The Best Practice Test Preparation for the CPC Certification Exam
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AAPC CPC Exam Syllabus Topics:
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NEW QUESTION # 31
Dr. Burns sees newborn baby James at the birthing center on the same day after the cesarean delivery. Dr.
Burns examined baby James, the maternal and newborn history, ordered appropriate blood test tests and hearing screening. He met with the family at the end of the exam.
How would Dr. Bums report his services?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: C
Explanation:
Dr. Burns is providing initial hospital or birthing center care for the evaluation and management of a normal newborn infant. CPT code 99460 is used to report initial hospital or birthing center care, per day, for evaluation and management of a normal newborn infant. This includes a comprehensive history, examination, and medical decision-making. The description of the service provided fits this CPT code accurately.
References: CPT Professional Edition (current year), AMA.
NEW QUESTION # 32
View MR 099407
MR 099407
Emergency Department Visit
Chief Complaint: VOMITING.
This started just prior to arrival and is still present. He has had nausea and vomiting. No diarrhea, black stools, bloody stools or abdominal pain. Pt is diabetic and has been having elevated blood sugars (320 mg/dL).
REVIEW OF SYSTEMS: Unobtainable due to patient's altered mental status.
PAST HISTORY: Poorly controlled diabetes mellitus, with history of poor compliance.
Medications: See Nurses Notes.
Allergies: PCN.
SOCIAL HISTORY: Nonsmoker. No alcohol use or drug use.
ADDITIONAL NOTES: The nursing notes have been reviewed.
PHYSICAL EXAM
Appearance: Lethargic. Patient in mild distress.
Vital Signs: Have been reviewed-tachycardic.
Eyes: Pupils equal, round and reactive to light.
ENT: Dry mucous membranes present.
Neck: Normal inspection. Neck supple.
CVS: Tachycardia. Heart sounds normal. Pulses normal.
E D. Course: Insulin IV drip per protocol, at 10 units/hr.
Zofran 8 mg 01:33 Jul 13 2008 IVP.
Phenergan 25 mg IVP. 07:52. Discussed case with physician. Dr. X. Reviewed test results. Agreed upon treatment plan. Physician will see patient in hospital.
Total critical care time: 45 min.
Disposition: Admitted to Intensive Care Unit. Condition: stable.
Admit decision based on need for monitoring and IV hydration and medications.
CLINICAL IMPRESSION: Vomiting, diabetic ketoacidosis, probable diabetes insipidus.
What E/M code is reported for this encounter?
- A. 99291, 99292
- B. 0
- C. 1
- D. 2
Answer: D
NEW QUESTION # 33
An established patient suffering from migraines without aura, no mention of intractable migraine, and no mention of status migrainosus, is seen by his ophthalmologist who conducts a visual field examination of both eyes. The examination was accomplished plotting four isopters utilizing the Goldmann perimeter testing method. The patient and requesting physician receive the interpretation and report on the same date of service.
What procedure and diagnosis codes are reported for this encounter?
- A. 92083, G43.019
- B. 92082, G43.019
- C. 92082, G43.009
- D. 92081, G43.009
Answer: C
Explanation:
* Procedure: Visual field examination of both eyes using Goldmann perimeter testing with four isopters.
* CPT Code:
* 92082: This code is for visual field examination with intermediate examination.
* ICD-10-CM Code:
* G43.009: Migraine without aura, not intractable, without status migrainosus.
* Code Selection Justification: The visual field exam method and complexity align with 92082. The patient's diagnosis of non-intractable migraine without aura is coded as G43.009.
References:
* AMA CPT Professional Edition (current year)
* ICD-10-CM (current year)
NEW QUESTION # 34
A patient who has colon adenocarcinoma undergoes a laparoscopic partial colectomy. The surgeon removes the proximal colon and terminal ileum and reconnects the cut ends of the distal ileum and remaining colon.
What procedure and diagnosis codes are reported?
- A. 44205, C18.9
- B. 44140, C18.9
- C. 44204, C18.2
- D. 44160, C18.2
Answer: A
NEW QUESTION # 35
Patient has undergone open surgery for a left total knee arthroplasty. While in the recovery room, he continued to have severe postoperative pain. The surgeon ordered a femoral block for postoperative pain. The anesthesiologist evaluated the patient and performed a left femoral block, which provided significant post-operative pain relief.
What CPT coding is reported?
- A. 01380, 64447-59-LT
- B. 01402, 64447-59-LT
- C. 01404, 64450, 01996
- D. 01402, 64448-59-LT, 01996
Answer: D
NEW QUESTION # 36
An interventional radiologist performs an abdominal paracentesis in his office utilizing ultrasonic imaging guidance to remove excess fluid. What CPT coding is reported?
- A. 49082, 76942-26
- B. 49082, 76942
- C. 49083, 76942-26
- D. 0
Answer: D
NEW QUESTION # 37
A comatose patient is seen in the ER. The patient has a history of depression. Drug testing confirm she overdosed on tricyclic antidepressant drugs doxepin, amoxapine, and clomipramine.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: C
NEW QUESTION # 38
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. 0
- B. 1
- C. 2
- D. 3
Answer: A
NEW QUESTION # 39
Patient had polyps removed on a previous colonoscopy. The patient returns three months later for a follow-up examination for another colonoscopy. No new polyps are seen.
