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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q188-Q193):

NEW QUESTION # 188
A patient had surgery a year ago to repair two flexor tendons in his forearm. He is in surgery for a secondary repair for the same two tendons.
Which CPT coding is reported?

A. 0
B. 25263 x 2
C. 25272 x 2
D. 1

Answer: B

NEW QUESTION # 189
View MR 001394
MR 001394
Operative Report
Procedure: Excision of 11 cm back lesion with rotation flap repair.
Preoperative Diagnosis: Basal cell carcinoma
Postoperative Diagnosis: Same
Anesthesia: 1% Xylocaine solution with epinephrine warmed and buffered and injected slowly through a 30- gauge needle for the patient's comfort.
Location: Back
Size of Excision: 11 cm
Estimated Blood Loss: Minimal
Complications: None
Specimen: Sent to the lab in saline for frozen section margin control.
Procedure: The patient was taken to our surgical suite, placed in a comfortable position, prepped and draped, and locally anesthetized in the usual sterile fashion. A #15 scalpel blade was used to excise the basal cell carcinoma plus a margin of normal skin in a circular fashion in the natural relaxed skin tension lines as much as possible The lesion was removed full thickness including epidermis, dermis, and partial thickness subcutaneous tissues. The wound was then spot electro desiccated for hemorrhage control. The specimen was sent to the lab on saline for frozen section.
Rotation flap repair of defect created by foil thickness frozen section excision of basal cell carcinoma of the back. We were able to devise a 12 sq cm flap and advance it using rotation flap closure technique. This will prevent infection, dehiscence, and help reconstruct the area to approximate the situation as it was prior to surgical excision diminishing the risk of significant pain and distortion of the anatomy in the area. This was advanced medially to close the defect with 5 0 Vicryl and 6-0 Prolene stitches.
What CPTcoding is reported for this case?

A. 14001, 11606-51, 12034-51
B. 14001, 11606-51
C. 0
D. 1

Answer: B

Explanation:
For the excision of an 11 cm lesion with a rotation flap repair, the appropriate CPT codes are 14001 for the adjacent tissue transfer or rearrangement (12 sq cm flap) and 11606-51 for the excision of a malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm. Modifier 51 indicates multiple procedures. The detailed operative report specifies the lesion size and the technique used, justifying these codes.References: CPTProfessional Edition (current year), AMA.

NEW QUESTION # 190
An elderly patient comes into the emergency department (ED) with shortness of breath. An ECG is performed The final diagnosis at discharge is impending myocardial infarction.
According to ICD-10-CM guidelines, how is this reported?

A. I20.0
B. R06.02
C. I21.3, R06.02
D. I20.0, R06.02

Answer: C

Explanation:
Impending myocardial infarction is reported with I21.3 for a myocardial infarction (acute). The shortness of breath, which is a symptom, is coded separately as R06.02. According to ICD-10-CM guidelines, when a definitive diagnosis is established, the diagnosis code is sequenced first followed by symptom codes.References: ICD-10-CM (current year), Chapter 9: Diseases of the Circulatory System (I00-I99), ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.9.e.4.

NEW QUESTION # 191

Refer to the supplemental information when answering this question:
View MR 065174
What E/M code is reported for this encounter?

A. 0
B. 1
C. 2
D. 3

Answer: C

Explanation:
To determine the correct E/M code, we need to consider the three key components: history, examination, and medical decision making (MDM).
* History:
* The documentation indicates an expanded problem-focused history. This is supported by the detailed history of present illness, including the patient's description of symptoms, family history, and review of systems with pertinent positives and negatives.
* Examination:
* The examination is also expanded problem-focused. The physician focused on the relevant systems (head, neck, throat) and documented specific findings related to the chief complaint (thyromegaly).
* Medical Decision Making:
* The MDM is straightforward. The physician is evaluating a new problem (bilateral thyroid nodules) with a low level of risk. Although further workup is planned, this alone doesn't automatically increase the MDM complexity.
Based on these components, 99213 is the most appropriate code.
Why other options are incorrect:
* 99212: Requires a problem-focused history and examination, which is less comprehensive than what was documented.
* 99214 and 99215: Require a higher level of MDM (low or moderate complexity) and/or a more detailed examination. The documentation doesn't support this level of service.
References:
* CPT Codes 99211-99215: Office or other outpatient visit for the evaluation and management of an established patient
* 1995 and 1997 Documentation Guidelines for Evaluation and Management Services: These guidelines provide detailed criteria for selecting the appropriate E/M code based on history, examination, and MDM.
* AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.

NEW QUESTION # 192
A patient presents to the surgical suite for a planned sterilization procedure via a bilateral excisional vasectomy.
What is the correct CPTcode and diagnosis code for the service?

A. 55250-50, Z30.2
B. 55250, Z30.012
C. 55250-50, Z30.012
D. 55250, Z30.2

Answer: D

Explanation:
1. Procedure and CPTCode Selection:
The patient underwent a bilateral excisional vasectomy for sterilization.
CPTCode 55250 represents a bilateral vasectomy with excision, which includes postoperative care. The code already implies a bilateral procedure, so it is not necessary to add the -50 modifier for bilateral designation.
2. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code Z30.2 is used for encounter for sterilization and is the correct code to report for a planned sterilization procedure such as a vasectomy.
Code Z30.012 is specific to encounter for sterilization of a female patient, which does not apply in this male patient scenario.
3. Rationale for Excluding Other Options:
55250-50 (in options C and D) is unnecessary because the CPTcode 55250 inherently covers a bilateral vasectomy, and applying the -50 modifier is redundant.
Z30.012 (options B and D) is incorrect as it pertains to female sterilization procedures, not male.
4. AAPC and CPTCoding Guidelines:
According to AAPC guidelines, 55250 is reported without a bilateral modifier, as the procedure inherently covers both sides. Additionally, Z30.2 is the correct ICD-10-CM code for male sterilization procedures.
Thus, the correct answer based on CPTand ICD-10-CM guidelines is A. 55250, Z30.2.

NEW QUESTION # 193
......

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