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NEW QUESTION # 112
(A female patient underwent a mastectomy on herleft breastlast year due to breast cancer. The surgery was successful in eliminating the cancer and no further treatment was required. However, a recent diagnosis now includes cancer thatmetastasized to her liver. What ICD-10-CM coding is reported?)
- A. C22.9, C50.912
- B. C78.7, C50.912
- C. C78.7, Z85.3
- D. C78.7, C79.81
Answer: C
Explanation:
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.
NEW QUESTION # 113
An interventional radiologist performs an abdominal paracentesis using fluoroscopic guidance to remove excess fluid. The procedure is performed in the hospital. What CPT coding is reported?
- A. 49083,77001-26
- B. 49083.77002-26
- C. 0
- D. 1
Answer: C
Explanation:
49083 - Abdominal paracentesis, diagnostic or therapeutic; with imaging guidance This code includes imaging guidance (ultrasound or fluoroscopy).
Per CPT guidelines, do not separately report fluoroscopy or ultrasound guidance with 49083.
The procedure was performed in the hospital, but CPT coding does not change based on site of service.
Why Other Options Are Incorrect:
A (49082) - Used without imaging guidance
B / D - Imaging guidance codes (77001, 77002) are bundled into 49083 per CPT and NCCI edits Official CPT Guidance:
When a paracentesis is performed with imaging guidance, report 49083 only.
NEW QUESTION # 114
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 CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: B
Explanation:
1. Procedure and CPT Code 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.
CPT Code 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 CPT Coding 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 # 115
A patient who was experiencing severe abdominal pain underwent abdominal imaging and results showed several peritoneal tumors of various sizes.
The patient elected to have the tumors removed. An incision was made to access the intra-abdominal peritoneal cavity, where four tumors were identified, measured, and excised.
The largest was 2 cm, two were 1 cm each, and the smallest was 0.5 cm. Pathology report indicated the tumors were malignant.
What CPT and ICD-10-CM coding is reported7
- A. 49186. C76.2
- B. 49187, C76.2
- C. 49186. C48.2
- D. 49189. K66.8
Answer: C
Explanation:
Procedure Coding:
49186 - Excision or destruction of intra-abdominal tumors, 1-4 tumors
Four tumors excised # correct code selection
Size does not alter code selection once tumor count is determined
Diagnosis Coding:
C48.2 - Malignant neoplasm of peritoneum, unspecified
Pathology confirms malignancy
C76.2 is used for ill-defined sites, not appropriate when peritoneum is specified Why Other Options Are Incorrect:
B - 49187 is for 5 or more tumors
D - K66.8 = non-malignant peritoneal disorder
NEW QUESTION # 116
(A patient presents for evaluation of suspicious skin lesions. During the encounter, the provider performs:
* Incisional biopsy of adeep inflammatory lesionon the upper arm
* Punch biopsy of aseparate lesionon the forearm
* Shave biopsy of asuperficial lesionon the shoulder
Each biopsy is performed on a separate lesion for diagnostic purposes, and all specimens are submitted to pathology. What CPT coding is reported?)
- A. 11106, 11105, 11103
- B. 11106, 11104-51, 11102-51
- C. 11106, 11104, 11102
- D. 11106, 11105-51, 11103-51
Answer: C
Explanation:
CPT biopsy codes for the skin are selected bytechniqueand whether the biopsy istangential (shave), punch, or incisional. In this scenario, three different biopsy techniques are performed onthree separate lesions:
anincisional biopsyof a deep lesion (upper arm), apunch biopsy(forearm), and ashave biopsy(shoulder). The correct primary codes are11106(incisional biopsy, single lesion),11104(punch biopsy, single lesion), and11102 (tangential/shave biopsy, single lesion). Because each is a distinct lesion and a distinct technique, CPT coding uses the appropriatebase codesfor each technique rather than "add-on additional lesion" codes, and you do not automatically apply modifier-51in CPT-answer logic unless the question specifically tests payer/claim- processing conventions. The CPC exam typically expects the straightforward reporting of all three correct biopsy codes when performed on separate lesions with separate specimens submitted. Therefore, optionBis the best match.
