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

The procedure involves eustachian tube inflation to remove serous mucoid fluid in the right ear of a 2-year-old patient with chronic otitis media.

Procedure Description:

Eustachian tube inflation to remove fluid.

General anesthesia.

Incision to the tympanum and suctioning of thick mucoid fluid.

CPT® Coding:

69421-RT: Eustachian tube inflation, transnasal or transoral; with catheterization, including general anesthesia. The modifier -RT indicates the right ear.

AMA's CPT® Professional Edition (current year).

CPT® Assistant for detailed coding guidelines on eustachian tube procedures.

1. CPT® Code 11604: This code is used for the excision of a malignant lesion on the back, with a size of 3.5 cm including margins. The 11600 series covers excision of malignant skin lesions, with 11604 being the correct code for a lesion size over 3.0 cm but not exceeding 4.0 cm.

2. CPT® Code 17110: This code is appropriate for the destruction of a benign lesion on the face (right cheek) via cryosurgery. 17110 covers the destruction of benign lesions (up to 14 lesions).

3. ICD-10-CM Code C44.509: This code represents unspecified malignant neoplasm of skin of trunk (back).

4. ICD-10-CM Code D23.39: This code is used for a benign neoplasm of skin of other parts of the face (right cheek).

Explanation of other options:

A. 11604, 11442, C76.8, C76.0: Incorrect because 11442 is for excision of a benign lesion, not a malignant lesion.

B. 11404, 11442, C44.509, D23.39: Incorrect because 11404 is used for a benign lesion excision, not malignant.

D. 11604, 11642, C76.8, C76.0: Incorrect as 11642 would indicate a second malignant excision rather than the benign lesion destruction.

Thus, the correct answer is C. 11604, 17110, C44.509, D23.39.

Procedure Coding (CPT®):

69910 – Labyrinthectomy, complete; transmastoid approach

Provider performed:

Mastoidectomy

Complete destruction/removal of semicircular canals, utricle, and saccule

This is a complete labyrinthectomy, not partial

69990 – Microsurgical techniques, requiring use of operating microscope

Separately reportable with otologic procedures

Modifier -51 not required (add-on code)

Diagnosis Coding (ICD-10-CM):

H81.391 – Peripheral vertigo, right ear

Correct laterality and condition

Why Other Options Are Incorrect:

69905 – Partial labyrinthectomy

R42 – Symptom code (dizziness), not used when definitive diagnosis exists

Cervical spondylosis with myelopathy: Condition requiring decompressive surgery.

Bilateral posterior laminectomy, facetectomies, foraminotomies: Procedures performed to decompress nerve roots.

Interspaces C5-C6 and C6-C7: Specific levels where the procedures were performed.

CPT code 63045 is used for the initial cervical laminectomy, and 63048 is for each additional segment. The combination covers the decompression across two interspaces.

Medical terms often consist of a root word and a suffix.

Hepat/o = liver

-itis = inflammation

Therefore, hepatitis literally means inflammation of the liver.

The incorrect options refer to inflammation of other body parts:

Dermatitis – inflammation of the skin

Gastritis – inflammation of the stomach

Arthritis – inflammation of the joints

Hence, the correct answer is C. Hepatitis.

The scenario describes an emergency basic life support (BLS) ambulance service. The appropriate HCPCS Level II code for BLS emergency transport is A0429.

Modifier QN indicates that the service was provided by an ambulance supplier, and SH indicates the services were provided in an emergency situation.

HCPCS Level II, current year

Service location = campground → domiciliary/home visit

Patient is new

99344 = New patient domiciliary visit, moderate MDM

Prolonged Services:

Additional 25 minutes beyond base time

99417 is used for prolonged services with office/home E/M codes

Why others are incorrect:

99349 – Established patient

99204 – Office visit (wrong location)

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.

In this scenario, the procedure involved the excision of a large sacral pressure ulcer with deep tissue damage that required muscle and bone removal and was followed by a layered flap closure. The coding reflects both the extent of the ulcer and the procedure performed:

1. CPT® Code 15937: This code describes excision of a pressure ulcer with muscle and bone removal followed by flap closure, which matches the detailed procedure performed on the sacral ulcer.

2. ICD-10-CM Code L89.156: This code is used for a stage 4 sacral pressure ulcer, indicating the presence of deep tissue damage down to muscle and possibly bone, which aligns with the clinical findings.

Explanation of other options:

A. 15933, L89.153 and B. 15931, L89.153: These codes do not adequately describe the excision with muscle and bone removal nor the stage 4 severity of the ulcer.

C. 15935, L89.156: Although L89.156 is correct for a stage 4 ulcer, 15935 does not account for both muscle and bone excision with flap closure.

Therefore, the correct answer is D. 15937, L89.156, accurately capturing the procedure performed and the severity of the ulcer.

Impending myocardial infarction is reported with I21.3 for a myocardial infarction (acute). The shortness of breath, which is a symptom, is coded separately as R06.02. According to ICD-10-CM guidelines, when a definitive diagnosis is established, the diagnosis code is sequenced first followed by symptom codes.

ICD-10-CM (current year), Chapter 9: Diseases of the Circulatory System (I00-I99), ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.9.e.4.