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AAPC CPC FINAL EXAM 2023-2024 REAL EXAM WITH
QUESTIONS AND CORRECT ANSWERS(VERIFIED
ANSWERS)|AGARDE
A 46-year-old female had a previous biopsy that indicated positive malignant margins anteriorly on the right side of her neck. A 0.5 cm margin was drawn out and a 15 blade scalpel was used for full excision of an 8 cm lesion. Layered closure was performed after the removal. The specimen was sent for permanent histopathologic examination. What are the CPT® code(s) for this procedure? A. 11626 B. 11626, 12004 - 51 C. 11626, 12044 - 51 D. 11626, 13132 - 51, 13133 - C. 11626, 12044 - 51 A 30-year-old female is having 15 sq cm debridement performed on an infected ulcer with eschar on the right foot. Using sharp dissection, the ulcer was debrided all the way to down to the bone of the foot. The bone had to be minimally trimmed because of a sharp point at the end of the metatarsal. After debriding the area, there was minimal bleeding because of very poor circulation of the foot. It seems that the toes next to the ulcer may have some involvement and cultures were taken. The area was dressed with sterile saline and dressings and then wrapped. What CPT® code should be reported? A. 11043 B. 11012 C. 11044 D. 11042 - C. 11044 A 64-year-old female who has multiple sclerosis fell from her walker and landed on a glass table. She lacerated her forehead, cheek and chin and the total length of these lacerations was 6 cm. Her right arm and left leg had deep cuts measuring 5 cm on each extremity. Her right hand and right foot had a total of 3 cm lacerations. The ED physician repaired the lacerations as follows: The forehead, cheek, and chin had debridement and cleaning of glass debris with the lacerations being closed with one layer closure, 6-0 Prolene sutures. The arm and leg were repaired by layered closure, 6-0 Vicryl subcutaneous sutures and Prolene sutures on the skin. The hand and foot were closed with adhesive strips. Select the
appropriate procedure codes for this visit. A. 99283 - 25, 12014, 12034 - 59, 12002 - 59, 11042 - 51 B. 99283 - 25, 12053, 12034 - 59, 12002 - 59 C. 99283 - 25, 12014, 12034 - 59, 11042 - 51 D. 99283 - 25, 12053, 12034 - 59 - D. 99283 - 25, 12053, 12034 - 59 A 52-year-old female has a mass growing on her right flank for several years. It has finally gotten significantly larger and is beginning to bother her. She is brought to the Operating Room for definitive excision. An incision was made directly overlying the mass. The mass was down into the subcutaneous tissue and the surgeon encountered a well encapsulated
A. 21932, D17.
B. 21935, D17.
C. 21931, D17.
D. 21925, D17.9 - C. 21931, D17.
Question 5 PREOPERATIVE DIAGNOSIS: Right scaphoid fracture. TYPE OF PROCEDURE: Open reduction and internal fixation of right scaphoid fracture. DESCRIPTION OF PROCEDURE: The patient was brought to the operating room; anesthesia having been administered. The right upper extremity was prepped and draped in a sterile manner. The limb was elevated, exsanguinated, and a pneumatic arm tourniquet was elevated. An incision was made over the dorsal radial aspect of the right wrist. Skin flaps were elevated. Cutaneous nerve branches were identified and very gently retracted. The interval between the second and third dorsal compartment tendons was identified and entered. The respective tendons were retracted. A dorsal capsulotomy incision was made, and the fracture was visualized. There did not appear to be any type of significant defect at the fracture site. A 0. Kirschner wire was then used as a guidewire, extending from the proximal pole of the scaphoid distal ward. The guidewire was positioned appropriately and then measured. A 25 - mm Acutrak® drill bit was drilled to 25 mm. A 22.5-mm screw was selected and inserted and rigid internal fixation was accomplished in this fashion. This was visualized under the OEC imaging device in multiple projections. The wound was irrigated and closed in layers. Sterile dressings were then applied. The patient tolerated the procedure well and left the operating room in stable condition. What CPT® code is reported for this procedure? A. 25628-RT B. 