CPC Exam Dumps - AAPC Certified Professional Coder Questions and Answers

This is a subsequent nursing facility care visit.

MDM Analysis (2021+ E/M Guidelines):

Problems: Multiple chronic conditions → Moderate

Data: 4 labs + telemetry → Moderate

Risk: Prescription drug management → Moderate

99309 – Subsequent nursing facility care, moderate MDM

Why others are incorrect:

99307 / 99308 – Low complexity

99305 – Initial nursing facility care

An ED visit involvingNSTEMIwith abnormal troponin, EKG confirmation, and escalation to cardiology for admission representshigh acuityand high risk of morbidity/mortality, supporting the highest-level ED E/M in typical CPC exam scenarios:99285. The definitive ED diagnosis isNSTEMI, which is coded asI21.4. When a definitive diagnosis is established (NSTEMI), you generally do not separately code the presenting symptomchest pain (R07.9)as an additional diagnosis unless the symptom is unrelated or specifically required; here it is the presenting symptom attributable to the MI and not separately necessary. Options A and C use inpatient consult codes (99254/99255) rather than an ED E/M code and are inappropriate for the ED provider’s service. Option D understates the acuity and incorrectly includes symptom coding as if no definitive diagnosis were made. Therefore, the correct answer is99285 with I21.4.

11765 = Excision of nail fold (wedge excision), ingrown toenail

TA = Left great toe

Other codes are incorrect:

11730 = Partial nail avulsion

11750 = Nail excision

11755 = Biopsy

Correct answer: 11765-TA

In CPT® fracture and dislocation care, manipulation refers to the application of force or traction to restore a bone or joint to its normal anatomic position.

This is a key distinction between with manipulation and without manipulation, which directly affects CPT code selection (e.g., 23505 vs. 23500).

Manipulation may be performed closed (no incision) or open (with incision).

1. E/M Code Category Selection:

The patient was placed in observation care on 12/2/20XX for an acute asthma exacerbation and stayed in observation for a total of 16 hours, with discharge occurring on 12/3/20XX.

The appropriate E/M category for patients in observation care for a period that includes both admission and discharge on separate calendar dates is "Hospital Inpatient or Observation Care Services", with specific codes for admission and discharge on different dates.

2. Code Range and Specific Codes:

Code Range 99234-99236 applies to cases where observation care includes both admission and discharge, particularly when they occur on different calendar days and the total duration of care is under 24 hours.

For discharge on the subsequent day, 99238-99239 (Hospital Inpatient or Observation Discharge Services) applies, depending on the time spent on discharge.

3. Rationale for Excluding Other Options:

Option B and Option D include Initial Hospital Inpatient or Observation Care codes (99221-99223), which are typically used for admissions to inpatient care rather than for observation care scenarios as presented here.

Option C incorrectly combines Subsequent Inpatient or Observation Care codes (99231-99233), which are used for follow-up days rather than discharge services.

4. AAPC and CPT® Coding Guidelines:

According to CPT® guidelines, the 99234-99236 code range is used when observation care requires both admission and discharge on different dates, and 99238-99239 is appropriate for discharge services.

Therefore, the correct answer is A. Hospital Inpatient or Observation Care Services (Including Admission and Discharge Services) (99234-99236) and Hospital Inpatient or Observation Discharge services (99238-99239).

99222: This code is used for initial hospital care, per day, for the evaluation and management of a patient, which requires a detailed or comprehensive history, a detailed or comprehensive examination, and medical decision making of moderate complexity.

The documentation shows a detailed history (including HPI, ROS, PMH, SH, and FH) and a detailed examination (covering multiple organ systems). The medical decision making involves the management of an acute asthma exacerbation, which includes admitting the patient to observation status, administering oral steroids, and planning for further diagnostic testing.

CPT® Professional Edition, AMA

Intermediate repair includes single-layer closure with extensive cleaning, debridement, or removal of debris, or layered closure of one or more deeper layers.

Option B meets the definition due to extensive cleaning and debris removal.

Option C would be a complex repair.

Option D is a simple repair.

Extensive undermining alone does not define intermediate repair.

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.

33779 = Arterial switch operation (definitive repair)

33955 = Open central cannulation for ECMO

33985 = ECMO management

Modifier -58 = staged/related procedure

73522 = Bilateral hips with pelvis, 3–4 views

Modifier -76 = Repeat procedure by the same physician

Modifier -51 identifies multiple procedures