Free Practice Questions for AAPC CPC Exam

For a complete bilateral mastectomy with insertion of breast prosthesis performed during the same surgical session, the correct CPT® codes are:

1. 19303-50: This code represents a complete mastectomy (removal of breast tissue) performed bilaterally (indicated by the -50 modifier).

2. 19340-50: This code is for the immediate insertion of a breast prosthesis following mastectomy, also performed bilaterally.

Explanation of other options:

A. 19303-50, 19342-50: Incorrect because 19342 is for the insertion of a breast implant, which differs from a prosthesis.

B. 19305-50, 19340-50: 19305 describes a modified radical mastectomy, which is more extensive than what is documented here.

C. 19325-50: This code represents a breast augmentation procedure, not a mastectomy with prosthesis insertion.

Thus, the correct answer is D. 19303-50, 19340-50, which accurately describes a bilateral mastectomy with prosthesis insertion.

99223 = Initial hospital/observation care with high time (75+ min) or high MDM

Prolonged service 99418 is bundled into observation services

This patient presents to the ER with syncope, requiring a comprehensive evaluation and critical care. Here's the breakdown of the codes:

CPT Code 99291-25: Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes  

This code is appropriate because the patient's syncope and vital signs (low blood pressure, shallow respirations, low oxygen saturation) indicate a critical condition requiring immediate intervention.

Modifier -25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service. This modifier is appended because the critical care services were provided in addition to the separately reported procedures below.  

CPT Code 92950: Cardiopulmonary resuscitation (eg, CPR, external cardiac massage, endotracheal intubation, ventilation)

While the documentation doesn't explicitly mention CPR, it states the patient was unresponsive upon arrival but had spontaneous pulse and respirations. This suggests possible resuscitation efforts were performed by the paramedics before the physician's assessment.

CPT Code 31500: Intubation, endotracheal, emergency procedure

Although not explicitly stated, the documentation indicates the patient was placed on "high flow oxygen," which strongly suggests endotracheal intubation was performed to manage the patient's respiratory distress.

CPT Code 82803: Blood gases, arterial, pH, PCO2, PO2, with oxygen saturation; interpretation and report

This code is likely reported based on the patient's respiratory distress and the need to monitor their oxygenation status.

Why other options are incorrect:

99285: This is a standard emergency department visit code and doesn't capture the critical nature of the patient's condition.

99285-25, 99291-25, 92950, 31500, 82803: This includes 99285, which is not necessary as 99291 encompasses the evaluation and management.

99291-25, 99292-25, 92950, 31500: This includes 99292, which is for subsequent critical care time. There's no indication in the documentation that the physician provided critical care beyond the initial 74 minutes.

Laminectomy and Facetectomy (63047 and 63048): The laminectomies at L4 and L5 with facetectomies fall under CPT codes 63047 (for the initial segment) and 63048 (for each additional segment).

Posterior Arthrodesis (22612 and 22614 x 3): The posterior arthrodesis from L1-L5 is coded with 22612 for the primary segment (L4-L5) and 22614 for each additional segment (L1-L4).

Placement of Pedicle Screws (22842): The placement of pedicle screws at L2, L3, and L4 is captured under CPT code 22842 for segmental instrumentation.

The procedure involves eustachian tube inflation to remove serous mucoid fluid in the right ear of a 2-year-old patient with chronic otitis media.

Procedure Description:

Eustachian tube inflation to remove fluid.

General anesthesia.

Incision to the tympanum and suctioning of thick mucoid fluid.

CPT® Coding:

69421-RT: Eustachian tube inflation, transnasal or transoral; with catheterization, including general anesthesia. The modifier -RT indicates the right ear.

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

CPT® Assistant for detailed coding guidelines on eustachian tube procedures.

In medical terminology, the suffix -graph refers to an instrument used for recording data or the process of recording. This suffix is commonly tested on the CPC exam.

Examples include:

Electrocardiograph – instrument used to record heart activity

Angiograph – instrument used to record images of blood vessels

To distinguish from related suffixes:

-gram = the record or image itself

-graphy = the process of recording

Thus, option A is correct.

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.

22514 = Vertebroplasty, lumbar (L5)

22515 = Each additional vertebral body (sacrum)

Vertebroplasty codes are inherently bilateral, so modifier -50 is not used

71048 – Radiologic examination, chest; complete, minimum of 4 views

Includes 6 views

CPT codes are based on ranges, not per-view billing

Why Other Options Are Incorrect:

71047 – 2 views only

CPT does not allow “× view” reporting