Most UptoDate Medical Tests AAPC-CPC Exam Dumps PDF 2025

100% Free Medical Certification AAPC-CPC Dumps PDF Demo Cert Guide Cover

NEW QUESTION # 55
A patient has a colonoscopy in which the provider removes three polyps from the transverse colon. The first polyp is removed by means of a hot snare technique, and the following two polyps are removed using hot biopsy forceps. What CPT code(s) should be reported for this encounter?

• A. 45385, 45384-59
• B. 0
• C. 1
• D. 45385, 45384-59, 45384-59

Answer: A

Explanation:
When coding colonoscopies, remember that the number of removal techniques is what has a bearing on code selection and not the number of lesions and/or polyps that are being removed. In this case, two techniques are being used: I) the snare technique (CPT 45385) and 2) the hot biopsy forceps technique (CPT 45384). Modifier 59 is appended onto the secondary code to indicate that separate polyps '.vere removed by two different techniques. CPT 45388 is reported when a provider uses any methods other than snare and hot biopsy forceps to remove a lesion and/or polyp.

NEW QUESTION # 56
The appendix is removed through an abdominal incision due to metastatic colon malignancy. How should this be reported?

• A. 44970, C78.5
• B. 44970, C18.9, C78.5
• C. 44950, C78.5
• D. 44950, C78.5, C18.9

Answer: D

Explanation:
An open appendectomy procedure is reported with CPT 44950. A metastatic colon malignancy is a cancer that began in the colon but has spread to other areas. In this scenario, that means that the primary malignancy is the colon, and the secondary malignancy is the appendix.
Additionally, ICD-IO-CM guidelines state that when "treatment is directed toward the metastatic site only, the metastatic site is designated as the principal/first-listed diagnosis. The primary malignancy is coded as an additional code." The malignancy codes do not specifically state
"appendix," but the ICD-IO-CM coding crosswalk in the neoplasm table assigns this diagnosis as C78.5 secondary malignant neoplasm of large intestine and rectum.

NEW QUESTION # 57
An 88-year-old patient with Medicare comes in for her yearly flu shot. After receiving a 0.5 mL single shot dose of preservative-free Alfuria intramuscularly, the provider observes the patient for 15 minutes to monitor any adverse reactions. How should the provider code for this encounter?

• A. 90471, 90656, Z23
• B. 99211-25, 90471, 90656, Z23, Z03.89
• C. G0008, 90656, Z23
• D. 96372, 90686 Z23

Answer: C

Explanation:
The patient has Medicare insurance and therefore requires the use of an HCPC code (G0008) in place of a CPT intramuscular injection code. The use of an E/M code in answer B is not warranted because the provider only administered services related to the vaccination. The appropriate diagnosis code for any vaccination would be Z23.

NEW QUESTION # 58
A physician performs a simple repair on a Medicare patient who comes in with a 2.7 cm cut, an open wound, on the neck. The repair is made with Dermabond. Which CPT code(s) should be reported?

• A. 99213-25, G0168
• B. G0168
• C. 0
• D. 12002, G0168

Answer: B

Explanation:
When a wound is repaired with a tissue adhesive, Medicare accepts only the HCPC code G0168. Answers B and C accurately reflect the repair code for a commercial carrier. An E/M would not be added as an additional charge because the patient's encounter was only for the repair, thus eliminating answer D.

NEW QUESTION # 59
An established 27-year-old female patient is seen with complaints of fatigue and muscle aches that began 3 days ago. The physician draws two vials of blood, collects a urine sample, and performs a pregnancy test. The patient is instructed to drink 8 ounces of water daily, rest, and follow up in 3 days for her results. What CPT codes should be reported for this encounter?

• A. 99213, 81025, 36410, 81005
• B. 99213, 81025, 36415, 81002
• C. 99212, 81025, 36410x2, 99000, 81020
• D. 99212, 81025, 36416, 81007

Answer: B

Explanation:
The documentation demonstrates that the number and complexity of problems addressed is low (fatigue and muscle aches are self-limited problems), the amount or complexity of data to be reviewed and analyzed is moderate (three unique tests), and the risk of complications, morbidity, or mortality of patient management is minimal (the patient was advised to drink more water). (To determine the final level of medical decision making, choose the lowest of the highest two elements. In this scenario, the final level of medical decision making is low, and the CPT code is
99213. Vihen reporting a routine venipuncture, use CPT code 36415. CPT code 36410(a) is reported when it is medically necessary for the physician to draw a patient's blood, and 36416 describes capillary blood collected through a skin prick-certainly not enough to fill two vials. CPT code 99000 can be used to report a specimen being transported to an outside laboratory, but that is unknown in this scenario. A generic urinalysis is reported with CPT code 81002 unless specifically stated that an automated analyzer (81005), a commercial kit (81007), and/or an agar test (81020) was utilized.

