AAPC CCVTC Certification Sample Questions

The AAPC Certified Cardiovascular and Thoracic Surgery Coder Certification Sample Question Set on this page is designed to familiarize you with the actual AAPC CCVTC exam format and question types. These sample questions help you understand how questions are structured and what to expect on test day. While they provide a useful starting point, they represent only a limited preview of the real exam experience.

These sample questions are intended for evaluation and familiarization only. To understand exam style, pacing, and reasoning patterns more clearly, we recommend trying our online sample practice environment. If you are preparing for the AAPC Certified Cardiovascular and Thoracic Surgery Coder (CCVTC) and want to assess your readiness more rigorously, structured, timed, scenario-based practice is recommended. This approach aligns with the cognitive demands and professional expectations typically associated with Medical coders, specialty surgery coders, cardiovascular and thoracic surgery coding professionals working in settings such as Hospitals, surgical centers, specialty practices.

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The demo introduces core concepts, while full-length premium simulations provide deeper, scenario-based coverage that more closely reflects the actual cognitive demands of the AAPC Certified Cardiovascular and Thoracic Surgery Coder exam, particularly in areas such as Cardiovascular and thoracic surgery coding, operative note abstraction, ICD-10-CM/CPT®/HCPCS Level II code assignment. You can use these sample questions as a starting point, then progress to the AAPC CCVTC Certification Practice Exam for stronger readiness. Our premium simulations are designed to mirror real exam conditions, helping you refine reasoning, pacing, and decision-making before your official exam attempt.

AAPC CCVTC Sample Questions:

01. A cardiothoracic surgeon documents an office E/M service for a patient with a painful, enlarging postoperative seroma after prior pacemaker pocket revision by another physician. During the same encounter, the surgeon performs needle aspiration of the seroma. The E/M documentation includes a separately identifiable assessment of possible infection, review of device history, and decision-making beyond the aspiration itself. Which modifier approach is most appropriate for the E/M service if payer rules require modifier support?
a) Do not report the E/M service because an aspiration was performed during the same encounter.
b) Append modifier 59 to the E/M service because the E/M and aspiration are distinct procedures.
c) Append modifier 57 to the E/M service because any procedure performed after an office visit is major surgery.
d) Append modifier 25 to the E/M service because the note supports a significant, separately identifiable E/M service on the same day as a minor procedure.

02. A patient is 3 weeks postoperative from tracheal resection. The surgeon sees the patient for routine airway follow-up and planned removal of skin sutures. The note documents improved breathing, normal healing, and no new airway complication. Which reporting approach is most appropriate?
a) Report modifier 79 because the airway is separate from the skin sutures.
b) Report a staged-procedure modifier because suture removal always represents a second-stage procedure.
c) Do not separately report the encounter because it represents routine related postoperative care within the Global surgical package.
d) Report an unrelated E/M service with modifier 24 because the patient’s breathing is reassessed.

03. A procedure note documents transapical transcatheter aortic valve replacement. The surgeon performs a small left thoracotomy, accesses the left ventricular apex, introduces the delivery system through the apex, deploys the prosthetic valve across the native aortic valve, repairs the apical access site, and closes the thoracotomy. No femoral arterial access is used for valve delivery. Which coding principle is most appropriate?
a) Report transapical TAVR because the valve was delivered through left ventricular apical access rather than transfemoral access.
b) Report diagnostic thoracoscopy because the chest was entered through a limited incision.
c) Report open surgical aortic valve replacement because a small thoracotomy was performed.
d) Report transfemoral TAVR because all catheter-based aortic valve replacements use femoral access.

04. A surgeon performs a right thoracoscopic wedge resection and separately documents a right parietal pleural biopsy during the same session. The wedge resection is for a peripheral lung nodule, while the pleural biopsy is for a separate pleural plaque. The operative note identifies separate specimens and distinct diagnostic questions. Which modifier approach is most appropriate if payer edits bundle the pleural biopsy?
a) Append modifier 24 because the pleural plaque is unrelated to the lung nodule.
b) Append modifier 59 or an appropriate X{EPSU} modifier to the pleural biopsy when documentation supports it as a distinct procedural service.
c) Append modifier 57 because the surgeon decided to biopsy the pleura during the operation.
d) Append modifier 50 because both procedures were performed on the right side.

