Review for AAPC CPC exam 2025 REAL EXAM 100
QUESTIONS & CORRECT ANSWERS|GRADED A+.
15-year-old male is seen by the pediatrician in his office for having excessive thirst and
frequent urination. A urine dip is performed showing +3 sugar and with some ketones.
Glucometer reading is done showing a blood sugar range of 500-600. Physician sends
the patient with his father to the hospital for emergency admission and insulin drip. The
pediatrician meets the patient at the hospital and performs a medically appropriate
history and exam continuing treatment for the patient. How should the pediatrician code
the E/M service for this visit?
A. Office visit E/M code only
B. Initial Hospital Inpatient E/M code and Office Visit E/M code with modifier 25
C. Initial Hospital Inpatient E/M code only
D. Subsequent Hospital Inpatient E/M code – ANS b. Initial hospital inpatient E/M code
and office visit E/M coe with modifier 25
According to CPT® subsection guidelines for Initial Hospital Care: When the patient is
admitted to the hospital as an inpatient or to observation status in the course of an
encounter in another site of service (eg, hospital emergency department, office, nursing
facility), the services in the initial site may be separately reported. Modifier 25 may be
added to the other evaluation and management service to indicate a significant,
separately identifiable service by the same physician or other qualified health care
professional was performed on the same date.
A 2-year-old male requires a central venous catheter. Using xylocaine local anesthesia
a percutaneous approach is used in the neck and venous access is achieved. A
subcutaneous tunnel is created from the anterior chest wall to the venotomy site and the
catheter passed through the tunnel. The CV catheter is then placed at the superior vena
cava and sutured in position. Which procedure code is reported?
A. 36568
B. 36555
C. 36557
D. 36560 - ANSc. 36557
The selection of the central venous codes are based on the technique of placement, if
there is a use of port or pump, and the age of the patient. Procedure performed is for
placement of a central venous catheter eliminating multiple choice A. An access device
is not inserted eliminating multiple choice D. The documentation supports that a
subcutaneous tunnel is created to place the catheter guiding you to code 36557.
A 22 year old is in an outpatient facility for an inguinal hernia repair. Just before surgery,
the surgeon discovers the patient is positive for MRSA and the surgery is canceled.
Which ICD-10-CM code(s) shoudl be reported for the outpatient service?
a. A49.02
b. A49.01, K40.90, Z53.09
c. Z53.09
,d. K40.90, A49.02, Z53.09 - ANSd. K40.90, A49.02, Z53.09
ICD-10-CM guideline for outpatient services IV.A.1 states to report reason for the
surgery as the first listed diagnosis even if the surgery is canceled due to a
contraindication.
A 24 year old woman developed a keloid scar as a result of a third degree burn son the
LEFT upper arm. What ICD-10-Cm code(s) is/are reports?
a. L91.0
b. T22.332D
c. L91.0, T22.332S
d. T22.332A, L91.0 - ANSc. L91.0, T22.332S
A keloid is a type of scar resulting from granulation tissue at the site of a healed skin
injury. This would be considered a sequela (late effect) after the acute phase of the
burn. Per ICD-10-CM guideline I.B.10, coding of sequela generally requires 2 codes
sequenced in the following order: the condition or nature of the sequela is sequenced
first (keloid scar). The sequela code is sequenced second.
A 24-year-old patient had an abscess by her vulva which burst. She has developed a
soft tissue infection caused by gas gangrene. The area was debrided of necrotic
infected tissue. All of the pus was removed and irrigation was performed with a liter of
saline until clear and clean. The infected area was completely drained and the wound
was packed gently with sterile saline moistened gauze and pads were placed on top of
this. The correct CPT® code is:
A. 56405
B. 10061
C. 11004
D. 11042 - ANSc. 11004
The abscess had already burst, with no need to perform an incision to open it,
eliminating multiple choice answers A and B. The difference between multiple choice
answers C and D, is that the patient is having the debridement performed due to a soft
tissue infection in the perineum area. The correct code is 11004 for debridement of
necrotized infected tissue on the external genitalia.
