AAPC CPC Chapter 20 Test Questions with Answers Rated A
A patient who has had two recent seizures using moderate sedation, and the physician or other
underwent a 3-hour EEG study. What CPT® code is qualified health care professional rendering the
reported? - -95813 diagnostic or therapeutic service also manages the
sedation. This code is specific for the age of the
Rationale: In the CPT® Index look for EEG which patient and up to 15 minutes of time. Add-on 99153 is
directs you to Electroencephalography (EEG). Under for each additional 15 minutes of intraservice time.
Electroencephalography (EEG)/Monitoring you are
directed to 95812-95813, 95950-95953 and 95956.
Code range 95812 - 95813 is based on time. Code A new patient with cystic fibrosis underwent
95813 describes an EEG (electroencephalogram), evaluation of lung function, including percussion,
more than 1 hour. This patient had a 3-hour study vibration and cupping to the chest wall to facilitate his
which is reported with 95813. lung function. What CPT® code(s) is/are reported for
this service? - -94667
A 15 year-old underwent placement of a cochlear Rationale: In the CPT® Index look for
implant 1 year ago. It now needs to be Pulmonology/Therapeutic/Manipulation of Chest Wall
reprogrammed. What CPT® code is reported for the or Chest Wall/Manipulation which directs you to
reprogramming? - -92604 94667-94668. 94667 is the correct code since it
includes the patient's first time, and it includes the
Rationale: Cochlear implants differ from hearing aids; evaluation.
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 A patient was brought to the emergency department
Cochlear Device/Programming which directs you to in cardiac arrest. The physician immediately initiated
codes 92602, 92604. The code selection is based on CPR. What CPT® code is reported for CPR? - -
the age of the patient and whether it is the initial 92950
programming or subsequent reprogramming. Code
92604 describes subsequent reprogramming for a Rationale: Medical personnel usually begin
patient age 7 or older. cardiopulmonary resuscitation (CPR) which provides
artificial breathing and chest compressions for a
person in cardiac arrest. In the CPT® Index you can
A 5 year-old fell on broken glass and required look for either CPR or Cardiopulmonary Resuscitation
suturing of a laceration. Due to the age and or Resuscitation/Cardiopulmonary. All indexed items
combative behavior of the patient, the provider direct you to code 92950.
utilized moderate sedation while repairing the
laceration. The provider gave the child 50 mg of
Ketamine IM. A nurse monitored the patient during A patient with hypertensive cardiovascular disease is
the procedure which took 30 minutes. What CPT® admitted by his primary care provider. What is/are the
code is reported for moderate sedation? - - correct ICD-10-CM code(s) for this encounter? -
99152, 99153 -I11.9
Rationale: Moderate sedation is often used for Rationale: In the ICD-10-CM Alphabetic Index look
pediatric patients in situations not normally requiring for Hypertension,
sedation. In this case, the provider administered hypertensive/cardiovascular/disease (arteriosclerotic)
sedation with a nurse assisting in monitoring the (sclerotic) which states to see Hypertension, heart.
patient. In the CPT® Index look for Look for Hypertension/heart (disease) (conditions in
Sedation/Moderate/with Independent Observation I51.4-I51.9 due to hypertension) directing you to
and you are directed to code range 99151-99153. I11.9. ICD-10-CM guideline, I.C.9.a.1., states code
Code selection is based on age of the patient and the I11- is used when a causal relationship is stated or
length of time. Code 99152 describes an encounter implied. Tabular List confirms code I11.9 is correct as
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, AAPC CPC Chapter 20 Test Questions with Answers Rated A
heart failure is not documented. Verification in the Tabular List confirms Z23 is for an
encounter for immunization. This code is nonspecific
as to the type of vaccination that is given. The type of
A patient with chronic respiratory failure is visited at vaccination given (i.e. influenza, MMR, DPT) will be
home by a certified respiratory therapist to manage specified by procedure/HCPCS codes.
