Prepare Important Exam with AAPC-CPC Exam Dumps(2026)
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NEW QUESTION # 77
During surgery to remove a malignant melanoma from the intestinal tract, one frozen section is sent for pathological consultation to confirm an adequate excision of the margins. A second specimen is also sent, which requires frozen sections on two tissue blocks. What CPT code(s) should the pathologist report?
- A. 88331, 88331, 88332
- B. 88329, 88331, 88332, 88332
- C. 88331, 88332, 88332
- D. 88331, 88332
Answer: A
Explanation:
CPT code 88331 is used to report only a single specimen. In this scenario, there are Evo separate specimens being sent to the pathologist. The first specimen, with one frozen section, is reported with CPT code 88331. The second specimen has tv.ro tissue blocks with frozen sections, thus represented by coding 88331 for the first tissue block, followed by 88332 for the additional tissue block CPT code 88329 is inclusive to 88331 and should not be reported separately.
NEW QUESTION # 78
If a provider documents in an assessment that a patient is obese, but the BMI extracted from the chart is consistent with morbid obesity, what should be reported on the claim?
- A. Obesity
- B. Morbid obesity and the appropriate BMI
- C. Obesity and the appropriate BMI
- D. Morbid obesity
Answer: C
Explanation:
The diagnosis is always based on the provider's documentation, which in this case would be obesity. Coding guidelines also state that if there is a reportable diagnosis related to weight, "the BMI can be assigned from documentation of someone other than the patient's provider, such as nursing notes."
NEW QUESTION # 79
CPT code 99135 is an example of a qualifying circumstance.
- A. True
- B. False
Answer: A
Explanation:
The statement is true. When it comes to reporting anesthesia services, qualifying circumstances are factors that put a patient at an unusually high health risk. A qualifring circumstance is reported with CPT codes 99100-99140, which are listed separately, in addition to the primary anesthesia code. If reporting one of these add-on codes, documentation must be submitted to support the necessity of such services.
NEW QUESTION # 80
A surgeon performs a posterior fusion on the L2-L5 of the spine due to degenerative disc disease. CPT and ICD-IOOI code(s) should be reported?
- A. 22800, M51.37
- B. 22533, M51.37
- C. 22612, 22614x 3, M51.36
- D. 22612, 22614x2, MSI.36
Answer: D
Explanation:
The code for a joint fusion using a posterior approach is 22612. In this scenario, there are three fusion levels: L2-L3, L3-L4, and L4-L5. Following the primary code, 22614 would be billed tv;ice and with no modifier because it is an add-on code. ICD-IO-CM code M51.37 is for degenerative discs in the lumbosacral region; however, L2-L5 is considered the lumbar region.
NEW QUESTION # 81
A female patient experiencing swollen lymph nodes is seen for a follow-up to discuss the results of her open axillary biopsy that occurred last week The results are positive for diffuse large cell lymphom a. The patient is given multiple treatment options, including success rates, risks, and side effects. She opts to begin radiation treatment next week. What CPT and ICD-IO-CM codes should the provider report for this visit?
- A. 99214, (285.94
- B. 99213-24, C83.84
- C. 99214-24, 25, 99024, C83.34
- D. 99024, C85.84
Answer: C
Explanation:
To determine which services to report for this encounter, it is important to understand which services were rendered on the last. The patient had an open biopsy of the axillary lymph nodes (CPT 38525) last week This procedure has a postoperative 90-day global period. This means that any related services provided to the patient within that time are reported with zero-charge CPT
99024. Services such as biopsy results, follow-up incisional care, and any postoperative complications are all inclusive to this code. As the patient was given biopsy results, CPT 99024 should be reported for this encounter. However, CPT guidelines also state that when it comes to diagnostic procedures, "care of the condition for which the diagnostic procedure was performed...
is not included and may be listed separately." In this case, that care begins with the discussion of treatment options with their identified risks, and the decision to begin radiation. This level of moderate medical decision-making is reported by means of E/M CPT 99214. Modifier 24 is appended to indicate that is it unrelated to postoperative care, and modifier 25 is appended to indicate it is separately identifiable to CPT 99024. ICD-IO-CM crosswalk for lymphoma, diffuse large cell, is C83.34.
NEW QUESTION # 82
An established patient presents complaining of clumpy, white discharge for 3 days. A vaginal exam reveals an old tampon, which is removed. Diflucan is sent to the pharmacy, instructions given, and the patient is told to follow up in I week. How would the provider code the visit?
- A. 99213,N89.8, T19.2LXA
- B. 57415, T19.2XXA, N89.8
- C. 57415, 99212-25, T19.2kVA
- D. 99213, T19.2XXA, N89.8
Answer: D
Explanation:
Although a foreign body was removed, 57415 in answers A and B cannot be reported because anesthesia was not used. The documentation supports low-level medical decision making, so the appropriate E/M would be 99213. VVhen comparing answers C and D, bear in mind that ICD-IO-CM requires sequencing "the underlying condition first, followed by the manifestation."
NEW QUESTION # 83
A patient opts to replace his semi-rigid penile prosthesis with a multicomponent, inflatable penile prosthesis. What CPT code(s) should the urologist report if this was completed in one encounter?