A 41 year old male is in his doctor's office for a follow up of an abnormality which was
noted on an abdominal CT scan. He also had a chest x-ray (PA and lateral views)
performed in the office due to chest tightness. He states he otherwise feels well and is
here to go over the results of his chest x-ray performed in the office, and the CT scan
performed at the diagnostic center. The results of the chest x-ray were normal. CT scan
of the abdomen showed a small mass in his RIGHT upper quadrant. What CPT codes
are reported for the doctor's office radiological services?
a. 71046-26, 74150-26
b. 71046,74150
c. 71046-26, 74150
d. 71046, 74150-26 - ANSd. 71046, 74150-26
,Look in the CPT index for x-ray/chest. Code 71046 is the correct code for 2 views. The
chest x-ray was taken in the doctor's office and interpreted. This means the doctor's
office can bill the code without appending a modifier. Next look in the CPT book for
CT/scan/without contrast/abdomen. The correct code for the CT scan is 74150. Modifier
26 is appended to the CT scan code, as it was performed at another site and the doctor
only interpreted the image
A 45-year-old male is in outpatient surgery to excise a basal cell carcinoma of the right
nose and have reconstruction with an advancement flap. The 1.2 cm lesion with an
excised diameter of 1.5 cm was excised with a 15-blade scalpel down to the level of the
subcutaneous tissue, totaling a primary defect of 1.8 cm. Electrocautery was used for
hemostasis. An adjacent tissue transfer of 3 sq cm was taken from the nasolabial fold
and was advanced into the primary defect. Which CPT® code(s) is (are) reported?
A. 14060
B. 11642, 14060
C. 11642, 15115
D. 15574 - ANSA. 14060
An adjacent tissue transfer (advancement flap) was used to repair a defect on the nose
due to an excision of a malignant lesion, eliminating multiple choice answers C and D.
The section guidelines in the CPT® codebook for Adjacent Tissue or Rearrangement
indicate that the excision of a benign lesion (11400-11446) or a malignant lesion
(11600-11646) is included in codes for adjacent tissue transfer (14000-14302), and are
not separately reported. This eliminates multiple choice answer B.
A 46-year-old female with history of cervical carcinoma underwent placement of an ileal
conduit, with subsequent development of left hydronephrosis. A retrograde ureteral
catheter was recently placed. She returns today for catheter exchange. Patient was
placed in the supine on the operating table. The ileal conduit was accessed. The
existing catheter was removed over a guidewire and replaced with a similar 10 French
50 cm long locking pigtail catheter. Contrast was injected for monitoring, confirming
good position of the catheter placement. Interpretation and report is in the record.
IMPRESSION: Left retrograde ureteral catheter exchange via the ileal conduit. How is
this reported?
A. 50435
B. 50693
C. 50385
D. 50688, 75984-26 - ANSd. 50688, 75984-26
The patient presents for a ureteral catheter exchange via the ileal conduit. 50435 is not
correct because it is an exchange of the catheter percutaneously. 50693 is performed
using a percutaneous approach for placement of a ureteral stent, which is not
performed in this case. 50385 is performed using a transurethral approach, which is not
correct. The exchange is performed via the ileal conduit, which is reported with 50688.
Monitoring contrast imaging is performed. There is a parenthetical note under 50688
that states that imaging is reported with 75984.
, A 47-year-old patient was previously treated with external fixation for a type IIIA open
left tibia fracture. There is now nonunion of the left proximal tibia and he is admitted for
open reduction of tibia with bone grafting. Approximately 30 grams of cancellous bone
was harvested from the iliac crest. The fracture site was exposed and the area of
nonunion was osteotomized, cleaned, and repositioned. Interfragmentary compression
was applied and three screws and the harvested bone graft were packed into the
fracture site. What are the correct codes for this diagnosis and procedure?
