AAPC CPC FINAL PRACTICE TEST Questions and answers, 100% Accurate. A covered entity does NOT include a. Healthcare providers

AAPC CPC FINAL PRACTICE TEST Questions and answers, 100% Accurate. A covered entity does NOT include a. Healthcare providers b. Health plans c. Patients d. Clearinghouses - ✔✔-c. Patients What does MAC stands for? ...

AAPC CPC FINAL PRACTICE TEST Questions and answers, 100% Accurate. A covered entity does NOT include a. Healthcare providers b. Health plans c. Patients d. Clearinghouses - ✔✔-c. Patients What does MAC stands for? a. Medicare Administrative Contractor b. Medicare Advisory Contractor c. Medicaid Administrative Contractor d. Medicaid Alert Contractor - ✔✔-a. Medicare Administrative Contractor When are providers responsible for obtaining an ABN for a service NOT considered medically necessary? a. After providing a service or item to a beneficiary. b. Prior to providing a service or item to a beneficiary. c. After a denial has been received from Medicare. d. During a procedure or service. - ✔✔-b. Prior to providing a service or item to a beneficiary AAPC credentialed coders have proven mastery of what information? a. Code sets b. Evaluation and management principles c. Documentation guidelines d. All of the above - ✔✔-d. All of the above Local Coverage Determinations are administered by whom? a. LMRPs b. NCDs c. State Law d. Each regional MAC - ✔✔-d. Each regional MAC Rationale: Each Medicare Administrative Contractor (MAC) is then responsible for interpreting national policies into regional policies Which of the following best describes constituent components of the human lymphatic system? a. Lymph nodes, lymphatic vessels, spleen, thoracic duct b. Lymph nodes, lymphatic vessels, thymus gland, pancreas c. Lymph nodes, lymphatic vessels, tonsils, liver d. Lymph nodes, lymphatic vessels, bone marrow, kidneys - ✔✔-a. Lymph nodes, lymphatic vessels, spleen, thoracic duct The term hemic specifically refers to what bodily fluid? a. Bile interstitial fluid b. Interstitial fluid c. Blood d. Lymph - ✔✔-c. Blood Which part of the brain controls blood pressure, heart rate and respiration? a. Cerebellum b. Cerebrum c. Cortex d. Medulla - ✔✔-d. Medulla The radiology term fluoroscopy is described as: a. Use of high-frequency sound waves to image anatomic structures b. An X-ray procedure allowing the visualization of internal organs in motion c. Technique using magnetism, radio waves and a computer to produce images d. A scan using an X-ray beam rotating around the patient - ✔✔-b. An X-ray procedure allowing the visualization of internal organs in motion Which of the following characterizes the disorder dystonia? a. Difficulty swallowing b. Slowness of motion c. Abnormal muscle tone causing abnormal postures and muscle spasm d. Impairment of speech - ✔✔-c. Abnormal muscle tone causing abnormal postures and muscle spasm In the ICD-10-CM Alphabetic Index what is the code next to the main term called? a. Category Code b. Default Code c. Unspecified Code d. Subcategory Code - ✔✔-b. Default Code What is the ICD-10-CM code for eyestrain? a. H53.10 b. H53.10, H53.10 c. H57.811, H57.812 d. H57.813 - ✔✔-a. H53.10 What is the ICD-10-CM code for fatigue? a. R29.898 b. F45.8 c. F48.8 d. R53.83 - ✔✔-d. R53.83 A patient sees his primary care provider for chest pain and regurgitation. The provider's diagnosis for the patient is gastroesophageal reflux. What diagnosis code(s) should be reported? a. K21.9 b. K21.9, R07.9, K21.9 c. R07.9, R11.10 d. R07.9, R11.10, K21.9 - ✔✔-a. K21.9 A 45 year-old female with malignant Mullerian duct cancer is receiving her first treatment of chemotherapy. What diagnosis codes are reported? a. C79.82, Z51.11 b. C57.7, Z51.11 c. Z51.11, D28.7 d. Z51.11, C57.7 - ✔✔-d. Z51.11, C57.7 According to ICD-10-CM guidelines, when a patient is seen for management of anemia due to malignancy, how is it reported? a. Anemia is the only condition reported. b. The malignancy is the only condition reported. c. Anemia is reported first, followed by the code for the malignancy. d. The malignancy is reported first, followed by the code for the anemia. - ✔✔-d. The malignancy is reported first, followed by the code for the anemia. What ICD-10-CM code is reported for a patient who is a habitual abuser of cannabis? a. F12.159 b. F12.129 c. F12.121 d. F12.10 - ✔✔-d. F12.10 A patient presents to the ED with weakness on the left side and aphasia. Tests are ordered and the patient is admitted with a cerebrovascular accident (CVA). What ICD-10-CM