his home oxygen therapy. What CPT® and ICD-10-
CM codes are reported? - -99503, J96.10
A 70 year-old patient with chronic obstructive asthma
Rationale: In the CPT® Index look for Home is brought to the urgent care center with increased
Services/Respiratory Therapy and you are directed wheezing and coughing. The provider initiated an
to 99503. In the ICD-10-CM Alphabetic Index, look albuterol inhalation treatment, one dose, delivered by
for Failure, failed/respiration, respiratory/chronic and nebulizer. After treatment, the patient's exacerbation
you are directed to J96.10. Verification in the Tabular was somewhat improved but the provider determined
List confirms code selection. a second treatment was necessary. What codes are
reported? - -94640, 94640-76, J7609 x 2, J44.1
A patient with chronic myeloid leukemia (CML), Rationale: In the CPT® Index look for Inhalation
BCR/ABL-positive has an implanted access port for Treatment/for Airway Obstruction/Pressured or
delivery of chemotherapy. The device needs to be Nonpressured and you are directed 94640. Inhalation
irrigated before receiving treatment. What ICD-10- treatment was given therapeutically in treating the
CM and CPT® codes are reported for the irrigation? - acute airway obstruction. Two treatments were given
-96523, C92.10 so code 94640 is reported twice. Under code 94640
there is a parenthetical instruction stating to use
Rationale: In the CPT® Index look for modifier 76 if more than one inhalation treatment is
Irrigation/Venous Access Device. Report code 96523 performed on the same date. Because treatment is in
for irrigation of an implanted venous access device. the office (urgent care is considered office treatment),
the provider will also bill for the medication used. In
In the ICD-10-CM Alphabetic Index look for this case, it is albuterol. In the HCPCS Level II
Leukemia/chronic myeloid, BCR/ABL-positive and codebook go to the Table of Drugs and Biologicals
you are directed to C92.1-. In the Tabular List the 5th and look for Albuterol, unit dose form which directs
character of 0 is used to indicate there is no mention you to J7609, J7613. J7609 is reported for albuterol
of having achieved remission. per dose. Two doses were given reporting J7609 x 2.
For the diagnosis in the ICD-10-CM Alphabetic Index
A 49 year-old female was brought to the emergency look for Asthma/chronic obstructive/with exacerbation
department. She was lethargic, but awake. She is (acute) directing you to J44.1. There is no mention of
four years post liver transplant. Neurology was status asthmaticus, but exacerbation is mentioned.
consulted who determined the patient was The diagnosis code is J44.1. Verification in the
encephalopathic with altered mental status. There Tabular List confirms code selection.
was some question whether she had a seizure. An
EEG and WADA test were performed. What CPT®
and ICD-10-CM codes are reported? - -95958, What ICD-10-CM code is reported for an anaphylactic
G93.40, R41.82, Z94.4 reaction to peanuts, initial encounter? - -
T78.01XA
What ICD-10-CM code is reported when a flu vaccine Rationale: In the ICD-10-CM Alphabetic Index look
is administered? - -Z23 for Anaphylactic/shock or reaction which states see
Shock, anaphylactic. Look for
Rationale: In the ICD-10-CM Alphabetic Index look Shock/anaphylactic/due to food
for Vaccination (prophylactic)/encounter for Z23. (nonpoisonous)/peanuts which directs you to T78.01.
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A patient who has had two recent seizures using moderate sedation, and the physician or other
underwent a 3-hour EEG study. What CPT® code is qualified health care professional rendering the
reported? - -95813 diagnostic or therapeutic service also manages the
sedation. This code is specific for the age of the
Rationale: In the CPT® Index look for EEG which patient and up to 15 minutes of time. Add-on 99153 is
directs you to Electroencephalography (EEG). Under for each additional 15 minutes of intraservice time.
Electroencephalography (EEG)/Monitoring you are
directed to 95812-95813, 95950-95953 and 95956.
Code range 95812 - 95813 is based on time. Code A new patient with cystic fibrosis underwent
95813 describes an EEG (electroencephalogram), evaluation of lung function, including percussion,
more than 1 hour. This patient had a 3-hour study vibration and cupping to the chest wall to facilitate his
which is reported with 95813. lung function. What CPT® code(s) is/are reported for
this service? - -94667
A 15 year-old underwent placement of a cochlear Rationale: In the CPT® Index look for
implant 1 year ago. It now needs to be Pulmonology/Therapeutic/Manipulation of Chest Wall
reprogrammed. What CPT® code is reported for the or Chest Wall/Manipulation which directs you to
reprogramming? - -92604 94667-94668. 94667 is the correct code since it
includes the patient's first time, and it includes the
Rationale: Cochlear implants differ from hearing aids; evaluation.
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 A patient was brought to the emergency department
Cochlear Device/Programming which directs you to in cardiac arrest. The physician immediately initiated
codes 92602, 92604. The code selection is based on CPR. What CPT® code is reported for CPR? - -
the age of the patient and whether it is the initial 92950
programming or subsequent reprogramming. Code
92604 describes subsequent reprogramming for a Rationale: Medical personnel usually begin
patient age 7 or older. cardiopulmonary resuscitation (CPR) which provides
artificial breathing and chest compressions for a
person in cardiac arrest. In the CPT® Index you can
A 5 year-old fell on broken glass and required look for either CPR or Cardiopulmonary Resuscitation
suturing of a laceration. Due to the age and or Resuscitation/Cardiopulmonary. All indexed items
combative behavior of the patient, the provider direct you to code 92950.
