AAPC CPC FINAL EXAM QUESTION
BANK (2 VERSIONS)
EXAM WITH
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS)
D
An infant with genu valgum is brought to the operating room to have a bilateral
O
medial distal femur hemiepiphysiodesis done. On each knee, the C-arm was used
to localize the growth plate. With the growth plate localized, an incision was made
N
medially on both sides. This was taken down to the fascia, which was opened. The
O
periosteum was not opened. The Orthofix® figure-of-eight plate was placed and
T
checked with X-ray. We then irrigated and closed the medial fascia with 0 Vicryl
suture. The skin was closed with 2-0 Vicryl and 3-0 Monocryl®. What procedure
C
code is reported?
O
PY
A. 27470-50
B. 27475-50
C. 27477-50
D. 27485-50 - Correct Answer > D. 27485-50
The patient is a 67-year-old gentleman with metastatic colon cancer recently
operated on for a brain metastasis, now for placement of an Infuse-A-Port for
continued chemotherapy. The left subclavian vein was located with a needle and a
guide wire placed. This was confirmed to be in the proper position
fluoroscopically. A transverse incision was made just inferior to this and a
subcutaneous pocket created just inferior to this. After tunneling, the introducer
,was placed over the guide wire and the power port line was placed with the
introducer and the introducer was peeled away. The tip was placed in the
appropriate position under fluoroscopic guidance and the catheter trimmed to the
appropriate length and secured to the power port device. The locking mechanism
was fully engaged. The port was placed in the subcutaneous pocket and everything
sat very nicely fluoroscopically. It was secured to the underlying soft tissue - Correct
Answer > C. 36561, 77001-26
Question 8
A CT scan identified moderate-sized right pleural effusion in a 50 year-old male.
This was estimated to be 800 cc in size and had an appearance of fluid on the CT
Scan. A needle is used to puncture through the chest tissues and enter the pleural
D
cavity to insert a guidewire under ultrasound guidance. A pigtail catheter is then
O
inserted at the length of the guidewire and secured by stitches. The catheter will
remain in the chest and is connected to drainage system to drain the accumulated
N
fluid. The CPT® code is:
O
T
A. 32557
C
B. 32555
O
C. 32556
PY
D. 32550 - Correct Answer > A. 32557
The patient is a 59-year-old white male who underwent carotid endarterectomy for
symptomatic left carotid stenosis a year ago. A carotid CT angiogram showed a
recurrent 90% left internal carotid artery stenosis extending into the common
carotid artery. He is taken to the operating room for re-do left carotid
endarterectomy. The left neck was prepped and the previous incision was carefully
reopened. Using sharp dissection, the common carotid artery and its branches were
dissected free. The patient was systematically heparinized and after a few minutes,
clamps were applied to the common carotid artery and its branches. A longitudinal
arteriotomy was carried out with findings of extensive layering of intimal
hyperplasia with no evidence of recurrent atherosclerosis. A silastic balloon-tip
,shunt was inserted first proximally and then distally, with restoration of flow.
Several layers of intima were removed and the endart - Correct Answer > B. 35301,
35390
A 52-year-old patient is admitted to the hospital for chronic cholecystitis for which
a laparoscopic cholecystectomy will be performed. A transverse infraumbilical
incision was made sharply dissecting to the subcutaneous tissue down to the fascia
using access under direct vision with a Vesi-Port and a scope was placed into the
abdomen. Three other ports were inserted under direct vision. The fundus of the
gallbladder was grasped through the lateral port, where multiple adhesions to the
gallbladder were taken down sharply and bluntly: The gallbladder appeared
chronically inflamed. Dissection was carried out to the right of this identifying a
D
small cystic duct and artery, was clipped twice proximally, once distally and
O
transected. The gallbladder was then taken down from the bed using electrocautery,
delivering it into an endo-bag and removing it from the abdominal cavity with the
N
umbilical port. What CPT® and ICD-10-C - Correct Answer > B. 47562, K81.1
O
T
A 70-year-old female who has a history of symptomatic ventral hernia was advised
C
to undergo laparoscopic evaluation and repair. An incision was made in the
O
epigastrium and dissection was carried down through the subcutaneous tissue. Two
5-mm trocars were placed, one in the left upper quadrant and one in the left lower
PY
quadrant and the laparoscope was inserted. Dissection was carried down to the area
of the hernia where a small defect was clearly visualized. There was some
omentum, which was adhered to the hernia and this was delivered back into the
peritoneal cavity. The mesh was tacked on to cover the defect. What procedure
code(s) is (are) reported?
