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AAPC Final Exam Questions and Answers 2025
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Local Coverage Determinations are administered by whom? a. State Law b. NCDs c. Each regional MAC d. LMRPs Correct ans - c. Each regional MAC ABN stands for __ _. a. Advanced Benefits Notification b. Advisory Beneficial Notice c. Admitting Beneficiary Notice d. Advance Beneficiary Notice Correct ans - d. Advance Beneficiary Notice What type of health insurance provides coverage for low-income families? a. Commercial HMO b. Medicaid c. Medicare d. Commercial PPO Correct ans - b. Medicaid Which type of information is NOT maintained in a medical record? a. Treatment outcomes b. Financial records c. Medical or surgical interventions d. Observations Correct ans - b. Financial records According to the OIG, internal monitoring and auditing should be performed by what means? a. Focused audits on problems brought to the attention of the compliance officer. b. Baseline audits. c. Periodic audits. d. Audits on all denied claims. Correct ans - c. Periodic audits. Urine is transported from the kidneys to the urinary bladder by which structure? a. Ureter b. Urethra c. Kidney pelvis d. Urinary vein Correct ans - a. Ureter
Which of the following does NOT circulate fluids throughout the body? a. Venous system b. Endocrine system c. Arterial system d. Lymphatic system Correct ans - b. Endocrine system What is a function of the alveoli in the lungs? a. Oxygen exchange b. Nicotine is destroyed c. Fluid in the lungs absorbed d. Providing an airway to breathe Correct ans - a. Oxygen exchange Cytopathology is the study of: a. Tissue b. Cells c. Blood d. Organs Correct ans - b. Cells The meaning of heteropsia (or anisometropia) is: a. Blindness in half the visual field b. Double vision c. Unequal vision in the two eyes d. Blindness in both eyes Correct ans - c. Unequal vision in the two eyes What is the meaning of provider in the ICD-10-CM guidelines? a. Insurance company b. The hospital c. The physician d. The patient Correct ans - c. The physician What is the ICD-10-CM code for hay fever? a. J30. b. J30. c. J30. d. J45.909 Correct ans - a. J30. What is the ICD-10-CM code for eyestrain? a. H53.10, H53. b. H57.
a. E85.3, N b. E85.4, N c. N08, E85. d. N08, E85.4 Correct ans - b. E85.4, N A 45 year-old-male patient has developed an ulcer on his upper back. He has had diabetes for several years and is on insulin. The provider determines that the ulcer is due to his diabetes. What ICD-10-CM codes are reported? a. E11.622, Z79. b. E11.9, L98.429, Z79. c. E11.622, L98.429, Z79. d. E11.622, L98.429 Correct ans - c. E11.622, L98.429, Z79. In which circumstances would an external cause code be reported? a. Delivery of a newborn. b. Causes of injury or health condition. c. Chemotherapy treatment of neoplasms. d. Only for the cause of motor vehicle accidents. Correct ans - b. Causes of injury or health condition. Patient presents with no menses and positive pregnancy test but an ultrasound reveals no uterine contents. An embryo has implanted on the left ovary and this is treated with laparoscopic oophorectomy. What ICD-10-CM code is reported for this procedure? a. O00. b. O00. c. O00. d. O00.09 Correct ans - b. O00. A patient has an open displaced fracture of the second cervical vertebra. This is her fifth visit and the fracture is healing normally. What ICD-10-CM code is reported? a. S12.9XXS b. S12.190D c. S12.9XXD d. S12.190A Correct ans - b. S12.190D A 43 year-old female presents to the provider for a diabetic ulcer of the right ankle. What ICD-10-CM codes are reported? a. L97. b. L97.319, E11. c. L97.319, E11.