A. 27724, S82.102N
B. 27758, S82.202S
C. 27722, S82.202P
D. 27759, S82.102N - ANSa. 27724, S82.102N
The selection of the code is based on the anatomic location and method of repair.
Codes are 27758 and 27759 are not reported with this scenario because the fracture is
not an acute traumatic fracture. The physician is repairing a nonunion tibia fracture
(failure of two ends of a fracture to completely heal). Eliminating multiple choices B and
D. To select the correct choice you need to find out what type of graft was used. Your
hints are "bone grafting" and "iliac crest," which leads you to the code 27724. The bone
graft was harvested from the iliac crest, and then the graft is placed at the fracture site
of the tibia compressing it for desired position and alignment and the screws were used
to stabilize the fracture.
In the ICD-10-CM Alphabetic Index, look for Nonunion/fracture-see Fracture, by site.
Look for Fracture, traumatic/tibia/upper end referring you to code S82.10-. Compete
code in the Tabular List, S82.102N. ICD-10-CM Coding Guideline, I.C.19.c.1, indicates
Care of complications of fractures, such as malunion and nonunion, should be reported
with the appropriate 7th character for subsequent care with nonunion (K, M, N) or
subsequent care with malunion (P, Q, R).
A 50 year old female presents to her provider with symptoms of insomnia and upset
stomach. The provider suspects she is in premenopausal. She is diagnosed with
impending menopause. What diagnosis coed (s) should be reported?
a. G47.00, K30
b. N95.9
c. N95.9, G47.00, K30
d. E28.319 - ANSa. G47.00, K30
ICD-10-CM guidelines I.B.11 states to reference the ICD-10-CM Alphabetic Index to
determine if the condition has a subentry for impending or threatened and reference
main term entries for Impending and Threatened. If the subterms are listed, assign the
given code. If the subterms are not listed, code the existing underlying condition(s) and
not the condition described as impending or threatening. Look in the Alphabetic Index
for Impending. There is not a subterm for menopause; therefore, the symptoms are
coded.
QUESTIONS & CORRECT ANSWERS|GRADED A+.
15-year-old male is seen by the pediatrician in his office for having excessive thirst and
frequent urination. A urine dip is performed showing +3 sugar and with some ketones.
Glucometer reading is done showing a blood sugar range of 500-600. Physician sends
the patient with his father to the hospital for emergency admission and insulin drip. The
pediatrician meets the patient at the hospital and performs a medically appropriate
history and exam continuing treatment for the patient. How should the pediatrician code
the E/M service for this visit?
A. Office visit E/M code only
B. Initial Hospital Inpatient E/M code and Office Visit E/M code with modifier 25
C. Initial Hospital Inpatient E/M code only
D. Subsequent Hospital Inpatient E/M code – ANS b. Initial hospital inpatient E/M code
and office visit E/M coe with modifier 25
According to CPT® subsection guidelines for Initial Hospital Care: When the patient is
admitted to the hospital as an inpatient or to observation status in the course of an
encounter in another site of service (eg, hospital emergency department, office, nursing
facility), the services in the initial site may be separately reported. Modifier 25 may be
added to the other evaluation and management service to indicate a significant,
separately identifiable service by the same physician or other qualified health care
professional was performed on the same date.
A 2-year-old male requires a central venous catheter. Using xylocaine local anesthesia
a percutaneous approach is used in the neck and venous access is achieved. A
subcutaneous tunnel is created from the anterior chest wall to the venotomy site and the
catheter passed through the tunnel. The CV catheter is then placed at the superior vena
cava and sutured in position. Which procedure code is reported?
A. 36568
B. 36555
C. 36557
D. 36560 - ANSc. 36557
The selection of the central venous codes are based on the technique of placement, if
there is a use of port or pump, and the age of the patient. Procedure performed is for
placement of a central venous catheter eliminating multiple choice A. An access device
is not inserted eliminating multiple choice D. The documentation supports that a
subcutaneous tunnel is created to place the catheter guiding you to code 36557.