05. A thoracic surgery note states: “Empyema of the left pleural space after pneumonia. Plan open drainage and decortication". The provider documents persistent fever, loculated pleural fluid, and positive pleural culture. No malignancy is documented. Which diagnosis-coding approach best reflects the documentation?
a) Report malignant pleural effusion because loculated pleural fluid requires thoracic surgery.
b) Report spontaneous pneumothorax because the pleural space is involved.
c) Report pleural empyema with the documented infectious context when supported by ICD-10-CM conventions.
d) Report lung cancer because empyema requiring surgery is presumed secondary to malignancy.

06. An operative note documents resection of two ribs and reconstruction of the lateral chest wall with prosthetic mesh after excision of a malignant chest wall tumor. The surgeon does not enter the lung parenchyma and does not perform lobectomy or wedge resection. Which coding principle is most appropriate?
a) Report diagnostic thoracoscopy because no lung tissue was removed.
b) Report chest wall tumor resection with reconstruction as supported by the rib resection and mesh repair documentation.
c) Report thoracoscopic wedge resection because ribs were removed near the lung.
d) Report lobectomy because chest wall malignancies are coded as lung resections.

07. During the same operative session, a surgeon performs a planned second-stage vascular procedure that was documented in the original operative plan 4 weeks earlier. The patient is still in the Global surgical period of the first operation. The current note states: “Second-stage revascularization performed today as planned". Which modifier decision is most appropriate for the staged procedure?
a) Append modifier 58 to the staged procedure because it was planned prospectively and performed during the postoperative period.
b) Append modifier 57 to the staged procedure because the second operation confirms that surgery was necessary.
c) Append modifier 24 to the staged procedure because the patient is still in the Global surgical period.
d) Append modifier 25 to the staged procedure because the surgeon documented a separate operative note.

08. Two cardiothoracic surgeons work together as co-surgeons on a complex open thoracoabdominal aortic aneurysm repair. The operative documentation identifies each surgeon’s distinct portion of the same primary procedure, and both surgeons dictate their operative roles. The payer recognizes co-surgeon reporting when supported. Which modifier concept is most appropriate?
a) Use modifier 50 because two surgeons operated during the same session.
b) Use the co-surgeon modifier when each surgeon performs a distinct part of the same procedure and documentation supports both roles.
c) Use modifier 52 because the primary surgeon did not personally perform every portion of the case.
d) Use modifier 24 because the second surgeon’s work is unrelated to the primary surgeon’s work.

09. A vascular surgeon documents: “Chronic total occlusion of the right subclavian artery with vertebrobasilar insufficiency symptoms. No acute embolus. No upper-extremity venous thrombosis. Plan carotid-subclavian bypass". Which diagnosis-coding approach best reflects the documentation?
a) Report only dizziness because vertebrobasilar symptoms are more important than the vascular diagnosis.
b) Report upper-extremity deep venous thrombosis because the subclavian vessel is involved.
c) Report acute arterial embolism because any subclavian occlusion requiring bypass is acute.
d) Report chronic right subclavian artery occlusive disease with the documented vascular insufficiency context when supported.

10. A patient undergoes thoracic duct ligation for postoperative chylothorax. During the postoperative Global surgical period, the surgeon sees the patient for routine chest tube output review, diet instructions, and wound check. The note documents decreasing output and no new complication. Which reporting approach is most appropriate?
a) Do not separately report the visit because it is routine related postoperative care included in the Global surgical package.
b) Report an E/M service with modifier 24 because diet instructions were discussed.
c) Report modifier 79 because chylothorax is a separate diagnosis from wound healing.
d) Report an E/M service with modifier 57 because the surgeon reviewed chest tube output.

Answers:

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Note: These sample questions are not official exam questions and are intended only for familiarization and study purposes. If you find any typos or data entry errors in these AAPC Certified Cardiovascular and Thoracic Surgery Coder (CCVTC) sample questions, please let us know by emailing us at feedback@medicoexam.com