Practice Test2012 for the AAPC CPC Exam ® Practice Test 2012 for the AAPC CPC Exam ® 2012 Practice Test for the AAPC CPC® Exam is published by HCPro, Inc. Copyright © 2012 HCPro, Inc. All rights reserved. Printed in the United States of America. 5 4 3 2 1 ISBN: 978-1-60146-914-4 No part of this publication may be reproduced, in any form or by any means, without prior written consent of HCPro, Inc., or the Copyright Clearance Center (978/750-8400). Please notify us immediately if you have received an unauthorized copy. HCPro, Inc., provides information resources for the healthcare industry. HCPro, Inc., is not affiliated in any way with The Joint Commission, which owns the JCAHO and Joint Commission trademarks. CPT copyright 2010 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. Lisa Rae Roper, MHA, CCS-P, CPC, CPC-I, PCS, Author Lauren McLeod, Editorial Director Shelly Gray, RHIA, CCS, Reviewer Mike Mirabello, Senior Graphic Artist Terry Santana-Johnson, RHIT, CCS, CCS-P, Reviewer Matt Sharpe, Production Manager Kathleen Horgan, Associate Editor Shane Katz, Art Director Ilene G. MacDonald, CPC, Associate Editorial Director Jean St. Pierre, Senior Director of Operations Advice given is general. Readers should consult professional counsel for specific legal, ethical, or clinical questions. Arrangements can be made for quantity discounts. For more information, contact: HCPro, Inc. 75 Sylvan Street, Suite A-101 Danvers, MA 01923 Telephone: 800/650-6787 or 781/639-1872 Fax: 800/639-8511 E-mail:
[email protected] Visit HCPro online at: www.hcpro.com and www.hcmarketplace.com 01/2012 21932 iii Contents 2012 CPC Practice Test........................................................................................... 1 Integumentary System.................................................................................................................... 2 Musculoskeletal System.................................................................................................................. 4 Respiratory and Cardiovascular Systems.......................................................................................... 7 Digestive System...........................................................................................................................10 Urinary System, Male and Female Genital Systems.........................................................................13 Nervous System, Eye and Ocular Adnexa, and Auditory System......................................................16 Evaluation and Management.........................................................................................................19 Anesthesia................................................................................................................................... 22 Radiology......................................................................................................................................24 Laboratory and Pathology..............................................................................................................26 Medicine...................................................................................................................................... 29 Medical Terminology and Anatomy................................................................................................32 ICD-9-CM.................................................................................................................................... 35 HCPCS Level II.............................................................................................................................. 38 Coding Guidelines........................................................................................................................ 39 Practice Management....................................................................................................................41 2012 CPC Practice Test Answer Key.................................................................... 43 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 1 2012 CPC Practice Test The following Certified Professional Coder (CPC) practice test was developed by Lisa Rae Roper, MHA, CCS-P, CPC, CPC-I, PCS, an adjunct instructor for HCPro’s Certified Coder Boot Camp®, to help JustCoding Platinum members interested in obtaining a CPC credential prepare for the exam. Unless the question states otherwise, assume that a physician documented all the information pro- vided. You have two minutes to complete each question. You may not use any outside materials for this test other than the 2012 CPT®, ICD-9-CM, and HCPCS Level II manuals. 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 2 Integumentary System 1. Dr. Smith performed a cryosurgery to destroy three premalignant lesions for a patient. Which code(s) should you report for this procedure? a. 17106 b. 17260 c. 17003 x 3 d. 17000, 17003 x 2 2. Which codes should be reported for the following case? Preoperative diagnosis: Lesion, left hand Confirmed by pathology postoperative diagnosis: Primary malignant carcinoma, left hand Procedure performed: Excision of malignant carcinoma, left hand Anesthesia: General; 40 ml of lidocaine was infiltrated into the wound prior to making the incision Procedure: The patient was brought to the operative suite where the left hand was prepped and dressed. A circular incision was made to include the 1-cm lesion with narrowest margins of 0.6 cm with dissection down to subcutaneous tissue. Homeostasis was obtained; the wound was closed with simple mattress sutures. The patient tolerated the procedure well and was returned to the recovery room in good condition with sterile dressing in place. a. 11603, 173.60 b. 11622, 173.60 c. 11423, 198.2 d. 11403, 198.2 3. Nancy underwent a fine needle aspiration with imaging guidance for a lesion in the right breast. During the aspiration procedure, a percutaneous metallic clip was placed in the right breast. Which codes describe this procedure? a. 10022-RT, 19295-RT b. 10021-RT, 19295-RT c. 19290-RT, 19297-59 d. 19295-59, 10021-RT © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 3 4. Which of the following procedures could be coded with a breast reconstruction with free flap? a. Harvesting of the flap b. Microvascular transfer c. Closure of the donor site and inset shaping the flap into a breast d. None of the above 5. Barry underwent a complex incision and drainage due to a postoperative wound infection, which required an extensive secondary closure of the surgical site. Which codes describe this procedure? a. 13160, 10081-59 b. 10121, 12020-51 c. 13160, 10180-51 d. 10061, 12021-59 6. Stephanie discovered a lesion on her trunk and was referred to Dr. Ralph, a trained Mohs surgeon, for treatment. Stephanie had no prior pathology of this lesion; therefore, Dr. Ralph completed a diagnostic skin biopsy with frozen section prior to the surgery. After reviewing the biopsy results, Dr. Ralph took the patient to the procedure suite and performed a Mohs surgery that same day. Dr. Ralph’s final report indicated the procedure required three stages, including five tissue blocks in each stage. He had to take an additional four blocks in stage two to verify margins and cell structure. Which codes should Dr. Ralph report for this entire encounter? a. 17313, 17314 x 2, 17315 x 4, 11100-59, 88331-59 b. 17313, 17314 x 2, 17315-59 c. 17311, 17312 x 2, 17315 d. 17311, 17312 x 4, 17315-59, 11101-51, 88331-51 7. Mark cut his hand and arm while working on his car. Dr. Bill applied sutures to both the arm and hand wounds. An intermediate closure of 16 cm was placed in the arm and a simple closure of 3.6 cm was placed in the hand. Which codes should Dr. Bill report? a. 12004, 12035-59 b. 12035, 12002-51 c. 12035, 12002-59 d. 13132, 12036-51 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 4 8. A patient underwent an excision of a 2.1-cm diameter malignant lesion on her nose. An 11.2-sq-cm adjacent tissue transfer was required to repair the primary and secondary defect sites. How should you code this procedure? a. 11643, 14061-59 b. 14061 c. 11646, 13152-51, 13153-51 d. 11443, 12054-59 9. Glen required a replacement of his nonbiodegradable drug delivery implant system. Glen was taken into the procedure suite where he was prepped. Dr. Roberts injected a local anesthetic and made a 3.2-cm incision in the skin for removal of the previous cylinder. He then replaced the cylinder and sutured the new device in place with a single running stitch. The 3.2-cm trunk wound was closed with simple sutures. The device was tested, with excellent results. The patient tolerated the procedure well and was released from care with a sterile dressing in place. How should this procedure be coded? a. 11983, 12032-51 b. 11982, 12032-59 c. 11981, 11982-51, 11983-51, 12002-59 d. 11983, 12002-51 Musculoskeletal System 10. A patient reports a history of right groin pain, which is worse with sitting and rising from a sitting position. Physical examination, x-rays, and CT scans confirm a cam lesion in the right femoral head-neck region and noted as the cause for loss of rotation. Dr. Curtis completed an arthroscopy of the right hip with debridement and a femoroplasty. How should Dr. Curtis report her procedure? a. 29914-RT b. 29862-RT, 29914-59 c. 29861-RT, 29862, 29914 d. 29860-RT, 29862-59, 29914-59 11. Dr. Reese completed a deep transfer of the anterior tibial and flexor digitorum tendons. Which code(s) should be used to report this procedure? a. 27658 x 2 b. 27690, 27692-51 c. 27691, 27692 d. 27691, 27692 x 2 © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 5 12. Which code(s) should you report for the following case? Preoperative diagnosis: Procedures: Left knee medial collateral ligament tear Exam under anesthesia Anterior cruciate ligament tear Diagnostic arthroscopy of left knee Possible meniscus tear Left knee arthroscopic repair of lateral meniscus Postoperative diagnosis: Same Tourniquet time: 2.5 hours Procedure: The patient was taken to the operating room and positioned, and an epidural anesthetic was placed. Once the anesthetic had taken effect, the patient’s left leg was examined under anesthesia and noted to have increased valgus laxity with end point, a positive Lachman test, and positive pivot-shift test. The patient was prepped and draped in the normal fashion, exsanguinated, and the tourniquet applied to a 350 mmHg. The knee was then insufflated and irrigated with fluid. Using the arthroscopic sheath, visualization of the knee joint began. Attention was turned to the lateral meniscus where the tear was debrided. Using the arthroscope, the lateral meniscus was sutured with two mattress- type sutures of non-absorbable 2-0 material. The sutures were then tied and visualized with arthroscopy to reveal the meniscus to be in excellent shape and stable position. The 3.5-cm wound was thoroughly irrigated and closed with intermediate subcutaneous sutures. A sterile compression dressing was applied. The patient was placed in a TED hose and Watco brace, setting the brace between 40º and 60º of free motion. He was then taken to the recovery room in stable condition. The instrument, sponge, and needle counts were correct. a. 29882, 29877-52, 29870-51 b. 29866, 29868 c. 29870, 29882, 12032 d. 29882 13. Two weeks ago, Sam underwent an open repair of his lower femur due to a traumatic fracture suffered while snow skiing. His leg is healing as expected, and no new treatment is required to the femur. Today, he returns as planned for an application of a new long leg cast. The cast application is completed by the same physician who performed the surgery. How should today’s services be reported? a. 29345-58, V53.7, V54.15 b. 99024, V53.7, V54.15 c. 29345, 29700-59, 99024, V53.7, V54.29 d. 29345-76, 821.22, V53.7, V54.16 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 6 14. What type of soft tissue tumor resection is commonly used for malignant tumors or very aggressive benign tumors? a. Manipulative soft tissue resection b. Radical soft tissue resection c. Residual soft tissue resection d. Manageable soft tissue resection 15. A patient was stabbed in the right arm. A surgeon took the patient to an operating suite and completed wound exploration. The surgeon widened the wound to achieve proper visualization and completed subcutaneous debridement and ligation of minor subcutaneous blood vessels. No further procedures were required for this wound exploration. The arm wound was closed and dressed in the usual fashion. The patient tolerated the procedure well and was returned to the recovery room in good condition. How would you report this procedure? a. 20103, 11011-51 b. 20103 c. 20103, 11011-59 d. 11043, 12036-59, 20103-51 16. A patient underwent an anterior interbody arthrodesis with discectomy, osteophytectomy, fusion, and decompression of nerve roots at levels C3, C4, and C5. Application of anterior instrumentation was placed from C3–C5. During this procedure, a previous fusion was also explored at C6–C7. Which codes would you use to report this procedure? a. 22551, 22585 x 2, 22845-51, 22830-59 b. 22554, 22585 x 2, 22845, 22830-51 c. 22600, 22614, 22842, 22830-59 d. 22551, 22552, 22845, 22830-51 17. Which code(s) would you report for an aspiration and injection of a cyst to the bone of the left great toe? a. 20600 b. 20612 c. 20615 d. 20600, 20612-59 © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 7 18. A patient suffering from a nonhealing knee tendon underwent a platelet-rich plasma injection under imaging guidance. How should you report this procedure? a. 0232T b. 20551 c. 20551, 77002 d. 0232T, 20551, 77002 19. Dr. Bender completed a therapeutic manipulation of the temporomandibular joint. An anesthesiologist placed this healthy 54-year-old patient under general anesthesia and monitored the patient during the procedure. The intraservice time was noted as one hour. The patient tolerated the procedure well and was returned to the recovery room in good condition. How would Dr. Bender’s services be reported? a. 21073, 99144, 99145 x 2 b. 21480 c. 21073 d. 21480, 99149, 99150 x 2 Respiratory and Cardiovascular Systems 20. Dr. Walters performed a subsequent thoracentesis of the pleural cavity for aspiration with needle fluoroscopic guidance. Which codes should Dr. Walters report for his professional services? a. 32422, 77012-26 b. 32421, 77002-26 c. 32421, 77012-26 d. 32421-26, 77002-TC 21. Alicia is 20 months old and suffering from chronic inflammation of the trachea, which is causing difficulty in breathing. Dr. Marion inserted a planned incisional tracheal tube for Alicia. This procedure was completed under general