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AAPC CPC FINAL EXAM REAL EXAM 100 QUESTIONS AND CORRECT ANSWERS(VERIFIED ANSWERS)|AGRADE
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11/3/23, 7:07 PM AAPC - CPC Coding Exam study lecture notesAAPC - CPC Coding Exam 2011: The Certification Step
Final Examination
Name:
Date: Time: 5.40 Minutes
Question 1
46 year old female had a previous biopsy that indicated positive margins anteriorly on the right
side of her neck. A 0.5 cm margin was drawn out and a 15 blade scalpel was used for full excision
of an 8cm lesion. Light undermining of all margins was performed along with layered closure.
The specimen was sent for permanent histopathologic examination. What are the code(s) for
this procedure?
A. 11426 B. 11626 C. 11626, 12044-51 D. 11426, 13132, 13133
Question 2
30 year old female is having debridement performed on an infected ulcer with eschar on the
right foot. Using sharp dissection, the ulcer and eschar infection was debrided all the way to
down to the bone of the foot. The bone had to be minimally trimmed because of a sharp point
at the end of the metatarsal. After debriding the area, there was minimal bleeding because of
very poor circulation of the foot. It seems that the toes next to the ulcer may have some
involvement and cultures were taken. The area was dressed with sterile saline and dressings and
then wrapped. What CPT code should be reported?
A. 11000 B. 11011 C. 11044 D. 15004
Question 3
64 year old female who has multiple sclerosis fell from her walker and landed on a glass table.
She lacerated her forehead, cheek and chin and the total length of these lacerations was 6 cm.
Her right arm and left leg had deep cuts measuring 5 cm on each extremity. Her right hand and
right foot had a total of 3 cm lacerations. The ED physician repaired the lacerations as follows:
The forehead, cheek, and chin had debridement and cleaning of glass debris with the lacerations
being closed with 6-0 Prolene sutures. The arm and leg were repaired by 6-0 Vicryl subcutaneous
sutures and prolene sutures on the skin. The hand and foot were closed with adhesive strips.
Select the appropriate procedure codes for this visit.
A. 12014, 12034-51, 12002-51, 11041-51 B. 12053, 12034-51, 12002-51
C. 12014, 12034-51, 11041-51 D. 12053, 12034-51
Question 4
52 year old female has a mass growing on her right flank for several years. It has finally gotten
significantly larger and is beginning to bother her. She is brought to the Operating Room for
definitive excision. An incision was made directly overlying the mass. The mass was down into
the subcutaneous tissue and the surgeon encountered a well encapsulated lipoma
approximately 4 centimeters. This was excised primarily bluntly with a few attachments divided
with electrocautery. What CPT should be reported?
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A. 21932, 214.9 B. 21935, 214.1 C. 21931, 214.1 D. 21925, 789.39
Question 5
PREOPERATIVE DIAGNOSIS: Right scaphoid fracture. TYPE OF PROCEDURE: Open reduction and
internal fixation of right scaphoid fracture. DESCRIPTION OF PROCEDURE: The patient was
brought to the operating room, anesthesia having been administered. The right upper extremity
was prepped and draped in a sterile manner. The limb was elevated, exsanguinated, and a
pneumatic arm tourniquet was elevated. An incision was made over the dorsal radial aspect of
the right wrist. Skin flaps were elevated. Cutaneous nerve branches were identified and very
gently retracted. The interval between the second and third dorsal compartment tendons was
identified and entered. The respective tendons were retracted. A dorsal capsulotomy incision
was made, and the fracture was visualized. There did not appear to be any type of significant
defect at the fracture site. A 0.045 Kirschner wire was then used as a guidewire, extending from
the proximal pole of the scaphoid distalward. The guidewire was positioned appropriately and
then measured. A 25-mm Acutrak drill bit was drilled to 25 mm. A 22.5-mm screw was selected
and inserted and rigid internal fixation was accomplished in this fashion. This was visualized
under the OEC imaging device in multiple projections. The wound was irrigated and closed in
layers. Sterile dressings were then applied. The patient tolerated the procedure well and left the
operating room in stable condition. What code should be used for this procedure?
A. 25628-RT B. 25624-RT C. 25645-RT D. 25651-RT
Question 6
An infant with genu valgum is brought to the operating room to have a bilateral medial distal
femur hemiepiphysiodesis done. On each knee, the C-arm was used to localize the growth plate.
With the growth plate localized, an incision was made medially on both sides. This was taken
down to the fascia, which was opened. The periosteum was not opened. The Orthofix figure-of-
eight plate was placed and checked with x-ray. We then irrigated and closed the medial fascia
with 0 Vicryl suture. The skin was closed with 2-0 Vicryl and 3-0 Monocryl. What procedure code
should be used?
A. 27470-50 B. 27475-50 C. 27477-50 D. 27485-50
Question 7
The patient is a 67 -year-old gentleman with metastatic colon cancer recently operated on for a
brain metastasis, now for placement of an Infuse-A-Port for continued chemotherapy. The left
subclavian vein was located with a needle and a guide wire placed. This was confirmed to be in
the proper position fluoroscopically. A transverse incision was made just inferior to this and a
subcutaneous pocket created just inferior to this. After tunneling, the introducer was placed
over the guide wire and the power port line was placed with the introducer and the introducer
was peeled away. The tip was placed in the appropriate position under fluoroscopic guidance
and the catheter trimmed to the appropriate length and secured to the power port device. The
locking mechanism was fully engaged. The port was placed in the subcutaneous pocket and
everything sat very nicely fluoroscopically. It was secured to the underlying soft tissue with 2-0
silk stitch. What code should be used for this procedure?
