Download AAPC CPC FINAL EXAM AND PRACTICE EXAM 2024 NEWEST 190 QUESTIONS WITH DETAILED VERIFIED ANS and more Exams Nursing in PDF only on Docsity!
AAPC CPC FINAL EXAM AND PRACTICE EXAM 2024
NEWEST 190 QUESTIONS WITH DETAILED
VERIFIED ANSWERS/ ALREADY GRADED A+
A 12-month-old receives the following vaccinations: Hepatitis B, Hib, Varicella, and Mumps-measles-rubella. What ICD- 10 - CM code(s) is/are reported for the vaccinations? a. B19.10, B01.9, B26.9, B05.9, B06.9, Z b. Z23, B19.10, B01.9, B26.9, B05.9, B06. c. Z d. B19.10, B01.9, B26.9, B05.9, B06.9 - ANSWERc. Z A 15 year old underwent placement of a cochlear implant 1 year ago. It now needs to be reprogrammed. What CPT® code is reported for the reprogramming? a. 92603 b. 92601 c. 92604 d. 92602 - ANSWERc. 9260 4 Response Feedback: Rationale: Cochlear implants differ from hearing aids; they bypass the damaged part of the ear. The use of a cochlear implant involves relearning how to hear and react to sounds. In the CPT® Index look for Cochlear Device/Programming which directs you to codes 92602, 92604. The code selection is based on the age of the patient and whether it is the initial programming or subsequent reprogramming. Code 92604 describes subsequent reprogramming for a patient age 7 or older. A 16-year-old male is brought to the ED by his mother. He was riding his bicycle in the park when he fell off the bike. The patient's right arm is painful to touch, discolored, and swollen. The X-ray shows a closed fracture of the ulna. What ICD- 10 - CM codes are reported? a. S52.201A, V19.9XXA, Y92. b. S52.201A, V18.4XXA, Y92. c. S52.201A, V18.0XXA, Y92. d. S52.209A, V18.4XXA, Y92.830 - ANSWERc. S52.201A, V18.0XXA, Y92. A 16-year-old male is brought to the ED by his mother. He was riding his bicycle in the park when he fell off the bike. The patient's right arm is painful to touch, discolored, and swollen. The X-ray shows a closed fracture of the ulna. What ICD- 10 - CM codes are reported? a. S52.201A, V18.0XXA, Y92. b. S52.201A, V18.4XXA, Y92. c. S52.209A, V18.4XXA, Y92.
d. S52.201A, V19.9XXA, Y92.830 - ANSWERa. S52.201A, V18.0XXA, Y92. A 25-year-old male presents with a deviated nasal septum. The patient undergoes a nasal septum repair and submucous resection. Cartilage from the bony septum was detached and the nasoseptum was realigned and removed in a piecemeal fashion. Thereafter, 4-0 chronic was used to approximate mucous membranes. Next, submucous resection of the turbinates was handled in the usual fashion by removing the anterior third of the bony turbinate and lateral mucosa followed by bipolar cauterization. What CPT® codes are reported? a. 30450, 30999- 51 b. 30520, 30140- 51 c. 30420, 30140- 51 d. 30620, 30999- 51 - ANSWERb. 30520, 30140- 51 A 26-year-old female with a one-year history of a left tympanic membrane perforation. She has extensive tympanosclerosis with a nonhealing perforation. Her options, including observation with water precautions or surgery, were discussed. The patient wished to proceed with surgery. With use of the operating microscope, the surgeon performs a left lateral graft tympanoplasty. What CPT® code is reported? - ANSWER69631-LT Rationale: During the procedure, a tympanoplasty is performed. There is no mention of a mastoidectomy or ossicular chain reconstruction being performed. From the CPT® Index look for Tympanoplasty/without Mastoidectomy then verify the code in the numeric section. Modifier LT is used to indicate the procedure was performed on the left ear. A 28-year-old female patient is returning to her provider's office with complaints of RLQ pain and heartburn with a temperature of 100.2. The provider performs a medically appropriate history and exam. Abdominal ultrasound is ordered and the patient has mild appendicitis. The provider prescribes antibiotics to treat the appendicitis in hopes of avoiding an appendectomy. What are the correct CPT® and ICD- 10 - CM codes for this encounter? a. 99213, K37, R b. 99202, R10.31, K c. 99203, K d. 99203, R50.9, R12, R10.31, K37 - ANSWERa. 99213, K37, R A 3-year-old is brought into the ED crying. He cannot bend his left arm after his older brother twisted it. X-ray is performed and the ED physician diagnoses the patient has a dislocated nursemaid elbow. The ED physician reduces the elbow successfully. The patient is able to move his arm again. The patient is referred to an orthopedist for follow- up care. What CPT® and ICD- 10 - CM codes are reported?