utilized moderate sedation while repairing the
laceration. The provider gave the child 50 mg of
Ketamine IM. A nurse monitored the patient during A patient with hypertensive cardiovascular disease is
the procedure which took 30 minutes. What CPT® admitted by his primary care provider. What is/are the
code is reported for moderate sedation? - - correct ICD-10-CM code(s) for this encounter? -
99152, 99153 -I11.9
Rationale: Moderate sedation is often used for Rationale: In the ICD-10-CM Alphabetic Index look
pediatric patients in situations not normally requiring for Hypertension,
sedation. In this case, the provider administered hypertensive/cardiovascular/disease (arteriosclerotic)
sedation with a nurse assisting in monitoring the (sclerotic) which states to see Hypertension, heart.
patient. In the CPT® Index look for Look for Hypertension/heart (disease) (conditions in
Sedation/Moderate/with Independent Observation I51.4-I51.9 due to hypertension) directing you to
and you are directed to code range 99151-99153. I11.9. ICD-10-CM guideline, I.C.9.a.1., states code
Code selection is based on age of the patient and the I11- is used when a causal relationship is stated or
length of time. Code 99152 describes an encounter implied. Tabular List confirms code I11.9 is correct as
1/6
, AAPC CPC Chapter 20 Test Questions with Answers Rated A
heart failure is not documented. Verification in the Tabular List confirms Z23 is for an
encounter for immunization. This code is nonspecific
as to the type of vaccination that is given. The type of
A patient with chronic respiratory failure is visited at vaccination given (i.e. influenza, MMR, DPT) will be
home by a certified respiratory therapist to manage specified by procedure/HCPCS codes.
his home oxygen therapy. What CPT® and ICD-10-
CM codes are reported? - -99503, J96.10
A 70 year-old patient with chronic obstructive asthma
Rationale: In the CPT® Index look for Home is brought to the urgent care center with increased
Services/Respiratory Therapy and you are directed wheezing and coughing. The provider initiated an
to 99503. In the ICD-10-CM Alphabetic Index, look albuterol inhalation treatment, one dose, delivered by
for Failure, failed/respiration, respiratory/chronic and nebulizer. After treatment, the patient's exacerbation
you are directed to J96.10. Verification in the Tabular was somewhat improved but the provider determined
List confirms code selection. a second treatment was necessary. What codes are
reported? - -94640, 94640-76, J7609 x 2, J44.1
A patient with chronic myeloid leukemia (CML), Rationale: In the CPT® Index look for Inhalation
BCR/ABL-positive has an implanted access port for Treatment/for Airway Obstruction/Pressured or
delivery of chemotherapy. The device needs to be Nonpressured and you are directed 94640. Inhalation
irrigated before receiving treatment. What ICD-10- treatment was given therapeutically in treating the
CM and CPT® codes are reported for the irrigation? - acute airway obstruction. Two treatments were given
-96523, C92.10 so code 94640 is reported twice. Under code 94640
there is a parenthetical instruction stating to use
Rationale: In the CPT® Index look for modifier 76 if more than one inhalation treatment is
Irrigation/Venous Access Device. Report code 96523 performed on the same date. Because treatment is in
for irrigation of an implanted venous access device. the office (urgent care is considered office treatment),
the provider will also bill for the medication used. In
In the ICD-10-CM Alphabetic Index look for this case, it is albuterol. In the HCPCS Level II
Leukemia/chronic myeloid, BCR/ABL-positive and codebook go to the Table of Drugs and Biologicals
you are directed to C92.1-. In the Tabular List the 5th and look for Albuterol, unit dose form which directs
character of 0 is used to indicate there is no mention you to J7609, J7613. J7609 is reported for albuterol
of having achieved remission. per dose. Two doses were given reporting J7609 x 2.
For the diagnosis in the ICD-10-CM Alphabetic Index
A 49 year-old female was brought to the emergency look for Asthma/chronic obstructive/with exacerbation
department. She was lethargic, but awake. She is (acute) directing you to J44.1. There is no mention of
four years post liver transplant. Neurology was status asthmaticus, but exacerbation is mentioned.
consulted who determined the patient was The diagnosis code is J44.1. Verification in the
encephalopathic with altered mental status. There Tabular List confirms code selection.
was some question whether she had a seizure. An
EEG and WADA test were performed. What CPT®
and ICD-10-CM codes are reported? - -95958, What ICD-10-CM code is reported for an anaphylactic
G93.40, R41.82, Z94.4 reaction to peanuts, initial encounter? - -
T78.01XA
What ICD-10-CM code is reported when a flu vaccine Rationale: In the ICD-10-CM Alphabetic Index look
is administered? - -Z23 for Anaphylactic/shock or reaction which states see
Shock, anaphylactic. Look for
Rationale: In the ICD-10-CM Alphabetic Index look Shock/anaphylactic/due to food
for Vaccination (prophylactic)/encounter for Z23. (nonpoisonous)/peanuts which directs you to T78.01.
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