Updated Medical Tests AAPC-CPC Dumps – Check Free AAPC-CPC Exam Dumps (2025)
Updated AAPC-CPC exam with Medical Tests Real Exam Questions
NEW QUESTION # 22
Code the following procedure note:
A selective catheter is placed into the thoracic aorta, where it is then manipulated into the left coronary artery and followed through into the right common carotid artery. Contrast injections are made, and digital imaging is performed. Upon completion, the catheter is removed, pressure is applied at the puncture site, and the patient is discharged.
- A. 36215, 36216-59
- B. 0
- C. 36200, 36215, 36216-59
- D. 1
Answer: A
Explanation:
The left coronary artery and the right common carotid artery would each be considered their own vascular family. Therefore, when the starting point of selective catheterization is the aorta, the left coronary artery would be considered first order (36215) in the vascular family and the right common carotid artery would be considered the second order (36216). Modifier 59 is appended to indicate that a different vascular family was examined in one session. Contrast materials and catheterization into the aorta are inclusive to the nvo procedures and are not to be separately coded.
NEW QUESTION # 23
A physician provides a GIPO 39-weeks twin gestational patient with antepartum care, delivery, and postpartum care. Baby A was delivered vaginally without complications, and Baby B was delivered by Cesarean due to fetal tachycardi a. Assign the correct ICD-IO-CM and CPT codes.
- A. 59510, 076, Z3A39, Z37.o and 59409-51, Z3A39, Z37.o
- B. 59400, Z37.o and 59510-51, 036.8332, Z37.o
- C. 59409, Z3A.39, Z37.o and 59510-51, 076, Z3A39, Z37.o
- D. 59410, Z37.2 and 59510-51, 076, Z37.2
Answer: A
Explanation:
The Cesarean delivery (59510) would be sequenced first because this code has the highest RVU and would include the antepartum and postpartum care. The vaginal delivery by itself (59409), without antepartum and postpartum care, would be reported secondary because the charges for the antepartum and postpartum care of the mother have already been included in the Cesarean delivery code.
NEW QUESTION # 24
In the Current Procedural Terminology book, how is the icon "Excludes" meant to be interpreted?
- A. It may identify services that are not bundled and may lead the user to a more appropriatecode.
- B. Acausal relationship should be presumed between the tvo conditions.
- C. It may include services that are bundled and cannot be separately billed.
- D. An additional code should be reported to fully describe a condition.
Answer: A
Explanation:
The "Excludes" note identifies services that are not bundled into a procedure and may be reported in addition to the primary code. It may also lead the user to another code that would be more appropriate for the procedure being reported. Answer B describes "with." Answer C describes the icon "Includes." Answer D describes the "code also" note attached to a diagnosis.
NEW QUESTION # 25
Code the following note:
A male patient with a medical history of chronic obstructive pulmonary disease (COPD) presented to the emergency room 3 days ago with tachycardia and shortness of breath. He was intubated and admitted with acute respiratory failure (ARE) due to an acute exacerbation of COPD. Upon follow-up with the patient today, dark sputum was noted in the intubation tube, and testing confirmed aspiration pneumoni a. I will start him on 875 mg of amoxicillin every 12 hours and follow up tomorrow.
- A. 99233, 169.0
- B. 99231, 169.0, 196.00, 144.1
- C. 99232, 144.1, 196.00, 169.0, ROO.O
- D. 99232, 196.00, 144.1, 169.0
Answer: D
Explanation:
This documentation supports a decision-making of moderate complexity (number and complexity of problems addressed: high; amount and/or complexity of data to be reviewed and analyzed: minimal: diagnostic procedures and management examples: moderate), making CPT
99232 the most accurate description of services rendered. Regarding selection and sequencing of the diagnoses, always select the reason for the admission as the primary diagnosis code. In this case, the patient was admitted for ARF 096.00). The secondary code would be the underlying COPD
044.1), and conditions arising after admission would be tertiary and so forth. Tachycardia would not be reported because it is a symptom of ARF and symptoms are not reportable when the underlying disease has been confirmed.
NEW QUESTION # 26
An extracapsular cataract extraction procedure was performed on a patient with a clouded and discolored lens. The physician uses iris hooks in the right pupil to ensure safe and controlled access to the cataract and blue staining dye to visualize the capsulorhexis. Using suction, the existing lens capsule is removed, and an intraocular lens is inserted. What should the physician report?
