AAPC CPCテスト対策書、CPC問題と解答

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AAPC CPC問題と解答、CPC資格取得講座

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AAPC CPC 認定試験の出題範囲：

トピック出題範囲
トピック 1
  • Special Senses (Ocular and Auditory): This section of the exam measures the skills of coding specialists and covers the coding of procedures related to the eyes and ears. Topics include surgeries on the cornea, retina, and middle
  • inner ear, as well as related diagnostic procedures.
トピック 2
  • Integumentary System: This section of the exam measures the skills of medical coders and covers procedures related to the skin and related structures. Topics include excisions, biopsies, repairs, and destruction services, focusing on accurate code selection and modifier usage for integumentary interventions.
トピック 3
  • Anesthesia: This section of the exam measures the skills of medical coders and involves coding anesthesia services based on surgical site, complexity, and time. It tests the understanding of anesthesia modifiers and the importance of linking anesthesia codes with the correct primary procedures.
トピック 4
  • Respiratory System: This section of the exam measures the skills of medical coders and evaluates the ability to code procedures involving the nose, sinuses, larynx, trachea, bronchi, and lungs. Attention is given to services like endoscopies, excisions, and resections within the respiratory tract.
トピック 5
  • Accurate ICD-10-CM Coding: This section of the exam measures the skills of medical coders and focuses on the precise assignment of diagnosis codes using the ICD-10-CM system. The goal is to ensure accurate representation of patient conditions, proper sequencing, and a clear linkage between diagnoses and services.
トピック 6
  • Hemic & Lymphatic Systems, Mediastinum, Diaphragm: This section of the exam measures the skills of medical coders and includes procedures related to the spleen, lymph nodes, bone marrow, as well as surgical interventions in the mediastinum and diaphragm. Coders must differentiate procedures by region and system accurately.
トピック 7
  • The Business of Medicine: This section of the exam measures the skills of medical coders and covers foundational knowledge regarding the healthcare system, reimbursement models, insurance payers, HIPAA compliance, and the ethical responsibilities coders hold within clinical and billing environments. It establishes the context in which coding decisions directly affect healthcare operations and financial outcomes.
トピック 8
  • Pathology & Laboratory: This section of the exam measures the skills of medical coders and includes lab tests, specimen analysis, and pathological examination procedures. It ensures that coders understand how to apply codes for chemistry panels, cultures, and histopathological diagnostics.
トピック 9
  • Endocrine System and Nervous System: This section of the exam measures the skills of medical coders and assesses the ability to assign codes for surgeries involving glands, the brain, spinal cord, and peripheral nerves. Procedures like resections and electrical stimulation are part of the evaluated content.
トピック 10
  • Urinary System and Male Genital System: This section of the exam measures the skills of medical coders and assesses understanding of procedures on kidneys, bladder, ureters, prostate, and male reproductive organs. Proper use of CPT codes for surgical and diagnostic interventions is tested.
トピック 11
  • Evaluation & Management Services: This section of the exam measures the skills of coding specialists and covers office visits, hospital care, consultations, and other E
  • M services. It tests the understanding of time-based coding, medical decision-making, and history
  • exam components per current CMS guidelines.
トピック 12
  • Introduction to CPT®, HCPCS Level II, and Modifiers: This section of the exam measures the skills of coding specialists and introduces candidates to CPT® coding for procedures, HCPCS Level II for supplies and services, and the correct use of modifiers. It helps learners distinguish between different code sets and understand their place in medical billing.
トピック 13
  • Digestive System: This section of the exam measures the skills of coding specialists and evaluates the coding of surgeries and procedures involving the oral cavity, pharynx, esophagus, stomach, intestines, liver, pancreas, and related organs. Understanding endoscopic procedures is particularly critical here.
トピック 14
  • Review of Anatomy: This section of the exam measures the skills of coding specialists and covers a high-level understanding of human anatomy. It includes organs, systems, directional terminology, and anatomical locations, enabling coders to link procedures and diagnoses to the correct bodily structures with accuracy and consistency.
トピック 15
  • Radiology: This section of the exam measures the skills of coding specialists and focuses on diagnostic imaging procedures including X-rays, CT scans, MRIs, ultrasounds, and nuclear medicine. It emphasizes proper selection of codes based on anatomical site and modality used.
トピック 16
  • Female Reproductive System and Maternity Care & Delivery: This section of the exam measures the skills of coding specialists and evaluates coding accuracy for gynecological and obstetric procedures. It includes deliveries, antepartum care, cesarean sections, and surgical procedures involving female reproductive anatomy.
トピック 17
  • Musculoskeletal System: This section of the exam measures the skills of coding specialists and focuses on coding procedures involving bones, joints, muscles, and tendons. It covers surgeries, reductions, arthroscopies, and fracture treatments, emphasizing accurate mapping of procedures to anatomical areas.

AAPC Certified Professional Coder (CPC) Exam 認定 CPC 試験問題 (Q34-Q39):

質問 # 34
A 42-year-old with chronic left trochanteric bursitis is scheduled to receive an injection at the Pain Clinic. A 22-gauge spinal needle is introduced into the trochanteric bursa under ultrasonic guidance, and a total volume of 8 cc of normal saline and 40 mg of Kenalog was injected.
What CPT code should be reported for the surgical procedure?

