CPC Exam Dumps - AAPC Certified Professional Coder Questions and Answers

33016 = Pericardiocentesis, including imaging guidance (e.g., ultrasound) when performed.Because the code already includes imaging guidance, you do not separately report 76942.So the correct coding is 33016 only → B.

45346 = Sigmoidoscopy with ablation (reported once)

K63.5 = Polyp of colon

Procedure Coding (CPT®):

31287 – Nasal/sinus endoscopy, surgical; with sphenoidotomy

Correct because the surgeon performed a surgical endoscopic sphenoidotomy to evaluate and treat sphenoid sinus injury.

No CSF leak repair was performed, so codes 31290–31291 are not appropriate.

31231-59 – Nasal endoscopy, diagnostic

Diagnostic endoscopy is separately reportable because:

It was performed to evaluate traumatic injury

It is not bundled into the surgical service when it provides distinct diagnostic information

Modifier -59 indicates a separate and distinct service per NCCI edits.

Diagnosis Coding (ICD-10-CM):

S02.109A – Unspecified fracture of base of skull, initial encounter for closed fracture

The anterior cranial fossa fracture with sphenoid sinus involvement qualifies as a skull base fracture

No CSF leak is documented

Correct 7th character “A” for initial encounter

Why Other Options Are Incorrect:

A – Incorrect format and duplicated CPT logic

B – 31267 = maxillary sinus, wrong sinus

D – 31291 includes CSF leak repair, which was not performed

1. Procedure and CPT® Code Selection:

The patient requires a surgical nasal sinus endoscopy to repair a cerebrospinal fluid (CSF) leak caused by a skull fracture that resulted in CSF draining into the nasal passage.

Code 31291 is the correct CPT® code for an endoscopic repair of a cerebrospinal fluid leak in the sphenoid sinus. This procedure code is appropriate because it specifically addresses surgical endoscopy for CSF leak repair in the sinus region.

Other codes provided, such as 31287 (nasal/sinus endoscopy with balloon dilation) and 31235 (nasal endoscopy with biopsy), do not match the description for surgical repair of a CSF leak and are therefore inappropriate for this case.

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

ICD-10-CM Code S02.19XA is used to describe a fracture of the anterior cranial base, which fits the described injury of the skull with cerebrospinal fluid leakage.

External cause code V47.5XXA is used for motor vehicle accidents involving a car hitting a stationary object.

Y92.411 is the appropriate code to describe the location of the accident as a highway.

3. Exclusion of Additional Procedure Codes:

There is no need for a second endoscopy code or a modifier, as 31291 fully describes the endoscopic repair procedure for the CSF leak.

4. AAPC and CPT® Coding Guidelines:

Per AAPC guidelines, procedure codes for sinus endoscopy are chosen based on the specific type of intervention (e.g., CSF leak repair). The guidelines for ICD-10-CM stress including external cause codes and location codes for trauma cases related to motor vehicle accidents.

Thus, the correct answer based on CPT® and ICD-10-CM coding standards is B. 31291, S02.19XA, V47.5XXA, Y92.411.

1. Procedure and CPT® Code Selection:

The patient underwent a thyroidectomy for malignancy in the right lobe, as well as the removal of the parathyroid gland due to a suspected malignant lesion.

CPT® Code 60505 is for the parathyroidectomy with exploration of parathyroid glands and is appropriate for the removal of the parathyroid gland due to a suspected malignancy.

CPT® Code 60220 represents a thyroid lobectomy (total removal of one lobe of the thyroid), which applies to the removal of the right thyroid lobe in this case.

2. Modifier 59:

Modifier 59 is added to 60220 to indicate that the thyroid lobectomy is a distinct procedure from the parathyroidectomy, performed in a separate anatomical site during the same surgical session.

3. Rationale for Excluding Other Options:

Code 60500 (in options A and C) is for a parathyroid exploration only, not including the actual removal of the parathyroid gland, so it does not apply here.

Code 60240 (in option D) is for a total thyroidectomy, which involves removal of the entire thyroid gland. Since only the right lobe was removed, 60220 (thyroid lobectomy) is correct.

4. AAPC and CPT® Coding Guidelines:

Per AAPC guidelines, 60505 is the appropriate code for parathyroidectomy procedures involving exploration or suspected malignancy, and 60220 with Modifier 59 accurately reflects the separate and distinct thyroid lobectomy procedure.

Thus, the correct answer is B. 60505, 60220-59.

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

Modifier selection for discontinued procedures depends onsettingandhow far the procedure progressed. In the CPT modifier framework,-53(Discontinued Procedure) is used when a physician terminates a procedure due toextenuating circumstances or those that threaten the well-being of the patientafter the procedure has begun. Here, anesthesia was given, the incision was made, and then respiratory distress occurred—clearly a patient safety issue requiring stopping the surgery. That matches modifier-53for the surgeon’s claim. Modifier-74is afacilitymodifier (commonly used by ambulatory surgery centers/hospitals for discontinued outpatient procedures after anesthesia), not the surgeon’s CPT modifier in the typical CPC context. Modifier-47indicates anesthesia by the surgeon, which is not the key fact here and does not represent discontinuation. Modifier-52is for reduced services when a service is partially reduced at the physician’s discretion, not terminated for patient safety. Therefore, the oral surgeon reports21060-53.

The patient is seeing a new doctor in the same specialty group for an enlarged goiter and is undergoing a medically appropriate history and exam, along with a fine needle aspiration biopsy.

Procedure Description:

Medically appropriate history and exam.

Review of TSH results and ultrasound.

Ordering of fine needle aspiration biopsy.

CPT® Coding:

99202: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making.

Since it has been two years since the last visit and the patient is being seen by a new doctor in the same specialty group, the encounter is considered a new patient visit.

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

CPT® Assistant for detailed coding guidelines on evaluation and management services.

Basal cell carcinoma is amalignantskin neoplasm, so the excision is coded from11600–11646(malignant lesion excision), not11400–11446(benign lesion excision). The scalp is in the anatomic group that includesscalp/neck/hands/feet/genitalia, and the excised diameterincluding marginsdetermines the malignant excision code range. A size of3.7 cmfalls into the3.1–4.0 cmcategory, which corresponds to11624for malignant excision in that location group. Closure is separately reportable when it is anintermediate (layered) repair, so you add12032(intermediate repair, scalp/axillae/trunk/extremities;2.6–7.5 cm) when documentation supports layered closure beyond simple repair. Diagnosis coding should reflectbasal cell carcinoma of scalp/neck, which isC44.41. Options that use benign excision or benign diagnosis codes are incorrect for basal cell carcinoma.

60254 = Subtotal thyroidectomy for malignancy with radical neck dissection

60260 = Total thyroidectomy

60220 = Partial thyroidectomy, benign

60252 = Total thyroidectomy with radical neck dissection