AAPC CPC - Certified Professional Coder (CPC) Exam

In this case, a CRNA provided anesthesia for an urgent endoscopic procedure. To select the appropriate codes, we consider both the anesthesia code for the procedures performed and the modifiers relevant to the CRNA’s role and the patient’s physical status:

1. 00813: This CPT® code covers "Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum," which is appropriate since the colonoscopy extended to the ileum and into the lower duodenum. 00731 (anesthesia for upper GI endoscopy) would not fully apply, as the main procedure targeted lower intestinal areas as well.

2. QZ Modifier: Indicates the anesthesia was performed by a CRNA without medical direction by an anesthesiologist, which aligns with the scenario where the CRNA independently administered anesthesia.

3. P3 Modifier: Reflects the physical status of "severe systemic disease" for this patient, as she has both end-stage renal failure and myelodysplastic syndrome.

4. 99100: This code is added to reflect "special anesthesia circumstances" given the patient’s extreme frailty (platelet count of 3,000), which warrants additional consideration.

5. 99140: Used for emergency conditions, which applies here due to the urgent nature of the bleeding investigation.

Thus, 00813-QZ-P3, 99100, 99140 accurately reflects the anesthesia services provided by the CRNA in this emergency scenario.

The Office of Inspector General (OIG) provides compliance program guidance to form the basis of a voluntary compliance program for provider practices. This guidance is intended to help healthcare providers develop effective internal controls to monitor adherence to applicable statutes, regulations, and program requirements of Federal healthcare programs. The OIG issues various compliance guidelines and resources to assist organizations in establishing comprehensive compliance programs to prevent fraud, waste, and abuse.

OIG Compliance Program Guidance, AMA's CPT® Professional Edition, and healthcare compliance resources.

The mediastinum is an anatomical region located in the thoracic cavity. It is bounded by the sternum in front, the vertebral column at the back, and is situated between the lungs. It contains the heart, trachea, esophagus, thymus, and other structures, but it is not itself an organ. Therefore, the correct answer is that it is a location in the chest.

ICD-10-CM, Medical Anatomy and Physiology textbooks

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.

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.

This is destruction of malignant lesions (SCC).

17261 = Malignant lesion destruction, trunk/arms/legs, 0.6–1.0 cm

17262 = Same location, 1.1–2.0 cm

Feet are included in trunk/arms/legs.

Therefore, 17262, 17261 is correct.

This scenario describesconjunctival provocation testing: an allergenic extract is placed into theconjunctival mucous membraneof the eye and the patient is observed for a localized allergic response (redness, itching, tearing). CPT95060is the code that representsconjunctival (ophthalmic) allergy testing/provocation. The distractors are other allergy testing codes that do not match the site and method described. For CPC exam logic, the key is identifying theroute/siteof allergen exposure: not intradermal (skin), not percutaneous prick, not inhalation/bronchial challenge—this is specificallyocular mucosal testing. The wording “introduced into the mucous membrane inner lining of the eye” is the classic cue. Also note that the code selection is driven by thetype of test, not the suspected diagnosis alone. Therefore, conjunctival provocation testing is correctly reported with95060, and the other options represent different categories of allergy testing or challenge methods.

38573 includes comprehensive laparoscopic staging with bilateral pelvic lymphadenectomy and paraaortic sampling

All listed components are bundled into this code

The procedure is apercutaneous needle biopsy of the liver, which is reported withCPT 47000(needle biopsy of liver; percutaneous). Because the biopsy is performed withCT guidance, you also report the appropriate imaging guidance code77012(CT guidance for needle placement). The number of core specimens (four) doesnotchange the CPT reporting here; you code the biopsy service, not each specimen. For diagnosis, the biopsy is performed to evaluate aliver mass, which supports reporting the sign/symptom/abnormal finding code provided in the options (R16.0) rather than a definitive benign neoplasm code, because “rule out benign hepatic adenoma” is not a confirmed diagnosis. Options A–C incorrectly assignD13.4(benign neoplasm of liver) despite the condition being unconfirmed in the question stem, and/or include unrelated codes. Therefore, the correct coding combination is47000, 77012, R16.0.

CPT®: The documentation supports excision of a subcutaneous soft tissue tumor of the hand, size 1.5 cm.

26111 = Excision of tumor/soft tissue of hand or finger, subcutaneous, 1.5 cm or less

26115 would be for a larger size range (not supported by “1.5 cm” in the question).

ICD-10-CM: Pathology confirms subcutaneous hemangioma (benign vascular tumor).

D18.01 = Hemangioma of skin and subcutaneous tissueCodes D21.01/D21.11 are benign neoplasm of connective/soft tissue categories, but the most accurate match here (and the one reflected in the answer choices) is D18.01 for hemangioma of skin/subcutaneous tissue.

Typing correction applied: the options showed “018.01”; the correct ICD-10-CM format is D18.01.