A. 49560, 49568
B. 49652
C. 49653
D. 49652, 49568 - Correct Answer > B. 49652
, The patient is a 50-year-old gentleman who presented to the emergency room with
signs and symptoms of acute appendicitis with possible rupture. He has been
brought to the operating room. An infraumbilical incision was made which a 5-mm
VersaStep™ trocar was inserted. A 5-mm 0- degree laparoscope was introduced. A
second 5-mm trocar was placed suprapubically and a 12-mm trocar in the left
lower quadrant. A window was made in the mesoappendix using blunt dissection
with no rupture noted. The base of the appendix was then divided and placed into
an Endo-catch bag and the 12-mm defect was brought out. Select the appropriate
code for this procedure:
A. 44970
B. 44950
C. 44960
D
O
D. 44979 - Correct Answer > A. 44970
N
A 45-year-old male is going to donate his kidney to his son. Operating ports where
O
placed in standard position and the scope was inserted. Dissection of the renal
T
artery and vein was performed isolating the kidney. The kidney was suspended
C
only by the renal artery and vein as well as the ureter. A stapler was used to divide
O
the vein just above the aorta and three clips across the ureter, extracting the kidney.
This was placed on ice and sent to the recipient room. The correct CPT® code is:
PY
A. 50543
B. 50547
C. 50300
D. 50320 - Correct Answer > B. 50547
A 67-year-old female having urinary incontinence with intrinsic sphincter
deficiency is having a cystoscopy performed with a placement of a sling. An
incision was made over the mid urethra dissected laterally to urethropelvic
ligament. Cystoscopy revealed no penetration of the bladder. The edges of the sling
were weaved around the junction of the urethra and brought up to the suprapubic
BANK (2 VERSIONS)
EXAM WITH
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS)
D
An infant with genu valgum is brought to the operating room to have a bilateral
O
medial distal femur hemiepiphysiodesis done. On each knee, the C-arm was used
to localize the growth plate. With the growth plate localized, an incision was made
N
medially on both sides. This was taken down to the fascia, which was opened. The
O
periosteum was not opened. The Orthofix® figure-of-eight plate was placed and
T
checked with X-ray. We then irrigated and closed the medial fascia with 0 Vicryl
suture. The skin was closed with 2-0 Vicryl and 3-0 Monocryl®. What procedure
C
code is reported?
O
PY
A. 27470-50
B. 27475-50
C. 27477-50
D. 27485-50 - Correct Answer > D. 27485-50
The patient is a 67-year-old gentleman with metastatic colon cancer recently
operated on for a brain metastasis, now for placement of an Infuse-A-Port for
continued chemotherapy. The left subclavian vein was located with a needle and a
guide wire placed. This was confirmed to be in the proper position
fluoroscopically. A transverse incision was made just inferior to this and a
subcutaneous pocket created just inferior to this. After tunneling, the introducer
,was placed over the guide wire and the power port line was placed with the
introducer and the introducer was peeled away. The tip was placed in the
appropriate position under fluoroscopic guidance and the catheter trimmed to the
appropriate length and secured to the power port device. The locking mechanism
was fully engaged. The port was placed in the subcutaneous pocket and everything
sat very nicely fluoroscopically. It was secured to the underlying soft tissue - Correct
Answer > C. 36561, 77001-26
Question 8
A CT scan identified moderate-sized right pleural effusion in a 50 year-old male.