A 22 year old is in an outpatient facility for an inguinal hernia repair. Just before surgery,
the surgeon discovers the patient is positive for MRSA and the surgery is canceled.
Which ICD-10-CM code(s) shoudl be reported for the outpatient service?
a. A49.02
b. A49.01, K40.90, Z53.09
c. Z53.09
,d. K40.90, A49.02, Z53.09 - ANSd. K40.90, A49.02, Z53.09
ICD-10-CM guideline for outpatient services IV.A.1 states to report reason for the
surgery as the first listed diagnosis even if the surgery is canceled due to a
contraindication.
A 24 year old woman developed a keloid scar as a result of a third degree burn son the
LEFT upper arm. What ICD-10-Cm code(s) is/are reports?
a. L91.0
b. T22.332D
c. L91.0, T22.332S
d. T22.332A, L91.0 - ANSc. L91.0, T22.332S
A keloid is a type of scar resulting from granulation tissue at the site of a healed skin
injury. This would be considered a sequela (late effect) after the acute phase of the
burn. Per ICD-10-CM guideline I.B.10, coding of sequela generally requires 2 codes
sequenced in the following order: the condition or nature of the sequela is sequenced
first (keloid scar). The sequela code is sequenced second.
A 24-year-old patient had an abscess by her vulva which burst. She has developed a
soft tissue infection caused by gas gangrene. The area was debrided of necrotic
infected tissue. All of the pus was removed and irrigation was performed with a liter of
saline until clear and clean. The infected area was completely drained and the wound
was packed gently with sterile saline moistened gauze and pads were placed on top of
this. The correct CPT® code is:
A. 56405
B. 10061
C. 11004
D. 11042 - ANSc. 11004
The abscess had already burst, with no need to perform an incision to open it,
eliminating multiple choice answers A and B. The difference between multiple choice
answers C and D, is that the patient is having the debridement performed due to a soft
tissue infection in the perineum area. The correct code is 11004 for debridement of
necrotized infected tissue on the external genitalia.
A 41 year old male is in his doctor's office for a follow up of an abnormality which was
noted on an abdominal CT scan. He also had a chest x-ray (PA and lateral views)
performed in the office due to chest tightness. He states he otherwise feels well and is
here to go over the results of his chest x-ray performed in the office, and the CT scan
performed at the diagnostic center. The results of the chest x-ray were normal. CT scan
of the abdomen showed a small mass in his RIGHT upper quadrant. What CPT codes
are reported for the doctor's office radiological services?
a. 71046-26, 74150-26
b. 71046,74150
c. 71046-26, 74150
d. 71046, 74150-26 - ANSd. 71046, 74150-26
,Look in the CPT index for x-ray/chest. Code 71046 is the correct code for 2 views. The
chest x-ray was taken in the doctor's office and interpreted. This means the doctor's
office can bill the code without appending a modifier. Next look in the CPT book for
CT/scan/without contrast/abdomen. The correct code for the CT scan is 74150. Modifier
26 is appended to the CT scan code, as it was performed at another site and the doctor
only interpreted the image
A 45-year-old male is in outpatient surgery to excise a basal cell carcinoma of the right
nose and have reconstruction with an advancement flap. The 1.2 cm lesion with an
excised diameter of 1.5 cm was excised with a 15-blade scalpel down to the level of the
subcutaneous tissue, totaling a primary defect of 1.8 cm. Electrocautery was used for
hemostasis. An adjacent tissue transfer of 3 sq cm was taken from the nasolabial fold
and was advanced into the primary defect. Which CPT® code(s) is (are) reported?
A. 14060
B. 11642, 14060
C. 11642, 15115
D. 15574 - ANSA. 14060
An adjacent tissue transfer (advancement flap) was used to repair a defect on the nose
due to an excision of a malignant lesion, eliminating multiple choice answers C and D.
