AAPC-CPC Actual Questions Answers Pass With Real AAPC-CPC Exam Dumps
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NEW QUESTION # 89
V codes are related to which procedures/products?
- A. Enteral therapy
- B. Durable medical equipment
- C. Orthotic procedures
- D. Hearing services
Answer: D
Explanation:
Durable medical equipment is represented by E codes, orthotic procedures are L codes, and enteral therapy is inclusive to B codes in the HCPC manual.
NEW QUESTION # 90
ICD-IO-CM codes R50.9, R05.9, R53.81, and 102.9 are all symptoms ofJ10.00.
- A. True
- B. False
Answer: A
Explanation:
The statement is true. In general, R codes are descriptive of a patient's signs and symptoms.
ICD-IO-CM crosswalk for an unspecified sore throat is 102.9 (acute pharyngitis) and is also considered a symptom of the influenza and pneumonia. Being that there is a definitive diagnosis of an influenza, these symptoms would not be reported to an insurance carrier with Jl 0.00.
NEW QUESTION # 91
What is/are the code(s) for the repair of an incarcerated hernia in the inner groin requiring mesh placement on a 32-year-old female patient?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: D
Explanation:
There are several different types ofhernias that are categorized by their location. A hernia located in the inner groin is inguinal, and a hernia located on the outer groin is femoral. The repair of an incarcerated inguinal hernia on a 32 -year-old patient is coded to CPT 49507. Hernia mesh is used to reduce the risk of recurrence, and implantation of it is inclusive to an inguinal, umbilical, femoral, and laparoscopic hernia repair.
NEW QUESTION # 92
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. Payment Plan Contract
- B. Advance Beneficiary Notice
- C. Health Insurance Portability and Accountability Act (HIPAA) Release
- D. National Coverage Determination
Answer: B
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 # 93
Which patient is receiving critical care services?
- A. A 60-year-old male is admitted with an acute chronic heart failure exacerbation causinghypoxic respiratory failure. The patient is intubated, sedated, and started on 50 mg ofertapenem for a potential lung infection.
- B. A 47 -year-old female with a history of unrepaired chronic heart disease and anemia has anoxygen saturation level of 80. She is put on a nasal cannula and given a blood transfusion toimprove her oxygen-carrying capacity and oxygen saturation level.
- C. A 93 -year-old male is admitted to the intensive care unit for monitoring after a coronaryangioplasty procedure that was performed to relieve symptoms of atherosclerosis.
- D. A 67 -year-old female receives chronic ventilator therapy after a cerebral infarction thatcaused hemorrhage in the brain.
Answer: A
Explanation:
CPT guidelines define critical care as an illness or injury that acutely impairs one or more vital organ systems, where there is a high probability of imminent or life-threatening deterioration in the patients condition. Additionally, to report a critical care service, the documentation should provide evidence of high-complexity medical decision-making (e.gendotracheal tube insertion, defibrillation, fluid administration for shock, Narcan, etc.). Answer B is the only option listed that contains documentation to support critical care services.
This male patient has Vyvo life-threatening conditions, in which emergent intervention is provided to prevent further deterioration. In ansvver A the female patient may have a life-threatening condition: however, administering oxygen via a nasal cannula and/or transfusing blood does not qualify as critical care. Management of a patient who receives chronic ventilator therapy is also not considered critical care because the medical decision-making involved in the therapy is quite low.
The care a patient receives after having surgery would be considered routine and postoperative, regardless of where they are sent, unless a complication arises in which one or more of the vital organ systems begins to deteriorate in a fashion that poses a threat to life.
NEW QUESTION # 94
A gastroenterologist performs a gastric bypass surgery on an obese patient with a body mass index of 52. During the procedure, the size of the stomach is reduced by 77%; the intestine is bypassed from the duodenum and then attached to the ileum. The pylorus is preserved and left intact. Which CPT code best describes the surgery performed?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: D
Explanation:
In this scenario, the gastroenterologist performed a procedure known as a biliopancreatic diversion with duodenal switch (BPD/DS). A BPD/DS removes a portion of the stomach and transfers parts of the duodenum and small intestine to the lower end of the large intestine in an effort to limit intestinal absorption for weight loss. CPT codes 43842-43843 describe gastric restrictive procedures without gastric bypass. However, gastric bypass was done in rearranging the small intestine to connect to the ileum.
NEW QUESTION # 95
What must the documentation for a consultation include?