- A. 0
- B. 1
- C. 54415, 54405-51
- D. 54405, 54415-51
Answer: A
Explanation:
Penile prosthesis procedure codes are based on the type of prosthesis being used. In this scenario, a semi-rigid prosthesis is being replaced by a multicomponent inflatable one. Currently, there are no CPT codes that encompass the removal of one type of prosthesis and insertion of another type. The most common course of action might be to code the removal and insertion separately and amend a multi-procedural modifier on the secondary code. However, CPT 54415 indicates that the prosthesis removed was not replaced by another, which is an inaccurate description of services rendered. In this case, only the insertion (CPT 54405) should be reported because it has the highest RVU value.
NEW QUESTION # 84
The base unit for anesthesia CPT code 00600 is 10 units. If an anesthesiologist spends 105 minutes in the procedure room with a patient, how many units should be reported for reimbursement?
- A. 11 units
- B. 17 units
- C. 14 units
- D. 12 units
Answer: B
Explanation:
To calculate the total number of units, it is important to understand that anesthesia time is measured in 15-minute intervals (or in fractions thereof). In this scenario, take the total number of minutes spent on the procedure (105) and divide it by 15. The total number of time units is 7. The time units are then added to the base unit (10) for a total of 17 units.
NEW QUESTION # 85
Code the following note:
A 43 -year-old new female patient with a history of type I diabetes was referred to my office by Dr. White, her primary care physician. Patient complains of blurred vision that began 2 weeks ago, however, reports compliance to a strict, healthy diet and to prescribed 10 mg of dexamethasone every day for 1 month. Given that the only change appears to be the dexamethasone, I suspect the blurred vision is an adverse reaction and will decrease the dosage to 5 mg per day. Patient will follow up with me in 1 week if symptoms persist.
Total time spent on todays encounter is 30 minutes.
- A. 99204, HS3.8, ElO.9
- B. 99203, H53.8, ElO.69
- C. 99244, H53.8, T38.OX5A, ElO.9
- D. 99243, H53.8 ElO.39
Answer: A
Explanation:
When choosing between an outpatient evaluation and management code or a consultation service code, bear in mind the following four elements: request, reason, report, and intent. Although the first three elements are documented and support a consultation service, the endocrinologist is assuming immediate care of the patienYs condition. In this case, the visit is not a consultation but a new transfer of care, which is encompassed by CPT codes 99202-99205. For this visit, coding based on medical decision-making as opposed to the total time spent on the encounter that day would be more advantageous. This is because coding based on time would lead a coder to report CPT code
99203 or a low level of medical decision making, whereas the medical decision-making is actually moderate, represented by CPT code 99204.
The documentation reflects that the blurry vision is most likely due to the dexamethasone:
therefore, a causal relationship is not assumed betvveen the two conditions and should not be coded as such. Because an adverse reaction is suspected and not confirmed, it should not be coded. This general rule does not apply to inpatient encounters.
NEW QUESTION # 86
A surgeon performs a craniectomy to excise a meningioma located above the tentorium cerebelli. During the procedure, an extradural hematoma is noted and removed via the same craniectomy site. How should the surgeon report the procedure?
- A. 61512, 61312-59
- B. 61312-22
- C. 61519, 61314-51
- D. 0
Answer: D
Explanation:
Surgical procedures on the nervous system are identified by where inside the skull they occur. A meningioma is being excised from above the tentorium cerebelli, otherwise known as supratentorial (CPT 61512). The removal of an extradural hematoma is inclusive to the primary craniectomy code because the finding is incidental and the same surgical site is used for its removal.
If the surgeon had to create a separate incision to access the extradural hematoma, that excision could be reported separately with modifier 59.
NEW QUESTION # 87
CPT code 11102 is a column 2 code that has an NCCI edit of 1 when paired with CPT code 11402. How would this be interpreted?
- A. The two codes are exclusive of each other and can never be billed together.
- B. If being billed together, only report one unit of each.
- C. The two codes are inclusive of each other and can never be billed together.
- D. The two codes can be billed together with an appropriate modifier.
Answer: D
Explanation:
NCCI stands for National Correct Coding Initiative and was created by CMS to prevent unbundling and prevent incorrect payments. Column one represents a correct code when listed next to column two. There are three edits listed with the combination of the two columns: 0, 1, and
9. Edit 0 means that the two codes should never, under any circumstance, be reported together. Edit
1 means that the procedures may be coded together with the use of a modifier. Edit 9 means that the edit does nota I .
NEW QUESTION # 88
A female patient with type II diabetes, asthma, and hypertension is admitted with complaints of chest pain. Testing rules out heart attack and other underlying conditions as the cause. Which diagnosis codes should be listed on the discharge note?
- A. Z03.89
- B. R07.9
- C. R07.9, Ell.9, J45.909, 110
- D. Z03.89
Answer: C
Explanation:
The primary diagnosis on an inpatient record would be the primary reason the patient was admitted. In this case, because a definitive diagnosis could not be confirmed, the symptom of chest pain would be selected instead. The previously confirmed chronic conditions would also be coded because they affect the management of inpatient care. Diabetes would be coded to an unspecified code because the term "with" implies a causal relationship between the conditions that is not implicitly documented. Per ICD-IO-CM guidelines, a rule-out code is not assigned when "any signs or symptoms related to the suspected condition are present."
