CPC Exam Dumps - AAPC Certified Professional Coder Questions and Answers

1. Procedure and CPT® Code Selection:

The patient underwent a cardiac MRI to assess the morphology and function of the heart under stress, involving both non-contrast and contrast-enhanced imaging. Additionally, pharmacological stress testing was performed to evaluate the coronary arteries.

CPT® Code 75563 is appropriate for a cardiac MRI with both stress and rest imaging, including morphology and function studies with contrast and pharmacologic stress testing. This code accurately captures the entire scope of the MRI study described in this case.

Modifier 26 is applied to indicate the professional component of the service if the cardiologist is providing only the interpretation and not the technical component.

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

ICD-10-CM Code I25.118 is used for atherosclerotic heart disease with unstable angina. This code accurately reflects the diagnosis provided in the scenario.

3. Rationale for Excluding Other Options:

Code 75559 (option B) represents a cardiac MRI without stress testing, which does not cover the pharmacologic stress component performed here.

Code 75557 (in option D) is for a limited cardiac MRI that does not include both stress and non-stress imaging, so it is incorrect for this comprehensive test.

ICD-10-CM Code I25.110 (in options C and D) is for atherosclerosis with angina pectoris without unstable angina, making I25.118 more appropriate given the diagnosis of unstable angina.

4. AAPC and CPT® Coding Guidelines:

AAPC and CPT® guidelines support the use of 75563 for comprehensive cardiac MRI studies with stress testing, both with and without contrast.

Therefore, the correct answer is A. 75563-26, I25.118.

For Mohs micrographic surgery, CPT® coding is based on the anatomic location of the lesion, the number of stages, and the number of tissue blocks per stage.

17311: This code is used for Mohs surgery on body areas such as the trunk, arms, or legs for the first stage.

17315: This is an add-on code used when more than five tissue blocks are examined in a single stage. Since this case involved six tissue blocks, 17315 is appropriate.

Explanation of incorrect answers:

A. 17313, 17314, 17315: Incorrect, as 17313 applies to the head, neck, hands, feet, or genitalia, not the arm.

C. 17313, 17315: Incorrect, as 17313 is not appropriate for the arm.

D. 17311, 17312, 17315: 17312 is used for additional stages beyond the first, which is not applicable here since only one stage was performed.

E. 85B2-335 is not a valid CPT code for Mohs surgery.

Thus, the correct answer is B. 17311, 17315, which accurately reflects a single-stage Mohs surgery with six tissue blocks on the arm.

For ERCP, CPT coding follows the rule that thetherapeutic ERCP code includes the diagnostic ERCP workperformed during the same session. In this case, the key performed service isstent insertion into the biliary duct, which is captured by43274(ERCP with placement of endoscopic stent into biliary or pancreatic duct). You donotseparately report the diagnostic ERCP code43260when the therapeutic service (stent placement) is performed, because the diagnostic component is considered part of the overall ERCP service. Code43276is used forstent removal and/or exchange, which is not described here. Option D is incorrect because it pairs another ERCP service with stent placement, and the scenario does not support multiple distinct ERCP therapeutic services beyond stenting. CPC exam tip: when a single ERCP session includes diagnostic evaluation plus a therapeutic intervention, report themost definitive therapeutic ERCP code—here,43274.

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.

99222 = Initial hospital inpatient care, moderate MDM

Extensive diagnostic workup → moderate complexity

Final diagnosis established during admission

Diagnosis Coding:

G00.9 – Bacterial meningitis, unspecified

Do not code symptoms (fever, neck pain) once definitive diagnosis is confirmed

Why others are incorrect:

99284 – ED visit

99264 – Inpatient consultation (deleted code)

Symptom-only diagnosis codes inappropriate

The place of service code 22 is used for services performed in an outpatient hospital setting, including outpatient surgical floors. This code indicates that the procedure was done in a hospital but not requiring an inpatient admission.