NEW QUESTION # 60
A patient tests positive for coronavirus (SARS-CoV-2) and bronchitis after presenting with a cough. What diagnosis code(s) should be reported?

• A. J40,B97.29, Z20.828
• B. U07.1,J40
• C. U07.1,J40, Z20.828
• D. 140, 897.29, R05.9

Answer: B

Explanation:
The underlying condition should always be first listed, which in this case would be the SARS- COV-2 infection (U07.1). The description of the code then prompts the biller to list the manifestations, which would be the unspecified bronchitis 040). In answer A. cough would not be coded as a symptom because the patients illness is confirmed. Answers C and D, which include a suspected exposure code, can also be eliminated because this code is used only when the existence ofthe illness in the patient is unknown or negative.

NEW QUESTION # 61
If a cardiologist bills an electrocardiogram (93010) in the emergency department and then follows up with the patient a week later for arteriosclerosis, he should bill an established patient E/M.

• A. True
• B. False

Answer: B

Explanation:
The statement is false. According to CPT, a new patient is one who has "not received professional services from the physician." In lieu of this, because the cardiologist only interpreted an electrocardiogram and did not actually provide care to the patient, a new patient E/M service should be billed.

NEW QUESTION # 62
Dr. Black orders a hepatitis panel for a patient who has recently returned from traveling abroad and is now experiencing lower abdominal pain. The laboratory completed a hepatitis A antibody test, hepatitis B core antibody test, and a hepatitis C antibody test. Select the CPT and the ICD-IO-CM codes that the laboratory will report.

• A. 86709, 86705, 86803, RIO.31, RIO.32
• B. 86709, 86705, 86803, RIO.30
• C. 80074, RIO.30
• D. 80074-52, RIO.30

Answer: B

Explanation:
The hepatitis B surface antigen test was not performed, so the actual panel code in answer A was not completed, leaving each test to be reported separately. It would not be appropriate to add modifier 52 to 80074 in answer B. Because the provider did not specify which side the lower abdominal pain was on, it would be reported as unspecified with RIO.30, eliminating answer C.

NEW QUESTION # 63
Medical necessity has been established if a laboratory runs additional testing on a urine sample to determine the presence of a drug class that was not in question during confirmation testing.

• A. True
• B. False

Answer: B

Explanation:
The statement is false. To establish medical necessity, the provider/laboratory must indicate the drug class they are screening for prior to the test.

NEW QUESTION # 64
A patient who is experiencing rectal bleeding has a colonoscopy. Prior to the procedure, the provider administers general anesthesi a. What CPT code(s) should be reported?

• A. 45378-47
• B. 45382, 00811
• C. 45378, 0081147
• D. 0

Answer: A

Explanation:
The patient is having the colonoscopy done because they have been experiencing symptoms.
Therefore, the colonoscopy would be considered diagnostic versus screening. CPT crosswalk for a diagnostic colonoscopy is 45378. The documentation gives no indication that any bleeding was identified and controlled. When the surgeon performing the primary procedure is simultaneously administering anesthesia services, modifier 47 is appended rather than billing an additional anesthesia delivery code.

NEW QUESTION # 65
A radiation oncologist reviews the port films, dose delivery, and treatment parameters of a 52-year-old female patient who has received external beam therapy three times in the current week He also spends 15 minutes examining the patient and collecting an intake of her response to the treatment program. Which CPT code(s) should the physician report?

• A. 0
• B. 1
• C. 99213-25, 77401x3units
• D. 77435, 99213-25

Answer: B

Explanation:
Treatment management of a patient undergoing radiation therapy is reimbursed by reporting CPT codes 77427-77470. Treatment management includes a review ofthe port films, dosimetry, dose delivery, treatment parameters, a physical examination, and related counseling. It would therefore not be appropriate to bill for a separate evaluation and management. CPT 77435 describes treatment management for a course of stereotactic body radiation therapy (SBRT), which the patient is not receiving. CPT 77401 describes the actual radiation and not the evaluation from the physician. CPT 77431 is reported when the entire course of therapy consists of one or nvo treatment sessions: however, a coder can infer from the documentation that the patient in this scenario has or will receive multiple sessions over the course of one or more weeks. Additionally, CPT guidelines advise that only three treatment sessions must occur to support the face-to-face encounter described in CPT 77427.

NEW QUESTION # 66
A surgeon performs a craniectomy to excise a meningioma located above the tentorium cerebelli. During the procedure, an extradural hematoma is noted and removed via the same craniectomy site. How should the surgeon report the procedure?

