AAPC-CPC Online Practice Questions and Answers

A patient complains of tarry, black stool, and epigastric tightness. An esophagogastroduodenoscopy is recommended to evaluate the source of the bleeding. The endoscope is inserted orally. The esophagus appears normal on scope insertion. No evidence of bleeding in the stomach. The scope is then passed into the duodenum, where a polyp is found and removed with hot biopsy forceps. No evidence of bleeding post procedure.

What CPT?code is reported?

A. 43251

B. 43250

C. 43255

D. 43270

A patient with empyema requires a Schede thoracoplasty.

What CPT?code is reported for this procedure?

A. 32906

B. 32999

C. 32905

D. 32900

View MR 099401

MR 099401

Established Patient Office Visit

Chief Complaint: Patient presents with bilateral thyroid nodules.

History of present illness: A 54-year-old patient is here for evaluation of bilateral thyroid nodules. Thyroid ultrasound was done last week which showed multiple thyroid masses likely due to multinodular goiter. Patient stated that she can "feel"

the nodules on the left side of her thyroid. Patient denies difficulty swallowing and she denies unexplained weight loss or gain. Patient does have a family history of thyroid cancer in her maternal grandmother. She gives no other problems at

this time other than a palpable right-sided thyroid mass.

Review of Systems:

Constitutional: Negative for chills, fever, and unexpected weight change.

HENT: Negative for hearing loss, trouble swallowing and voice change.

Gastrointestinal: Negative for abdominal distention, abdominal pain, anal bleeding, blood in stool, constipation, diarrhea, nausea, rectal pain, and vomiting

Endocrine: Negative for cold Intolerance and heat intolerance.

Physical Exam:

Vitals: BP: 140/72, Pulse: 96, Resp: 16, Temp: 97.6 (36.4 ), Temporal SpO2: 97%

Weight: 89.8 kg (198 lbs ), Height: 165.1 cm (65")

General Appearance: Alert, cooperative, in no acute distress

Head: Normocephalic, without obvious abnormality, atraumatic

Throat: No oral lesions, no thrush, oral mucosa moist

Neck: No adenopathy, supple, trachea midline, thyromegaly is present, no carotid bruit, no JVD

Lungs: Clear to auscultation, respirations regular, even, and unlabored

Heart: Regular rhythm and normal rate, normal S1 and S2, no murmur, no gallop, no rub, no click

Lymph nodes: No palpable adenopathy

ASSESSMENT/PLAN:

1) Multinodular goiter - the patient will have a percutaneous biopsy performed (minor procedure).

What E/M code is reported for this encounter?

A. 99212

B. 99214

C. 99213

D. 99215

A patient with Parkinson's has sialorrhea. The physician administers an injection of atropine bilaterally into a total of four submandibular salivary glands. What CPT?coding is reported?

A. 64611

B. 64611-50

C. 64611-52

D. 64611 x 4

A patient with three thyroid nodules is seen for an FNA biopsy. Using ultrasonic guidance, the provider inserts a 25-gauge needle into each nodule. Nodular tissue is aspirated and sent to pathology. What CPT?coding reported?

A. 10005, 10006 x 2, 76942

B. 10006 x 3

C. 10005, 10006 x 2

D. 10021, 10004 x 2, 76942

A 60-year-old male has three-vessel disease and supraventricular tachycardia which has been refractory to other management. He previously had pacemaker placement and stenting of LAD coronary artery stenosis, which has failed to solve the problem. He will undergo CABG with autologous saphenous vein and an extensive modified MAZE procedure to treat the tachycardia.

He is brought to the cardiac OR and placed in the supine position on the OR table. He is prepped and draped, and adequate endotracheal anesthesia is assured. A median sternotomy incision is made and cardiopulmonary bypass is initiated. The endoscope is used to harvest an adequate length of saphenous vein from his left leg. This is uneventful and bleeding is easily controlled. The vein graft is prepared and cut to the appropriate lengths for anastomosis. Two bypasses are performed: one to the circumflex and another to the obtuse marginal. The left internal mammary is then freed up and it is anastomosed to the ramus, the first diagonal, and the LAD. An extensive maze procedure is then performed and the patient is weaned from bypass. At this point, the sternum is closed with wires and the skin is reapproximated with staples. The patient tolerated the procedure without difficulty and was taken to the PACU.

Choose the procedure codes for this surgery.

A. 33533, 33257, 33519, 33508

B. 33535, 33259, 33519, 33508

C. 33533, 33257-51, 33519-51, 33508-51

D. 33535, 33259 51, 33519-51, 33508-51

View MR 002395 MR 002395 Operative Report Pre-operative Diagnosis: Acute rotator cuff tear Post-operative Diagnosis: Acute rotator cuff tear, synovitis Procedures: 1) Rotator cuff repair 2) Biceps Tenodesis 3) Claviculectomy 4) Coracoacromial ligament release Indication: Rotator cuff injury of a 32-year-old male, sustained while playing soccer. Findings: Complete tear of the right rotator cuff, synovitis, impingement. Procedure: The patient was prepared for surgery and placed in left lateral decubitus position. Standard posterior arthroscopy portals were made followed by an anterior- superior portal. Diagnostic arthroscopy was performed. Significant

synovitis was carefully debrided. There was a full-thickness upper 3rd subscapularis tear, which was repaired. The lesser tuberosity was debrided back to bleeding healthy bone and a Mitek 4.5 mm helix anchor was placed in the lesser tuberosity. Sutures were passed through the subcapulans in a combination of horizontal mattress and simple interrupted fashion and then tied. There was a partial-thickness tearing of the long head of the biceps. The biceps were released and then anchored in the intertubercular groove with a screw. There was a large anterior acromial spur with subacromial impingement. A CA ligament was released and acromioplasty was performed. Attention was then directed to the

supraspinatus tendon tear. The tear was V-shaped and measured approximately 2.5 cm from anterior to posterior. Two Smith and Nephew PEEK anchors were used for the medial row utilizing Healicoil anchors. Side-to-side stitches were placed. One set of suture tape from each of the medial anchors was then placed through a laterally placed Mitek helix PEEK knotless anchor which was fully inserted after tensioning the tapes. A solid repair was obtained. Next there were severe degenerative changes at the AC joint of approximately 8 to 10 mm. The distal clavicle was resected taking care to preserve the superior AC joint capsule. The shoulder was thoroughly lavaged. The instruments were removed and the incisions were closed in routine fashion. Sterile dressing was applied. The patient was transferred to recovery in stable condition.

What CPT?coding is reported for this case?

A. 29827, 29828-51, 29824-51, 29826

B. 29827, 29824-51, 29826-51

C. 29827, 29828-51, 29824-51, 29826, 29805-59

D. 29827, 29824-51, 29826-51, 29805-59

Which bone is located in the lower extremity?

A. Humerus

B. Femur

C. Radius

D. Ulna

The surgical preparation of a 25 sq cm wound on the right leg is performed along with a 25 sq cm wound on the left leg.

What CPT?code is reported?

A. 15002

B. 15004

C. 15004 x 2

D. 15002 x 2

A 60-year-old man presents for a sigmoidoscopy. The physician inserts a flexible scope into the patient's rectum and determines that the rectum is clear of polyps. The scope is advanced to the sigmoid colon and examined. A total of three polyps are found in the sigmoid colon. Polyps are removed using the snare technique. The flexible scope is withdrawn. What CPT?and ICD-10-CM codes are reported?

A. 45308, K63.5

B. 45346, K62.1

C. 45338, K63.5

D. 45309, K62.1