Pass the AAPC Certified Professional Coder CPC Questions and answers with ExamsMirror

1. Procedure and CPT® Code Selection:

The patient underwent an open partial colectomy involving the removal of the proximal colon and terminal ileum with reconnection of the distal ileum to the remaining colon.

CPT® Code 44160 is specific for an open partial colectomy with removal of a portion of the colon and the terminal ileum with an ileocolostomy (reconnection of the ileum to the colon). This accurately describes the procedure performed.

Code 44140 is for a partial colectomy without removal of the terminal ileum, making it inappropriate in this case.

Codes 44205 and 44204 involve laparoscopic approaches for colectomy procedures, but since this procedure was open, these codes are not suitable.

2. Diagnosis and ICD-10-CM Code Selection:

ICD-10-CM Code C18.2 is for a malignant neoplasm of the ascending colon, which is specified in this case as colon adenocarcinoma.

Code C18.9 represents an unspecified malignant neoplasm of the colon, which is less specific than C18.2. Therefore, C18.2 is the most accurate choice based on the location of the adenocarcinoma.

3. AAPC and CPT® Coding Guidelines:

Per AAPC guidelines, selecting the correct colectomy code involves identifying the specific approach (open vs. laparoscopic) and anatomical structures resected, both of which align with 44160 for this open ileocolic resection.

Thus, the correct answer, based on CPT® and ICD-10-CM guidelines, is D. 44160, C18.2.

The correct J codes are selected based on the specific medications administered and their quantities:

J2405 represents "ondansetron, 1 mg," and since the patient received a 2 mg dose, J2405 is reported once with a quantity of 2 mg.

J1885 represents "ketorolac tromethamine, 15 mg," which matches the single 15 mg dose administered to the patient, so J1885 is reported once.

Each J code is billed according to the precise dosage given, as no multipliers are required beyond the single-unit codes provided in choice A, making it the correct answer.

According to ICD-10-CM coding guidelines for substance use, abuse, and dependence, when multiple levels (use, abuse, and dependence) of the same substance are documented, only the highest level of severity is coded. The hierarchy is as follows: dependence > abuse > use.

D. If both use and dependence are documented, assign only the code for dependence is correct, as dependence represents the highest severity level and supersedes both use and abuse.

A. is incorrect because if both use and abuse are documented without dependence, only abuse would be coded as it is of a higher severity than use.

B. is incorrect because all three codes (use, abuse, dependence) should not be reported together; only the highest level should be coded.

C. is incorrect because if both abuse and dependence are documented, only dependence (the higher severity level) should be coded, not abuse.

Therefore, the correct answer is D. If both use and dependence are documented, assign only the code for dependence.

1. Procedure and CPT® Code Selection:

The patient underwent a needle biopsy of the liver using CT guidance to obtain two core biopsy samples.

CPT® Code 47000 is for a percutaneous needle biopsy of the liver, which covers the liver biopsy procedure.

CPT® Code 77012 is the correct code for CT guidance for needle placement in soft tissue, which includes the guidance required to obtain accurate liver biopsy samples.

2. Rationale for Excluding Other Options:

Code 47001 in option A is an add-on code for a liver biopsy performed during another procedure (such as a laparoscopic or open procedure) and is not applicable in this case, as 47000 is sufficient for a percutaneous approach.

Code 76942 (in option A) represents ultrasound guidance, not CT guidance, and thus is incorrect.

Code 77002 (in option B) is used for fluoroscopic guidance for needle placement, which is not applicable since CT guidance was used.

Option C incorrectly includes 47001, which is not needed as 47000 fully covers the percutaneous needle biopsy.

3. AAPC and CPT® Coding Guidelines:

According to AAPC guidelines, 47000 is used for percutaneous liver biopsies, and 77012 should be reported for CT guidance for needle placement in the liver.

Therefore, the correct answer is D. 47000, 77012.

Lesion excision codes in the CPT® codebook include the removal of the lesion along with the necessary margins and a simple (nonlayered) closure when performed. These codes do not cover intermediate or complex closures, which are reported separately if performed. The measurement for selecting the appropriate lesion excision code includes the lesion and the margins required for complete excision.References: AMA's CPT® Professional Edition, lesion excision guidelines.

Procedure: Impedance testing via tympanometry is performed to assess hearing loss in the left ear.

