CPC Exam Dumps - AAPC Certified Professional Coder Questions and Answers

1. Procedure and CPT® Code Selection:

The scenario describes a labial gland biopsy of the salivary gland, performed in the office with a local anesthetic. The provider made an incision in the lower labial mucosa and took tissue samples from the salivary gland for biopsy.

Code 42400 is the correct CPT® code for a biopsy of a salivary gland. This code is specific to a biopsy without a more extensive excision or major surgery, aligning perfectly with the scenario of sampling salivary gland tissue.

2. Ruling Out Other Options:

Code 42408 is for the excision of a deep lobe of a parotid gland, which is a more extensive procedure than a simple biopsy and does not apply to this case.

Code 42405 is for the removal of an entire submandibular gland, which is a full excision and not applicable here.

Code 42450 is used for the removal of a sublingual gland, not for a biopsy of the labial salivary gland.

3. AAPC and CPT® Coding Guidelines:

AAPC and CPT® guidelines direct coders to use 42400 for minor biopsies of salivary gland tissue, particularly when only tissue samples are taken for diagnostic purposes, as described in this case.

Based on CPT® coding guidelines, the correct answer is C. 42400.

A41.52 = Sepsis due to Enterococcus.

When the organism is specified, a combination code is used.

No additional code for severe sepsis is documented.

1. Procedure and CPT® Code Selection:

The test performed is a therapeutic drug assay to measure the concentration of vancomycin in the patient’s blood.

CPT® Code 80184 is specific for a therapeutic drug assay of vancomycin, making it the correct code to report for this test.

2. Rationale for Excluding Other Options:

Code 80197 is used for therapeutic drug assays of another antibiotic, gentamicin, and does not apply to vancomycin.

Code 80202 is for measuring the levels of cyclosporine, another drug, and is not relevant to vancomycin.

Code 80299 is for an unlisted therapeutic drug assay, which is unnecessary since a specific code (80184) exists for vancomycin.

3. AAPC and CPT® Coding Guidelines:

According to AAPC guidelines, specific therapeutic drug assay codes, like 80184 for vancomycin, should be used when available.

Therefore, the correct answer is C. 80184.

Formultiple gestation vaginal deliveries, CPT global obstetric care is generally reported as the global code for thefirst fetus(here59400: antepartum + vaginal delivery + postpartum), and an additionaldelivery-onlycode for each additional fetus (here59409) with an appropriate modifier (commonly-51in exam-style choices). You donotreport59400 twicebecause the global package is not duplicated for each baby; only the additional delivery service is added for the additional fetus. Diagnosis coding: this is atwin pregnancy, dichorionic/diamniotic, third trimester→O30.043. Delivery outcome for twins →Z37.2, and weeks of gestation →Z3A.36. Because delivery occurred at36 weeks(preterm threshold is <37 weeks), and the options use thepreterm labor with preterm deliverycategory with fetus identifiers, the correct pairing shown isO60.14X1 and O60.14X2(fetus 1 and fetus 2). Option D is the only one matching correct CPT multiple-delivery structure and appropriate diagnosis set.

Emergency department visit with high severity

99285 = High complexity ED E/M

Shave removal → CPT 11300–11313, not excision (11400–11646).

Face (nose) → 11310–11313

0.6–1.0 cm → 11311

Inflamed seborrheic keratosis → L82.0

CPT Code 43246: Esophagogastroduodenoscopy, with transoral insertion of intra-abdominal tube (e.g., gastrostomy or jejunostomy)

This code describes the attempted PEG tube placement.

Modifier -52: Reduced services. This modifier is appended because the procedure was aborted and the PEG tube was not successfully placed.

ICD-10-CM Code K94.29: Other specified disorders of digestive system

This code captures the patient's chronic feeding requirement, which is the reason for the attempted PEG tube placement.

ICD-10-CM Code K44.9: Diaphragmatic hernia without obstruction or gangrene

This code reports the small hiatal hernia that was found during the procedure.

In medical terminology,“-graph”refers to aninstrument used to record(or produce a record), while“-gram”refers to therecord/image produced, and“-graphy”refers to theprocess of recording. This set is frequently tested because the terms look similar. Example: anelectrocardiographis the instrument; anelectrocardiogram (ECG/EKG)is the tracing produced;electrocardiographyis the act of recording. The distractors are surgical suffixes:“-desis”typically indicates surgical binding/fusion, and“-rrhaphy”indicates surgical repair by suture. “Z-plasty” is a plastic surgery technique; “instrument used for Z-plasty” is not a standard suffix definition. For CPC-style questions, the safest approach is to memorize the trio:graph (instrument)/gram (record)/graphy (process). That pattern also helps with radiology terms (mammogram, angiography) and diagnostic testing vocabulary.

This is aninitial hospital/observation evaluation(first visit during the stay), so the correct code family is theinitial observation/inpatient E/Mlevel. The stem providestotal time = 85 minutesand also statesmoderate MDM. Under current E/M rules, you can select the code based oneither MDM or total time(when time is used, it includes the physician’s qualifying time on that date). The time of85 minutesfits the time range for99223(the highest initial hospital/observation level by time) even if MDM is described as moderate. The prolonged service add-on99418requires meeting the threshold beyond the primary code’s time before it can be added; with 85 minutes, you do not reach the additional increment needed to report 99418. Therefore, you report99223 only. CPC exam tip: when time is explicitly provided and is high, it often drives the level; do not add prolonged time unless the documented time clearly exceeds the primary code’s requirement by the necessary increment.

For a procedure involving the placement of a 6-French sheath and catheter into the coronary artery, advancing to the left ventricle, performing ventriculography with power injection of contrast agent, obtaining pressures in the left heart, and imaging the coronary arteries, the correct CPT® code is 93458. This code includes all the components of the described procedure.