Response Feedback: Rationale: Patient is receiving a type of internal radiation therapy delivering a high dose of radiation (HDR) from implants (applicators with the iridium) placed via the vaginal cavity (intracavitary). This is found in the CPT® Index by looking for Brachytherapy/Intracavitary Application directing you to 0395T, 77761-77763. The CPT® subsection guidelines under the heading Clinical Brachytherapy, definitions are given to differentiate simple, intermediate and complex brachytherapy. Code 77762 is reported for the intracavitary application of five to 10 sources (intermediate); six applicators were used for this procedure making 77762 the correct code. A 33-year-old patient visits his primary care provider to discuss a lap band procedure for his morbid obesity. His caloric intake is in excess of 4,000 calories per day and his BMI is currently 45. What ICD- 10 - CM code(s) is/are reported? a. E66.01, Z68. b. E66.3, Z68. c. E66. d. E66.01, Z68.45 - ANSWERa. E66.01, Z68. A 4-year-old patient, who accidentally ingests valium found in his mother's purse, is found unconscious and rushed to the ED. The child is treated by the ED physician, who inserted a tube orally into the stomach and performed a gastric lavage, removing the stomach contents. What CPT® and ICD- 10 - CM codes are reported? a. 43754, R40.20, T42.71XA b. 43753, T42.4X1A, R40. c. 43755, T43.501A d. 43756, T42.71XA - ANSWERb. 43753, T42.4X1A, R40. Rationale: Code 43753 is the correct CPT® code for gastric lavage performed for the treatment of ingested poison. Look in the CPT® Index for Gastric Lavage, Therapeutic/Intubation. The ICD- 10 - CM code for the poisoning is found in the Table of Drugs and Chemicals by looking for Valium/Poisoning, Accidental (unintentional) column, referring you to code T42.4X1-. In the Tabular List a 7 th character is needed to complete the code. A is reported as the 7 th character because this was the patient's initial encounter.The next code is the manifestation of ingesting the Valium, unconsciousness. Unconsciousness is found in the ICD- 10 - CM Alphabetic Index and directs you to see Coma R40.20. The Tabular List confirms this code is reported for unconsciousness. A 45-year-old female with malignant Müllerian duct cancer is receiving her first treatment of chemotherapy. What diagnosis codes are reported? a. C79.82, Z51. b. C57.7, Z51. c. Z51.11, C57. d. Z51.11, D28.7 - ANSWERc. Z51.11, C57.
A 45-year-old patient is scheduled to have an INFUSAID pump installed. He has primary liver cancer and the pump is being inserted for continuous administration of 5- FU. A pocket is created just under the skin and the pump is placed in the pocket. A catheter is attached to the pump and to the subclavian vein. The pump is filled with a chemotherapy agent provided by the hospital and the patient is given his first treatment and observed for adverse reaction and discharged to home. What ICD- 10 - CM codes are reported? a. Z51.11, C22. b. Z51.11, C22. c. C22.9, Z51. d. C22.8, Z51.11 - ANSWERa. Z51.11, C22. Rationale: ICD- 10 - CM Guideline I.C.2.e.2 indicates an encounter for chemotherapy code is to be reported as the primary code with a code for the cancer as secondary when the reason for the visit is solely for chemotherapy. Look in the ICD- 10 - CM Alphabetic Index for Chemotherapy (session) (for)/cancer Z51.11. For the malignancy, look in the ICD- 10 - CM Table of Neoplasms for liver/primary and use the code from the Malignant Primary column which directs the coder to C22.8. Verify code selection in the Tabular List. A 45-year-old presents to the operating room with a right index trigger finger and left shoulder bursitis. The left shoulder was injected with 1 cc of Xylocaine, 1 cc of Celestone and 1 cc of Marcaine. An approximately 1-inch incision was made over the A1 pulley in the distal transverse palmar crease. This incision was taken through skin and subcutaneous tissue. The A1 pulley was identified and released in its entirety. The wound was irrigated with antibiotic saline solution. The subcutaneous tissue was injected with Marcaine without epinephrine. The skin was closed with 4-0 Ethilon suture. Clean dressing was applied. What CPT® codes are reported? a. 20553-F6, 20610- 51 - LT b. 20552-F6, 20605- 52 - LT c. 26055-F6, 20610- 76 - LT d. 26055-F6, 20610- 51 - LT - ANSWERd. 26055-F6, 20610- 51 - LT A 47-year-old male presents with chronic back pain and lower left leg radiculitis. A laminectomy is performed on the inferior end of L5. The microscope is used to perform microdissection. There was a large extradural cystic structure on the right side underneath the nerve root as well as the left. The entire intraspinal lesion was evacuated. What CPT® code(s) is/are reported for this procedure? a. 63252, 69 990 b. 63267, 69990 c. 63277 d. 63272 - ANSWERb. 63267, 69990