What diagnosis coding is reported for the second colonoscopy?
- A. K63.5
- B. Z09, K63.5
- C. Z09, Z86.010
- D. Z86.010, K63.5
Answer: B
NEW QUESTION # 40
A surgeon performs midface LeFort I reconstruction on a patient's facial bones to correct a congenital deformity. The reconstruction is performed in two pieces in moving the upper jawbone forward and repositioning the teeth of the maxilla of the mid face.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: B
Explanation:
The procedure described involves a LeFort I reconstruction, which is a type of orthognathic surgery performed to correct deformities of the midface. In this scenario, the surgeon performed the reconstruction in two pieces, moving the upper jawbone forward and repositioning the teeth of the maxilla. According to the CPT guidelines, CPT code 21146 describes a LeFort I (maxilla only) osteotomy, two-piece segment, including bone grafts (includes obtaining autografts). This code matches the description provided.
References:
* AMA's CPT Professional Edition (current year), Code 21146
NEW QUESTION # 41
A 60-year-old male suffering from degenerative disc disease at the L3-L4 and L5-S1 levels was placed under general anesthesia. Using an anterior approach, the L3-L4 disc space was exposed. Using blunt dissection, the disc space was cleaned. The disc space was then sized and trialed. Excellent placement and insertion of the artificial disc at L3-L4 was noted. The area was inspected and there was no compression of any nerve roots. Same procedure was performed on L5-S1 level. Peritoneum was then allowed to return to normal anatomic position and entire area was copiously irrigated. The wound was closed in a layered fashion. The patient tolerated the discectomy and arthroplasty well and was returned to recovery in good condition. What CPT coding is reported for this procedure?
- A. 22857 x 2
- B. 0
- C. 22857, 22860
- D. 1
Answer: C
NEW QUESTION # 42
A patient with malignant lymphoma is administered the antineoplastic drug Rituximab 800 mg and then 100 mg of Benadryl.
Which HCPCS Level II codes are reported for both drugs administered intravenously?
- A. J9312, J1200
- B. J9312 x 80, J1200 x 2
- C. J9312, Q0163
- D. J9312 x 80, 00163 x 2
Answer: A
Explanation:
The patient with malignant lymphoma is administered Rituximab (800 mg) and Benadryl (100 mg) intravenously.
* Procedure Description:
* Administration of Rituximab (800 mg) intravenously.
* Administration of Benadryl (100 mg) intravenously.
* HCPCS Level II Coding:
* J9312: Injection, Rituximab, 10 mg.
* For 800 mg, report 80 units of J9312.
* J1200: Injection, Diphenhydramine HCl, up to 50 mg.
* For 100 mg, report 2 units of J1200.
References:
* HCPCS Level II Code Book (current year).
* HCPCS Level II coding guidelines for intravenous drug administration.
NEW QUESTION # 43
A business requires drug testing for cocaine and methamphetamines prior to hiring a job candidate. A single analysis with direct optical observation is performed, followed by a confirmation for cocaine.
Which codes are used for reporting the testing and confirmation?
- A. 80306, 80375
- B. 80306 x 2, 80353
- C. 80305, 80353
- D. 80305 x 2, 80353
Answer: C
NEW QUESTION # 44
A patient had surgery a year ago to repair two flexor tendons in his forearm. He is in surgery for a secondary repair for the same two tendons.
Which CPT coding is reported?
- A. 25272 x 2
- B. 0
- C. 25263 x 2
- D. 1
Answer: B
Explanation:
The scenario involves a secondary repair of two flexor tendons in the forearm. CPT code 25272 describes the repair of a secondary flexor tendon injury, including a graft, in the forearm and/or wrist, which fits the description provided. This code should be reported once, as the procedure encompasses the repair of multiple tendons.
References:
* AMA's CPT Professional Edition (current year), Code 25272
NEW QUESTION # 45
View MR 005398
MR 005398
Operative Report
Preoperative Diagnosis: Nonfunctioning right kidney with ureteral stricture.
Postoperative Diagnosis: Nonfunctioning right kidney with ureteral stricture.
Procedure: Right nephrectomy with partial ureterectomy.
Findings and Procedure: Under satisfactory general anesthesia, the patient was placed in the right flank position. Right flank and abdomen were prepared and draped out of the sterile field. Skin incision was made between the 11th and 12th ribs laterally. The incision was carried down through the underlying subcutaneous tissues, muscles, and fascia. The right retroperitoneal space was entered. Using blunt and sharp dissection, the right kidney was freed circumferentially. The right artery, vein, and ureter were identified. The ureter was dissected downward where it is completely obstructed in its distal extent. The ureter was clipped and divided distally. The right renal artery was then isolated and divided between 0 silk suture ligatures. The right renal vein was also ligated with suture ligatures and 0 silk ties. The right kidney and ureter were then submitted for pathologic evaluation. The operative field was inspected, and there was no residual bleeding noted, and then it was carefully irrigated with sterile water. Wound closure was then undertaken using 0 Vicryl for the fascial layers, 0 Vicryl for the muscular layers, 2-0 chromic for subcutaneous tissue, and clips for the skin. A Penrose drain was brought out through the dependent aspect of the incision. The patient lost minimal blood and tolerated the procedure well.
