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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q15-Q20):

NEW QUESTION # 15
The gastroenterologist performs a simple excision of three external hemorrhoids and one internal hemorrhoid, each lying along the left lateral column. The operative report indicates that the internal hemorrhoid is not prolapsed and is outside of the anal canal.
What CPT and ICD-10CM codes are reported?

A. 46250, K64.0, K64.9
B. 46320, 46945, K64.0, K64.9
C. 46250, 46945, K64.0, K64.4
D. 46255, K64.0, K64.4

Answer: D

Explanation:
CPT code 46255 describes the excision of both internal and external hemorrhoids, which matches the procedure described. The ICD-10-CM codes K64.0 (First degree hemorrhoids) and K64.4 (Residual hemorrhoids) describe the conditions treated.
References:
* AMA's CPT Professional Edition (current year), Code 46255
* ICD-10-CM (current year), Codes K64.0, K64.4

NEW QUESTION # 16
Regarding the CPTSurgery Guidelines for a surgical code designated as a "Separate Procedure", which statement is FALSE?

A. A service that is commonly carried out as an integral component of a total service or procedure is identified by the inclusion of the term "separate procedure."
B. When a procedure is designated as a separate procedure and carried out independently or considered to be unrelated from the total primary service, it may be reported.
C. To identify a service designated as a "separate procedure" that is reported with an unrelated primary service, append modifier 79 to the code.
D. The codes designated as "separate procedure" should not be reported in addition to the code for the total procedure or service of which it is an integral component.

Answer: C

Explanation:
In CPTSurgery 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.

NEW QUESTION # 17
A patient suffering from idiopathic dystonia is seen today and receives the following Botulinum injections:
three muscle injections in both upper extremities and seven injections in six paraspinal muscles.
How are these injections reported according to the CPT guidelines?

A. 64642, 64643, 64647
B. 64642-50, 64643-50, 64647
C. 64644, 64647 x 7
D. 64642 x 3, 64642 x 3, 64647 x 7

Answer: B

Explanation:
For the injections, CPT code 64642 is used for chemodenervation of one extremity; 64643 for each additional extremity, and 64647 for chemodenervation of muscles in the paraspinal region. The modifier -50 is added to 64642 and 64643 to indicate bilateral procedures. According to CPT guidelines, when multiple sites are treated, each site is coded separately, and appropriate modifiers are used.References: AMA's CPT Professional Edition (current year), Surgery section, Nervous System.

NEW QUESTION # 18
A 10-year-old had a cochlear implant in his left ear few weeks ago. Today he sees the audiologist to initialize and program the implant.
What CPTcode is reported?

A. 0
B. 1
C. 2
D. 3

Answer: C

Explanation:
1. Procedure and CPTCode Selection:
The patient had a cochlear implant placed in the left ear and is now seeing the audiologist for initialization and programming of the implant.
CPTCode 92603 is specific for initial programming of a cochlear implant for patients younger than 12 years old. This includes the setup and initial adjustments required for the cochlear implant, making it the correct code.
2. Rationale for Excluding Other Options:
Code 92626 is used for evaluating auditory function with the cochlear implant, focusing on assessment rather than programming, and is therefore incorrect for this programming session.
Code 92630 is for aural rehabilitation following cochlear implant, which does not apply to the programming
/initiation stage.
Code 92604 is for subsequent programming sessions after the initial programming and is therefore not applicable for the first-time programming.
3. AAPC and CPTCoding Guidelines:
According to AAPC guidelines, 92603 is the appropriate code for initial programming of a cochlear implant in children under 12 years of age.
Therefore, the correct answer is D. 92603.

NEW QUESTION # 19
A 46-year-old female is admitted to the hospital by her urologist for a left ureteral calculus. The urologist visits her again on day two and performs a low for number and complexity of problems addressed, minimal for amount and/or complexity of data to be reviewed and analyzed, and moderate for risk of complications.
What E/M service is reported for day two?

A. 0
B. 1
C. 2
D. 3

Answer: C

Explanation:
1. E/M Service Code Selection:
On day two, the urologist provided an evaluation and management (E/M) service for a hospitalized patient with a low level for the number and complexity of problems addressed, minimal complexity for data reviewed, and moderate risk of complications.
CPTCode 99232 is for a subsequent hospital care E/M service with a level of "Expanded Problem Focused" history and examination, with Medical Decision Making (MDM) of Moderate complexity. This matches the description provided, as the MDM includes a low number of problems, minimal data, and moderate risk.
2. Rationale for Excluding Other Options:
Code 99233 is for a subsequent hospital care visit with high complexity MDM (e.g., addressing a high number of problems or higher levels of data review), which does not align with the moderate risk described here.
Code 99221 is for initial hospital care, not a subsequent visit.
Code 99231 represents a lower level of subsequent hospital care with straightforward or low complexity MDM, which does not meet the moderate risk criteria in this scenario.
3. AAPC and CPTCoding Guidelines:
AAPC and CPTguidelines indicate 99232 as appropriate for subsequent hospital visits with moderate MDM, such as this visit with moderate risk but minimal data complexity.
Therefore, the correct answer is B. 99232.

NEW QUESTION # 20
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