UPDATED [Mar 29, 2026] Pass American Academy of Professional Coders: Certified Professional Coder Exam with Latest Questions
AAPC-CPC Exam Practice Questions prepared by Medical Tests Professionals
NEW QUESTION # 45
A physician provides a GIPO 39-weeks twin gestational patient with antepartum care, delivery, and postpartum care. Baby A was delivered vaginally without complications, and Baby B was delivered by Cesarean due to fetal tachycardi a. Assign the correct ICD-IO-CM and CPT codes.
- A. 59410, Z37.2 and 59510-51, 076, Z37.2
- B. 59400, Z37.o and 59510-51, 036.8332, Z37.o
- C. 59409, Z3A.39, Z37.o and 59510-51, 076, Z3A39, Z37.o
- D. 59510, 076, Z3A39, Z37.o and 59409-51, Z3A39, Z37.o
Answer: D
Explanation:
The Cesarean delivery (59510) would be sequenced first because this code has the highest RVU and would include the antepartum and postpartum care. The vaginal delivery by itself (59409), without antepartum and postpartum care, would be reported secondary because the charges for the antepartum and postpartum care of the mother have already been included in the Cesarean delivery code.
NEW QUESTION # 46
An established 4-year-old patient is seen by her pediatrician with complaints of pain in her left wrist after falling. The pediatrician determines the wrist is sprained and applies a splint that will keep the wrist from being able to move. The patient's mother is told to follow up if symptoms worsen. What code(s) should be reported for this encounter?
- A. 99212-25, 29125, S8451
- B. 29125, S8451
- C. 29126, E1805
- D. 99212-25, 29126, E1805
Answer: C
Explanation:
The "application of casts and strapping" guidelines located in the surgery section of the CPT book explain that a splint is reported when the physician providing the initial service does not perform, or expects to perform, any other treatment. In this case, because the visit was minimal and directed only at the sprain with no intended follow-up care, only the application of the splint would be reported. The application itself is considered static because the wrist is completely immobilized. HCPC crosswalk for a wrist splint, in addition to knowing the difference bet',veen static and dynamic, would immediately lend itself to the correct HCPC: S8451.
NEW QUESTION # 47
A patient with a stab wound to the chest was taken to the operating room and put under general anesthesia for a thoracotomy. The anesthesiologist should report CPT 00520 with the total number of time units spent providing face-to-face care with the patient.
- A. False
- B. True
Answer: A
Explanation:
The statement is false. CPT 00520 is anesthesia services for closed-chest procedures.
However, a thoracotomy is an open procedure involving a surgical incision to the chest wall. The correct CPT code that should be reported is 00540 (anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum).
NEW QUESTION # 48
An established patient presents complaining of clumpy, white discharge for 3 days. A vaginal exam reveals an old tampon, which is removed. Diflucan is sent to the pharmacy, instructions given, and the patient is told to follow up in I week. How would the provider code the visit?
- A. 57415, 99212-25, T19.2kVA
- B. 99213,N89.8, T19.2LXA
- C. 99213, T19.2XXA, N89.8
- D. 57415, T19.2XXA, N89.8
Answer: C
Explanation:
Although a foreign body was removed, 57415 in answers A and B cannot be reported because anesthesia was not used. The documentation supports low-level medical decision making, so the appropriate E/M would be 99213. VVhen comparing answers C and D, bear in mind that ICD-IO-CM requires sequencing "the underlying condition first, followed by the manifestation."
NEW QUESTION # 49
A patient with right knee pain is seen in a physician's office for an x-ray. Anteroposterior and lateral views of the right knee were obtained by the technician, and images confirm right knee pain secondary to degenerative osteoarthritis. Which CPT and ICD-IO-CM code(s) should be reported?
- A. 73560-TC-RT, MI 7.11, M25.561
- B. 73560-26-RT, MI 7.11, M25.561
- C. 73560-TC-RT, MI 7.11
- D. 73560-RT, MI 7.11
Answer: D
Explanation:
The CPT crosswalk for x-ray of knee directs the coder to 73560-73580. Because two views were obtained, the correct code would be 73560 (radiologic examination, knee; I or 2 views).