正解：D

解説：
The injection into the trochanteric bursa under ultrasonic guidance is coded with CPT 20611, which describes an injection of a major joint or bursa with ultrasound guidance. The modifier -LT indicates the procedure was performed on the left side.
Reference:
AMA's CPT Professional Edition (current year), Code 20611


質問 # 35
A 60-year-old male has three-vessel disease and supraventricular tachycardia which has been refractory to other management. He previously had pacemaker placement and stenting of LAD coronary artery stenosis, which has failed to solve the problem. He will undergo CABG with autologous saphenous vein and an extensive modified MAZE procedure to treat the tachycardia.
He is brought to the cardiac OR and placed in the supine position on the OR table. He is prepped and draped, and adequate endotracheal anesthesia is assured. A median sternotomy incision is made and cardiopulmonary bypass is initiated. The endoscope is used to harvest an adequate length of saphenous vein from his left leg. This is uneventful and bleeding is easily controlled. The vein graft is prepared and cut to the appropriate lengths for anastomosis. Two bypasses are performed: one to the circumflex and another to the obtuse marginal. The left internal mammary is then freed up and it is anastomosed to the ramus, the first diagonal, and the LAD. An extensive maze procedure is then performed and the patient is weaned from bypass. At this point, the sternum is closed with wires and the skin is reapproximated with staples. The patient tolerated the procedure without difficulty and was taken to the PACU.
Choose the procedure codes for this surgery.

正解：B


質問 # 36
A 26-year-old male presents with a deep laceration from a kitchen knife to his right hand. The surgeon washes the open wound with sterile saline. Clamps are applied. The provider cleans the vessel and prepares the edges of thee wound. She then repairs the bleeding vessel with sutures. The clamps are removed and the provider uses a Doppler probe to check the blood flow pattern through the repaired vessel.
What CPTcode is reported?

正解：D

解説：
1. Procedure and CPTCode Selection:
The scenario describes the repair of a bleeding vessel in the patient's right hand. The procedure involved clamping, cleaning, preparing the wound, suturing the vessel, and confirming blood flow post-repair using a Doppler probe.
Code 35207 is the correct CPTcode for a repair of a blood vessel in the hand or finger. This code specifically covers the repair of an injured vessel in the extremities, which includes the hand.
Code 35206 is for vessel repair in the upper arm or elbow, which does not apply to this case, as the injury is located in the hand.
Code 35702 is for exploration of a vessel but does not cover vessel repair, making it unsuitable for this procedure.
Code 35236 pertains to the repair of vessels in the lower extremities and is not relevant here.
2. Modifier:
Modifier RT is used to indicate that the procedure was performed on the right side of the body.
3. AAPC and CPTCoding Guidelines:
AAPC guidelines specify the use of codes in the 35201-35286 series for direct repair of blood vessels in specific anatomical areas. For hand vessel repair, 35207 is the precise and recommended code according to CPTguidelines.
Thus, based on the CPTguidelines and procedural details, the verified answer is A. 35207-RT.


質問 # 37
Ten-year-old boy has a painful felon abscess of the deep tissues of the palmar surface of his right thumb. The provider makes an incision on one side of the nail and then across the fingertip parallel to the end of the nail. He identifies the area of abscess and drains it. A drainage tube is inserted.
What CPT and ICD-10-CM is reported?

正解：C

解説：
1. Procedure and CPT Code Selection:
The procedure involves an incision and drainage (I&D) of a deep abscess (felon) on the palmar surface of the right thumb. A felon is an abscess in the pulp of the fingertip, often involving deep tissue.
Code 26010 is specific for incision and drainage of a finger abscess, which includes the thumb. This code applies to cases where the abscess is drained from a deep tissue level.
Code 26011 is similar but involves the use of extensive drainage or debridement, which is not indicated in this case. Therefore, 26011 is not appropriate here.
Code 10061 refers to incision and drainage of abscesses at different locations on the body but not for specific areas such as the thumb, making it inappropriate in this context.
Code 10140 pertains to the evacuation of hematoma, seroma, or fluid but does not apply to abscesses, so it is not suitable for this scenario.
2. Modifier:
Modifier F5 is added to specify that the procedure was performed on the right thumb.
3. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code L02.511 is appropriate for cutaneous abscess of the right finger, as it accurately describes the diagnosis of a felon on the thumb.
L03.011 would represent cellulitis but does not specify an abscess, making it less precise for this case.
4. AAPC and CPT Coding Guidelines:
The AAPC guidelines for coding finger abscess drainage emphasize the selection of specific codes for deep tissue drainage procedures in extremities. Additionally, correct laterality should be included with the use of modifiers and specific ICD-10-CM codes for an accurate representation of the site and nature of the condition.
Thus, based on the coding standards and guidelines, the verified answer is B. 26010-F5, L02.511.


質問 # 38
A Medicare patient that is on dialysis for ESRD is seen by the nurse for a Hep B vaccination. This patient is given a dialysis patient dosage as part of a three-dose schedule. The nurse administers the Hep B vaccine in the right deltoid. The physician reviews the chart and signs off on the nurse's note.
What procedure and diagnosis codes are reported for the scheduled vaccine injection for this Medicare patient?

正解：D

解説：
Procedure: Hepatitis B vaccine administration for a Medicare patient on dialysis.
CPT and HCPCS Codes:
G0010: Administration of Hepatitis B vaccine.
90740: Hepatitis B vaccine, dialysis or immunosuppressed patient dosage, 3-dose schedule.
ICD-10-CM Codes:
Z23: Encounter for immunization.
N18.6: End-stage renal disease.
Z99.2: Dependence on renal dialysis.
Code Selection Justification: G0010 is used for the administration of the vaccine for Medicare patients, and
90740 captures the specific vaccine for dialysis patients. The ICD-10 codes represent the encounter for vaccination and the patient's dialysis status.
AMA CPT Professional Edition (current year)
ICD-10-CM (current year)
HCPCS Level II (current year)


質問 # 39
......

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