AAPC Certified Professional Coder (CPC) CPC Exam Questions
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Where is a Warthin's tumor found?
Correct Answer: C
What is a Warthin's Tumor?
A Warthin's tumor (also formally known as papillary cystadenoma lymphomatosum) is a completely benign (non-cancerous) tumor.
It is the second most common benign tumor of the salivary glands, right behind pleomorphic adenoma.
Key Characteristics to Know:
Location: It is almost exclusively found in the parotid gland, which is the largest salivary gland located right in front of and below your ears. It is unique because it is often found in the lower part (tail) of this gland.
High Association with Smoking: It is one of the very few tumors heavily linked to a specific habit—smokers are roughly 8 times more likely to develop a Warthin's tumor than non-smokers.
Bilateral Potential: It is the salivary gland tumor most likely to occur on both sides (bilateral) or have multiple distinct tumors within the same gland.
Histology (Microscopic Look): Under a microscope, it has a very distinct "double layer" of cells forming cystic spaces, surrounded by dense lymphoid tissue (immune cells).
Because it is slow-growing and completely benign, treatment usually just involves a simple, conservative surgical removal of the lump, and it rarely ever comes back.
In rhinoplasty:
Correct Answer: A
Patient is diagnosed with dacryocystitis, which is the inflammation of?
Correct Answer: D
Medical terms can be a bit tricky to deconstruct, but we can break this one down by looking closely at its Greek medical roots:
Dacryo-: Means "tear"
Cyst-: Means "sac" or "bladder"
-itis: Means "inflammation"
Put them all together, and dacryocystitis is the inflammation or infection of the lacrimal sac (the tear sac located in the inner corner of the eye near the nose). It usually happens when a tear duct becomes blocked, causing tears to build up and bacteria to grow inside the sac, leading to pain, redness, and swelling.
What the Other Options Are Called:
A (Cornea): Inflammation of the cornea is called keratitis.
B (Fingernail): Inflammation or infection around the edges of a fingernail is called paronychia.
C (Eardrum): Inflammation of the eardrum is called myringitis.
The documentation states: He was then sterilely prepped and draped along the flank and abdomen in the usual sterile fashion. I first made a skin incision off the tip of the twelfth rib, extending medially along the banger’s lines of the skin. This was approximately 3.5 cm in length. Once this incision was carried sharply, electrocautery was used to gain access through the external oblique, internal oblique, and transverse abdominis musculature and fascia. What surgical approach was used for this procedure?
Correct Answer: D
The correct answer is indeed D (Open).
Why "Open" is the Correct Approach
The documentation explicitly outlines the hallmark steps of an open surgical approach:
Making a Skin Incision: The surgeon cuts directly through the skin using a scalpel ("made a skin incision off the tip of the twelfth rib... approximately 3.5 cm in length").
Layer-by-Layer Dissection: The surgeon then cuts directly through successive layers of muscle and tissue under direct visualization ("electrocautery was used to gain access through the external oblique, internal oblique, and transverse abdominis musculature and fascia").
This particular open approach is known as a flank incision (often used to access the kidneys or retroperitoneal space).
Why the Other Options are Incorrect
A is incorrect (Percutaneous): A percutaneous approach means accessing an internal area blindly or under radiologic guidance via a small needle puncture through the skin (like a needle biopsy), rather than cutting open layers of muscle.
B is incorrect (Laparoscopic): A laparoscopic (or minimally invasive) approach involves making tiny keyhole incisions to insert a camera (laparoscope) and long specialized tools. It would explicitly mention inserting a camera, inflating the abdomen with gas (pneumoperitoneum), or using a "trocar."
C is incorrect: There is more than enough specific anatomical mapping and structural documentation here to definitively classify this as an open procedure.
A patient that delivered her second child vaginally has a history of having a previous cesarean delivery for the first child.
What CPT code is reported for the delivery of the second child with antepartum care and postpartum care with the same provider?
Correct Answer: B
1. Procedure and CPT Code Selection:
The patient delivered her second child vaginally after having a previous cesarean delivery for her first child. This scenario describes a Vaginal Birth After Cesarean (VBAC).
CPT Code 59610 is specific for a vaginal delivery after a previous cesarean delivery, including antepartum and postpartum care with the same provider, which matches this case exactly.
2. Rationale for Excluding Other Options:
Code 59410 covers only vaginal delivery with postpartum care but does not include a history of previous cesarean delivery, so it is not appropriate for a VBAC.
Code 59400 is for routine vaginal delivery with antepartum and postpartum care but, again, does not account for a previous cesarean, so it does not apply in this VBAC scenario.
Code 59614 is for a VBAC but does not include antepartum care, making it incomplete for this scenario since the question specifies that antepartum, delivery, and postpartum care were provided by the same provider.
3. AAPC and CPT Coding Guidelines:
AAPC and CPT guidelines indicate that 59610 should be used for a complete VBAC service that includes antepartum, delivery, and postpartum care by the same provider.
Therefore, based on CPT guidelines, the correct answer is B. 59610.