d. 93303, I51.0 - ANSWERa. 93303- 2 6, Q21. A 54-year-old male goes to his primary care provider with dizziness. On physical exam his blood pressure is 200/130. After a complete work-up, including laboratory tests, the provider makes a diagnosis of end stage renal disease and hypertension. What are the appropriate diagnosis codes for this encounter? a. I12.0, N18. b. I10, N18. c. I10, N18. d. I12.0 - ANSWERa. I12.0, N18. 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 CPT® and ICD- 10 - CM codes are reported for the encounter? a. 48548, K85. b. 48520, K86. c. 48520, K85. d. 48548, K86.1 - ANSWERd. 48548, K86. A 58-year-old patient sees the provider for confusion and loss of memory. The provider diagnoses the patient with early onset stages of Alzheimer's disease with dementia. What ICD- 10 - CM codes are reported? a. F02.80, G30.0, F29, F41. b. G30.0, F02. c. F02.80, G30. d. G30.0, F02.80, F29, R41.3 - ANSWERb. G30.0, F02. A 58-year-old patient sees the provider for confusion and loss of memory. The provider diagnoses the patient with early onset stages of Alzheimer's disease with dementia. What ICD- 10 - CM codes are reported? a. G30.0, F02. b. F02.80, G30.0, F29, R41. c. F02.80, G30. d. G30.0, F02.80, F29, R41.3 - ANSWERa. G30.0, F02. A 59-year-old is suffering from foraminal spinal stenosis. Patient is to have a L4-L laminectomy on the right side. Under general anesthesia a knife dissection was made on the back and was taken down to the fascia. The fascia on the right side of the spine was stripped. The deep Taylor retractor was placed. Using an intraoperative X-ray, the physician traced out the foramen of L4-L5. There appeared to be some compression at this lamina into the foramen and significant stenosis. The provider removed the spinous process and lamina. Nerve roots canals are freed by removal of the facet. Compression
is relieved by removing bony overgrowth around the foramen. What CPT® code is reported for this procedure? a. 63017 b. 63005 c. 63047 d. 63030 - ANSWERc. 63047 Response Feedback: Rationale: In the CPT® Index look for Laminectomy/with Facetectomy directing you to 63045 - 63048, 0202T, 0274T, 0275T. A laminectomy with knife dissection is being performed for spinal stenosis eliminating codes 0202T, 0274T, and 0275T. Codes 63045 - 63048 are reported based on location. This was performed on the lumbar, making the correct code 63047. 63030 is a code specific to the interspaces and codes 63001 and 63017 specifically state without facetectomy making them incorrect choices. A 59-year-old patient is having surgery on the pericardial sac, without use of a pump oxygenator. The perfusionist placed an arterial line. What CPT® coding is reported for anesthesia? a. 00560, 36620 b. 00560 c. 00561 d. 00562 - ANSWERb. 00560 Response Feedback: Rationale: In the CPT® Index look for Anesthesia/Heart which directs you to codes 00560 - 00567, 00580 or look for Anesthesia/Intrathoracic System which directs you to multiple code ranges. Refer to the numeric section to determine 00560 is the correct code for without use of a pump oxygenator. The arterial line placement (36620) was not provided by the anesthesiologist. 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. 53447 b. 53446 c. 53448 d. 53445 - ANSWERd. 53445 Rationale: In the CPT® Index look for Insertion/Prosthesis/Urethral Sphincter. You're directed to 53444-53445. Codes 53446-53448 are for the removal or removal/replacement of the inflatable sphincter. CPT® 53445 describes the insertion of an inflatable urethra/bladder neck sphincter, including placement of pump, reservoir and cuff. 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
PHYSICAL EXAMINATION:
GENERAL: Mild respiratory distress at rest VITAL SIGNS: BP 168/84, HR 58, temperature 98.1. LUNGS: Worsening bibasilar crackles CARDIOVASCULAR: RRR, no MRGs. EXTREMITIES: Show worsening lower extremity edema. LABS: BUN 5 - ANSWERd. Subsequent Hospital Visit (99231-99233) A 65-year-old was admitted in the hospital two days ago and is being examined today by his primary care physician, who has been seeing him since he has been admitted. Primary care physician is checking for any improvements or if the condition is worsening. CHIEF COMPLAINT:CHF INTERVAL HISTORY: CHF symptoms worsened since yesterday. Now has some resting dyspnea. HTN remains poorly controlled with systolic pressure running in the 160s. Also, I'm concerned about his CKD, which has worsened, most likely due to cardio-renal syndrome. REVIEW OF SYSTEMS: Positive for orthopnea and one episode of PND. Negative for flank pain, obstructive symptoms or documented exposure to nephrotoxins. PHYSICAL EXAMINATION: GENERAL: Mild respiratory distress at rest VITAL SIGNS: BP 168/84, HR 58, temperature 98.1. LUNGS: Worsening bibasilar crackles CARDIOVASCULAR: RRR, no MRGs. EXTREMITIES: Show worsening lower extremity edema. LABS: BUN 5 - ANSWERd. Subsequent Hospital Visit (99231-99233) Response Feedback: Rationale: This is a subsequent hospital visit which is reported with code range 99231-
- The patient was admitted in the hospital two days ago and the primary care physician has been seeing the patient since he has been admitted to the hospital. Initial Hospital Visit (99221-99223) is when the doctor is initially admitting the patient to the hospital. Inpatient Consultation (99251-99255) is when the provider requests for another provider to see the patient to recommend care for a specific condition or to accept ongoing management for the patient's condition. Established Patient Office/Outpatient Visit (99211-99215) is when the patient is being seen in the office setting, not the hospital. A 66-year-old male with a history of anemia presents for a liver core biopsy to evaluate for possible cirrhosis. The patient was brought to the CAT scan suite in which limited CT images of the upper abdomen were performed for biopsy needle placement. The appropriate site for the liver core biopsy was chosen. The patient's skin was then marked with the computer coordinates. An 18-gauge needle was advanced into the appropriate site and a sample was obtained. What CPT® codes are reported? a. 47000, 77012- 26 b. 47000, 77002- 26
c. 47100, 74150- 26 d. 47100, 76942- 26 - ANSWERa. 47000, 77012- 26 Response Feedback: Rationale: Biopsy of the liver is taken by a needle (percutaneous) under computed tomography guidance (CT). In the CPT® Index look for Biopsy/Liver 47000, 47001, 47100, 47700. Code 47000 describes a percutaneous needle biopsy of the liver. Below CPT code 47000 you are given codes for imaging guidance. Code 77012 describes the CT guidance for needle placement. Modifier 26 is appended to indicate the professional service. A 75-year-old established patient sees his regular primary care provider for a physical screening prior to joining a group home. He has no new complaints. The patient has an established diagnosis of cerebral palsy and type 2 diabetes and is currently on his meds. A comprehensive history and examination is performed. The provider counsels the patient on the importance of taking his medication and gives him a prescription for refills. Blood work was ordered. PPD was done and flu vaccine given. Patient already had a vision exam. No abnormal historical facts or finding are noted. What CPT® code is reported? a. 99387 b. 99214 c. 99215 d. 99397 - ANSWERd. 99397 A 77-year-old patient was scheduled for a left total hip replacement due to degenerative joint disease (DJD) and the anesthesiologist documented the DJD as primary. The pre- anesthesia assessment indicates the patient had surgery in 2015 for gastroesophageal reflux disease (GERD). What ICD- 10 - CM coding is reported? a. M16. b. M16. c. K21. d. M16.9, K21.9 - ANSWERb. M16. A child has a splinter under the right middle fingernail. What ICD- 10 - CM code is reported? a. S61.222A b. S61.227A c. S61.242A d. S60.452A - ANSWERd. S60.452A A child is seen in a hospital based pediatric clinic for active treatment of 10% first and second degree burns to the left calf area and 5% third degree burns on her right hand. What ICD- 10 - CM codes are reported? a. T23.301A, T24.232A, T24.132A