code(s) is/are reported? a. I67.89 b. R53.1, R47.01 c. I63.50 d. I63.9 - ✔✔-d. A patient is admitted after being found unresponsive at home. The patient had right-sided hemiplegia and aphasia from a previous CVA. The provider documents a current cerebral infarction due to occlusion of the right middle cerebral artery as the final diagnosis and the patient is transferred for rehabilitation. What ICD-10-CM code(s) is/are reported? a. I67.89, I69.959, I69.920 b. I65.319 c. I67.89, I69.954, R47.01 d. I63.511, I69.351, I69.320 - ✔✔-d. I63.511, I69.351, I69.320 Response Feedback: Rationale: Refer to ICD-10-CM guideline I.C.9.d.2. Look in the ICD-10-CM Alphabetic Index for Infarct, infarction/cerebral/due to/occlusion NEC/cerebral arteries directing you to code I63.5-. Report I63.511 Cerebral infarct due to unspecified occlusion or stenosis of right middle cerebral artery. This patient has a history of CVA with right-sided hemiplegia and aphasia. Look in the Alphabetic Index for Sequelae (of)/infarction/cerebral/hemiplegia which directs the coder to I69.35-. Also look for Sequelae/infarction/cerebral/aphasia I69.320. Verify in the Tabular List I69.351 Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side.Per ICD-10-CM guideline I.C.9.d.1 because the right side was affected and we do not know the dominant side, the default for dominance is right Four years post hepatic transplant, the patient is diagnosed with combined hepatocellular carcinoma and cholangiocarcinoma of the liver. What ICD-10-CM codes are reported? a. T86.49, C80.2, C22.0, C22.1, Z94.4 b. C80.2, C22.0 c. C80.2, C22.0, C22.1, Z94.4 d. T86.49, C80.2, C22.0 - ✔✔-d. T86.49, C80.2, C22.0 What is NOT an example of active treatment for pathological fractures? a. Surgical treatment b. Emergency department encounter c. Evaluation and treatment by a new provider d. Cast change - ✔✔-d. Cast change A patient was admitted three weeks following a normal vaginal delivery with a postpartum breast abscess. What ICD-10-CM code is reported? a. O91.12 b. O91.22 c. N61.1 d. O91.13 - ✔✔-a. O91.12 What is/are the external cause code(s) for a passenger involved in an MVA that lost control on the highway and hit a guardrail? a. Y92.411 b. V47.6XXA c. V47.5XXA d. V47.6XXA, Y92.411 - ✔✔-a. Y92.411 A 7 year-old female patient was seen in the emergency department after being bitten by a dog. The child received treatment for the puncture wounds to her left leg. She also received a rabies vaccine because the dog was known to have rabies. What ICD-10-CM codes are reported? a. S81.852A, Z20.3, Z23, W54.0XXA b. S81.812A, Z20.3, Z23, W54.0XXA c. S81.812A, A82.9, Z23, W54.0XXA d. S81.852A, Z23, W54.0XXA - ✔✔-a. S81.852A, Z20.3, Z23, W54.0XXA A male patient is here for his chemotherapy for metastatic carcinoma of the liver secondary to cancer of the right areola. What ICD-10-CM codes are reported? a. C22.9, C50.019, Z51.11 b. Z51.11, C78.7, C50.021 c. Z51.11, C50.029, C78.7 d. C78.7, C50.021, Z51.11 - ✔✔-b. Z51.11, C78.7, C50.021 Rationale: ICD-10-CM guideline I.C.2.e.2 states that if a patient admission/encounter is solely for the administration of chemotherapy, immunotherapy, or radiation therapy, assign code Z51.0 Encounter for antineoplastic radiation therapy, or Z51.11 Encounter for antineoplastic chemotherapy, or Z51.12 Encounter for antineoplastic immunotherapy as the first listed or principal diagnosis. In the ICD-10-CM Alphabetic Index look for Encounter (with health service) (for)/chemotherapy for neoplasm guiding you to code Z51.11. Next, look in the Alphabetic Index for Metastasis, metastatic/cancer/from specified site and you are directed to see Neoplasm, malignant, by site. In the ICD-10-CM Table of Neoplasms look for Neoplasm, neoplastic/liver and select the code from the Malignant Secondary column, guiding you to code C78.7. Next look for Neoplasm, neoplastic/areola and select the code from the Malignant Primary column or Neoplasm, neoplastic/breast/areola and select the code from the Malignant Primary column, guiding you to subcategory code C50.0-. In the Tabular List, the 5th character is reported for the sex of the patient. In this case the patient is a male resulting in a 5th character of 2. The 6th character is for laterality; 1 is for right. The complete code is C50.021 for primary cancer of the right male areola. When assigning breast cancer codes make sure to select for the correct sex of the patient. The secondary cancer is listed first because the chemotherapy is directed to the secondary site per ICD-10-CM