NEW QUESTION # 117
(Patient is having an orchiectomy. Which part of the body is being performed on?)
- A. Prostate
- B. Testicle
- C. Epididymis
- D. Scrotum
Answer: B
Explanation:
The key is the root and suffix:orch/o(or orchi/o) refers to thetestis/testicle, and-ectomymeanssurgical removal.
Therefore,orchiectomyis the surgical removal of atesticle(one or both, depending on context). The distractors are nearby male reproductive structures that commonly appear in anatomy questions: thescrotumis the external sac that houses the testes (procedures there might be scrotoplasty or scrotal surgery, not orchiectomy). Theepididymisis the structure attached to the testicle where sperm mature and are stored (removal would be epididymectomy). Theprostateis a gland at the base of the bladder (removal would be prostatectomy). On the CPC exam, terminology questions often use anatomic proximity to tempt you into picking a "nearby" structure-always lock onto the combining form first (orch = testis), then confirm the procedure suffix (-ectomy = removal).
NEW QUESTION # 118
According to the Repair (Closure) CPT guidelines, what type of repair is reported when a single layer closure includes copious irrigation and extensive cleaning to remove particulate matter?
- A. Simple repair plus a code for irrigation
- B. Complex repair
- C. Simple repair
- D. Intermediate repair
Answer: D
Explanation:
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.References:
AMA's CPT Professional Edition, Repair (Closure) guidelines.
NEW QUESTION # 119
A 53-year-old male arrived at the ER due to severe ocular trauma to the right eye. He was at work on a metal drilling machine and a metallic item penetrates his right eyeball. A foreign body is in the posterior segment of the eye and corneal laceration with multiple posterior perforated sites were noted. He is brought back to the surgical suite. The surgeon removes the metallic foreign body using large retinal forceps. The laceration of the cornea is sutured and the provider also performs a pars plana lensectomy.
What is the CPTand ICD-10-CM codes are reported?
- A. 65235-RT, 66852-51-RT, 65275-51-RT. S05.51XA, W31.1XXA
- B. 65235-RT, 66852-51-RT, 65280-51-RT. S05.31XA, W31.0XXA
- C. 65265-RT, 66852-51-RT, 65280-51-RT, S05.51XA, W31.1XXA
- D. 65265-RT, 66852-51-RT, 65275-51-RT, S05.31XA, W31.0XXA
Answer: C
Explanation:
1. Procedure and CPTCode Selection:
The patient required surgical intervention for severe ocular trauma involving removal of a foreign body from the posterior segment of the eye, suturing of the corneal laceration, and a pars plana lensectomy.
CPTCode 65265 is for removal of a foreign body from the posterior segment of the eye without the use of a magnet. This code is appropriate for the removal of the metallic foreign body using retinal forceps.
CPTCode 66852 covers the pars plana lensectomy, which was performed as part of the surgical treatment.
CPTCode 65280 is used for repairing a corneal laceration with multiple perforations, which applies to the corneal suturing.
2. Modifiers:
Modifier RT is used to indicate that the procedures were performed on the right eye.
Modifier 51 is added to indicate multiple procedures performed during the same surgical session.
3. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code S05.51XA is appropriate for penetrating wound of the right eyeball with a foreign body in the posterior segment.
ICD-10-CM Code W31.1XXA is used to indicate that the injury was caused by contact with a metalworking and woodworking machine.
4. Rationale for Excluding Other Options:
Codes 65235 and 65275 in options B, C, and D refer to foreign body removal from the anterior chamber and the anterior segment, respectively, which are not appropriate since the foreign body was located in the posterior segment.
Codes S05.31XA and W31.0XXA in options C and D represent different eye injuries and types of machines, which do not match the scenario described.
5. AAPC and CPTCoding Guidelines:
According to AAPC guidelines, codes should be selected based on the specific location (posterior segment) and the type of foreign body removal. Each procedure, including the corneal repair, should be coded to capture the full extent of the treatment.
Therefore, the correct answer is A. 65265-RT, 66852-51-RT, 65280-51-RT, S05.51XA, W31.1XXA.