endotracheal anesthesia. The patient tolerated the procedure well and was returned to the recovery room in stable condition. How should Dr. Marion report this procedure? a. 31610 b. 31601 c. 31830 d. 31615 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 8 22. Dr. Manning, a thoracic surgeon, was asked to consult with Nancy, a 66-year-old female with atherosclerotic heart disease. The patient, who requested the visit, is well known to Dr. Manning, who performed thoracic surgery on her two years ago. She was seen in his office Monday morning for a consultative visit with mild complaints of fatigue and shortness of breath. Dr. Manning dictated a comprehensive history, comprehensive examination, and high-complexity decision-making. During this consultation, Dr. Manning made the decision to reoperate on Nancy. He sent a written report back to her cardiologist, Dr. Shaw, regarding the need for another surgery to take place the following day. Monday evening, Nancy was admitted to the hospital to start the prep for the planned bypass surgery Tuesday morning. Tuesday’s operative report Preoperative diagnosis: Atherosclerotic heart disease Postoperative diagnosis: Same Anesthesia: General Procedure: The patient was brought to the operating room and placed in the supine position. With the patient under general intubation anesthesia, the anterior chest, abdomen, and legs were prepped and draped in the usual fashion. Review of a postoperative angiography showed severe, recurrent, two-vessel disease with normal ventricular function. A segment of the femoropopliteal artery was harvested using endoscopic vein-harvesting technique and prepared for grafting. The patient was heparinized and placed on cardiopulmonary bypass. The patient was cooled as necessary for the remainder of the procedure and an aortic cross-clamp was placed. The harvested vein was anastomosed to the aorta and brought down to the circumflex and anastomosed into place. An artery was anastomosed to the left subclavian artery and brought down to the left anterior descending and anastomosed into place. The aortic cross-clamp was removed after 55 minutes with spontaneous cardioversion to a normal sinus rhythm. The patient was warmed and weaned from the bypass without difficulties after 104 minutes. The patient achieved homeostasis. The chest was drained and closed in layers in the usual fashion. The leg was closed in the usual fashion. Sterile dressings were applied and the patient returned to intensive care recovery in satisfactory condition. How should Dr. Manning report his services for Monday and Tuesday in this case? a. Monday: 99255-57; Tuesday: 33511, 33517, 35600 b. Monday: 99215-57; Tuesday: 33533, 33517-51, 35572-80, 33530-51, 33508-51 c. Monday: 99255-57; Tuesday: 33533, 33510, 33572, 33530 d. Monday: 99215-57; Tuesday: 33533, 33517, 35572, 33530, 33508 23. A patient had a temporary transvenous pacemaker system inserted with electrodes placed in the right atrial and ventricular chambers. How should you report this service? a. 33211 b. 33208 c. 33213, 33208-51 d. 33211, 33208-51 © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 9 24. Marvin, a 51-year-old patient, required a conversion of a single-chamber pacemaker system to a dual-chamber system. The previously placed electrode was removed transvenously. The skin pocket was opened and the pulse generator removed. The skin pocket was then relocated and a dual system was placed with transvenous electrodes in both the right atrial and ventricular chambers. The system was tested and the new skin pocket was then closed. The patient tolerated the procedure well. How should you report these services? a. 33208, 33234-51, 33233-51, 33222-51, 33214-51 b. 33208, 33214-51, 33223-51 c. 33208, 33234-51, 33233-51, 33222-51 d. 33214, 33222-51 25. A patient required a battery change for a single-chamber pacing cardioverter-defibrillator system. The battery was taken out in a subcutaneous fashion and a new battery was placed. The cardioverter-defibrillator was then reattached to the electrodes, which were intact. The device was programmed, threshold tested, and the skin pocket was then closed. How should these services be reported? a. 33244, 33241-51, 33240, 93641-51 b. 33262, 93641-51 c. 33262, 33241-51, 93641-26 d. 33241, 33240-51, 33233-51 26. Dr. Lim completed an external ECG with 48-hour continuous rhythm testing during which analysis was performed for Mr. Brown. The report was reviewed and interpretation completed for evaluation of change to the pacemaker system. The report conclusion stated predominant rhythm of atrial fibrillation with noncontrolled left ventricular rate. Dr. Lim scheduled Mr. Brown for placement of a biventricular pacemaker, which will be connected to his current pacemaker system. How should Dr. Lim report her services for the cardiovascular monitoring? a. 33224 b. 33244, 93224-59 c. 93224 d. 33208, 33225-51, 93225-59 27. A patient had a coronary endarterectomy during the same surgical session for a repair to a coronary arteriovenous chamber fistula. The fistula repair did not require a cardiopulmonary bypass to complete the procedure. How should these services be reported? a. 33572, 33501 b. 33500, 33572-59 c. 33501 d. 33507, 33501-59 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 10 28. A patient suffering from chronic inflammation of the maxillary sinus underwent a surgical endoscopic transnasal balloon dilation procedure to restore normal sinus function. During this procedure, maxillary antrostomy with removal of tissue was completed. How should you report these procedures? a. 31267 b. 31267, 31295-59 c. 31295, 31256-59, 31267-59 d. 31297 29. A patient underwent a recurrent destruction of the laryngeal nerve for therapeutic purposes. How would you report this procedure? a. 31595 b. 31599 c. 31595, 64681-59 d. 64614, 31599-59 Digestive System 30. A patient with ongoing symptoms of weight loss, constipation, and blood in stool verified with occult testing underwent a rectal approach colonoscopy with snare removal of three colonic polyps. The pathology report, which was returned to the physician the same day of the procedure, revealed benign colon polyps. How should you report this? a. 44393, 211.3 b. 45385 x 3, 783.21, 564.00, 792.1, 211.3 c. 45378, 45385 x 3, 211.3 d. 45385, 211.3 31. A patient was fully prepped for a diagnostic colonoscopy; however, an object then shifted into the descending colon just below the splenic flexure. The physician was unable to advance the scope beyond the splenic flexure. How would you report this diagnostic colonoscopy? a. 44388-52 b. 45330 c. 45378-53 d. None of the above © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 11 32. Jennifer, a 3-year-old patient, swallowed a marble that became lodged in her esophagus. An esophagotomy via thoracic approach was completed for removal of the foreign body. The patient tolerated the procedure well and was returned to the recovery room in good condition. How should you code this procedure? a. 43045 b. 43020 c. 43215 d. 43135 33. An otherwise healthy 22-year-old patient was scheduled for repair of an incarcerated bilateral recurrent inguinal hernia. The patient was taken into a same-day OR, where she was prepped, positioned, and draped in the usual fashion. The anesthesiologist administered general anesthesia and indicated the patient was ready for the surgery to begin. The surgeon created the incision and started the procedure. At this point, the patient went into shock due to the surgery and the procedure was halted. The patient was stabilized and returned to the recovery room. How should the surgeon report this procedure? a. 49507-47, 998.00, 550.10, V64.1 b. 49521-53, 550.13, 998.00, V64.1 c. 00830-P1, 49521-51, 550.10, 998.00, V64.1 d. 49521-74, 550.13, 998.00, V64.1 34. How would the following case be coded? Preoperative diagnosis: Lesion, buccal submucosa, right lower lip Postoperative diagnosis: Same Procedure performed: Excision of lesion, buccal submucosa, right lower lip Anesthesia: Local Procedure: The patient was placed in the supine position. A measured 7x8 mm hard lesion is felt under the submucosa of the right lower lip. After application of 1% Xylocaine® with 1:1000 epinephrine, the lesion was completely excised. The lesion does not extend into the muscle layer. The 8-cm wound was closed with complex mattress sutures to the submucosal level and dressed in typical sterile fashion. The patient tolerated the procedure well and returned to the recovery area in satisfactory condition. a. 40816, 210.4 b. 40814, 40831-51, 210.4 c. 40814, 528.9 d. 40814, 210.4 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 12 35. A patient underwent an EGD with transendoscopic ultrasound-guided transmural fine needle aspiration. How should you code this procedure? a. 43242, 76942-26 b. 43242 c. 43235, 43238-59 d. 43235, 43242-51, 76942-26 36. A patient underwent a laparoscopic repair of a paraesophageal hernia with fundoplasty with implantation of mesh. During the procedure, a laparoscopic esophageal lengthening was completed. Which codes capture this procedure? a. 43327, 43282-59 b. 43333, 43283-51 c. 43281, 43282-59, 43283-51 d. 43282, 43283 37. A patient underwent an enterectomy in the small intestine with four resections and anastomoses. How should you report this type of procedure? a. 44130 b. 44120 x 4 c. 44111 d. 44120, 44121 x 3 38. Veronica, a 55-year-old patient, has left upper quadrant pain with a negative ultrasound. Veronica’s physician explains the need for a diagnostic and possible surgical procedure to determine the cause of this pain. She agrees to the procedure, completes overnight fast and prep, signs a consent for surgery, and is then taken to a procedure room. After nasal spray of 2% Xylocaine® is administered, the tube is introduced through one nostril, down the back of the throat, and positioned into the stomach as the patient swallows. The diagnostic duodenal intubation and aspiration is completed. However, the physician decides to reposition the tube under fluoroscopic guidance and obtain multiple duodenal fluid specimens during the same operative session. The patient tolerates the procedure well and is moved to the recovery suite. How would you report the physician services? a. 43757 b. 43756, 43757-52 c. 43755 d. 43755, 43756-59, 43757-59 © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 13 39. A patient has an adjustable gastric restrictive device component removed and replaced via a laparoscopic procedure. How should you code this procedure? a. 43773 b. 43772, 43773-51 c. 43888 d. 43845 Urinary System, Male and Female Genital Systems 40. A patient had three needle biopsies of the prostate completed under imaging and guidance. Which codes capture the professional services for this procedure? a. 55700 x 3, 76942-26 b. 10022, 55700 x 3, 76942-26 c. 55700, 76942-26 d. 55705 x 3, 10022, 76942-26 41. Newborn baby boy Martinez underwent a procedure to slit the prepuce to relieve constriction that prevented retraction of the foreskin over the head of the penis. The slit tissue was sutured at the divided skin to control bleeding. The patient tolerated the procedure well. How would Dr. David report his services for this procedure? a. 54000-63 b. 54000 c. 54001-52 d. 54001-63 42. A patient underwent destruction of extensive condyloma lesions on the penis. The documentation stated 12 or more lesions were visible and treated during this session. The procedure was completed by laser technique. The patient received follow-up and post-procedure care instructions and was discharged in good condition. How should you report this procedure? a. 54057 x 12, 54065-59 b. 54065 x 12 c. 54057-22 d. 54065 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 14 43. A patient underwent an injection procedure for voiding urethrocystography with contrast. During the same investigative session, the physician completed all components of a urethral pressure profile study and a simple UFR including interpretation of the results. How should you report the professional services for this procedure? a. 51600, 74455-26, 51727-51, 51736-51 b. 51605, 74430-26, 51727-26, 51741-51 c. 51600, 74430-26, 51727-26, 51797-51 d. 51605, 74455-TC, 51727-26, 51736-51 44. A physician completed a cystourethroscopy with insertion of two permanent urethral stents. How should you report this? a. 53855 x 2 b. 52282 x 2 c. 52281, 53855-59 d. 52282 x 2, 52305-59 45. What modifier should be reported with the procedure code for transurethral resection of residual, or regrowth of, obstructive prostate tissue when the procedure is performed by the same physician during a postoperative period? a. -22 b. -52 c. -77 d. -78 46. Dr. Laura completed a vaginal delivery in the hospital for Stephanie, a 30-year-old patient. This is Stephanie’s first child and she delivered a healthy baby boy. Dr. Laura has taken care of Stephanie during the entire pregnancy and followed her through the postpartum period. Dr. Laura’s documentation stated that during the delivery admission, Stephanie required prophylactic antibiotics because she has mitral valve prolapse. How should Dr. Laura report the delivery care and diagnosis for this patient? a. 650, 424.0, V30.0, 59400 b. 424.0, V30.0, 59510 c. 648.61, 424.0, V27.0, 59400 d. 414.0, 648.61, V27.0, 59614 © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 15 47. Diane suffered a spontaneous incomplete miscarriage during the second trimester and required surgical completion of this event. How should this procedure be reported? a. 59812 b. 59820 c. 59821 d. 59840 48. An established patient required medical attention for removal of an impacted foreign body from the vaginal canal. Her physician documented a detailed history, detailed examination including enlargement of the vaginal opening with introduction of speculum, and identification of the foreign body as a tampon. The patient was asked to return to the office if she had any complications, fever, or abnormal discharge or heavy bleeding. How should you report the services performed? a. 99214-25, 57415 b. 99214 c. 57415 d. 57415-52 49. One week ago, Marion underwent a surgical laparoscopy with vaginal hysterectomy including removal of a 275-g uterus tube and ovaries due to cancer of the endometrium. Today she was admitted for a planned insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy. During this procedure, the surgeon inserted the device and took x-rays to ensure placement. Once the device was in the proper location, it was fixed into position by tightening the applicator base plate and locking mechanism. Marion tolerated the procedure well and was sent to the recovery suite in satisfactory condition. How