CPC Exam Dumps - AAPC Certified Professional Coder Questions and Answers

1. Procedure and CPT® Code Selection:

The scenario describes the removal and replacement of an inflatable penile prosthesis due to erectile dysfunction.

CPT® Code 54416 is specifically used for the removal and replacement of a multi-component inflatable penile prosthesis. This code accurately describes the procedure performed.

2. Rationale for Excluding Other Options:

Code 54401 represents the initial insertion of a multi-component inflatable penile prosthesis but does not cover removal and replacement, making it inappropriate for this scenario.

Code 54400 is for the insertion of a non-inflatable (malleable) penile prosthesis, which does not apply here as the prosthesis is inflatable.

Code 4417 does not exist in the CPT® coding system and is likely a typo or incorrect option.

3. AAPC and CPT® Coding Guidelines:

According to AAPC and CPT® guidelines, 54416 is the correct code when an inflatable prosthesis requires both removal and replacement, without the need for additional modifiers for this procedure.

Therefore, the correct answer based on CPT® guidelines is D. 54416.

The outermost protective layer of the skin is called the epidermis. It serves as a barrier to protect the body against environmental elements, pathogens, and helps to retain moisture. The epidermis itself is composed of several sub-layers, with the stratum corneum being the outermost layer.

ICD-10-CM (current year), Chapter 12: Diseases of the Skin and Subcutaneous Tissue (L00-L99).

IV hydration is coded byduration. CPT96360is forinitial intravenous hydration(typically the first hour). CPT96361is an add-on code foreach additional hourbeyond the initial hour, reported when the hydration time exceeds 60 minutes and meets the additional-hour threshold. The scenario documents hydration for1 hour and 30 minutes (90 minutes). That supports reporting theinitial hour(96360) plusone additional hour(96361) because the infusion extends beyond the initial hour and reaches the qualifying threshold for an additional hour as defined by CPT time rules (time is rounded/assigned based on midpoints, not per minute). The other options usetherapeutic infusioncodes (96365/96366), which are for medications/drugs, not for hydration with normal saline when the primary purpose is hydration. CPC exam tip: if the service is specifically “hydration” and the fluid is normal saline for dehydration/heat exhaustion, use96360/96361and apply time-based logic.

CPT Code 55706: Biopsy, prostate; needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance.

This code accurately describes the procedure performed. The documentation clearly states that a stereotactic template was used to guide the biopsy needles, and multiple samples were taken (saturation biopsies). This code includes imaging guidance.  

CPT Code 76942: Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation.  

Although 55706 includes imaging guidance, code 76942 is also reported separately because the transrectal ultrasound provided initial diagnostic images and was then used for guidance during the biopsy. This is supported by the documentation which states "Using a B & K ultrasound probe, a transrectal ultrasound of the prostate was obtained. Once this was done...a biopsy needle is inserted into the prostate...under ultrasound guidance." This indicates distinct uses of the ultrasound.

Important Note: While some sources suggest that 76942 and the diagnostic transrectal ultrasound code (76872) are bundled, it's crucial to consult the latest National Correct Coding Initiative (NCCI) edits for the most up-to-date guidance.

For a patient with a mass in the left lower lung suspected to be cancer that is currently documented as a tumor of uncertain behavior, with existing ovarian cancer with metastases to the liver, the ICD-10-CM codes are:

D38.1: Neoplasm of uncertain behavior of bronchus and lung.

C56.9: Malignant neoplasm of unspecified ovary.

C78.7: Secondary malignant neoplasm of liver and intrahepatic bile duct.

D38.1 is used because the behavior of the lung tumor is uncertain, and C56.9 and C78.7 are used to document the known primary and metastatic cancers.

ICD-10-CM guidelines

AMA's CPT® Professional Edition (current year)

For professional claims,Place of Service (POS) 12is used to indicate services performed in the patient’shome/private residence. This is a high-frequency reimbursement concept because POS impacts payer processing, fee schedules, and in some cases whether certain services are payable. POS codes like 41 and 42 are not used for a private home setting:41is typically associated withambulance—land, and42withambulance—air or water(transport settings rather than a location of patient residence). POS 65 refers to a specific facility-type setting (commonly associated withend-stage renal disease treatment facilities) and is not a home. On CPC-style questions, the key is recognizing that “private residence” equalshome—not assisted living, skilled nursing, or a facility. Correct POS reporting supports medical necessity review and correct payment and helps prevent denials, recoupments, and compliance risk. When documentation states the service occurred at the patient’s residence, POS 12 is the standard selection.

80143 = Acetaminophen level

80324/80329 = Drug classes, not specific analytes

80299 = Unlisted therapeutic drug assay

80430 = Growth hormone suppression panel

Individual tests are reported with units

MEDICINE & CARDIOLOGY

CPT code 99450 is used for the examination of a patient for the purpose of establishing medical baseline information or for insurance purposes. Since Eric's primary care provider completed the required physical exam documentation for his life insurance policy, this is appropriately reported with code 99450. References: CPT® Professional Edition (current year), AMA.

Under HIPAA (Health Insurance Portability and Accountability Act), PHI stands for Protected Health Information. It includes any individually identifiable health information related to a patient’s health status, provision of healthcare, or payment for healthcare. Protection of PHI is a key compliance topic on the CPC exam.