CPT® Code:

92567: This code is for tympanometry (impedance testing) without reflex threshold measurements.

Code Selection Justification: The procedure involved tympanometry without reflex threshold, which is specifically coded as 92567.

References:

AMA CPT® Professional Edition (current year)

1. Procedure and CPT® Code Selection:

The patient underwent a partial nephrectomy (removal of part of the left kidney) via a laparoscopic approach.

CPT® Code 50543 is specifically used for a laparoscopic partial nephrectomy, which is an accurate description of this procedure.

2. Rationale for Excluding Other Options:

Code 50548 is used for a laparoscopic radical nephrectomy, which involves the complete removal of the kidney and surrounding structures; therefore, it does not apply to this partial nephrectomy.

Code 50220 represents an open partial nephrectomy, not a laparoscopic approach, and is therefore incorrect for this procedure.

Code 50546 is for a laparoscopic radical nephrectomy with bilateral removal of kidneys, which is not applicable in this case where only a partial removal of the left kidney was performed.

3. AAPC and CPT® Coding Guidelines:

AAPC and CPT® guidelines indicate that the use of 50543 is appropriate for any laparoscopic partial nephrectomy, regardless of the laterality, and it specifically identifies laparoscopic technique over open surgery.

Therefore, based on CPT® guidelines, the correct answer is C. 50543.

1. Procedure and CPT® Code Selection:

The procedure described is a craniectomy to access and remove a supratentorial intracerebral hematoma using a suction device.

CPT® Code 61314 is specific for a craniectomy or craniotomy for evacuation of a hematoma, supratentorial (within the upper portion of the brain), and includes any required dural repair and closure. This code precisely describes the procedure performed to remove the hematoma.

2. Rationale for Excluding Other Options:

Code 61154 is used for a burr hole procedure for the evacuation of a hematoma, which is a less invasive approach and does not involve a craniectomy.

Code 61313 is for a craniectomy or craniotomy to evacuate an infratentorial hematoma, which is located in the lower portion of the brain (posterior fossa) and is not applicable here.

Code 61312 is for evacuation of an epidural or subdural hematoma and does not apply to an intracerebral hematoma as described in this case.

3. AAPC and CPT® Coding Guidelines:

According to AAPC guidelines, 61314 is the appropriate code for craniectomy procedures aimed at removing supratentorial intracerebral hematomas, as it covers the full scope of the documented procedure.

Thus, the correct answer is A. 61314.

47563: Laparoscopic cholecystectomy with cholangiography is coded as 47563. The report details the laparoscopic removal of the gallbladder with intraoperative cholangiography.

74300-26: The radiological supervision and interpretation for the cholangiography is coded as 74300 with modifier -26 (Professional Component) since the interpretation was done by the physician.

References:

CPT® Professional Edition, AMA

1. Procedure and CPT® Code Selection:

The patient underwent a pulmonary function test that included spirometry, vital capacity, breathing capacity, and flow volume measurements before and after bronchodilator administration.

CPT® Code 94060 is for spirometry, including the bronchodilator responsiveness testing, which involves capturing pre- and post-bronchodilator measurements. This code accurately reflects the testing performed.

CPT® Code 94010 is for spirometry testing without bronchodilator, which might be considered redundant in this case since 94060 encompasses spirometry testing with and without bronchodilator. However, some practices may code both, but generally, 94060 alone should suffice.

2. Diagnosis and ICD-10-CM Code Selection:

ICD-10-CM Code J45.901 is used for unspecified asthma with acute exacerbation. This code is appropriate given that the diagnosis indicates intermittent asthma with exacerbation.

J45.21 represents mild intermittent asthma without the specification of exacerbation, making it less accurate than J45.901 in this context.

3. Rationale for Excluding Other Options:

Code 94070 (options B and C) is for bronchospasm provocation testing, which does not apply to standard pulmonary function testing with bronchodilator responsiveness.

Option D includes J45.21, which does not capture the exacerbation aspect and is therefore incorrect.

4. AAPC and CPT® Coding Guidelines:

According to AAPC guidelines, 94060 should be used when pre- and post-bronchodilator spirometry is performed, and J45.901 is appropriate for asthma with exacerbation.

Therefore, the correct answer is A. 94060, 94010, J45.901.