Download AAPC CPC Final Exam 2025: 100 Questions with Verified Solutions and more Exams Law in PDF only on Docsity!
Local Coverage Determinations are administered by whom? a. State Law b. NCDs c. Each regional MAC d. LMRPs ✔✔c. Each regional MAC ABN stands for. a. Advanced Benefits Notification b. Advisory Beneficial Notice c. Admitting Beneficiary Notice d. Advance Beneficiary Notice ✔✔d. Advance Beneficiary Notice What type of health insurance provides coverage for low-income families? a. Commercial HMO b. Medicaid c. Medicare d. Commercial PPO ✔✔b. Medicaid Which type of information is NOT maintained in a medical record? a. Treatment outcomes b. Financial records c. Medical or surgical interventions d. Observations ✔✔b. Financial records According to the OIG, internal monitoring and auditing should be performed by what means? a. Focused audits on problems brought to the attention of the compliance officer.
AAPC CPC Final Exam 2025 | 100 QUESTIONS
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b. Baseline audits. c. Periodic audits. d. Audits on all denied claims. ✔✔c. Periodic audits. Urine is transported from the kidneys to the urinary bladder by which structure? a. Ureter b. Urethra c. Kidney pelvis d. Urinary vein ✔✔a. Ureter Which of the following does NOT circulate fluids throughout the body? a. Venous system b. Endocrine system c. Arterial system d. Lymphatic system ✔✔b. Endocrine system What is a function of the alveoli in the lungs? a. Oxygen exchange b. Nicotine is destroyed c. Fluid in the lungs absorbed d. Providing an airway to breathe ✔✔a. Oxygen exchange Cytopathology is the study of: a. Tissue b. Cells c. Blood d. Organs ✔✔b. Cells The meaning of heteropsia (or anisometropia) is: a. Blindness in half the visual field b. Double vision c. Unequal vision in the two eyes d. Blindness in both eyes ✔✔c. Unequal vision in the two eyes What is the meaning of provider in the ICD- 10 - CM guidelines?
a. I15. b. I13. c. R03. d. I10 ✔✔c. R03. A 32 year-old male was seen in the ASC for removal of two lipomas. One was located on his back and the other was located on the right forearm. Both involved subcutaneous tissue. What ICD- 10 - CM code(s) is/are reported? a. D17.1, D17. b. D17.21, D17. c. D17. d. D17.39 ✔✔b. D17.21, D17. What is the time frame defining when pain becomes chronic? a. After the global period b. One year c. The 30th day d. No time frame ✔✔d. No time frame A patient with amyloidosis being treated for glomerulonephritis. What ICD- 10 - CM codes are reported? a. E85.3, N b. E85.4, N c. N08, E85. d. N08, E85.4 ✔✔b. E85.4, N A 45 year-old-male patient has developed an ulcer on his upper back. He has had diabetes for several years and is on insulin. The provider determines that the ulcer is due to his diabetes. What ICD- 10 - CM codes are reported? a. E11.622, Z79. b. E11.9, L98.429, Z79. c. E11.622, L98.429, Z79. d. E11.622, L98.429 ✔✔c. E11.622, L98.429, Z79. In which circumstances would an external cause code be reported?
