Free Practice Questions for AAPC CPC Exam

A diagnostic mammogram performed on both breasts with computer-aided detection (CAD) is reported with CPT® code 77066. This code is used when CAD is utilized to further analyze the images for possible lesions, and it covers both breasts.

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.

1. Procedure Details and CPT® Code Selection:

The patient is undergoing stage 2 treatment for double outlet right ventricle (DORV) with a removal of the pulmonary artery band and transposition repair of the great vessels.

Code 33779 is specific for correction of a double outlet right ventricle, with transposition of the great arteries. This code accurately reflects the procedure performed, including the complex repair involving the transposition of the pulmonary trunk and aortic root.

Code 33953 is used to report the initiation of extracorporeal membrane oxygenation (ECMO), which was used to maintain oxygenation during the procedure.

Code 33985 is for the termination of ECMO following the surgical repair once heart function has resumed. Both 33953 and 33985 accurately document the initiation and termination of ECMO during this complex heart repair.

2. Modifier Selection:

Modifier 78 (unplanned return to the operating room for a related procedure during the postoperative period) is appropriate here. This is a subsequent stage in the treatment plan, but due to the complexity and specific surgical intervention required, it is treated as a return to the OR for related procedure coding.

Modifier 58 (staged or related procedure during the postoperative period) would not be as suitable here because the procedure involves a new return to the OR.

3. AAPC and CPT® Coding Guidelines:

AAPC guidelines support the use of specific modifiers (78 for unplanned return) and appropriate ECMO codes (33953 and 33985) in complex cardiac cases requiring bypass and staged treatment.

Thus, the correct CPT® codes based on CPT® and AAPC coding standards are C. 33779-78, 33953-78, 33985-78.

Procedure: Complete cardiac MRI for morphology and function without contrast, followed by contrast with four additional sequences and stress imaging.

CPT® Codes:

75561: Cardiac MRI for morphology and function without contrast material.

75563: Cardiac MRI with contrast and further sequences.

ICD-10-CM Codes:

I50.1: Left ventricular failure.

I49.1: Premature ventricular contractions.

Code Selection Justification: The CPT® codes accurately capture the MRI procedures performed. The ICD-10-CM codes represent the diagnoses of left ventricular failure and premature ventricular contractions.

AMA CPT® Professional Edition (current year)

ICD-10-CM (current year)

HCPCS Level II (current year)

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

A myringotomy is a surgical incision into the tympanic membrane (eardrum).

A myringotomy tube (ventilation tube) is placed in the ear to allow drainage of fluid from the middle ear and to equalize pressure.

Therefore, the correct answer is A. Ear.

30901 = Control of anterior epistaxis, limited, any method

30903/30905/30906 are for extensive packing or posterior epistaxis

1. Procedure and CPT® Code Selection:

The provider performed both a bronchoscopy and a microlaryngoscopy to evaluate the patient’s airway due to respiratory distress and stridor.

Code 31622 is used for a diagnostic bronchoscopy, which includes the inspection of the trachea, carina, and bronchial structures. Since the bronchoscopy was diagnostic and no additional therapeutic procedures were performed, this is the appropriate code.

Code 31526 is for direct laryngoscopy with the use of an operating microscope or telescope (microlaryngoscopy). This code is appropriate given the use of a Parson’s laryngoscope and magnifying telescope to inspect the larynx.

2. Modifier 51:

Modifier 51 is added to 31526 to indicate that it was performed in conjunction with another procedure (31622, bronchoscopy). Modifier 51 denotes multiple procedures without the necessity of a separate incision.

3. Exclusion of Code 69990:

Code 69990 is used for the use of an operating microscope in microsurgery but is not coded separately when the procedure (such as microlaryngoscopy) already includes visualization with a microscope or telescope as part of the CPT® descriptor. Thus, 69990 is not separately reported in this scenario, per CPT® guidelines.

4. AAPC and CPT® Coding Guidelines:

The guidelines specify that when visualization or microlaryngoscopy is inherently part of the procedure (as in 31526), 69990 should not be billed separately. Also, the use of Modifier 51 for multiple procedures in the same session is appropriate.

Therefore, the verified answer, following the CPT® and AAPC coding rules, is A. 31622, 31526-51.

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.

Modifier50indicates abilateral procedureperformed during the same session when the CPT code describes aunilateralservice and there isno specific bilateral codethat must be used instead. Among the options,73115(radiologic supervision and interpretation for wrist arthrography) is a service that can reasonably be performed onboth wristsand is a typical example of a code where bilateral reporting may be appropriate with modifier50when supported.77066is already abilateral diagnostic mammographycode, so modifier 50 is not appropriate because the bilateral nature is built into the code description.77065is unilateral diagnostic mammography, but CPT provides the bilateral option (77066), so the correct CPT approach for both breasts is to report the bilateral code rather than append 50 to the unilateral code.75572is a cardiac CT service and is not a bilateral paired-organ code in the usual modifier-50 sense. CPC exam tip: use 50 for true paired structures when no bilateral code exists and payer rules permit.