD-10-Cm code(s) is/are reports?

• L91.0
• T22.332D
• L91.0, T22.332S

d. T22.332A, L91.0 - CORRECT ANSWER: c. L91.0, T22.332S

A keloid is a type of scar resulting from granulation tissue at the site of a healed skin injury. This would be considered a sequela (late effect) after the acute phase of the burn. Per ICD-10-CM guideline I.B.10, coding of sequela generally requires 2 codes sequenced in the following order: the condition or nature of the sequela is sequenced first (keloid scar). The sequela code is sequenced second. 2 / 4

A 24-year-old patient had an abscess by her vulva which burst. She has developed a soft tissue infection caused by gas gangrene. The area was debrided of necrotic infected tissue. All of the pus was removed and irrigation was performed with a liter of saline until clear and clean. The infected area was completely drained and the wound was packed gently with sterile saline moistened gauze and pads were placed on top of

this. The correct CPT® code is:

A. 56405

B. 10061

C. 11004

D. 11042 - CORRECT ANSWER: c. 11004

The abscess had already burst, with no need to perform an incision to open it, eliminating multiple choice answers A and B. The difference between multiple choice answers C and D, is that the patient is having the debridement performed due to a soft tissue infection in the perineum area. The correct code is 11004 for debridement of necrotized infected tissue on the external genitalia.

A 41 year old male is in his doctor's office for a follow up of an abnormality which was noted on an abdominal CT scan. He also had a chest x-ray (PA and lateral views) performed in the office due to chest tightness. He states he otherwise feels well and is here to go over the results of his chest x-ray performed in the office, and the CT scan performed at the diagnostic center. The results of the chest x-ray were normal. CT scan of the abdomen showed a small mass in his RIGHT upper quadrant. What CPT codes are reported for the doctor's office radiological services?

• 71046-26, 74150-26
• 71046,74150
• 71046-26, 74150

d. 71046, 74150-26 - CORRECT ANSWER: d. 71046, 74150-26

Look in the CPT index for x-ray/chest. Code 71046 is the correct code for 2 views. The chest x-ray was taken in the doctor's office and interpreted. This means the doctor's office can bill the code without appending a modifier. Next look in the CPT book for CT/scan/without contrast/abdomen. The correct code for the CT scan is 74150. Modifier 26 is appended to the CT scan code, as it was performed at another site and the doctor only interpreted the image

A 45-year-old male is in outpatient surgery to excise a basal cell carcinoma of the right nose and have reconstruction with an advancement flap. The 1.2 cm lesion with an excised diameter of 1.5 cm was excised with a 15-blade scalpel down to the level of the subcutaneous tissue, totaling a primary defect of 1.8 cm. Electrocautery was used for hemostasis. An adjacent tissue transfer of 3 sq cm was taken from the nasolabial fold and was advanced into the primary defect. Which CPT® code(s) is (are) reported?

A. 14060

B. 11642, 14060

C. 11642, 15115

D. 15574 - CORRECT ANSWER: A. 14060 3 / 4

An adjacent tissue transfer (advancement flap) was used to repair a defect on the nose due to an excision of a malignant lesion, eliminating multiple choice answers C and D.The section guidelines in the CPT® codebook for Adjacent Tissue or Rearrangement indicate that the excision of a benign lesion (11400-11446) or a malignant lesion (11600-11646) is included in codes for adjacent tissue transfer (14000-14302), and are not separately reported. This eliminates multiple choice answer B.

A 46-year-old female with history of cervical carcinoma underwent placement of an ileal conduit, with subsequent development of left hydronephrosis. A retrograde ureteral catheter was recently placed. She returns today for catheter exchange. Patient was placed in the supine on the operating table. The ileal conduit was accessed. The existing catheter was removed over a guidewire and replaced with a similar 10 French 50 cm long locking pigtail catheter. Contrast was injected for monitoring, confirming good position of the catheter placement. Interpretation and report is in the record.IMPRESSION: Left retrograde ureteral catheter exchange via the ileal conduit. How is this reported?

A. 50435

B. 50693

C. 50385

D. 50688, 75984-26 - CORRECT ANSWER: d. 50688, 75984-26

The patient presents for a ureteral catheter exchange via the ileal conduit. 50435 is not correct because it is an exchange of the catheter percutaneously. 50693 is performed using a percutaneous approach for placement of a ureteral stent, which is not performed in this case. 50385 is performed using a transurethral approach, which is not correct. The exchange is performed via the ileal conduit, which is reported with 50688.Monitoring contrast imaging is performed. There is a parenthetical note under 50688 that states that imaging is reported with 75984.

A 47-year-old patient was previously treated with external fixation for a type IIIA open left tibia fracture. There is now nonunion of the left proximal tibia and he is admitted for open reduction of tibia with bone grafting. Approximately 30 grams of cancellous bone was harvested from the iliac crest. The fracture site was exposed and the area of nonunion was osteotomized, cleaned, and repositioned. Interfragmentary compression was applied and three screws and the harvested bone graft were packed into the fracture site. What are the correct codes for this diagnosis and procedure?

A. 27724, S82.102N

B. 27758, S82.202S

C. 27722, S82.202P

D. 27759, S82.102N - CORRECT ANSWER: a. 27724, S82.102N

The selection of the code is based on the anatomic location and method of repair.Codes are 27758 and 27759 are not reported with this scenario because the fracture is not an acute traumatic fracture. The physician is repairing a nonunion tibia fracture (failure of two ends of a fracture to completely heal). Eliminating multiple choices B and

• To select the correct choice you need to find out what type of graft was used. Your

hints are "bone grafting" and "iliac crest," which leads you to the code 27724. The bone

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