• A. 61312-22
• B. 61512, 61312-59
• C. 0
• D. 61519, 61314-51

Answer: C

Explanation:
Surgical procedures on the nervous system are identified by where inside the skull they occur. A meningioma is being excised from above the tentorium cerebelli, otherwise known as supratentorial (CPT 61512). The removal of an extradural hematoma is inclusive to the primary craniectomy code because the finding is incidental and the same surgical site is used for its removal.
If the surgeon had to create a separate incision to access the extradural hematoma, that excision could be reported separately with modifier 59.

NEW QUESTION # 67
A 74-year-old patient presents with a fever. She is admitted into observational care after her labs confirm a diagnosis of pneumoni a. She has a medical history of being HIV positive. How should this be reported?

• A. 99236, 118.9, B20
• B. 99222, B20, 118.9
• C. 99235, B20, 118.9
• D. 99223, 118.9, B20

Answer: B

Explanation:
Hospital inpatient and observation care services (99221-99236) are selected based on the level of medical decision-making. In this scenario, reporting a code from the initial hospital inpatient and observation care services would be most appropriate (99221-99223), as the documentation indicates the patient is being admitted. When leveling this service, consider that the patient has an acute illness with systemic symptoms (pneumonia) and a stable, chronic illness (HIV). Labs were reviewed to confirm the diagnosis, and a decision was made to admit the patient into observation. Therefore, the final level of medical decision-making is moderate, making the E/M code 99222. Even though pneumonia is the reason for admission, ICD-IO-CM guidelines stipulate that a confirmed HIV diagnosis takes precedence in sequencing when the reason for admission is HIV related.

NEW QUESTION # 68
Code the following note:
A 43 -year-old new female patient with a history of type I diabetes was referred to my office by Dr. White, her primary care physician. Patient complains of blurred vision that began 2 weeks ago, however, reports compliance to a strict, healthy diet and to prescribed 10 mg of dexamethasone every day for 1 month. Given that the only change appears to be the dexamethasone, I suspect the blurred vision is an adverse reaction and will decrease the dosage to 5 mg per day. Patient will follow up with me in 1 week if symptoms persist.
Total time spent on todays encounter is 30 minutes.

• A. 99203, H53.8, ElO.69
• B. 99244, H53.8, T38.OX5A, ElO.9
• C. 99243, H53.8 ElO.39
• D. 99204, HS3.8, ElO.9

Answer: D

Explanation:
When choosing between an outpatient evaluation and management code or a consultation service code, bear in mind the following four elements: request, reason, report, and intent. Although the first three elements are documented and support a consultation service, the endocrinologist is assuming immediate care of the patienYs condition. In this case, the visit is not a consultation but a new transfer of care, which is encompassed by CPT codes 99202-99205. For this visit, coding based on medical decision-making as opposed to the total time spent on the encounter that day would be more advantageous. This is because coding based on time would lead a coder to report CPT code
99203 or a low level of medical decision making, whereas the medical decision-making is actually moderate, represented by CPT code 99204.
The documentation reflects that the blurry vision is most likely due to the dexamethasone:
therefore, a causal relationship is not assumed betvveen the two conditions and should not be coded as such. Because an adverse reaction is suspected and not confirmed, it should not be coded. This general rule does not apply to inpatient encounters.

NEW QUESTION # 69
Under the oversight of the pediatrician, a nurse reviews the vaccine and allergr history of a 13-year-old established patient just prior to administering a live varicella virus vaccine subcutaneously. What procedure code(s) should be reported?

• A. 99211-25, 90716, 90460
• B. 99211-25, 90716, 90471
• C. 90716, 90471
• D. 90716, 90460

Answer: C

Explanation:
Although CPT 99211 can be reported for limited assessments performed by nonphysician staff members, the vaccine and allergy history intake is considered vaccine related and not separately reportable. CPT 90460 is reported when a physician provides counseling about the benefits and risks associated with the vaccine and signs and symptoms that would indicate an adverse reaction.
Because the physician did not document seeing the patient at this encounter, report CPT 90471 for the administration of the immunization.

NEW QUESTION # 70
Alzheimer's disease with early onset usually presents itself in which age group?

• A. 30-40 years old
• B. 50-60 years old
• C. 40-50 years old
• D. 60-70 years old

Answer: C

Explanation:
According to CPT, the rarest form of Alzheimer's disease occurs before 30 years of age.
Early onset Alzheimer's disease usually affects those between the age of 40 and 50 years old. The most common form of Alzheimers disease occurs after the age of 65 and is largely contributed to a combination of environmental and genetic factors.

NEW QUESTION # 71
CPT code 99135 is an example of a qualifying circumstance.

