AAPC CPC Final Exam 2022
A patient sustained a neck strain as a driver in an
automobile accident, losing control,
hydroplaning and hitting a tree off the highway which
caused the car to overturn. He has continued to have neck
pain and stiffness. He sees a chiropractor who assesses
the patient and manipulates his neck. The diagnosis is
neck strain. What CPT® and ICD-10-CM codes are
reported for the chiropractor?
a. 98940, M95.3, V47.3XXA
b. 98943, M54.2, V47.2XXA
c. 98941, S16.1XXA, V47.9XXA
d. 98940, S16.1XXA, V47.0XXA - CORRECT ANSWER
A qualified genetics counselor is working with a child who
has been diagnosed with fragile X syndrome. After
extensive research about the condition, she meets with
the parents to discuss the features of the disease and the
child's prognosis. The session lasted 45 minutes. What
CPT® and ICD-10-CM codes are reported?
a. 96040, Q99.9
b. 96040 x 2, Q99.8
c. 96040 x 2, Q99.2
d. 96040, Q99.2 - CORRECT ANSWER
PREOPERATIVE DIAGNOSIS : Heart Block
POSTOPERATIVE DIAGNOSIS: Heart Block
,ANESTHESIA: Local anesthesia
NAME OF PROCEDURE: Reimplantation of dual chamber
pacemaker
DESCRIPTION: The chest was prepped with Betadine
and draped in the usual sterile fashion. Local anesthesia
was obtained by infiltration of 1% Xylocaine. A subfascial
incision was made about 2.5 cm below the clavicle, and
the old pulse generator was removed. Using the Seldinger
technique, the subclavian vein was cannulated and
through this, the old atrial lead was removed, and a new
atrial lead (serial # 6662458) was placed in the right atrium
and to the atrial septum. Thresholds were obtained as
follows: The P-wave was 1.4 millivolts, atrial threshold was
1.6 millivolts with a resultant current of 3.5 mA and
resistance of 467 ohms.
Using a second subclavian stick in the Seldinger
technique, the old ventricular lead was removed and a
new ventricular lead (se - CORRECT ANSWER
PROCEDURES PERFORMED:
1. Bilateral facet joint injections, L4-L5
2. Bilateral facet joint injections, L5-S1.
3. Fluoroscopy.
TECHNIQUE: The AP view was aligned with the proper tilt
so that the end plates for the desired levels were
perpendicular. The AP image showed the sacrum and the
L5 spinous process. Manual palpation located the sacral
hiatus. The 6-inch, 20-gauge needle with a slight volar
bend was inserted using fluoroscopy into each facet joint
under AP image. The bilateral L4-L5, and L5-S1 facet
joints were injected in a systematic fashion from caudal to
,cranial. A sterile dressing was applied. The patient
tolerated the procedure well with no complications and
was transferred to recovery in good condition. What CPT®
codes are reported?
a. 64493-50, 64494 x 2
b. 64493-50, 64494 x 2, 77002-26
c. 64493-50, 64494-50-51, 77002-26
d. 64493-50 x 2 - CORRECT ANSWER
Preoperative Diagnosis: Left orbital cyst, hemangioma
versus lymphangioma
Postoperative Diagnosis: Left orbital cyst, hemangioma
versus lymphangioma
Procedures Performed: Aspiration of left orbital cyst with
injection of Kenalog
Anesthesia: General
Complications: None
Estimated Blood Loss: Minimal
Indications for Procedure: The patient presents with a
small cyst of the superior medial left orbit felt to be
suggestive for hemangioma versus lymphangioma. Risks,
benefits, and alternatives of steroid injection to inactivate
the cyst were reviewed. These risks included failure to
work and significant visual loss. After discussion, they
elected to proceed.
Description of Procedure: After informed operative
consent was obtained, the patient was brought to the
operating room and laid in the supine position. General
anesthetic was administered per the anesthesiologist. A
25-gauge needle on a 5-cc syringe was placed within the -
CORRECT ANSWER
, This 56-year-old female presented with a degenerative
posteromedial meniscal flap tear of the right knee. After
appropriate preoperative evaluation, the patient was taken
to the operating room where general anesthesia was
instituted. The patient was placed supine on the operating
table. The right lower extremity was sterilely prepped and
draped for arthroscopic surgery. The leg was
exsanguinated and the tourniquet inflated. The
arthroscope was introduced first through the anterolateral
portal with medial suprapatellar portal utilized. The lateral
compartment looked fairly good. There were some
minimal medial degenerative changes. In the medial
compartment there was a full-thickness area of
osteochondral degeneration with a flap of cartilage noted.
It was possible to remove this with a bleeding bony bed
with beveled edges of cartilage. The ligament itself was
intact. The retropatellar area was normal with Grade I
chon - CORRECT ANSWER
Operative Report
Indications: This is a third follow-up EGD dilation on this
40-year-old patient for a pyloric channel ulcer which has
been slow to heal with resulting pyloric stricture. This is a
repeat evaluation and dilation.
Medications: Intravenous Versed 2 mg. Posterior
pharyngeal Cetacaine spray.