d. E11.622, L97.319 Correct ans - d. E11.622, L97. A patient is prescribed anticonvulsant medication for her seizures. She returns to her doctor three days later with nausea and rash due to taking the anticonvulsant medication. The provider notes that this is a drug reaction to an anticonvulsant and changes the medication. What ICD-10-CM codes are reported? a. L27.0, R11.2, T42.71XA b. R21, R11.2, T42.71XA c. R21, R11.0, T42.75XA d. L27.0, R11.0, T42.75XA Correct ans - d. L27.0, R11.0, T42.75XA What surgical status indicator represents the Global Surgical Package for endoscopic procedures (without an incision) where there is no postoperative period after the day of the surgery?? a. XXX b. 000 c. 010 d. 090 Correct ans - 000 What code represents a secondary rhinoplasty where a small amount of work is performed on the tip of the nose? a. 30430 b. 30420 c. 30435 d. 30400 Correct ans - 30430 What is the appropriate modifier to use when two surgeons perform separate distinct portions of the same procedure? a. 59 b. 66 c. 62 d. 80 Correct ans - 62 What is the correct CPT® coding for a cystourethroscopy with brush biopsy of the renal pelvis? a. 52005, 52007 b. 52007 c. 52000, 52007 d. 52005 Correct ans -
Operative Report Pre-Operative and Post-Operative Diagnosis: Squamous cell carcinoma, left leg Open wound, right leg Personal history of squamous cell carcinoma, right leg INDICATIONS FOR SURGERY: The patient is an 81 year-old white man with biopsy-proven squamous cell carcinoma of his left leg. I marked the areas for excision with gross normal margins of 5 mm, and I drew my planned skin graft donor site from his left lateral thigh. He also had an open wound of his right leg from a squamous cell carcinoma excised four months ago; the skin graft had not taken. We plan on re-skin grafting the area. The patient is aware of all of these markings, and understands the surgery and location. DESCRIPTION OF PROCEDURE: The patient was taken to the operating room. IV Ancef was given. I used plain lidocaine for his local anesthetic throughout the procedure until the skin grafts were inset. The anterior of his leg and the thigh were infiltrated with local anesthetic. Both lower extremities were prepped and draped circumferentially, which included the left thigh on the left side. I excised the lesion on his left leg as drawn into the subcutaneous fat. Hemostasis achieved with the Bovie cautery. I then excised the wound on his right leg to lower the bacterial counts. I took a 1-2 mm margin around the wound and excised the granulation tissue as well. Hemostasis was achieved using the Bovie cautery. I then changed gloves. A split- thickness skin graft was harvested from the left thigh using the Zimmer dermatome. This was meshed 1:5:1. By this time, the pathology returned showing the margins were clear. Skin grafts were inset on each leg wound using the skin stapler. Xeroform and gauze bolster was placed over the skin graft using 4-0 nylon. The skin graft donor site was dressed with OpSite. The legs were further dressed with heavy cast padding and the double Ace wrap. The patient tolerated the procedure well. PROCEDURES: Excision squamous cell carcinoma, left leg with excised diameter of 2.5 cm, repaired with a split-thickness skin graft measuring 5.1 cm². Excisional preparation of right leg wound repaired with a split-thickness skin graft measuring 3.2 cm². What CPT® codes are reported? a. 15100, 11603-51-LT, 15002-51-RT b. 15100, 11403-51-LT, 15100-51-RT c. 15100, 11603-51-LT d. 15100, 15100-51-LT, 11603-51-LT, 15002-51-RT Correct ans - In ICD-10-CM, what classification system is used to report open fracture classifications? a. Muller AO classification of fractures b. PHF classification of fractures c. Danis-Weber classification d. Gustilo classification for open fractures Correct ans -
