AAPC CPC - Certified Professional Coder (CPC) Exam

33016 = Pericardiocentesis, including imaging guidance (e.g., ultrasound) when performed.Because the code already includes imaging guidance, you do not separately report 76942.So the correct coding is 33016 only → B.

The procedure involves a tympanoplasty with a radical mastoidectomy and removal of a cholesteatoma from the middle ear, including grafting of the eardrum without ossicular chain reconstruction.

Procedure Description:

Tympanoplasty.

Radical mastoidectomy.

Removal of cholesteatoma from the middle ear.

Grafting technique used to repair the eardrum without ossicular chain reconstruction.

CPT® Coding:

69645: Tympanoplasty with mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), radical or complete, with removal of cholesteatoma; with mastoid obliteration.

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

CPT® Assistant for detailed coding guidelines on otolaryngology procedures.

1. Procedure and CPT® Code Selection:

The patient underwent a cardiac MRI to assess the morphology and function of the heart under stress, involving both non-contrast and contrast-enhanced imaging. Additionally, pharmacological stress testing was performed to evaluate the coronary arteries.

CPT® Code 75563 is appropriate for a cardiac MRI with both stress and rest imaging, including morphology and function studies with contrast and pharmacologic stress testing. This code accurately captures the entire scope of the MRI study described in this case.

Modifier 26 is applied to indicate the professional component of the service if the cardiologist is providing only the interpretation and not the technical component.

2. Diagnosis and ICD-10-CM Code Selection:

ICD-10-CM Code I25.118 is used for atherosclerotic heart disease with unstable angina. This code accurately reflects the diagnosis provided in the scenario.

3. Rationale for Excluding Other Options:

Code 75559 (option B) represents a cardiac MRI without stress testing, which does not cover the pharmacologic stress component performed here.

Code 75557 (in option D) is for a limited cardiac MRI that does not include both stress and non-stress imaging, so it is incorrect for this comprehensive test.

ICD-10-CM Code I25.110 (in options C and D) is for atherosclerosis with angina pectoris without unstable angina, making I25.118 more appropriate given the diagnosis of unstable angina.

4. AAPC and CPT® Coding Guidelines:

AAPC and CPT® guidelines support the use of 75563 for comprehensive cardiac MRI studies with stress testing, both with and without contrast.

Therefore, the correct answer is A. 75563-26, I25.118.

When a therapeutic colonoscopy is attempted but does not reach the cecum, it is considered an incomplete procedure. According to the CPT® Colonoscopy Decision Tree, if the colonoscopy extends beyond the splenic flexure but does not reach the cecum, the appropriate way to code this incomplete colonoscopy is by appending modifier 53 to indicate a discontinued procedure due to extenuating circumstances or risk to the patient.

A. 45378-53 is the correct answer as it designates a diagnostic colonoscopy with modifier 53, signifying that the procedure was started but not completed.

B. 45330 is incorrect as it represents a sigmoidoscopy, which only goes up to the splenic flexure.

C. 45331-45347 refers to therapeutic colonoscopies that were completed to the cecum.

D. 45379-45398 with modifier 52 is incorrect because modifier 52 is used for reduced services, which does not accurately describe an incomplete colonoscopy.

Thus, the correct answer is A. 45378-53.

NCCIstands for theNational Correct Coding Initiative. Its purpose is to promote correct coding by identifying code pairs that shouldnotbe reported together in most circumstances, helping preventunbundlingand improper payment. The NCCI includesProcedure-to-Procedure (PTP) editsand guidance that reflect common clinical coding conventions (for example, when one service is considered integral to another). Importantly, NCCI edits do not “eliminate the need for modifiers”; rather, they clarify when a modifier (such as-59or an appropriate X{EPSU} modifier) may be allowedonly whendocumentation supports that the services were truly distinct (different site, session, lesion, or other qualifying circumstance). Options A and C incorrectly name the initiative and misstate its function, and option B is not the correct expansion or purpose. For CPC exam readiness, understand NCCI as a primary Medicare edit set widely used as a reference by many payers, supporting consistent and accurate reporting and reducing payment errors.

1. Procedure and CPT® Code Selection:

The otolaryngologist was asked to perform a general otolaryngologic examination of the patient under general anesthesia to evaluate for injuries sustained from a traumatic fall.

CPT® Code 92502 is appropriate for a general otolaryngologic examination under general anesthesia. This code is used specifically when an ENT examination is performed under anesthesia, as was the case here.

2. Rationale for Excluding Other Options:

Code 92512 is for nasal function studies, such as rhinomanometry, which does not apply to a general otolaryngologic examination.

Code 21310 is for the treatment of a nasal fracture (closed treatment), which would only be appropriate if the otolaryngologist had performed a fracture reduction or repair. Since only an examination was performed, 21310 is not appropriate.

Code 92502-51 (option B) is incorrect because the -51 modifier (multiple procedures) is unnecessary; only a single examination was performed.

3. ICD-10-CM Code:

Since only the examination was performed and not treatment, the ICD-10-CM code for nasal fracture (likely S02.2XXA for unspecified fracture of the nasal bones, initial encounter) would be reported separately by the facility or based on final documentation.

4. AAPC and CPT® Coding Guidelines:

AAPC guidelines support the use of 92502 for general ENT examinations performed under anesthesia, especially in cases of trauma evaluation without surgical intervention.

Therefore, the correct answer is D. 92502.

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.

AMA ' s CPT® Professional Edition (current year), Surgery section, Nervous System.

Cochlear implant surgery is anearprocedure and maps to anesthesia code00120in this question’s option framework. The anesthesiologist ismedically directingCRNAs and is concurrently directing5CRNAs. Under anesthesia modifier rules, when an anesthesiologist is directingmore than fourconcurrent anesthesia procedures, the correct modifier isAD(medical supervision by a physician: more than four concurrent anesthesia procedures). Physical status is given asP3(severe systemic disease), so append-P3. The diagnosis is progressive sensorineural hearing loss in the right ear; in the options,H90.41represents unilateral sensorineural hearing loss (right ear) as provided. Options usingAAwould indicate the anesthesiologist personally performed anesthesia (not true here), andQY/QXrepresent medical direction structures but do not match the “more than four” concurrency described (which specifically triggersADin these exam-style choices). Therefore, the correct reporting by the anesthesiologist is00120-AD-P3, H90.41.

1. Procedure and CPT® Code Selection:

The patient underwent a lymphangiography of both arms in an outpatient radiology setting to evaluate suspected lymphangitis.

CPT® Code 75803 is for bilateral lymphangiography of an extremity. This code covers lymphangiography procedures where multiple images are obtained in the study of lymphatic channels and nodes in an extremity.

2. Modifier for Bilateral Procedure:

Modifier 50 is applied to indicate that the procedure was performed bilaterally (on both arms). This modifier appropriately reflects the bilateral nature of the lymphangiography.

3. Rationale for Excluding Other Options:

Code 75801 is for lymphangiography of a single extremity and does not apply to bilateral procedures.

Code 75801-50 (option B) would indicate bilateral use of a code meant for a single extremity, which is not appropriate when a specific bilateral code, 75803, is available.

Option C, without the bilateral modifier, would not indicate that both arms were examined.

4. AAPC and CPT® Coding Guidelines:

AAPC guidelines specify using 75803 for bilateral lymphangiography procedures of extremities, and Modifier 50 is applied for clarity on bilateral involvement.

Therefore, the correct answer is D. 75803-50.

Removal of a foreign body from the nose using forceps or other instrumentation is coded with CPT 30300. This code includes the use of local anesthesia, which aligns with the scenario where a nasal decongestant was used.