- A. Which family member prompted the consultation, a written report ofthe physical findings/recommendations, and the time spent discussing the recommended treatment plan
- B. Documentation of assumption of care, who requested the consultation, and the consultingproviders, professional opinion
- C. The reason for the consultation, the time spent discussing the recommended treatmentplan, and a medical decision-making of moderate complexity
- D. Who requested the consultation, the consulting providers, professional opinion, and awritten report that is provided to the referring physician
Answer: D
Explanation:
Per CPT guidelines, the Office of Inspector General, and Medicare, a consultation must include who requested the consultation, the consulting provider's professional opinion, and a written report of the findings, which is provided to the referring physician. Time can be used to select the level of E/M; however, it is not required if all three components of the documentation are met (history, exam, and medical decision-making). Additionally, once the provider assumes care, a subsequent code appropriate for that place of service would be reported (e.g., 99211-99215) and not a consultation code.
NEW QUESTION # 96
A patient tests positive for coronavirus (SARS-CoV-2) and bronchitis after presenting with a cough. What diagnosis code(s) should be reported?
- A. U07.1,J40
- B. J40,B97.29, Z20.828
- C. 140, 897.29, R05.9
- D. U07.1,J40, Z20.828
Answer: A
Explanation:
The underlying condition should always be first listed, which in this case would be the SARS- COV-2 infection (U07.1). The description of the code then prompts the biller to list the manifestations, which would be the unspecified bronchitis 040). In answer A. cough would not be coded as a symptom because the patients illness is confirmed. Answers C and D, which include a suspected exposure code, can also be eliminated because this code is used only when the existence ofthe illness in the patient is unknown or negative.
NEW QUESTION # 97
Which is NOT considered inclusive to hydration services?
- A. Catheter flush
- B. Subcutaneous catheter access
- C. Flush solution
- D. Catheter declotting
Answer: D
Explanation:
Catheter access, standard supplies such as a flush solution, and the flush at the end of the infusion are all considered necessary to facilitate the infusion and are inclusive to CPT codes
96360-96361. Declotting a catheter involves the injection of a thrombolytic agent to dissolve the clot and is separately reportable with CPT 36593.
NEW QUESTION # 98
In which scenario would the modifier 53 be appended?
- A. A patient receives an x-ray of one femur when the doctor ordered bilateral views.
- B. A surgeon decides to stop a gallbladder removal procedure in the hospital operating roomafter the patient has extensive bleeding at the incision site.
- C. An IUD removal is not completed because the patient reports severe pain when thespeculum is inserted.
- D. The surgeon decides to terminate a routine colonoscopy when the patient becomeshypertensive before receiving anesthesia in the outpatient procedure room.
Answer: B
Explanation:
Modifier 53 is used to indicate that a procedure was terminated by the provider after anesthesia was given due to extenuating circumstances that affected the health of the patient.
Although option B is similar, the procedure that was discontinued was done so prior to anesthesia in the outpatient setting, in which case modifier 73 would be appended.
NEW QUESTION # 99
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: D
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 # 100
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. 59400, Z37.o and 59510-51, 036.8332, Z37.o
- B. 59510, 076, Z3A39, Z37.o and 59409-51, Z3A39, Z37.o
- C. 59410, Z37.2 and 59510-51, 076, Z37.2
- D. 59409, Z3A.39, Z37.o and 59510-51, 076, Z3A39, Z37.o
Answer: B
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 # 101
Diagnostic endoscopy is always inclusive to a surgical endoscopy.
- A. True
- B. False
Answer: A
Explanation:
The statement is true. When multiple endoscopic procedures are performed in the same session, only the most extensive service should be reported. In this case, it would be the surgical endoscopy because it has a higher revenue value.
NEW QUESTION # 102
A 34-year-old established male patient presents for treatment to his lower back. He reports exacerbated symptoms due to lifting heavy materials at work. The osteopath performs a problem-focused history and exam followed by manipulative treatment to the lumbar and sacral region of the spine. What procedure(s) should the osteopath report?
- A. 0
- B. 99212-25, 97140x2
- C. 99212-25, 98925
- D. 1
Answer: C
Explanation:
Osteopathic manipulation services do not include evaluation and management services.
Although the patient's treatment has already been established, the osteopathic physician has enough supporting documentation to report a separate evaluation and management code.
Manipulation services rendered by an osteopathic physician are reported with CPT codes 98925-
98929. A chiropractor would report manipulative treatment to t'.vo body regions with CPT 98940, and a physical therapist would report CPT 97140.
