AAPC CPC FINAL EXAM REAL EXAM 3 LATEST
VERSIONS EACH VERSION CONTAINS 100
QUESTIONS AND CORRECT ANSWERS(VERIFIED
ANSWERS)|AGRADE
•
___________ fixation with pins, screws, plates, or wires is placed directly on or in the
bone to immobilize a fractured bone and to maintain alignment while it heals.
a. Manipulation
b. Reduction
c. Internal
d. Casting - ✔✔ANSW✔✔..c. Internal
Arthroscopic portals were created, and the knee was systematically examined and
probed. Best option was to proceed with a limited partial meniscectomy. A series of
straight-angled and curved basket punches was used to perform a saucerization of the
damaged portion of the meniscus, leaving the intact portion of the medial meniscus in
place. Approximately 50% remained. Next, our attention was turned to the ACL repair.
Through a 5 cm longitudinal anterior incision, a central one-third tendon bone was
harvested. A 10 mm graft was taken and bone plug sculpted. The graft was tightened in
extension about 2.5 mm and actually lengthened in flexion, and this was considered
acceptable. What CPT codes?
a.29888-RT, 29880-51-RT
b.29889-RT, 29880-51-RT
c.29888-RT, 29882-51-RT
d.29888-RT, 29881-51-RT - ✔✔ANSW✔✔..d. 29888-RT, 29881-51-RT
POSTOPERATIVE DIAGNOSIS: Heart Block
NAME OF PROCEDURE: Reimplantation of dual chamber pacemaker
DESCRIPTION: A subfascial incision was made about 2.5 cm below the clavicle, and
the old pulse generator was removed. Using the Seldinger technique, the subclavian
vein was cannulated and through this, the old atrial lead was removed, and a new atrial
lead (serial # 6662458) was placed in the right atrium and to the atrial septum. Using a
second subclavian stick in the Seldinger technique, the old ventricular lead was
removed and a new ventricular lead (serial # 52236984) was inserted and placed into
the right ventricular apex Leads were connected to the pacemaker generator (serial #
,22561587), which was inserted into the previously created pocket. What CPT® codes
are reported?
a. 33207, 33206-51, 33236-51
b. 33202, 33233-51
c. 33235, 33208-51, 33233-51
d. 33208, 33238-51, 33241-51 - ✔✔ANSW✔✔..c. 33235, 33208-51, 33233-51
Rationale: Code 33235 reports removal of the electrodes of a dual pacemaker lead
system. Code 33208 reports replacement of permanent pacemaker generator with
transvenous electrodes to the right atrium and right ventricle, and 33233 reports the
removal of a pacemaker generator. Modifier 51 reports multiple procedures performed
during the same session. Look in the CPT® Index for Pacemaker, Heart/Insertion which
direct you to 33206-33208. Next look for Pacemaker, Heart/Removal/Pulse Generator
Only which directs you to 33233. Look for Pacemaker, Heart /Removal/Transvenous
Electrodes which directs the coder to 33234-33235.
PREOPERATIVE & POSTOPERATIVE DIAGNOSES:
2. Back pain.
3. Neck pain
NAME OF PROCEDURE:
1. Right breast reduction of 1950 g.
2. Right free-nipple graft.
3. Left breast reduction of 1915 g.
4. Left free-nipple graft.
DESCRIPTION OF PROCEDURE: On each side the free-nipple grafts were harvested.
They were marked to be side specific and were stored on the back table in moistened
lap sponges. I amputated the inferior portion of the breast from the right side. I then
moved to the left and again amputated the inferior portion of the breast. The nipple-
areolar complexes were de-epithelialized using the scalpel. The free-nipple grafts were
then retrieved from the back table. They were each defatted using scissors and were
placed in an on-lay fashion on the appropriate side, and each was inset using 5-0 plain
sutures. Closure was done. What CPT® code is reported?
a. 19325
b. 19318-50
c. 19318
d. 19325-50 - ✔✔ANSW✔✔..b. 19318-50
Procedure: Colectomy with a take-down of splenic flexure.
