CPC Exam Dumps - AAPC Certified Professional Coder Questions and Answers

24300 = Manipulation of elbow under anesthesia

Anesthesia codes (01710) are not reported by the surgeon, only by the anesthesiologist

24605 is for closed treatment of elbow dislocation, which is not documented

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).

The prefix “sub-” means below or under.

Common examples include subcutaneous (below the skin) and sublingual (under the tongue).

This is a core concept tested under medical terminology on the CPC exam.

When a prior malignancy has been eradicated and the patient is no longer receiving treatment for the primary site, ICD-10-CM directs you to use apersonal history of malignant neoplasmcode rather than an active primary cancer code. Here, the breast cancer was treated successfully last year and no further therapy was required, so the breast cancer ishistory, not active. The new current condition ismetastatic cancer to the liver, which is coded as asecondary malignant neoplasm of liver and intrahepatic bile duct (C78.7). Because the primary breast cancer is not documented as active or under current treatment, you donotcode an active breast malignancy (C50.-). Instead, you addZ85.3 (personal history of malignant neoplasm of breast)to show the prior cancer history relevant to the current metastatic disease. Option A incorrectly codes a primary liver cancer. Option C incorrectly codes active breast cancer. Option D codes metastasis to the adrenal gland, not the liver.

According to the CPT® guidelines for Repair (Closure), an intermediate repair includes the closure of a wound with one or more layers of subcutaneous tissue and superficial fascia in addition to the skin (epidermal and dermal) closure. It also involves extensive cleaning of the wound, which includes copious irrigation and the removal of particulate matter. This description fits the scenario provided in the question.

AMA ' s CPT® Professional Edition, Repair (Closure) guidelines.

The procedure involves a right nephrectomy with partial ureterectomy for a nonfunctioning right kidney with ureteral stricture.

Procedure Description:

Right nephrectomy (removal of the kidney).

Partial ureterectomy (removal of part of the ureter).

CPT® Coding:

50220: Nephrectomy, including partial ureterectomy, any open approach.

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

CPT® Assistant for detailed coding guidelines on nephrectomy procedures.

CPT70450describes aCT of the head/brain without contrast. When aradiology facilityperforms the technical portion (scanner, technologist, supplies) and theprovider only interprets and reportsthe study, the provider bills theprofessional componentusing modifier-26. That is exactly what the vignette describes: the radiology facility performed the scan, and the provider received images and provided the interpretation—so the provider reports70450-26. Reporting70450alone would imply billing the global service (professional + technical), which would be incorrect because the provider did not supply the equipment/technical resources. Modifier-TCis used to bill thetechnical component, which would be reported by the facility, not the interpreting provider in this scenario. Modifier-26-TCtogether is not appropriate because it would contradict itself (professional and technical simultaneously). CPC exam tip: always determinewho performedthe technical work andwho interpreted; then use-26for interpretation-only billing.

The National Correct Coding Initiative (NCCI) was developed by CMS to:

Prevent unbundling

Define procedure-to-procedure (PTP) edits

Identify when modifiers (such as -59) may be appropriate

NCCI edits are critical for accurate CPT® coding and proper reimbursement.

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.

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.