Free Practice Questions for AAPC CPC Exam

1. Procedure and CPT® Code Selection:

The scenario describes the excision of a 5 cm tumor located in the left lower quadrant of the abdominal wall. The tumor was excised down to the dermis and subcutaneous layers and removed using electrocautery.

Code 22903 is appropriate for the excision of a soft tissue tumor in the abdominal wall greater than 5 cm, making it the correct CPT® code.

Code 22901 applies to the excision of a soft tissue tumor in the abdominal wall but only for tumors 5 cm or less. Given that the tumor in this case is exactly 5 cm, it meets the threshold for 22903, which is more appropriate here.

2. Diagnosis and ICD-10-CM Code Selection:

ICD-10-CM Code D49.2 is used for a neoplasm of unspecified behavior in the abdominal area, reflecting the fact that the pathology report is pending to determine if the tumor is malignant.

Code C76.2 would be incorrect because it is for malignant neoplasms of unspecified abdominal areas, which we cannot confirm based on the initial excision. Similarly, R19.04 (indicating a mass in the abdominal region) is a symptom code and is not appropriate for a definitive diagnosis when a neoplasm code (D49.2) exists.

3. AAPC and CPT® Coding Guidelines:

Per AAPC coding guidelines, the size of the tumor is critical in selecting the correct excision code for abdominal wall neoplasms. Additionally, if the tumor’s pathology is not confirmed as malignant, it is coded as a neoplasm of unspecified behavior until further details are known.

Therefore, based on CPT® and ICD-10-CM coding guidelines, the verified answer is B. 22903, D49.2.

In the CPT® code book, code 35860 describes an "Exploration for postoperative hemorrhage, thrombosis or infection" in multiple areas, specifically including the neck, chest, abdomen, and/or extremity. This code is used when a surgeon explores these areas postoperatively to locate and address complications such as bleeding, clots, or infections.

B, C, and D are incorrect as they do not fully encompass all the areas listed in the actual description of CPT® code 35860, which includes all four regions (neck, chest, abdomen, and extremity).

Thus, the correct answer is A. Exploration for postoperative hemorrhage, thrombosis or infection; neck, chest, abdomen, and/or extremity.

Kerat/o = cornea

-itis = inflammation

Keratitis specifically means inflammation of the cornea, which is the transparent anterior portion of the eye.

Other options are incorrect because:

Blepharitis = inflammation of the eyelid

Conjunctivitis = inflammation of the conjunctiva

Scleritis = inflammation of the sclera

The National Correct Coding Initiative (NCCI) was developed by CMS to:

Prevent unbundling

Define procedure-to-procedure (PTP) edits

Identify when modifiers (such as -59) may be appropriate

NCCI edits are critical for accurate CPT® coding and proper reimbursement.

Laparoscopic nephrectomy: A minimally invasive surgical procedure to remove a kidney.

Part of the ureter: Removal includes part of the ureter.

50220: Nephrectomy (open procedure), which doesn't apply since the procedure was laparoscopic.

50548: Nephrectomy, partial, laparoscopic, which doesn't match the full nephrectomy performed.

50543: Laparoscopy, surgical; nephrectomy with total ureterectomy.

50543 is the correct CPT code for the laparoscopic removal of the kidney along with part of the ureter, fitting the scenario described.

In medical billing, Place of Service (POS) code 31 is used to indicate that a service was performed in a skilled nursing facility (SNF). POS codes are standardized by the Centers for Medicare & Medicaid Services (CMS) to specify the location where services are provided.

A. 32 refers to a nursing facility (NF), which is different from a skilled nursing facility in terms of the level of care provided.

B. 20 indicates urgent care facility.

C. 22 is used for outpatient hospital services.

Thus, the correct answer is D. 31 for a skilled nursing facility.

In this case, a CRNA provided anesthesia for an urgent endoscopic procedure. To select the appropriate codes, we consider both the anesthesia code for the procedures performed and the modifiers relevant to the CRNA’s role and the patient’s physical status:

1. 00813: This CPT® code covers "Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum," which is appropriate since the colonoscopy extended to the ileum and into the lower duodenum. 00731 (anesthesia for upper GI endoscopy) would not fully apply, as the main procedure targeted lower intestinal areas as well.

2. QZ Modifier: Indicates the anesthesia was performed by a CRNA without medical direction by an anesthesiologist, which aligns with the scenario where the CRNA independently administered anesthesia.

3. P3 Modifier: Reflects the physical status of "severe systemic disease" for this patient, as she has both end-stage renal failure and myelodysplastic syndrome.

4. 99100: This code is added to reflect "special anesthesia circumstances" given the patient’s extreme frailty (platelet count of 3,000), which warrants additional consideration.

5. 99140: Used for emergency conditions, which applies here due to the urgent nature of the bleeding investigation.

Thus, 00813-QZ-P3, 99100, 99140 accurately reflects the anesthesia services provided by the CRNA in this emergency scenario.

81025 – Urine pregnancy test, by visual color comparison methods

Correct for office-based urine pregnancy testing

Why Other Options Are Incorrect:

81000–81005 – Urinalysis codes, not pregnancy testing

For the excision of an 11 cm lesion with a rotation flap repair, the appropriate CPT codes are 14001 for the adjacent tissue transfer or rearrangement (12 sq cm flap) and 11606-51 for the excision of a malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm. Modifier 51 indicates multiple procedures. The detailed operative report specifies the lesion size and the technique used, justifying these codes.

S06.0X1A = Concussion with brief LOC

V40.5XXA = Driver injured in collision with fixed object

V47.5XXA = Car accident, driverExternal cause codes correctly describe mechanism and role.