AAPC CPC Exam Questions

Correct answer: A type of E/M service provided at the request of another physician or appropriate source to either recommend care for a specific condition/problem or to determine whether to accept responsibility for ongoing management of the patient's entire care or for the care of a specific condition/problem

The Evaluation and Management section gives great, detailed information on every service, helping the coder to understand better. Consultations are no exception. Located after the hospital inpatient services, consultations are "defined" in the following way: "A consultation is a type of E/M service provided at the request of another physician or appropriate source to either recommend care for a specific condition/problem or to determine whether to accept responsibility for ongoing management of the patient's entire care or for the care of a specific condition/problem." This would be the correct answer to the question.

The other answers are also a part of the same section; however, they all describe different parts of consultations, not what a consultation actually is. Therefore, these would not be the correct answer.

Correct answer: Electrolyte, Renal function

The easiest way to answer this question is to look up the different panels in the Pathology and Laboratory section. Chloride is found in different types of panels including all of the metabolic ones. If you look closely, you will see that there are two other panels that it is a part of—the electrolyte panel and the renal function panel. It cannot be found in the lipid panel, the obstetric panel, or the general health panel.

Correct answer: 67808

CPT code 67808 describes either single or multiple chalazia excised under general anesthesia.

CPT code 67800 describes a single chalazion removal; this case presents more than a single chalazion to be removed.

CPT code 67801 describes removing more than one chalazion on the same eyelid. This case documented chalazion removal on each of the upper and lower lids.

CPT code 67805 is a similar code, but it does not include general anesthesia; this case was administered with general anesthesia.

Correct answer: 59841

Searching the CPT index for dilation and evacuation, induced abortion, leads to 59841.

CPT code 59840 describes a dilation and curettage. This was a dilation and evacuation.

CPT code 59812 describes a treatment for incomplete abortion. This was an induced abortion.

CPT code 59851 describes an induced abortion with D&C or D&E with amniotic injections. There were no amniotic injections in this case.

Correct answer: They are both parts of the ear

The medical prefix staped/o stands for the stapes, which is a part of the middle ear. The medical prefix myring/o stands for the tympanic membrane, which is the technical term for the eardrum. These two prefixes are both parts of the ear.

Correct answer: 24931

In the index of the CPT book, you will look up amputation, arm, upper, with implant. This gives you the code range 24931-24935, which can be found in the Musculoskeletal System section. Turning to this section, you will see that code 24931, which is for amputation, arm through humerus with implant is the correct code.

Code 24900 is for an amputation of the arm without an implant. While it is partially correct, it does not have all the components the question is asking for, so this is an incorrect answer. Code 24999 is for an unlisted procedure, humerus/elbow. The procedure mentioned in the question is listed, so this is not the correct answer. Code 24925 is for an amputation of the arm, secondary closure/scar revision. This is not mentioned in the question, so this is incorrect.

Correct answer: Amniocentesis

One method to answer this question is to review the word part listings at the beginning of the book, where the suffix -centesis is listed to describe amniocentesis. Another would be to visit the list of illustrations or visit the CPT index for amniocentesis and research the code 59000, where there is a graphic of amniocentesis, illustrating that it is removal of fluid from the amniotic sac.  

Pericardiocentesis removes fluid from the pericardium; this procedure can be researched in the CPT index leading to the cardiovascular and respiratory surgeries. That would be an indication that pericardiocentesis is not an amniotic procedure. Amniocatheterization is not found in the CPT index and is not a valid procedure; if it were, it would involve catheterization, not needle placement and fluid extraction. Paracentesis researched in the CPT index leads to a variety of drainage techniques in differing body parts, including the fetus, but it is not the same as amniocentesis.

Correct answer: 93010, 96360, 96361

This question needs at least two different codes in order to correctly code the situation. First, you will find the code for the ECG. In the index of the CPT book, you will look up electrocardiography, 12 lead. This gives you two codes: 3120F and 93000. Code 3120F is a Category II code and will not be used in this instance. Code 93000 can be found in the Medicine section. Going back to the question, the physician only interprets the report from the ECG and did not perform it, so 93000 is incorrect. When you look a bit further down the code selection, you will see there is a code for interpretation and report only for a 12-lead ECG, which is code 93010. This would be the correct code for the first part of the question. The next part will be to code the NS (normal saline) hydration drip. In the index, you will look up infusion, hydration, which gives you the code range 96360-96361. Going back to the Medicine section, you will see that 96361 is an add-on to code 96360, which is for an intravenous infusion, hydration, from 31 minutes to an hour. Each additional hour would be reported with 96361. In the question, the NS drip is given to the patient for about 2 hours. This would be coded with both 96360 and 96361.

