[2023年10月] 更新されたのはAAPC CPC問題集PDFオンラインエンジン
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質問 # 20
A physician prescribes carbamazepine to treat a patient with epileptic seizures. After six months, the physician performs a therapeutic drug test to monitor the total level of the drug in the patient.
What CPT and ICD-10-CM coding is used for the six month-evaluation?
- A. 80157, R56.9
- B. 80156, R56.9
- C. 80156, G40.909
- D. 80157, G40.909
正解：C
質問 # 21
A 65-year-old man had a right axillary block by the anesthesiologist. When the arm was totally numb, the arm was prepped and draped, and the surgeon performed tendon repairs of the right first, second, and third fingers. The anesthesiologist monitored the patient throughout the case.
What anesthesia code is reported?
- A. 01830
- B. 01810
- C. 01820
- D. 01840
正解：B
質問 # 22
A cardiologist attempted to perform a percutaneous transluminal coronary angioplasty of a totally occluded blood vessel. The surgeon stopped the procedure because of an anatomical problem creating risk for the patient and preventing performance of the catheterization.
What modifier is appended to the procedure code?
- A. 0
- B. 1
- C. 2
- D. 3
正解：B
質問 # 23
Which one of the following is an example of a case in which a diabetes-related problem exists and the code for diabetes is never sequenced first?
- A. If the patient is being treated for secondary diabetes
- B. If the patient has an underdose of insulin due to an insulin pump malfunction
- C. If the patient is being treated for type 2 diabetes
- D. If the patient has hyperglycemia that Is not responding to medication
正解：B
質問 # 24
A complete cardiac MRI for morphology and function without contrast, followed by contrast with four additional sequences and stress imaging, is performed on a patient with systolic left ventricular congestive heart failure and premature ventricular contractions.
What CPT and ICD-10-CM codes are reported?
- A. 75563, I50.20, I49.3
- B. 75561, 75563, I50.1, I49.1
- C. 75559, I50.20, I49.3
- D. 75557, 75559, I50.1, I49.1
正解：A
質問 # 25
A 6-French sheath and catheter is placed into the coronary artery and is advanced to the left side of the heart into the ventricle. Ventriculography is performed using power injection of contrast agent. Pressures in the left heart are obtained. The coronary arteries are also selected and imaged.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
正解：A
質問 # 26
The gastroenterologist performs a simple excision of three external hemorrhoids and one internal hemorrhoid, each lying along the left lateral column. The operative report indicates that the internal hemorrhoid is not prolapsed and is outside of the anal canal.
What CPT and ICD-10CM codes are reported?
- A. 46320, 46945, K64.0, K64.9
- B. 46255, K64.0, K64.4
- C. 46250, K64.0, K64.9
- D. 46250, 46945, K64.0, K64.4
正解：C
質問 # 27
View MR 006399
MR 006399
Operative Report
Preoperative Diagnosis: Chronic otitis media in the right ear
Postoperative Diagnosis: Chronic otitis media in the right ear
Procedure: Eustachian tube inflation
Anesthesia: General
Blood Loss: Minimal
Findings: Serous mucoid fluid
Complications: None
Indications: The patient is a 2-year-old who presented to the office with chronic otitis media refractory to medical management. The treatment will be eustachian tube inflation to remove the fluid. Risks, benefits, and alternatives were reviewed with the family, which include general anesthetic, bleeding, infection, tympanic membrane perforation, routine tubes, and need for additional surgery. The family understood these risks and signed the appropriate consent form.
Procedure in Detail: After the patient was properly identified, he was brought into the operating room and placed supine. The patient was prepped and draped in the usual fashion. General anesthesia was administered via inhalation mask, and after adequate sedation was achieved, a medium-sized speculum was placed in the right ear and cerumen was removed atraumatically using instrument with operative microscope. The tube is dilated, an incision is made to the tympanum and thick mucoid fluid was suctioned. The patient was awakened after having tolerated the procedure well and taken to the recovery room in stable condition.
What CPT coding is reported for this case?
- A. 69433-RT
- B. 69436-RT
- C. 69421-RT
- D. 69420-RT
正解：C
質問 # 28
A patient with empyema requires a Schede thoracoplasty.