should today’s professional services be reported? a. 58554, 57156-58 b. 57156-59, 77326-26 c. 58554, 57156-59, 77326-26 d. 57156-58 50. What code should be reported for a diagnostic dilation and curettage for a patient experiencing heavy bleeding that is not associated with pregnancy? a. 58120 b. 59160 c. 57800 d. 57700 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 16 Nervous System, Eye and Ocular Adnexa, and Auditory System 51. A 43-year-old patient who suffers from severe intermittent vertigo has been definitively diagnosed with Meniere’s disease. After a year of various treatments, medications, tests, and behavior/lifestyle changes that have failed to lessen the symptoms, she now presents for a transcanal chemical labyrinthotomy to the right ear. Dr. Miller visualizes the tympanic membrane with an operating microscope, cleans the ear canal, and makes a small incision into the tympanic membrane. Gentamicin is delivered into the right ear. The patient is repositioned with the right ear up and monitored by the nurse. The perfusion is repeated to achieve the maximum result. The ear is suctioned, cleaned, and carefully examined for bleeding. The patient tolerated the procedure well and is returned to the recovery area in satisfactory condition. How would Dr. Miller report his professional services? a. 386.04, 69801 x 2, 69990-51 b. 386.04, 69905 x 2, 69990-51 c. 386.00, 69801, 69990 d. 386.00, 69905, 69990 52. What code(s) would be reported for the following case? Preoperative diagnosis: Bilateral impacted ventilating tube Postoperative diagnosis: Same Anesthesia: General Procedure performed: Removal and replacement of new tubes, bilaterally via tympanostomy Procedure: Sammie, a 16-year-old patient, was admitted and taken to the operative suite and placed under general anesthesia by inhalation. When adequate sedation was achieved, a 3.8-mm speculum was inserted into the left ear, wax removed, and speculum removed. The impacted tube was then removed. A new site was achieved within the same tympanosclerotic plaque and a new tube placed. The same procedure was repeated to the right ear. Sammie was sent to the recovery suite in stable condition. a. 69424-50, 69436-50 b. 69433-50 c. 69436-50 d. 69424-50, 69433-50 © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 17 53. James returned two weeks after surgery, as planned, for a change in his epidural drug delivery system. Today Dr. Harvey opened the previous incision site. The previously placed reservoir was removed and a new programmable subcutaneous pump was connected to the catheter and secured with sutures, tested, and programmed. The subcutaneous incision was closed in layers with a sterile dressing placed. The patient tolerated the procedure well. How should Dr. Harvey report this service? a. 62362-58 b. 62365, 62362-59 c. 62350-58 d. 62350, 62355-59 54. Dr. Adams completed an anterior discectomy with decompression including osteophytectomy to levels C3–C5. For proper visualization, Dr. Adams used an operating microscope during all phases of the procedure. How should Dr. Adams report this procedure? a. 63075, 63078-51, 69990-51 b. 63075, 63078-51, 22551 x 2, 69990-51 c. 22554 x 2 d. 63075, 63076 55. With which code set or individual codes can add-on code 61781 be correctly reported? a. 61720–61791 b. 62201 or 77432 c. 77371–77373 d. None of the above 56. Carl, a 28-year-old patient, has a history of epilepsy with recurrent seizures. His seizures are intolerable even with medication management. He does not experience non-epileptic seizures, which was confirmed by EEG recordings. Today he underwent an open procedure for implantation of cranial nerve neurostimulator electrode array, which was coiled around the vagus nerve. The pulse generator was connected to the neuroÂ� stimulator array, tested, and repositioned to ensure maximum effectiveness. The pulse generator was placed and sutured into a created subcutaneous pocket. Again, the system is tested to ensure proper functionality. The subcutaneous tissues and skin are closed with deep sutures and skin staples. Carl tolerated the procedure well and was returned to the recovery suite in stable condition. Which code(s) should be reported for today’s services? a. 61885, 64568-59 b. 64568 c. 61531 d. 64570, 61888-59, 64568-59 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 18 57. A 6-month-old patient required a bilateral subdural tap through a suture. How would this initial procedure be reported? a. 61000 b. 61001-63 c. 61000-50 d. 61020-63, 61000-50 58. A patient with Bell’s palsy is unable to squint, blink, or close her left eyelid. To protect the eye, Dr. Risser completes a temporary tarsorrhaphy with a Frost suture technique. How would you report this procedure? a. 67875-LT b. 67710-LT c. 67840-LT d. 67950-LT 59. What code(s) should be reported with the following case? Preoperative diagnosis: Total retinal detachment, right eye Postoperative diagnosis: Same Procedure performed: Complex repair of retinal detachment with photocoagulation, scleral buckle, sclerotomy/vitrectomy Anesthesia: Local Procedure: The patient was placed, prepped, and draped in the usual manner. Adequate local anesthesia was adminiÂ� stered. The operating microscope was used to visualize the retina, which has fallen into the posterior cavity. The vitreous was extracted using a VISC to complete the posterior sclerotomy. Minimal scar tissue was removed to release tension from the choroid. The retina was repositioned and attached using photocoagulation laser, a gas bubble, and a suture placement of a scleral buckle around the eye. The positioning of the retina was checked during the procedure to ensure proper alignment. Antibiotic ointment was applied to the eye prior to placement of a pressure patch. The patient tolerated the procedure well and returned to the recovery suite in satisfactory condition. a. 361.05, 67113-RT, 67107-51, 67145-51, 66990-51 b. 361.05, 67113-RT c. 361.00, 67113-RT, 66990-RT d. 361.00, 67113-RT, 67107-51, 67145-51, 66990-51 © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 19 60. A patient had a bilateral strabismus surgery involving the medial and lateral rectus muscles. The surgeon explored and repaired a detached extraocular muscle in the right eye and placed bilateral posterior fixation sutures with muscle recession. How should you report this procedure? a. 67316-50, 67332-RT, 67334-50 b. 67316-50, 67332-RT, 67335-50 c. 67312-50, 67340-RT, 67334-50 d. 67312-50, 67340-RT, 67335-50 Evaluation and Management Questions in this section represent coding guidelines, not payer-specific rules. 61. Dr. June dictated the following chart note. Which code would be reported for this evaluation and management visit? Subjective: Mae is a 41-year-old female well known to me. She presents for her annual examination. Menses are regular without intermenstrual bleeding. When seen a year ago, she felt fatigued; blood work at that time showed her to be hypokalemic. She resumed a potassium supplement at that time and feels much better. She has no headaches or other complaints. She reports slight vaginal itching during the summer months but is not experiencing this problem today. Medications: Parlodel 2.5 mg bid, chlorthalidone 60 mg daily, potassium supplement daily, OTC multivitamin supplement daily Objective: Breasts without masses, bilateral galactorrhea, no axillary adenopathy. Abdomen soft and non-tender. Pelvic exam reveals external genitalia normal; vagina rugous with small amount of yellow discharge; cervix clean; uterus anterior, mobile, non-tender, and normal in size, shape, and consistency. Adnexa clear and non-tender. Pap smear obtained; wet smear is unremarkable. Assessment: 1. Long history of galactorrhea well controlled on Parlodel®, as are her menses 2. Has taken chlorthalidone daily for many years for fluid retention Plan: 1. Yearly refills for Parlodel 2.5 mg po bid, chlorthalidone 60 mg daily, and potassium supplement one daily 2. Continue on OTC multivitamin supplement daily 3. Ordered annual mammography 4. Ordered annual serum prolactine and serum potassium levels 5. Patient doing well should return in one year or as needed a. 99213 b. 99396 c. 99386 d. 99203 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 20 62. Today Glen was discharged from a nursing facility after recovering from a hip replacement. It took Dr. Loma 45 minutes to complete the final detailed examination; review detailed history, surgery notes, and lab work; write refills for prescriptions; complete orders for continued physical therapy; and provide detailed verbal instructions to Glen and his family regarding his ongoing care. How would Dr. Loma report her services? a. 99024 b. 99239 c. 99309, 99316 d. 99316 63. Dr. Mayer admitted Sally to observation status Monday afternoon related to minor changes to an EKG and a dizzy spell. His dictated note for initial observation status included a comprehensive history, comprehensive examination, and moderate decision-making. He started her on new medications and wanted to continue to observe her until he was sure her condition was stable. On Tuesday, Dr. Mayer saw Sally, who was still receiving observation services as an outpatient, and dictated a chart note related to her changes since his last visit. The note consisted of an expanded problem-focused interval history, expanded problem-focused examination, and straightforward decision-making. How should Dr. Mayer report Tuesday’s visit? a. 99220-25, 99232 b. 99220, 99226-25 c. 99232 d. 99225 64. Dr. Peters is Tim’s family physician. During today’s visit with Dr. Peters, Tim complained of fatigue, light- headedness, and intermediate chest pains. Dr. Peters called Dr. Counsel, a cardiologist, and asked for a work-in visit for Tim. Dr. Counsel saw Tim in the office later that afternoon, performed a comprehensive examination, and obtained an extended history of the present illness with complete past family, social, and personal history. Dr. Counsel’s decision-making was based on review of extensive records and test results provided by the patient, the high risk of complications, and the extensive management options. Dr. Counsel sent a written report back to Dr. Peters outlining the visit and plans for insertion of a pacemaker in the next few days. How would Dr. Counsel report today’s visit? a. 99214 b. 99245 c. 99244 d. 99205 © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 21 65. Dr. Mike asked Dr. Susan to conduct a follow-up consultation with Lou, a 15-year-old patient who had a tympanotomy three days ago and is still hospitalized. Dr. Susan consulted for Lou the day after surgery for a fever and mild seizures. The patient was stable until today when Lou’s fever returned and he suffered another mild seizure. Dr. Susan dictated a detailed history and physical examination and high decision-making related to her findings. How would Dr. Susan report her services for today’s visit? a. 99253 b. 99234 c. 99233 d. 99252 66. A physician provided 185 minutes of critical care for an 82-year-old patient suffering from heart failure. The physician documented an additional 20 minutes, outside the critical care time, which was dedicated to insertion of a peripherally inserted venous access device. During this encounter, the physician obtained a frontal chest x-ray, pulse oximetry, and arterial puncture for blood gases. How should these services be reported? a. 99291-25, 99292 x 4, 36571 b. 99291-25, 99292 x 4, 71010, 94760, 36600 c. 99291, 99292 x 5 d. 99291, 99292 x 4 67. Warfarin therapy management anticoagulation codes 99363–99364 describe what type of management? a. Outpatient management b. Inpatient management c. Online in conjunction with inpatient management d. Online in conjunction with outpatient management 68. Baby Jones is 26 days old and requires continued intensive care services but is not considered critically ill. Her present body weight is 1,400 grams. Dr. Rob initially admitted Baby Jones to her service on Monday. Dr. Rob completed a visit with Baby Jones and her parents on Tuesday and Wednesday. How would Dr. Rob report all three days of service? a. 99468, 99469 x 2 b. 99477, 99478 x 2 c. 99460, 99462 x 2 d. 99291, 99292 x 2 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 22 69. Today Dr. Miller completed an annual assessment with Mary, an established patient. Mary has been living in a nursing facility for the past three years. Today’s documentation included an assessment of her overall condition, her continued need for 24-hour nursing assistance, and her decline in mental acuity. Dr. Miller dictated a comprehensive history, comprehensive examination, high decision-making, and notes related to discussions with her extended family. Additionally, he completed the required resident assessment instrument and protocols and Minimum Data Set paperwork. Which code(s) should Dr. Miller report for today’s visit? a. 99306 b. 99215 c. 99318 d. 99310-25, 99318 70. What is the time requirement for reporting subsequent units of physician standby services? a. Second and subsequent periods of standby beyond the first 15 minutes may not be reported even if an additional 15 minutes are spent on the unit or floor b. Second and subsequent periods of standby beyond the first 15 minutes may be reported only if a full 15 minutes of standby was provided for each unit of service reported c. Second and subsequent periods of standby beyond the first 30 minutes may be reported only if a full 30 minutes of standby was provided for each unit of service reported d. Second and subsequent periods of standby beyond the first 30 minutes may be reported if greater than 15 minutes of standby was provided for each unit of service reported Anesthesia 71. An anesthesiologist provided general anesthesia for open repair of a fractured pelvis column involving the acetabulum for a 74-year-old patient. Further documentation for this patient includes severe hypertension and uncontrolled diabetes. How should the anesthesiologist report her services? a. 01173-P3, 99100 b. 27226, 01190-P3, 99100 c. 01190-P4, 99100-51 d. 01170-P4 © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 23 72. Dr. Burns, a surgeon, provided regional anesthesia and completed an exploration for postoperative hemorrhage in the neck on a 55-year-old patient with moderate cardiovascular disease. How would Dr. Burns report his services for this case? a. 00350-P2, 35800 b. 35800-47 c. 00350-P2 d. 00350-47 73. Why should the add-on code 99100 for qualifying circumstances not be reported with the following codes: 00326, 00561, 00834, and 00836? a. Age of the patient is not a factor with any anesthesia codes or add-on codes b. Age of the patient as older than 