identify the infection. Look for Bronchitis/acute or subacute/due to/virus/echovirus directing you to code J20.7. A gonioscopy is an examination of what part of the eye: a. Anterior chamber of the eye b. Lacrimal duct c. Interior surface of the eye d. Posterior segment - ANSWERa. Anterior chamber of the eye A new patient visits the internal medicine clinic today for diabetes, hypertension, arthritis, and a history of cardiac disease. The provider performs a medically appropriate history and exam. Blood pressure is high. All other conditions are stable. Labs ordered are HbA1c and complete blood count (CBC). Changing the dosage for blood pressure medication. Will follow up in 3 months. What CPT® code is reported? a. 99213 b. 99204 c. 99214 d. 99203 - ANSWERb. 99204 Response Feedback: Rationale: In the CPT® Index look for Office and/or Other Outpatient Services/Office Visit/New Patient and you are directed to codes 99202-99205. 2021 E/M Guidelines for Office and Other Outpatient services are reported based on Medical decision making and requires two of three elements to be met or exceeded for a new patient. 2+ stable chronic illness and 1 chronic illness with exacerbation (Moderate), two unique lab tests are ordered (HbA1c and CBC) (Low/Limited), level of risk - prescription management (Moderate). Correct code is 99204. A patient arrives at the urgent care facility with a swollen ankle. Anteroposterior and lateral view X-rays of the ankle are taken to determine whether the patient has a fractured ankle. What CPT® code(s) is/are reported? a. 73600 X 2 b. 73610 c. 73600, 73610 d. 73600 - ANSWERd. 73600 A patient has a right thyroid lobectomy for a thyroid follicular lesion. An incision is made 2 cm above the sternal notch and carried through the platysma. The right thyroid was dissected free from the surrounding tissues. The isthmus was divided from the left thyroid lobe. The left thyroid lobe was explored revealing a single nodule. The right thyroid lobe was completely removed from the trachea and surrounding tissues. It was marked and sent off the table as a specimen. What CPT® code is reported? a. 60220 b. 60240
c. 60200 d. 60210 - ANSWERa. 60220 Rationale: The patient had a unilateral thyroidectomy. Because only the right side is removed, it is a total unilateral (partial) thyroidectomy. In the CPT® Index look for Thyroidectomy/Partial directing you to code range 60210-60225. 60220 reports a unilateral total thyroid lobectomy with or without isthmusectomy. A patient is having surgery to repair a recurrent left inguinal hernia without obstruction. What ICD- 10 - CM code is reported? a. K40. b. K40. c. K40. d. K40.90 - ANSWERb. K40. A patient is in the OR for an arthroscopy of the medial compartment of his left knee. A meniscectomy is performed. What is the correct code used to report for the anesthesia services? a. 01400 b. 01402 c. 29880-LT d. 29870-LT - ANSWERa. 01400 A patient is seen for three extra visits during the third trimester of her 30-week pregnancy because of her history of pre-eclampsia during her previous pregnancy which puts her at risk for a recurrence of the problem during this pregnancy. No problems develop. What diagnosis code(s) is/are reported for these three extra visits? a. O09.893, Z3A. b. O14.03, Z3A. c. Z34. d. Z34.83, O09.893, Z3A.30 - ANSWERa. O09.893, Z3A. 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. C44. b. C44. c. D79. d. C79.2 - ANSWERa. C44. A patient presented with a right ankle fracture. After induction of general anesthesia, the right leg was elevated and draped in the usual manner for surgery. A longitudinal incision was made parallel and posterior to the fibula. It was curved anteriorly to its distal end. The skin flap was developed and retracted anteriorly. The distal fibula