- A. 66982-RT, Q12.8
- B. 66982-RT, H27.8
- C. 66984-RT, H26.8
- D. 66984-RT, H18.891
Answer: B
Explanation:
When deciding between a routine extracapsular cataract removal and a complex extracapsular cataract removal, bear in mind the code descriptor for a complex procedure involves
"devices or techniques not generally used in a routine cataract surgery (e.g., iris expansion device)." Because iris hooks were used, the procedure is complex (CPT 66982). When it comes to the diagnosis, do not get confused with the anatomy of the eye. Although the cornea works with the lens to help refract light, they are anatomically separate, thus eliminating answer B as an acceptable choice. A congenital condition is one that is genetic and/or present from birth. The documentation does not specifiy the origin, nor does it indicate when the lens abnormality began. Symptoms of a cataract include clouded and discolored lenses but should not be reported unless the physician clearly identifies this as the diagnosis. Coding crosswalk for diseases of the lens leads a coder to H27.8 (other specified disorders of lens).
NEW QUESTION # 27
A diaphragm resection and repair are done using a biologic mesh to reduce the formation of adhesions. Which procedure code should be reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: D
Explanation:
A diaphragm resection is reported with CPT codes 39560-39561. The use ofa biologic mesh makes the repair complex, whereas a simple repair would implement only internal sutures.
NEW QUESTION # 28
If a patient is receiving hospice care in a physician's office, which place of service code should be reported on the claim?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: C
Explanation:
Place of service (POS) codes "specify the entity where service(s) were rendered." In this case, hospice care was provided in an office, which would correspond to POS 11. POS 34 is hospice care provided in a facility, POS 71 is a public health clinic that provides ambulatory medical care, and POS 62 is an outpatient rehabilitation facility providing services that would include physical and occupational therapy.
NEW QUESTION # 29
Which is NOT a violation of Health Insurance Portability and Accountability Act (HIPAA)?
- A. An employee drops off patient records on a physician,s porch.
- B. An encrypted laptop is stolen from a physician,s vehicle.
- C. An office does not perform a risk assessment of electronic health information.
- D. A hospital with a multilayered cybersecurity defense experiences a data breach by acybercriminal.
Answer: D
Explanation:
HIPAA is in place to reduce the level of risk associated with a potential violation and/or breach. In answer C, even though a breach has occurred, the hospital has appropriate preventative measures in place and is not in violation of HIPAA. Leaving a laptop in an unattended vehicle or medical records outside is high-risk behavior that gives opportunity for an unauthorized person to access protected health information (PHI) and/or electronic protected health. In answer D, a medical practice is required to perform a risk analysis to PHI and/or ePHI and recti$ any failures within a timely manner.
NEW QUESTION # 30
A 72 -year-old patient is admitted due to atrial fibrillation. A comprehensive electrophysiology study is completed with fluoroscopic guidance, followed by a cardiac catheter ablation during the same procedure. The procedure took 22 minutes, and the patient was moderately sedated. Which CPT codes should the cardiologist report?
- A. 93650, 93619-26-59, 99152
- B. 93650, 93619-26-59, 77001, 99152, 99153
- C. 93656, 99152
- D. 93656, 77001, 99152, 99153
Answer: C
Explanation:
It is common practice to perform both an electrophysiology (EP) study and a cardiac ablation procedure in the same session. These procedures have been bundled in the CPC manual, and the coding of such is dependent on the type of arrhythmia being treated. The EP study and cardiac ablation are not to be reported separately. In this scenario, the patient has atrial fibrillation, which is reported with CPT 93656. When fluoroscopy is used for guidance rather than for diagnostic imaging, it is usually not reported separately from the primary procedure. Moderate sedation can be reported when used, and selection is based on time. CPT 99152 and 99153 are counted in 15-minute intervals. lvVhen the procedure does not fall on a 15-minute interval, it must at least meet the halfway point of the time stated to be reported.
NEW QUESTION # 31
A patient relocates after receiving treatment for an arm fracture. The patient schedules an appointment with a new orthopedist to remove the cast. The orthopedic office should report the fracture diagnosis code with the seventh character A to indicate active treatment.
- A. False
- B. True
Answer: A
Explanation:
The statement is false. When a patient is in the healing and/or recovery phase of an injury, the seventh character would be D to indicate that the care is subsequent-whether the provider has treated the patient in the past or not.