The section guidelines in the CPT® codebook for Adjacent Tissue or Rearrangement
indicate that the excision of a benign lesion (11400-11446) or a malignant lesion
(11600-11646) is included in codes for adjacent tissue transfer (14000-14302), and are
not separately reported. This eliminates multiple choice answer B.
A 46-year-old female with history of cervical carcinoma underwent placement of an ileal
conduit, with subsequent development of left hydronephrosis. A retrograde ureteral
catheter was recently placed. She returns today for catheter exchange. Patient was
placed in the supine on the operating table. The ileal conduit was accessed. The
existing catheter was removed over a guidewire and replaced with a similar 10 French
50 cm long locking pigtail catheter. Contrast was injected for monitoring, confirming
good position of the catheter placement. Interpretation and report is in the record.
IMPRESSION: Left retrograde ureteral catheter exchange via the ileal conduit. How is
this reported?
A. 50435
B. 50693
C. 50385
D. 50688, 75984-26 - ANSd. 50688, 75984-26
The patient presents for a ureteral catheter exchange via the ileal conduit. 50435 is not
correct because it is an exchange of the catheter percutaneously. 50693 is performed
using a percutaneous approach for placement of a ureteral stent, which is not
performed in this case. 50385 is performed using a transurethral approach, which is not
correct. The exchange is performed via the ileal conduit, which is reported with 50688.
Monitoring contrast imaging is performed. There is a parenthetical note under 50688
that states that imaging is reported with 75984.
, A 47-year-old patient was previously treated with external fixation for a type IIIA open
left tibia fracture. There is now nonunion of the left proximal tibia and he is admitted for
open reduction of tibia with bone grafting. Approximately 30 grams of cancellous bone
was harvested from the iliac crest. The fracture site was exposed and the area of
nonunion was osteotomized, cleaned, and repositioned. Interfragmentary compression
was applied and three screws and the harvested bone graft were packed into the
fracture site. What are the correct codes for this diagnosis and procedure?
A. 27724, S82.102N
B. 27758, S82.202S
C. 27722, S82.202P
D. 27759, S82.102N - ANSa. 27724, S82.102N
The selection of the code is based on the anatomic location and method of repair.
Codes are 27758 and 27759 are not reported with this scenario because the fracture is
not an acute traumatic fracture. The physician is repairing a nonunion tibia fracture
(failure of two ends of a fracture to completely heal). Eliminating multiple choices B and
D. To select the correct choice you need to find out what type of graft was used. Your
hints are "bone grafting" and "iliac crest," which leads you to the code 27724. The bone
graft was harvested from the iliac crest, and then the graft is placed at the fracture site
of the tibia compressing it for desired position and alignment and the screws were used
to stabilize the fracture.
In the ICD-10-CM Alphabetic Index, look for Nonunion/fracture-see Fracture, by site.
Look for Fracture, traumatic/tibia/upper end referring you to code S82.10-. Compete
code in the Tabular List, S82.102N. ICD-10-CM Coding Guideline, I.C.19.c.1, indicates
Care of complications of fractures, such as malunion and nonunion, should be reported
with the appropriate 7th character for subsequent care with nonunion (K, M, N) or
subsequent care with malunion (P, Q, R).
A 50 year old female presents to her provider with symptoms of insomnia and upset
stomach. The provider suspects she is in premenopausal. She is diagnosed with
impending menopause. What diagnosis coed (s) should be reported?
a. G47.00, K30
b. N95.9
c. N95.9, G47.00, K30
d. E28.319 - ANSa. G47.00, K30
ICD-10-CM guidelines I.B.11 states to reference the ICD-10-CM Alphabetic Index to
determine if the condition has a subentry for impending or threatened and reference
main term entries for Impending and Threatened. If the subterms are listed, assign the
given code. If the subterms are not listed, code the existing underlying condition(s) and
not the condition described as impending or threatening. Look in the Alphabetic Index
for Impending. There is not a subterm for menopause; therefore, the symptoms are
coded.
