AAPC CHAPTER 19 EXAM QUESTIONS
WITH 100% CORRECT ANSWERS
A 28 year-old female patient is returning to her provider's office with complaints of RLQ
pain and heartburn with a temperature of 100.2. The provider performs a detailed
history, detailed exam and determines the patient has mild appendicitis. The provider
prescribes antibiotics to treat the appendicitis in hopes of avoiding an appendectomy.
What are the correct CPT® and ICD-10-CM codes for this encounter? - Answer- 99214,
K37, R12
Fred is fishing at the local area lake while on vacation. He gets lightheaded and dizzy
and goes to the local hospital Emergency Department. He's evaluated by the ED
provider. This is the first time he has been to this hospital. What subsection is used to
report the ED visit? - Answer- Emergency Department Services
A 77 year-old Medicare beneficiary has a digital rectal examination for prostate cancer
screening and the provider orders a PSA. How would this be reported? - Answer-
G0102
A 75 year-old established patient sees his regular primary care provider for a physical
screening prior to joining a group home. He has no new complaints. The patient has an
established diagnosis of cerebral palsy and type 2 diabetes and is currently on his
meds. A comprehensive history and examination is performed. The provider counsels
the patient on the importance of taking his medication and gives him a prescription for
refills. Blood work was ordered. PPD was done and flu vaccine given. Patient already
had a vision exam. No abnormal historical facts or finding are noted. What CPT® code
is reported? - Answer- 99397
A 45 year-old established, female patient is seen today at her provider's office. She is
complaining of severe dizziness and feels like the room is spinning. She has had
palpitations on and off for the past 12 months. For the ROS, she reports chest tightness
and dyspnea but denies nausea, edema or arm pain. She drinks two cups of coffee per
day. Her sister has WPW (Wolff-Parkinson-White) syndrome. An extended exam of five
organ systems are performed. This is a new problem. An EKG is ordered and labs are
drawn, and the provider documents a moderate complexity MDM. What CPT® code is
reported for this visit? - Answer- 99214
What ICD-10-CM code is reported for vertigo? - Answer- R42
, A provider makes a home care visit to a 63 year-old hemiplegic patient who has been
experiencing insomnia for the last two weeks. The patient has been home bound for the
last year. The last visit from this provider was four months ago to manage his DM. The
physician performs an expanded problem focused examination and low MDM. The
provider speaks with the spouse about the possibility of placing the patient in a nursing
facility. What CPT® code is reported? - Answer- 99348
A provider admits Mrs. Smith to the hospital. She is there for five days. The provider
sees her each day she's in the hospital. What subcategory of E/M codes would be used
for days two, three and four? - Answer- Subsequent Hospital Care
If the pain is sharp, stabbing or dull, what is the component of the History of Present
Illness (HPI)? - Answer- Quality
What modifier is used to report an evaluation and management service mandated by a
court order? - Answer- 32
According to CPT® guidelines what is the first step in selecting an evaluation and
management code? - Answer- Determine the category and subcategory
A 32 year-old patient sees Dr. Smith for a consult at the request of his PCP, Dr. Long,
for an ongoing problem with allergies. The patient has failed Claritin and Alavert and
feels his symptoms continue to worsen. Dr. Smith performs an expanded problem
focused history and exam and discusses options with the patient on allergy
management. The MDM is straightforward. The patient agrees he would like to be
tested to possibly gain better control of his allergies. Dr. Smith sends a report to Dr.
Long thanking him for the referral and includes the date the patient is scheduled for
allergy testing. Dr. Smith also includes his findings from the encounter. What E/M code
is reported? - Answer- 99242
Mr. Flintstone is seen by his oncologist just two days after undergoing extensive testing
for a sudden onset of petechiae, night sweats, swollen glands and weakness. After a
brief review of history, Dr. B. Marrow re-examines Mr. Flintstone. The exam is
documented as expanded problem focused and the medical decision making of
moderate complexity. The oncologist spends an additional 45 minutes discussing Mr.
Flintstone's new diagnosis of Hodgkin's lymphoma, treatment options and prognosis.
What is/are the appropriate procedure code(s) for this visit? - Answer- 99213, 99354
What ICD-10-CM code is reported for angina pectoris with a documented spasm? -
Answer- I20.1
What ICD-10-CM code is reported for nausea and vomiting? - Answer- R11.2
A 10 year-old girl is scheduled for her yearly physical with her pediatrician. At the time
of the visit, the patient complains of watery eyes, scratchy throat and stuffy nose for the
WITH 100% CORRECT ANSWERS
A 28 year-old female patient is returning to her provider's office with complaints of RLQ
pain and heartburn with a temperature of 100.2. The provider performs a detailed
history, detailed exam and determines the patient has mild appendicitis. The provider
prescribes antibiotics to treat the appendicitis in hopes of avoiding an appendectomy.
