AAPC - CPC FINAL EXAM 2024
QUESTIONS AND ANSWERS
What form is used to submit a provider's charge to the insurance carrier?
a. UB-04
b. Provider reimbursement form
c. CMS-1500
d. ABN
c. CMS-1500
Which coding manuals do outpatient coders focus on learning?
a. CPT, HCPCS Level II and ICD-10-CM
b. CPT and ICD-10-CM
c. ICD-10-CM and ICD-10-PCS
d. CPT, HCPCS Level II, ICD-10-CM, ICD-10-PCS
a. CPT, HCPCS Level II and ICD-10-CM
In what year was HITECH enacted as part of the American Recovery and
Reinvestment Act?
a. 2010
b. 2009
c. 2000
d. 2007
b. 2009
Voluntary compliance programs also provide benefits by not only helping to
prevent erroneous or ____, but also by showing that the provider practice is
making additional good faith efforts to submit claims appropriately.
a. Over utilized codes
b. Duplicative claims
c. Fraudulent claims
d. Mistaken principals
c. Fraudulent claims
Which CMS product describes whether specific medical items, services,
treatment procedures or technologies are considered medically necessary under
Medicare?
a. Medicare Claims Processing Manual
,b. National Coverage Determinations Manual
c. Relative Value Files
d. Medicare Physician Fee Schedule Final Rule
b. National Coverage Determinations Manual
Which condition results from an injury to the head? The symptoms include
headache, dizziness and vomiting.
a. Meningitis
b. Concussion
c. Epilepsy
d. Parkinson's disease
b. Concussion
In order, starting with the innermost layer, what are the four walls of the digestive
tract?
a. Mucosa, submucosa, muscle, serosa
b. Serosa, mucosa, submucosa, muscle
c. Mucosa, submucosa, serosa, muscle
d. Muscle, submucosa, mucosa, serosa
a. Mucosa, submucosa, muscle, serosa
Which one of the following best describes psoriasis?
a. A chronic condition characterized by red, dry, elevated lesions, covered by
silvery scales
b. An inflammatory condition characterized by redness pustular and vesicular
lesions, crusts, and scales
c. An allergic reaction characterized by wheals and generally accompanied by
pruritus
d. A contagious infection of skin generally caused by staphylococcus bacterium
a. A chronic condition characterized by red, dry, elevated lesions, covered by silvery
scales
A form of milk produced the first few days after giving birth is:
a. Prolactin
b. Colostrum
c. Lactose
d. Chorion
b. Colostrum
A condition where the thyroid is overactive is called:
,a. Thyrotoxicosis
b. Panhypopituitarism
c. Ketosis
d. Thyroiditis
a. Thyrotoxicosis
What do the instructions and conventions of the classification take precedence
over?
a. CPT
b. Documentation
c. Official Coding Guidelines
d. Nothing. They are only used in the event of no other instruction.
c. Official Coding Guidelines
What is the sequencing order when coding a sequela (late effect)?
a. They symptom is coded first followed by the residual condition and the late
effect code
b. The cause of the late effect is coded first and the residual condition is coded
second
c. The cause of the late effect is coded first; the residual condition is second
followed by the symptoms
d. The residual condition is coded first, and the code(s)for the cause of the late
effect are coded as secondary
d. The residual condition is coded first, and the code(s)for the cause of the late effect
are coded as secondary
Using the ICD-10-CM Alphabetic Index, which main term below has an
instructional note indicating another main term may also be referenced that may
provide additional Alphabetic Index entries that may be useful?
a. Diabetes
b. Fibrosarcoma
c. Appendicitis
d. Symptoms
b. Fibrosarcoma
A 50-year-old female presents to her provider with symptoms of insomnia and
upset stomach. The provider suspects she is premenopausal. She is diagnosed
with impending menopause. What diagnosis code(s) should be reported?
a. E28.319
b. G47.00, K30
, c. N95.9, G47.00, K30
d. N95.9
b. G47.00, K30
Rationale: ICD-10-CM guideline I.B.11 states to reference the ICD-10-CM Alphabetic
Index to determine if the condition has a subentry for impending or threatened and also
reference main term entries for Impending and Threatened. If the subterms are listed,
assign the given code. If the subterms are not listed, code the existing underlying
condition(s) and not the condition described as impending or threatened. Look in the
Alphabetic Index for Impending. There is not a subterm for menopause; therefore, the
symptoms are coded. Look for Insomnia (organic) which directs the coder to G47.00.
Next, look for Upset/stomach which directs the coder to K30. Verify code selection in
the Tabular List.
What is the ICD-10-CM code for a laceration on the left shoulder, subsequent
encounter?
a. S51.009D
b. S46.001D
c. S51.801D
d. S41.012D
d. S41.012D
According to ICD-10-CM guidelines, when a patient is seen for management of
anemia due to malignancy, how is it reported?
a. Anemia is reported first, followed by the code for the malignancy
b. The malignancy is the only condition reported
c. Anemia is the only condition reported
d. The malignancy is reported first, followed by the code for the anemia
d. The malignancy is reported first, followed by the code for the anemia
A 23-year-old patient presents to the emergency department (ED) with a cut on
his leg. He is a confirmed AIDS patient as documented in the record. What ICD-
10-CM codes should be reported?
a. S81.819a, Z71.7
b. S81.819a, Z11.4
c. S81.819A, B20
d. S819A, R75
c. S81.819A, B20
A 50-year-old patient has a mass removed from his chest. The surgeon sends it to
pathology. The pathology report indicates the mass is a benign tumor. What ICD-
QUESTIONS AND ANSWERS
What form is used to submit a provider's charge to the insurance carrier?
