AAPC CPC EXAMS PRACTICE B STUDY GUIDE Questions with
Correct Answers (Grade A+)
Question 1: 1. Indication: Patient has a hypertrophic scar on the posterior side of the left leg, at the
level of the knee. This has begun to restrict his mobility. His physical therapy trial was unsuccessful.
Procedure: After the proper induction of anesthesia, the subcutaneous tissue of the patient's left leg
beneath the scar was infiltrated with crystalloid solution containing epinephrine to minimize blood loss.
The scar was then excised down to viable dermis. Hemostasis was obtained with epinephrine soaked
pads. Skin was harvested from the patient's thigh in a split thickness fashion and was used to cover the
90 sq cm defect created by the surgery. The graft was secured with skin staples, and then dressed with
fine mesh gauze followed by medication-soaked gauze. The donor site was dressed with mesh followed
by Adaptic™, followed by a dry dressing and an Ace wrap. What are the CPT® codes?
A. 15110-52, 15002
B. 15100, 11406
C.
Answer:
Question 2: 2. The physician is called in to perform repairs for a 17 year-old girl involved in a motor
vehicle accident. She sustained an 8.6 cm laceration to her forehead, a 5.5 cm laceration to her right
cheek, a 4 cm laceration to her left cheek, a 4 cm laceration across her chin, and a 12.5 cm laceration to
her chest. The wound on her chin required a layered closure. All other wounds required complex
closure. The CPT® codes to report are:
A. 13132, 13133 x 4, 13101, 12052
B. 13132, 13133 x 3, 13133-52, 13101, 13102, 12052
C. 13132, 13133 x 3, 13101, 13102, 12052
D. 13131, 13132, 13133 x 3, 13101, 13102, 12052
Answer:
Question 3: 3. A 36 year-old male presents to have multiple lesions destroyed. Three benign lesions on
his face are destroyed and five actinic keratoses on his left arm are destroyed. The CPT® code(s) to
report is (are):
A. 17000, 17003
B. 17000, 17003 x 4, 17110
C. 17110
D. 17260 x 5, 17110 x 3
Answer:
Page 1
,Question 4: 4. Patient is having ongoing back and hip pain. The physician elects to perform a sacroiliac
injection at an ambulatory surgery center. After sterile prep, the patient is placed prone position. A
needle is placed under fluoroscopic guidance into the SI joint and a mixture of 20 mg of Celestone and
Marcaine is injected for pain relief. Report the CPT® code(s).
A. 27096, 77003-26
B. 20611
C. 20552
D. 27096
Answer:
Question 5: 5. Patient is seen in the hospital's outpatient surgical area with a diagnosis of a displaced
comminuted closed fracture of the lateral condyle, right elbow. An ORIF procedure was performed,
which included the following techniques: An incision was made in the area of the lateral epicondyle.
This was carried through subcutaneous tissue, and the fracture site was easily exposed. Inspection
revealed the fragment to be rotated in two places, about 90 degrees. It was possible to manually reduce
this quite easily, and the manipulation resulted in an almost anatomic reduction. This was fixed with
two pins driven across the humerus. The pins were cut off below skin level. The wound was closed with
plain catgut subcutaneously and 5-0 nylon for the skin. Dressings and a long arm cast were applied.
Which is the correct ICD-10-CM and CPT® code assignment?