Response Feedback: Rationale: In the CPT® Index look for Manipulation/Chiropractic. The neck is the cervical spine and code selection is based on the number regions treated. In this case, 1 region is treated making 98940 is the correct code choice. In the ICD- 10 - CM Alphabetic Index look for Strain/cervical or Strain/neck referring you to code S16.1-. The Tabular List shows seven characters are needed to complete the code. X is used as a placeholder for the 5 th and 6th characters. A is the 7th character for the initial encounter receiving active treatment. Next, report the external cause. The patient was the driver in a non-collision vehicle accident when he lost control of the car. Look in the ICD- 10 - CM External Cause of Injuries Index for Accident/car which states to see Accident, transport, car occupant. Look for Accident/transport/car occupant/driver/collision (with)/stationary object/nontraffic. When referring to the Tabular List, subcategory code V47.0 is used and it shows seven characters are needed to complete this code. X is used as the 5th and 6thcharacters and A, initial encounter, is used for the 7thcharacter. A patient undergoes heart surgery for angina decubitus and coronary artery disease (CAD). What ICD- 10 - CM coding is reported? a. I25. b. I25. c. I20. d. I25.119 - ANSWERa. I25. A patient was referred to the radiology department for chronic low back pain. The radiology report indicated there was no marrow abnormality identified and the conus medullaris was unremarkable. Additional findings include: L4-L5: There is a minor diffusely bulging annulus at L4-L5. A small focal disc bulge is seen in far lateral position on the left at L4-L5 within the neural foramen. No definite encroachment on the exiting nerve root at this site is seen. No significant spinal stenosis is identified. L5-S1: There is a diffusely bulging annulus at L5-S1, with a small focal disc bulge centrally at this level. There is minor disc desiccation and disc space narrowing at L5-S1. No significant spinal stenosis is seen at L5-S1. The final diagnosis is minor degenerative disc disease at L4- L5 and L5-S1, as described. What ICD- 10 - CM code(s) is/are reported? a. M51.36, M51. b. M51. c. M51.37, M54. d. M51.36, M54.50 - ANSWERb. M51.36, M51. Response Feedback: Rationale: Look in the ICD- 10 - CM Alphabetic Index for Degeneration, degenerative/intervertebral disc NOS/lumbar region directing you to code M51.36. Look in the ICD- 10 - CM Alphabetic Index for Degeneration, degenerative/intervertebral disc NOS/lumbosacral region directing you to code M51.37. Verify code selection in the
Tabular List. The low back pain is a symptom of the degenerative disc disease and is not reported separately. A patient who may have a stricture of the artery is undergoing an aortogram in which the left femoral artery was cannulated with a catheter advanced into the infrarenal abdominal aorta. Contrast medium was injected, and films taken by serialography showing the aortoiliac inflow vessels were widely patent. The bilateral common femoral arteries appear normal. What CPT® codes are reported for the professional component? a. 36200, 75625- 26 b. 36200, 75805- 26 c. 36200, 75630- 26 d. 36200, 75635- 26 - ANSWERc. 36200, 75630- 26 A patient will be undergoing a transplant and needs HLA tissue typing with DR/DQ multiple antigen and lymphocyte mixed culture. How will these services be coded? a. 86805-26, 86817 b. 86806-26, 86817 c. 86816-26, 86821 d. 86817, 86821 - ANSWERd. 86817, 86821 Response Feedback:Rationale: In the CPT® Index look for Tissue/Typing/Human Leukocyte Antigen (HLA)/Antibodies. Code 86817 is the correct code to report for HLA tissue typing with DR/DQ. Then, look in the CPT® Index for Tissue/Typing/Lymphocyte Culture referring you to code 86821. Codes 86805 and 86806 are for lymphocytotoxicity, not A patient with a cyst like mass on his left external auditory canal was visualized under the microscope and a microcup forceps was used to obtain a biopsy of tissue along the posterior superior canal wall. What CPT® code is reported? a. 69105-LT b. 69140-RT c. 69145-LT d. 69100-RT - ANSWERa. 69105-LT A patient with a long history of endometriosis has an open surgical approach to perform an exploratory laparotomy for an enlarged right ovary seen on ultrasound with other possible masses on the uterus and in the peritoneum. Exploration reveals these masses to be endometriosis including a chocolate cyst (endometrioma) of the right ovary, right fallopian tube and peritoneum. The endometriomas are all small, less than 5 cm, and laser is used to ablate them, except the ovarian cyst, which is excised. During the procedure the patient also has a tubal ligation. What are the CPT® and ICD- 10 - CM codes reported for this service?