70 years is part of the code; therefore, it does not require the add-on code c. Age of child as older than 1 year is part of the code; therefore, it does not require the add-on code d. Age of child as younger than 1 year is part of the code; therefore, it does not require the add-on code 74. A patient undergoing a cervical surgery received general anesthesia for a procedure performed in a sitting position. The patient is 54 years old and healthy, aside from the current cervical problem. How should the anesthesiologist report his services? a. 00604 b. 00600-P1 c. 00604-P1 d. 00620 75. A patient underwent drainage of a pelvic abscess via transvaginal approach. The patient was under moderate sedation for the procedure, which was provided by the same operating physician. The intraservice time was clocked at 45 minutes. How should the sedation services be reported for this procedure? a. 58823, 00940 b. 00940-P2 c. 58823 d. 58823-P2 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 24 76. According to the anesthesia guidelines, what forms of monitoring are not included or bundled with anesthesia services? a. Intra-arterial b. Central venous c. Swan-Ganz d. All of the above 77. Dr. Will, an anesthesiologist, provided three days of hospital management for epidural continuous drug administration. These services were performed after insertion of the epidural catheter. How should Dr. Will report these days of care? a. 01996-P1 x 3 b. 01996 c. 64999-P1 d. 64999 78. A patient with a third-degree burn of 54% of his body is being treated under anesthesia for excision, debridement, and extensive skin grafting. The patient’s condition is listed as severe, and he is not expected to survive without the operation. The operation is further complicated by the emergency condition of the patient, and delaying this procedure could lead to loss of body parts. How should the anesthesiologist report her services with this procedure? a. 01952-P5, 01953-P5 x 5, 99140 b. 01952-P5, 01953-P5 c. 01951, 01952, 01953 x 4 d. 01951, 01952, 01953 x 5, 99140-51 Radiology 79. How should you report services for a 3-D radiation therapy simulation field setup? a. 77290 b. 77295 c. 77263 d. 77280, 77295 © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 25 80. A patient with a history of family breast cancer is now suffering from swelling in both arms and under- goes a bilateral lymphangiography. How should the professional services and diagnoses be reported for this procedure? a. 75807-26, 729.81, V10.3 b. 75801-26, 729.81, V16.3 c. 75803-26, 729.81, V10.3 d. 75803-26, 729.81, V16.3 81. Angela, a 28-year-old patient, is pregnant with triplets. She is in her second trimester and is being evaluated by transabdominal ultrasound with real-time imaging for fetal sizes. This is her third follow-up ultrasound to ensure the adequacy of fetal growth, development, and weight. How would you report this service? a. 76816, 76816-59, 76816-59 b. 76816, 76810 x 2 c. 76830, 76830-59, 76830-59 d. 76805, 76810 x 2 82. A patient had an MRI of the face without contrast materials followed by contrast for six further sequences during the same scanning session. How should this professional service be reported? a. 70540-26, 70542 x 5 b. 70540, 70542-26 c. 70543-26 d. 70543 x 5 83. The code set 74176–74178 should be reported how many times per CT session of the abdomen and pelvis? a. For each organ scanned b. Once c. Twice d. This code set has been deleted 84. A therapeutic radiologist performed a comprehensive history, comprehensive examination, and high complexity decision-making when admitting a patient. After admission, the same physician placed 12 interstitial ribbons for clinical brachytherapy. How would you report these services? a. 77778 b. 99223, 77778 c. 99223, 77763 d. 77763 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 26 85. A patient underwent a whole-body diagnostic nuclear medicine test because of thyroid carcinoma metastases with uptake. How would these services, radiopharmaceuticals, and/or drugs be reported? a. 78018, 78020: Services do not include radiopharmaceuticals or drugs that are reported separately b. 78070, 78020-51: Services do not include radiopharmaceuticals or drugs that are reported separately c. 79005, 72020: Services include radiopharmaceuticals or drugs d. 78018, 78020: Services include radiopharmaceuticals or drugs 86. Joann had a diagnostic mammography of her left breast with computer-aided detection. During the same session, two lesions were identified and mammographic guidance needle placements were completed. How should these services be reported? a. 77032-LT, 77057-LT, 77052-LT b. 77032-LT x 2, 77056-LT, 77051-LT c. 77032-LT x 2, 77055-LT, 77051-LT d. 77032, 77055-LT, 77051-51 87. A patient completed three radiation treatment sessions for two separate treatment areas with use of multiple blocks. Each session consisted of 8 MeV of radiation being delivered. How should these technical services be reported? a. 77408 x 3-TC b. 77408 x 3 c. 77411-TC d. 77413 x 3-TC Laboratory and Pathology 88. Which code(s) should be reported for the following case? Clinical history: Mass in the body of stomach Gross description: Cavity effusion – two Diff-Quik four smears prepared with simple filter and interpretation Specimen received: Stomach mass touch prep Adequacy: Specimen satisfactory for cytological evaluation Diagnosis: Primary malignant neoplasm – body of the stomach © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 27 Notes: Cytology completed on specimen. The malignant cells show subjective features suggestive of small-cell carcinoma; however, cell size is more attuned with non-small-cell carcinoma. a. 151.4, 88106 b. 209.63, 88104 c. 789.30, 151.4, 88106 d. 209.63, 151.3, 88108 89. Dr. Ross, a pathologist, completed both gross and microscopic surgical pathology after a lung wedge biopsy. Dr. Miles, the surgeon, sent a single specimen to the laboratory after the completion of a limited biopsy by thoracotomy. How would Dr. Ross report her services? a. 88300, 88307 b. 32151, 88305-26 c. 88307 d. 88307-26 90. Robert was sent to a local laboratory for pre-employment drug screening. He provided a urine sample to the laboratory technologist. The technologist completed a qualitative screening, including one procedure for multiple drug classes using non-chromatographic methods with a multiplexed kit. The test was negative and results were sent back to the requesting employer. How should you report this laboratory service? a. 80102 b. 80100, 80101 c. 80103 d. 80104 91. Jane underwent a combined rapid anterior pituitary evaluation panel with multiple exposures and suppressions and had a hepatic function panel. How should these tests be reported? a. 82024 x 4, 83002 x 4, 83001 x 4, 84146 x 4, 83003 x 4, 82533 x 4, 84443 x 4 b. 80418, 80076 c. 80418, 82024, 83002, 83001, 84146, 83003, 82533, 84443 d. 80076 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 28 92. Dr. Thomas received a request for consultation that included records and specimens. Dr. Thomas did not see the patient, but documented the patient as inpatient status with a comprehensive family history of colon cancer. The patient takes multiple medications and is at high risk of complications due to weight loss, chronic diarrhea, and a continued fever. His confirmative opinion, based on the review of specimens and records, indicates positive small-cell cancer. Dr. Thomas sent his written report back to the requesting physician. How should Dr. Thomas report his services? a. 99254 b. 88325 c. 99254-25, 88325-26 d. 88323 93. Which modifier appended to code 88239 would describe solid tumor testing of Von Hipple–Lindau disease? a. -59 b. -1Z c. -0F d. -P6 94. Larry had a venipuncture during his annual physical examination. The blood sample was used for the following antibody tests: West Nile IgM, Shigella, mumps, and total hepatitis B. How should you report these tests? a. 36415 b. 86486 c. 86788, 86771, 86735, 86704 d. 36415-32, 86788, 86771, 86735, 86704 95. Today, an extended culture of five-day embryos was completed. The transfer tests will be completed when the culture test results are confirmed. The culture testing results are scheduled for return within 48 hours. How should the culture service be reported? a. 89272 b. 89250 c. 89258 d. 89255, 89272 © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 29 96. A patient had the following blood tests completed as part of her primary care physician’s described metabolic panel: albumin, bilirubin total, calcium total, carbon dioxide, chloride, creatinine, glucose, phosphatase alkaline, potassium, protein total, sodium, transferase (ALT SGPT), transferase aspartate (AST SGOT), urea nitrogen (BUN), bilirubin direct, and a hepatitis A IgM. How should these services be reported? a. 80053, 82248, 86709 b. 80053-22 c. 80076-52, 80074-52, 80053-52 d. 80047, 80053, 80076 97. A patient had glucose tolerance testing completed on five specimens. How should these laboratory services be reported? a. 82947, 82951, 82952-51 b. 82951, 82952 x 2 c. 82947, 82952 x 5 d. 82951 x 5 Medicine 98. Mae’s physician asked her to wear a glucose monitoring device to obtain more accurate information about her blood sugars. She had sensors placed and was then hooked up to a calibrated wearable device. Once this was complete, the technician provided Mae with training for the noninvasive ambulatory continuous glucose monitoring device. After wearing the device for 72 hours, Mae’s physician’s office removed the device, printed recordings, and downloaded analyses reports to its computer system. Which code captures this service? a. 99090 b. 99091 c. 95250 d. 95251 99. Edna, a 72-year-old patient, returned to her regular pulmonologist for a follow-up visit. Dr. Harry documented Edna’s chief complaint as fatigue after recovering from a minor flu. His documentation supports a past history of smoking, COPD, and well-controlled diabetes. Edna lives with her husband, maintains her weight with a balanced diet, and exercises in the warm weather but feels “shut in” during the winter. Dr. Harry noted a detailed examination, reviewed multiple treatment options, and reviewed moderate risks for complications. Dr. Harry completed a six-minute walking pulmonary stress test to evaluate distance, dyspnea, desaturation, 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 30 and heart rate. The stress test was repeated with adequate rest walks, pre-/post-spirometry and oximetry, and interpretation and evaluation protocol for Edna’s entry into a pulmonary rehabilitative program. Which code(s) should Dr. Harry report for today’s services? a. 99214-25, 94620 b. 99204-25, 94621 c. 94799 d. 99213-25, 94620 x 2 100. A 19-year-old patient received immunizations at her health clinic. The immunizations were administered by a medical assistant at the same clinic. The patient was seen two weeks ago but was unable to complete the immunizations due to a stomach virus. Today, she is symptom-free and receives an intramuscular split virus influenza enhanced immunogenicity via increased antigen content vaccine and an intramuscular hepatitis A immunization. Which codes capture these services? a. 99211-25, 90662, 90667, 90473-51, 90474-51 b. 99213-25, 90632-51, 90666-51, 90471-51, 90472-51 c. 90460, 90632-51, 90632-51 d. 90632, 90662, 90471, 90472 101. What codes are not reported in conjunction with the following code descriptor? Comprehensive electrophysiologic evaluations including insertion and repositioning of multiple electrode catheters with indication or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, and His bundle recording a. 93600, 93602, 93610, 93612, 93618, 93619 b. No codes are restricted from conjunction reporting with 93620 c. 93600-51, 93602-51, 93610-51, 93612-51, 93618-51, 93619 d. Both a and c 102. An 11-year-old female had one face-to-face visit with her physician and received three daily dialysis services during a one-month period prior to her kidney transplant. How should these services be reported? a. 90945 b. 90968 x 3 c. 90964 x 3 d. 90956 © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 31 103. Which codes should be reported for the following case? Preoperative diagnosis: Coronary arteriosclerosis of native arteries, chronic occlusion of coronary arteries Postoperative diagnosis: Same Anesthesia: Conscious sedation by procedure physician with presence of trained observer Procedure: The 64-year-old patient was prepped, draped, and positioned in the usual fashion. After adequate sedation was administered, an access site into the right femoral artery was achieved. The catheter devices were advanced into position. Extensive review of the current anatomy was completed along with review of the previous catheterization. The procedure continued as planned with placement of two drug-eluting stents in the left circumflex, PTCA to the right coronary artery, and atherectomy for occlusion in the left anterior descending artery. Adequate flow was reviewed and confirmed via angiograms upon completion of the procedures. The guiding catheter was withdrawn after flow confirmation. Total intraservice time was noted at 1 hour 30 minutes. The sheath was secured to the groin with a suture and the patient was moved to recovery in good condition. Standing orders were given for sheath removal when the heparin effects are noted as normal through blood tests. Normal pressure is to be applied at the groin as needed with placement of a sandbag or ice bag. a. 414.01, 414.2, 92980-LC, 92984-RC, 92996-LD b. 414.2, 424.0, 92980, 92984, 92996 c. 414.2, 424.0, 92980, 92982-51, 92995-51 d. 424.0, 414.2, 92980-LC, 92984-RC, 92996-LD, 99144, 99145 x 2 104. A patient suffering from nystagmus completed a basic vestibular function evaluation with testing and recording in five different positions with gaze fixation; optokinetic, bidirectional, foveal, and peripheral stimulation; and oscillation. An additional vertical electrode and vertical axis rotational testing was employed during testing. How should this procedure be reported? a. 92545, 92541-59, 92542-59, 92540-59 b. 92540, 92545, 92542, 92546, 92547 c. 92540, 92546, 92547 d. 92545, 92547-51 105. A patient underwent a left heart catheterization by transseptal puncture through an intact septum with image supervision and interpretation and intraprocedural injection for left ventriculography. During the procedure, pharmacologic agents were administered and measured. An arm ergometry was employed for exercise study to assess hemodynamics before and after the procedure. How should this procedure be reported? a. 93458, 93462, 93463, 93464 x 2 b. 93452, 93566, 93462, 93463, 93464 x 2 c. 93452, 93566, 93462, 93463, 