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NEW QUESTION # 187
A 50-year-old patient presented with a persistent cough has not responded to standard treatments. The patient's physician decides to perform a flexible bronchoscopy with bronchial biopsies to further investigate the cause. A flexible bronchoscope is inserted through the patient's mouth and into the bronchial tubes. Five biopsies are taken for further testing. The biopsies were sent to the lab for analysis to determine the next steps in the patient's treatment plan.
What CPT coding is reported?
- A. 0
- B. 1
- C. 31625 x 5
- D. 31628 x 5
Answer: A
Explanation:
The procedure described is flexible bronchoscopy with bronchial biopsy (biopsy taken from the bronchi
/bronchial tubes).
31625 = Bronchoscopy, flexible, with biopsy (single or multiple)
Important CPC concept: when the CPT descriptor is "single or multiple", you code it once, even if multiple biopsies are taken.
31628 is for transbronchial lung biopsy, which is not what is described (the question specifies bronchial tubes
/bronchial biopsies).Therefore, A is correct.
NEW QUESTION # 188
(In the ICD-10-CM code book, which instructional note given in the Tabular List indicates whentwo conditions cannot be reported together?)
- A. Excludes2
- B. Not elsewhere classifiable (NEC)
- C. Not otherwise specified (NOS)
- D. Excludes1
Answer: D
Explanation:
AnExcludes1note means"NOT CODED HERE"and indicates that the two conditionscannot be reported togetherbecause they are eithermutually exclusiveor one condition is inherently included in the other in that context. In practical CPC exam terms, if an Excludes1 note applies between two codes, you generallydo not assign both codes on the same encounter. This is different fromExcludes2, which means the excluded condition isnot part of the code, but the patient may haveboth conditions at the same time, soboth codes may be reportedif supported by documentation. NEC (Not Elsewhere Classifiable) points you to a more specific code when available; NOS (Not Otherwise Specified) reflects insufficient detail in documentation. The question is specifically about a note that prevents reporting two conditions together-this is the hallmark definition ofExcludes1under ICD-10-CM conventions and is heavily tested on CPC exams.
NEW QUESTION # 189
What does the suffix -graph mean?
- A. Instrument used for Z plasty
- B. Instrument for recording data
- C. Surgical repair by suture
- D. Surgical binding by fusion
Answer: B
Explanation:
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.
NEW QUESTION # 190
A 60-year-old male suffering from degenerative disc disease at the L3-L4 and L5-S1 levels was placed under general anesthesia. Using an anterior approach, the L3-L4 disc space was exposed. Using blunt dissection, the disc space was cleaned. The disc space was then sized and trialed. Excellent placement and insertion of the artificial disc at L3-L4 was noted. The area was inspected and there was no compression of any nerve roots.
Same procedure was performed on L5-S1 level. Peritoneum was then allowed to return to normal anatomic position and entire area was copiously irrigated. The wound was closed in a layered fashion. The patient tolerated the discectomy and arthroplasty well and was returned to recovery in good condition. What CPT coding is reported for this procedure?
- A. 0
- B. 22857 x 2
- C. 22857, 22860
- D. 1
Answer: B
Explanation:
This scenario describes an anterior discectomy and arthroplasty at two levels (L3-L4 and L5-S1) using artificial discs. CPT code 22857 describes total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), single interspace, lumbar. Since the procedure was performed at two levels, the code should be reported twice.
References:
* AMA's CPT Professional Edition (current year), Code 22857
NEW QUESTION # 191
Refer to the exhibit.
Refer to the supplemental information when answering this question:
View MR 623654
What CPTO coding is reported for this case?
- A. 14001, 11606-51, 12034-51
- B. 0
- C. 14001, 11606-51
- D. 1
Answer: D
NEW QUESTION # 192
A patient underwent a cystourethroscopy with a pyeloscopy using lithotripsy to break up the ureteral calculus.
An indwelling stent was also inserted during the same operative session on the same side. This service was performed in the outpatient hospital surgery center.
What CPT coding reported?