25624-RT C. 25645 - RT D. 25651 - RT - A. 25628 - RT An infant with genu valgum is brought to the operating room to have a bilateral medial distal femur hemiepiphysiodesis done. On each knee, the C-arm was used to localize the growth plate. With the growth plate localized, an incision was made medially on both sides. This was taken down to the fascia, which was opened. The periosteum was not opened. The Orthofix® figure-of-eight plate was placed and checked with X-ray. We then irrigated and closed the medial fascia with 0 Vicryl suture. The skin was closed with 2-0 Vicryl and 3- 0 Monocryl®. What procedure code is reported? A. 27470 - 50 B. 27475 - 50 C. 27477 - 50 D. 27485 - 50 - D. 27485 - 50 The patient is a 67 - year-old gentleman with metastatic colon cancer recently operated on
for a brain metastasis, now for placement of an Infuse-A-Port for continued chemotherapy. The left subclavian vein was located with a needle and a guide wire placed. This was confirmed to be in the proper position fluoroscopically. A transverse incision was made just inferior to this and a subcutaneous pocket created just inferior to this. After tunneling,
A 52-year-old patient is admitted to the hospital for chronic cholecystitis for which a laparoscopic cholecystectomy will be performed. A transverse infraumbilical incision was made sharply dissecting to the subcutaneous tissue down to the fascia using access under direct vision with a Vesi-Port and a scope was placed into the abdomen. Three other ports
were inserted under direct vision. The fundus of the gallbladder was grasped through the lateral port, where multiple adhesions to the gallbladder were taken down sharply and bluntly: The gallbladder appeared chronically inflamed. Dissection was carried out to the right of this identifying a small cystic duct and artery, was clipped twice proximally, once distally and transected. The gallbladder was then taken down from the bed using electrocautery, delivering it into an endo-bag and removing it from the abdominal cavity with the umbilical port. What CPT® and ICD- 10 - CM codes are reported? A. 47564, K81. B. 47562, K81. C. 47610, K81. D. 47600, K81.1 - B. 47562, K81. A 70-year-old female who has a history of symptomatic ventral hernia was advised to undergo laparoscopic evaluation and repair. An incision was made in the epigastrium and dissection was carried down through the subcutaneous tissue. Two 5-mm trocars were placed, one in the left upper quadrant and one in the left lower quadrant and the laparoscope was inserted. Dissection was carried down to the area of the hernia where a small defect was clearly visualized. There was some omentum, which was adhered to the hernia and this was delivered back into the peritoneal cavity. The mesh was tacked on to cover the defect. What procedure code(s) is (are) reported? A. 49560, 49568 B. 49652 C. 49653 D. 49652, 49568 - B. 49652 The patient is a 50-year-old gentleman who presented to the emergency room with signs and symptoms of acute appendicitis with possible rupture. He has been brought to the operating room. An infraumbilical incision was made which a 5-mm VersaStep™ trocar was inserted. A 5-mm 0- degree laparoscope was introduced. A second 5-mm trocar was placed suprapubically and a 12-mm trocar in the left lower quadrant. A window was made in the mesoappendix using blunt dissection with no rupture noted. The base of the appendix was then divided and placed into an Endo-catch bag and the 12 - mm defect was brought out. Select the appropriate code for this procedure: A. 44970 B. 44950 C. 44960 D. 44979 - A. 44970 A 45-year-old male is going to donate his kidney to his son. Operating ports where placed in standard position and the scope was inserted. Dissection of the renal artery and vein was performed isolating the kidney. The kidney was suspended only by the renal artery and vein as well as the ureter. A stapler was used to divide the vein just above the aorta and
C. 50300
D. 50320 - B. 50547