A 49 year-old female presented with chronic deQuervain's disease and has been unresponsive to physical therapy, bracing or cortisone injection. She has opted for more definitive treatment. After induction of anesthesia, the patient's left arm was prepared and draped in the normal sterile fashion. Local anesthetic was injected using a combination 2% lidocaine and 0.25% Marcaine. A transverse incision was made over the central area of the first dorsal compartment. The subcutaneous tissues were gently spread to protect the neural and venous structures. The retractors were placed. The fascial sheath of the first dorsal compartment was then incised and opened carefully. The underlying thumb abductor and extensor tendons were identified. The tissues were dissected and the extensor retinaculum of the first extensor compartment was incised. The fibrotic tissue was incised and the tendons gently released. The tendons were freely moving. Subcutaneous tissues were closed with a 3-0 Vicryl and the skin with 3-0 Prolene subcuticular closure. Steri-strips, Xeroform and dry sterile dressings were applied. What CPT® code is reported? a. 25001-LT b. 25118-LT c. 25085-LT d. 25000-LT Correct ans - This 45 year-old male presents to the operating room with a painful mass of the right upper arm. Upon deep dissection a large mass in the soft tissue of the patient's shoulder was noted. The mass appeared to be benign in nature. With deep blunt dissection and electrocautery, the mass was removed and sent to pathology. What CPT® code is reported? a. 23075-RT b. 23066-RT c. 23030-RT d. 23076-RT Correct ans - A 16 year-old female was hit by a car while crossing a two-lane highway. She was taken to the hospital by ambulance. She was found to have an open wound of the left lower thigh, just above the knee and a displaced fracture of the left femoral neck. She was taken to the operating room within four hours of her injury. She was given general endotracheal anesthesia and was prepped and draped in sterile fashion. Debridement including excision of devitalized skin and muscle was performed on the lateral thigh. The area was approximately 15 sq cm. After debridement and thorough copious irrigation, the wound was closed with layer sutures and a dressing was applied and then covered with adhesive plastic. The patient was then prepped and draped for the fracture and turned on her right side. We all rescrubbed. An 8 inch incision was made over the left hip and the head of the femur was exposed. Multiple fragments from the neck and the greater tuberosity were removed. The decision was made to replace the femoral head. The femur was removed from the acetabulum and the femoral head was removed. The femoral canal was reamed and a prosthesis was placed. It was then replaced in the acetabulum with a good fit, and the
d. 31603, T17.290A Correct ans - What ICD-10-CM codes are reported for postoperative pulmonary edema due to fluid overload from an infusion? a. T80.89XA, J81.1, Y63. b. J95.89, E87.70, Y63. c. J81.0, E87.70, Y63. d. T81.9XXA, J81.1, Y63.0 Correct ans - A 27 year-old girl has been on the lung transplant list for months and today she will be receiving a LT and RT lung from an individual involved in an MVA. This person was DOA at the hospital and is an organ donor. The donor pneumonectomy was performed by physician A, the backbench work by physician B and the transplant of both lungs into the prepped and waiting patient by physician C. What is the correct coding for the removal (physician A), preparation (physician B) and insertion (physician C) of the lungs? a. 32850, 32855, 32851 b. 32850, 32856, 32851 x 2 c. 32850, 32856, 32853 d. 32850, 32855 x 2, 32850-50 Correct ans - A 45 year-old presents with acute pericarditis. The surgeon makes a small incision between two ribs and enters the thoracic cavity. An endoscope is introduced and the pericardial sac is examined by direct visualization. Using an instrument introduced through the