CPC Exam Dumps - AAPC Certified Professional Coder Questions and Answers

When hypertension and chronic kidney disease (CKD) are documented together, ICD-10-CM assumes a cause-and-effect relationship.

I12.9 = Hypertensive chronic kidney disease with stage 1–4 CKD

N18.2 = CKD stage 2

I12.0 is only for CKD stage 5 or ESRD, which does not apply here.

Therefore, the correct code combination is I12.9, N18.2.

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

1. Procedure and CPT® Code Selection:

The procedure described is a craniectomy to access and remove a supratentorial intracerebral hematoma using a suction device.

CPT® Code 61314 is specific for a craniectomy or craniotomy for evacuation of a hematoma, supratentorial (within the upper portion of the brain), and includes any required dural repair and closure. This code precisely describes the procedure performed to remove the hematoma.

2. Rationale for Excluding Other Options:

Code 61154 is used for a burr hole procedure for the evacuation of a hematoma, which is a less invasive approach and does not involve a craniectomy.

Code 61313 is for a craniectomy or craniotomy to evacuate an infratentorial hematoma, which is located in the lower portion of the brain (posterior fossa) and is not applicable here.

Code 61312 is for evacuation of an epidural or subdural hematoma and does not apply to an intracerebral hematoma as described in this case.

3. AAPC and CPT® Coding Guidelines:

According to AAPC guidelines, 61314 is the appropriate code for craniectomy procedures aimed at removing supratentorial intracerebral hematomas, as it covers the full scope of the documented procedure.

Thus, the correct answer is A. 61314.

S06.0X1A = Concussion with brief LOC

V40.5XXA = Driver injured in collision with fixed object

V47.5XXA = Car accident, driverExternal cause codes correctly describe mechanism and role.

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.

In this encounter, the correct coding order follows ICD-10-CM guidelines for coding multiple conditions when AIDS (B20) is documented, as it takes precedence. The patient's diagnosis of AIDS, documented with code B20, is reported as the primary diagnosis since it is a chronic condition. The M17.31 code is used to document unilateral primary osteoarthritis of the right knee, unrelated to AIDS but causing the patient's knee pain.

Explanation of each answer choice:

A. B20, M17.31: Correctly lists AIDS (B20) as the primary diagnosis and osteoarthritis of the right knee (M17.31) as the secondary diagnosis.

B. Z21, M08.861: Z21 represents asymptomatic HIV, not AIDS, which is incorrect here, and M08.861 is the code for juvenile idiopathic arthritis, not relevant in this case.

C. M17.11, B20: Incorrect as M17.11 is for unilateral primary osteoarthritis of the right knee, not left, and does not prioritize B20 as required.

D. M17.31, B20: Incorrect because it does not list B20 as the primary diagnosis, which is necessary per coding guidelines when AIDS is documented.

Thus, the correct answer is A. B20, M17.31.

65420 = Excision or transposition of pterygium without graft

LT = Left eye

H11.002 = Pterygium of left eye

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.

Procedure Coding (CPT®):

59821 – Induced abortion, by vaginal suppository, amniotic fluid injection, or other medical means

Used for fetal demise at ≥14 weeks gestation

Labor was medically induced and fetus delivered

Diagnosis Coding (ICD-10-CM):

O36.4XX0 – Maternal care for intrauterine death, not applicable or unspecified

Correct maternal record diagnosis

Z3A.19 – 19 weeks gestation

Required per ICD-10-CM guidelines for obstetric encounters

Why Other Options Are Incorrect:

A / D – ICD-9 code (002.1) is invalid

C – Missing required gestational age code

In CPT® Surgery Guidelines, a "separate procedure" code is used to identify a service that is typically performed as part of a larger procedure and should not be coded separately when it is an integral component of that primary service. However, it may be reported independently if it is performed alone or is unrelated to the primary procedure.

A. is true because a separate procedure may be reported if it is performed independently or is unrelated to the primary procedure.

B. is true, as "separate procedure" codes are not reported in addition to the code for the primary procedure when they are part of the total procedure.

C. is correct because "separate procedure" designation indicates that the service is often part of a more comprehensive procedure but can be reported separately when performed alone.

D. is false because modifier 79 is not used for unrelated "separate procedures." Instead, modifier 59 is typically used to indicate a "distinct procedural service" when reporting a separate procedure that is unrelated to the primary service.

Therefore, the correct answer is D. To identify a service designated as a "separate procedure" that is reported with an unrelated primary service, append modifier 79 to the code.