AAPC CPC Practice Exam D

Which Z code category can ONLY be reported as a first listed diagnosis code? A. Z67 B. Z69 C. Z58 D. Z03

D. Z03 The Official ICD-10-CM Coding Guidelines provides a list of Z code categories and Z codes that can only be reported as a first listed diagnosis code. The list can be found in the ICD-10-CM codebook referring to guideline I.C.21.c.16.

Which of the following anatomical sites have septums? A. Nose, heart B. Kidney, lung C. Sternum, coccyx D. Orbit, ovary

A. Nose, heart Both the heart and the nose have a septum, defined as a wall dividing two chambers. The nasal septum separates the two nostrils. A septum also divides the right and left atriums and right and left ventricles of the heart. In the CPT® Index, look for the term Septum or Septal referring you to codes pertaining to the nose or heart.

Lordosis is a disorder of which anatomical site? A. Spine B. Hand C. Male genitalia D. Nasal sinus

A. Spine Lordosis is a spinal deformity in which the anterior curvature of the lumbar spine is excessive. It is also called a "sway back." Lordosis may be caused by tight lower back muscles, obesity, or pregnancy. It can lead to lower back pain. Look in the ICD-10-CM Alphabetical Index for Lordosis referring you to M40.50. In the Tabular List the code is in Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99). When reviewing the codes for category M40 they are selected by the area of the spine (thoracic, lumbar, cervical, etc.).

The patient has a history of symptomatic HIV and has been treated for an HIV related illness. Which ICD-10-CM code is reported? A. Z21 B. B20 C. Z20.6 D. R75

B. B20 Always pause to consider the meaning of "history" when you see it in a note. Physician documentation does not always dovetail with the language of ICD-10-CM. History is a good example of this. A physician may document that the patient has a history of a disease, and this usually means the disease has been eradicated. It may, however, mean that the disease is not a diagnosis new at this encounter, but something ongoing in the patient's care. It may also mean that this is a problem that the patient has had and resolved in the past, and that it has recurred. In the case of "history of symptomatic HIV," we all know this is not a disease that resolves. Once a patient has symptomatic HIV, the patient whether they have symptoms at the time of the service, or not, the diagnosis is coded as B20. According to the Official Guidelines, I.C.1.a.2.(d), once a patient with HIV is treated for any HIV-related illness or is described as having any condition(s) resulting from his/her HIV positive status, report code B20.

What is the full CPT® code description for 61535? A. Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure) B. Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure) C. For removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure) D. For excision of epileptogenic focus without electrocorticography during surgery; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure)

B. Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure) In the CPT® codebook the description for code 61535 is indented which means the description from 61533 up to the semicolon is the beginning of the full description for 61535.

Which one of the following is an example of fraud? A. Reporting the code for ultrasound guidance when used to perform a liver biopsy B. Reporting a biopsy and excision performed on the same skin lesion during the same encounter C. Failing to append modifier 26 on an X-ray that is performed and interpreted in the physician's office D. Reporting a lab panel with an additional lab test that is not included in the lab panel

B. Reporting a biopsy and excision performed on the same skin lesion during the same encounter Answer B is the only example of unbundling of CPT® which would result in a fraudulent claim. According to National Correct Coding Initiative (NCCI) and CPT® coding guidelines, a biopsy performed on the same lesion as an excision during the same encounter is an incidental service and is not reported separately. If ultrasound guidance is performed for a liver biopsy, it is billable. X-rays performed in a physician's office do not require modifier 26, because the physician owns the equipment and performs the interpretation, he bills the global service. Lab panels can be reported with additional lab tests that are not listed in a lab panel.

What is orchitis? A. Inner ear imbalance B. Lacrimal infection C. Inflammation of testis D. Inflammation of an ilioinguinal hernia

C. Inflammation of testis Orchitis is marked by painful swelling of the testis. It may occur without cause, or be the result of infection. The Greek root "orchis" means testicle, and - "itis" is a suffix indicating inflammation or infection. Look in the ICD-10-CM Alphabetic Index for Orchitis referring you to code N45.2. In the Tabular List this code is found under Diseases of the Male Genital Organs (N40-N53).

Which one of the following patients might be documented as having meconium staining? A. Woman with renal failure B. Teenage boy with sickle cell anemia C. Newborn with pneumonia D. Man with alcoholic cirrhosis of liver

C. Newborn with pneumonia Meconium is fetal stool, composed of materials ingested in utero. It is odorless and tarlike. Meconium is usually expelled in a neonate's first bowel movements, but during stress before or during birth, may be expelled into the amniotic fluid. It can be inhaled into the fetal lung and cause pneumonia at birth. Meconium staining refers to discoloration of the amniotic fluid, or of the neonate (for example, meconium staining of fingernails). Look in the ICD-10-CM Alphabetic Index for Stain, staining/meconium (newborn) refers you to a newborn code, P96.83.

The patient is a 16-year-old female with pelvic pain. Her ultrasound is normal. A laparoscopy found several small cysts in the area of the fallopian tubes. These cysts are called: A. Pilonidal cysts B. Myomas C. Paratubal cysts D. Synovial cysts

C. Paratubal cysts Paratubal cysts are benign, they are frequently found adjacent to the fallopian tubes. Pilonidal cyst develops in the deeper layers of the skin in the lower back near the upper crease of the buttocks. Myomas or leiomyomas are benign tumors of the uterus. Synovial cyst develops in any joint, for example at the back of the knee. Look in the ICD-10-CM Alphabetic Index for, Cyst/paratubal N83.8. Go to the Tabular List and the code indicates where these cysts are located.

Which place of service code is reported for fracture care performed by an orthopedic physician in the ED? A. 11 B. 20 C. 22 D. 23

D. 23 Place of service codes are reported on the claim form to identify the site of the service provided. In this case, the services are rendered in the ED which is reported with place of service (POS) 23. The place of service codes can be found in the CPT® codebook.