NEW QUESTION # 32
Which type of anesthesia is NOT separately reportable?
- A. Regional anesthesia
- B. Spinal anesthesia
- C. Metacarpal blocks
- D. Monitored anesthesia care
Answer: C
Explanation:
CPT surgery guidelines uphold that local infiltration, metacarpal/metatarsal/digital block, or topical anesthesia is always included in the surgical package. Under monitored anesthesia care (MAC), a patient is sedated but typically still aware, and the presence of qualified anesthesia personnel is required. Spinal and regional anesthesia is used for a variety of different procedures and is also separately reportable.
NEW QUESTION # 33
A patient has an elective bilateral vasectomy under regional anesthesi
a. The procedure is completed within 15 minutes. What CPT and ICD-IO-CM code(s) should the provider report?
- A. 55250, Z30.2
- B. 55250-50, Z30.8
- C. 55250, 00921, Z30.2
- D. 55250, 89321, Z30.8
Answer: A
Explanation:
A vasectomy includes a sperm analysis and regional anesthesia and should not be unbundled for higher reimbursement. A vasectomy includes both unilateral and bilateral sides, so modifier 50 should never be appended. In this circumstance, CPT 55250 should be billed as a standalone procedure to encompass all services delivered. Additionally, although the documentation does not give a specific diagnosis, it can be inferred from "elective" that the procedure is not to treat an underlying illness or injury. Therefore, Z30.2 (encounter for sterilization) is the evident diagnosis for this type of procedure because the patient is being sterilized. Z30.8 (encounter for other contraceptive management) can be used for an encounter discussing post vasectomy sperm count.
NEW QUESTION # 34
A low-risk obstetrical patient is told to come in for weekly ultrasounds in her first trimester. This is an example of what?
- A. Misuse
- B. Abuse
- C. Waste
- D. Fraud
Answer: C
Explanation:
In this case, the patient is not at risk, and most organs either are not developed and/or cannot be visualized in the first trimester. Thus, this would constitute as waste due to the provider overutilizing services that result in unnecessary cost. AAPC defines fraud as purposely billing "for services that were never given or to bill for a service that has a higher reimbursement than the service provided." Abuse is payment for services "that are billed by mistake by providers."
NEW QUESTION # 35
During surgery to remove a malignant melanoma from the intestinal tract, one frozen section is sent for pathological consultation to confirm an adequate excision of the margins. A second specimen is also sent, which requires frozen sections on two tissue blocks. What CPT code(s) should the pathologist report?
- A. 88331, 88332, 88332
- B. 88329, 88331, 88332, 88332
- C. 88331, 88332
- D. 88331, 88331, 88332
Answer: D
Explanation:
CPT code 88331 is used to report only a single specimen. In this scenario, there are Evo separate specimens being sent to the pathologist. The first specimen, with one frozen section, is reported with CPT code 88331. The second specimen has tv.ro tissue blocks with frozen sections, thus represented by coding 88331 for the first tissue block, followed by 88332 for the additional tissue block CPT code 88329 is inclusive to 88331 and should not be reported separately.
NEW QUESTION # 36
An established patient presents complaining of clumpy, white discharge for 3 days. A vaginal exam reveals an old tampon, which is removed. Diflucan is sent to the pharmacy, instructions given, and the patient is told to follow up in I week. How would the provider code the visit?
- A. 99213,N89.8, T19.2LXA
- B. 99213, T19.2XXA, N89.8
- C. 57415, 99212-25, T19.2kVA
- D. 57415, T19.2XXA, N89.8
Answer: B
Explanation:
Although a foreign body was removed, 57415 in answers A and B cannot be reported because anesthesia was not used. The documentation supports low-level medical decision making, so the appropriate E/M would be 99213. VVhen comparing answers C and D, bear in mind that ICD-IO-CM requires sequencing "the underlying condition first, followed by the manifestation."
NEW QUESTION # 37
A young man is triaged in the emergency room after sustaining multiple injuries in a car accident. The physician performs the following limited exams with image documentation: an abdominal and retroperitoneal ultrasound, a transthoracic echocardiography, and a chest ultrasound. He indicates in his report that all findings are normal. What charges should the provider submit to the insurance company?