a. Delivery of a newborn. b. Causes of injury or health condition. c. Chemotherapy treatment of neoplasms. d. Only for the cause of motor vehicle accidents. ✔✔b. Causes of injury or health condition. Patient presents with no menses and positive pregnancy test but an ultrasound reveals no uterine contents. An embryo has implanted on the left ovary and this is treated with laparoscopic oophorectomy. What ICD- 10 - CM code is reported for this procedure? a. O00. b. O00. c. O00. d. O00.09 ✔✔b. O00. A patient has an open displaced fracture of the second cervical vertebra. This is her fifth visit and the fracture is healing normally. What ICD- 10 - CM code is reported? a. S12.9XXS b. S12.190D c. S12.9XXD d. S12.190A ✔✔b. S12.190D A 43 year-old female presents to the provider for a diabetic ulcer of the right ankle. What ICD- 10 - CM codes are reported? a. L97. b. L97.319, E11. c. L97.319, E11. d. E11.622, L97.319 ✔✔d. E11.622, L97. A patient is prescribed anticonvulsant medication for her seizures. She returns to her doctor three days later with nausea and rash due to taking the anticonvulsant medication. The provider notes that this is a drug reaction to an anticonvulsant and changes the medication. What ICD- 10 - CM codes are reported? a. L27.0, R11.2, T42.71XA b. R21, R11.2, T42.71XA c. R21, R11.0, T42.75XA d. L27.0, R11.0, T42.75XA ✔✔d. L27.0, R11.0, T42.75XA
d. HCPCS Level II codes ✔✔ Which statement is true regarding coding of carbuncles and furuncles in ICD- 10 - CM? a. There are separate codes for carbuncles and furuncles. b. The differentiation between a carbuncle and a furuncle is specified by a 7th character extender. c. Code L02.43 is a complete code. d. Carbuncles and furuncles are reported with the same code. ✔✔ Patient presents to the physician for removal of a squamous cell carcinoma of the right cheek. After the area is prepped and draped in a sterile fashion the surgeon measured the lesion, and documented the size of the lesion as 2.3 cm at its largest diameter. Additionally, the physician took margins of 2 mm on each side of the lesion. Single layer closure was performed. The patient tolerated the procedure well. What CPT® code(s) is/are reported? a. 11643, 12013 b. 11642, 12013 c. 11643 d. 11442 ✔✔ Joe has a terrible problem with ingrown toenails. He goes to the podiatrist to have a nail permanently removed along with the nail matrix. What CPT® code is reported? a. 11720 b. 11765 c. 11730 d. 11750 ✔✔ Patient presents with a suspicious lesion on her left arm. With the patient's permission the physician marked the area for excision. The margins and lesion measured a total of 0.9 cm. The wound measuring 1.2 cm was closed in layers using 4 - 0 Monocryl and 5 - 0 Prolene. Pathology later reported the lesion to be a sebaceous cyst. What codes are reported? a. 13121, 11401 - 51, D22. b. 11402, L72. c. 11401, D22. d. 12031, 11401 - 51, L72.3 ✔✔
Operative Report Pre-Operative and Post-Operative Diagnosis: Squamous cell carcinoma, left leg Open wound, right leg Personal history of squamous cell carcinoma, right leg INDICATIONS FOR SURGERY: The patient is an 81 year-old white man with biopsy- proven squamous cell carcinoma of his left leg. I marked the areas for excision with gross normal margins of 5 mm, and I drew my planned skin graft donor site from his left lateral thigh. He also had an open wound of his right leg from a squamous cell carcinoma excised four months ago; the skin graft had not taken. We plan on re-skin grafting the area. The patient is aware of all of these markings, and understands the surgery and location. DESCRIPTION OF PROCEDURE: The patient was taken to the operating room. IV Ancef was given. I used plain lidocaine for his local anesthetic throughout the procedure until the skin grafts were inset. The anterior of his leg and the thigh ✔✔ In ICD- 10 - CM, what classification system is used to report open fracture classifications? a. Muller AO classification of fractures b. PHF classification of fractures c. Danis-Weber classification d. Gustilo classification