AAPC CPC PRACTICE EXAM D
QUESTIONS AND ANSWERS
Which one of the following is an example of fraud?
km km km km km km km km km
A. Reporting the code for ultrasound guidance when used to perform a liver biopsy
km km km km km km km km km km km km km
B. Reporting a biopsy and excision performed on the same skin lesion during the same encou
km km km km km km km km km km km km km km km
nter
C. Failing to append modifier 26 on an X-
km km km km km km km km
ray that is performed and interpreted in the physician's office
km km km km km km km km km
D. Reporting a lab panel with an additional lab test that is not included in the lab panel - ans-
km km km km km km km km km km km km km km km km km km km
B. Reporting a biopsy and excision performed on the same skin lesion during the same encou
km km km km km km km km km km km km km km km
nter
Answer B is the only example of unbundling of CPT® which would result in a fraudulent claim.
km km km km km km km km km km km km km km km km
According to National Correct Coding Initiative (NCCI) and CPT® coding guidelines, a biops
km km km km km km km km km km km km km
y performed on the same lesion as an excision during the same encounter is an incidental ser
km km km km km km km km km km km km km km km km
vice and is not reported separately. If ultrasound guidance is performed for a liver biopsy, it is
km km km km km km km km km km km km km km km km km
billable. X- km
rays performed in a physician's office do not require modifier 26, because the physician owns
km km km km km km km km km km km km km km km
the equipment and performs the interpretation, he bills the global service. Lab panels can be r
km km km km km km km km km km km km km km km
eported with additional lab tests that are not listed in a lab panel.
km km km km km km km km km km km km
Which place of service code is reported for fracture care performed by an orthopedic physicia
km km km km km km km km km km km km km km
n in the ED?
km km km
A. 11 km
B. 20 km
C. 22 km
D. 23 - ans-D. 23
km km km km
Place of service codes are reported on the claim form to identify the site of the service provide
km km km km km km km km km km km km km km km km km
d. In this case, the services are rendered in the ED which is reported with place of service (P
km km km km km km km km km km km km km km km km km km
OS) 23. The place of service codes can be found in the CPT® codebook.
km km km km km km km km km km km km km
What is the full CPT® code description for 61535?
km km km km km km km km
A. Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for l
km km km km km km km km km km km km km km km
ong-
term seizure monitoring; for removal of epidural or subdural electrode array, without excision
km km km km km km km km km km km km km
of cerebral tissue (separate procedure)
km km km km
B. Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array,
km km km km km km km km km km km km km km k
mwithout excision of cerebral tissue (separate procedure)
km km km km km km
C. For removal of epidural or subdural electrode array, without excision of cerebral tissue (se
km km km km km km km km km km km km km km
parate procedure) km
D. For excision of epileptogenic focus without electrocorticography during surgery; for remov
km km km km km km km km km km km
al of epidural or subdural electrode array, without excision of cerebral tissue (separate proced
km km km km km km km km km km km km km
QUESTIONS AND ANSWERS
Which one of the following is an example of fraud?
km km km km km km km km km
A. Reporting the code for ultrasound guidance when used to perform a liver biopsy
km km km km km km km km km km km km km
B. Reporting a biopsy and excision performed on the same skin lesion during the same encou
km km km km km km km km km km km km km km km
nter
C. Failing to append modifier 26 on an X-
km km km km km km km km
ray that is performed and interpreted in the physician's office
km km km km km km km km km
D. Reporting a lab panel with an additional lab test that is not included in the lab panel - ans-
km km km km km km km km km km km km km km km km km km km
B. Reporting a biopsy and excision performed on the same skin lesion during the same encou
km km km km km km km km km km km km km km km
nter
Answer B is the only example of unbundling of CPT® which would result in a fraudulent claim.
km km km km km km km km km km km km km km km km
According to National Correct Coding Initiative (NCCI) and CPT® coding guidelines, a biops
km km km km km km km km km km km km km
y performed on the same lesion as an excision during the same encounter is an incidental ser
km km km km km km km km km km km km km km km km
vice and is not reported separately. If ultrasound guidance is performed for a liver biopsy, it is
km km km km km km km km km km km km km km km km km
billable. X- km
rays performed in a physician's office do not require modifier 26, because the physician owns
km km km km km km km km km km km km km km km
the equipment and performs the interpretation, he bills the global service. Lab panels can be r
km km km km km km km km km km km km km km km
eported with additional lab tests that are not listed in a lab panel.
km km km km km km km km km km km km
Which place of service code is reported for fracture care performed by an orthopedic physicia
km km km km km km km km km km km km km km
n in the ED?
km km km
A. 11 km
B. 20 km
C. 22 km
D. 23 - ans-D. 23
km km km km
Place of service codes are reported on the claim form to identify the site of the service provide
km km km km km km km km km km km km km km km km km
d. In this case, the services are rendered in the ED which is reported with place of service (P
km km km km km km km km km km km km km km km km km km
OS) 23. The place of service codes can be found in the CPT® codebook.
km km km km km km km km km km km km km
What is the full CPT® code description for 61535?
km km km km km km km km
A. Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for l
km km km km km km km km km km km km km km km
ong-
term seizure monitoring; for removal of epidural or subdural electrode array, without excision
km km km km km km km km km km km km km
of cerebral tissue (separate procedure)
km km km km
B. Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array,
km km km km km km km km km km km km km km k
mwithout excision of cerebral tissue (separate procedure)
km km km km km km
C. For removal of epidural or subdural electrode array, without excision of cerebral tissue (se
km km km km km km km km km km km km km km
parate procedure) km
D. For excision of epileptogenic focus without electrocorticography during surgery; for remov
km km km km km km km km km km km
al of epidural or subdural electrode array, without excision of cerebral tissue (separate proced
km km km km km km km km km km km km km
