AAPC CPC Chapter 20 Exam
Questions and Verified Answers + Rationales
1. A patient who has had two recent seizures underwent a 3-hour EEG study. What CPT® code
is reported?
ANS: 95813
Rationale: In the CPT® Index look for EEG which directs you to Electroencephalography (EEG).
Under Electroencephalography (EEG)/Monitoring you are directed to 95812-95813, 95950-95953
and 95956. Code range 95812 - 95813 is based on time. Code 95813 describes an EEG
(electroencephalogram), more than 1 hour.
This patient had a 3-hour study which is reported with 95813.
2. A 15 year-old underwent placement of a cochlear implant 1 year ago. It now needs to be
reprogrammed. What CPT® code is reported for the reprogramming?
ANS: 92604
Rationale: Cochlear implants differ from hearing aids; they bypass the damaged part of the ear. The
use of a cochlear implant involves relearning how to hear and react to sounds. In the CPT® Index
look for Cochlear Device/Programming which directs you to codes 92602, 92604. The code
selection is based on the age of the patient and whether it is the initial programming or subsequent
reprogramming. Code 92604 describes subsequent reprogramming for a patient age 7 or older.
3. A 5-year-old fell on broken glass and required suturing of a laceration. Due to the age and
combative behavior of the patient, the provider utilized moderate sedation while repairing the
laceration. The provider gave the child 50 mg of Ketamine IM. A nurse monitored the patient
during the procedure which took 30 minutes. What CPT® code is reported for moderate
sedation?
ANS: 99152, 99153
Rationale: Moderate sedation is often used for pediatric patients in situations not normally requiring
sedation. In this case, the provider administered sedation with a nurse assisting in monitoring the
patient. In the CPT® Index look for Sedation/Moderate/with Independent Observation and you are
directed to code range 99151-99153. Code selection is based on age of the patient and the length
of time. Code 99152 describes an encounter using moderate sedation, and the physician or other
qualified health care professional rendering the diagnostic or therapeutic service also manages the
sedation. This code is specific for the age of the patient and up to 15 minutes of time. Add-on 99153
is for each additional 15 minutes of intraservice time.
4. A new patient with cystic fibrosis underwent evaluation of lung function, including
percussion, vibration and cupping to the chest wall to facilitate his lung function. What CPT®
code(s) is/are reported for this service?
ANS: 94667
Rationale: In the CPT® Index look for Pulmonology/Therapeutic/Manipulation of Chest Wall or
Chest Wall/Manipulation which directs you to 94667-94668. 94667 is the correct code since it
includes the patient's first time, and it includes the evaluation.
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, 5. A patient was brought to the emergency department in cardiac arrest.
The physician immediately initiated CPR. What CPT® code is reported for CPR?
ANS: 92950
Rationale: Medical personnel usually begin cardiopulmonary resuscitation (CPR) which provides
artificial breathing and chest compressions for a person in cardiac arrest. In the CPT® Index you can
look for either CPR or Cardiopulmonary Resuscitation or Resuscitation/Cardiopulmonary. All indexed
items direct you to code 92950.
6. A patient with hypertensive cardiovascular disease is admitted by his primary care provider.
What is/are the correct ICD-10-CM code(s) for this encounter?
ANS: I11.9
Rationale: In the ICD-10-CM Alphabetic Index look for Hypertension,
hypertensive/cardiovascular/disease (arteriosclerotic) (sclerotic) which states to see Hypertension,
heart. Look for Hypertension/heart (disease) (conditions in I51.4-I51.9 due to hypertension) directing
you to I11.9. ICD-10-CM guideline, I.C.9.a.1., states code I11- is used when a causal relationship is
stated or implied. Tabular List confirms code I11.9 is correct as heart failure is not documented.
7. A patient with chronic respiratory failure is visited at home by a certified respiratory
therapist to manage his home oxygen therapy. What CPT® and ICD-10-CM codes are
reported?
ANS: 99503, J96.10
Rationale: In the CPT® Index look for Home Services/Respiratory Therapy and you are directed to
99503. In the ICD-10-CM Alphabetic Index, look for Failure, failed/respiration, respiratory/chronic and
you are directed to J96.10. Verification in the Tabular List confirms code selection.
8. A patient with chronic myeloid leukemia (CML), BCR/ABL-positive has an implanted access
port for delivery of chemotherapy. The device needs to be irrigated before receiving
treatment. What ICD-10-CM and CPT® codes are reported for the irrigation?
ANS: 96523, C92.10
Rationale: In the CPT® Index look for Irrigation/Venous Access Device. Report code 96523 for
irrigation of an implanted venous access device.
In the ICD-10-CM Alphabetic Index look for Leukemia/chronic myeloid, BCR/ABL-positive and you are
directed to C92.1-. In the Tabular List the 5th character of 0 is used to indicate there is no mention of
having achieved remission.