- A. 0
- B. 52353, 52332-51
- C. 52352, 52332-51
- D. 52325, 52332-51
Answer: A
Explanation:
* Cystourethroscopy: This is a procedure that involves the use of a cystoscope to look inside the urethra and bladder.
* Pyeloscopy: Involves the examination of the upper urinary tract, typically done through the cystoscope.
* Lithotripsy: A procedure that uses shock waves or a laser to break up stones in the kidney, bladder, or ureter.
* Indwelling stent insertion: A procedure to place a stent in the ureter to help urine flow from the kidney to the bladder.
* 52356: Cystourethroscopy with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization and/or ureteral stent placement).
The code 52356 includes all components mentioned: cystourethroscopy, pyeloscopy, lithotripsy, and stent insertion performed in the same operative session.
References:
* AMA's CPT Professional Edition (current year)
* ICD-10-CM (current year), HCPCS Level II (current year)
NEW QUESTION # 193 
Refer to the supplemental information when answering this question:
View MR 004813
What CPT and ICD-10-CM codes are reported?
- A. 43752-52, K94.29, K44.9
- B. 43246-52, K94.29, K44.9
- C. 43752, K94.29, Z93.1
- D. 43246, K94.29, Z93.1
Answer: B
Explanation:
CPT Code 43246: Esophagogastroduodenoscopy, with transoral insertion of intra-abdominal tube (e.g., gastrostomy or jejunostomy) This code describes the attempted PEG tube placement.
Modifier -52: Reduced services. This modifier is appended because the procedure was aborted and the PEG tube was not successfully placed.
ICD-10-CM Code K94.29: Other specified disorders of digestive system
This code captures the patient's chronic feeding requirement, which is the reason for the attempted PEG tube placement.
ICD-10-CM Code K44.9: Diaphragmatic hernia without obstruction or gangrene This code reports the small hiatal hernia that was found during the procedure.
References:
CPT Code 43246: Esophagogastroduodenoscopy, with transoral insertion of intra-abdominal tube (e.g., gastrostomy or jejunostomy) Modifier 52: Reduced services ICD-10-CM Code K94.29: Other specified disorders of digestive system ICD-10-CM Code K44.9: Diaphragmatic hernia without obstruction or gangrene AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.
NEW QUESTION # 194
(A patient is seen by her podiatrist to treat a painfulleft ingrown toenailon the big toe. The podiatrist performs awedge excisionof the skin of the nail fold at the lateral margin. Local anesthetic is administered, and an elliptical incision is made through subcutaneous tissue of the affected nail groove. A wedge-shaped piece of soft tissue from the nail margins is removed. What CPT code is reported?)
- A. 11730-TA
- B. 11765-TA
- C. 11755-TA
- D. 11750-TA
Answer: B
Explanation:
The key phrase is"wedge excision of the skin of the nail fold"with removal of a wedge-shaped portion ofsoft tissueat the nail margin. This describesexcision of the nail and nail matrixprocedures used for ingrown toenails when the nail margin and/or matrix is treated more definitively than a simple avulsion. CPT11765is used forwedge excision of skin of nail fold(the classic code for the wedge excision approach). By contrast,
11730representssimple avulsion of the nail plate(removal of nail plate), which does not match a wedge excision of the nail fold soft tissue.11750describesexcision of nail and nail matrix(more matrix-focused wording) and is a common distractor; however, the vignette specifically emphasizes wedge excision of thenail fold.11755relates to nail procedures that do not match this scenario. The "TA" modifier indicatesleft great toefor anatomical specificity on the claim.
NEW QUESTION # 195
A patient with severe diverticulitis in the sigmoid colon presents to surgery for a partial colectomy. The physician performs an exploratory laparoscopic laparotomy to verify the location of the diverticulitis. Once identified, it was noted that there was bleeding from the diverticulitis. The physician transects the descending colon and then transects at the line of the rectum.
The physician mobilizes the splenic flexure in order to create a colostomy with the proximal portion of the remaining colon. The distal portion of the colon is closed. The physician washes the patient's abdomen with saline, removes all trocars and instruments, and then closes the abdomen with sutures.
What CPT and ICD-10-CM codes are reported?