NEW QUESTION # 89
A physician documents a comprehensive electrophysiologic evaluation with an unsuccessful attempted induction of arrhythmi a. Upon review, the bundle-of-His recording is missing. What code(s) should be reported?
- A. 0
- B. 93620-52
- C. 93610, 93602, 93612, 93603, 93618
- D. 93619-52
Answer: C
Explanation:
To bill a comprehensive electrophysiologic evaluation (93619-93622), the following five components must be documented: right atrial pacing (93610), right atrial recording (93602), right ventricular pacing (93612), right ventricular recording (93603), and bundle-of-His recording (93600). If the documentation does not support all five components, each study must be reported separately, as opposed to billing the procedure with a "reduced services" modifier. The exception to this rule would be if an add-on procedure were performed and required to be reported in addition to the comprehensive electrophysiologic evaluation. In this case, however, the attempted induction arrhythmia (93618) is not an add-on code and can be reported in addition to the primary procedures.
NEW QUESTION # 90
Which is NOT a type of injection through which contrast is administered?
- A. Intravascular
- B. Intrathecal
- C. Intra-articular
- D. Intramuscular
Answer: D
Explanation:
Per CPT guidelines, administration of contrast materials is given through the following routes: intravascular, intra-articular, and intrathecal. Alternate routes also include orally and/or rectally; however, the "contrast administration alone does not qualify as a study 'with contrast'"
NEW QUESTION # 91
A physician performs an esophagogastroduodenoscopy on a patient who has GERD. A single tissue sample is obtained from the upper gastrointestinal tract using biopsy forceps. A reflux test was also done and a bravo capsule temporarily attached to the esophageal wall to monitor pH levels. What procedures should the physician report?
- A. 43235, 91034
- B. 43239, 91035
- C. 43239, 91034
- D. 43235, 91035
Answer: B
Explanation:
To report an esophagogastroduodenoscopy, see CPT code range 43233-43259. In this scenario, the procedure is not considered diagnostic (43235) because the physician is stating the patient has GERD. Additionally, the tissue sample was obtained by means of biopsy forceps and not by brushing or washing. The secondary procedure is a reflux test and an esophageal pH test by means of a bravo capsule, which evaluates the level of acid refluxing into the esophagus. Although CPT 91035 doesn't specifically state a capsule in the description of the code, it would fall under a
"mucosal attached" placement. A nasal catheter was not used, so reporting CPT 91034 would be incorrect.
NEW QUESTION # 92
A 74-year-old patient presents with a fever. She is admitted into observational care after her labs confirm a diagnosis of pneumoni a. She has a medical history of being HIV positive. How should this be reported?
- A. 99235, B20, 118.9
- B. 99236, 118.9, B20
- C. 99223, 118.9, B20
- D. 99222, B20, 118.9
Answer: D
Explanation:
Hospital inpatient and observation care services (99221-99236) are selected based on the level of medical decision-making. In this scenario, reporting a code from the initial hospital inpatient and observation care services would be most appropriate (99221-99223), as the documentation indicates the patient is being admitted. When leveling this service, consider that the patient has an acute illness with systemic symptoms (pneumonia) and a stable, chronic illness (HIV). Labs were reviewed to confirm the diagnosis, and a decision was made to admit the patient into observation. Therefore, the final level of medical decision-making is moderate, making the E/M code 99222. Even though pneumonia is the reason for admission, ICD-IO-CM guidelines stipulate that a confirmed HIV diagnosis takes precedence in sequencing when the reason for admission is HIV related.
NEW QUESTION # 93
A complete pulmonary function test using a body plethysmograph is performed on a patient in conjunction with spirometry. After reviewing the results, a provider suspects the presence of an obstructive disease and administers a bronchodilating medicine just prior to repeating the test to reevaluate the expiratory flow rate. Which code(s) should be reported?
- A. 99212-25, 94726, 94060-76
- B. 94726, 94060
- C. 94726, 94060-51
- D. 99212-25, 94726,94010-51, 94060-51
Answer: B
Explanation:
Answers A and B can be eliminated because the complete pulmonary function test includes interpretation of the test results: therefore, the review ofthis would not be considered separately identifiable. The CPT code 94060 includes spirometry before and after a bronchodilator has been administered, so a separate spirometry code (94010) would be inappropriate. Last, a modifier is not needed because the procedures are routinely done in conjunction with each other.
NEW QUESTION # 94
Modifier 50 is not an appropriate modifier to append on CPT code 52000.
- A. True
- B. False
Answer: A
Explanation:
The statement is true. In general, modifier 50 is not appended on cystourethroscopies because human anatomy has only one bladder. However, if the descriptor includes "with ureteral catherization," the procedure can be performed tvvice and billed once with modifier 50 because there are two ureters. CPT 52000 does not include this descriptor.
NEW QUESTION # 95
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