endoscope, the surgeon creates an opening in the pericardial sac for drainage purposes. What CPT® code is reported? a. 32659 b. 32662 c. 32658 d. 32661 Correct ans - Patient presents to her physician 10 weeks following a true posterior wall myocardial infarction. The patient is still symptomatic and is diagnosed with ischemic heart disease. What is (are) the correct ICD-10-CM code(s) for this condition? a. I21. b. I22. c. I25. d. Z51.89, I25.9 Correct ans - Due to infections from hemodialysis, the physician replaces a dual chamber implantable defibrillator system with a multi-lead system with an epicardial lead and transvenous dual
chamber lead defibrillator system. The original dual leads are extracted transvenously. The generator pocket is relocated. What CPT® codes are reported? a. 33244, 33220-51, 33264-51, 33223- b. 33243, 33202-51, 33263-51, 33223- c. 33241, 32330-51, 33263-51, 33223- d. 33244, 33202-51, 33264-51, 33223-59 Correct ans - A patient presents to the hospital for a cardiovascular SPECT study. A single study is performed under stress, but without quantification, with a wall motion study, and ejection fraction. Select the CPT® code(s) for this procedure. a. 78451, 78472 b. 78451 c. 78453 d. 78453, 78472 Correct ans - In the hospital setting a patient undergoes transcatheter placement of an extracranial vertebral artery stent in the right vertebral artery. Which CPT® code is reported by the physician providing only the radiologic supervision and interpretation? a. 0075T b. 0075T- c. 35301 d. 35005 Correct ans - A patient is brought to the operating suite when she experiences a large output of blood in her chest tubes post CABG. The physician performing the original CABG yesterday is concerned about the post-operative bleeding. He explores the chest and finds a leaking anastomosis site and he resutured. a. 35761- b. 35241 c. 35761 d. 35820-78 Correct ans - A patient is seen in the ED for nausea and vomiting that has persisted for 4 days. The ED physician treats the patient for dehydration which is documented in the patient's record as the final diagnosis. What ICD-10-CM code(s) is/are reported for this encounter? a. R11.2, E86. b. E86. c. R11. d. R11.10, R11.0, E86.0 Correct ans -
a. 50080 b. 50130 c. 50040 d. 50081 Correct ans - A 63 year-old male presents for the insertion of an artificial inflatable urinary sphincter for urinary incontinence. A 4.5 cm cuff, 22 ml balloon, 61-70 mmHg artificial inflatable urinary sphincter was inserted. What CPT® code is reported for this service? a. 53446 b. 53448 c. 53447 d. 53445 Correct ans - A fracture of the corpus cavernosum penis is repaired. What is the correct code? a. 54440 b. 54420 c. 54430 d. 54435 Correct ans - Patient comes in today to the provider's office for routine monthly Foley catheter change. A two way Foley catheter is replaced in the usual sterile fashion. An abdominal urinary drainage bag and bedside bag are given to the patient. What is/are the correct code(s)? a. 51702, A4338, A4357, A b. 51100 c. 51102 d. 51701, A4338, A4357, A4358 Correct ans - The patient is a pleasant 51 year-old male with morbid obesity, weighing approximately 560 pounds and BMI being 85.1. He has uncontrolled diabetes and was evaluated due to testicular pain. He was found to have erythema, edema and possible areas of eschar on the scrotum. He was transferred to the hospital, evaluated and found to be stable with cellulitis and suspect early Fournier's gangrene. What are the appropriate ICD-10-CM codes reported? a. N49.2, E11.9, E66.01, Z68. b. N50.1, E11.9, N49.2, E66.01, Z68. c. N50.1, N49.2, E66.01, Z68. d. E66.01, E11.9, N50.1, E66.01, Z68.52 Correct ans - A 40 year-old presents with vaginal bleeding for several weeks unrelated to her menstrual cycle. The gynecologist orders an ultrasound to obtain more information for a diagnosis. What diagnosis code is appropriate for this encounter?