guideline I.C.2.b. Verify code selection in the Tabular List. What is the correct CPT® code for a complete, four-view, chest X-ray? a. 71048 b. 71046 x 2 c. 71047 d. 71045 x 4 - ✔✔-a. 71048 How many days does it take CMS to implement HCPCS Level II Temporary Codes that have been reported as added, changed or deleted? a. 90 b. 30 c. 60 d. 365 - ✔✔-a. 90 What codes are voluntarily reported to payers, provide evidence-based performance-measure data? a. HCPCS Level II codes b. CPT® Category I codes c. CPT® Category III codes d. CPT® Category II codes - ✔✔-d. CPT® Category II codes HCPCS Level II includes code ranges that consist of what type of codes? a. Permanent national codes, miscellaneous codes and temporary national codes b. Permanent national codes, dental codes and category II codes c. Category II codes, temporary national codes and miscellaneous codes d. Dental codes, morphology codes, miscellaneous codes and permanent national codes - ✔✔-a. Permanent national codes, miscellaneous codes and temporary national codes When procedures are "mandated" by third party payers, what modifier would you use? a. 52 b. 26 c. 76 d. 32 - ✔✔-d. 32 A patient is taken to surgery for removal of a squamous cell carcinoma of the right thigh. What is the correct diagnosis code for today's procedure? a. C79.2 b. C79.89 c. C44.702 d. C44.722 - ✔✔-d. C44.722 A 14 year-old boy was thrown against the window of the car on impact. The resulting injury was a starshaped pattern cut to the top of his head. In the ED, the MD on call for plastic surgery was asked to evaluate the injury and repair it. The total length of the intermediate repair was 5+4+4+5 cm (18 cm total). The star-like shape allowed the surgeon to pull the wound edges together nicely in a natural Yplasty in two spots. What CPT® code is reported for the repair? a. 14041 b. 13121 c. 14040 d. 12035 - ✔✔-d. 12035 A patient presents with a recurrent seborrheic keratosis of the left cheek. The area was marked for a shave removal. The area was infiltrated with local anesthetic, prepped and draped in a sterile fashion. The lesion measuring 1.8 cm was shaved using an 11-blade. Meticulous hemostasis was achieved using light pressure. The specimen was sent for permanent pathology. The patient tolerated the procedure well. What CPT® code is reported? a. 11642 b. 11200 c. 11312 d. 11442 - ✔✔-c. 11312 INDICATIONS FOR SURGERY: The patient is an 82 year-old male with biopsy-proven basal cell carcinoma of his right lower eyelid extending to the upper part of the cheek. I marked the area for rhomboidal excision and I drew my planned rhomboid flap. The patient observed these markings in a mirror, he understood the surgery and agreed on the location and we proceeded. DESCRIPTION OF PROCEDURE: The area was infiltrated with local anesthetic. The face was prepped and draped in sterile fashion. I excised the lesion as drawn into the subcutaneous fat. Hemostasis was achieved using Bovie cautery. Modified Mohs analysis showed the margin to be clear. I incised the rhomboid flap as drawn and elevated the flap with a full-thickness of subcutaneous fat. Hemostasis was achieved in the donor site, the Bovie cautery was not used, hand held cautery was used. The flap was rotated into the defect. The donor site was closed and flap inset in layers using 5-0 Monocryl and 6-0 Prolene. The patient tolerated the procedure well. The total site measured 1.3 cm x 2.7 cm. What CPT® code(s) should be reported? a. 14040, 14060 b. 14060, 11643 c. 14060 d. 11643 - ✔✔-c. 14060 Operative Report PREOPERATIVE DIAGNOSIS: Congenital left breast deformity. POSTOPERATIVE DIAGNOSIS: Congenital left breast deformity. PROCEDURE PERFORMED: Placement of left breast implant using mentor catalog #, lot #, serial #, 425 cc smooth round moderate profile implant filled with 475 cc of normal saline for breast reconstruction. INDICATIONS FOR SURGERY: The patient is a 34 year-old female who approximately 15 to 16 years ago had a left breast implant placed for breast reconstruction for her congenital deformity of the left breast. This implant ruptured and in late September 20XX, I performed a capsulectomy and exchanged her ruptured implant for a new implant. About a week after surgery the patient developed an infection. Due to the infection, her implant had to be removed. The patient's infection has completely resolved and she is now ready to have her implant replaced. In the preoperative holding area, I marked her for the ideal position of this implant and performed a breast exam not