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AAPC CPC Exam Syllabus Topics:
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NEW QUESTION # 81
A cardiologist performs remote monitoring for a 30-day period via a previously implanted hemodynamic pulmonary artery pressure monitor for a patient with congestive heart failure with resulting pulmonary edema.
The first month of monitoring includes weekly downloads, interpretations, trend analysis, and subsequent reports.
What CPTcode is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: B
Explanation:
1. Procedure and CPTCode Selection:
The cardiologist provided remote monitoring over a 30-day period for a hemodynamic pulmonary artery pressure monitor implanted in a patient with congestive heart failure.
CPTCode 93264 is appropriate for remote monitoring of a hemodynamic system for up to 30 days. This code includes services such as weekly data transmissions, interpretation, trend analysis, and reporting- exactly as described in this case.
2. Rationale for Excluding Other Options:
Code 93286 is for in-person interrogation and programming of pacemakers or defibrillators, not for remote monitoring of a hemodynamic monitor, making it incorrect.
Code 93288 is for interrogation device evaluation (remote), specifically for pacemakers or defibrillators, and does not apply to a pulmonary artery pressure monitor.
Code 93279 is for in-person programming of certain cardiac devices, which does not match the remote monitoring described in this scenario.
3. AAPC and CPTCoding Guidelines:
AAPC and CPTguidelines specify that 93264 is the correct code when reporting remote hemodynamic monitoring for a pulmonary artery pressure device over a period of up to 30 days, including data review and interpretation.
Therefore, the correct answer is B. 93264.
NEW QUESTION # 82
According to the Application of Cast and Strapping CPT guidelines, what is reported when an orthopedic provider performs initial fracture care treatment for a closed scaphoid fracture of the wrist, applies a short arm cast, and the patient will be returning for subsequent fracture care?
- A. 25622, 29075
- B. 0
- C. 29075-22
- D. 1
Answer: B
NEW QUESTION # 83
A cardiologist attempted to perform a percutaneous transluminal coronary angioplasty of a totally occluded blood vessel. The surgeon stopped the procedure because of an anatomical problem creating risk for the patient and preventing performance of the catheterization.
What modifier is appended to the procedure code?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: C
NEW QUESTION # 84
According to the Application of Cast and Strapping CPTguidelines, what is reported when an orthopedic provider performs initial fracture care treatment for a closed scaphoid fracture of the wrist, applies a short arm cast, and the patient will be returning for subsequent fracture care?
- A. 0
- B. 25622, 29075
- C. 29075-22
- D. 1
Answer: D
Explanation:
For initial fracture care of a closed scaphoid fracture, code 25622 is used, which includes treatment and initial casting. The application of the cast is part of the fracture care and is not reported separately. CPTguidelines specify that casting or strapping performed as part of the fracture care is included in the fracture care code.
References: AMA's CPTProfessional Edition (current year), Surgery section, Musculoskeletal System.
NEW QUESTION # 85
The gastroenterologist performs a simple excision of three external hemorrhoids and one internal hemorrhoid, each lying along the left lateral column. The operative report indicates that the internal hemorrhoid is not prolapsed and is outside of the anal canal.
What CPT and ICD-10CM codes are reported?
- A. 46250, K64.0, K64.9
- B. 46255, K64.0, K64.4
- C. 46320, 46945, K64.0, K64.9
- D. 46250, 46945, K64.0, K64.4
Answer: A
NEW QUESTION # 86
A patient arrives for a PEG placement. The patient requires tube feeds for nutrition but frequently pulls out the dobhoffs tube. An EGD was performed. Several attempts were made to place the PEG tube without success so the procedure was aborted. During the withdraw of the scope, a small hiatal hernia was noted in the stomach. The scope was removed the the patient transferred to recovery.
What CPT and ICD-10-CM coding is reported?
- A. 43246-53, K94.29, K44.9
- B. :43830-52, Z43.1
- C. 43246, K94.29, Z93.1
- D. 49450-53, K94.29, K44.9
Answer: A
NEW QUESTION # 87
Which statement is TRUE for an Excludes2 note that is under a code in the Tabular List for ICD-10-CM?
- A. It is acceptable to report both the code and the excluded code together, when applicable.
- B. It indicates that the code excluded should always be reported with an Excludes1 code.
- C. That the two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- D. It is a pure excludes note, meaning "NOT CODED HERE!"
Answer: A
Explanation:
In ICD-10-CM coding, an Excludes2 note under a code indicates that the condition listed in the note is not included in the definition of the code, but it does not necessarily mean they cannot coexist. This type of note means that while the conditions are distinct, it may be appropriate to report both codes if a patient has both conditions at the same time.