93464 x 2 d. 93452, 93462, 93463, 93464 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 32 106. A patient completed a diagnostic computerized ophthalmic scan of the retina on both eyes. The physician’s interpretation and report included changes to the retina in the right eye from a previous study. The left retina looked stable with no changes noted. The patient is scheduled for a follow-up study in three weeks to assess any new changes and treatment as needed. How should the physician report her services? a. 92132-50, 92134-26 b. 92132 c. 92134 d. 92134-50 107. Cameron received 60 minutes of insight-oriented psychotherapy in an outpatient facility. During this same visit, Cameron complained of an upset stomach due to his new medications. The medications were reviewed and new medications were prescribed, a flare-up of his seasonal allergies was documented, and a persistent cough is noted. The documentation included the psychotherapy notes with an additional 35 minutes dedicated to a problem-focused history, problem-focused examination, and low-complexity decision-making. How would the physician services be reported? a. 90822 b. 99213-25, 99354, 90815 c. 90809 d. 99213-25, 90809 Medical Terminology and Anatomy 108. What condition is caused by an accumulation of uric acid crystals in the base joint of the large toe and other joints of the feet and legs? a. Bursitis b. Fibrosis c. Arthritis d. Gout 109. What part of the eye is the white, outermost layer of the eyeball, composed of tough connective tissue? a. Pupil b. Iris c. Cornea d. Sclera © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 33 110. What term describes a muscle shortening its length in a resting state and then remaining in this position? a. Contracture b. Atrophy c. Hypertrophy d. Contusion 111. Which of the following represents the correct pathway for electrical activity in the heart? a. SA node, Purkinje fibers, AV node, bundle branches b. SA node, AV node, bundle branches, Purkinje fibers c. AV node, SA node, Purkinje fibers, bundle branches d. Purkinje fibers, bundle branches, SA node, AV node 112. Which term describes cancer of the large intestine and rectum? a. Gastrointestinal cancer b. Duodenal cancer c. Colorectal cancer d. Colorectal gastrointestinal cancer 113. What process describes blood cell formation occurring in the red bone marrow? a. Syneresis b. Hematopoiesis c. Fibrinolysis d. Erythrocytosis 114. MIF is what type of laboratory test? a. Miller inventory fraction b. Macro isolate freeze c. Migration inhibitory factor d. Minerva iodine filler 115. What is Travert? a. A procedure on nerve fibers b. A drug c. An instrument for ear surgeries d. The outer plastic for cast material 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 34 116. What is the temporary circulation route that exists only between a developing baby and its mother? a. Hepatic circulation b. Fetal circulation c. Renal circulation d. Pulmonary circulation 117. What is the doughnut-shaped gland that surrounds the superior portion of the male urethra just below the bladder? a. Adrenal gland b. Prostate gland c. Spermatic gland d. Ejaculatory gland 118. Which joint movement is limited to flexion and extension in a single plane? a. Hinge joint b. Ball-and-socket joint c. Pivot joint d. Suture joint 119. What does the prefix “aniso-” mean? a. Superior b. Bilateral c. Unequal d. Like 120. The lymphatic system is sometimes referred to as which other system? a. Endocrine system b. Respiratory system c. Immune system d. Blood circulatory system © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 35 121. Which term describes death of breast tissue resulting from interrupted blood flow to this area? a. Hypercirculation b. Agglutination c. Complement d. Infarction 122. What muscles are found between the metacarpals that cause abduction of the proximal phalanges of the fingers? a. Interossei b. Flexor pollicis c. Extensor indicis d. Pronator teres 123. What does a corneal pachymetry determine? a. Corneal thickness b. Corneal body location c. Corneal power calculation d. Corneal position ICD-9-CM 124. Six weeks ago, Terry underwent a biopsy procedure and was diagnosed with secondary metastatic liver carcinoma. His doctors are uncertain about the location of the primary site and have ordered further testing. Today, Terry is undergoing chemotherapy for the liver cancer. How should the diagnosis codes be reported for today’s service? a. 197.7, 199.1, V58.11 b. V58.81, 238.9, 197.7 c. V58.11, 199.1, 155.2 d. V58.11, 197.7, 199.1 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 36 125. Jodie is 28 weeks pregnant with her second child. During an office visit two weeks ago, she mentioned experiencing some edema and headaches. Dr. Smith noted a higher-than-usual blood pressure for Jodie and asked her to come in for continued blood pressure monitoring and a urine test. Her urine test came back positive for excessive protein. During her visit today, her blood pressure is 140/95, which is consistent with the past abnormal readings. She still has continued abnormal edema but no headache. Dr. Smith tells Jodie she has preeclampsia and wants her to schedule visits more often during the next two months for monitoring. What code(s) should be listed in Jodie’s record for today’s visit? a. 642.43 b. 782.3, 796.2, V22.2 c. 642.43, 646.13, V22.1 d. 642.53 126. Lynn is a 53-year-old patient who previously received treatment by external fixation for a Grade I right tibial fracture. She suffered the fracture falling from a ladder while cleaning the gutters on her home. Today she underwent an open reduction of the right proximal tibia with bone grafting for nonunion. What diagnosis codes would Dr. Rennin report for today’s encounter? a. 823.02, 733.82, E881.0 b. 823.00, 905.4, E881.0, E013.9, E000.8 c. 733.82, 905.4, E929.3 d. E929.3, 905.4, 733.82 127. Dr. Martin completed a diagnostic GI endoscopy on Larry, a 42-year-old patient who complained of diarrhea, blood in his stool, and stomach cramps. Dr. Martin diagnosed Larry with diverticulitis of the colon as the cause of bleeding and other symptoms. How should Dr. Martin report her diagnosis code(s) for this encounter? a. 562.12 b. 562.13, 787.91, 578.1, 789.00 c. 562.11, 578.9 d. 562.13 © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 37 128. Dr. Ben admitted Claire for treatment of her acute and chronic pyelonephritis, mild hypertension, and secondary diabetes with associated macular edema. During this encounter, Claire received insulin to temporarily bring her blood sugar under control. How should the diagnosis codes be reported for this admission encounter? a. 590.10, 590.00, 401.9, 249.50, 362.07 b. 590.00, 590.11, 401.1, 250.00, 362.07 c. 590.10, 590.00, 401.9, 250.50, 362.07, V58.67 d. 362.07, 249.50, 401.9, 590.01 590.10 129. Sara is being seen for a spontaneous pathologic fracture of her right hip with additional damage to the intertrochanteric section of the bone. The documentation indicates the patient also has symptomatic HIV disease. Sara has had previous pathologic fractures of the ulna and vertebral segments, which have since healed. How should the diagnosis codes be reported for this encounter? a. 733.14, 733.12, 733.13, 042 b. 042, 733.14, V13.51 c. 733.14, 042, V13.51 d. 820.21, 042, V15.51 130. Baby Jones is being treated in the emergency room for shaken baby syndrome with subdural hematoma, concussion with loss of consciousness for 34 minutes, and retinal hemorrhage resulting from the patient’s stepmother not being able to get the baby to stop crying. Baby Jones’ stepmother, who was drunk at the time of the accident, admitted to shaking the patient, but did not mean to harm him. How should the diagnosis codes be reported for this encounter? a. 995.54, 852.24, 850.12, 362.81, E968.8, E967.0, E000.9 b. 995.55, 852.23, 305.00, 362.81, E968.8, E967.0 c. 995.55, 852.22, 850.12, 362.81, E968.8, E967.2 d. 995.55, 852.22, 362.81, E968.8, E967.2 131. Jason was burned during a military scuba diving exercise when steam was released from a steam pipe. He suffered second- and deep third-degree burns to the entire anterior side of his right leg, second-degree burns to part of the right palm, and a second- and third-degree burn to his right forearm. The documentation indicated 25% of the total body surface area (TBSA) was burned, of which 19% were third-degree burns. How would the diagnosis codes be reported for Jason’s burns? a. 945.49, 943.31, 944.25, 948.11, E924.2, E000.1, E002.0 b. 945.34, 943.31, 944.25, 948.00, E924.8, E000.1, E002.0 c. 945.49, 943.31, 944.25, 948.21, E924.8, E000.1, E002.4 d. 943.31, 944.55, 948.11, 945.34, E924.8, E000.1, E002.4 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 38 132. Karen is being treated for widespread rheumatoid arthritis and polyneuropathy in collagen vascular disease. How should you report these diagnosis codes? a. 711.09, 714.0, 359.6 b. 357.1, 714.0 c. 714.0, 357.1 d. 711.09, 359.6 133. Ruth was treated for a skin rash, nausea, and vomiting due to an accidental poisoning when she ate wild berries. How should Ruth’s diagnosis codes be reported for this encounter? a. 787.01, 988.1, 782.1, E863.4 b. 988.1, 787.01, 782.1, E865.3 c. 988.2, 787.01, 693.1, E865.3 d. 988.2, E865.3 HCPCS Level II 134. Mrs. Smith underwent a hemipelvectomy to remove a tumor in her uppermost right hip region. After healing from the operation, she was fitted with a prosthetic and started physical therapy. Which supply code(s) would be reported for her hemipelvectomy, Canadian type; molded socket, hip joint, single-axis constant-friction knee, shin, SACH foot? a. L5400-F9 b. L5331-50 c. L5280-RT d. L5280-RT, L5595 135. What modifier should be reported when services are delivered via asynchronous telecommunication system? a. GC b. JW c. GQ d. HC © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 39 136. Jane had her ostomy pouch replaced. Her new ostomy pouch is drainable, with extended wear barrier attached, with built-in convexity (1 piece). How should you report this supply? a. A4390 b. A4387 c. A4385 d. A4392 137. Sherry, a 5-year-old patient, was diagnosed with immune thrombocytopenic purpura and started on Privigen® 1,000 mg. Which diagnosis and medication (drug) code should be reported for her injections? a. 287.33, 446.6, J1459 x 2 b. 446.6, J1459 c. 287.31, J1459 x 2 d. 776.1, 287.31, J1459 138. Joe lost his ability to speak as the result of an accident. Today he received a speech-generating synthesized device, which is activated by physical contact with the device. Which code would you report for the supply of this device? a. E2502 b. E2510 c. E2500 d. E2508 Coding Guidelines 139. In the CPT® Professional Edition, the same detailed definition for separate procedures can be located in which main section guidelines? a. Evaluation and Management, Surgery, and Medicine b. Medicine, Radiology, and Surgery c. Radiology, Surgery, and Pathology and Laboratory d. Cardiovascular System, Radiology, and Medicine 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 40 140. What do the guidelines for Category II codes state about the use of these codes? a. The use of these codes is optional and may not be used as a substitute for Category I codes b. The use of these codes is mandatory and required for proper coding as substitutes for Category I codes c. The use of these codes is required only for reporting to federal regulatory agencies related to new technology d. The use of these codes is indispensable and required for proper coding in addition to Category I codes 141. Which of the following does the CPT ® Professional Edition indicate is always included in addition to the operation per se? a. Evaluating the patient in the pre-anesthesia recovery area b. Local infiltration, general, and digital block or topical anesthesia c. Immediate postoperative care, including dictating operative notes and talking with the family and other physicians d. Prior to the decision for surgery, all evaluation and management visits are included 142. How does the CPT ® Professional Edition describe concurrent care of a patient? a. Concurrent care is the provision of similar evaluation and management services for different patients during the same day. When this care is provided, no special reporting is required. b. Concurrent care is the provision of management for some or all of the patient’s current problems and relinquishing responsibility of past management to another physician. When this care is provided, special forms must be completed. c. Concurrent care is the provision of similar services to the same patient by more than one physician on the same day. When concurrent care is provided, no special reporting is required. d. Concurrent care is the provision of different services to the same patient by one physician on the same day. When concurrent care is provided, special reporting is required. 143. Which elements are listed to determine the complexity of decision-making for evaluation and management codes? a. Number of diagnoses or management options, amount and/or complexity of data to be reviewed, and risk of complications and/or morbidity or mortality b. Minimal management options, amount and/or complexity of lab results, and risk of complications c. Number of diagnoses or management options, unit and floor time, and risk of complications and/or morbidity or mortality d. Amount and/or complexity of data to be reviewed, risk of complications, and number of diagnoses related only to past family and/or social history © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 41 144. Which types of contrast administration alone do not qualify as a study “with contrast”? a. Oral and/or extravascular b. Oral and/or intrathecal c. Oral and/or intravascular d. Oral and/or rectal Practice Management 145. What organization is responsible for updating CPT codes each year? a. American Health Information Management Association (AHIMA) b. American Medical Association (AMA) c. Centers for Medicare & Medicaid Services (CMS) d. American Hospital Association (AHA) 146. The OIG Work Plan for 2012 indicates mandatory reporting with special modifiers when a manufacturer’s credit is provided for services associated with replacement of medical devices. What percent of credit is required for special modifier reporting associated with this regulation? a. 71% b. 25% c. 50% d. 22% 147. What does the abbreviation PQRS refer to in relation to medical coding? a. Physical Quality Reporting Standards b. Physician Quality Reporting System c. Physician Quality Reimbursement Solutions d. Physical Quantity Reporting Structure 148. Which two organizations evaluate, establish regulations, and provide accreditation standards for managed care organizations? a. National Committee for Quality Assurance (NCQA) and The Joint Commission b. NCQA and CMS c. CMS and Quality Improvement System for Managed Care (QISMC) d. The Joint Commission and QISMC 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 42 149. Which two federal government agencies make up the ICD-9-CM Coordination and Maintenance Committee? a. National Center for Health Statistics (NCHS) and CMS b. CMS and AHIMA c. NCHS and AHIMA d. NCHS and CMS 150. The Federal Register is organized into four categories of documentation: i. Presidential Documents iii. Proposed Rules ii. Rules and Regulations iv. Notices What three sections are included as additional sections? a. Common Language, Separate Parts, Reader Tools b. Corrections, Separate Portions, Reader Tools c. Common Language, Separate Regulations, Reader Aids d. Corrections, Separate Parts, Reader Aids © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 43 2012 CPC Practice Test Answer Key 1. d. One way to locate this answer in the index of the CPT® Professional Edition is under “Destruction,” “Skin,” then “Premalignant.” The add-on code 17003 has the word “each,” which indicates the lesions are reported separately, not as a group. 