AMA ' s CPT® Professional Edition (current year), Place of Service Codes.

The procedure involves a laparoscopic partial colectomy where the surgeon removes the proximal colon and terminal ileum, then reconnects the cut ends of the distal ileum and remaining colon.

Procedure Description:

Laparoscopic partial colectomy.

Removal of the proximal colon and terminal ileum.

Anastomosis of the distal ileum and remaining colon.

CPT® Coding:

44204: Laparoscopy, surgical; colectomy, partial, with anastomosis.

ICD-10-CM Coding:

C18.2: Malignant neoplasm of ascending colon.

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

ICD-10-CM for corresponding diagnosis codes.

1. Procedure and CPT® Code Selection:

The scenario describes the fabrication of an ocular prosthesis due to a severe injury to the left eye. A prosthesis made from silicon materials was created and customized to restore cosmetic appearance.

Code 21088 is the correct CPT® code for facial prosthesis involving materials, such as silicone, specifically designed to address anatomical loss in the eye region. This code accurately reflects the custom fabrication of a prosthesis to replace or augment damaged eye structures for aesthetic purposes.

2. Ruling Out Other Options:

Code 21077 applies to the prosthetic augmentation or replacement of mandibular or maxillary bone, not ocular prostheses, so it does not apply here.

Code 21080 covers the fabrication of facial prosthetics but is not specific to the ocular area and is more generalized. Given the focused nature of the eye, 21088 is more appropriate.

Code 21086 pertains to the creation of orbital prostheses (used for areas surrounding the eye) but not specifically for an ocular prosthesis. Since this scenario involves an intraocular replacement, 21088 is the most precise choice.

3. AAPC and CPT® Guidelines:

According to AAPC guidelines, using codes for facial prosthetics requires matching the specific anatomical site and purpose of the prosthesis. CPT® 21088 is directly applicable to prosthetic replacements within the ocular region, making it the best fit.

Thus, based on the CPT® guidelines and coding standards, the verified answer is C. 21088.

1. Procedure and CPT® Code Selection:

The patient received IV hydration therapy with normal saline, which lasted for 1 hour and 30 minutes.

CPT® Code 96360 is used for initial IV hydration for the first hour. This code applies to the first 31-60 minutes of hydration therapy.

CPT® Code 96361 is used for each additional hour of IV hydration. Since the hydration lasted 1 hour and 30 minutes, 96361 should be reported once to cover the additional 30 minutes after the initial hour.

2. Rationale for Excluding Other Options:

Code 96365 is for initial IV infusion for therapeutic, prophylactic, or diagnostic purposes, rather than hydration, and is not applicable in this case.

Code 96366 is used for additional therapeutic, prophylactic, or diagnostic infusions and does not apply to hydration services.

Option A (96360) would only cover the initial hour of hydration, missing the additional 30 minutes, which is appropriately coded with 96361.

3. AAPC and CPT® Coding Guidelines:

According to AAPC and CPT® guidelines, 96360 should be used for the first hour of IV hydration, and 96361 should be used for each additional hour or portion of an hour beyond the initial 60 minutes.

Therefore, the correct answer is D. 96360, 96361.

Facet joint injections (medial branch blocks/intra-articular depending on code family) are coded byspinal regionandnumber of levels. Thoracic facet injections use64490for thefirst level,64491for thesecond level, and64492for thethird and each additional level(within the thoracic region). This case includesthree thoracic levels: T2–T3 (1st), T3–T4 (2nd), and T4–T5 (3rd). Because the injections arebilateral, you applymodifier -50to each of the level codes per the answer set’s style. Fluoroscopic guidance isbuilt intothese injection codes under current CPT rules, so you donotseparately report a fluoroscopy code (such as 76000). Options B and C are forlumbar/sacralfacet injection families, not thoracic. Option A incorrectly doubles units rather than using the correct third-level add-on coding structure. Therefore,64490-50, 64491-50, 64492-50is correct.