A: is incorrect because Excludes1, not Excludes2, indicates that certain codes should not be reported together.
C: is a description of an Excludes1 note, which implies that the two conditions should not be coded together because they cannot occur simultaneously.
D: is also a description of an Excludes1 note, which serves as a "NOT CODED HERE!" directive.
Therefore, the correct answer is B. It is acceptable to report both the code and the excluded code together, when applicable.
NEW QUESTION # 88
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 CPTcoding is reported for this case?
- A. 0
- B. 1
- C. 14001, 11606-51
- D. 14001, 11606-51, 12034-51
Answer: C
Explanation:
For the excision of an 11 cm lesion with a rotation flap repair, the appropriate CPT codes are 14001 for the adjacent tissue transfer or rearrangement (12 sq cm flap) and 11606-51 for the excision of a malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm. Modifier 51 indicates multiple procedures. The detailed operative report specifies the lesion size and the technique used, justifying these codes.References: CPTProfessional Edition (current year), AMA.
NEW QUESTION # 89
An 8-year-old patient is placed under general anesthesia for treatment of a right orbital fracture due to a traumatic fall to the nose and face from a swing set. An on-call otolaryngologist is asked to perform a general otolaryngologic examination to evaluate the patient. A mild nasal fracture is the diagnosis given by the otolaryngologist.
What is the CPTand ICD-10-CM coding for the otolaryngologist's services?
- A. 0
- B. 1
- C. 21310, 92502-51
- D. 2
Answer: A
Explanation:
1. Procedure and CPTCode Selection:
The otolaryngologist was asked to perform a general otolaryngologic examination of the patient under general anesthesia to evaluate for injuries sustained from a traumatic fall.
CPTCode 92502 is appropriate for a general otolaryngologic examination under general anesthesia. This code is used specifically when an ENT examination is performed under anesthesia, as was the case here.
2. Rationale for Excluding Other Options:
Code 92512 is for nasal function studies, such as rhinomanometry, which does not apply to a general otolaryngologic examination.
Code 21310 is for the treatment of a nasal fracture (closed treatment), which would only be appropriate if the otolaryngologist had performed a fracture reduction or repair. Since only an examination was performed,
21310 is not appropriate.
Code 92502-51 (option B) is incorrect because the -51 modifier (multiple procedures) is unnecessary; only a single examination was performed.
3. ICD-10-CM Code:
Since only the examination was performed and not treatment, the ICD-10-CM code for nasal fracture (likely S02.2XXA for unspecified fracture of the nasal bones, initial encounter) would be reported separately by the facility or based on final documentation.
4. AAPC and CPTCoding Guidelines:
AAPC guidelines support the use of 92502 for general ENT examinations performed under anesthesia, especially in cases of trauma evaluation without surgical intervention.
Therefore, the correct answer is D. 92502.
NEW QUESTION # 90
A diagnostic mammogram is performed on the left and right breasts. Computer-aided detection is also used to further analyze the image for possible lesions.
What CPT coding is reported for this radiology service?
- A. 0
- B. 77066-50
- C. 77065-LT, 77065-RT
- D. 77067-50
Answer: A
NEW QUESTION # 91
Mr. Woolridge has had a suspicious lesion on his left shoulder for approximately eight weeks that is not healing. On the dermatologist's exam of left shoulder blade, there is excoriation and scabbing and the lesion not healing. Patient agrees and wishes to proceed with a punch biopsy of the lesion. A punch biopsy is taken of the lesion and sent to pathology. A simple repair is performed at the biopsy site.
What CPT and ICD-10-CM codes are reported?
- A. 11104, D49.2
- B. 11102, 12001-51, D49.2
- C. 11104,12001-51, L98.9
- D. 11102, L98.9
Answer: A
NEW QUESTION # 92
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. 25263 x 2
- B. 25272 x 2
- C. 0
- D. 1
Answer: D
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 # 93
Where is a Warthin's tumor found?
- A. Back of eye
- B. Ovary
- C. Bone
- D. Salivary gland
Answer: D
NEW QUESTION # 94
A 26-year-old male presents with a deep laceration from a kitchen knife to his right hand. The surgeon washes the open wound with sterile saline. Clamps are applied. The provider cleans the vessel and prepares the edges of thee wound. She then repairs the bleeding vessel with sutures. The clamps are removed and the provider uses a Doppler probe to check the blood flow pattern through the repaired vessel.
What CPTcode is reported?
- A. 35206-RT
- B. 35236-RT
- C. 35207-RT
- D. 35702-RT
Answer: C
Explanation:
1. Procedure and CPTCode Selection:
The scenario describes the repair of a bleeding vessel in the patient's right hand. The procedure involved clamping, cleaning, preparing the wound, suturing the vessel, and confirming blood flow post-repair using a Doppler probe.