2. b. The CPT® Professional Edition guidelines for excision of malignant lesions indicate a simple closure is included and measurement for excision includes the lesion diameter plus the narrowest margins equal the excised diameter. The narrowest margins in this question are listed as a total of 6 cm and the lesion is 1 cm; therefore, the total excised diameter is 1.6 cm (narrowest margins + the clinical diameter of the lesion = total excised diameter). 3. a. The fine needle aspiration is listed as the primary procedure with the add-on code reporting the metallic clip. An add-on code should not be listed as a primary procedure, nor should modifier -59 be appended to add-on codes. Review the definition of modifier -59 in Appendix A of the CPT® Professional Edition to help determine placement of modifiers. 4. d. One way to find this answer in the index of the CPT® Professional Edition is the main term “Reconstruction,” “Breast,” then “with Free Flap.” Once the code is located, cross-reference to review the parenthetical notes below the code description for bundled or included procedures. 5. c. The parenthetical note below code 10180 provides guidance for surgical wound closure codes. Because this question indicates a postoperative infection and secondary closure, review the codes carefully for proper assignment. Modifier -51 is used to indicate multiple procedures. 6. a. The biopsy and frozen sections are reported with modifier -59 because there was no prior pathology of the lesion and the Mohs surgery occurred on the same day. Selection of Mohs surgery codes is based on anatomic location and number of stages, which include five tissue blocks. Code 17315 is reported for additional tissue blocks after the first five, any stage. 7. c. Repair (closure) guidelines indicate the most complicated repair should be coded as the primary procedure and modifier -59 should be reported when more than one classification of wound is repaired. This is a change in the coding guidelines as of CPT 2012. It is important to review the anatomic groupings associated with repair codes. 8. b. The guidelines in the CPT® Professional Edition listed with excision of malignant lesions state that, in cases of excision performed in conjunction with adjacent tissue transfer, the coder should report only the adjacent tissue transfer code. The lesion excision is not separately reportable. 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 44 9. d. One way to find this answer in the CPT® Professional Edition index is under the main term “Reinsertion,” then “Drug Delivery Implant.” 10. a. Code 29914 has a symbol listed to indicate that this code is resequenced. Additionally, the parenthetical note listed with this code provides information related to correct reporting of codes used in conjunction. 11. c. One way to find the code range in the index of the CPT® Professional Edition is under the main term “Tendon,” “Transfer,” then “Leg, Lower.” Reporting the add-on code is required for the additional tendon. According to the modifier -51 definition in the CPT® Professional Edition, this modifier should not be appended to add-on codes. 12. d. This is a surgical arthroscopy procedure, which includes the diagnostic arthroscopy. You can find the coding note related to diagnostic and surgical arthroscopies multiple times in the CPT® Professional Edition. Specifically, this note can be found under the subcategory heading “Endoscopy/Arthroscopy” with this code set. The wound closure is included with the procedure and should not be coded separately. 13. a. The casting would be coded for the application of a new cast by the same physician who completed the surgery. As stated in the question, this was a planned application; therefore, modifier -58 should be appended. The guidelines are listed under the subheading for application of casts and strapping in the CPT® Professional Edition. 14. b. You can find the definition of a radical resection of soft tissue tumors in the CPT® Professional Edition at the beginning of the section on the musculoskeletal system. 15. b. You can find this answer in the index of the CPT® Professional Edition under “Exploration,” “Extremity,” then “Penetrating Wound.” The exploration of wound subcategory guidelines list the procedures that are included or bundled. This was a wound exploration only; therefore, no other codes would be reported, according to the subcategory guidelines. 16. d. Careful review of the approach and level of spinal surgery is important to determine the correct code selection. Modifier -51 should not be appended to add-on codes for spinal instrumentation; however, guidelines with spinal fusion exploration indicate modifier -51 should be appended to this code when performed with a definitive procedure. Per CPT Assistant March 2010, p. 9, explorations shouldn’t be reported when conducted as part of an initial fusion. However, separate codes can be reported for adjacent levels of arthrodesis. 17. c. This question is specifically for a bone cyst. There is no mention of an arthrocentesis in this question. © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 45 18. a. The parenthetical note under code 20551 indicates the use of a Category III code for this procedure. According to CPT® Changes: An Insider’s View 2011, the imaging guidance, harvesting, and preparation are included with the code and should not be reported separately. 19. c. This procedure was completed under general anesthesia, not moderate sedation. The codes for moderate sedation should not be reported with this procedure as the description of the code includes the words “general anesthesia.” 20. b. Modifier -26 is used to report professional services. The thoracentesis does not have a technical compo- nent; therefore, modifier -26 is not required. Modifier -26 is used to report the professional side of the radiology service. 21. b. This tracheostomy was a planned procedure for a 20-month-old patient. The anesthesia code would not be reported for the operating physician. 22. d. The patient requested the consult in this question; therefore, evaluation and management consult codes are not reported. Modifier -57 is applied to the evaluation and management code because the decision for surgery was made during this visit. The bypass surgery in this question is a combination procedure using one artery and one vein; therefore, the combination (add-on) code is reported in addition to the arterial grafting code. The venous grafting codes are reported when only veins are used in a procedure. The add-on code for reoperation would be reported since the primary procedure (or first operation) was more than one month prior to the subsequent bypass surgery. Additionally, the add-on code for harvesting the femoropopliteal vein would be reported. The use of modifier -51 would not be appropriately appended to add-on codes per the Appendix A of the CPT® Professional Edition. 23. a. This question deals with the placement of a dual temporary pacemaker; therefore, codes for permanent pacemaker systems would not be reported. 24. d. This is an upgrade from a single to dual pacemaker system. Code 33214 includes removal of the old system, testing, and insertion of the new system. In this question, a revision of the skin pocket would be reported separately. 25. b. According to the CPT® Professional Edition subcategory guidelines with pacemaker and pacing cardioverter-defibrillator, when the “battery” of one of these systems is replaced, it is actually the pulse generator that is changed. For 2012, there are combination codes that describe the removal and replacement of the pulse generator. Add modifier -51 to 93461. 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 46 26. c. This question focuses on the cardiovascular monitor testing. The placement of the biventricular pacemaker is scheduled, but not stated as completed; coding for services not completed would be incorrect. 27. c. This repair includes an endarterectomy or angioplasty when completed with the basic procedure. This note can be found in the CPT® Professional Edition under the “Coronary artery anomalies” subheading. 28. a. Review of the parenthetical notes with this code in the CPT® Professional Edition will assist with correct conjunctive coding. 29. a. One way to find this procedure in the index of the CPT® Professional Edition is under the main term “Nerves,” “Destruction,” then “Laryngeal Recurrent.” 30. d. The definitive diagnosis of benign colon polyps should be reported, not the signs and symptoms for this question. The signs and symptoms would be appropriate if there was not a definitive diagnosis available for the study. The diagnostic colonoscopy is included with the surgical colonoscopy; therefore, only code 45385 is required for correct procedure reporting. 31. c. The CPT® Professional Edition includes a definition of colonoscopy and coding tips. In the coding tip for colonoscopy, modifier -53 is appropriate with documentation regarding non-advancement of the scope beyond the splenic flexure. 32. a. One way to find this procedure in the index of the CPT® Professional Edition is under the main term “Esophagus,” “Removal,” and “Foreign Bodies.” In this question, an esophagotomy was completed; therefore, you should not report a code for an endoscopic approach. 33. b. This question indicates anesthesia was started and then the condition of the patient changed. Modifier -53 indicates a discontinued procedure after administration of anesthesia and is appended to the surgery code. Modifier -74 is for hospital use for outpatient surgery. 34. c. The complex repair is included with this excision code and should not be reported separately. The diagnosis in this question is a lesion, not a neoplasm. 35. b. Code 43242 includes the ultrasound. Review the parenthetical notes with this code to help determine correct reporting. 36. d. One way to find this procedure in the index of the CPT® Professional Edition is under the main term “Laparoscopy,” then “Esophagogastric Fundoplasty” and/or “Esophageal Lengthening.” Review the definition for modifier -51 in Appendix A of the CPT® Professional Edition to help determine placement of this modifier. © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 47 37. d. The add-on code 44121 is reported for each additional resection and anastomosis of the small intestine. In this case, four total resections and anastomoses were completed; therefore, report the add-on code with three units. 38. a. The diagnostic procedure is included with the surgical procedure and should not be reported separately. 39. a. One way to locate this answer in the index of the CPT® Professional Edition is under the main term “Laparoscopy,” then “Gastric Restrictive Procedures.” Once the code range is located, cross-reference for correct code selection. 40. c. One way to find this answer in the index of the CPT® Professional Edition is under the main term “Prostate,” then “Biopsy.” Notice that code 55700 indicates single or multiple, which means the code should be reported only one time per session. 41. b. Code 54000 describes a newborn; therefore, modifier -63 would not be reported with this code. The CPT® Professional Edition provides this information in the parenthetical note following this code. 42. d. Code 54065 includes extensive destruction of lesion(s) of the penis. This code is reported one time regardless of the number of lesions destroyed during a session. 43. a. Review of the subcategory notes in the CPT® Professional Edition with urodynamics indicates that modifier -51 should be used when more than one of these codes is listed in the same investiture session. 44. b. Code 52282 indicates stent (singular); therefore, when more than one stent is placed, the units should be reported. 45. d. The parenthetical notes provided in the CPT® Professional Edition with procedure code for resection of residual prostate tissue indicate modifier -78 would be appended if the procedure is performed by the same physician during a postoperative period. 46. c. The routine obstetric care, including the ante- and postpartum care with vaginal delivery, is reported with code 59400. The diagnosis codes for this case are assigned for the pregnancy complicated by cardiovascular disease. The mitral valve prolapse is then reported as the specific condition. According to the ICD-9 Guidelines for Chapter 11, these codes have sequencing priority. 47. a. One way to find this answer in the index of the CPT® Professional Edition is under the main heading “Miscarriage,” then “Incomplete Abortion.” 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 48 48. b. In the CPT® Professional Edition alphabetic index, “Removal,” “Foreign Body,” then “Vagina” directs you to code 57415. The CPT® Professional Edition provides a parenthetical note below code 57415 that references use of the appropriate evaluation and management codes for impacted vaginal foreign body reÂ� moval without anesthesia. This is an example of reading carefully both the question and parenthetical notes around the code. Code 57415 includes the use of anesthesia (other than local). Because anesthesia was not used to remove the foreign body, it is not appropriate to report 57415. 49. d. According to CPT® Changes: An Insider’s View 2011, this code includes x-ray confirmation for location of the apparatus. 50. a. Code 58120 is described as non-obstetrical, whereas 59160 is used for postpartum hemorrhage. 