for open fractures ✔✔ A 49 year-old female presented with chronic deQuervain's disease and has been unresponsive to physical therapy, bracing or cortisone injection. She has opted for more definitive treatment. After induction of anesthesia, the patient's left arm was prepared and draped in the normal sterile fashion. Local anesthetic was injected using a combination 2% lidocaine and 0.25% Marcaine. A transverse incision was made over the central area of the first dorsal compartment. The subcutaneous tissues were gently spread to protect the neural and venous structures. The retractors were placed. The fascial sheath of the first dorsal compartment was then incised and opened carefully. The underlying thumb abductor and extensor tendons were identified. The tissues were dissected and the extensor retinaculum of the first extensor compartment was incised. The fibrotic tissue was incised and the tendons gently released. The tendons were fre ✔✔ 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
d. Thymus ✔✔a. Spleen An 18 month-old patient is seen in the ED unable to breathe due to a toy he swallowed which had lodged in his throat. Soon brain death will occur if an airway is not established immediately. The ED provider performs an emergency transtracheal tracheostomy. What CPT® and ICD- 10 - CM codes are reported? a. 31601, 31603, T17.228A b. 31601, J34.9, T17.298A c. 31603, T17.220A d. 31603, T17.290A ✔✔ What ICD- 10 - CM codes are reported for postoperative pulmonary edema due to fluid overload from an infusion? a. T80.89XA, J81.1, Y63. b. J95.89, E87.70, Y63. c. J81.0, E87.70, Y63. d. T81.9XXA, J81.1, Y63.0 ✔✔ A 27 year-old girl has been on the lung transplant list for months and today she will be receiving a LT and RT lung from an individual involved in an MVA. This person was DOA at the hospital and is an organ donor. The donor pneumonectomy was performed by physician A, the backbench work by physician B and the transplant of both lungs into the prepped and waiting patient by physician C. What is the correct coding for the removal (physician A), preparation (physician B) and insertion (physician C) of the lungs? a. 32850, 32855, 32851 b. 32850, 32856, 32851 x 2 c. 32850, 32856, 32853 d. 32850, 32855 x 2, 32850 - 50 ✔✔ A 45 year-old presents with acute pericarditis. The surgeon makes a small incision between two ribs and enters the thoracic cavity. An endoscope is introduced and the pericardial sac is examined by direct visualization. Using an instrument introduced through the endoscope, the surgeon creates an opening in the pericardial sac for drainage purposes. What CPT® code is reported? a. 32659
b. 32662 c. 32658 d. 32661 ✔✔ 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 ICD- 10 - CM code(s) for this condition? a. I21. b. I22. c. I25. d. Z51.89, I25.9 ✔✔ Due to infections from hemodialysis, the physician replaces a dual chamber implantable defibrillator system with a multi-lead system with an epicardial lead and transvenous dual chamber lead defibrillator system. The original dual leads are extracted transvenously. The generator pocket is relocated. What CPT® codes are reported? a. 33244, 33220 - 51, 33264 - 51, 33223 - 59 b. 33243, 33202 - 51, 33263 - 51, 33223 - 59 c. 33241, 32330 - 51, 33263 - 51, 33223 - 59 d. 33244, 33202 - 51, 33264 - 51, 33223 - 59 ✔✔ A patient presents to the hospital for a cardiovascular SPECT study. A single study is performed under stress, but without quantification, with a wall motion study, and ejection fraction. Select the CPT® code(s) for this procedure. a. 78451, 78472 b. 78451 c. 78453 d. 78453, 78472 ✔✔ In the hospital setting a patient undergoes transcatheter placement of an extracranial vertebral artery stent in the right vertebral artery. Which CPT® code is reported by the physician providing only the radiologic supervision and interpretation? a. 0075T b. 0075T- 26 c. 35301 d. 35005 ✔✔