NEW QUESTION # 120
A diagnostic mammogram is performed on the left and right breasts. Computer-aided detection is also used to further analyze the image for possible lesions.
What CPT coding is reported for this radiology service?
- A. 77066-50
- B. 77065-LT, 77065-RT
- C. 77067-50
- D. 0
Answer: D
NEW QUESTION # 121
A 4-year-old, critically ill child is admitted to the PICU from the ED with respiratory failure due to an exacerbation of asthma not manageable in the ER. The PICU provider takes over the care of the patient and starts continuous bronchodilator therapy and pharmacologic support with cardiovascular monitoring and possible mechanical ventilation support.
What is the E/M code for this encounter?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: B
Explanation:
The code 99471 is used for initial inpatient neonatal critical care, per day, for the evaluation and management of a critically ill infant or young child. Given the scenario where a 4-year-old critically ill child is admitted to the PICU and requires intensive care management, this code is appropriate as it reflects the critical care provided beyond the emergency department services. Reference: CPT Professional Edition (current year), AMA.
NEW QUESTION # 122
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. 46320, 46945, K64.0, K64.9
- B. 46255, K64.0, K64.4
- C. 46250, K64.0, K64.9
- D. 46250, 46945, K64.0, K64.4
Answer: B
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.
Reference:
AMA's CPT Professional Edition (current year), Code 46255
ICD-10-CM (current year), Codes K64.0, K64.4
NEW QUESTION # 123
A 49-year-old patient arrives with hearing loss in his left ear. Impedance testing via tympanometry is performed.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: A
NEW QUESTION # 124
The spleen is in what organ system?
- A. Nervous
- B. Digestive
- C. Endocrine
- D. Lymphatic
Answer: D
NEW QUESTION # 125
(What is done when a surgeon performs a bilateral oophorectomy?)
- A. Removal of both fallopian tubes
- B. Removal of both ovaries
- C. A sling procedure for vaginal prolapse
- D. Laparoscopic removal of the uterus
Answer: B
Explanation:
Break the term into parts:"oophor-"refers to theovary, and"-ectomy"meanssurgical removal/excision. The modifier"bilateral"meansboth sides(right and left). Put together,bilateral oophorectomymeanssurgical removal of both ovaries. This is commonly confused withsalpingectomy(removal of fallopian tube[s]) andhysterectomy (removal of uterus). CPC terminology questions often use these closely related female-reproductive terms as distractors, so the safest approach is to anchor on the root: "oophor" = ovary, "salping" = fallopian tube,
"hyster/uter" = uterus. If it were removal of both tubes, it would bebilateral salpingectomy; removal of uterus (open or laparoscopic) is still a hysterectomy, not an oophorectomy. The "bilateral" part is critical-without it, an oophorectomy could be unilateral (one ovary).
NEW QUESTION # 126
A patient presents with recurrent spontaneous episodes of dizziness of unclear etiology. Caloric vestibular testing is performed irrigating both ears with warm and cold water while evaluating the patient's eye movements. There is a total of three irrigations.
What CPT coding is reported?
- A. 92537-50-52
- B. 92538-50
- C. 92537-50
- D. 92537-52
Answer: C
Explanation:
Procedure: Caloric vestibular testing performed on both ears with three irrigations.
CPT Code:
92537: Caloric vestibular test with recording, bilateral; bithermal (i.e., one warm and one cool irrigation in each ear).
Modifier -50: Bilateral procedure.
Code Selection Justification: The procedure performed was bilateral caloric vestibular testing with bithermal irrigation, appropriately coded with 92537 and modifier -50 for bilateral procedures.
AMA CPT Professional Edition (current year)
NEW QUESTION # 127
Refer to the supplemental information when answering this question:
View MR 000281
What anesthesia and diagnosis codes are reported for this case?
- A. 00812, D62, N18.6, Z99.2
- B. 00812, D64.9, K62.5, N18.6, Z99.2
- C. 00811, D64.9, K62.5, N18.6, Z99.2
- D. 00811, D62, N18.6, Z99.2
Answer: D
Explanation:
CPT Code 00811: Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to the splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing This code is reported for anesthesia services provided during a colonoscopy that is diagnostic in nature.
