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AAPC CPC EXAM PRACTICE D, E, F
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AAPC CPC EXAM PRACTICE D, E, F CPC EXAM D - 1. Indication: Patient has a hypertrophic scar on the posterior side of the left leg, at the level of the knee. This has begun to restrict his mobility. His physical therapy trial was unsuccessful. Procedure: After the proper induction of anesthesia, ...

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  • April 3, 2023
  • 57
  • 2022/2023
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AAPC CPC EXAM PRACTICE D, E, F
CPC EXAM D -



1. Indication: Patient has a hypertrophic scar on the posterior side of the left leg, at

the level of the knee. This has begun to restrict his mobility. His physical therapy trial was

unsuccessful. Procedure: After the proper induction of anesthesia, the subcutaneous tissue of

the patient's left leg beneath the scar was infiltrated with crystalloid solution containing

epinephrine to minimize blood loss. The scar was then excised down to viable dermis.

Hemostasis was obtained with epinephrine soaked pads. Skin was harvested from the patient's

thigh in a split thickness fashion and was used to cover the 90 sq cm defect created by the

surgery. The graft was secured with skin staples, and then dressed with fine mesh gauze

followed by medication-soaked gauze. The donor site was dressed with mesh followed by

Adaptic™, followed by a dry dressing and an Ace wrap. What are the CPT® codes?

A. 15110-52, 15002

B. 15100, 11406

C. 15100, 15002

D. 15110, 15002 -



2. The physician is called in to perform repairs for a 17 year-old girl involved in a motor

vehicle accident. She sustained an 8.6 cm laceration to her forehead, a 5.5 cm laceration to her

right cheek, a 4 cm laceration to her left cheek, a 4 cm laceration across her chin, and a 12.5 cm

laceration to her chest. The wound on her chin required a layered closure. All other wounds

required complex closure. The CPT® codes to report are:

A. 13132, 13133 x 4, 13101, 12052

B. 13132, 13133 x 3, 13133-52, 13101, 13102, 12052

C. 13132, 13133 x 3, 13101, 13102, 12052

D. 13131, 13132, 13133 x 3, 13101, 13102, 12052 -

,3. A 36 year-old male presents to have multiple lesions destroyed. Three benign

lesions on his face are destroyed and five actinic keratoses on his left arm are destroyed. The

CPT® code(s) to report is (are):

A. 17000, 17003

B. 17000, 17003 x 4, 17110

C. 17110

D. 17260 x 5, 17110 x 3 -



4. Patient is having ongoing back and hip pain. The physician elects to perform a

sacroiliac injection at an ambulatory surgery center. After sterile prep, the patient is placed

prone position. A needle is placed under fluoroscopic guidance into the SI joint and a mixture of

20 mg of Celestone and Marcaine is injected for pain relief. Report the CPT® code(s).

A. 27096, 77003-26

B. 20611

C. 20552

D. 27096 -



5. Patient is seen in the hospital's outpatient surgical area with a diagnosis of a

displaced comminuted closed fracture of the lateral condyle, right elbow. An ORIF procedure

was performed, which included the following techniques: An incision was made in the area of

the lateral epicondyle. This was carried through subcutaneous tissue, and the fracture site was

easily exposed. Inspection revealed the fragment to be rotated in two places, about 90 degrees.

It was possible to manually reduce this quite easily, and the manipulation resulted in an almost

anatomic reduction. This was fixed with two pins driven across the humerus. The pins were cut

off below skin level. The wound was closed with plain catgut subcutaneously and 5-0 nylon for

the skin. Dressings and a long arm cast were applied. Which is the correct ICD-10-CM and CPT®

code assignment?

A. 24579-RT, 29065-51-RT, S42.451B

B. 24577-RT, S42.451A

,C. 24579-RT, S42.451A

D. 24575-RT, S42.451B -



6. A 35 year-old female patient presents with acute onset of severe pain since

October. Her workup has revealed evidence of disk herniation with loss of lordosis at the C5-C6.

