AAPC - Final Exam
65 year-old was admitted in the hospital two days ago and is being examined today by
his primary care physician, who has been seeing him since he has been admitted.
Primary care physician is checking for any improvements or if the condition is
worsening.
CHIEF COMPLAINT: CHF
INTERVAL HISTORY: CHF symptoms worsened since yesterday.
Now has some resting dyspnea. HTN remains poorly controlled with systolic pressure
running in the 160s. Also, I'm concerned about his CKD, which has worsened, most
likely due to cardio-renal syndrome.
REVIEW OF SYSTEMS: Positive for orthopnea and one episode of PND. Negative for
flank pain, obstructive symptoms or documented exposure to nephrotoxins.
PHYSICAL EXAMINATION:
GENERAL: Mild respiratory distress at rest
VITAL SIGNS: BP 168/84, HR 58, temperature 98.1.
LUNGS: Worsening bibasilar crackles
CARDIOVASCULAR: RRR, no MRGs.
EXTREMITIES: Show worsening lower extremity edema.
LABS: BU - ANS-
A 1 year post-thyroidectomy patient who had thyroid cancer is coming in for area
imaging of the neck and chest to evaluate for metastases. What CPT® code(s) is/are
reported for the nuclear medicine exam?
a. 78013
b. 78015, 78020
c. 78014
d. 78015 - ANS-
A 16 year-old female was hit by a car while crossing a two-lane highway. She was taken
to the hospital by ambulance. She was found to have an open wound of the left lower
thigh, just above the knee and a displaced fracture of the left femoral neck. She was
taken to the operating room within four hours of her injury. She was given general
endotracheal anesthesia and was prepped and draped in sterile fashion. Debridement
including excision of devitalized skin and muscle was performed on the lateral thigh.
The area was approximately 15 sq cm. After debridement and thorough copious
irrigation, the wound was closed with layer sutures and a dressing was applied and then
covered with adhesive plastic. The patient was then prepped and draped for the fracture
and turned on her right side. We all rescrubbed. An 8 inch incision was made over the
,left hip and the head of the femur was exposed. Multiple fragments from the neck an -
ANS-
A 27 year-old girl has been on the lung transplant list for months and today she will be
receiving a LT and RT lung from an individual involved in an MVA. This person was
DOA at the hospital and is an organ donor. The donor pneumonectomy was performed
by physician A, the backbench work by physician B and the transplant of both lungs into
the prepped and waiting patient by physician C.
What is the correct coding for the removal (physician A), preparation (physician B) and
insertion (physician C) of the lungs?
a. 32850, 32855, 32851
b. 32850, 32856, 32851 x 2
c. 32850, 32856, 32853
d. 32850, 32855 x 2, 32850-50 - ANS-
A 32 year-old ETOH dependent female is in a partial hospitalization program and has
been seeing an addictive disease specialist (psychotherapist) in a chemical dependency
program. Her employer is aware of her problem. She was referred to the group through
their Employee Assistance Program. As long as she is in compliance they will support
her efforts. Recently, she has arrived late at the meetings. The provider met with the
patient and discussed the importance of her treatment, compliance with the program
and avoidance of situations in which she may use alcohol. She denies contact with her
previous associates and assures the provider she has had no alcohol intake since
beginning the substance abuse treatment program. They will continue to reinforce her
progress and successful sobriety. Time of the session was 45 minutes. What CPT® and
ICD-10-CM codes are reported?
a. 90832, F10.220
b. 90832, F10.20
c. 90834, F10.20 - ANS-
A 32 year-old male was seen in the ASC for removal of two lipomas. One was located
on his back and the other was located on the right forearm. Both involved subcutaneous
tissue. What ICD-10-CM code(s) is/are reported?
a. D17.1, D17.23
b. D17.21, D17.1
c. D17.30
d. D17.39 - ANS-b. D17.21, D17.1
A 40 year-old presents with vaginal bleeding for several weeks unrelated to her
menstrual cycle. The gynecologist orders an ultrasound to obtain more information for a
diagnosis. What diagnosis code is appropriate for this encounter?
a. N92.1
, b. N92.4
c. N92.6
d. N93.9 - ANS-
A 42 year-old patient was undergoing anesthesia in an ASC and began having
complications prior to the administration of anesthesia. The surgeon immediately
discontinued the planned surgery. If the insurance company requires a reported
modifier, what modifier best describes the extenuating circumstances?
a. 53
b. 23
c. 73
d. 74 - ANS-
A 43 year-old female presents to the provider for a diabetic ulcer of the right ankle.
What ICD-10-CM codes are reported?
a. L97.319
b. L97.319, E11.9
c. L97.319, E11.622
d. E11.622, L97.319 - ANS-d. E11.622, L97.319
A 43 year-old patient with a severe systemic disease is having surgery to remove an
integumentary mass from his neck. What CPT® code and modifier are reported for the
anesthesia service?
a. 00300-P2
b. 00300-P3
c. 00322-P3
d. 00350-P3 - ANS-
A 45 year-old presents with acute pericarditis. The surgeon makes a small incision
between two ribs and enters the thoracic cavity. An endoscope is introduced and the
pericardial sac is examined by direct visualization. Using an instrument introduced
through the endoscope, the surgeon creates an opening in the pericardial sac for
drainage purposes. What CPT® code is reported?
a. 32659
b. 32662
c. 32658
d. 32661 - ANS-
A 45 year-old-male patient has developed an ulcer on his upper back. He has had
diabetes for several years and is on insulin. The provider determines that the ulcer is
due to his diabetes. What ICD-10-CM codes are reported?