ICD-10-CM Code D62: Acute posthemorrhagic anemia
This is the most accurate postoperative diagnosis. The operative report states "Anemia due to acute blood loss." ICD-10-CM Code N18.6: End stage renal disease This code captures the patient's documented history of ESRD.
ICD-10-CM Code Z99.2: Dependence on renal dialysis
This code is necessary to report the patient's dialysis status, as it affects the overall risk of the procedure.
Why other options are incorrect:
00812: This code is for therapeutic colonoscopies, not diagnostic.
D64.9: This code is for anemia, unspecified. D62 is more specific to the patient's condition.
K62.5: This code is for lower gastrointestinal bleeding, but the anemia is the primary diagnosis in this case.
Reference:
CPT Code 00811: Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to the splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing ICD-10-CM Code D62: Acute posthemorrhagic anemia ICD-10-CM Code N18.6: End stage renal disease ICD-10-CM Code Z99.2: Dependence on renal dialysis AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.
NEW QUESTION # 128
(A provider orders a liquid chromatography mass spectrometry (LC-MS) definitive drug test for a patient suspected ofacetaminophen (analgesic) overdose. What CPT code is reported for the test?)
- A. 0
- B. 1
- C. 2
- D. 3
Answer: B
Explanation:
Acetaminophen is a specific drug with a dedicated quantitative laboratory code. Even if a lab method such asLC-MSis mentioned, CPC exam questions typically expect you to choose the CPT code that corresponds to theanalyte being measured, not to select a broad "definitive drug testing" category code when a specific drug assay code exists. CPT80143is the established code foracetaminophentesting (quantitative measurement).
Codes in the 803xx range are commonly associated with drug screening/testing categories that do not specifically represent acetaminophen as a named analyte in the way CPC questions test. Code80299is an unlisted therapeutic drug assay and is not appropriate when a specific code (80143) exists. Therefore, the correct answer is80143. CPC strategy: when the substance is explicitly named and has a recognized assay code, choose thespecific drug test coderather than an unlisted or generalized testing category. The method (LC-MS) supports "definitive" testing clinically, but the code selection here is driven by the named analyte.
NEW QUESTION # 129
The evisceration of ocular contents was performed using a surgical microscope for enhanced visualization.
The procedure was performed on the left eye and an implant was not placed in the ocular cavity.
What CPTcoding is reported?
- A. 65093-LT, 69990
- B. 65091-LT, 69990-51
- C. 65091-LT
- D. 65093-LT
Answer: C
Explanation:
1. Procedure and CPTCode Selection:
The procedure performed was an evisceration of ocular contents without the placement of an implant. The surgical microscope was used for enhanced visualization, but this does not require a separate code if the primary procedure code includes it inherently.
CPTCode 65091 is used for an evisceration of the ocular contents without implant placement. This code correctly describes the procedure performed on the left eye.
2. Modifier:
Modifier LT is added to indicate that the procedure was performed on the left eye.
3. Exclusion of Code 69990:
Code 69990 is for the use of an operating microscope, but it should not be billed separately when it is used as part of a procedure where enhanced visualization is typical or expected, such as an evisceration procedure.
According to CPTguidelines, 69990 is not separately reported when the microscope is used for visualization in procedures where its use is considered part of the standard of care.
4. Rationale for Excluding Other Options:
Code 65093 is for an evisceration with implant placement, which does not apply since no implant was used.
Options B and C incorrectly include 69990, which is not separately reportable in this scenario.
5. AAPC and CPTCoding Guidelines:
According to AAPC and CPTcoding guidelines, 65091 is sufficient to capture the procedure without the need to add code 69990 for the microscope.
Therefore, the correct answer is D. 65091-LT.
NEW QUESTION # 130
A 7-year-old boy is brought to the pediatric clinic by his mother. She reported that her son is complaining of discomfort in both ears and loss of hearing in the left ear for the past two days. The pediatrician diagnosis is impacted cerumen. Pediatrician with the mother's consent removes impacted cerumen using water irrigation In the right ear. For the left ear the cerumen impaction is removed using instrumentation.