What CPT coding is reported for this case?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: C
NEW QUESTION # 46
A patient is diagnosed with sepsis and associated acute respiratory failure.
What ICD-10-CM code selection is reported?
- A. A41.9
- B. A41.9, R65.20, J96.00
- C. A41.9, J96.00
- D. A41.9, R65.21, J96.00
Answer: C
NEW QUESTION # 47
A Medicare patient is scheduled for a screening colonoscopy.
What code is reported for Medicare?
- A. 0
- B. G0105
- C. G0121
- D. G0106
Answer: B
Explanation:
* Medicare provides specific codes for screening colonoscopy based on the patient's risk factors. For a Medicare patient scheduled for a screening colonoscopy who is at high risk (such as those with a history of intestinal polyps), the appropriate code is G0105.
* G0105 is used for colorectal cancer screening; colonoscopy on individuals at high risk.
References:
* HCPCS Level II, current year
* Medicare Guidelines for Colorectal Cancer Screening
NEW QUESTION # 48
View MR 001394
MR 001394
Operative Report
Procedure: Excision of 11 cm back lesion with rotation flap repair.
Preoperative Diagnosis: Basal cell carcinoma
Postoperative Diagnosis: Same
Anesthesia: 1% Xylocaine solution with epinephrine warmed and buffered and injected slowly through a 30-gauge needle for the patient's comfort.
Location: Back
Size of Excision: 11 cm
Estimated Blood Loss: Minimal
Complications: None
Specimen: Sent to the lab in saline for frozen section margin control.
Procedure: The patient was taken to our surgical suite, placed in a comfortable position, prepped and draped, and locally anesthetized in the usual sterile fashion. A #15 scalpel blade was used to excise the basal cell carcinoma plus a margin of normal skin in a circular fashion in the natural relaxed skin tension lines as much as possible The lesion was removed full thickness including epidermis, dermis, and partial thickness subcutaneous tissues. The wound was then spot electro desiccated for hemorrhage control. The specimen was sent to the lab on saline for frozen section.
Rotation flap repair of defect created by foil thickness frozen section excision of basal cell carcinoma of the back. We were able to devise a 12 sq cm flap and advance it using rotation flap closure technique. This will prevent infection, dehiscence, and help reconstruct the area to approximate the situation as it was prior to surgical excision diminishing the risk of significant pain and distortion of the anatomy in the area. This was advanced medially to close the defect with 5 0 Vicryl and 6-0 Prolene stitches.
What CPT coding is reported for this case?
- A. 14001, 11606-51
- B. 0
- C. 14001, 11606-51, 12034-51
- D. 1
Answer: B
NEW QUESTION # 49
A catheter was placed into the abdominal aorta via the right common femoral artery access. An abdominal aortography was performed. The right and left renal artery were adequately visualized. The catheter was used to selectively catheterize the right and left renal artery. Selective right and left renal angiography were then performed, demonstrating a widely patent right and left renal artery.
What CPT coding is reported?
- A. 36253, 75625-26
- B. 0
- C. 1
- D. 36252, 75625-26
Answer: B
NEW QUESTION # 50
A catheter was placed into the abdominal aorta via the right common femoral artery access. An abdominal aortography was performed. The right and left renal artery were adequately visualized. The catheter was used to selectively catheterize the right and left renal artery. Selective right and left renal angiography were then performed, demonstrating a widely patent right and left renal artery.
What CPT coding is reported?
- A. 0
- B. 36253, 75625-26
- C. 36252, 75625-26
- D. 1
Answer: C
Explanation:
CPT code 36252 describes selective catheter placement of the main renal artery with angiography of both kidneys, which matches the procedure of selectively catheterizing the right and left renal arteries and performing angiography. Additionally, CPT code 75625-26 is for an abdominal aortography with interpretation and report. The -26 modifier indicates that the professional component of the service was performed.
References:
* AMA's CPT Professional Edition (current year), Codes 36252, 75625-26
NEW QUESTION # 51
An incision is made in the scalp, a craniectomy is performed to access the area where electrodes are present.
The electrodes are removed. The surgical wound is closed.
What procedure code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: D
Explanation:
The procedure described involves the removal of electrodes from the cranial area after making an incision in the scalp and performing a craniectomy.
* Procedure Description:
* Incision in the scalp.
* Craniectomy to access the area with electrodes.
* Removal of electrodes.
* Closure of the surgical wound.
* CPT Coding:
* 61860: Removal of intracranial neurostimulator electrodes, including burr hole(s) or craniectomy.
References:
* AMA's CPT Professional Edition (current year).
* CPT Assistant for detailed coding guidelines on neurostimulator procedures.
NEW QUESTION # 52
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