Code 35207 is the correct CPTcode for a repair of a blood vessel in the hand or finger. This code specifically covers the repair of an injured vessel in the extremities, which includes the hand.
Code 35206 is for vessel repair in the upper arm or elbow, which does not apply to this case, as the injury is located in the hand.
Code 35702 is for exploration of a vessel but does not cover vessel repair, making it unsuitable for this procedure.
Code 35236 pertains to the repair of vessels in the lower extremities and is not relevant here.
2. Modifier:
Modifier RT is used to indicate that the procedure was performed on the right side of the body.
3. AAPC and CPTCoding Guidelines:
AAPC guidelines specify the use of codes in the 35201-35286 series for direct repair of blood vessels in specific anatomical areas. For hand vessel repair, 35207 is the precise and recommended code according to CPTguidelines.
Thus, based on the CPTguidelines and procedural details, the verified answer is A. 35207-RT.
NEW QUESTION # 95
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: C
Explanation:
* 99222: This code is used for initial hospital care, per day, for the evaluation and management of a patient, which requires a detailed or comprehensive history, a detailed or comprehensive examination, and medical decision making of moderate complexity.
* The documentation shows a detailed history (including HPI, ROS, PMH, SH, and FH) and a detailed examination (covering multiple organ systems). The medical decision making involves the management of an acute asthma exacerbation, which includes admitting the patient to observation status, administering oral steroids, and planning for further diagnostic testing.
References:
* CPT Professional Edition, AMA
NEW QUESTION # 96
A complete cardiac MRI for morphology and function without contrast, followed by contrast with four additional sequences and stress imaging, is performed on a patient with systolic left ventricular congestive heart failure and premature ventricular contractions.
What CPT and ICD-10-CM codes are reported?
- A. 75557, 75559, I50.1, I49.1
- B. 75563, I50.20, I49.3
- C. 75559, I50.20, I49.3
- D. 75561, 75563, I50.1, I49.1
Answer: D
Explanation:
* Procedure: Complete cardiac MRI for morphology and function without contrast, followed by contrast with four additional sequences and stress imaging.
* CPT Codes:
* 75561: Cardiac MRI for morphology and function without contrast material.
* 75563: Cardiac MRI with contrast and further sequences.
* ICD-10-CM Codes:
* I50.1: Left ventricular failure.
* I49.1: Premature ventricular contractions.
* Code Selection Justification: The CPT codes accurately capture the MRI procedures performed. The ICD-10-CM codes represent the diagnoses of left ventricular failure and premature ventricular contractions.
References:
* AMA CPT Professional Edition (current year)
* ICD-10-CM (current year)
* HCPCS Level II (current year)
NEW QUESTION # 97
The outermost protective layer of skin is called the:
- A. Hypodermis
- B. Subcutaneous tissue
- C. Dermis
- D. Epidermis
Answer: D
NEW QUESTION # 98
A 20-year-old female is being seen for the first time by a primary care physician to have a yearly physical. During the examination for the physical, the provider discovers non-inflammed lesions on her legs and arms. The physician performs a complete physical and additional separate documentation for the treatment of the lesions on the bilateral upper and lower extremities. The provider has the patient buy an over-the-counter ointment and will continue to watch them.
What CPT coding is reported for this visit?
- A. 99385-25, 99203
- B. 0
- C. 99385, 99203-25
- D. 1
Answer: A
NEW QUESTION # 99
A patient has nausea with several episodes of emesis along with severe stomach pain due to dehydration.
Normal saline is infused in the same bag with 2 mg ondansetron to help with the nausea. Then a dose of 15 mg ketorolac tromethamine was given for the stomach pain.
What J codes are reported for these services?
- A. J2405, J1885
- B. J2405 x 2, J1835 x 15
- C. J2405 x 2, J1885
- D. J2405, J1885 x 15
Answer: A
Explanation:
The correct J codes are selected based on the specific medications administered and their quantities:
J2405 represents "ondansetron, 1 mg," and since the patient received a 2 mg dose, J2405 is reported once with a quantity of 2 mg.
J1885 represents "ketorolac tromethamine, 15 mg," which matches the single 15 mg dose administered to the patient, so J1885 is reported once.
Each J code is billed according to the precise dosage given, as no multipliers are required beyond the single- unit codes provided in choice A, making it the correct answer.
NEW QUESTION # 100
Mrs. Wilder presents with right and left leg swelling. Venous thrombosis imaging of each leg is done and shows deep venous embolism and thrombosis in each leg.
What CPTand ICD-10-CM codes are reported?