A. 24579-RT, 29065-51-RT, S42.451B
B. 24577-RT, S42.451A
C. 24579-RT, S42.
Answer:
Question 6: 6. A 35 year-old female patient presents with acute onset of severe pain since October. Her
workup has revealed evidence of disk herniation with loss of lordosis at the C5-C6. Intraoperative
findings were consistent with two large fragments of free disk fragments in the foramen at C5-C6 on
the right side. After general anesthesia, the patient was placed on the operative table in the supine
position. All pressure points were cushioned and a transverse skin incision was fashioned under
fluoroscopic guidance over the C5-C6 disc space. Dissection through the platysma eventually allowed
for exposure of the anterior entrance to the vertebral body of C5 and C6 and retractors were inserted
to maintain adequate exposure. The operating microscope was brought into the field. Caspar posts
were placed and slight distraction allowed exposure. A complete discectomy was performed at C5-C6
by using endplate curets pituitary rongeurs
Answer:
Page 2
,Question 7: 7. OPERATION: Dual chamber transvenous implantable pacing cardioverter-defibrillator
system implantation with leads. INDICATIONS: A 67 year-old, white gentleman has significant
underlying ischemic cardiomyopathy with EF of 25 percent, prior infarcts, remote history of syncope,
and at a high risk for malignant ventricular arrhythmias. He has had a recent T wave alternans test
which was clearly abnormal. He has had episodes of resting bradycardia, also noted. He meets Madit II
criteria for insertion of a transvenous implantable pacing cardioverter-defibrillator (ICD).
PROCEDURE: After informed consent had been obtained, the patient was brought to the outpatient
hospital lab in the fasting state. The left anterior chest was prepped and draped in a sterile fashion.
Intravenous sedation and local anesthetic were given. After local anesthetic, a 5 cm incision was made
at the left deltopectoral groove. With blunt dissection
Answer:
Question 8: 8. The patient comes in today to have an arteriovenous fistula created to facilitate dialysis.
The surgeon performs an upper arm basilic vein transposition based on the patient's previous arterial
duplex scan. Which is the appropriate CPT® code for this procedure?
A. 36825
B. 36830
C. 36818
D. 36819
Answer:
Question 9: 9. A 56 year-old with lung cancer developed an effusion that is suspicious for malignancy.
Needle aspiration is performed to obtain a sample of the fluid for pathological examination. A needle is
inserted between the ribs and into the pleural space, and the fluid is withdrawn. The specimen is sent to
pathology. Choose the CPT® code that reports the procedure described.
A. 32554
B. 32555
C. 32551
D. 32400
Answer:
Question 10: 10. A 67 year-old male patient is referred for a flex sigmoidoscopy exam to remove polyps.
The physician found three polyps in the rectosigmoid junction. They were removed by hot biopsy
forceps. The path report indicated the polyps were benign. What is the CPT® code to report for this
encounter?
A. 45333
B. 45315
C. 45384
D. 45346
Answer:
Page 3
, Question 11: 11. Name of Procedure: Endoscopic retrograde cholangiopancreatography with stent
placement and antral biopsy. Indications: 50 year-old male who underwent liver transplantation for
end-stage liver disease secondary to chronic hepatitis C and hepatocellular carcinoma in 01/2007. The
patient has cholestatic liver enzymes, requiring ERCP before placement of a 7-French 12 cm stent and
to evaluate the biliary system. Description of Procedure: The patient was taken to the fluoroscopy suite
in the GI lab where he was found to be alert and oriented x 3. After discussing risks and benefits of the
procedure, informed consent was obtained. Patient was kept in the semi prone position. After adequate
conscious sedation, an Olympus side-viewing therapeutic scope was inserted through the mouth all the
way to the second portion of the duodenum. Then, the common bile duct was cannulated and the
cholangiogram was obtained. After the fl
Answer:
Question 12: 12. A patient with rectal bleeding underwent a proctosigmoidoscopy that showed she had
two internal hemorrhoids. The anus was prepped and draped. A field block with Marcaine 0.25% was
then placed. There was an internal prolapsing hemorrhoid in the anterior midline. This was rubber
band ligated by applying two bands. In the posterior midline, there was another internal hemorrhoid
that was banned in the same manner. Code the procedure.
A. 0249T
B. 46221
C. 46945
D. 46930
Answer:
Question 13: 13. A neonatal male had an elective circumcision before being discharged home from the
newborn nursery. The physician uses a ring block for the local anesthetic and the foreskin is placed
over the glans. A clamp is selected for the size of the glans and a constricting circular ring is placed over
the foreskin to compress and devascularized the foreskin. The devascularized foreskin is excised with a
scalpel and the clamp is left in place. Which CPT® code should be used?