d. K57.10 ✔✔ A 57 year-old patient with chronic pancreatitis presents to the operating room for a pancreatic duct-jejunum anastomosis by the Puestow-type operation. What are the correct CPT® and ICD- 10 - CM codes for the encounter? a. 48548, K85. b. 48548, K86. c. 48520, K86. d. 48520, K85.80 ✔✔ Margaret has a cholecystoenterostomy with a Roux-en-Y. Five hours later, she has an enormous amount of pain, abdominal swelling and a spike in her temperature. She is returned to the OR for an exploratory laparotomy and subsequent removal of a sponge that remained behind from surgery earlier that day. The area had become inflamed and was demonstrating early signs of peritonitis. What is the correct coding for the subsequent services on this date of service? The same surgeon took her back to the OR as the one who performed the original operation. What CPT® code is reported? a. 49000 - 58 b. 49402 - 77 c. 49000 - 77 d. 49402 - 78 ✔✔ What is the correct CPT® code for a percutaneous pyelostolithotomy with dilation and basket extraction measuring 1 cm? a. 50080 b. 50130 c. 50040 d. 50081 ✔✔ A 63 year-old male presents for the insertion of an artificial inflatable urinary sphincter for urinary incontinence. A 4.5 cm cuff, 22 ml balloon, 61-70 mmHg artificial inflatable urinary sphincter was inserted. What CPT® code is reported for this service? a. 53446
b. 53448 c. 53447 d. 53445 ✔✔ A fracture of the corpus cavernosum penis is repaired. What is the correct code? a. 54440 b. 54420 c. 54430 d. 54435 ✔✔ Patient comes in today to the provider's office for routine monthly Foley catheter change. A two way Foley catheter is replaced in the usual sterile fashion. An abdominal urinary drainage bag and bedside bag are given to the patient. What is/are the correct code(s)? a. 51702, A4338, A4357, A b. 51100 c. 51102 d. 51701, A4338, A4357, A4358 ✔✔ The patient is a pleasant 51 year-old male with morbid obesity, weighing approximately 560 pounds and BMI being 85.1. He has uncontrolled diabetes and was evaluated due to testicular pain. He was found to have erythema, edema and possible areas of eschar on the scrotum. He was transferred to the hospital, evaluated and found to be stable with cellulitis and suspect early Fournier's gangrene. What are the appropriate ICD- 10 - CM codes reported? a. N49.2, E11.9, E66.01, Z68. b. N50.1, E11.9, N49.2, E66.01, Z68. c. N50.1, N49.2, E66.01, Z68. d. E66.01, E11.9, N50.1, E66.01, Z68.52 ✔✔ A 40 year-old presents with vaginal bleeding for several weeks unrelated to her menstrual cycle. The gynecologist orders an ultrasound to obtain more information for a diagnosis. What diagnosis code is appropriate for this encounter? a. N92. b. N92. c. N92.
b. 59414, 59300 - 51, O73.0, O70.1, Z3A.26, Z37. c. 59414, 59300 - 51, O62.3, O70.9, Z3A.26, Z37. d. 59409, O80, Z3A.26, Z37.0 ✔✔ What does contralateral mean? a. Affecting or originating in the opposite side. b. Contractions occurring on opposite sides of the body. c. Pertaining to the same side of the body. d. Lateral contractions. ✔✔b. Contractions occurring on opposite sides of the body. A patient with MEN1 (Multiple Endocrine Neoplasia 1) has surgery to remove three of her parathyroid glands and part of the fourth parathyroid gland. What CPT® and ICD- 10 - CM codes are reported? a. 60505, E31. b. 60505, E31. c. 60500, E31. d. 60502, E31.22 ✔✔ How is Streptococcal A Meningitis reported in ICD- 10 - CM? a. Only Streptococcal, group A, as the cause of diseases classified elsewhere is reported. b. Only one code is reported for streptococcal meningitis. c. Streptococcal, group A, as the cause of diseases classified elsewhere is reported first; Streptococcal meningitis is reported second. reported first; Streptococcal, group A, as the cause of diseases classified elsewhere is reported second. A 47 year-old female presents to the OR for a partial corpectomy to three thoracic vertebrae. One surgeon performs the transthoracic approach while another surgeon performs the three vertebral nerve root decompressions necessary. How should each provider involved code their portion of the surgery? a. 63087 - 52, 63088 - 52 x 2 b. 63087 - 80, 63088 - 80 x 2 c. 63085 - 62, 63086 - 62 x 2 d. Streptococcal meningitis is reported first; Streptococcal, group A, as the cause of diseases classified elsewhere is reported second. ✔✔d. Streptococcal meningitis is