showing a mass in either breast and no mass in axillae and we proceeded. We discussed with the patient that even though her original implant was placed in subglandular position I felt it would be beneficial to place the implant behind her pectoralis major muscle in submuscular position today. The patient agreed and we proceeded. DESCRIPTION OF PROCEDURE: The patient was given 1 g of IV Vancomycin. The patient was taken to the operating room; general anesthesia was induced and bilateral pneumatic compression stockings were worn throughout the procedure. A lower body Bair Hugger was placed. Both arms were secured to padded arm boards using Kerlix rolls. The neck, chest, axillae, and upper abdomen were prepped and draped in sterile fashion. I began by incising the central portion of her previous scar. I dissected down to the pectoralis major muscle. A submuscular plane was developed through a lateral approach and the inferior and medial origin of the muscle was partially divided using the Bovie cautery. Meticulous hemostasis was achieved using Bovie cautery. There were no signs of infection nor were there any pockets of seroma fluid or hematoma. The wound was carefully inspected. Meticulous hemostasis was achieved. Gloves were changed. The implant was opened and air was evacuated. It was placed in the submuscular pocket and the wound was temporarily closed using a skin stapler. The implant was filled to its maximum volume of 475 cc of normal saline. The patient was sat up. I adjusted the volume and ultimately felt she needed a 475 cc implant for breast symmetry with her contralateral breast. Once I was satisfied with the position of the implant, the patient was placed supine. Gloves were changed again. The fill tube was removed and I then secured the filled valves digitally and the deepest layer of breast tissue was closed using 3-0 Vicryl in running suture and the skin was closed in three layers using 4-0 Monocryl, 5-0 Monocryl, and 5-0 Prolene. The wound was dressed with Xeroform and gauze. The patient tolerated the procedure well. She was taken to recovery in good condition. What CPT® and ICD-10-CM codes are reported? a. 19325-LT, N64.89 b. 19342-LT, Q83.9 c. 19316-LT, N64.89 d. 19340-LT, Q83.9 - ✔✔-b. 19342-LT, Q83.9 In ICD-10-CM, what classification system is used to report open fracture classifications? a. Muller AO classification of fractures b. Danis-Weber classification c. Gustilo classification for open fractures d. PHF classification of fractures - ✔✔-c. Gustilo classification for open fractures A patient is given Xylocaine, a local anesthetic, by injection in the thigh above the site to be biopsied. A small bore needle is then introduced into the muscle, about 3 inches deep, and a muscle biopsy is taken. What CPT® code is reported for this service? a. 20206 b. 27324 c. 20225 d. 20205 - ✔✔-a. 20206 This 45 year-old male presents to the operating room with a painful mass of the right upper arm. Upon deep dissection a large mass in the soft tissue of the patient's shoulder was noted. The mass appeared to be benign in nature. With deep blunt dissection and electrocautery, the mass was removed and sent to pathology. What CPT® code is reported? a. 23030-RT b. 23075-RT c. 23076-RT d. 23066-RT - ✔✔-d. 23066-RT A 22 year-old female sustained a dislocation of the right elbow with a medial epicondyle fracture while on vacation. The patient was given general anesthesia and the elbow was reduced and was stable. The medial epicondyle was held in the appropriate position and was reduced in acceptable position and elevated. A long arm splint was applied. The patient is referred to an orthopedist when she returns to her home state in a few days. What CPT® code(s) are reported? a. 24576-54-RT, 24620-54-51-RT b. 24565-54-RT, 24605-54-51-RT c. 24577-54-RT, 24600-54-51-RT d. 24575-54-RT, 24615-54-51-RT - ✔✔-b. 24565-54-RT, 24605-54-51-RT A patient is seen in the hospital's outpatient surgical area with a diagnosis of a displaced fracture of the lateral condyle, right elbow. An ORIF (open reduction) procedure was performed and included the following techniques: An incision was made in the area of the lateral epicondyle. This was carried through subcutaneous tissue, and the fracture site was easily exposed. Inspection revealed the fragment to be rotated in two places about 90 degrees. It was possible to manually reduce this quite easily, and the manipulation resulted in an almost anatomic reduction. This was fixed with two pins driven across the humerus. The pins were cut