- A. 93308, 76705-59, 76770-59, 76604-59
- B. 93304-26, 76705-26, 76775-26, 76604-26
- C. 93304-TC, 76700-TC, 76770-TC, 76604-TC
- D. 93308-26, 76705-26, 76775-26, 76604-26
Answer: D
Explanation:
CPT code 93304 describes an echocardiography used to evaluate a congenital defect. In this case, the provider is screening for any trauma-related injuries to the heart. Bearing in mind that the study is limited leads you to CPT 93308. Modifier 26 is used on all CPT codes because the procedures are being performed in a hospital setting. Therefore, only the professional component of the service should be billed. Modifier TC is reported by the entity providing the equipment, which in this case would be the hospital. Modifier 59 is not necessary because the procedures are routinely done in conjunction with each other.
NEW QUESTION # 38
A female patient presents to her obstetrical office 32 -weeks pregnant for a bi-weekly ultrasound. Code the following technician's report:
Fetal views obtained via transabdominal ultrasound as follows:
BPD: 32 mm
Femur Length: 63 mm
Head Circumference: 288 mm
Abdominal Circumference: 270 mm
BPP 8/8
NST from 11:15 to 12:17, showing 160 BPM and positive movement activity Doppler shows adequate systolic and diastolic flow velocities of the fetal umbilical artery.
- A. 76816, 76818, 76820
- B. 76815-TC, 76819-TC, 76820-TC
- C. 76816-TC, 76816-TC, 76820-TC
- D. 76815, 78819, 76820
Answer: A
Explanation:
CPT 76815 is a limited ultrasound, in which only the fetal heartbeat, position, placental location, and/or volume of amniotic fluid are evaluated. In this scenario, much more was done than a limited study. The ultrasound technician documented age-appropriate fetal measurements, which are supported by CPT 76816. A biophysical profile (BPP) was also done, which monitors the fetus's movements, tone, and breathing as well as evaluates the volume of amniotic fluid. Each of these elements counts as 2 units of grading to evaluate the general well-being ofthe fetus. The desired score of a BPP is 8/8. Because a fetal nonstress test (NST) was completed in conjunction with a BPP, report CPT 76818 instead of CPT 76819. Modifier TC is used to reflect that only a technical component of the procedure was completed. However, because the patient received these services in an obstetrical office that employs the physicians providing prenatal care and owns the ultrasound equipment the code should be submitted without modifiers TC or 26 to receive 100% reimbursement.
NEW QUESTION # 39
A patient is seen in the emergency room with a thermal burn to the left thigh because of a fire. The patient denies feelings of hypothermi a. Vitals are obtained, and a physical examination reveals that approximately 4% of the body is affected by second-degree burns, and nonviable tissue needs to be removed to avoid the risk of infection. After consent is obtained, the physician debrides the wound, cleanses the area, and applies a gauze. The patient is discharged and told to follow up with their primary care physician in 2 days. What CPT code(s) should be reported for this encounter?
- A. 99283-25, 16020
- B. 99282-25, 16020
- C. 0
- D. 16020, 99282
Answer: A
Explanation:
When billing for physician services in the emergency room, it is appropriate to report a standalone E/M when the documentation supports its necessity in determining the need for appropriate treatment. Modifier 25 is necessary to the E/M code when being billed alongside a procedure and/or surgery to indicate a separately billable service. In this case, the documentation supports decision-making of moderate complexity. CPT code 99283 meets these criteria, whereas CPT code 99282 reflects a medical decision-making of low complexity and does not accurately portray the services rendered. The emergency room visit is always the first listed code, followed by the procedure and/or surgery performed.
NEW QUESTION # 40
Which form is used to make a patient aware of the potential monetary liability they will have if their procedure is not likely to be covered by Medicare?
- A. Health Insurance Portability and Accountability Act (HIPAA) Release
- B. Payment Plan Contract
- C. National Coverage Determination
- D. Advance Beneficiary Notice
Answer: D
Explanation:
National Coverage Determination is a reference guide for physicians to determine which services are covered by Medicare. The HIPAA Release is a form that must be signed by the patient prior to release of medical records and can be revoked at any time. The HIPAA Privacy Rule is in place to protect the patien& health information.
NEW QUESTION # 41
A patient is scheduled for a total knee replacement. The assigned anesthesiologist performs a femoral nerve block using an ultrasound machine just prior to entering the operating room to aid in postoperative pain control. Once in the operating room, general anesthesia is administered to the patient. What CPT code(s) should the anesthesiologist report?
