AAPC CPC PRACTICE EXAM D
Questions and Answers
1. Which one of the following is an example of fraud?
A. Reporting the code for ultrasound guidance when used to perform a liver biopsy
B. Reporting a biopsy and excision performed on the same skin lesion during the
same encounter
C. Failing to append modifier 26 on an X-ray that is performed and interpreted in the
physician's office
D. Reporting a lab panel with an additional lab test that is not included in the lab panel
ANS B. Reporting a biopsy and excision performed on the same skin lesion during the same encounter
Answer B is the only example of unbundling of CPT® which would result in a fraudulent claim. According to National Correct
Coding Initiative (NCCI) and CPT® coding guidelines, a biopsy performed on the same lesion as an excision during the same
encounter is an incidental service and is not reported separately. If ultrasound guidance is performed for a liver biopsy, it is billable.
X-rays performed in a physician's office do not require modifier 26, because the physician owns the equipment and performs the
interpretation, he bills the global service. Lab panels can be reported with additional lab tests that are not listed in a lab panel.
2. Which place of service code is reported for fracture care performed by an
orthopedic physician in the ED?
A. 11
B. 20
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, C. 22
D. 23
ANS D. 23
Place of service codes are reported on the claim form to identify the site of the service provided. In this case, the services are rendered in
the ED which is reported with place of service (POS) 23. The place of service codes can be found in the CPT® codebook.
3. What is the full CPT® code description for 61535?
A. Craniotomy with elevation of bone flap; for subdural implantation of an
electrode array, for long-term seizure monitoring; for removal of epidural or
subdural electrode array, without excision of cerebral tissue (separate proce-
dure)
B. Craniotomy with elevation of bone flap; for removal of epidural or subdural
electrode array, without excision of cerebral tissue (separate procedure)
C. For removal of epidural or subdural electrode array, without excision of
cerebral tissue (separate procedure)
D. For excision of epileptogenic focus without electrocorticography during surgery;
for removal of epidural or subdural electrode array, without excision of cerebral tissue
(separate procedure)
ANS B. Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision
of cerebral tissue (separate procedure)
In the CPT® codebook the description for code 61535 is indented which means the description from 61533 up to the semicolon is
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Questions and Answers
1. Which one of the following is an example of fraud?
A. Reporting the code for ultrasound guidance when used to perform a liver biopsy
B. Reporting a biopsy and excision performed on the same skin lesion during the
same encounter
C. Failing to append modifier 26 on an X-ray that is performed and interpreted in the
physician's office
D. Reporting a lab panel with an additional lab test that is not included in the lab panel
ANS B. Reporting a biopsy and excision performed on the same skin lesion during the same encounter
Answer B is the only example of unbundling of CPT® which would result in a fraudulent claim. According to National Correct
Coding Initiative (NCCI) and CPT® coding guidelines, a biopsy performed on the same lesion as an excision during the same
encounter is an incidental service and is not reported separately. If ultrasound guidance is performed for a liver biopsy, it is billable.
X-rays performed in a physician's office do not require modifier 26, because the physician owns the equipment and performs the
interpretation, he bills the global service. Lab panels can be reported with additional lab tests that are not listed in a lab panel.
2. Which place of service code is reported for fracture care performed by an
orthopedic physician in the ED?
A. 11
B. 20
1/
7
, C. 22
D. 23
ANS D. 23
Place of service codes are reported on the claim form to identify the site of the service provided. In this case, the services are rendered in
the ED which is reported with place of service (POS) 23. The place of service codes can be found in the CPT® codebook.
3. What is the full CPT® code description for 61535?
A. Craniotomy with elevation of bone flap; for subdural implantation of an
electrode array, for long-term seizure monitoring; for removal of epidural or
subdural electrode array, without excision of cerebral tissue (separate proce-
dure)
B. Craniotomy with elevation of bone flap; for removal of epidural or subdural
electrode array, without excision of cerebral tissue (separate procedure)
C. For removal of epidural or subdural electrode array, without excision of
cerebral tissue (separate procedure)
D. For excision of epileptogenic focus without electrocorticography during surgery;
for removal of epidural or subdural electrode array, without excision of cerebral tissue
(separate procedure)
ANS B. Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision
of cerebral tissue (separate procedure)
In the CPT® codebook the description for code 61535 is indented which means the description from 61533 up to the semicolon is
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