a. N92. b. N92. c. N92. d. N93.9 Correct ans - An ED physician treats a 30 year-old patient who was a victim of a rape. She has bruises and other trauma as well as a laceration of the vaginal wall, which is repaired with sutures (colporrhaphy) by the ED physician. What are the CPT® and ICD-10-CM codes reported for this procedure? a. 59300, S31.41XA, T74.21XA b. 57260, N89. c. 57200, S31.41XA, T74.21XA d. 57289, N89.8 Correct ans - What does the abbreviation IVF mean? a. In vitro fertilization b. Infundibulum via Fallopian tube c. Intravaginal foreign body d. Intravenous fluids Correct ans - a. In vitro fertilization A patient has ovarian cancer of both ovaries. She has removal of her ovaries with peritoneal washings and assessment of the abdomen for any metastases, including inspection of omentum, diaphragm and multiple biopsies. Lymph nodes in the pelvic and peri-aortic areas were also biopsied. She has previously had a hysterectomy. What are the CPT® and ICD-10-CM codes reported for this service? a. 58943, C56.1, C56. b. 58950, 49255, C79.61, C79. c. 58720, 38770, C56.1, C79. d. 58940, C56.1, C56.2 Correct ans - Mrs. Smith is visiting her mother and is 150 miles away from home. She is in the 26th week of pregnancy. In the late afternoon she suddenly feels a gush of fluids followed by strong uterine contractions. She is rushed to the hospital but the baby is born before they arrive. In the ED she and the baby are examined and the retained placenta is delivered. The baby is in the neonatal nursery doing okay. Mrs. Smith has a 2nd degree perineal laceration secondary to precipitous delivery which was repaired by the ED physician. She will return home for her postpartum care. What ICD-10-CM and CPT® codes are reported by the ED physician? a. 59409, 59414-51, 59300-51, O62.3, O70.1, Z3A.26, Z37. b. 59414, 59300-51, O73.0, O70.1, Z3A.26, Z37. c. 59414, 59300-51, O62.3, O70.9, Z3A.26, Z37.
b. 62270, 76942-26, G95. c. 62270, G12. d. 62269, 76942-26, G95.0 Correct ans - What does IOL stand for? a. Interdimensional ocular lengths b. Iridescence over lamina c. Intraocular lens d. Interoptic laser Correct ans - c. Intraocular lens Patient had an abscess in the external auditory canal which was incised and drained in the office. What CPT® code is reported? a. 69000 b. 69020 c. 69540 d. 69105 Correct ans - What CPT® code is reported for a tympanoplasty with mastoidotomy and with ossicular chain reconstruction in the right ear? a. 69636-RT b. 69632-RT c. 69644-RT d. 69646-RT Correct ans - A 70 year-old female has a drooping left eyelid obstructing her vision and has consented to having the blepharoptosis repaired. A skin marking pencil was used to outline the external proposed skin incision on the left upper eyelid. The lower edge of the incision was placed in the prominent eyelid crease. The skin was excised to the levator aponeurosis. An attenuated area of levator aponeurosis was dehisced from the lower strip. Three 6-0 silk sutures were then placed in mattress fashion, attaching this attenuated tissue superiorly to the intact tissue inferiorly. This provided moderate elevation of the eyelid. What CPT® code is reported? a. 67911-E b. 67901-E c. 67903-E d. 67904-E1 Correct ans - A 53 year-old woman with scarring of the right cornea has significant corneal thinning with a high risk of perforation and underwent reconstruction of the ocular surface. The eye is incised and an operating microscope is used with sponges and forceps to debride necrotic corneal epithelium. Preserved human amniotic membrane is first removed from the storage medium and transplanted by trimming the membrane to fit the thinning area of the
cornea then sutured. This process was repeated three times until the area of thinning is flush with surrounding normal thickness cornea. All of the knots are buried and a bandage contact lens is placed with topical antibiotic steroid ointment. What CPT® code is reported? a. 65435 b. 65780 c. 65781 d. 65710 Correct ans - What are the three classifications of anesthesia? a. General, Regional and Moderate Sedation b. General, Regional and Epidural c. General, Regional and Monitored Anesthesia Care d. General, MAC and Conscious Sedation Correct ans - c. General, Regional and Monitored Anesthesia Care What time is used to report the start of anesthesia time? a. Surgery start time b. Entering the operating room c. When the anesthesiologist begins to prepare the patient for anesthesia d. During the pre-anesthesia assessment Correct ans - c. When the anesthesiologist begins to prepare the patient for anesthesia A 42 year-old patient was undergoing anesthesia in an ASC and began having complications prior to the administration of anesthesia. The surgeon immediately discontinued the planned surgery. If the insurance company requires a reported modifier, what modifier best describes the extenuating circumstances? a. 53 b. 23 c. 73 d. 74 Correct ans - What ICD-10-CM code is reported for a reaction to anesthesia, initial encounter? a. T88.59XA b. T88.2XXA c. T88.52XA d. T88.4XXA Correct ans - A 43 year-old patient with a severe systemic disease is having surgery to remove an integumentary mass from his neck. What CPT® code and modifier are reported for the anesthesia service?