a. UB-04
b. Provider reimbursement form
c. CMS-1500
d. ABN
c. CMS-1500
Which coding manuals do outpatient coders focus on learning?
a. CPT, HCPCS Level II and ICD-10-CM
b. CPT and ICD-10-CM
c. ICD-10-CM and ICD-10-PCS
d. CPT, HCPCS Level II, ICD-10-CM, ICD-10-PCS
a. CPT, HCPCS Level II and ICD-10-CM
In what year was HITECH enacted as part of the American Recovery and
Reinvestment Act?
a. 2010
b. 2009
c. 2000
d. 2007
b. 2009
Voluntary compliance programs also provide benefits by not only helping to
prevent erroneous or ____, but also by showing that the provider practice is
making additional good faith efforts to submit claims appropriately.
a. Over utilized codes
b. Duplicative claims
c. Fraudulent claims
d. Mistaken principals
c. Fraudulent claims
Which CMS product describes whether specific medical items, services,
treatment procedures or technologies are considered medically necessary under
Medicare?
a. Medicare Claims Processing Manual
,b. National Coverage Determinations Manual
c. Relative Value Files
d. Medicare Physician Fee Schedule Final Rule
b. National Coverage Determinations Manual
Which condition results from an injury to the head? The symptoms include
headache, dizziness and vomiting.
a. Meningitis
b. Concussion
c. Epilepsy
d. Parkinson's disease
b. Concussion
In order, starting with the innermost layer, what are the four walls of the digestive
tract?
a. Mucosa, submucosa, muscle, serosa
b. Serosa, mucosa, submucosa, muscle
c. Mucosa, submucosa, serosa, muscle
d. Muscle, submucosa, mucosa, serosa
a. Mucosa, submucosa, muscle, serosa
Which one of the following best describes psoriasis?
a. A chronic condition characterized by red, dry, elevated lesions, covered by
silvery scales
b. An inflammatory condition characterized by redness pustular and vesicular
lesions, crusts, and scales
c. An allergic reaction characterized by wheals and generally accompanied by
pruritus
d. A contagious infection of skin generally caused by staphylococcus bacterium
a. A chronic condition characterized by red, dry, elevated lesions, covered by silvery
scales
A form of milk produced the first few days after giving birth is:
a. Prolactin
b. Colostrum
c. Lactose
d. Chorion
b. Colostrum
A condition where the thyroid is overactive is called:
,a. Thyrotoxicosis
b. Panhypopituitarism
c. Ketosis
d. Thyroiditis
a. Thyrotoxicosis
What do the instructions and conventions of the classification take precedence
over?
a. CPT
b. Documentation
c. Official Coding Guidelines
d. Nothing. They are only used in the event of no other instruction.
c. Official Coding Guidelines
What is the sequencing order when coding a sequela (late effect)?
a. They symptom is coded first followed by the residual condition and the late
effect code
b. The cause of the late effect is coded first and the residual condition is coded
second
c. The cause of the late effect is coded first; the residual condition is second
followed by the symptoms
d. The residual condition is coded first, and the code(s)for the cause of the late
effect are coded as secondary
d. The residual condition is coded first, and the code(s)for the cause of the late effect
are coded as secondary
Using the ICD-10-CM Alphabetic Index, which main term below has an
instructional note indicating another main term may also be referenced that may
provide additional Alphabetic Index entries that may be useful?
a. Diabetes
b. Fibrosarcoma
c. Appendicitis
d. Symptoms
b. Fibrosarcoma
A 50-year-old female presents to her provider with symptoms of insomnia and
upset stomach. The provider suspects she is premenopausal. She is diagnosed
with impending menopause. What diagnosis code(s) should be reported?
a. E28.319
b. G47.00, K30
, c. N95.9, G47.00, K30
d. N95.9
b. G47.00, K30
Rationale: ICD-10-CM guideline I.B.11 states to reference the ICD-10-CM Alphabetic
Index to determine if the condition has a subentry for impending or threatened and also
reference main term entries for Impending and Threatened. If the subterms are listed,
assign the given code. If the subterms are not listed, code the existing underlying
condition(s) and not the condition described as impending or threatened. Look in the
Alphabetic Index for Impending. There is not a subterm for menopause; therefore, the
symptoms are coded. Look for Insomnia (organic) which directs the coder to G47.00.
Next, look for Upset/stomach which directs the coder to K30. Verify code selection in
the Tabular List.
What is the ICD-10-CM code for a laceration on the left shoulder, subsequent
encounter?
a. S51.009D
b. S46.001D
c. S51.801D
d. S41.012D
d. S41.012D
According to ICD-10-CM guidelines, when a patient is seen for management of
anemia due to malignancy, how is it reported?
a. Anemia is reported first, followed by the code for the malignancy
b. The malignancy is the only condition reported
c. Anemia is the only condition reported
d. The malignancy is reported first, followed by the code for the anemia
d. The malignancy is reported first, followed by the code for the anemia
A 23-year-old patient presents to the emergency department (ED) with a cut on
his leg. He is a confirmed AIDS patient as documented in the record. What ICD-
10-CM codes should be reported?
a. S81.819a, Z71.7
b. S81.819a, Z11.4
c. S81.819A, B20
d. S819A, R75
c. S81.819A, B20
A 50-year-old patient has a mass removed from his chest. The surgeon sends it to
pathology. The pathology report indicates the mass is a benign tumor. What ICD-