Modifier TC and modifier 26 indicate only technical and professional components: however, because the x-ray was performed in a physician's office, 73560 would be reported without either because the practice provided both components. In terms of diagnosis, the knee pain would not be reported because it is a symptom of a definitive diagnosis.
NEW QUESTION # 50
The relative value units of a procedure are based on how much effort is involved, expenses that the practice will incur, and the level of risk associated with it.
- A. False
- B. True
Answer: B
Explanation:
The statement is true. An insurance carrier will use these three measures to determine what the RVU of a procedure should be. Then, based on that, a medical coder can determine what the expected payment should be. Generally, the higher the RVU of a procedure is, the higher the payment will be.
NEW QUESTION # 51
What is the difference between presumptive and definitive testing?
- A. Presumptive testing confirms the presence of a drug class; definitive testing identifies thequantity or presence of a drug.
- B. Presumptive testing is based on exhibited signs and/or symptoms; definitive testing isbased on lab results.
- C. Presumptive testing requires additional observation time; definitive testing requires ablood draw.
- D. Presumptive testing assumes a diagnosis; definitive testing confirms a diagnosis.
Answer: A
Explanation:
A presumptive test reports whether the patient is positive or negative for a specific drug. A definitive test would analyze which specific agent and/or how much of that agent is in the patients' system.
NEW QUESTION # 52
A patient is seen in the emergency room with a thermal burn to the left thigh because of a fire. The patient denies feelings of hypothermi a. Vitals are obtained, and a physical examination reveals that approximately 4% of the body is affected by second-degree burns, and nonviable tissue needs to be removed to avoid the risk of infection. After consent is obtained, the physician debrides the wound, cleanses the area, and applies a gauze. The patient is discharged and told to follow up with their primary care physician in 2 days. What CPT code(s) should be reported for this encounter?
- A. 99282-25, 16020
- B. 16020, 99282
- C. 0
- D. 99283-25, 16020
Answer: D
Explanation:
When billing for physician services in the emergency room, it is appropriate to report a standalone E/M when the documentation supports its necessity in determining the need for appropriate treatment. Modifier 25 is necessary to the E/M code when being billed alongside a procedure and/or surgery to indicate a separately billable service. In this case, the documentation supports decision-making of moderate complexity. CPT code 99283 meets these criteria, whereas CPT code 99282 reflects a medical decision-making of low complexity and does not accurately portray the services rendered. The emergency room visit is always the first listed code, followed by the procedure and/or surgery performed.
NEW QUESTION # 53
A patient with a history of colon cancer was treated with radiation therapy. CT scans and blood tests show the malignancy has been eradicated. The patient is directed to take 81 mg of aspirin daily over the course of the next year to help prevent reoccurrence of the malignancy. What ICD-IO-CM code(s) should be reported by the provider on subsequent visits related to this patient's condition?
- A. C18.9
- B. Z85.038
- C. Z48.3, C18.9
- D. Z08, Z85.038
Answer: D
Explanation:
Regarding Z08, ICD-IO-CM guidelines state: "The follow-up codes are used to explain continuing surveillance following completed treatment of a disease. They imply that the condition has been fully treated and no longer exists." When using a follow-up code as the primary reason for an encounter, a history code indicating what condition the patient originally had should be assigned as secondary. Aftercare codes are used to describe the continued treatment of a disease. In this case, the malignancy has been eradicated, the disease no longer exists, and aspirin is being used merely as a preventative measure. History codes can never be reported as first listed; rather, a follow-up code or other current disease and/or condition should precede it.
NEW QUESTION # 54
A patient has an elective bilateral vasectomy under regional anesthesi
a. The procedure is completed within 15 minutes. What CPT and ICD-IO-CM code(s) should the provider report?
