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

ICD-10-CM guidelines state that healing pressure ulcers are coded as the stage documented.

L89.624 = Pressure ulcer of left heel, stage 4

Stage 4 ulcers involve full-thickness tissue loss and are commonly referenced in exam scenarios involving treatment of healing ulcers

Unspecified stage or laterality codes are not appropriate when documentation supports specificity.

Blue Cross Blue Shield is a commercial or private payer, which means it is an insurance company that provides health insurance plans to individuals and groups. In contrast, Medicare and Medicaid are government programs, and the Veterans Health Administration (VHA) is a federal healthcare system for military veterans.

AMA's CPT® Professional Edition (current year), Appendix B: Payers and Reimbursement.

Injection of atropine: Atropine is administered to reduce sialorrhea.

Bilateral submandibular salivary glands: The physician administers the injections into the salivary glands.

Total of four glands: Indicates that multiple glands are treated in the same session.

CPT code 64611 accurately represents chemodenervation of the salivary glands, bilateral. The use of -50, -52, or x4 modifiers is not appropriate since CPT guidelines include bilateral procedures in this code without needing additional modifiers or codes.

52352 = Cystourethroscopy with ureteroscopy, removal of calculus with manipulation (basket)

52353 is for laser lithotripsy

52356 includes stent placement (not performed)

1. Procedure and CPT® Code Selection:

The patient required surgical intervention for severe ocular trauma involving removal of a foreign body from the posterior segment of the eye, suturing of the corneal laceration, and a pars plana lensectomy.

CPT® Code 65265 is for removal of a foreign body from the posterior segment of the eye without the use of a magnet. This code is appropriate for the removal of the metallic foreign body using retinal forceps.

CPT® Code 66852 covers the pars plana lensectomy, which was performed as part of the surgical treatment.

CPT® Code 65280 is used for repairing a corneal laceration with multiple perforations, which applies to the corneal suturing.

2. Modifiers:

Modifier RT is used to indicate that the procedures were performed on the right eye.

Modifier 51 is added to indicate multiple procedures performed during the same surgical session.

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

ICD-10-CM Code S05.51XA is appropriate for penetrating wound of the right eyeball with a foreign body in the posterior segment.

ICD-10-CM Code W31.1XXA is used to indicate that the injury was caused by contact with a metalworking and woodworking machine.

4. Rationale for Excluding Other Options:

Codes 65235 and 65275 in options B, C, and D refer to foreign body removal from the anterior chamber and the anterior segment, respectively, which are not appropriate since the foreign body was located in the posterior segment.

Codes S05.31XA and W31.0XXA in options C and D represent different eye injuries and types of machines, which do not match the scenario described.

5. AAPC and CPT® Coding Guidelines:

According to AAPC guidelines, codes should be selected based on the specific location (posterior segment) and the type of foreign body removal. Each procedure, including the corneal repair, should be coded to capture the full extent of the treatment.

Therefore, the correct answer is A. 65265-RT, 66852-51-RT, 65280-51-RT, S05.51XA, W31.1XXA.

22514 = Vertebroplasty, lumbar (L5)

22515 = Each additional vertebral body (sacrum)

Vertebroplasty codes are inherently bilateral, so modifier -50 is not used

1. Procedure and CPT® Code Selection:

The urinalysis performed was non-automated and without microscopy.

CPT® Code 81002 is appropriate for a non-automated urinalysis without microscopy. This code accurately reflects the test performed in the office.

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

ICD-10-CM Code R30.0 is used for dysuria, which was one of the patient's presenting symptoms.

ICD-10-CM Code R10.30 is used for lower abdominal pain, another presenting symptom.

Since the urinalysis ruled out a urinary tract infection, N39.0 (UTI) is not appropriate as a final diagnosis.

3. Rationale for Excluding Other Options:

Code 81000 (in options A and B) is for a urinalysis with microscopy, which was not performed here.

N39.0 is used when a UTI is confirmed, which is incorrect for this case since the urinalysis was negative, ruling out UTI.

4. AAPC and CPT® Coding Guidelines:

AAPC guidelines recommend coding based on the symptoms when a specific diagnosis (such as UTI) is ruled out. Therefore, R30.0 and R10.30 are appropriate symptom codes for this encounter.

Thus, the correct answer is C. 81002, R30.0, R10.30.

For the procedure involving access to the subclavian vein and advancing a catheter to the inferior vena cava for injection and imaging, the following codes are used:

36010 for the catheter placement.

75825-26 for the supervision and interpretation of the imaging.

Modifier -26 indicates the professional component of the radiological supervision and interpretation.

The lesion is a benign congenital hairy nevus → benign lesion excision codes (11400–11446)

Location: thigh (trunk/arms/legs)

Excision size with margins = 4.5 cm → 11406 (4.1–5.0 cm)

Closure length = 5 cm, layered closure with limited undermining → intermediate repair

12032 = Intermediate repair, trunk/extremities, 2.6–7.5 cm

Modifier -51 applies to the secondary procedure

1. Procedure and CPT® Code Selection:

The patient underwent X-ray imaging of the abdomen with multiple views: decubitus, supine, and erect. This is a comprehensive study that includes different positioning to evaluate the abdomen.

CPT® Code 74022 is appropriate for an abdominal X-ray with a minimum of three views. This code accurately reflects the multiple views taken in this scenario.

2. Modifier 26:

Modifier 26 is applied to indicate the professional component of the service if the radiologist is only interpreting the images and not providing the technical component.

3. Rationale for Excluding Other Options:

Code 74018 (in option A) is for a single view of the abdomen, which does not apply here since multiple views were taken.

Code 74019 (in option C) covers two views of the abdomen, which is insufficient for this three-view study.

Code 74021 (in option D) represents an abdominal X-ray with more limited or focused views and does not align with the comprehensive three-view study described.

4. AAPC and CPT® Coding Guidelines:

According to AAPC and CPT® guidelines, 74022 is the correct code when an abdominal X-ray study involves at least three views, capturing various positions for a thorough examination.

Therefore, the correct answer is B. 74022-26.