65 year-old was admitted in the hospital two days ago and is being examined today by
his primary care physician, who has been seeing him since he has been admitted.
Primary care physician is checking for any improvements or if the condition is
worsening.
CHIEF COMPLAINT: CHF
INTERVAL HISTORY: CHF symptoms worsened since yesterday.
Now has some resting dyspnea. HTN remains poorly controlled with systolic pressure
running in the 160s. Also, I'm concerned about his CKD, which has worsened, most
likely due to cardio-renal syndrome.
REVIEW OF SYSTEMS: Positive for orthopnea and one episode of PND. Negative for
flank pain, obstructive symptoms or documented exposure to nephrotoxins.
PHYSICAL EXAMINATION:
GENERAL: Mild respiratory distress at rest
VITAL SIGNS: BP 168/84, HR 58, temperature 98.1.
LUNGS: Worsening bibasilar crackles
CARDIOVASCULAR: RRR, no MRGs.
EXTREMITIES: Show worsening lower extremity edema.
LABS: BU - ANS-
A 1 year post-thyroidectomy patient who had thyroid cancer is coming in for area
imaging of the neck and chest to evaluate for metastases. What CPT® code(s) is/are
reported for the nuclear medicine exam?
a. 78013
b. 78015, 78020
c. 78014
d. 78015 - ANS-
A 16 year-old female was hit by a car while crossing a two-lane highway. She was taken
to the hospital by ambulance. She was found to have an open wound of the left lower
thigh, just above the knee and a displaced fracture of the left femoral neck. She was
taken to the operating room within four hours of her injury. She was given general
endotracheal anesthesia and was prepped and draped in sterile fashion. Debridement
including excision of devitalized skin and muscle was performed on the lateral thigh.
The area was approximately 15 sq cm. After debridement and thorough copious
irrigation, the wound was closed with layer sutures and a dressing was applied and then
covered with adhesive plastic. The patient was then prepped and draped for the fracture
and turned on her right side. We all rescrubbed. An 8 inch incision was made over the
,left hip and the head of the femur was exposed. Multiple fragments from the neck an -
ANS-
A 27 year-old girl has been on the lung transplant list for months and today she will be
receiving a LT and RT lung from an individual involved in an MVA. This person was
DOA at the hospital and is an organ donor. The donor pneumonectomy was performed
by physician A, the backbench work by physician B and the transplant of both lungs into
the prepped and waiting patient by physician C.
What is the correct coding for the removal (physician A), preparation (physician B) and
insertion (physician C) of the lungs?
a. 32850, 32855, 32851
b. 32850, 32856, 32851 x 2
c. 32850, 32856, 32853
d. 32850, 32855 x 2, 32850-50 - ANS-
A 32 year-old ETOH dependent female is in a partial hospitalization program and has
been seeing an addictive disease specialist (psychotherapist) in a chemical dependency
program. Her employer is aware of her problem. She was referred to the group through
their Employee Assistance Program. As long as she is in compliance they will support
her efforts. Recently, she has arrived late at the meetings. The provider met with the
patient and discussed the importance of her treatment, compliance with the program
and avoidance of situations in which she may use alcohol. She denies contact with her
previous associates and assures the provider she has had no alcohol intake since
beginning the substance abuse treatment program. They will continue to reinforce her
progress and successful sobriety. Time of the session was 45 minutes. What CPT® and
ICD-10-CM codes are reported?
a. 90832, F10.220
b. 90832, F10.20
c. 90834, F10.20 - ANS-
A 32 year-old male was seen in the ASC for removal of two lipomas. One was located
on his back and the other was located on the right forearm. Both involved subcutaneous
tissue. What ICD-10-CM code(s) is/are reported?
a. D17.1, D17.23
b. D17.21, D17.1
c. D17.30
d. D17.39 - ANS-b. D17.21, D17.1
A 40 year-old presents with vaginal bleeding for several weeks unrelated to her
menstrual cycle. The gynecologist orders an ultrasound to obtain more information for a
diagnosis. What diagnosis code is appropriate for this encounter?
a. N92.1
, b. N92.4
c. N92.6
d. N93.9 - ANS-
A 42 year-old patient was undergoing anesthesia in an ASC and began having
complications prior to the administration of anesthesia. The surgeon immediately
discontinued the planned surgery. If the insurance company requires a reported
modifier, what modifier best describes the extenuating circumstances?
a. 53
b. 23
c. 73
d. 74 - ANS-
A 43 year-old female presents to the provider for a diabetic ulcer of the right ankle.
What ICD-10-CM codes are reported?
a. L97.319
b. L97.319, E11.9
c. L97.319, E11.622
d. E11.622, L97.319 - ANS-d. E11.622, L97.319
A 43 year-old patient with a severe systemic disease is having surgery to remove an
integumentary mass from his neck. What CPT® code and modifier are reported for the
anesthesia service?
a. 00300-P2
b. 00300-P3
c. 00322-P3
d. 00350-P3 - ANS-
A 45 year-old presents with acute pericarditis. The surgeon makes a small incision
between two ribs and enters the thoracic cavity. An endoscope is introduced and the
pericardial sac is examined by direct visualization. Using an instrument introduced
through the endoscope, the surgeon creates an opening in the pericardial sac for
drainage purposes. What CPT® code is reported?
a. 32659
b. 32662
c. 32658
d. 32661 - ANS-
A 45 year-old-male patient has developed an ulcer on his upper back. He has had
diabetes for several years and is on insulin. The provider determines that the ulcer is
due to his diabetes. What ICD-10-CM codes are reported?
