AAPC CPC CERTIFICATION FINAL EXAM
AND PRACTICE EXAM NEWEST 2024-2025
ACTUAL EXAM COMPLETE ALL 300
QUESTIONS
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 – answer 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 - answer 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 – answer 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 – answer 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 – answer 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 – answer 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 - answer 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 – answer 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 – answer b. Colostrum
A condition where the thyroid is overactive is called:
a. Thyrotoxicosis
b. Panhypopituitarism
c. Ketosis
d. Thyroiditis – answer 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. – answer 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 – answer 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 – answer 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 – answer 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 – answer 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 – answer 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 – answer 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-10-CM code is reported?
a. D49.2
b. C49.3
c. C79.89
d. D36.7 – answer d. D36.7
Mrs. Johnson is here today to receive an intercostal nerve block to mitigate the debilitating pain
of her malignancy. Her cancer has metastasized to her bones in her thoracic spine. What ICD-10-
CM codes are reported?
a. M54.6, C79.51, C80.1
b. C79.51, G89.3, M54.6, C80.1
c. G89.3, C79.51, C80.1
d. C79.51, G89.3, C80.1 – answer c. G89.3, C79.51, C80.1
After referral from the ED, a patient sees an ophthalmologist to examine an old injury with a
retained magnetic iron metal foreign body in his posterior wall within the right eye. There is
concern for an infection. What ICD-10-CM codes are reported?
a. H44.741, Z18.11
b. H44.641, Z18.11
c. S05.51XD, Z18.11
d. S05.51XA, Z18.11 – answer b. H44.641, Z18.11
What is the definition of a postpartum complication?
AND PRACTICE EXAM NEWEST 2024-2025
ACTUAL EXAM COMPLETE ALL 300
QUESTIONS
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 – answer 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 - answer 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 – answer 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 – answer 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 – answer 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 – answer 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 - answer 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 – answer 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 – answer b. Colostrum
A condition where the thyroid is overactive is called:
a. Thyrotoxicosis
b. Panhypopituitarism
c. Ketosis
d. Thyroiditis – answer 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. – answer 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 – answer 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 – answer 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 – answer 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 – answer 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 – answer 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 – answer 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-10-CM code is reported?
a. D49.2
b. C49.3
c. C79.89
d. D36.7 – answer d. D36.7
Mrs. Johnson is here today to receive an intercostal nerve block to mitigate the debilitating pain
of her malignancy. Her cancer has metastasized to her bones in her thoracic spine. What ICD-10-
CM codes are reported?
a. M54.6, C79.51, C80.1
b. C79.51, G89.3, M54.6, C80.1
c. G89.3, C79.51, C80.1
d. C79.51, G89.3, C80.1 – answer c. G89.3, C79.51, C80.1
After referral from the ED, a patient sees an ophthalmologist to examine an old injury with a
retained magnetic iron metal foreign body in his posterior wall within the right eye. There is
concern for an infection. What ICD-10-CM codes are reported?
a. H44.741, Z18.11
b. H44.641, Z18.11
c. S05.51XD, Z18.11
d. S05.51XA, Z18.11 – answer b. H44.641, Z18.11
What is the definition of a postpartum complication?