A. 36556, 77001-26 B. 36558
C. 36561, 77001-26 D. 36571
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Question 8
A CT scan identified moderate-sized right pleural effusion in a 50-year-old male. This was
estimated to be 800 cc in size and had an appearance of fluid on the CT Scan. A surgical puncture
using an aspirating needle punctured through the chest tissues and entered the pleural cavity.
Fluid was aspirated, draining the effusion under ultrasound guidance using 1% lidocaine as local
anesthetic. What procedure code should be used?
A. 32421, 76942-26 B. 32422, 77002-26
C. 32420, 76942-26 D. 32400, 77012-26
Question 9
The patient is a 59-year-old white male who underwent carotid endarterectomy for symptomatic
left carotid stenosis a year ago. A carotid CT angiogram showed a recurrent 90% left internal
carotid artery stenosis extending into the common carotid artery. He is taken to the operating
room for re-do left carotid endarterectomy. The left neck was prepped and the previous incision
was carefully reopened. Using sharp dissection, the common carotid artery and its branches
were dissected free. The patient was systematically heparinized and after a few minutes clamps
applied to the common carotid artery and its branches. A longitudinal arteriotomy was carried
out with findings of extensive layering of intimal hyperplasia with no evidence of recurrent
atherosclerosis. A silastic balloon-tip shunt was inserted first proximally and then distally, with
restoration of flow. Several layers of intima were removed and the endarterectomized surfaces
irrigated with heparinized saline. An oval Dacron patch was then sewn into place with running 6-
0 Prolene. Which CPT code should be used?
A. 35301 B. 35301, 35390
C. 35302 D. 35311, 35390
Question 10
A 52-year-old patient is admitted to the hospital for chronic cholecystitis for which a laparoscopic
cholecystectomy will be performed. A transverse infraumbilical incision was made sharply
dissecting to the subcutaneous tissue down to the fascia using access under direct vision with a
Vesi-Port and a scope was placed into the abdomen. Three other ports were inserted under
direct vision. The fundus of the gallbladder was grasped through the lateral port, where multiple
adhesions to the gallbladder were taken down sharply and bluntly: The gallbladder appeared
chronically inflamed. Dissection was carried out to the right of this identifying a small cystic duct
and artery, was clipped twice proximally, once distally and transected. The gallbladder was then
taken down from the bed using electrocautery, delivering it into an endo-bag and removing it
from the abdominal cavity with the umbilical port. What CPT and ICD-9 codes should be
reported?
A. 47564, 574.10 B. 47562, 575.11
C. 47610, 574.70 D. 47600, 575.10
Question 11
A 70-year-old female who has a history of symptomatic ventral hernia was advised to undergo
laparoscopic evaluation and repair. An incision was made in the epigastrium and dissection was
carried down through the subcutaneous tissue. Two 5-mm trocars were placed, one in the left
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upper quadrant and one in the left lower quadrant and the laparoscope was inserted. Dissection
was carried down to the area of the hernia where a small defect was clearly visualized. There
was some omentum, which was adhered to the hernia and this was delivered back into the
peritoneal cavity. The mesh was tacked on to cover the defect. What procedure code(s) should
be used?
A. 49560, 49568 B. 49653
C. 49652 D. 49653, 49568
Question 12
The patient is a 50-year-old gentleman who presented to the emergency room with signs and
symptoms of acute appendicitis with possible rupture. He has been brought to the operating
room. An infraumbilical incision was made which a 5-mm VersaStep trocar was inserted. A 5-mm
0- degree laparoscope was introduced. A second 5-mm trocar was placed suprapubically and a
12-mm trocar in the left lower quadrant. A window was made in the mesoappendix using blunt
dissection with no rupture noted. The base of the appendix was then divided and placed into an
Endo-catch bag and the 12-mm defect was brought out. Select the appropriate code for this
visit:
A. 44970 B. 44950 C. 44960 D. 44979
Question 13
45-year-old male is going to donate his kidney to his son. Operating ports where placed in
standard position and the scope was inserted. Dissection of the renal artery and vein was
performed isolating the kidney. The kidney was suspended only by the renal artery and vein as
well as the ureter. A stapler was used to divide the vein just above the aorta and three clips
across the ureter, extracting the kidney. This was placed on ice and sent to the recipient room.
The correct CPT code is:
A. 50543 B. 50547 C. 50300 D. 50320
Question 14
67-year-old female having urinary incontinence with intrinsic sphincter deficiency is having a
cystoscopy performed with a placement of a sling. An incision was made over the mid urethra
dissected laterally to urethropelvic ligament. Cystoscopy revealed no penetration of the bladder.
The edges of the sling were weaved around the junction of the urethra and brought up to the
suprapubic incision. A hemostat was then placed between the sling and the urethra, ensuring no
tension. What code should be used for this procedure?
A. 57288 B. 57287 C. 52000, 57288 D. 52000, 51992
Question 15
16-day-year old male baby is in the OR for a repeat circumcision due to redundant foreskin that
caused circumferential scarring from the original circumcision. Anesthetic was injected and an
incision was made at base of the foreskin. Foreskin was pulled back and the excess foreskin was
taken off and the two raw skin surfaces were sutured together to create a circumferential
anastomosis. Select the appropriate code for this surgery:
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