• A. False
• B. True

Answer: B

Explanation:
The statement is true. When it comes to reporting anesthesia services, qualifying circumstances are factors that put a patient at an unusually high health risk. A qualifring circumstance is reported with CPT codes 99100-99140, which are listed separately, in addition to the primary anesthesia code. If reporting one of these add-on codes, documentation must be submitted to support the necessity of such services.

NEW QUESTION # 72
A new, 29-year-old female patient is seen for a preventative visit and receives counseling that totals 30 minutes about contraceptive management. How would the provider code the CPT code(s) for this visit?

• A. 99385, 99203-25
• B. 0
• C. 99385, 99402-25
• D. 99385, 99417, 99417

Answer: B

Explanation:
If 99402 is part of a more complex service, it would not be separately identifiable, thus eliminating answer A Because 99385 includes counseling/anticipatory guidance/risk factor reduction interventions, the additional 30 minutes that the provider spent discussing contraceptives would not be considered a significant, separately identifiable E/M service, eliminating answer B. Last, because time is not a factor when selecting a preventative service,
99417 reflected in answer C, indicating a prolonged outpatient E/M service totaling 30 minutes would not apply.

NEW QUESTION # 73
Assign the CPT codes for the following surgical note:
A patient who is confirmed to have lymphoma is placed under general anesthesi a. A flexible bronchoscope is first inserted through the oral cavity to determine if the primary carcinoma has spread to the lung tissue. No lesions are observed in the bronchus, and the bronchoscope is removed. An incision is then made in the parasternal second left intercostal space, thus exposing the anterior mediastinal lymph nodes. Tissue samples from the lymph nodes are removed without complication. The incision is closed with sutures, and the patient is discharged to recovery.

• A. 39402, 31622-51
• B. 39010, 31622-51
• C. 39010, 31623-51
• D. 39402, 31623-51

Answer: B

Explanation:
The first procedure documented is a bronchoscopy, reported with CPT codes 31622-31654.
Because the procedure was specifically aimed at confirming a diagnosis based off a previously confirmed malignancy, the bronchoscopy would be considered diagnostic (CPT 31622). The second procedure performed is a mediastinotomy with removal of cancerous tissue. An incision made into the parasternal intercostal space is considered transthoracic, making the correct procedure code
39010. Sequencing is based off the highest RVU value, and modifier 51 is appended to the bronchoscopy procedure code to indicate that multiple procedures were performed in the same session.

NEW QUESTION # 74
Which service would NOT be covered under Medicare part A?

• A. Home health care
• B. Inpatient hospital care
• C. Observation hospital care
• D. Hospice care

Answer: C

Explanation:
Observation hospital care is provided to patients who are not sick enough to be admitted.
Therefore, it is considered an outpatient service and is covered under Medicare part B.

NEW QUESTION # 75
A diaphragm resection and repair are done using a biologic mesh to reduce the formation of adhesions. Which procedure code should be reported?

• A. 0
• B. 1
• C. 2
• D. 3

Answer: D

Explanation:
A diaphragm resection is reported with CPT codes 39560-39561. The use ofa biologic mesh makes the repair complex, whereas a simple repair would implement only internal sutures.

NEW QUESTION # 76
An established female patient presents to a video conference with her internist with complaints of a nonproductive cough. She receives 15 minutes of counseling about the symptoms of COVID-19 and is directed to an unaffiliated testing site. What CPT and ICD-IO-CM codes should be reported?

• A. 99442, R05.9
• B. 99213-95, R05.9
• C. 99213-95, R05.9, Z20.828
• D. 99442, R05.9, Z20.828

Answer: B

Explanation:
When coding a telehealth encounter for an outpatient practice that occurs over audio-video technology (e.g. Skype), the appropriate office visit E/M would be reported with modifier 95. The patient must initiate the telehealth encounter. Although similar, CPT code 99442 is billed when a patient initiates communication with a provider through an online patient portal. ICD-IO-CM Z20.828 is reported only when a patient does not exhibit any symptoms of a disease the patient is suspected to have been exposed to.

NEW QUESTION # 77
A patient is having difficulties breast-feeding and receives a lactation consultation by a certified lactation consultant under the general supervision of a mid-level practitioner. How should this service be reported?

• A. 0
• B. 1
• C. 2
• D. 3

Answer: A

Explanation:
CPT 98960 is used by nonphysician healthcare professionals who provide education to patients that enable them to self-manage established conditions. CPT 99078 could also be used to report lactation services, but these are specifically rendered in a group setting. CPT 98966 is used for healthcare management via the telephone, and CPT 99211 is not considered the most appropriate descriptor for services rendered in this instance.

NEW QUESTION # 78
......

Updated Medical Tests AAPC-CPC Dumps – PDF & Online Engine: https://pass4sure.examstorrent.com/AAPC-CPC-exam-dumps-torrent.html