This was estimated to be 800 cc in size and had an appearance of fluid on the CT
Scan. A needle is used to puncture through the chest tissues and enter the pleural
D
cavity to insert a guidewire under ultrasound guidance. A pigtail catheter is then
O
inserted at the length of the guidewire and secured by stitches. The catheter will
remain in the chest and is connected to drainage system to drain the accumulated
N
fluid. The CPT® code is:
O
T
A. 32557
C
B. 32555
O
C. 32556
PY
D. 32550 - Correct Answer > A. 32557
The patient is a 59-year-old white male who underwent carotid endarterectomy for
symptomatic left carotid stenosis a year ago. A carotid CT angiogram showed a
recurrent 90% left internal carotid artery stenosis extending into the common
carotid artery. He is taken to the operating room for re-do left carotid
endarterectomy. The left neck was prepped and the previous incision was carefully
reopened. Using sharp dissection, the common carotid artery and its branches were
dissected free. The patient was systematically heparinized and after a few minutes,
clamps were applied to the common carotid artery and its branches. A longitudinal
arteriotomy was carried out with findings of extensive layering of intimal
hyperplasia with no evidence of recurrent atherosclerosis. A silastic balloon-tip
,shunt was inserted first proximally and then distally, with restoration of flow.
Several layers of intima were removed and the endart - Correct Answer > B. 35301,
35390
A 52-year-old patient is admitted to the hospital for chronic cholecystitis for which
a laparoscopic cholecystectomy will be performed. A transverse infraumbilical
incision was made sharply dissecting to the subcutaneous tissue down to the fascia
using access under direct vision with a Vesi-Port and a scope was placed into the
abdomen. Three other ports were inserted under direct vision. The fundus of the
gallbladder was grasped through the lateral port, where multiple adhesions to the
gallbladder were taken down sharply and bluntly: The gallbladder appeared
chronically inflamed. Dissection was carried out to the right of this identifying a
D
small cystic duct and artery, was clipped twice proximally, once distally and
O
transected. The gallbladder was then taken down from the bed using electrocautery,
delivering it into an endo-bag and removing it from the abdominal cavity with the
N
umbilical port. What CPT® and ICD-10-C - Correct Answer > B. 47562, K81.1
O
T
A 70-year-old female who has a history of symptomatic ventral hernia was advised
C
to undergo laparoscopic evaluation and repair. An incision was made in the
O
epigastrium and dissection was carried down through the subcutaneous tissue. Two
5-mm trocars were placed, one in the left upper quadrant and one in the left lower
PY
quadrant and the laparoscope was inserted. Dissection was carried down to the area
of the hernia where a small defect was clearly visualized. There was some
omentum, which was adhered to the hernia and this was delivered back into the
peritoneal cavity. The mesh was tacked on to cover the defect. What procedure
code(s) is (are) reported?
A. 49560, 49568
B. 49652
C. 49653
D. 49652, 49568 - Correct Answer > B. 49652
, The patient is a 50-year-old gentleman who presented to the emergency room with
signs and symptoms of acute appendicitis with possible rupture. He has been
brought to the operating room. An infraumbilical incision was made which a 5-mm
VersaStep™ trocar was inserted. A 5-mm 0- degree laparoscope was introduced. A
second 5-mm trocar was placed suprapubically and a 12-mm trocar in the left
lower quadrant. A window was made in the mesoappendix using blunt dissection
with no rupture noted. The base of the appendix was then divided and placed into
an Endo-catch bag and the 12-mm defect was brought out. Select the appropriate
code for this procedure:
A. 44970
B. 44950
C. 44960
D
O
D. 44979 - Correct Answer > A. 44970
N
A 45-year-old male is going to donate his kidney to his son. Operating ports where
O
placed in standard position and the scope was inserted. Dissection of the renal
T
artery and vein was performed isolating the kidney. The kidney was suspended
C
only by the renal artery and vein as well as the ureter. A stapler was used to divide
O
the vein just above the aorta and three clips across the ureter, extracting the kidney.
This was placed on ice and sent to the recipient room. The correct CPT® code is:
PY
A. 50543
B. 50547
C. 50300
D. 50320 - Correct Answer > B. 50547
A 67-year-old female having urinary incontinence with intrinsic sphincter
deficiency is having a cystoscopy performed with a placement of a sling. An
incision was made over the mid urethra dissected laterally to urethropelvic
ligament. Cystoscopy revealed no penetration of the bladder. The edges of the sling
were weaved around the junction of the urethra and brought up to the suprapubic