Intraoperative findings were consistent with two large fragments of free disk fragments in the

foramen at C5-C6 on the right side. After general anesthesia, the patient was placed on the

operative table in the supine position. All pressure points were cushioned and a transverse skin

incision was fashioned under fluoroscopic guidance over the C5-C6 disc space. Dissection

through the platysma eventually allowed for exposure of the anterior entrance to the vertebral

body of C5 and C6 and retractors were inserted to maintain adequate exposure. The operating

microscope was brought into the field. Caspar posts were placed and slight distraction allowed

exposure. A complete discectomy was performed at C5-C6 by using endplate curets pituitary

rongeurs and Kerrison rongeurs. The posterior longitudinal ligament was resected and beneath

the posterior longitudinal ligament, two significant sized disc fragments were noted in the

foramen at C5-C6. These were removed using pituitary and Decker instruments. The endplates

were then decorticated so that they were parallel to each other and a midline keel was

performed on AP and lateral fluoroscopy. A size #1 by 5 mm interbody Kineflex-C device was

placed under fluoroscopic guidance. Satisfied with the positioning of the device, the decision

was made to close. What is the correct CPT® code for this procedure?

A. 63075

B. 63081

C. 22856

D. 22554 -



7. OPERATION: Dual chamber transvenous implantable pacing

cardioverter-defibrillator system implantation with leads. INDICATIONS: A 67 year-old, white

gentleman has significant underlying ischemic cardiomyopathy with EF of 25 percent, prior

infarcts, remote history of syncope, and at a high risk for malignant ventricular arrhythmias. He

, has had a recent T wave alternans test which was clearly abnormal. He has had episodes of

resting bradycardia, also noted. He meets Madit II criteria for insertion of a transvenous

implantable pacing cardioverter-defibrillator (ICD). PROCEDURE: After informed consent had

been obtained, the patient was brought to the outpatient hospital lab in the fasting state. The

left anterior chest was prepped and draped in a sterile fashion. Intravenous sedation and local

anesthetic were given. After local anesthetic, a 5 cm incision was made at the left deltopectoral

groove. With blunt dissection and cautery, this was carried down through the pre pectoralis

fascia. The cephalic vein was identified and ligated distally. Through the venotomy, a subclavian

venogram was performed to provide a roadmap. The atrial and ventricular leads were then

advanced into the vessel to the level of the right atrium under fluoroscopic guidance. The

ventricular lead was maneuvered to the right ventricular outflow tract, and then through the RV

apex where it was actively fixed. Good sensing and pacing thresholds were demonstrated. The

lead was anchored to the pre-pectoralis fascia with interrupted 2-0 Tycron sutures. 10-volt

pacing did not result in diaphragmatic capture. The atrial lead was maneuvered to the

anterolateral right atrial wall where it was actively fixed. Good sensing and pacing thresholds

were demonstrated. The lead was anchored to the pre-pectoralis fascia with interrupted 2-0

Tycron sutures. 10-volt pacing did not result in diaphragmatic capture. A subcutaneous pocket

was created with good hemostasis achieved. The pocket was subsequently irrigated with

solution of Bacitracin. The generator was connected to the lead, and then placed in the pocket

with no tension on the lead. The deep fascial layer was closed with interrupted 2-0 Vicryl suture.

The subcutaneous closure was made with running 3-0 Vicryl suture. Subcuticular closure was

made with running 4-0 Vicryl suture. Steri-strips were applied. Ventricular fibrillation was

induced with a T wave shock. This was successfully sensed and terminated with a 15 joule shock

to sinus rhythm. High voltage impedance was 39 ohms. Dry dressing was placed over the

wound. The patient returned to the floor in stable condition without apparent complications.

Which of the following CPT® code(s) accurately describes the basic procedure summarized in

this report?

A. 33208

B. 33249, 76000-26

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