1
AAPC CH 5 PAS EXAM NEWEST VERSION -2025/2026- 100+ Q
AND ANS MOST POPULAR EXAM GUARANTEED SUCCESS
N17.9, E86.0, N18.3, I95.9
CASE 2
Reason for consult: Acute renal failure (Indication for the visit.)
HPI: The patient was followed in the past by my associate for CKD, with baseline
creatinine of 1.8 two weeks ago. Found to have severe ARF this morning
associated with acidosis and moderate hyperkalemia after presenting to the ER
with complaint of dehydration. (These conditions were
diagnosed by another physician in the emergency room.) The patient is admitted
under observation status to the hospitalist service and the renal team is called for
a consult.
ROS: Cardiovascular: Negative for CP/PND. GI: Negative for nausea, positive for
diarrhea. GU: Negative for obstructive symptoms or documented exposure to
nephrotoxins. All other systems reviewed and are negative.
PFSH: Negative family history of hereditary renal disease and negative history of
tobacco or ETOH abuse.
, 2
EXAM: Constitutional: 99/52, 18, 102. NAD. Conversant. Eyes: anicteric sclera, no
proptosis, PERRL. ENMT: Normal aside from somewhat dry mucus membranes.
Cardiovascular: RRR, no MRGs, no edema. Respiratory: Lungs CTA, normal
respiratory effort. GI: NABS, no HSM. Skin: Warm and dry, decreased turgor.
Psychiatric: A&OX3 with appropriate affect.
Labs: BUN = 99, creatinine = 3.6, HCO3 = 14, K = 5.9.
IMPRESSION
1. New, acute renal failure, due to dehydration
2. Underlying stage III CKD
3. Mild hypotension
(Code the definitive diagnoses documented by the provider.)
PLAN
1. Bolus with another liter of NS wide open.
2. Then start D5W with 3 amps of HCO3 at 150 cc/hr.
, 3
3. Repeat labs in eight hours.
4. Further diagnostic testing will be ordered if there is no improvement of volume
repletion.
What diagnosis code(s) are reported?
L97.521, L97.511, R60.0, M79.672
CASE 3
PROGRESS NOTE
Chief complaint: Multiple ulcers.
Subjective: The patient returns, accompanied by her caregiver who states that she
believes the ulcers have gotten "about as good as they are going to." The edema
of the leg seems to be controlled much better.
Objective: Exam reveals marked improvement of the edema (The edema is
improving.) of both lower legs, the right is better than the left. All of the ulcers are
now extremely superficial and seem to almost be partial thickness skin.(The ulcers
are healing.) There is no cellulitis. The only uncomfortable area seems to be on
the sole of the left foot where there are considerable bony abnormality and/or
tophaceous deposits which have distorted the bottom of her foot dramatically. To
relieve the left foot pain,(Location of the foot pain. Patient had foot pain likely due
to tophaceous deposits which are an indication of gout. This is not a definitive
diagnosis documented by the provider. Code the symptom.) a sole nerve block
posterior to the lateral malleolus is carried out with a 50:50 mixture of 1%
AAPC CH 5 PAS EXAM NEWEST VERSION -2025/2026- 100+ Q
AND ANS MOST POPULAR EXAM GUARANTEED SUCCESS
N17.9, E86.0, N18.3, I95.9
CASE 2
Reason for consult: Acute renal failure (Indication for the visit.)
HPI: The patient was followed in the past by my associate for CKD, with baseline
creatinine of 1.8 two weeks ago. Found to have severe ARF this morning
associated with acidosis and moderate hyperkalemia after presenting to the ER
with complaint of dehydration. (These conditions were
diagnosed by another physician in the emergency room.) The patient is admitted
under observation status to the hospitalist service and the renal team is called for
a consult.
ROS: Cardiovascular: Negative for CP/PND. GI: Negative for nausea, positive for
diarrhea. GU: Negative for obstructive symptoms or documented exposure to
nephrotoxins. All other systems reviewed and are negative.
PFSH: Negative family history of hereditary renal disease and negative history of
tobacco or ETOH abuse.
, 2
EXAM: Constitutional: 99/52, 18, 102. NAD. Conversant. Eyes: anicteric sclera, no
proptosis, PERRL. ENMT: Normal aside from somewhat dry mucus membranes.
Cardiovascular: RRR, no MRGs, no edema. Respiratory: Lungs CTA, normal
respiratory effort. GI: NABS, no HSM. Skin: Warm and dry, decreased turgor.
Psychiatric: A&OX3 with appropriate affect.
Labs: BUN = 99, creatinine = 3.6, HCO3 = 14, K = 5.9.
IMPRESSION
1. New, acute renal failure, due to dehydration
2. Underlying stage III CKD
3. Mild hypotension
(Code the definitive diagnoses documented by the provider.)
PLAN
1. Bolus with another liter of NS wide open.
2. Then start D5W with 3 amps of HCO3 at 150 cc/hr.
, 3
3. Repeat labs in eight hours.
4. Further diagnostic testing will be ordered if there is no improvement of volume
repletion.
What diagnosis code(s) are reported?
L97.521, L97.511, R60.0, M79.672
CASE 3
PROGRESS NOTE
Chief complaint: Multiple ulcers.
Subjective: The patient returns, accompanied by her caregiver who states that she
believes the ulcers have gotten "about as good as they are going to." The edema
of the leg seems to be controlled much better.
Objective: Exam reveals marked improvement of the edema (The edema is
improving.) of both lower legs, the right is better than the left. All of the ulcers are
now extremely superficial and seem to almost be partial thickness skin.(The ulcers
are healing.) There is no cellulitis. The only uncomfortable area seems to be on
the sole of the left foot where there are considerable bony abnormality and/or
tophaceous deposits which have distorted the bottom of her foot dramatically. To
relieve the left foot pain,(Location of the foot pain. Patient had foot pain likely due
to tophaceous deposits which are an indication of gout. This is not a definitive
diagnosis documented by the provider. Code the symptom.) a sole nerve block
posterior to the lateral malleolus is carried out with a 50:50 mixture of 1%