Code 93000, as mentioned above, is not only for the 12-lead ECG but the interpretation and report. The physician did not perform the ECG himself, so this is incorrect. Code 93005 is for an ECG tracing only, no interpretation and report. Again, the testing was not done by the physician, so this would also be incorrect. Again, code 96361 is only an add-on code and cannot be used on its own.

Correct answer: Esophagogastroduodenoscopy

This is an excellent question for learning medical terminology. Each part of this answer is a prefix (and one suffix) and tells exactly what it is: Esophag(o) for the esophagus, gastr(o) for the stomach, duoden(o) for the duodenum, and -scopy, meaning the procedure to view by using a scope (or a long tube with a camera). This procedure allows the doctor to view down the esophagus, into the stomach, and down to the duodenum. It helps to detect ulcers and GERD (gastroesophageal reflux disease), along with many other various digestive diseases.

The other answers, while similar, are not the correct terminology, so they are incorrect.

Correct answer: 43241-52

The esophagogastroduodenoscopy was performed along with the placement of a catheter. Searching the CPT index under esophagogastroduodenoscopy, Insertion, Catheter or Tube directs to 43241. This does describe the procedure that was performed. Since this procedure did not go all the way to the duodenum, modifier -52 of reduced procedure, is appended.

CPT code 43246-52 describes the placement of a percutaneous gastrostomy tube. The case describes a catheter.

CPT code 43235 describes the dilation of the gastric/duodenal stricture using a technique such as a balloon. The case describes the insertion of a catheter.

CPT code 43206 describes an esophagoscopy, with optical endomicroscopy. The case describes an EGD, going further than the esophagus, into the stomach, and insertion of a catheter.

Correct answer: Oral administration of contrast material

Radiology has many types of studies for many reasons. A “with contrast” study uses a contrast material to properly view the body part/organ in question. Some examples of “with contrast” studies include computed tomographic angiography (CTA), magnetic resonance imaging (MRI), and magnetic resonance angiography (MRA) procedures.

If a study is done with either oral or rectal contrast only, it does not count as a “with contrast” study.

Correct answer: Abnormal swelling or herniation

Besides the proximity of each organ these diseases affect, hydrocele, cystocele, and rectocele are similar in another way. As you can see, each disease name ends with the same suffix, -cele. -Cele stands for swelling or hernia, and each disease listed in the question affects the body in this way. Hydrocele causes abnormal swelling by fluid piling up in a sac-like structure, such as the testicles; cystocele is caused by the bladder bulging into weakened vaginal wall tissue, causing herniation; and rectocele is caused by rectal muscle bulging into weakened vaginal wall tissue, causing herniation. So for this question, the correct answer is abnormal swelling or herniation.

Correct answer: A patient's driver's license found in the parking lot of a healthcare facility shortly after their appointment

According to HIPAA resources, PHI is information that can be used to identify an individual in connection with their medical record treatment or diagnosis data. A patient's driver's license, found in a healthcare facility parking lot does not connect the individual with their healthcare information.

A patient photo is an image of the patient; connecting that patient with the survivorship of a disease in the clinical area is PHI. (To be HIPAA-compliant, the patient would have to authorize the use of the photo for a specific period of time.)

A voice recording left on the office voicemail system in which the patient identifies themselves and requests information about their blood test results is PHI. (To be HIPAA-compliant, only authorized staff members should have access to hearing messages on the voicemail system.)

A patient's operative report is PHI, as it identifies the patient and a healthcare treatment. (To be HIPAA-compliant, only authorized staff members should have access to operative reports.)

Correct answer: 64740

For this question, you will first go to the CPT index and look up transection, nerve. This gives you the code range 64732-64772, which is located in the Nervous system section. The difference between these codes is basically on what nerve the transection is performed. The question specifically mentions that it is performed on the lingual nerve, so you will see that code 64740 is the correct answer.

Codes 64732, 64746 and 64744 are all for transection procedures; however, they differ by the nerve they are performed on (64732 is performed on the supraorbital nerve, 64746 is performed on the phrenic nerve, and 64744 is performed on the greater occipital nerve). Because of this, these codes are not the correct answer to the question.

Correct answer: 15852

In the CPT index, you would look up dressings, change, anesthesia, which gives you the code 15852. Turning to the Integumentary system section, where this code is located, you will see that it is for a dressing change under anesthesia. Since this is exactly what the question is asking for, this code would be the correct answer.

