AAPC CPC Evaluation & Management Practice Test

AAPC CPC Exam Evaluation & Management Practice Test: Try our free American Academy of Professional Coders (AAPC) Certified Professional Coder (CPC) Evaluation & Management review questions and answers for better CPC certification prep.

AAPC CPC Evaluation & Management Practice Test

Q1. 45-year-old established, female patient is seen today at her doctor’s office. She is complaining of dizziness and feels like the room is spinning. She has had palpitations on and off for the past 12 months. She reports chest tightness and dyspnea but denies nausea, edema, or arm pain. She drinks two cups of coffee per day. Her sister has WPW (Wolff-Parkinson-White) syndrome. An extended five body area examination is performed. This is a new problem. An EKG is ordered and labs are drawn, and the physician documents a moderate complexity MDM. What CPT® code should be reported for this visit?

  1. 99214
  2. 99215
  3. 99203
  4. 99204
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 Answer Key: A

Rationale: This is a follow up visit indicating an established patient seen in the clinic. In the CPT® Index, see Established Patient/Office Visit. The code range to select from is 99211-99215. For this code range, two of three key components must be met. History – PF (HPI-Brief, ROS-None, PFSH-Pert), Exam – Problem Focused, MDM – Moderate (Mgmt options – 1 stable problem, one new problem with workup; Data reviewed – lab and EKG; Level of Risk Moderate with unknown cause of pulmonary HTN). 99212 is the level of visit supported

Q2. 33 year-old male was admitted to the hospital on 12/17/XX from the ER, following a motor vehicle accident. His spleen was severely damaged and a splenectomy was performed.. The patient is being discharged from the hospital on 12/20/XX. During his hospitalization the patient experienced pain and shortness of breath, but with an antibiotic regimen of Levaquin, he improved. The attending physician performed a final examination and reviewed the chest X-ray revealing possible infiltrates and a CT of the abdomen ruled out any abscess. He was given a prescription of Zosyn. The patient was told to follow up with his PCP or return to the ER for any pain or bleeding. The physician spent 20 minutes on the date of discharge.What CPT® code is reported for the 12/20 visit?

  1. 99221
  2. 99231
  3. 99238
  4. 99283
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 Answer Key: C

Rationale: The patient is being discharged from the hospital. Hospital discharge codes are determined based on the time documented the physician spent providing services to discharge the patient. The provider documented 20 minutes, which is reported with 99238.

Q3. 60-year-old woman is seeking help to quit smoking. She makes an appointment to see Dr. Lung for an initial visit. The patient has a constant cough due to smoking and some shortness of breath. No night sweats, weight loss, night fever, CP, headache, or dizziness. She has tried patches and nicotine gum, which has not helped. Patient has been smoking for 40 years and smokes 2 packs per day. She has a family history of emphysema. A limited three system exam was performed. Dr Lung discussed in detail the pros and cons of medications used to quit smoking. Counseling and education was done for 20 minutes of the 30 minute visit. Prescriptions for Chantrix and Tetracylcine were given. The patient to follow up in 1 month. A chest X-ray and cardiac work up was ordered. Select the appropriate CPT code(s) for this visit:.

  1. 99202
  2. 99203
  3. 99203, 99354
  4. 99214, 99354
View Correct Answer
 Answer Key: B

Rationale: Patient is coming to the doctor’s office for help to to quit smoking. The patient is new. The physician documents 20 minutes of the 30 minute visit was spent counseling the patient. E/M Guidelines identify when time is considered the key or controlling factor to qualify for a E/M service. When counseling and/or coordination of care is more than 50% face to face time in the office or other outpatient setting, time may be used to determine the level of E/M. The correct code is 99203 based on the total time of the visit which is 30 minutes..

Q4. The physician was called to the hospital floor for the medical management of a 56-year-old patient admitted one day ago with aspiration pneumonia and COPD. No chest pain at present, but still SOB and some swelling in his lower extremities. Patient was tachypenic yesterday; lungs reveal course crackles in both bases, right worse than left. The physician writes instructions to continue with intravenous antibiotic treatment and respiratory support He reviewed chest X-ray and labs. Patient is improving and a pulmonary consultation has been requested. What CPT® code is reported?