51. c. The patient in this question underwent a labyrinthotomy (incision), not a labyrinthectomy (excision). Refer to the notes in the CPT® Professional Edition for correct reporting. The parenthetical notes under code 69801 provide instructions for reporting once per day, and notes provided with the add-on code for the operating microscope indicate modifier -51 should not be reported with this code. 52. c. Refer to the parenthetical notes with code 69424 in the CPT® Professional Edition for correct reporting. This code is not reported in conjunction with code 69436. Modifier -50 is reported for a bilateral procedure. 53. a. One way to find this answer in the index of the CPT® Professional Edition is under “Infusion Pump” then “Spinal Cord.” This was a planned procedure during a postoperative period; therefore, modifier -58 would be reported. Notice that code 62362 includes the implantation or replacement; therefore, the removal is included with the replacement of the subcutaneous pump. 54. d. The procedure was performed anteriorly. Two interspaces were treated. According to the inclusion notes with code 69990, the operating microscope code would not be reported. 55. d. Review the CPT® Professional Edition parenthetical note under this code for proper code selection and reporting. 56. b. This was an initial implantation for the neurostimulator array and pulse generator. Code 64568 includes the creation of the skin pocket and testing of the system, according to CPT® Changes: An Insider’s View 2011. 57. a. This procedure code is described as unilateral or bilateral; therefore, modifier -50 is not required. Additionally, the description includes an infant and suture site. © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 49 58. a. Tarsorrhaphy is used to help patients who are unable to close their eyelids. In patients with Bell’s palsy (or other conditions that impede the ability to blink or close the eyelids), this procedure keeps the eyes protected and lubricated until the patient recovers from a paralysis condition. 59. b. Code 67113 includes multiple procedures related to the complex repair of a retinal detachment. These inclusive procedures, if performed, would not be reported separately. The use of the operating microscope would not be reported; see 69990 exclusions. 60. c. The CPT® Professional Edition provides multiple illustrations with strabismus surgery. These illustrations are helpful for review of anatomic locations of muscles. Codes for strabismus surgery are selected by the number and type of muscles used during a procedure. Additionally, add-on codes are provided to help define other conditions or procedures that may be completed at the time of the surgery. 61. b. This visit represents a well woman annual exam and would be reported with a preventive medicine service code with the correct age and established patient. 62. d. Place of service and time are vital to correct selection of discharge codes. This discharge was from a nursing facility with 45 minutes noted. 63. d. Subsequent observation care codes have a (#) symbol to indicate resequenced codes. These subsequent observation care codes require two of the three key components, and this question meets the level of care reported with code 99225. 64. b. Dr. Counsel’s visit qualifies for an office consultation based on the verbal request, rendering of an opinion, and a written report returned to the requesting provider. To determine the extent of history, review the defiÂ� nition of comprehensive history in the evaluation and management guidelines. Additionally, Table 1 in the same guidelines can be used to determine the level of decision-making. 65. c. This visit should be reported as a subsequent hospital visit. According to consultation subcategory guideÂ� lines in the CPT® Professional Edition, the consultant should report the initial consultation code for her first visit and then subsequent hospital codes for any additional visits related to the same hospitalization. 66. a. According to the CPT® Professional Edition guidelines for critical care, time spent performing separately reportable procedures or services should not be included in the calculation of critical care time. Therefore, the time spent for the insertion of the VAD is not bundled into the critical care time. The VAD procedure is not one of the bundled codes listed with critical care and should be reported separately. Attach modifier -25 to the initial critical care code to report a procedure on the same day. 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 50 67. a. One way to find this answer is to reference the codes and review the subcategory guidelines listed with anticoagulant management. 68. b. The selection of codes in this question depends on the age and present body weight of the baby. 69. c. An annual nursing facility assessment should not be coded on the same date as other nursing facility services codes. Review the parenthetical note below the code 99318 for correct code selection. 70. c. Per the CPT® Professional Edition subcategory guidelines with physician standby services, the second and subsequent periods of standby beyond the first 30 minutes can be reported only if a full 30 minutes is provided for each unit of service reported. 71. a. One way to find this answer in the index of the CPT® Professional Edition is under the main term “Anesthesia,” “Pelvis,” then “Repair.” The guidelines for anesthesia indicate the use of physician status modifiers when reporting anesthesia codes. Additionally, the add-on code 99100 identifies the age of the patient in this question. 72. b. Review of modifier -47 in Appendix A of the CPT® Professional Edition provides instructions for placement of this modifier on the procedure code when the surgeon provides either general or regional anesthesia. 73. d. The anesthesia guidelines in the CPT® Professional Edition provide add-on codes for qualifying cirÂ� cumstances. The code 99100 is used to report the age of a patient as younger than 1 or older than 70 years. The parenthetical note following this add-on code provides the codes where age is a factor and already defined; therefore, the add-on code is unnecessary for correct reporting. 74. c. Anesthesia code 00604 describes the patient in a sitting position. Careful review of codes will help determine the correct reporting if there is an anatomical location and/or position included in the description. 75. c. Code 58823 includes moderate sedation. The add-on codes for qualifying circumstances and physical status modifiers are listed with anesthesia codes and should not be appended to a surgical procedure code. 76. d. The anesthesia guidelines in the CPT® Professional Edition provide a list of services that are included or bundled when provided. Additionally, the monitoring services that are not bundled are listed in the same guidelines. 77. a. This question specifies reporting for three days of hospital management. Code 01996 would be reported x 3 units. © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 51 78. a. The total body surface area (TBSA) burned is 54%. The first code, 01952, includes 9% of the burn; the add-on code 01953 would be reported for each additional 9% (five units equal 45% plus the initial 9% reaches the total 54%). 79. b. You can find this answer in the index of the CPT® Professional Edition under the main term “Radiation therapy,” then “Field Set-up.” 80. d. This is a bilateral lymphangiography to the extremities (arms), which is stated in code 75803. Carefully select diagnosis codes that account for personal histories vs. family histories. In this question, the patient has a family history of breast cancer. 81. a. This is a follow-up ultrasound for triplets to measure the fetal sizes. Review the parenthetical note below this code in the CPT® Professional Edition for the use of modifier -59. 82. c. Code 70543 includes the MRI without contrast materials, followed by the images with contrast. Notice the parenthetical note in the CPT® Professional Edition below this code related to reporting once per imaging session. 83. b. The parenthetical notes in the CPT® Professional Edition below this code set provide reporting instructions. 84. a. In the CPT® Professional Edition subcategory guidelines for clinical brachytherapy, there are definitions for simple, intermediate, and complex applications for sources/ribbons. Additionally, these notes indicate the hospital admission and daily visits are included. 85. a. The parenthetical note below the add-on code 78020 provides correct conjunctive reporting instructions. Additionally, the subcategory guidelines with nuclear medicine in the CPT® Professional Edition indicate the drugs and radiopharmaceuticals supplied by the physician should be reported separately. 86. c. This question asks about unilateral diagnostic mammography. The other possible answers to this question either identify the wrong type of mammography or underreport the needle placement procedure. 87. b. Radiation treatment delivery is reported by MeV (mega electron volts). Each session should be reported separately. These codes are inherently technical as stated in the CPT® Professional Edition; therefore, modifier -TC is not appended to these services. 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 52 88. a. The diagnosis code is reported from the diagnosis description section of this report or the definitive findings. The clinical history indicates why the cytology is being evaluated. The procedure code is reported with the simple filter preparation and interpretation as stated in the question. 89. c. The specimen evaluated in this question was from a lung wedge biopsy. Review the codes in the surgical pathology section based on anatomy and/or location of the specimen, absence or presence of disease reported, and/or physician’s description of specimen received and studied. 90. d. This code is out of numerical sequence; therefore, there is one symbol listed with this code. Additionally, the parenthetical notes in the CPT® Professional Edition below code 80101 assist with selection of testing with multiplexed screening methods. 91. b. One way to find this code in the index of the CPT® Professional Edition is under the main term “Evocative/Suppression Test.” Review of the code range provided will lead to the combined rapid anterior pituitary evaluation panel. This panel code includes all the codes listed with the panel. 92. b. This service is a comprehensive consultation with review of records and specimens. Dr. Thomas did not see the patient in this question; therefore, an evaluation and management code is not reported. 93. c. The CPT® Professional Edition includes a list of modifiers for genetic testing. Review Appendix I for these modifiers. Additionally, the subcategory notes with cytogenetic studies refer to Appendix I for modifiers. 94. c. One way to find these codes in the CPT® Professional Edition is under the main term “Antibody,” then look for specific tests. 95. a. This question focuses on the culture and days of the embryos. The transfer code would be reported on the date of that service. (The ability to select pertinent information from exam questions is a key factor to successful test taking. To build testing skills, try reading the last sentence first to figure out what is being asked in the question, then focus on that information.) 96. a. Review of the subcategory guidelines in the CPT® Professional Edition under the heading “Organ or Disease-Oriented Panel” provides assistance with code selection. These notes indicate that the use of panel codes includes the tests within a specific panel; however, additional tests should be reported as necessary. 97. b. The parenthetical notes provided with add-on codes, such as code 82952, are helpful when determining code selection and reporting. © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 53 98. c. The second parenthetical note below code 99090 directs the coder to report with more specific codes when possible. In this question, the patient wore a 72-hour ambulatory glucose monitoring device, which is reported with a specific code. 99. a. Reporting an evaluation and management code with pulmonary stress testing is appropriate, according to the subcategory guidelines under the heading “Other Procedures” in the pulmonary medicine section of the CPT® Professional Edition. Additionally, CPT® Assistant, January 1999, Volume 9, Issue 1, indicates that pulmonary stress testing should be reported only once, even when repeated in the same session. 100. d. The administration (route) of immunizations is reported along with the vaccines (drug). The subcategory guidelines in the CPT® Professional Edition under the heading “Vaccines, Toxoids” indicate that modifier -51 should not be appended to these codes. Careful attention to the specific vaccine product is required for accurate reporting of these codes. 101. a. Analytical testing strategies should be employed when encountering this type of question. First, review the possible answers. Notice in answer b the code number is listed for the code descriptor. Second, look up the code 93620 and review the descriptor, then review the parenthetical notes listed below the code, which provide conjunction code reporting rules. Third, notice modifier -51 exempt statuses with codes listed, and finally, check off the codes listed in the test question to ensure proper exemption and/or reporting restrictions. 102. b. The subcategory guidelines provided in the CPT® Professional Edition with end-stage renal disease services provide code selection criteria. Additionally, examples are provided to assist with proper code selection. 103. a. The parenthetical notes in the CPT® Professional Edition with transcatheter placement of stent(s) indicate use of add-on codes for additional vessels treated with atherectomy or PTCA. In this question, three vessels/ arteries were treated, with modifiers applied to describe vessels/arteries treated. Review the procedures and anatomy for this question to select correct codes: two stents placed in left circumflex (report once per vessel regardless of the number of stent[s] placed), PTCA in the right coronary artery (add-on code), and atherÂ� ectomy in the left anterior descending artery (add-on code). The procedure codes in this question include moderate sedation by the same provider. Additionally, review of the diagnosis codes and correct reporting order is important to answer selection. 104. c. One way to find this answer in the index of the CPT® Professional Edition is under “Vestibular function tests.” Once this code range is located, review of the codes and parenthetical notes will help with code selection. 