Free AAPC CPC Practice Exam with Questions & Answers | Set: 7

94060 = Spirometry pre- and post-bronchodilator

94010 = Baseline spirometry

J45.21 = Mild intermittent asthma with exacerbation

When a patient experiences an underdose of insulin due to an insulin pump malfunction, the primary reason for the encounter would be the malfunction itself, which is coded first. The resulting hyperglycemia or hypoglycemia due to the pump failure is a secondary condition. According to ICD-10-CM guidelines, the code for the mechanical complication of the pump (T85.633-) is sequenced first, followed by a code for the diabetes with complication (E11.65 for type 2 diabetes with hyperglycemia).

ICD-10-CM (current year), Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88), ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.4.

1. Procedure Details and CPT® Code Selection:

The patient is undergoing stage 2 treatment for double outlet right ventricle (DORV) with a removal of the pulmonary artery band and transposition repair of the great vessels.

Code 33779 is specific for correction of a double outlet right ventricle, with transposition of the great arteries. This code accurately reflects the procedure performed, including the complex repair involving the transposition of the pulmonary trunk and aortic root.

Code 33953 is used to report the initiation of extracorporeal membrane oxygenation (ECMO), which was used to maintain oxygenation during the procedure.

Code 33985 is for the termination of ECMO following the surgical repair once heart function has resumed. Both 33953 and 33985 accurately document the initiation and termination of ECMO during this complex heart repair.

2. Modifier Selection:

Modifier 78 (unplanned return to the operating room for a related procedure during the postoperative period) is appropriate here. This is a subsequent stage in the treatment plan, but due to the complexity and specific surgical intervention required, it is treated as a return to the OR for related procedure coding.

Modifier 58 (staged or related procedure during the postoperative period) would not be as suitable here because the procedure involves a new return to the OR.

3. AAPC and CPT® Coding Guidelines:

AAPC guidelines support the use of specific modifiers (78 for unplanned return) and appropriate ECMO codes (33953 and 33985) in complex cardiac cases requiring bypass and staged treatment.

Thus, the correct CPT® codes based on CPT® and AAPC coding standards are C. 33779-78, 33953-78, 33985-78.

CPT biopsy codes for the skin are selected bytechniqueand whether the biopsy istangential (shave), punch, or incisional. In this scenario, three different biopsy techniques are performed onthree separate lesions: anincisional biopsyof a deep lesion (upper arm), apunch biopsy(forearm), and ashave biopsy(shoulder). The correct primary codes are11106(incisional biopsy, single lesion),11104(punch biopsy, single lesion), and11102(tangential/shave biopsy, single lesion). Because each is a distinct lesion and a distinct technique, CPT coding uses the appropriatebase codesfor each technique rather than “add-on additional lesion” codes, and you do not automatically apply modifier-51in CPT-answer logic unless the question specifically tests payer/claim-processing conventions. The CPC exam typically expects the straightforward reporting of all three correct biopsy codes when performed on separate lesions with separate specimens submitted. Therefore, optionBis the best match.

1. Procedure and CPT® Code Selection:

The urinalysis performed was non-automated and without microscopy.

CPT® Code 81002 is appropriate for a non-automated urinalysis without microscopy. This code accurately reflects the test performed in the office.

2. Diagnosis and ICD-10-CM Code Selection:

ICD-10-CM Code R30.0 is used for dysuria, which was one of the patient ' s presenting symptoms.

ICD-10-CM Code R10.30 is used for lower abdominal pain, another presenting symptom.

Since the urinalysis ruled out a urinary tract infection, N39.0 (UTI) is not appropriate as a final diagnosis.

3. Rationale for Excluding Other Options:

Code 81000 (in options A and B) is for a urinalysis with microscopy, which was not performed here.

N39.0 is used when a UTI is confirmed, which is incorrect for this case since the urinalysis was negative, ruling out UTI.

4. AAPC and CPT® Coding Guidelines:

AAPC guidelines recommend coding based on the symptoms when a specific diagnosis (such as UTI) is ruled out. Therefore, R30.0 and R10.30 are appropriate symptom codes for this encounter.

Thus, the correct answer is C. 81002, R30.0, R10.30.

CPT® code 15786 is used for abrasion treatment of a single lesion (e.g., for keratosis) through techniques like dermabrasion (lightly sanding the skin ' s surface). When treating multiple lesions in this manner, each lesion treated should be coded individually.

Since the patient has 5 keratosis lesions treated through sanding, 15786 x 5 accurately represents the procedure for each lesion.

Explanation of other options:

A. 15787 x 5: Incorrect because 15787 is designated for dermabrasion of " additional lesions " and would be used in conjunction with 15786, not alone.

B. 15786, 15787: Incorrect, as it does not account for all five lesions treated.

C. 15786, 15787 x 4: Incorrect, as 15787 is used only when performed in addition to 15786, not as a replacement for each additional lesion.

Therefore, the correct answer is D. 15786 x 5, which accurately reports the treatment of all five lesions.

This is a subsequent nursing facility care visit.

MDM Analysis (2021+ E/M Guidelines):

Problems: Multiple chronic conditions → Moderate

Data: 4 labs + telemetry → Moderate

Risk: Prescription drug management → Moderate

99309 – Subsequent nursing facility care, moderate MDM

Why others are incorrect:

99307 / 99308 – Low complexity

99305 – Initial nursing facility care

Service location = campground → domiciliary/home visit

Patient is new

99344 = New patient domiciliary visit, moderate MDM

Prolonged Services:

Additional 25 minutes beyond base time

99417 is used for prolonged services with office/home E/M codes

Why others are incorrect:

99349 – Established patient

99204 – Office visit (wrong location)

This scenario describes apalatoplasty(repair of cleft palate) withclosure of the alveolar ridgeusing abone graft. CPT code42210is the code that captures palatoplasty withclosure of the alveolar ridgeand associated bone grafting work as part of the reconstructive procedure described. Because the bone graft is part of the defined palatoplasty service in this code concept, you donotseparately report a generic bone graft harvesting code such as20900in the way the answer options suggest. The distractor42200is associated with a more limited palate repair (not matching the alveolar ridge closure with graft detail), and42205does not reflect the specific alveolar ridge closure with bone grafting described in the question stem. CPC exam strategy: identify the mostcomprehensive cleft palate repairthat matches the documentation; when a CPT code description includes the specific additional work (like alveolar ridge closure with graft), code that single comprehensive service.

For a comatose patient who has overdosed on tricyclic antidepressant drugs (doxepin, amoxapine, and clomipramine), the correct CPT® code is 80366. This code covers drug testing for tricyclic antidepressants, which includes the specific drugs mentioned in the scenario.