Code 15851 is for removal of sutures or staples requiring anesthesia. The patient had a bandage change done, not suture/staple removal, so this would be incorrect. Code 15879 is for suction-assisted lipectomy; head and neck, lower extremity. This does not match what was done in the question, so this also would be incorrect. Code 15860 is for the intravenous injection of agent to test vascular flow in flap or graft. A bandage change was done, not IV injection, so this would also be incorrect.

Correct answer: F41.1

In the alphabetic index of the ICD-10 book, you will look up anxiety, generalized. This gives you the code F41.1, which can be found in Chapter 5: Mental, Behavioral, and Neurodevelopmental Disorders. This code directly correlates to generalized anxiety disorder, which is exactly what the question asks for. Code F41.1 does not need any more characters to complete it, so this would be the correct answer to this question.

Code F40.8 is for other phobic anxiety disorders. This is not the type of anxiety the question is asking for, so this would be an incorrect answer. Code F43.0 is for acute stress reaction. This is not what the question is asking for, so this is incorrect. Code F41.9 is for anxiety disorder, unspecified. There is a code for GAD, so this would be incorrect.

Correct answer: Paralysis of arms and legs

In order to answer this question, you will have to break the word down into its two medical terms: quadr- and -plegia. Quadr- means four, and -plegia means paralysis. So, putting the two terms together would give you paralysis of four, or paralysis of four limbs, the arms and legs. Typically, someone who suffers from quadriplegia does not have the use of their waist or torso, but that can vary depending on how the patient became paralyzed. In terms of the question, paralysis of the arms and legs would be the correct answer.

If a patient is paralyzed from the waist down, it is called paraplegia, para- meaning "pair" or beyond and -plegia meaning paralysis. Like quadriplegia, paraplegia's effect on a patient can vary depending on how he became paralyzed. When it comes to this question, however, this is not the correct answer. Paralysis on either the right or left side of the body is called hemiplegia; hemi- meaning half and -plegia meaning paralysis. If a patient suffers from hemiplegia, just like any other paralysis, his symptoms could vary greatly. This, however, does not answer the question. Paralysis of the vocal cords does not have a name like the others mentioned above but can be known as vocal paresis; paresis being another word for paralysis. However, this does not answer the question either.

Correct answer: 33262

The CPT manual provides intensive guidelines and a chart to assist with coding for defibrillators and pacemakers. This case involves the removal and replacement of the battery component referred to as the pulse generator for a defibrillator of a single chamber, leading to CPT code 33262.

CPT code 33244 describes only the removal of an electrode for a single lead system.

CPT code 33241 describes only the removal of the pulse generator, not the replacement of the battery; modifier -51 is, therefore, also not appropriate.

CPT code 33240 is the insertion of an initial defibrillator.

CPT code 33236 describes the removal of an epicardial pacemaker by a specific approach; this is not documented in the case.

CPT code 33202 describes the insertion of an epicardial electrode by open incision; this is not documented in the case. Modifier -51, distinct procedure, would also not apply.

CPT code 33206 describes the implantation of a new or replacement pacemaker; this is not documented in the case. Therefore, modifier -51 is also incorrect.

CPT code 33233 describes the removal of a permanent pulse generator only; the case documents removal and replacement. Modifier -51, multiple procedures, therefore, also does not apply.

Correct answer: 99360 x2

In the CPT index, you would look up standby services, which gives you the code 99360. Turning to the Evaluation and Management section, you will see that this code is for a standby service, requiring prolonged attendance, each 30 minutes. The physician in the question is on standby for a total of 60 minutes. Since this code is only for 30 minutes each, you would code it twice, making the correct answer 99360 x2.

Code 99416 is an add-on code for a prolonged clinical staff service during an E/M service in the office/outpatient setting, direct patient contact with physician supervision, each additional 30 minutes. The question states that the physician is attending an actual surgical procedure. Also, this code is an add-on code. Therefore, this would not be the correct answer. Code 99367 is for a medical team conference, 30 minutes or more. The question mentions nothing about a medical team conference, so this would not be the correct answer either.

Correct answer: 76830

In the index of the CPT book, you will look up ultrasound, vaginal. This gives you the code 76830, which can be found in the Radiology section. Turning to this section, you will see that this code is for a transvaginal ultrasound. Since this is what the question is looking for, this would be the correct answer.

Code 76856 is for a complete pelvic ultrasound. Since this is not what the question is asking for, this is incorrect. Code 76857 is for a limited pelvic ultrasound. This is also not what the question is asking for, so this would be incorrect. Code 76870 is for a scrotal ultrasound. This is not what the question is asking for either, so this is incorrect.