Procedure: With the patient in the left lateral decubitus
position, the Olympus GIFXQ10 was inserted into the
proximal esophagus and advanced to the Z-line. The
esophageal mucosa was unremarkable. Stomach was
A patient sustained a neck strain as a driver in an
automobile accident, losing control,
hydroplaning and hitting a tree off the highway which
caused the car to overturn. He has continued to have neck
pain and stiffness. He sees a chiropractor who assesses
the patient and manipulates his neck. The diagnosis is
neck strain. What CPT® and ICD-10-CM codes are
reported for the chiropractor?
a. 98940, M95.3, V47.3XXA
b. 98943, M54.2, V47.2XXA
c. 98941, S16.1XXA, V47.9XXA
d. 98940, S16.1XXA, V47.0XXA - CORRECT ANSWER
A qualified genetics counselor is working with a child who
has been diagnosed with fragile X syndrome. After
extensive research about the condition, she meets with
the parents to discuss the features of the disease and the
child's prognosis. The session lasted 45 minutes. What
CPT® and ICD-10-CM codes are reported?
a. 96040, Q99.9
b. 96040 x 2, Q99.8
c. 96040 x 2, Q99.2
d. 96040, Q99.2 - CORRECT ANSWER
PREOPERATIVE DIAGNOSIS : Heart Block
POSTOPERATIVE DIAGNOSIS: Heart Block
,ANESTHESIA: Local anesthesia
NAME OF PROCEDURE: Reimplantation of dual chamber
pacemaker
DESCRIPTION: The chest was prepped with Betadine
and draped in the usual sterile fashion. Local anesthesia
was obtained by infiltration of 1% Xylocaine. A subfascial
incision was made about 2.5 cm below the clavicle, and
the old pulse generator was removed. Using the Seldinger
technique, the subclavian vein was cannulated and
through this, the old atrial lead was removed, and a new
atrial lead (serial # 6662458) was placed in the right atrium
and to the atrial septum. Thresholds were obtained as
follows: The P-wave was 1.4 millivolts, atrial threshold was
1.6 millivolts with a resultant current of 3.5 mA and
resistance of 467 ohms.
Using a second subclavian stick in the Seldinger
technique, the old ventricular lead was removed and a
new ventricular lead (se - CORRECT ANSWER
PROCEDURES PERFORMED:
1. Bilateral facet joint injections, L4-L5
2. Bilateral facet joint injections, L5-S1.
3. Fluoroscopy.
TECHNIQUE: The AP view was aligned with the proper tilt
so that the end plates for the desired levels were
perpendicular. The AP image showed the sacrum and the
L5 spinous process. Manual palpation located the sacral
hiatus. The 6-inch, 20-gauge needle with a slight volar
bend was inserted using fluoroscopy into each facet joint
under AP image. The bilateral L4-L5, and L5-S1 facet
joints were injected in a systematic fashion from caudal to
,cranial. A sterile dressing was applied. The patient
tolerated the procedure well with no complications and
was transferred to recovery in good condition. What CPT®
codes are reported?
a. 64493-50, 64494 x 2
b. 64493-50, 64494 x 2, 77002-26
c. 64493-50, 64494-50-51, 77002-26
d. 64493-50 x 2 - CORRECT ANSWER
Preoperative Diagnosis: Left orbital cyst, hemangioma
versus lymphangioma
Postoperative Diagnosis: Left orbital cyst, hemangioma
versus lymphangioma
Procedures Performed: Aspiration of left orbital cyst with
injection of Kenalog
Anesthesia: General
Complications: None
Estimated Blood Loss: Minimal
Indications for Procedure: The patient presents with a
small cyst of the superior medial left orbit felt to be
suggestive for hemangioma versus lymphangioma. Risks,
benefits, and alternatives of steroid injection to inactivate
the cyst were reviewed. These risks included failure to
work and significant visual loss. After discussion, they
elected to proceed.
Description of Procedure: After informed operative
consent was obtained, the patient was brought to the
operating room and laid in the supine position. General
anesthetic was administered per the anesthesiologist. A
25-gauge needle on a 5-cc syringe was placed within the -
CORRECT ANSWER
, This 56-year-old female presented with a degenerative
posteromedial meniscal flap tear of the right knee. After
appropriate preoperative evaluation, the patient was taken
to the operating room where general anesthesia was
instituted. The patient was placed supine on the operating
table. The right lower extremity was sterilely prepped and
draped for arthroscopic surgery. The leg was
exsanguinated and the tourniquet inflated. The
arthroscope was introduced first through the anterolateral
portal with medial suprapatellar portal utilized. The lateral
compartment looked fairly good. There were some
minimal medial degenerative changes. In the medial
compartment there was a full-thickness area of
osteochondral degeneration with a flap of cartilage noted.
It was possible to remove this with a bleeding bony bed
with beveled edges of cartilage. The ligament itself was
intact. The retropatellar area was normal with Grade I
chon - CORRECT ANSWER
Operative Report
Indications: This is a third follow-up EGD dilation on this
40-year-old patient for a pyloric channel ulcer which has
been slow to heal with resulting pyloric stricture. This is a
repeat evaluation and dilation.
Medications: Intravenous Versed 2 mg. Posterior
pharyngeal Cetacaine spray.
Procedure: With the patient in the left lateral decubitus
position, the Olympus GIFXQ10 was inserted into the
proximal esophagus and advanced to the Z-line. The
esophageal mucosa was unremarkable. Stomach was