- A. 01400, 01991, 76942
- B. 01400, 01991-59
- C. 01402
- D. 01402,64447_59, 76942
Answer: D
Explanation:
CPT crosswalk for anesthesia administered during a total knee replacement is 01402.
Although CPT 01991 does describe a nerve block, it is considered monitored anesthesia care because the patient is awake. However, in this scenario, general anesthesia is being used for the primary procedure, and the femoral nerve block is administered for postoperative pain management. Therefore, the nerve block would be billed as CPT 64447 with modifier 59 to indicate that it is separately reportable from the primary procedure. If, on the other hand, the nerve block was being used as a component of the general anesthesia, CPT 64447 would be considered inclusive to the general anesthesia and not reported separately. Ultrasound guidance is not currently bundled with the administration of a nerve block and, when used, should be reported separately with CPT 76942.
NEW QUESTION # 42
CPT code 99135 is an example of a qualifying circumstance.
- A. False
- B. True
Answer: B
Explanation:
The statement is true. When it comes to reporting anesthesia services, qualifying circumstances are factors that put a patient at an unusually high health risk. A qualifring circumstance is reported with CPT codes 99100-99140, which are listed separately, in addition to the primary anesthesia code. If reporting one of these add-on codes, documentation must be submitted to support the necessity of such services.
NEW QUESTION # 43
A patient with right knee pain is seen in a physician's office for an x-ray. Anteroposterior and lateral views of the right knee were obtained by the technician, and images confirm right knee pain secondary to degenerative osteoarthritis. Which CPT and ICD-IO-CM code(s) should be reported?
- A. 73560-TC-RT, MI 7.11, M25.561
- B. 73560-TC-RT, MI 7.11
- C. 73560-RT, MI 7.11
- D. 73560-26-RT, MI 7.11, M25.561
Answer: C
Explanation:
The CPT crosswalk for x-ray of knee directs the coder to 73560-73580. Because two views were obtained, the correct code would be 73560 (radiologic examination, knee; I or 2 views).
Modifier TC and modifier 26 indicate only technical and professional components: however, because the x-ray was performed in a physician's office, 73560 would be reported without either because the practice provided both components. In terms of diagnosis, the knee pain would not be reported because it is a symptom of a definitive diagnosis.
NEW QUESTION # 44
Which option would best fall under a level II HCPC code?
- A. Diagnostic colonoscopy
- B. Advanced life support
- C. A malignant neoplasm
- D. Radiation treatment management
Answer: B
Explanation:
A level II HCPC code describes medical devices, supplies, medication, and/or other services that a provider and/or entity used during a service provided to a patient. Advanced life support (ALS) fits this description because it is a set of life-saving protocols administered in transit.
Radiation treatment management and a diagnostic colonoscopy describe a level I HCPC code, otherwise known as a CPT code. If the patient was asymptomatic and the colonoscopy was for screening purposes only, a level II HCPC code could be assigned. However, a diagnostic procedure implies a past medical/family history that puts the patient at risk and/or symptoms that warrant the procedure. A malignant neoplasm describes an ICD-IO-CM code because it is a diagnosis.
NEW QUESTION # 45
What describes a surgical procedure that removes a portion of the vertebral body to relieve pressure on the spinal cord and nerves?
- A. Spinal fusion
- B. Corpectomy
- C. Laminectomy
- D. Insertion of interspinous process stabilization device
Answer: B
Explanation:
The insertion of an interspinous process stabilization device is done to increase the space within the neural foramen, release nerve pressure that causes physical pain, and create spinal stabilization. A spinal fusion is a surgical procedure that permanently joins Nto or more vertebrae into one solid bone so that no space exists between them. A laminectomy is a surgical procedure that removes the lamina to enlarge the spinal canal and relieve pressure on the spinal cord and/or nerves.
NEW QUESTION # 46
Which statement is true regarding the diaphragm?
- A. It is a collection of organs held together by connective tissue.
- B. It separates the thoracic cavity from the abdominal cavity.
- C. It performs an important function in blood flow.
- D. It forms tendons, ligaments, cartilage, and fat.
Answer: B
Explanation:
The diaphragm separates the thoracic cavity from the abdominal cavity by means of skeletal muscle. When the diaphragm contracts, air is drawn into the lungs. It therefore plays a key role in respiration. The mediastinum is surrounded by loose connective tissue and contains several anatomical structures including the heart. Connective tissue is distributed throughout the body to form tendons, ligaments, cartilage, and fat.
NEW QUESTION # 47
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