What are the correct CPT® and ICD-10-CM codes for this encounter? - Answer- 99214,
K37, R12
Fred is fishing at the local area lake while on vacation. He gets lightheaded and dizzy
and goes to the local hospital Emergency Department. He's evaluated by the ED
provider. This is the first time he has been to this hospital. What subsection is used to
report the ED visit? - Answer- Emergency Department Services
A 77 year-old Medicare beneficiary has a digital rectal examination for prostate cancer
screening and the provider orders a PSA. How would this be reported? - Answer-
G0102
A 75 year-old established patient sees his regular primary care provider for a physical
screening prior to joining a group home. He has no new complaints. The patient has an
established diagnosis of cerebral palsy and type 2 diabetes and is currently on his
meds. A comprehensive history and examination is performed. The provider counsels
the patient on the importance of taking his medication and gives him a prescription for
refills. Blood work was ordered. PPD was done and flu vaccine given. Patient already
had a vision exam. No abnormal historical facts or finding are noted. What CPT® code
is reported? - Answer- 99397
A 45 year-old established, female patient is seen today at her provider's office. She is
complaining of severe dizziness and feels like the room is spinning. She has had
palpitations on and off for the past 12 months. For the ROS, she reports chest tightness
and dyspnea but denies nausea, edema or arm pain. She drinks two cups of coffee per
day. Her sister has WPW (Wolff-Parkinson-White) syndrome. An extended exam of five
organ systems are performed. This is a new problem. An EKG is ordered and labs are
drawn, and the provider documents a moderate complexity MDM. What CPT® code is
reported for this visit? - Answer- 99214
What ICD-10-CM code is reported for vertigo? - Answer- R42
, A provider makes a home care visit to a 63 year-old hemiplegic patient who has been
experiencing insomnia for the last two weeks. The patient has been home bound for the
last year. The last visit from this provider was four months ago to manage his DM. The
physician performs an expanded problem focused examination and low MDM. The
provider speaks with the spouse about the possibility of placing the patient in a nursing
facility. What CPT® code is reported? - Answer- 99348
A provider admits Mrs. Smith to the hospital. She is there for five days. The provider
sees her each day she's in the hospital. What subcategory of E/M codes would be used
for days two, three and four? - Answer- Subsequent Hospital Care
If the pain is sharp, stabbing or dull, what is the component of the History of Present
Illness (HPI)? - Answer- Quality
What modifier is used to report an evaluation and management service mandated by a
court order? - Answer- 32
According to CPT® guidelines what is the first step in selecting an evaluation and
management code? - Answer- Determine the category and subcategory
A 32 year-old patient sees Dr. Smith for a consult at the request of his PCP, Dr. Long,
for an ongoing problem with allergies. The patient has failed Claritin and Alavert and
feels his symptoms continue to worsen. Dr. Smith performs an expanded problem
focused history and exam and discusses options with the patient on allergy
management. The MDM is straightforward. The patient agrees he would like to be
tested to possibly gain better control of his allergies. Dr. Smith sends a report to Dr.
Long thanking him for the referral and includes the date the patient is scheduled for
allergy testing. Dr. Smith also includes his findings from the encounter. What E/M code
is reported? - Answer- 99242
Mr. Flintstone is seen by his oncologist just two days after undergoing extensive testing
for a sudden onset of petechiae, night sweats, swollen glands and weakness. After a
brief review of history, Dr. B. Marrow re-examines Mr. Flintstone. The exam is
documented as expanded problem focused and the medical decision making of
moderate complexity. The oncologist spends an additional 45 minutes discussing Mr.
Flintstone's new diagnosis of Hodgkin's lymphoma, treatment options and prognosis.
What is/are the appropriate procedure code(s) for this visit? - Answer- 99213, 99354
What ICD-10-CM code is reported for angina pectoris with a documented spasm? -
Answer- I20.1
What ICD-10-CM code is reported for nausea and vomiting? - Answer- R11.2
A 10 year-old girl is scheduled for her yearly physical with her pediatrician. At the time
of the visit, the patient complains of watery eyes, scratchy throat and stuffy nose for the