NEW QUESTION # 103
A 74-year-old male patient recently had a bone marrow transplant due to aplastic anemi a. At his follow-up visit with the doctor, his blood is drawn and sent to the laboratory to determine if the engraftment was successful. The laboratory evaluates the immature reticulocyte fraction (IRF) using an automated cell counter and total reticulocyte by way of a manual count. What codes should the laboratory report?
- A. 85046, 85044, D61.9, Z94.81
- B. 85046, D61.9
- C. 85046, D61.9, Z79.89
- D. 85046, 85044, D61.9
Answer: B
Explanation:
When a hematologr procedure that could be billed alone is encompassed in another code, only the most complex of the tvo should be reported. Because CPT 85046 includes the reticulocyte count billing CPT 85044 as secondary despite using a different method would be considered an unbundling of services. Per ICD-IO-CM guidelines, an organ or tissue transplant status code is for use "only if there are no complications or malfunctions of the organ or tissue replaced." As the testing is to determine whether the engraftment was successful, a bone marrow transplant status code would not be appropriate until deemed by the provider.
NEW QUESTION # 104
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. 66984-RT, H26.8
- B. 66984-RT, H18.891
- C. 66982-RT, H27.8
- D. 66982-RT, Q12.8
Answer: C
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 # 105
If a provider documents in an assessment that a patient is obese, but the BMI extracted from the chart is consistent with morbid obesity, what should be reported on the claim?
- A. Obesity and the appropriate BMI
- B. Morbid obesity
- C. Obesity
- D. Morbid obesity and the appropriate BMI
Answer: A
Explanation:
The diagnosis is always based on the provider's documentation, which in this case would be obesity. Coding guidelines also state that if there is a reportable diagnosis related to weight, "the BMI can be assigned from documentation of someone other than the patient's provider, such as nursing notes."
NEW QUESTION # 106
What would NOT be included in critical care services?
- A. Gastric intubation
- B. Ventilator management
- C. CPR
- D. Pulse oximetry
Answer: C
Explanation:
CPR is not a bundled service to critical care and should be reported separately with CPT code
92950.
NEW QUESTION # 107
A mammogram is done on a patient who has a lump on her right breast at 4 0'clock and a lump in her left breast at 6 0'clock. What CPT and ICD-IO-CM code(s) should be reported?
- A. 77067, D48.61, D48.62
- B. 77067, D49.3
- C. 77065-50, N63.13, N63.20
- D. 77066, N63.14, N63.25
Answer: D
Explanation:
CPT code 77067 is a screening mammogram. In this case, the mammogram would be diagnostic because the purpose is to rule out and/or make a diagnosis based on physical exam findings. Code 77065-50 is an inappropriate use of the modifier because there exists a bilateral procedure code. A breast lump should only be coded to "mass" and not as a neoplasm unless specifically stated in the diagnosis. When deciphering the location of the mass, 12 0'clock is at the top of each breast, and the point of movement is clockwise. Therefore, 4 0'clock in the right breast is equivalent to the lower-inner quadrant, and 6 0'clock in the left breast is in the middle ofthe t".vo lower quadrants.
NEW QUESTION # 108
A patient undergoes surgery with anesthesia and is arousable with painful stimulation. What is the level of sedation the patient MOST likely received?
- A. Moderate sedation
- B. General anesthesia
- C. Minimal sedation
- D. Deep sedation
Answer: D
Explanation:
Minimal, moderate, and deep sedation all allow the patient to undergo a procedure without pain and without being completely unconscious. If a patient receives minimal sedation, they are responsive after receiving verbal stimulation. Moderate sedation causes a patient to respond only after tactile stimulation. General anesthesia causes the patient to be completely unarousable, even with painful stimulation.
NEW QUESTION # 109
A primary care physician is requesting a second opinion to determine which strain of Ebolavirus the patient has. The specimen is sent to a pathologist, who carefully examines it.
A written report is sent promptly back to the primary care physician, confirming Zaire Ebolavirus and recommending immediate isolation and emergency care. What code should be reported by the pathologist?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: C
Explanation:
A clinical pathology consultation was rendered at the request of the primary care physician.
The consultation is considered high based on the level of medical decision making. The CDC describes Ebola disease as a "rare and often deadly illness." Therefore, the number and complexity of problems addressed is high, as is the management ofthe disease due to the decision to escalate this case to hospital level care. E/M codes can be billed only when a patient themself is evaluated by the provider. In this case, the pathologist only evaluated a specimen.
NEW QUESTION # 110
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