A. 54150
B. 54160
C. 54161
D. 54150-52
Answer:
Page 4
Correct Answers (Grade A+)
Question 1: 1. Indication: Patient has a hypertrophic scar on the posterior side of the left leg, at the
level of the knee. This has begun to restrict his mobility. His physical therapy trial was unsuccessful.
Procedure: After the proper induction of anesthesia, the subcutaneous tissue of the patient's left leg
beneath the scar was infiltrated with crystalloid solution containing epinephrine to minimize blood loss.
The scar was then excised down to viable dermis. Hemostasis was obtained with epinephrine soaked
pads. Skin was harvested from the patient's thigh in a split thickness fashion and was used to cover the
90 sq cm defect created by the surgery. The graft was secured with skin staples, and then dressed with
fine mesh gauze followed by medication-soaked gauze. The donor site was dressed with mesh followed
by Adaptic™, followed by a dry dressing and an Ace wrap. What are the CPT® codes?
A. 15110-52, 15002
B. 15100, 11406
C.
Answer:
Question 2: 2. The physician is called in to perform repairs for a 17 year-old girl involved in a motor
vehicle accident. She sustained an 8.6 cm laceration to her forehead, a 5.5 cm laceration to her right
cheek, a 4 cm laceration to her left cheek, a 4 cm laceration across her chin, and a 12.5 cm laceration to
her chest. The wound on her chin required a layered closure. All other wounds required complex
closure. The CPT® codes to report are:
A. 13132, 13133 x 4, 13101, 12052
B. 13132, 13133 x 3, 13133-52, 13101, 13102, 12052
C. 13132, 13133 x 3, 13101, 13102, 12052
D. 13131, 13132, 13133 x 3, 13101, 13102, 12052
Answer:
Question 3: 3. A 36 year-old male presents to have multiple lesions destroyed. Three benign lesions on
his face are destroyed and five actinic keratoses on his left arm are destroyed. The CPT® code(s) to
report is (are):
A. 17000, 17003
B. 17000, 17003 x 4, 17110
C. 17110
D. 17260 x 5, 17110 x 3
Answer:
Page 1
,Question 4: 4. Patient is having ongoing back and hip pain. The physician elects to perform a sacroiliac
injection at an ambulatory surgery center. After sterile prep, the patient is placed prone position. A
needle is placed under fluoroscopic guidance into the SI joint and a mixture of 20 mg of Celestone and
Marcaine is injected for pain relief. Report the CPT® code(s).
A. 27096, 77003-26
B. 20611
C. 20552
D. 27096
Answer:
Question 5: 5. Patient is seen in the hospital's outpatient surgical area with a diagnosis of a displaced
comminuted closed fracture of the lateral condyle, right elbow. An ORIF procedure was performed,
which included the following techniques: An incision was made in the area of the lateral epicondyle.
This was carried through subcutaneous tissue, and the fracture site was easily exposed. Inspection
revealed the fragment to be rotated in two places, about 90 degrees. It was possible to manually reduce
this quite easily, and the manipulation resulted in an almost anatomic reduction. This was fixed with
two pins driven across the humerus. The pins were cut off below skin level. The wound was closed with
plain catgut subcutaneously and 5-0 nylon for the skin. Dressings and a long arm cast were applied.
Which is the correct ICD-10-CM and CPT® code assignment?