A 67-year-old female having urinary incontinence with intrinsic sphincter deficiency is having a cystoscopy performed with a placement of a sling. An incision was made over the mid urethra dissected laterally to urethropelvic ligament. Cystoscopy revealed no penetration of the bladder. The edges of the sling were weaved around the junction of the urethra and brought up to the suprapubic incision. A hemostat was then placed between the sling and the urethra, ensuring no tension. What CPT® code(s) is (are) reported? A. 57288 B. 57287 C. 57288, 52000 - 51 D. 51992, 52000 - 51 - A. 57288 A 16-day-old male baby is in the OR for a repeat circumcision due to redundant foreskin that caused circumferential scarring from the original circumcision. Anesthetic was injected and an incision was made at base of the foreskin. Foreskin was pulled back and the excess foreskin was taken off and the two raw skin surfaces were sutured together to create a circumferential anastomosis. Select the appropriate code for this surgery: A. 54150 B. 54160 C. 54163 D. 54164 - C. 54163 5 year-old female has a history of post void dribbling. She was found to have extensive labial adhesions, which have been unresponsive to topical medical management. She is brought to the operating suite in a supine position. Under general anesthesia the labia majora is retracted and the granulating chronic adhesions were incised midline both anteriorly and posteriorly. The adherent granulation tissue was excised on either side. What code should be used for this procedure? A. 58660 B. 58740 C. 57061 D. 56441 - D. 56441 The patient is a 64 year-old female who is undergoing a removal of a previously implanted Medtronic pain pump and catheter due to a possible infection. The back was incised; dissection was carried down to the previously placed catheter. There was evidence of infection with some fat necrosis in which cultures were taken. The intrathecal portion of the catheter was removed. Next the pump pocket was incised and the pump was dissected from the anterior fascia. A 7 - mm Blake drain was placed in the pump pocket through a stab incision and secured to the skin with interrupted Prolene. The pump pocket was copiously
irrigated with saline and closed in two layers. What are the CPT® and ICD- 10 - CM codes for this procedure? A. 62365, 62350 - 51, T85.898A, Z46. B. 62360, 62355 - 51, T85.79XA
medical decision making of moderate complexity. Which E/M service is reported? A. 99285 B. 99284 C. 99221
D. 99222 - C. 99221
A 20 - day-old infant was seen in the ER by the neonatologist admitting the baby to NICU for cyanosis and rapid breathing. The neonatologist performed intubation, ventilation management and a complete echocardiogram in the NICU and provided a report for the echocardiography which did indicate congenital heart disease. Select the correct codes for the physician service. A. 99468 - 25, 93303 - 26 B. 99471 - 25, 31500, 94002, 93303 - 26 C. 99460 - 25, 31500, 94002, 93303 - 26 D. 99291 - 25, 93303 - 26 - A. 99468 - 25, 93303 - 26 A 42-year-old with renal pelvis cancer receives general anesthesia for a laparoscopic radical nephrectomy. The patient has controlled type 2 diabetes otherwise no other co- morbidities. What is the correct CPT® and ICD- 10 - CM code for the anesthesia services? A. 00860 - P1, C64.9, E11. B. 00840-P3, C65.9, E11. C. 00862 - P2, C65.9, E11. D. 00868 - P2, C79.02, E11.9 - C. 00862 - P2, C65.9, E11. A healthy 32 - year-old with a closed distal radius fracture received monitored anesthesia care for an ORIF of the distal radius. What is the code for the anesthesia service? A. 01830 - P B. 01860-QS-P C. 01830 - QS-P D. 01860 - QS-G9-P1 - C. 01830 - QS-P A 10 - month-old child is taken to the operating room for removal of a laryngeal mass. What is (are) the appropriate anesthesia code(s) to report? A. 00320 B. 00326 C. 00320, 99100 D. 00326, 99100 - B. 00326 A catheter is placed in the left common femoral artery which was directed into the right the external iliac (antegrade). Dye was injected and a right lower extremity angiogram was performed which revealed patency of the common femoral and profunda femoris. The catheter was then manipulated into the superficial femoral artery (retrograde) in which a lower extremity angiogram was performed which revealed occlusion from the popliteal to the tibioperoneal artery. What are the procedure codes that describe this procedure? A. 36217, 75736 - 26 B. 36247, 75716 - 26