What CPT code is reported for this procedure?
- A. 0
- B. 1
- C. 2
- D. 3
正解：A
質問 # 29
A 5-year-old who has an allergy history experienced a possible reaction to peanuts. A quantitative, high-sensitive fluorescent enzyme immunoassay was used to measure specific IgE for recombinant peanut components. Results showed there was no reaction indicating the child has a peanut allergy.
What lab test is reported?
- A. 0
- B. 1
- C. 2
- D. 3
正解：C
質問 # 30
The outermost protective layer of skin is called the:
- A. Subcutaneous tissue
- B. Hypodermis
- C. Epidermis
- D. Dermis
正解：C
質問 # 31
View MR 004397
MR 004397
Operative Report
Preoperative Diagnosis: Calculi of the gallbladder
Postoperative Diagnosis: Calculi of the gallbladder, chronic cholecystitis Procedure: Cholecystectomy Indications: The patient is a 50-year-old woman who has a history of RUQ pain, which ultrasound revealed to be multiple gallstones. She presents for removal of her gallbladder.
Procedure: The patient was brought to the OR and prepped and draped in a normal sterile fashion. After adequate general endotracheal anesthesia was obtained, a trocar was placed and C02 was insufflated into the abdomen until an adequate pneumoperitoneum was achieved. A laparoscope was placed at the umbilicus and the gallbladder and liver bed were visualized. The gallbladder was enlarged and thickened, and there was evidence of chronic inflammatory changes. Two additional ports were placed and graspers were used to free the gallbladder from the liver bed with a combination of sharp dissection and electrocautery. Cystic artery and duct are clipped. Dye is injected in the gallbladder. Cholangiography revealed no intraluminal defect or obstruction. Gallbladder is dissected from the liver bed. The scope and trocars are removed.
What CPT coding is reported for this case?
- A. 47563, 74300-26
- B. 47600, 74300-26
- C. 47605, 74300-26
- D. 47562, 74300-26
正解：A
質問 # 32
This 27-year-old male has morbid obesity with a BMI of 45 due to a high calorie diet. He has decided to have an open Roux-en-Y gastric bypass. The patient is brought to the operating room and placed in supine position. A midline abdominal incision is made. The stomach is mobilized, and the proximal stomach is divided and stapled creating a small proximal pouch in continuity with the esophagus. A short limb of the proximal bowel of 155 cm is divided. It is brought up and anastomosed to the gastric pouch. The other end of the divided bowel is connected back into the distal small bowel to the short limb's gastric anastomosis to restore intestinal continuity. The abdominal incision is closed.
What are the procedure and diagnosis codes for this encounter?
- A. 43847, E66.01, Z68.42
- B. 43645, E66.8, Z68.42
- C. 43847, E66.9, Z68.42
- D. 43644, E66.01, Z68.43
正解：A
質問 # 33
Mr. Woolridge has had a suspicious lesion on his left shoulder for approximately eight weeks that is not healing. On the dermatologist's exam of left shoulder blade, there is excoriation and scabbing and the lesion not healing. Patient agrees and wishes to proceed with a punch biopsy of the lesion. A punch biopsy is taken of the lesion and sent to pathology. A simple repair is performed at the biopsy site.
What CPT and ICD-10-CM codes are reported?
- A. 11104,12001-51, L98.9
- B. 11104, D49.2
- C. 11102, L98.9
- D. 11102, 12001-51, D49.2
正解：B
質問 # 34
A diagnostic mammogram is performed on the left and right breasts. Computer-aided detection is also used to further analyze the image for possible lesions.
What CPT coding is reported for this radiology service?
- A. 77067-50
- B. 77066-50
- C. 0
- D. 77065-LT, 77065-RT
正解：C
質問 # 35
A 60-year-old male has three-vessel disease and supraventricular tachycardia which has been refractory to other management. He previously had pacemaker placement and stenting of LAD coronary artery stenosis, which has failed to solve the problem. He will undergo CABG with autologous saphenous vein and an extensive modified MAZE procedure to treat the tachycardia.