- A. 55250-50, Z30.8
- B. 55250, 89321, Z30.8
- C. 55250, Z30.2
- D. 55250, 00921, Z30.2
Answer: C
Explanation:
A vasectomy includes a sperm analysis and regional anesthesia and should not be unbundled for higher reimbursement. A vasectomy includes both unilateral and bilateral sides, so modifier 50 should never be appended. In this circumstance, CPT 55250 should be billed as a standalone procedure to encompass all services delivered. Additionally, although the documentation does not give a specific diagnosis, it can be inferred from "elective" that the procedure is not to treat an underlying illness or injury. Therefore, Z30.2 (encounter for sterilization) is the evident diagnosis for this type of procedure because the patient is being sterilized. Z30.8 (encounter for other contraceptive management) can be used for an encounter discussing post vasectomy sperm count.
NEW QUESTION # 55
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. 99213-25, 77401x3units
- C. 1
- D. 77435, 99213-25
Answer: C
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 # 56
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, 31623-51
- C. 39010, 31622-51
- D. 39402, 31623-51
Answer: C
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 # 57
A low-risk obstetrical patient is told to come in for weekly ultrasounds in her first trimester. This is an example of what?
- A. Waste
- B. Fraud
- C. Misuse
- D. Abuse
Answer: A
Explanation:
In this case, the patient is not at risk, and most organs either are not developed and/or cannot be visualized in the first trimester. Thus, this would constitute as waste due to the provider overutilizing services that result in unnecessary cost. AAPC defines fraud as purposely billing "for services that were never given or to bill for a service that has a higher reimbursement than the service provided." Abuse is payment for services "that are billed by mistake by providers."
NEW QUESTION # 58
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: B
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 # 59
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 # 60
What would NOT be included in a global obstetrical package?
- A. Sutures are removed from a first-degree perineal laceration during the delivery.
- B. Contraception following delivery is discussed at length.
- C. A patient with anemia comes in to check hemoglobin levels.
- D. A patient complains of flu-like symptoms and is prescribed an antibiotic.
Answer: D
Explanation:
The treatment of flu-like symptoms is considered a non-obstetric service, and a separate E/M can be billed for reimbursement. All other answer choices would be included in the global obstetrical package as routine care.
NEW QUESTION # 61
A physician inserts a chest tube through the right chest wall and into the pleural cavity to release trapped air in a 19-year-old patient with recurring pneumothorax. A second physician assists in providing moderate sedation. In total, the procedure took 8 minutes. What ICD-IO-CM and CPT codes should the provider report?
- A. 32551, 193.83
- B. 32551, 99156-59, 193.9
- C. 32550-62, 99156, 193.83
- D. 32550, 193.9
Answer: A
Explanation:
The code description "tube thoracostomy" is not clearly stated in the documentation, but CPT crosswalk for a 'tube placement" followed by "chest" leads the coder to CPT 32551. CPT 32550 describes the insertion of a catheter that allows the patient to drain pleural fluid in an outpatient setting. Moderate sedation can be separately billed but only by the provider administering the medication. The 193 series is circumstantial (e.g., spontaneous, acute). Even though the term
"recurrent" is not used, it does describe the background of the patient's condition and so would fall into the other specified diagnosis rather than unspecified.
NEW QUESTION # 62
Code the following physician's note:
A 14-year-old established patient is seen with mother to evaluate five 2 cm superficial lacerations to the left wrist. Patient admits to suicidal thoughts.
Lacerations were treated with Steri-Strips. Patient and mother counseled on suicide prevention and told to follow up with psych.
- A. 12004, S61.512A, T14.91XA
- B. 12004, S61.512A, R45.851
- C. 99214, S61.512A, T14.91XA
- D. 99213, S61.512A, R45.8S1
Answer: D
Explanation:
When the injury is treated with Steri-Strips or bandages, it should be reported with an E/M code and not a procedure code. Within the medical decision making, the number and complexity of problems addressed is low, the amount of data reviewed or analyzed is straightforward, and the risk of complications and/or morbidity or mortality of patient management from the injuries is low.
Therefore, the E/M is a 99213 because the medical decision-making is low. A suicide attempt would not be coded because the documentation is not specific as to whether the lacerations were an attempt at suicide.
NEW QUESTION # 63
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