A. 24579-RT, 29065-51-RT, S42.451B
B. 24577-RT, S42.451A
C. 24579-RT, S42.
Answer:
Question 6: 6. A 35 year-old female patient presents with acute onset of severe pain since October. Her
workup has revealed evidence of disk herniation with loss of lordosis at the C5-C6. Intraoperative
findings were consistent with two large fragments of free disk fragments in the foramen at C5-C6 on
the right side. After general anesthesia, the patient was placed on the operative table in the supine
position. All pressure points were cushioned and a transverse skin incision was fashioned under
fluoroscopic guidance over the C5-C6 disc space. Dissection through the platysma eventually allowed
for exposure of the anterior entrance to the vertebral body of C5 and C6 and retractors were inserted
to maintain adequate exposure. The operating microscope was brought into the field. Caspar posts
were placed and slight distraction allowed exposure. A complete discectomy was performed at C5-C6
by using endplate curets pituitary rongeurs
Answer:
Page 2
,Question 7: 7. OPERATION: Dual chamber transvenous implantable pacing cardioverter-defibrillator
system implantation with leads. INDICATIONS: A 67 year-old, white gentleman has significant
underlying ischemic cardiomyopathy with EF of 25 percent, prior infarcts, remote history of syncope,
and at a high risk for malignant ventricular arrhythmias. He has had a recent T wave alternans test
which was clearly abnormal. He has had episodes of resting bradycardia, also noted. He meets Madit II
criteria for insertion of a transvenous implantable pacing cardioverter-defibrillator (ICD).
PROCEDURE: After informed consent had been obtained, the patient was brought to the outpatient
hospital lab in the fasting state. The left anterior chest was prepped and draped in a sterile fashion.
Intravenous sedation and local anesthetic were given. After local anesthetic, a 5 cm incision was made
at the left deltopectoral groove. With blunt dissection
Answer:
Question 8: 8. The patient comes in today to have an arteriovenous fistula created to facilitate dialysis.
The surgeon performs an upper arm basilic vein transposition based on the patient's previous arterial
duplex scan. Which is the appropriate CPT® code for this procedure?
A. 36825
B. 36830
C. 36818
D. 36819
Answer:
Question 9: 9. A 56 year-old with lung cancer developed an effusion that is suspicious for malignancy.
Needle aspiration is performed to obtain a sample of the fluid for pathological examination. A needle is
inserted between the ribs and into the pleural space, and the fluid is withdrawn. The specimen is sent to
pathology. Choose the CPT® code that reports the procedure described.
A. 32554
B. 32555
C. 32551
D. 32400
Answer:
Question 10: 10. A 67 year-old male patient is referred for a flex sigmoidoscopy exam to remove polyps.
The physician found three polyps in the rectosigmoid junction. They were removed by hot biopsy
forceps. The path report indicated the polyps were benign. What is the CPT® code to report for this
encounter?
A. 45333
B. 45315
C. 45384
D. 45346
Answer:
Page 3
, Question 11: 11. Name of Procedure: Endoscopic retrograde cholangiopancreatography with stent
placement and antral biopsy. Indications: 50 year-old male who underwent liver transplantation for
end-stage liver disease secondary to chronic hepatitis C and hepatocellular carcinoma in 01/2007. The
patient has cholestatic liver enzymes, requiring ERCP before placement of a 7-French 12 cm stent and
to evaluate the biliary system. Description of Procedure: The patient was taken to the fluoroscopy suite
in the GI lab where he was found to be alert and oriented x 3. After discussing risks and benefits of the
procedure, informed consent was obtained. Patient was kept in the semi prone position. After adequate
conscious sedation, an Olympus side-viewing therapeutic scope was inserted through the mouth all the
way to the second portion of the duodenum. Then, the common bile duct was cannulated and the
cholangiogram was obtained. After the fl
Answer:
Question 12: 12. A patient with rectal bleeding underwent a proctosigmoidoscopy that showed she had
two internal hemorrhoids. The anus was prepped and draped. A field block with Marcaine 0.25% was
then placed. There was an internal prolapsing hemorrhoid in the anterior midline. This was rubber
band ligated by applying two bands. In the posterior midline, there was another internal hemorrhoid
that was banned in the same manner. Code the procedure.
A. 0249T
B. 46221
C. 46945
D. 46930
Answer:
Question 13: 13. A neonatal male had an elective circumcision before being discharged home from the
newborn nursery. The physician uses a ring block for the local anesthetic and the foreskin is placed
over the glans. A clamp is selected for the size of the glans and a constricting circular ring is placed over
the foreskin to compress and devascularized the foreskin. The devascularized foreskin is excised with a
scalpel and the clamp is left in place. Which CPT® code should be used?
A. 54150
B. 54160
C. 54161
D. 54150-52
Answer:
Page 4
