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AAPC - CHAPTER 18 PRACTICAL APPLICATIONS EXAM WITH VERIFIED ANSWERS

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AAPC - CHAPTER 18

AAPC - CHAPTER 18 PRACTICAL APPLICATIONS EXAM WITH VERIFIED ANSWERS 1. CASE 1 R/O MRSA - Central line catheter Clinical Indications:(Clinical indications provide med- ical necessity when there are no other findings.) Pa- tient with fever not responsive to antibiotics Collected: 03/30/XX 17:4...

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AAPC - CHAPTER 18 PRACTICAL APPLICATIONS EXAM
WITH VERIFIED ANSWERS
1. CASE 1 87641
A49.02
R/O MRSA - Central line catheter

Clinical Indications:(Clinical indications provide med-
ical necessity when there are no other findings.) Pa-
tient with fever not responsive to antibiotics

Collected: 03/30/XX 17:45

Accession Num: TXXXXX

Status: Authenticated

Method: Single nucleic acid sequence (Note the
method used to identify the infectious agent and/or
resistance.)

Culture:

Methicillin Resistant Staphylococcus aureus (MRSA)
isolated (Select the diagnosis code based on the find-
ings.)

What are the CPT and ICD-10-CM codes?

2. CASE 2 88367
88373
SURGICAL PATHOLOGY R87.619

ORDERING PHYSICIAN: Karen Smith, MD

PROCEDURES: Surgical pathology procedure per-
formed by a pathologist.

CLINICAL INDICATIONS: Patient presents to her gy-

, AAPC - CHAPTER 18 PRACTICAL APPLICATIONS EXAM
WITH VERIFIED ANSWERS
necologist for follow-up of an abnormal Papanicolaou
(Pap) smear. (Diagnosis used for lab.) The physician
refers patient for repeat Pap smear. The specimen is
sent for interpretation and report by the pathologist
providing consultative services.

SPECIMENS: Pap smear, cervix.

METHODOLOGY: Morphometric analysis Fluorescent
In Situ Hybridization (FISH) using computer-assisted
technology, professional component. (Procedure per-
formed.)

RESULTS: The pathologist reviews images from the
slides. The pathologist does not identify any copies
of the 3q26 (Initial stain.) and 5p15 (Additional stain.)
genes in the stained slide images. This report is con-
sistent with the patient's HPV results and the patient
is not at presently at risk to develop severe dysplasia.

A 41 year-old female presents to her gynecologist to
review her abnormal Pap results. The physician re-
views her Pap results which indicates that this pa-
tient is at risk for cervical cancer. The gynecologist
recommends the patient have a repeat Pap smear and
FISH studies to evaluate the tissue for the 3q26 and
5p15 genes which are associated with increased risk
to develop cervical dysplasia.
FISH studies may be ordered by gynecologist to evalu-
ate the presence of copies of the 3q26 and 5p15 genes.
The presence of these genes is associated with an in-
creased risk to develop severe cervical dysplasia, and
place the patient at a higher risk to develop invasive
cervical cancer.
The patient decides to have these studies and the
physician performs a Pap smear on the same day.
The specimen is sent for both HPV testing and probe
studies for the 3q26 and 5p15 genes.
Pathologist does the review and the interpretation and

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