He is brought to the cardiac OR and placed in the supine position on the OR table. He is prepped and draped, and adequate endotracheal anesthesia is assured. A median sternotomy incision is made and cardiopulmonary bypass is initiated. The endoscope is used to harvest an adequate length of saphenous vein from his left leg. This is uneventful and bleeding is easily controlled. The vein graft is prepared and cut to the appropriate lengths for anastomosis. Two bypasses are performed: one to the circumflex and another to the obtuse marginal. The left internal mammary is then freed up and it is anastomosed to the ramus, the first diagonal, and the LAD. An extensive maze procedure is then performed and the patient is weaned from bypass. At this point, the sternum is closed with wires and the skin is reapproximated with staples. The patient tolerated the procedure without difficulty and was taken to the PACU.
Choose the procedure codes for this surgery.
- A. 33533, 33257, 33519, 33508
- B. 33535, 33259 51, 33519-51, 33508-51
- C. 33535, 33259, 33519, 33508
- D. 33533, 33257-51, 33519-51, 33508-51
正解：A
質問 # 36
Which place of service code is submitted on the claim for a service that is performed in an outpatient surgical floor?
- A. 0
- B. 1
- C. 2
- D. 3
正解：C
質問 # 37
A 49-year-old patient arrives with hearing loss in his left ear. Impedance testing via tympanometry is performed.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
正解：C
質問 # 38
A couple presents to the freestanding fertility clinic to start in vitro fertilization. Under radiologic guidance, an aspiration needle is inserted (by aid of a superimposed guiding-line) puncturing the ovary and preovulatory follicle and withdrawing fluid from the follicle containing the egg.
What is the correct CPT code for this procedure?
- A. 0
- B. 1
- C. 2
- D. 3
正解：B
質問 # 39
A patient presents with recurrent spontaneous episodes of dizziness of unclear etiology. Caloric vestibular testing is performed irrigating both ears with warm and cold water while evaluating the patient's eye movements. There is a total of three irrigations.
What CPT coding is reported?
- A. 92537-50
- B. 92537-52
- C. 92537-50-52
- D. 92538-50
正解：B
質問 # 40
View MR 099407
MR 099407
Emergency Department Visit
Chief Complaint: VOMITING.
This started just prior to arrival and is still present. He has had nausea and vomiting. No diarrhea, black stools, bloody stools or abdominal pain. Pt is diabetic and has been having elevated blood sugars (320 mg/dL).
REVIEW OF SYSTEMS: Unobtainable due to patient's altered mental status.
PAST HISTORY: Poorly controlled diabetes mellitus, with history of poor compliance.
Medications: See Nurses Notes.
Allergies: PCN.
SOCIAL HISTORY: Nonsmoker. No alcohol use or drug use.
ADDITIONAL NOTES: The nursing notes have been reviewed.
PHYSICAL EXAM
Appearance: Lethargic. Patient in mild distress.
Vital Signs: Have been reviewed-tachycardic.
Eyes: Pupils equal, round and reactive to light.
ENT: Dry mucous membranes present.
Neck: Normal inspection. Neck supple.
CVS: Tachycardia. Heart sounds normal. Pulses normal.
E D. Course: Insulin IV drip per protocol, at 10 units/hr.
Zofran 8 mg 01:33 Jul 13 2008 IVP.
Phenergan 25 mg IVP. 07:52. Discussed case with physician. Dr. X. Reviewed test results. Agreed upon treatment plan. Physician will see patient in hospital.
Total critical care time: 45 min.
Disposition: Admitted to Intensive Care Unit. Condition: stable.
Admit decision based on need for monitoring and IV hydration and medications.
CLINICAL IMPRESSION: Vomiting, diabetic ketoacidosis, probable diabetes insipidus.
What E/M code is reported for this encounter?
- A. 99291, 99292
- B. 0
- C. 1
- D. 2
正解：C
質問 # 41
A 35-year-old female has cancer in her left breast. The surgeon performs a mastectomy, removing the breast tissue, skin, pectoral muscles, and surrounding tissue, including the axillary and internal mammary lymph nodes.
Which mastectomy code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
正解：D
質問 # 42
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