off below skin level. The wound was closed with plain catgut subcutaneously and 5-0 nylon for the skin. Dressings and a long arm cast were applied. What CPT® and ICD-10-CM codes are reported? a. 24577-RT, S42.451A b. 24579-RT, S42.451A c. 24579-RT, 29065-51-RT, S42.434B d. 24575-RT, S42.434B - ✔✔-c. 24579-RT, 29065-51-RT, S42.434B What CPT® code is reported for open decortication and parietal pleurectomy? a. 32652 b. 32225 c. 32320 d. 32220 - ✔✔-c. 32320 A 65 year-old patient is complaining of difficulty breathing. Patient is scheduled for a diagnostic VATS (Video-assisted thoracoscopic surgery). Under general anesthesia he was placed in left lateral decubitus position and a thoracoscope was inserted through a port site. The VATS exploration immediately revealed a mass of the right upper lobe. A biopsy was performed and sent to pathology. Results from pathology revealed small cell carcinoma. The decision was made to perform VATS and remove the upper lobe of the right lung. What CPT® code(s) is (are) reported? - ✔✔-32663 Rationale: The patient started out with a diagnostic VATS but it became a surgical VATS when the upper lobe of the right lung was removed. According to CPT® guidelines a surgical thoracoscopy always includes a diagnostic thoracoscopy. You will not report 32607 or 32609 which are diagnostic VATS codes. The removal of the upper lobe was performed by VATS. Code 32480 is not correct because that is if the patient had an open surgery to remove the upper lobe. A patient with AML (Acute Myelogenous Leukemia) has just learned his sister is an HLA (Human Leukocyte Antigen) match for him. Stem cells taken from the donor (the patient's sister) will be transplanted into the patient to help with his treatment. What CPT® code is used to report the harvesting of the stem cells from the donor (his sister)? a. 38204 b. 38205 c. 38206 d. 38207 - ✔✔-b. 38205 38205:Rationale: In the CPT® Index look for Stem Cell/Harvesting. This directs you to code range 38205, 38206. Code selection is based on whether it is allogenic (from a donor) or autologous (from the patient). This is allogenic making 38205 the correct code choice. A returning 2 year-old child is seen in the pediatrician's office with stridor and a bark like cough. The pediatrician examines the child quickly and determines the child has stridulous croup. The child is given a nebulizer breathing treatment in the office to improve PO 2 levels. Medication used is breathable Epinephrine. What CPT® and ICD-10-CM codes are reported? a. 94644, J04.2 b. 94644, R06.1, R05 c. 94640, J38.5 d. 94642, J38.5, R05, R06.1 - ✔✔-c. 94640, J38.5 A patient with chronic pneumothoraces presents for chemopleurodesis. Under local anesthesia a small incision is made between the ribs. A catheter is inserted into the pleural space between the parietal and pleural viscera. Subsequently, 5g of sterile asbestos free talc was introduced into the pleural space via the catheter. What CPT® and ICD-10-CM codes are reported? a. 32650, 32560, J93.11 b. 32601, 32560, J95.811 c. 32650, J95.811 d. 32560, J93.81 - ✔✔-d. 32560, J93.81 Patient presents to her physician 10 weeks following a true posterior wall myocardial infarction. The patient is still symptomatic and is diagnosed with ischemic heart disease. What is (are) the correct ICD10-CM code(s) for this condition? a. I22.8 b. I21.29 c. I25.2 d. Z51.89, I25.9 - ✔✔-d. Z51.89, I25.9 What information is needed in order to accurately code hypertension retinopathy in ICD-10-CM? a. The affected eye(s). b. Whether the hypertension is malignant or benign. c. Which side of the heart is affected? d. The stage of retinopathy - ✔✔-a. The affected eye(s). An arterial catheterization is performed by cutdown for transfusion. What CPT® code is reported? a. 36640 b. 36625 c. 36620 d. 36600 - ✔✔-b. 36625 INDICATIONS FOR CORONARY INTERVENTION: Acute inferior myocardial infarction. Documented mildly occlusive plaque with much clot in the right coronary artery. PROCEDURE: Insertion of temporary pacemaker in the right femoral vein. Primary stenting of the right coronary artery with a 4.5 x 16 mm Express stent. Angio-Seal to the vessels of the right common femoral artery post procedure, and also Angio-Seal of the right common femoral vein. TECHNIQUE: Judkins percutaneous approach from the right groin with Perclose at the arterial puncture site post procedure. CATHETERS: 4 French Angio-Jet catheter device, insertion of a 5 French temporary pacing wire, a 4.5 x 16 mm Express stent. PRESSURES: Aortic Pressure: 107/7