- A. 44206, 44213-51, K57.41
- B. 44212, 44213-51, K57.41
- C. 44206, 44213, K57.33
- D. 44212, 44213, K57.33
Answer: D
Explanation:
Procedure Coding (CPT):
44212 - Laparoscopic partial colectomy with end colostomy and closure of distal segment (Hartmann-type procedure) Correct because:
Sigmoid/descending colon resection
Proximal colostomy created
Distal rectal stump closed
44213 - Laparoscopic mobilization of splenic flexure
Separately reportable because:
Mobilization was necessary to exteriorize colon for colostomy
Not bundled into 44212
Modifier not required (no multiple-procedure discount with add-on logic) Diagnosis Coding (ICD-10-CM):
K57.33 - Diverticulitis of large intestine with perforation and bleeding, without abscess Documentation supports:
Diverticulitis
Active bleeding
No abscess reported
Why Other Options Are Incorrect:
A / B - 44206 = colectomy with anastomosis (not performed)
A / B - K57.41 includes abscess (not documented)
C - Missing splenic flexure add-on explanation
CPT & ICD-10-CM Guideline Alignment:
Hartmann procedure ≠ anastomosis
Bleeding elevates diagnosis specificity
Splenic flexure mobilization is separately reportable when clinically required
NEW QUESTION # 196
A 6-French sheath and catheter is placed into the coronary artery and is advanced to the left side of the heart into the ventricle. Ventriculography is performed using power injection of contrast agent. Pressures in the left heart are obtained. The coronary arteries are also selected and imaged.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: D
NEW QUESTION # 197
A patient arrived at the emergency department experiencing pain in both legs. The ED physician ordered a comprehensive duplex scan of the arteries in both lower extremities to rule out arteriosclerosis.
What CPT and ICD-10-CM codes are reported?
- A. 93926 x 2,170.303. M79.604, M79.605
- B. 93926 x 2. M79.604, M79.605
- C. 93925x2.170.303
- D. 93925, M79.604. M79.605
Answer: D
Explanation:
93925 - Duplex scan of arteries, bilateral lower extremities; complete
Includes both legs → do not bill twice
Diagnosis Codes:
M79.604 - Pain in right leg
M79.605 - Pain in left leg
Why others are incorrect:
93926 × 2 - Unilateral only
I70.303 - Arteriosclerosis not confirmed
NEW QUESTION # 198
A patient has squamous cell carcinoma lesions destroyed with cryosurgery:
0.6 cm right dorsal foot
2.0 cm left dorsal foot
What CPT coding is reported?
- A. 17262, 17261
- B. 0
- C. 17000, 17003
- D. 17272, 17271
Answer: A
Explanation:
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.
NEW QUESTION # 199
A 65-year-old man had a right axillary block by the anesthesiologist. When the arm was totally numb, the arm was prepped and draped, and the surgeon performed tendon repairs of the right first, second, and third fingers.
The anesthesiologist monitored the patient throughout the case.
What anesthesia code is reported?
- A. 01810
- B. 01830
- C. 01820
- D. 01840
Answer: B
Explanation:
* The anesthesia code for an axillary block for procedures on the upper arm and elbow, which includes the monitoring by the anesthesiologist throughout the procedure, is 01830. This code is appropriate for anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of the shoulder and axilla.
References:
* CPT Professional Edition, AMA
* Anesthesia Coding Guidelines
NEW QUESTION # 200
(Full Case:Location:ABC Outpatient Clinic.Patient:60-year-old menopausal female.Independent radiologist (not employed by hospital):Dr. Q.Chief complaint:Uterine cramping.Procedure:Transvaginal ultrasound.
Findings:Ovaries normal; measurements given (note: left ovary listed twice with different dimensions); uterus
5.2 × 5.1 × 4.0; endometrial stripe 0.8 cm; uterus without focal hypoechoic mass; ovoid anechoic foci in lower uterus/cervix due to Nabothian cysts; no adnexal fluid or mass; cervix thickness/length normal; true sagittal thickest portion measured.Question:What CPT and ICD-10-CM codes are reported for the independent radiologist that provided the interpretation of the ultrasound?)