What CPT coding is reported'
- A. 69210-50
- B. 69209-RT.69210-LT
- C. 69209-50
- D. 69209-LT.69210-RT
Answer: B
Explanation:
69209-RT - Removal of impacted cerumen using irrigation
69210-LT - Removal of impacted cerumen using instrumentation
Coding Rules Applied:
Different techniques → different CPT codes
Different ears → RT/LT modifiers, not modifier -50
Why Other Options Are Incorrect:
A - Modifiers reversed
B / D - Modifier -50 inappropriate when different CPT codes are used
NEW QUESTION # 131
Adenoids, tonsils, appendix, and spleen belong to which organ system?
- A. Nervous
- B. Gastrointestinal
- C. Cardiovascular
- D. Lymphatic
Answer: D
Explanation:
The adenoids, tonsils, appendix, and spleen are all part of the lymphatic system, which plays a crucial role in immune function and the filtration of pathogens. These organs contribute to the body's defense by trapping and eliminating bacteria and other pathogens.
Adenoids and tonsils are lymphatic tissues located in the throat and help prevent infection by filtering pathogens from inhaled or ingested particles.
The appendix contains lymphoid tissue and is thought to play a role in gut immunity.
The spleen filters blood, removing old or damaged blood cells and producing lymphocytes for immune response.
The other options are unrelated:
B: Gastrointestinal: Involved in digestion, but not specifically immune response.
C: Cardiovascular: Involved in blood circulation, not immune response.
D: Nervous: Coordinates sensory and motor functions, unrelated to lymphatic tissue.
Therefore, the correct answer is A. Lymphatic.
NEW QUESTION # 132
Refer to the supplemental information when answering this question:
View MR 065174
What E/M code is reported for this encounter?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: B
Explanation:
To determine the correct E/M code, we need to consider the three key components: history, examination, and medical decision making (MDM).
History:
The documentation indicates an expanded problem-focused history. This is supported by the detailed history of present illness, including the patient's description of symptoms, family history, and review of systems with pertinent positives and negatives.
Examination:
The examination is also expanded problem-focused. The physician focused on the relevant systems (head, neck, throat) and documented specific findings related to the chief complaint (thyromegaly).
Medical Decision Making:
The MDM is straightforward. The physician is evaluating a new problem (bilateral thyroid nodules) with a low level of risk. Although further workup is planned, this alone doesn't automatically increase the MDM complexity.
Based on these components, 99213 is the most appropriate code.
Why other options are incorrect:
99212: Requires a problem-focused history and examination, which is less comprehensive than what was documented.
99214 and 99215: Require a higher level of MDM (low or moderate complexity) and/or a more detailed examination. The documentation doesn't support this level of service.
References:
CPT Codes 99211-99215: Office or other outpatient visit for the evaluation and management of an established patient
1995 and 1997 Documentation Guidelines for Evaluation and Management Services: These guidelines provide detailed criteria for selecting the appropriate E/M code based on history, examination, and MDM.
AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.
NEW QUESTION # 133
(A 55-year-old female with severe coronary arteriosclerosis with angina is admitted for elective coronary artery bypass. The surgeon performed a coronary artery bypass using asaphenous vein harvested endoscopically. The vein graft was anastomosed to theobtuse marginaland theleft circumflex. What CPT coding is reported for this procedure?)
- A. 33511, 33508
- B. 0
- C. 33534, 33508
- D. 1
Answer: A
Explanation:
CABG coding depends on(1) number of coronary venous graftsand(2) the conduit type(venous vs arterial).
This case uses asaphenous vein graft(a venous conduit) to bypasstwocoronary targets: theobtuse marginaland theleft circumflex. The CPT code for CABG withtwo venous graftsis33511. The separate code33508is reported forendoscopic harvest of veinwhen performed for CABG, which is specifically documented here ("harvested endoscopically").33534is for anarterial graft(e.g., internal mammary artery) and does not match a saphenous vein-only description. Option D omits the separately reportable endoscopic harvest service documented. CPC exam approach: identify conduit (vein = 33510-33516 family), count distal anastomoses (two = 33511), and add endoscopic harvest (33508) when documented.
NEW QUESTION # 134
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