CPC Exam Dumps - AAPC Certified Professional Coder Questions and Answers

NCCIstands for theNational Correct Coding Initiative. Its purpose is to promote correct coding by identifying code pairs that shouldnotbe reported together in most circumstances, helping preventunbundlingand improper payment. The NCCI includesProcedure-to-Procedure (PTP) editsand guidance that reflect common clinical coding conventions (for example, when one service is considered integral to another). Importantly, NCCI edits do not “eliminate the need for modifiers”; rather, they clarify when a modifier (such as-59or an appropriate X{EPSU} modifier) may be allowedonly whendocumentation supports that the services were truly distinct (different site, session, lesion, or other qualifying circumstance). Options A and C incorrectly name the initiative and misstate its function, and option B is not the correct expansion or purpose. For CPC exam readiness, understand NCCI as a primary Medicare edit set widely used as a reference by many payers, supporting consistent and accurate reporting and reducing payment errors.

The patient was critically ill withhemodynamic instability, respiratory failure progression, and cardiac arrest, requiring intensive interventions (multiple IVs, large bolus,vasopressor infusion, resuscitation with CPR/defibrillation/medications, ABG management). The provider documents77 minutes of continuous critical care time. Critical care is reported with99291for thefirst 30–74 minuteson a date of service, and99292foreach additional 30 minutesbeyond that threshold. Because77 minutesexceeds 74 minutes, you report99291 + 99292(one unit of 99292 covers the additional time beyond the initial critical care window). You donotadditionally report an ED E/M code (e.g., 99285) on the same date for the same provider when critical care encompasses the ED evaluation and management during that time period; the critical care service is the appropriate E/M reporting. The scenario supports that critical care criteria are met: high probability of life-threatening deterioration and active physician management. Therefore, the correct E/M coding is99291, 99292.

Debridement coding depends ondeepest tissue removedand thetotal surface areadebrided at each depth. Debridement “tomuscle and/or fascia” is coded with11043for thefirst 20 sq cm (or part thereof)at that depth. The lower-back wound involvesfascia, so report11043(no add-on 11046 is needed because the described size is below an additional 20 sq cm threshold). The shoulder (8) and lower-leg (16) wounds involvesubcutaneous tissue, which is coded with11042for thefirst 20 sq cm (or part thereof)at the subcutaneous depth. Their combined area is24 sq cm, so you report11042plus add-on11045for theadditional 4 sq cmbeyond the first 20. Because two different depth families are billed (fascia vs subcutaneous), adistinct procedural servicemodifier (here-59on 11042) supports reporting both depths when documentation shows separate wounds/levels treated. This matches optionD.

The injection into the trochanteric bursa under ultrasonic guidance is coded with CPT® 20611, which describes an injection of a major joint or bursa with ultrasound guidance. The modifier -LT indicates the procedure was performed on the left side.

27380 = Repair, quadriceps muscle

S76.311A = Strain of muscle, fascia, tendon of right thigh, initial encounter

Code selection is based on specific muscle group and laterality

69209-RT – Removal of impacted cerumen using irrigation

69210-LT – Removal of impacted cerumen using instrumentation

Coding Rules Applied:

Different techniques → different CPT codes

Different ears → RT/LT modifiers, not modifier -50

Why Other Options Are Incorrect:

A – Modifiers reversed

B / D – Modifier -50 inappropriate when different CPT codes are used

Procedure: Complete cardiac MRI for morphology and function without contrast, followed by contrast with four additional sequences and stress imaging.

CPT® Codes:

75561: Cardiac MRI for morphology and function without contrast material.

75563: Cardiac MRI with contrast and further sequences.

ICD-10-CM Codes:

I50.1: Left ventricular failure.

I49.1: Premature ventricular contractions.

Code Selection Justification: The CPT® codes accurately capture the MRI procedures performed. The ICD-10-CM codes represent the diagnoses of left ventricular failure and premature ventricular contractions.

AMA CPT® Professional Edition (current year)

ICD-10-CM (current year)

HCPCS Level II (current year)

1. Procedure Details and CPT® Code Selection:

The patient underwent a catheter placement in the proper hepatic artery (a visceral artery), followed by dye injection and imaging to identify a stenosis, and finally a percutaneous transluminal angioplasty of the artery.

Code 36247 is appropriate for selective catheter placement in the third-order or more selective branch of a visceral artery. Since the proper hepatic artery is a selective branch accessed from the left femoral artery, this code accurately describes the catheter placement.

Code 75736 is for angiography of a selective visceral artery following catheter placement, which matches the imaging procedure performed here.

Code 37248 describes a percutaneous transluminal angioplasty of a visceral artery, which is the therapeutic intervention performed to treat the stenosis in the proper hepatic artery.

2. Modifiers:

Modifier 26 is used with 75736 to denote the professional component of the imaging service.

Modifier 59 indicates that the imaging (75736) is a distinct procedural service, separate from the therapeutic angioplasty (37248).

Modifier 51 is applied to 37248 to indicate it was a secondary procedure in addition to the diagnostic imaging and catheter placement.

3. Exclusion of Other Options:

Code 36253 (in choices A and D) is for selective catheter placement in a different vessel and does not apply to the hepatic artery.

Code 75726 is for non-selective abdominal aortography, which does not match the specific selective imaging of the hepatic artery.

4. AAPC and CPT® Coding Guidelines:

According to AAPC guidelines, each step in an angiographic and interventional radiology procedure is coded based on the level of vessel accessed, imaging performed, and therapeutic intervention completed, which is all accurately represented by 36247, 75736-26-59, and 37248-51.

Based on CPT® and AAPC coding guidelines, the correct answer is C. 36247, 75736-26-59, 37248-51.

You said:

The human shoulder is composed of three main bones: the clavicle (collarbone), scapula (shoulder blade), and humerus (upper arm bone). These bones form the shoulder joint, which is one of the most flexible and mobile joints in the human body, allowing for a wide range of motion.

AMA ' s CPT® Professional Edition (current year), Musculoskeletal System section.