56 - year-old female is having a bilateral mammogram with computer aid detection conducted as a screening because the patient has a family history of breast cancer. She does not presently have signs or symptoms of breast disease. What radiological services are reported? A. 77065 x 2 B. 77065, 77066 C. 77067 D. 77066 - C. 77067 A 63-year-old patient with bilateral ureteral obstruction presents to an outpatient facility for placement of a right and left ureteral stent along with an interpretation of a retrograde pyelogram. What codes should be reported? A. 52332, 74425 B. 52332 - 50, 74420 - 26 C. 52005, 74420 D. 52005 - 50, 74425 - 26 - B. 52332 - 50, 74420 - 26 Patient is coming in for a pathological examination for ischemia in the left leg. The first specimen is 1.5 cm of a single portion of arterial plaque taken from the left common femoral artery. The second specimen is 8.5 x 2.7 cm across x 1.5 cm in thickness of a cutaneous ulceration with fibropurulent material on the left leg. What surgical pathology codes should be reported for the pathologist? A. 88304 - 26, 88302 - 26 B. 88305 - 26, 88304 - 26 C. 88307 - 26, 88305 - 26 D. 88309 - 26, 88307 - 26 - B. 88305 - 26, 88304 - 26 During a craniectomy the surgeon asked for a consult and sent a frozen section of a large piece of tumor and sent it to pathology. The pathologist received a rubbery pinkish tan tissue measuring in aggregate 3 x 0.8 x 0.8 cm. The entire specimen is submitted in one block and also a gross and microscopic examination was performed on the tissue. The frozen section and the pathology report are sent back to the surgeon indicating that the tumor was a medulloblastoma. What CPT® code(s) will the pathologist report? A. 80500 B. 88331 - 26, 88307 - 26 C. 80502 D. 88331 - 26, 88332 - 26, 88304 - 26 - B. 88331 - 26, 88307 - 26 Physician orders a basic (80047) and comprehensive metabolic (80053) panels. Select the code(s) on how this is reported. A. 80053, 80047 B. 80053
- C. 36217, 75756 -
- D. 36247, 75710 - 26 - D. 36247, 75710 -
- C. 80047, 82040, 82247, 82310, 84075, 84155, 84460,
- D. 80053, 82330 - D. 80053,
eyelid. B. Entropion is facial droop and ectropion is a facial spasm. C. Entropion is the outward turning of the hands and ectropion is the inward turning of the hands.
D. Entropion inward turning of the feet and ectropion is the outward turning of the feet due to muscle disorder. - A. Entropion is the inward turning of the eyelid and ectropion is the outward turning of the eyelid. What is the full CPT® code description for 00846? A. Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy B. Radical hysterectomy C. Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified radical hysterectomy D. Radical hysterectomy not otherwise specified - A. Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy Ventral, umbilical, spigelian and incisional are types of: A. Surgical approaches B. Hernias C. Organs found in the digestive system D. Cardiac catheterizations - B. Hernias Fracturing the acetabulum involves what area? A. Skull B. Shoulder C. Pelvis D. Leg - C. Pelvis When a patient is having a tenotomy performed on the abductor hallucis muscle, where is this muscle located? A. Foot B. Upper Arm C. Upper Leg D. Hand - A. Foot A 44-year-old had a history of adenocarcinoma of the cervix on a conization in March 20XX who has been followed with twice-yearly endocervical curettages and Pap smears that were all negative for two years, per the recommendation of a GYN oncologist. Her Pap smear results from the last visit noted atypical glandular cells. In light of this, she underwent a colposcopy and the biopsy of the normal-appearing cervix on colposcopy was benign. The endocervical curettage was benign endocervical glands, and the endometrial sampling was benign endometrium. In light of the fact that she had had previous atypical glandular cells that led to diagnosis of adenocarcinoma and the concerns that this may have recurred, she had been recommended for a cone biopsy and fractional dilatation and curettage, which she is undergoing today. What ICD- 10 - CM code(s) should be reported?