105. d. Review the primary procedure and then the add-on codes, with special attention to the parenthetical notes for correct code selection. 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 54 106. c. The code descriptor includes services delivered bilaterally; therefore, modifier -50 is not required when reporting. Additionally, the anatomic location of the scan is important when selecting a code from this section. 107. c. Psychiatric therapeutic procedure subcategory guidelines in the CPT® Professional Edition indicate appropriate code selection is based on type of service, place of service, face-to-face time spent, and whether evaluation and management services are furnished on the same date as psychotherapy services. The time spent with the patient includes both the psychiatric and evaluation and management services. Note: The subjects of medical terminology, anatomy, and physiology are extensive. The questions represented in this practice exam have some answers that can be located within the coding manuals (CPT® , ICD-9, or HCPCS II) and some answers that cannot be found in the coding manuals. Such questions may require more than a couple of minutes to answer. If you are looking for additional resources to help you review medical terminology, anatomy, and physiology, the following free, online resources might be helpful: • JustCoding free Quizzes and free Quiz Archives provide online multiple-choice questions. Look for the questions dedicated to medical terminology and anatomy and physiology for more practice at www.justcoding.com. • Get Body Smart provides an online textbook with quizzes at www.getbodysmart.com. • MedlinePlus provides tutorials, videos, and dictionary resources at www.nlm.nih.gov/medlineplus. 108. d. Gout is the accumulation of uric acid crystals in the joint at the base of the large toe and other joints of the feet and legs. Arthritis is an inflammation of the whole joint, fibrosis is an inflammation of the fibrous connective tissue, and bursitis is an inflammation of the synovial bursa. 109. d. One way to find this answer is to review the eye anatomy figure preceding the “Eye and Ocular Adnexa” section of the CPT® Professional Edition. 110. a. One way to find this answer is by looking up “Contracture” in the alphabetic index of the ICD-9-CM Manual and cross-referencing the codes. This might help determine the correct answer through review of code descriptions. 111. b. You can find the illustration of cardiac anatomy in the CPT® Professional Edition preceding the “Cardiovascular System” section, which might be helpful with this question. This is an example of an exam question you might not be able to answer in two minutes with the resource books available for testing. If you © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 55 are not able to locate the correct answer in a reasonable amount of time, make the best decision possible and move on; do not waste time on any one question. 112. c. One way to find this answer is by using the ICD-9-CM Manual and the Neoplasm Table. Look up “Neoplasm, Colon.” A “see also” note indicates “Neoplasm, intestine, large and rectum.” 113. b. This is an example of an exam question that might not be answered in two minutes with the resource books available for testing. If you are not able to locate the correct answer in a reasonable amount of time, make the best decisions possible and move on; do not waste time on any one question. 114. c. This answer can be found in the index of the CPT® Professional Edition. 115. b. You can find this answer in the Table of Drugs and Chemicals in the ICD-9-CM Manual. 116. b. Carefully read exam questions. This is an example of a question in which reading for content is necessary to select the correct answer. 117. b. This answer can be found by reviewing the figure of male anatomy preceding the “Male Genital System” section in the CPT® Professional Edition. 118. a. This is an example of an exam question that might not be answered in two minutes with the resource books available for testing. If you are not able to locate the correct answer in a reasonable amount of time, make the best decision possible and move on; do not waste time on any one question. 119. c. This answer can be found in the “Illustrated Anatomical and Procedural Review” section of the CPT® Professional Edition. 120. c. This answer can be found online at MedlinePlus. This is an example of an exam question that might not be answered in two minutes with the resource books available for testing. If you are not able to locate the correct answer in a reasonable amount of time, make the best decisions possible and move on; do not waste time on any one question. 121. d. This term can be located in the alphabetic index of the ICD-9-CM Manual. It’s easier to find the correct answer by cross-referencing the code and the code descriptions. 122. a. In medical terminology, the prefix “inter-” means “between.” This might help you determine the correct answer. Additionally, you could find this answer online at MedlinePlus. This is an example of an exam question that might not be answered in two minutes with the resource books available for testing. If you are 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 56 not able to locate the correct answer in a reasonable amount of time, make the best decision possible and move on; do not waste time on any one question. 123. a. This answer can be found by looking up “Pachymetry” in the index of the CPT® Professional Edition. Once this code is located, cross-reference and read the procedure description to determine the correct answer. 124. d. The sequencing of diagnosis codes must follow coding guidelines for correct reporting. In this question, the chemotherapy code is reported first, followed by the site being treated (secondary), and then the unknown (primary) location. The sequencing and reporting of neoplasms can be found in Chapter 2 of the ICD-9-CM Official Guidelines for Coding and Reporting. Code 238.9 would not be appropriate because the primary site was uncertain, not the behavior of the neoplasm (benign or malignant). 125. a. The code for preeclampsia with antepartum condition not delivered during the current episode of care is 642.43. According to the ICD-9-CM Official Guidelines for Coding and Reporting, V22.2 is used only if the pregnancy is incidental to the encounter. It is the provider’s responsibility to state when a condition is not a complication of the pregnancy. Code 646.13 is not appropriate because the excludes note (under 642.4x) states that this code should not be assigned if edema in pregnancy is related to hypertension. The severity of the eclampsia was not documented; therefore, code 642.53 could not be assigned. 126. c. The current problem (nonunion of fracture), 733.82, is coded first, followed by 905.4 (late effect fracture of lower extremity) and E929.3 (late effect of fall). Answers a and b are incorrect because the code for a cur- rent fracture is listed. Per the ICD-9-CM Official Guidelines for Coding and Reporting, the activity and external cause status codes are not applicable with late effects. Answer d is incorrect because E codes should not be reported first. 127. d. Code 562.13 is a combination code that includes diverticulitis of the colon with hemorrhage. Answer a is incorrect because it is for diverticulosis with hemorrhage. Answer b is incorrect because the ICD-9-CM Official Guidelines for Coding and Reporting state that signs and symptoms should not be assigned when a related definitive diagnosis has been established. Answer c includes code 562.11, which states “without hemorrhage,” and code 578.9, which is for a GI hemorrhage that is unspecified. 128. a. Both acute and chronic pyelonephritis codes are listed at the same indention level in the index. To determine which code should be reported first, refer to the ICD-9-CM Official Guidelines for Coding and Reporting. The guidelines state that the acute code is listed first, followed by the chronic code. This question indicates that the patient has secondary diabetes with a manifestation of macular edema (249.50, 362.07). Per the instructional notes, the additional code to identify the specific manifestation is required. Mild hypertension is reported as 401.9. Answers b, c, and d are incorrect due to the sequencing of codes, with mention of an additional condition, type of diabetes, or use of insulin for temporary control of blood sugars. © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 57 129. c. The ICD-9-CM Official Guidelines for Coding and Reporting state that when the encounter is for a non- HIV-related condition, the non-related condition should be sequenced first, followed by code 042. Answers a, b, and d are incorrect due to sequencing of codes or reporting of fractures or history codes. 130. d. Watch carefully for codes related to length of time for loss of consciousness and current conditions. See notes under code 995.55 to assign additional codes for injuries. Separate code assignment is not appropriate for the concussion based on the excludes note at category 850. Per the ICD-9-CM Official Guidelines for Coding and Reporting, code E000.9 should not be assigned for an unspecified external cause status. Code 305.00 for alcohol abuse would not be appropriate on the baby’s record. 131. c. Carefully review the ICD-9-CM Official Guidelines for Coding and Reporting related to burns (Chapter 17, section c) before taking the CPC exam. Report burns by highest degree, followed by site-specific locations, then mixed-degree burns of the same site to the highest degree, then multiple sites within the same anatomic location to 5th digit of 9, and TBSA for total burn. The fifth digit is related to the third-degree portion of the burn. 132. c. Manifestation codes (italicized codes) cannot be listed first. Review the note listed with code 714.0. 133. c. List poisoning codes first, followed by conditions from the poisoning and then external cause codes. 134. c. You can find this answer in the index of the HCPCS Level II Manual under “Hemipelvectomy prosthesis.” 135. c. You can find this modifier in the HCPCS Level II Manual. It is used to report services delivered via asynchronous telecommunication from one location to another. 136. a. You can find this code in the index of the HCPCS Level II Manual under “Ostomy, supplies.” 137. c. The diagnosis code can be found in the ICD-9-CM index under “Thrombocytopenia, purpura.” The drug can be found in the HCPCS Level II Manual Table of Drugs under “Privigen.” Notice the unit dose listed in the table is 500 mg. This question states 1,000 mg would be given. 138. d. You can find this code in the index of the HCPCS Level II Manual under “Speech generating device.” Review the codes carefully to determine the correct answer. 139. b. One way to find this answer is by reviewing the six main section guidelines in the CPT® Professional Edition. A detailed definition for separate procedures can be found in three of the six main sections. The other sections have a brief mention of separate or multiple procedures or no mention. 2012 Practice Test for the AAPC CPC® Exam © 2012 HCPro, Inc. 58 140. a. The guidelines with Category II codes indicate these codes are used for supplemental tracking and performance measurements, and use of these codes is optional. Further, these codes may not be used as a substitute for Category I codes. 141. c. The definition of the CPT surgical package can be located in the surgery guidelines of the CPT® Professional Edition. Review of these bundled or included services will help you report services appropriately. 142. c. The CPT® Professional Edition provides a detailed definition of concurrent care and transfer of care in the Evaluation and Management guidelines. 143. a. The CPT® Professional Edition provides a table to help determine the level of decision-making in the Evaluation and Management main guidelines. The three elements listed at the top of this table are used when determining a specific type of decision-making. 144. d. This answer can be found in the CPT® Professional Edition in the radiology guidelines. 145. b. This answer can be found on the front cover and printed in the lower right-hand corner of each page of the CPT® Professional Edition. 146. c. You can find this answer in the 2012 OIG Work Plan under the section for replacement of medical devices. If you need to review this document, go to http://oig.hhs.gov/reports-and-publications/archives/workplan/ 2012/WP01-Mcare_ A+B.pdf. 147. b. More information related to PQRS and reporting measures can be found by following the intranet link listed in Appendix H of the CPT® Professional Edition. 148. a. The National Committee for Quality Assurance and The Joint Commission are responsible for voluntary accreditation standards. More information about these organizations can be reviewed at www.ncqa.org and www.jointcommission.org. 149. d. You can find this answer in the preface of the ICD-9-CM Manual. AHIMA is not a federal govern- ment agency. 150. d. The Federal Register is an important part of rules and regulations in healthcare management. You can find tutorials for the Federal Register at www.archives.gov/federal-register/tutorial/online-html.html#daily. © 2012 HCPro, Inc. 2012 Practice Test for the AAPC CPC® Exam 2012 Practice Test for the AAPC CPC Exam ® Nervous about taking the exam for your CPC credential? Don’t be! The team at JustCoding.com presents this 150-question practice exam updated for 2012 that you can use to study for the AAPC CPC exam. The practice exam mimics the actual CPC exam in a number of ways. It includes 150 multiple-choice questions (featuring 18 detailed, operative-type questions) and bases questions on material covered in HCPro’s Certified Coder Boot Camp®, which also prepares students to take the CPC exam. The exam, written by Certified Coder Boot Camp instructor Lisa Rae Roper, covers specific topics on which you’ll be tested for your CPC credential, including: — Integumentary system — Musculoskeletal system — Respiratory and cardiovascular systems — Digestive system — Urinary system — Nervous, eye and ocular, and auditory systems — Evaluation and management — Anesthesia — Radiology — Laboratory and pathology — Medicine — Medical terminology — Anatomy — ICD-9-CM and HCPCS Level II — Coding guidelines — Practice management We wish you good luck as you prepare to earn your CPC credential. Your colleagues at JustCoding.com are proud to be part of your practice team and look forward to helping you succeed in the years to come. AAPCPT 75 Sylvan Street, Suite A-101 | Danvers, MA 01923 www.hcmarketplace.com