This incision was carried down to the rectus muscles, which were separated in the
midline. The malignant intra-abdominal tumor was resected from the hepatic flexure into
the mid transverse colon. The mass could not be resected without removal of bowel,
attention was directed to mobilization of the splenic flexure. The ligamentous and
,peritoneal attachments were taken down around the splenic flexure of the colon until the
entire left colon was mobilized medially. Similar steps were done on the right side.
Attention was then directed towards re-anastomosis of the colon. Pathology report
showed intra-abdominal cancer, transverse colon and hepatic flexure cancer. The origin
of the cancer could not be determined from the specimen given. What CPT and ICD-10-
CM?
a. 44160, C18.8
b. 44140, C79.89, C78.5
c. 44140, 44139, C76.2, C18.8
d. 44147, 44139, C76.2, C18.8 - ✔✔ANSW✔✔..c. 44140, 44139, C76.2, C18.8
PROCEDURES PERFORMED:
1. Bilateral facet joint injections, L4-L5
2. Bilateral facet joint injections, L5-S1
3. Fluoroscopy.
TECHNIQUE: The AP view was aligned with the proper tilt so that the end plates for the
desired levels were perpendicular. The AP image showed the sacrum and the L5
spinous process. Manual palpation located the sacral hiatus. The 6-inch, 20-gauge
needle with a slight volar bend was inserted using fluoroscopy into each facet joint
under AP image. The bilateral L4-L5, and L5-S1 facet joints were injected in a
systematic fashion from caudal to cranial. A sterile dressing was applied. The patient
tolerated the procedure well with no complications and was transferred to recovery in
good condition. What CPT® codes are reported?
a. 64493-50 x 2
b. 64493-50, 64494-50-51, 77002-26
c. 64493-50, 64494 x 2, 77002-26
d. 64493-50, 64494 x 2 - ✔✔ANSW✔✔..d. 64493-50, 64494 x 2
A 15-year-old underwent placement of a cochlear implant 1 year ago. It now needs to
be reprogrammed. What CPT® code is reported for the reprogramming?
a. 92602
b. 92604
c. 92603
d. 92601 - ✔✔ANSW✔✔..b. 92604
Rationale: Cochlear implants differ from hearing aids; they bypass the damaged part of
the ear. The use of a cochlear implant involves relearning how to hear and react to
sounds. In the CPT® Index look for Cochlear Device/Programming which directs you to
codes 92602, 92604. The code selection is based on the age of the patient and whether
it is the initial programming or subsequent reprogramming. Code 92604 describes
subsequent reprogramming for a patient age 7 or older.
, A 16-year-old male is brought to the ED by his mother. He was riding his bicycle in the
park when he fell off the bike. The patient's right arm is painful to touch, discolored, and
swollen. The X-ray shows a closed fracture of the ulna. What ICD-10-CM codes are
reported?
a. S52.209A, V18.4XXA, Y92.830
b. S52.201A, V19.9XXA, Y92.830
c. S52.201A, V18.0XXA, Y92.830
d. S52.201A, V18.4XXA, Y92.831 - ✔✔ANSW✔✔..c. S52.201A, V18.0XXA, Y92.830
A 17-year-old female has a bone marrow biopsy for examination as a potential
volunteer stem cell donor for her mother who has acute monocytic leukemia (AML).
What diagnosis code(s) is/are used for the typing of the stem cell specimens?
a. C93.00, Z52.3
b. Z00.5
c. Z52.3, C93.00
d. C93.00 - ✔✔ANSW✔✔..b. Z00.5
A 23-year-old patient presents to the emergency department (ED) with a cut on his leg.
He is a confirmed AIDS patient as documented in the record. What ICD-10-CM codes
should be reported?
a. S81.819a, Z71.7
b. S81.819a, Z11.4
c. S81.819A, B20
d. S819A, R75 - ✔✔ANSW✔✔..c. S81.819A, B20
A 26-year-old patient presents with headache, neck pain and fever and is concerned he
may have meningitis. The patient was placed in the sitting position and given 0.5 mg
Ativan IV. His back was prepped and a 20-gauge needle punctured the spine between
L4 and L5 with the return of clear fluid. The cerebrospinal fluid was reviewed and
showed no sign of meningitis. What CPT® code is reported?
a. 62272
b. 62326
c. 62270
d. 62282 - ✔✔ANSW✔✔..c. 62270
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