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Questions and Verified Answers + Rationales
1. A patient who has had two recent seizures underwent a 3-hour EEG study. What CPT® code
is reported?
ANS: 95813
Rationale: In the CPT® Index look for EEG which directs you to Electroencephalography (EEG).
Under Electroencephalography (EEG)/Monitoring you are directed to 95812-95813, 95950-95953
and 95956. Code range 95812 - 95813 is based on time. Code 95813 describes an EEG
(electroencephalogram), more than 1 hour.
This patient had a 3-hour study which is reported with 95813.
2. A 15 year-old underwent placement of a cochlear implant 1 year ago. It now needs to be
reprogrammed. What CPT® code is reported for the reprogramming?
ANS: 92604
Rationale: Cochlear implants differ from hearing aids; they bypass the damaged part of the ear. The
use of a cochlear implant involves relearning how to hear and react to sounds. In the CPT® Index
look for Cochlear Device/Programming which directs you to codes 92602, 92604. The code
selection is based on the age of the patient and whether it is the initial programming or subsequent
reprogramming. Code 92604 describes subsequent reprogramming for a patient age 7 or older.
3. A 5-year-old fell on broken glass and required suturing of a laceration. Due to the age and
combative behavior of the patient, the provider utilized moderate sedation while repairing the
laceration. The provider gave the child 50 mg of Ketamine IM. A nurse monitored the patient
during the procedure which took 30 minutes. What CPT® code is reported for moderate
sedation?
ANS: 99152, 99153
Rationale: Moderate sedation is often used for pediatric patients in situations not normally requiring
sedation. In this case, the provider administered sedation with a nurse assisting in monitoring the
patient. In the CPT® Index look for Sedation/Moderate/with Independent Observation and you are
directed to code range 99151-99153. Code selection is based on age of the patient and the length
of time. Code 99152 describes an encounter using moderate sedation, and the physician or other
qualified health care professional rendering the diagnostic or therapeutic service also manages the
sedation. This code is specific for the age of the patient and up to 15 minutes of time. Add-on 99153
is for each additional 15 minutes of intraservice time.
4. A new patient with cystic fibrosis underwent evaluation of lung function, including
percussion, vibration and cupping to the chest wall to facilitate his lung function. What CPT®
code(s) is/are reported for this service?
ANS: 94667
Rationale: In the CPT® Index look for Pulmonology/Therapeutic/Manipulation of Chest Wall or
Chest Wall/Manipulation which directs you to 94667-94668. 94667 is the correct code since it
includes the patient's first time, and it includes the evaluation.
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, 5. A patient was brought to the emergency department in cardiac arrest.
The physician immediately initiated CPR. What CPT® code is reported for CPR?
ANS: 92950
Rationale: Medical personnel usually begin cardiopulmonary resuscitation (CPR) which provides
artificial breathing and chest compressions for a person in cardiac arrest. In the CPT® Index you can
look for either CPR or Cardiopulmonary Resuscitation or Resuscitation/Cardiopulmonary. All indexed
items direct you to code 92950.
6. A patient with hypertensive cardiovascular disease is admitted by his primary care provider.
What is/are the correct ICD-10-CM code(s) for this encounter?
ANS: I11.9
Rationale: In the ICD-10-CM Alphabetic Index look for Hypertension,
hypertensive/cardiovascular/disease (arteriosclerotic) (sclerotic) which states to see Hypertension,
heart. Look for Hypertension/heart (disease) (conditions in I51.4-I51.9 due to hypertension) directing
you to I11.9. ICD-10-CM guideline, I.C.9.a.1., states code I11- is used when a causal relationship is
stated or implied. Tabular List confirms code I11.9 is correct as heart failure is not documented.
7. A patient with chronic respiratory failure is visited at home by a certified respiratory
therapist to manage his home oxygen therapy. What CPT® and ICD-10-CM codes are
reported?
ANS: 99503, J96.10
Rationale: In the CPT® Index look for Home Services/Respiratory Therapy and you are directed to
99503. In the ICD-10-CM Alphabetic Index, look for Failure, failed/respiration, respiratory/chronic and
you are directed to J96.10. Verification in the Tabular List confirms code selection.
8. A patient with chronic myeloid leukemia (CML), BCR/ABL-positive has an implanted access
port for delivery of chemotherapy. The device needs to be irrigated before receiving
treatment. What ICD-10-CM and CPT® codes are reported for the irrigation?
ANS: 96523, C92.10
Rationale: In the CPT® Index look for Irrigation/Venous Access Device. Report code 96523 for
irrigation of an implanted venous access device.
In the ICD-10-CM Alphabetic Index look for Leukemia/chronic myeloid, BCR/ABL-positive and you are
directed to C92.1-. In the Tabular List the 5th character of 0 is used to indicate there is no mention of
having achieved remission.
2/8
