Medical Coding Training: CPC®
2019
Medical Coding Training: CPC?
Practical Application Workbook¡ªAnswer Key
Disclaimer
This course was current when it was published. Every reasonable effort has been made to assure the accuracy of the information
within these pages. The ultimate responsibility lies with readers to ensure they are using the codes, and following applicable
guidelines, correctly. AAPC employees, agents, and staff make no representation, warranty, or guarantee that this compilation of
information is error-free, and will bear no responsibility or liability for the results or consequences of the use of this course. This
guide is a general summary that explains guidelines and principles in profitable, efficient healthcare organizations.
US Government Rights
This product includes CPT?, which is commercial technical data and/or computer data bases and/or commercial computer
software and/or commercial computer software documentation, as applicable, which was developed exclusively at private expense
by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify,
reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/
or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995),
as applicable, for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/
or subject to the restricted rights provision of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any
applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
AMA Disclaimer
CPT? copyright 2018 American Medical Association. All rights reserved.
Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of
CPT?, and the AMA is not recommendation their use. The AMA does not directly or indirectly practice medicine or dispense
medical services. The AMA assumes no liability for data contained or not contained herein.
CPT? is a registered trademark of the American Medical Association.
Regarding HCPCS Level II
HCPCS Level II codes and guidelines discussed in this book are current as of press time. The 2017 code set for HCPCS Level II
were unavailable when published.
Clinical Examples Used in this Book
AAPC believes it is important in training and testing to reflect as accurate a coding setting as possible to students and examinees.
All examples and case studies used in our study guides, exams, and workbooks are actual, redacted office visit and procedure
notes donated by AAPC members.
To preserve the real-world quality of these notes for educational purposes, we have not re-written or edited the notes to the
stringent grammatical or stylistic standards found in the text of our products. Some minor changes have been made for clarity or
to correct spelling errors originally in the notes, but essentially, they are as one would find them in a coding setting.
? 2018 AAPC
2233 South Presidents Dr. Suites F-C, Salt Lake City, UT 84120
800-626-2633, Fax 801-236-2258,
Updated 10102018. All rights reserved.
ISBN 978-1-626886-667
CPC?, CIC?, COC?, CPC-P?, CPMA?, CPCO?, and CPPM? are trademarks of AAPC.
ii
2019 Medical Coding Training: CPC Practical Application Workbook¡ªAnswer Key
CPT? copyright 2018 American Medical Association. All rights reserved.
Contents
Chapter 1
The Business of Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Chapter 2
Medical Terminology and Anatomy Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Chapter 3
Introduction to ICD-10-CM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Chapter 4
ICD-10-CM Coding Chapters 1¨C11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Chapter 5
ICD-10-CM Coding Chapters 12¨C21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Chapter 6
Introduction to CPT?, Surgery Guidelines, HCPCS Level II, and Modifiers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Chapter 7
Integumentary System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Chapter 8
Musculoskeletal System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Chapter 9
Respiratory, Hemic, Lymphatic, Mediastinum, and Diaphragm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Chapter 10
Cardiovascular System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Chapter 11
Digestive System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Chapter 12
Urinary System and Male Genital System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Chapter 13
Female Reproductive System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
CPT? copyright 2018 American Medical Association. All rights reserved.
iii
Chapter 14
Endocrine and Nervous System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Chapter 15
Eye and Ocular Adnexa, Auditory Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
Chapter 16
Anesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Chapter 17
Radiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
Chapter 18
Pathology and Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Chapter 19
Evaluation and Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
Chapter 20
Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
iv
2019 Medical Coding Training: CPC Practical Application Workbook¡ªAnswer Key
CPT? copyright 2018 American Medical Association. All rights reserved.
Chapter
1
The Business of Medicine
Exercise 1
1.
What type of profession, other than coding, might a skilled coder enter?
Answer: Consultants, educators, medical auditors
2.
What is the difference between outpatient and inpatient coding?
Answer: Outpatient coders focus on assigning CPT?, HCPCS Level II, and ICD-10-CM codes. They work in provider
offices, outpatient clinics and facility outpatient departments. Outpatient facility coders also work with ambulatory
payment classifications (APCs).
Inpatient hospital coding focuses on a different subset of skills, where coders work with ICD-10-CM and ICD-10-PCS.
These coders also assign Medicare severity-diagnosis related groups (MS-DRGs) for reimbursement. Outpatient coders
usually have more interaction throughout the day and must communicate well with providers; inpatient coders tend to
have less interaction throughout the day.
3.
What is a mid-level provider?
Answer: Mid-level providers include physician assistants (PA) and nurse practitioners (NP). Mid-level providers are known
also as physician extenders because they extend the work of a physician.
4.
Discuss the different parts of Medicare and what each program covers.
Answer:
ll
ll
ll
ll
Medicare Part A helps to cover inpatient hospital care, as well as care provided in skilled nursing facilities, hospice
care, and home healthcare.
Medicare Part B covers two types of services: 1) Medically necessary provider services that are needed to diagnose or
treat a medical condition and that meet accepted standards of medical practice; and 2) preventive services to prevent
illness or detect it at an early stage. Medicare Part B is an optional benefit for which the patient pays a premium, an
annual deductible and generally has a 20% co-insurance except for preventive services covered under healthcare law.
Coders working in provider offices code mainly Medicare Part B claims.
Medicare Part C, also called Medicare Advantage, combines the benefits of Medicare Part A, Part B and sometimes
Part D. The plans are managed by private insurers approved by Medicare and may include preferred provider
organizations, health maintenance organizations, etc.
Medicare Part D is a prescription drug coverage program available to all Medicare beneficiaries for a fee. Private
companies approved by Medicare provide the coverage.
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