AAPC CERTIFIED PROFESSIONAL
CODER (CPC) EXAM (2027) QUESTIONS
AND ANSWERS
1. Which of the following is true regarding the HIPAA Security Rule?
A. It applies to all forms of Protected Health Information (PHI), including paper and oral.
B. It applies specifically to electronic Protected Health Information (ePHI).
C. It mandates the use of specific encryption software for all providers.
D. It is enforced solely by the Office of the Inspector General (OIG).
Answer: B
Conceptual Explanation: The HIPAA Security Rule specifically addresses the protection of
electronic Protected Health Information (ePHI), whereas the Privacy Rule covers PHI in all
forms.
2. A 45-year-old patient undergoes an excision of a 2.5 cm malignant lesion on the arm. The
repair required a layered closure of 3.0 cm. How should this be coded?
A. 11603, 12032
B. 11603
,C. 11403, 12032
D. 11603-51, 12032
Answer: A
Conceptual Explanation: Excision of a malignant lesion (11603 for 2.1-3.0 cm) and
intermediate repair (12032 for 2.6-7.5 cm) are both coded. According to CPT guidelines,
intermediate and complex repairs are coded separately from excision.
3. When coding for a screening colonoscopy that is converted to a diagnostic procedure due
to the removal of a polyp by snare technique, which modifier is most appropriate for a
Medicare patient?
A. Modifier 59
B. Modifier PT
C. Modifier 33
D. Modifier 52
Answer: B
Conceptual Explanation: For Medicare patients, modifier PT is used to indicate that a
colorectal cancer screening test was converted to a diagnostic or therapeutic service.
4. A patient is diagnosed with ‘metastatic carcinoma of the liver from the colon.’ The colon
was previously resected. How is this sequenced in ICD-10-CM?
A. Primary colon cancer (C18.9), secondary liver cancer (C78.7)
, B. Secondary liver cancer (C78.7), history of colon cancer (Z85.038)
C. Secondary liver cancer (C78.7), primary colon cancer (C18.9)
D. Primary liver cancer (C22.8), history of colon cancer (Z85.038)
Answer: B
Conceptual Explanation: The liver cancer is the current focus of treatment (secondary)
and the colon cancer is no longer present, so the secondary site is sequenced first, followed
by a ‘history of’ code for the primary site.
5. Which physical status modifier is used for a patient with a severe systemic disease that is a
constant threat to life?
A. P2
B. P4
C. P3
D. P5
Answer: B
Conceptual Explanation: P4 is the modifier for a patient with severe systemic disease that
is a constant threat to life.
CODER (CPC) EXAM (2027) QUESTIONS
AND ANSWERS
1. Which of the following is true regarding the HIPAA Security Rule?
A. It applies to all forms of Protected Health Information (PHI), including paper and oral.
B. It applies specifically to electronic Protected Health Information (ePHI).
C. It mandates the use of specific encryption software for all providers.
D. It is enforced solely by the Office of the Inspector General (OIG).
Answer: B
Conceptual Explanation: The HIPAA Security Rule specifically addresses the protection of
electronic Protected Health Information (ePHI), whereas the Privacy Rule covers PHI in all
forms.
2. A 45-year-old patient undergoes an excision of a 2.5 cm malignant lesion on the arm. The
repair required a layered closure of 3.0 cm. How should this be coded?
A. 11603, 12032
B. 11603
,C. 11403, 12032
D. 11603-51, 12032
Answer: A
Conceptual Explanation: Excision of a malignant lesion (11603 for 2.1-3.0 cm) and
intermediate repair (12032 for 2.6-7.5 cm) are both coded. According to CPT guidelines,
intermediate and complex repairs are coded separately from excision.
3. When coding for a screening colonoscopy that is converted to a diagnostic procedure due
to the removal of a polyp by snare technique, which modifier is most appropriate for a
Medicare patient?
A. Modifier 59
B. Modifier PT
C. Modifier 33
D. Modifier 52
Answer: B
Conceptual Explanation: For Medicare patients, modifier PT is used to indicate that a
colorectal cancer screening test was converted to a diagnostic or therapeutic service.
4. A patient is diagnosed with ‘metastatic carcinoma of the liver from the colon.’ The colon
was previously resected. How is this sequenced in ICD-10-CM?
A. Primary colon cancer (C18.9), secondary liver cancer (C78.7)
, B. Secondary liver cancer (C78.7), history of colon cancer (Z85.038)
C. Secondary liver cancer (C78.7), primary colon cancer (C18.9)
D. Primary liver cancer (C22.8), history of colon cancer (Z85.038)
Answer: B
Conceptual Explanation: The liver cancer is the current focus of treatment (secondary)
and the colon cancer is no longer present, so the secondary site is sequenced first, followed
by a ‘history of’ code for the primary site.
5. Which physical status modifier is used for a patient with a severe systemic disease that is a
constant threat to life?
A. P2
B. P4
C. P3
D. P5
Answer: B
Conceptual Explanation: P4 is the modifier for a patient with severe systemic disease that
is a constant threat to life.