  1. 99218
  2. 99221
  3. 99232
  4. 99231
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 Answer Key: D

Rationale: Physician is providing subsequent hospital care to an inpatient. The physician performed an expanded problem focused interval history (brief HPI, pertinent ROS since last assessment) + problem focused exam (1 system) + low MDM (prescription drug management, two data points and established diagnosis is improving. Subsequent hospital codes require two out of three key components. The code documented is a 99231.

Q5. An established patient presents to the office with a recurrence of bursitis in both shoulders. Range of motion is good and full, but he has tenderness in the subdeltoid bursa. Both shoulders were injected in the deltoid with 120mg Depo-Medrol. What CPT® code(s) is/are reported for this visit?

  1. 99211-25, 20610-50
  2. 99212-25, 20550-50
  3. 99212-25, 20610-50
  4. 20610-50
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 Answer Key: D

Rationale: For this encounter, no additional work in evaluating the patient has been performed to support an E/M service that is significant and separately identifiable from the procedure. Only the procedure should be billed. To perform an arthrocentesis, the physician inserts a needle through the skin and into a joint or bursa. A fluid sample may be removed from the joint or fluid may be injected for lavage or drug therapy. In the CPT® Index, look for Shoulder/Arthrocentesis. You are referred to code 20610. Review the code description to verify accuracy. Modifier 50 Bilateral Procedure is attached since both shoulders are injected.

Q6. An established 47-year-old patient presents to the physician’s office after falling last night at her home when she slipped in water on the kitchen floor. She is complaining of back pain and no tingling or numbness. Physician documents that she has full range motion of the spine, with discomfort. Her gait is within normal limits. Straight leg raising is negative. She requested no medication. It is recommended to use heat, such as a hot water bottle. Doctor’s Assessment: Back Strain. What E/M and ICD-9-CM codes are reported for this service?

  1. 99212, 847.9, E888.8, E849.0
  2. 99213, 846.9, E885.8, E849.0
  3. 99212, 847.9, E885.9, E849.0
  4. 99213, 847.9, E888.9, E849.0
View Correct Answer
 Answer Key: B 

Q7. 5-year-old is brought to the Emergency Department by ambulance, He had been found floating in a pool for an unknown amount of time. EMS started CPR which was continued by the ED physician along with endotracheal intubation and placement of a CVP. The ER physician spent 1 hour with the critically ill patient. The ED physician makes a notation the 1 hour does not include the time for the other separate billable. What CPT® codes should be reported?

  1. 92950, 99291-25, 36556, 31603
  2. 92950, 99291
  3. 92950, 99291-25, 36556, 31500
  4. 92950, 99285-25, 36556, 31500
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 Answer Key: C

Q8. Dr. X asks Dr. Y to look at a 65-year-old male who is in a nursing facility for decubitus ulceration. Dr. Y is unable to obtain history due to current mental status. He obtains a detailed history from Dr. X since the patient is unable to provide a history. A detailed exam along with low MDM is performed. Dr Y. recommends to Dr. X the patient needs to go to the surgical suite for debridement of the ulcerations. Since the patient is unstable at the moment due to elevated blood pressure and a UTI, they decide to delay surgery and to keep monitoring the patient until he stabilizes. Written report is documented. What CPT® code is reported?

  1. 99304
  2. 99234
  3. 99243
  4. 99253
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 Answer Key: D

Q9. An established patient presents to the clinic today for a follow-up of his pneumonia. He was hospitalized for 6 days, on IV antibiotics. He was placed back on Singulair and has been doing well with his breathing since then. An expanded problem focused exam was performed. Records were obtained from the hospital and the physician reviewed the labs and X-rays. The patient was told to continue antibiotics for another two weeks to 20 days, and the prescription Keteck was replaced with Zithromax. Patient to return to the clinic in two weeks for recheck of his breathing and re-X-ray then. What CPT® code should be reported?

  1. 99214
  2. 99242
  3. 99335
  4. 99213
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 Answer Key: D

Q10. A 90-year-old female was admitted this morning from observation status for chest pain to r/o angina. A cardiologist performs a comprehensive history and comprehensive exam. Her chest pain has been relieved with the nitroglycerin drip given before admission and she would like to go home. Doctor has written prescriptions to add to her regimen. He had given her Isosorbide, and she is tolerating it well. He will go ahead and send her home. We will follow up with her in a week. Patient was admitted and discharged on the same date of service. What CPT® code is reported?

  1. 99235
  2. 99217
  3. 99238
  4. 99221
View Correct Answer
 Answer Key: A

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