Rationale: Look in the CPT® Index for PTT. There is a note to See Thromboplastin, Partial Thromboplastin Time (PTT). PTT stands for Thromboplastin time, partial. Look in the CPT® Index for Thromboplastin/Partial Thromboplastin Time (PTT). Code 85730 is the correct code, there is no mention of substitution. A patient with hypertension presents to the outpatient hospital radiology department for an ultrasound due to a suspected suspicious mass. The patient's provider performed an ACTH and a 24-hour urinary free cortisol and short suppression test confirming the diagnosis of Cushing's disease. The radiology report indicated a 5.5 cm right adrenal mass that appeared well circumscribed and rounded. The final diagnosis indicated Cushing's disease secondary to a right adrenal tumor. The hypertension is due to the Cushing's syndrome. What ICD- 10 - CM codes are reported? a. D49.7, I15. b. D49.7, E24.9, I15. c. C74.91, E24.9, I d. C74.91, E24.9, I15.2 - ANSWERb. D49.7, E24.9, I15. Rationale: The patient has Cushing's disease secondary to an adrenal tumor. First code the adrenal tumor. We are told that there is a right adrenal tumor; however, we are not given more information as to a specific type of adrenal tumor and whether it is benign or malignant. In the ICD- 10 - CM Alphabetic Index look for Tumor (see also Neoplasm, unspecified behavior, by site). Look in the ICD- 10 - CM Table of Neoplasms for Neoplasm, neoplastic/adrenal and use the code from the Unspecified Behavior column directing you to D49.7. Next, in the ICD- 10 - CM Alphabetic Index find Cushing's/syndrome or disease which directs the coder to E24.9. The unspecified code for Cushing's syndrome is used because we are not given the specific type of Cushing's the patient has. The Cushing's syndrome is associated to the hypertension. Look for Hypertension/due to/endocrine disorder referring you to code I15.2. Verify all codes in the Tabular List. A patient with hypertensive end stage renal failure, stage 5, and secondary hyperparathyroidism is evaluated by the provider and receives peritoneal dialysis. The provider evaluates the patient once before dialysis begins. What CPT® and ICD- 10 - CM codes are reported? a. 90947, I12.0, N25. b. 90945, I10, N18.5, Z99.2, N25. c. 90945, I12.0, N18.6, Z99.2, N25. d. 90947, I12.0, N18.5, Z99.2 - ANSWERc. 90945, I12.0, N18.6, Z99.2, N25. A patient with mixed conductive and sensorineural hearing loss in the right ear has tried multiple medical therapies without recovery of her hearing. Patient has consented to have an electromagnetic bone conduction hearing device implanted in the temporal bone. What CPT® and ICD- 10 - CM codes are reported? a. 69710-RT, H90. b. 69714-RT, H90.
c. 69710-RT, H90. d. 69930-RT, H90.0 - ANSWERc. 69 710 - RT, H90. Response Feedback: Rationale: In the CPT® Index look for Hearing Aid/Implants/Bone Conduction/Implantation. You are referred to 69710. Review the code to verify accuracy. In the ICD- 10 - CM Alphabetical Index look for Loss (of)/hearing which states see also Deafness. Look for Deafness/mixed conductive and sensorineural/unilateral. You are referred to H90.7-. Review the code in the Tabular List to verify accuracy and 5 th character 1 is for right ear A physician orders a General Health Panel, all tests except a creatinine, including CBC with automated differential. What CPT® code(s) is/are reported? a. 80050- 52 b. 85025, 84443, 82040, 82247, 82310, 82374, 82435, 82947, 84075, 84132, 84155, 84295, 84460, 84450, 84520 c. 80050 d. 80050- 22 - ANSWERb. 85025, 84443, 82040, 82247, 82310, 82374, 82435, 82947, 84075, 84132, 84155, 84295, 84460, 84450, 84520 A pregnant patient presents to the ED with bleeding, cramping, and concerns of loss of tissue and material per vagina. On examination, the physician discovers an open cervical os with no products of conception seen. He tells the patient she has had an abortion. What type of abortion has she had? a. Missed b. Induced c. Spontaneous d. None of the above - ANSWERc. Spontaneous A pregnant woman in her 40th week has gestational diabetes which is controlled by diet. What ICD- 10 - CM code(s) is/are reported? a. O24.113, O24.410, Z3A. b. O24.410, Z3A. c. O24.410, O24. d. O24.913 - ANSWERb. O24.410, Z3A. A provider visits Mr. Smith's home monthly. Today, the provider performs a problem focused history, an expanded problem focused examination and a medical decision making of low complexity. What CPT® code is reported? a. Home visits are no longer reportable. b. 99347 c. 99348 d. 99349 - ANSWERc. 99348