- A. 74858-50, 182.401, 182.402
- B. 78457-50, 182.403
- C. 78457-RT, 78457-LT, 182.401, 182.402
- D. 78458, 182.403
Answer: B
Explanation:
1. Procedure and CPTCode Selection:
The patient underwent venous thrombosis imaging of each leg to assess for deep venous thrombosis (DVT).
CPTCode 78457 is used for a venous thrombosis imaging study. This code is appropriate for imaging to detect DVT.
Modifier 50 is applied to indicate a bilateral procedure, as imaging was performed on both legs.
2. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code I82.403 is used for acute embolism and thrombosis of unspecified deep veins of bilateral lower extremities. This code accurately describes the finding of DVT in both legs.
Other ICD-10-CM options, such as I82.401 and I82.402, specify unilateral lower extremity involvement, which does not accurately reflect the bilateral findings in this case.
3. Rationale for Excluding Other Options:
Code 78458 (in options A and D) is for a more comprehensive study, often cardiac or whole-body blood pool imaging, and is not specific to leg venous thrombosis.
Option C, which lists 78457 with individual RT and LT modifiers, is incorrect as Modifier 50 is appropriate for bilateral imaging on both legs.
4. AAPC and CPTCoding Guidelines:
According to AAPC and CPTguidelines, 78457 with Modifier 50 should be used for bilateral venous imaging studies, and I82.403 correctly captures bilateral DVT.
Thus, the correct answer is B. 78457-50, I82.403.
NEW QUESTION # 101
A 30-year-old patient with a scalp defect is having plastic surgery to insert tissue expanders. The provider inserts the implants, closes the skin, and increases the volume of the expanders by injecting saline solution. Tissue is expanded until a satisfactory aesthetic outcome is obtained to repair the scalp defect.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: C
NEW QUESTION # 102
A 67-year-old male presents with DJD and spondylolisthesis at L4-L5 The patient is placed prone on the operating table and, after induction of general anesthesia, the lower back is sterilely prepped and draped. One incision was made over L1-L5. This was confirmed with a probe under fluoroscopy. Laminectomies are done at vertebral segments L4 and L5 with facetectomies to relieve pressure to the nerve roots. Allograft was packed in the gutters from L1-L5 for a posterior arthrodesis. Pedicle screws were placed at L2, L3, and L4.
The construct was copiously irrigated and muscle; fascia and skin were closed in layers.
Select the procedure codes for this scenario.
- A. 63047, 63048, 22612, 22614 x 3, 22842
- B. 63017, 63048, 22612, 22808, 22842 x 3
- C. 63042, 63043, 22808, 22841 x 3
- D. 63005 x 2, 22612, 22614 x 3, 22842
Answer: A
Explanation:
* Laminectomy and Facetectomy (63047 and 63048): The laminectomies at L4 and L5 with facetectomies fall under CPT codes 63047 (for the initial segment) and 63048 (for each additional segment).
* Posterior Arthrodesis (22612 and 22614 x 3): The posterior arthrodesis from L1-L5 is coded with
22612 for the primary segment (L4-L5) and 22614 for each additional segment (L1-L4).
* Placement of Pedicle Screws (22842): The placement of pedicle screws at L2, L3, and L4 is captured under CPT code 22842 for segmental instrumentation.
References:
* AMA's CPT Professional Edition (current year)
* ICD-10-CM (current year)
* HCPCS Level II (current year)
NEW QUESTION # 103
In medical terminology, suffixes indicate the procedure, condition, disorder, or disease.
Which term contains a suffix?
- A. hypotension
- B. neuralgia
- C. malaise
- D. ambidextrous
Answer: B
Explanation:
The suffix in medical terminology provides information about a condition, procedure, disorder, or disease.
The term "neuralgia" contains the suffix "-algia," which refers to pain, indicating a painful condition of the nerves. In contrast:
A: malaise has no identifiable suffix related to a specific medical condition or disease.
B: ambidextrous has no suffix indicating a disease, condition, or procedure.
D: hypotension includes the prefix "hypo-" (indicating low), but the core term "tension" refers to pressure without an additional suffix specific to condition.
Thus, "neuralgia" is the correct answer as it directly includes a suffix ("-algia") that denotes a pain-related condition in medical terms.
NEW QUESTION # 104
A complete cardiac MRI for morphology and function without contrast, followed by contrast with four additional sequences and stress imaging, is performed on a patient with systolic left ventricular congestive heart failure and premature ventricular contractions.
What CPT and ICD-10-CM codes are reported?
- A. 75563, I50.20, I49.3
- B. 75561, 75563, I50.1, I49.1
- C. 75557, 75559, I50.1, I49.1
- D. 75559, I50.20, I49.3
Answer: A
NEW QUESTION # 105
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