A CT study of the lumbar spine (L2-L4) was performed with IV contrast in the hospital outpatient radiology department and the interpretation of the images is performed by the radiologist. What CPT® code(s) should be reported by the radiologist who is not an employee of the hospital? a. 72132 b. 72132- c. 72132-26, 72132-TC d. 72132-TC Correct ans - What modifier must always be applied to Medicare claims for tests performed in a site with a CLIA Waived certificate? a. 91 b. 26 c. 90 d. QW Correct ans - If the findings on examination of a Pap smear are normal and described as "negative for intraepithelial lesion or malignancy" this is an example of what type of results reporting? a. Surgical pathology b. Cytogenetics c. Bethesda d. Non-Bethesda Correct ans - A patient has a traumatic head injury and some cerebrospinal fluid (CSF) is removed to limit potential damage from swelling of the brain. The CSF is sent to pathology for examination and the results show unusual cytological counts, although no specific findings. The patient has had no previous symptoms known to his family members. What is the ICD- 10-CM code for this examination of CSF? a. A39. b. Z00. c. S06.1X0A d. R83.6 Correct ans - A urine pregnancy test is performed by the office staff using the Hybritech ICON (qualitative visual color comparison test). What CPT® code is reported? a. 84702 b. 81025 c. 81025, 36415 d. 84703 Correct ans -
A left breast biopsy is performed on a mass and the surgeon requests a frozen section examination of the specimen to determine whether more extensive resection is appropriate. The frozen section reveals no indications of malignancy. No other specimen is obtained but the remainder of the biopsy specimen is sent for further testing and examination, including decalcification. The results indicate breast fibrosclerosis only. What CPT® and ICD-10-CM codes are reported? a. 88331, 88313, N63. b. 88305, 88331, 88311, N60. c. 88307, 88305, 88331, 88313, N60. d. 88307, 88331, R92.0 Correct ans - A patient is seen by Dr. B who is covering on call services for Dr. A. The patient is an established patient with Dr. A. but she has not been seen by Dr. B. before. Which E/M subcategory is appropriate to report the services provided by Dr. B? a. Established patient office visit b. Preventive medicine visit c. Office consultation d. New patient office visit Correct ans - A patient is diagnosed as having both acute and chronic tonsillitis. How is this reported in ICD-10-CM? a. The chronic tonsillitis is reported first; the acute tonsillitis is reported second. b. The acute tonsillitis is reported first; the chronic tonsillitis is reported second. c. Only the chronic tonsillitis is reported. d. Only the acute tonsillitis is reported. Correct ans - A provider visits Mr. Smith's home monthly. Today, the provider performs a problem focused history, an expanded problem focused examination and a medical decision making of low complexity. What CPT® code is reported? a. Home visits are no longer reportable. b. 99348 c. 99349 d. 99347 Correct ans - An infant is born six weeks premature in rural Arizona and the pediatrician in attendance intubates the child and administers surfactant in the ET tube while waiting in the ER for the air ambulance. During the 45-minute wait, he continues to bag the critically ill patient on 100 percent oxygen while monitoring VS, ECG, pulse oximetry and temperature. The infant is in a warming unit and an umbilical vein line was placed for fluids and in case of emergent need for medications. How is this coded? a. 99471-25, 94610, 36510