d. 63085, 63086 - 82 x 2 ✔✔ A patient recently experienced muscle atrophy and noticed she did not have pain when she cut herself on a piece of glass. The provider decides to obtain a needle biopsy of the spinal cord under ultrasound guidance in the outpatient setting. The biopsy results come back as syringomyelia. What CPT® and ICD- 10 - CM codes are reported for the biopsy procedure? a. 62269, G12. b. 62270, 76942 - 26, G95. c. 62270, G12. d. 62269, 76942 - 26, G95.0 ✔✔ What does IOL stand for? a. Interdimensional ocular lengths b. Iridescence over lamina c. Intraocular lens d. Interoptic laser ✔✔c. Intraocular lens Patient had an abscess in the external auditory canal which was incised and drained in the office. What CPT® code is reported? a. 69000 b. 69020 c. 69540 d. 69105 ✔✔ What CPT® code is reported for a tympanoplasty with mastoidotomy and with ossicular chain reconstruction in the right ear? a. 69636 - RT b. 69632 - RT c. 69644 - RT d. 69646 - RT ✔✔ A 70 year-old female has a drooping left eyelid obstructing her vision and has consented to having the blepharoptosis repaired. A skin marking pencil was used to outline the external proposed skin incision on the left upper eyelid. The lower edge of the incision was placed in the prominent eyelid crease. The skin was excised to the
A 42 year-old patient was undergoing anesthesia in an ASC and began having complications prior to the administration of anesthesia. The surgeon immediately discontinued the planned surgery. If the insurance company requires a reported modifier, what modifier best describes the extenuating circumstances? a. 53 b. 23 c. 73 d. 74 ✔✔ What ICD- 10 - CM code is reported for a reaction to anesthesia, initial encounter? a. T88.59XA b. T88.2XXA c. T88.52XA d. T88.4XXA ✔✔ A 43 year-old patient with a severe systemic disease is having surgery to remove an integumentary mass from his neck. What CPT® code and modifier are reported for the anesthesia service? a. 00300 - P b. 00300 - P c. 00322 - P d. 00350 - P3 ✔✔ A non-Medicare patient reports for a bilateral screening mammography with CAD. What CPT® code(s) is/are reported? a. 77066 b. 77067 c. 77059 d. 77062 ✔✔ A 1 year post-thyroidectomy patient who had thyroid cancer is coming in for area imaging of the neck and chest to evaluate for metastases. What CPT® code(s) is/are reported for the nuclear medicine exam? a. 78013
b. 78015, 78020 c. 78014 d. 78015 ✔✔ A patient needing scoliosis measurements is coming in to have standing anteroposterior and lateral views of his entire thoracic and lumbar spine. What CPT® code(s) is/are reported for radiology? a. 72084 b. 72082 c. 72083 d. 72040, 72070, 72100 ✔✔ The patient is a 63 year-old gentleman diagnosed with rectal cancer, who had a resection of the cancer performed. He now presents to have a Port-A-Cath (a central venous access device) inserted for postoperative adjuvant therapy. An 18-gauge introducer needle was inserted into the left subclavian vein through which a soft tipped guide wire was inserted into the superior vena cava under fluoroscopy. A subcutaneous pouch in the anterior part of the chest was created for the port. The catheter was then tunneled and measured to length. The dilator and introducer sheath were passed over the wire into the superior vena cava under fluoroscopic guidance. The catheter was passed through the sheath and the port was applied with good venous return. What CPT® codes are reported? a. 36571, 77001 - 26 b. 36560, 77002 - 26 c. 36561, 77001 - 26 d. 36563, 77003 - 26 ✔✔ A CT study of the lumbar spine (L2-L4) was performed with IV contrast in the hospital outpatient radiology department and the interpretation of the images is performed by the radiologist. What CPT® code(s) should be reported by the radiologist who is not an employee of the hospital? a. 72132 b. 72132 - 26 c. 72132 - 26, 72132 - TC d. 72132 - TC ✔✔