- A. 76817-26, N94.9
- B. 76830-26, N94.89
- C. 76817, N94.89
- D. 76830, N94.9
Answer: B
Explanation:
The documented study is atransvaginal pelvic ultrasound, which is coded with76830(ultrasound, transvaginal). Because the service is billed by anindependent radiologist providing only the interpretation, the correct reporting is theprofessional componentwith modifier-26(interpretation and report), not the global code. That makes76830-26the correct CPT selection. Code76817is fortransvaginal ultrasound in pregnancy
/obstetric contexts, which is not supported here (the patient is menopausal and no pregnancy evaluation is described). For diagnosis, the chief complaint isuterine cramping, and the options provide pelvic pain codes; N94.89(other specified conditions associated with female genital organs and menstrual cycle) is the best match among the choices provided for uterine cramping/pelvic symptom documentation.N94.9is less specific ("unspecified"), so when a more specific option is available in the answer set, selectN94.89. Therefore, the correct combination for the interpreting independent radiologist is76830-26, N94.89.
NEW QUESTION # 201
A patient with empyema requires a Schede thoracoplasty.
What CPT code is reported for this procedure?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: B
NEW QUESTION # 202
View MR 002395
MR 002395
Operative Report
Pre-operative Diagnosis: Acute rotator cuff tear
Post-operative Diagnosis: Acute rotator cuff tear, synovitis
Procedures:
1) Rotator cuff repair
2) Biceps Tenodesis
3) Claviculectomy
4) Coracoacromial ligament release
Indication: Rotator cuff injury of a 32-year-old male, sustained while playing soccer.
Findings: Complete tear of the right rotator cuff, synovitis, impingement.
Procedure: The patient was prepared for surgery and placed in left lateral decubitus position. Standard posterior arthroscopy portals were made followed by an anterior-superior portal. Diagnostic arthroscopy was performed. Significant synovitis was carefully debrided. There was a full-thickness upper 3rd subscapularis tear, which was repaired. The lesser tuberosity was debrided back to bleeding healthy bone and a Mitek 4.5 mm helix anchor was placed in the lesser tuberosity. Sutures were passed through the subcapulans in a combination of horizontal mattress and simple interrupted fashion and then tied. There was a partial-thickness tearing of the long head of the biceps. The biceps were released and then anchored in the intertubercular groove with a screw. There was a large anterior acromial spur with subacromial impingement. A CA ligament was released and acromioplasty was performed. Attention was then directed to the supraspinatus tendon tear. The tear was V-shaped and measured approximately 2.5 cm from anterior to posterior. Two Smith & Nephew PEEK anchors were used for the medial row utilizing Healicoil anchors.
Side-to-side stitches were placed. One set of suture tape from each of the medial anchors was then placed through a laterally placed Mitek helix PEEK knotless anchor which was fully inserted after tensioning the tapes. A solid repair was obtained. Next there were severe degenerative changes at the AC joint of approximately 8 to 10 mm. The distal clavicle was resected taking care to preserve the superior AC joint capsule. The shoulder was thoroughly lavaged. The instruments were removed and the incisions were closed in routine fashion. Sterile dressing was applied. The patient was transferred to recovery in stable condition.
What CPT coding is reported for this case?
- A. 29827, 29824-51, 29826-51, 29805-59
- B. 29827, 29824-51, 29826-51
- C. 29827, 29828-51, 29824-51, 29826
- D. 29827, 29828-51, 29824-51, 29826, 29805-59
Answer: C
Explanation:
29827: Arthroscopic rotator cuff repair is correctly coded as 29827.
29828: Arthroscopic biceps tenodesis is an additional procedure and should be coded as 29828 with modifier
-51 (Multiple Procedures).
29824: Arthroscopic claviculectomy (partial resection of the distal clavicle) is coded as 29824 with modifier
-51.
29826: Arthroscopic subacromial decompression, including coracoacromial ligament release, is coded as
29826.
All these procedures were performed arthroscopically and documented in the operative report, justifying the use of these codes and the use of modifier -51 for multiple procedures.
CPT Professional Edition, AMA
NEW QUESTION # 203
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