Free Practice Questions for AAPC CPC Exam

37267 = Iliac artery stent placement

Angioplasty is bundled into the stent code

K0001 = Standard wheelchair

Other K000 codes represent specialized wheelchairs

Melanoma is a malignant neoplasm of melanocytes, which are pigment-producing cells found primarily in the skin. It is one of the most serious forms of skin cancer and is classified under ICD-10-CM category C43.- (Malignant melanoma of skin).

Osteosarcoma is a malignant tumor of bone, not skin (ICD-10-CM C40–C41).

Hemangioma is a benign tumor of blood vessels and is not malignant (often coded under D18.-).

Lymphoma is a malignancy of the lymphatic system, not a primary skin neoplasm (ICD-10-CM C81–C85), though rare cutaneous lymphomas exist, they are not the standard CPC exam answer here.

Actinic keratoses (AKs) are coded using thepremalignant lesion destructionCPT family17000–17004, regardless of the destruction method (e.g., laser, cryotherapy, electrosurgery), as long as the intent is destruction. Coding is based on thenumber of lesions treated in that session:17000covers thefirstlesion,17003is an add-on code for2–14 additional lesions, and17004is used when treating15 or more lesions. Because the encounter documents destruction of15 AK lesions, CPT requires reporting17004only (not 17000 + multiple units of 17003). Codes17110/17111are for destruction ofbenignlesions (e.g., warts, molluscum), which is the wrong lesion category. On CPC exams, the key is matchingpremalignant vs benignand then selecting the correct code bylesion count threshold—here the threshold is met for17004.

1. Procedure Type and CPT® Code Selection:

The physician performed an injection into the wrist joint for degenerative osteoarthritis management using Synvisc (a viscosupplementation product).

Code 20606 is the correct CPT® code for an arthrocentesis, aspiration, and/or injection procedure in an intermediate joint, such as the wrist. This code specifically includes the use of ultrasound guidance, which is often standard in such injections.

Code 20551 (injection of a single tendon origin) and 20526 (injection into a carpal tunnel) are incorrect here as they do not apply to intra-articular injections for joint osteoarthritis management.

2. Diagnosis Code Selection (ICD-10-CM):

The diagnosis is degenerative osteoarthritis in the right wrist.

ICD-10-CM Code M19.231 is used for primary osteoarthritis of the right wrist. This code directly reflects the diagnosis of primary osteoarthritis affecting this specific joint.

M19.031 would represent primary osteoarthritis in the wrist but does not specify laterality; therefore, it is less accurate than M19.231, which denotes the right wrist.

3. Summary of Code Application:

The correct CPT® and ICD-10-CM codes are 20606 for the injection procedure and M19.231 for primary osteoarthritis of the right wrist.

4. AAPC and CPT® Coding Guidelines:

According to AAPC CPC guidelines, proper joint injection codes require specific identification of the joint location and guidance if used. Additionally, selecting the most specific ICD-10-CM code for laterality is essential for accuracy in musculoskeletal diagnoses.

Thus, based on CPT® and ICD-10-CM coding guidelines, the verified answer is B. 20606, M19.231.

The Schede thoracoplasty for empyema is accurately described by CPT code 32905, which covers the radical procedure involving the resection of multiple ribs and often the obliteration of the pleural cavity to treat chronic empyema.

1. Procedure and CPT® Code Selection:

The patient initially underwent a laparoscopic total abdominal hysterectomy for endometriosis of the uterus. However, due to extensive adhesions, the surgeon converted the procedure to an open total abdominal hysterectomy to complete the surgery.

CPT® Code 58150 is appropriate for a total abdominal hysterectomy, including removal of the uterus and cervix, via an open approach. Since the procedure was converted to an open approach, 58150 is the correct code.

The -22 modifier is added to indicate increased procedural services due to the extensive adhesiolysis (removal of adhesions), which extended the surgery duration.

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

ICD-10-CM Code N80.00 is used for endometriosis of the uterus, which is the primary condition that prompted the hysterectomy.

ICD-10-CM Code N73.6 is appropriate for female pelvic peritoneal adhesions, reflecting the extensive adhesions that necessitated the conversion to open surgery.

3. Rationale for Excluding Other Options:

Code 58571 (in options B and C) is for a laparoscopic approach, which is incorrect because the procedure was converted to an open approach.

The -78 modifier is incorrect in this context because the conversion to open surgery was part of the same operative session and not an unplanned return to the OR.

Diagnosis code N99.4 (in options B and D) pertains to postprocedural pelvic adhesions, which does not apply here as the adhesions were not due to a prior procedure.

4. AAPC and CPT® Coding Guidelines:

AAPC guidelines specify using 58150 for an open total abdominal hysterectomy and adding the -22 modifier for increased complexity or time due to factors like extensive adhesiolysis.

Therefore, the correct answer based on CPT® and ICD-10-CM guidelines is A. 58150-22, N80.00, N73.6.

CPT code 99385 is used for initial comprehensive preventive medicine evaluation and management of an individual, including a detailed history and examination, and anticipatory guidance. Since additional documentation and treatment for non-inflamed lesions are provided, an additional E/M service code 99203 with modifier -25 (significant, separately identifiable evaluation and management service by the same physician on the same day) is appropriate to indicate both services were rendered. References: CPT® Professional Edition (current year), AMA.

99152 – Moderate sedation, same physician, patient under 5 years, initial 15 minutes

Time documented: 21 minutes

First 15 minutes = 99152

Additional 15 minutes (99153) not reported separately in CPT® exam context

Why others are incorrect:

99151 – Minimal sedation

99155 / 99156 – Different age/provider scenarios

IV hydration is coded byduration. CPT96360is forinitial intravenous hydration(typically the first hour). CPT96361is an add-on code foreach additional hourbeyond the initial hour, reported when the hydration time exceeds 60 minutes and meets the additional-hour threshold. The scenario documents hydration for1 hour and 30 minutes (90 minutes). That supports reporting theinitial hour(96360) plusone additional hour(96361) because the infusion extends beyond the initial hour and reaches the qualifying threshold for an additional hour as defined by CPT time rules (time is rounded/assigned based on midpoints, not per minute). The other options usetherapeutic infusioncodes (96365/96366), which are for medications/drugs, not for hydration with normal saline when the primary purpose is hydration. CPC exam tip: if the service is specifically “hydration” and the fluid is normal saline for dehydration/heat exhaustion, use96360/96361and apply time-based logic.