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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q326-Q331):

NEW QUESTION # 326
(A 58-year-old patient undergoes diagnostic facet joint injections. The physician performsbilateral paravertebral facet joint injectionsat theT2-T3, T3-T4, and T4-T5levels, usingfluoroscopic guidanceat each site. What CPT coding is reported for this encounter?)

Answer: D

Explanation:
Facet joint injections (medial branch blocks/intra-articular depending on code family) are coded byspinal regionandnumber of levels. Thoracic facet injections use64490for thefirst level,64491for thesecond level, and64492for thethird and each additional level(within the thoracic region). This case includesthree thoracic levels: T2-T3 (1st), T3-T4 (2nd), and T4-T5 (3rd). Because the injections arebilateral, you applymodifier -50 to each of the level codes per the answer set's style. Fluoroscopic guidance isbuilt intothese injection codes under current CPT rules, so you donotseparately report a fluoroscopy code (such as 76000). Options B and C are forlumbar/sacralfacet injection families, not thoracic. Option A incorrectly doubles units rather than using the correct third-level add-on coding structure. Therefore,64490-50, 64491-50, 64492-50is correct.


NEW QUESTION # 327
(The patient presents to the emergency department with chest pain. EKG showsNSTEMIand troponin is abnormal. The ED provider discusses the case with a cardiologist and the patient is admitted for heart catheterization/PCI. What is the E/M service and ICD-10-CM coding reported for the ED provider?)

Answer: C

Explanation:
An ED visit involvingNSTEMIwith abnormal troponin, EKG confirmation, and escalation to cardiology for admission representshigh acuityand high risk of morbidity/mortality, supporting the highest-level ED E/M in typical CPC exam scenarios:99285. The definitive ED diagnosis isNSTEMI, which is coded asI21.4. When a definitive diagnosis is established (NSTEMI), you generally do not separately code the presenting symptomchest pain (R07.9)as an additional diagnosis unless the symptom is unrelated or specifically required; here it is the presenting symptom attributable to the MI and not separately necessary. Options A and C use inpatient consult codes (99254/99255) rather than an ED E/M code and are inappropriate for the ED provider's service. Option D understates the acuity and incorrectly includes symptom coding as if no definitive diagnosis were made. Therefore, the correct answer is99285 with I21.4.


NEW QUESTION # 328
An established patient suffering from migraines without aura, no mention of intractable migraine, and no mention of status migrainosus, is seen by his ophthalmologist who conducts a visual field examination of both eyes. The examination was accomplished plotting four isopters utilizing the Goldmann perimeter testing method. The patient and requesting physician receive the interpretation and report on the same date of service.
What procedure and diagnosis codes are reported for this encounter?

Answer: D

Explanation:
* Procedure: Visual field examination of both eyes using Goldmann perimeter testing with four isopters.
* CPT Code:
* 92082: This code is for visual field examination with intermediate examination.
* ICD-10-CM Code:
* G43.009: Migraine without aura, not intractable, without status migrainosus.
* Code Selection Justification: The visual field exam method and complexity align with 92082. The patient's diagnosis of non-intractable migraine without aura is coded as G43.009.
References:
* AMA CPT Professional Edition (current year)
* ICD-10-CM (current year)


NEW QUESTION # 329
A 64-year-old with congestive heart failure (CHF) has pericardial effusion. The provider inserts a needle under ultrasound guidance, aspirating the fluid from the pericardial sac.
What CPT coding is reported?

Answer: D

Explanation:
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).


NEW QUESTION # 330
View MR 001394
MR 001394
Operative Report
Procedure: Excision of 11 cm back lesion with rotation flap repair.
Preoperative Diagnosis: Basal cell carcinoma
Postoperative Diagnosis: Same
Anesthesia: 1% Xylocaine solution with epinephrine warmed and buffered and injected slowly through a 30- gauge needle for the patient's comfort.
Location: Back
Size of Excision: 11 cm
Estimated Blood Loss: Minimal
Complications: None
Specimen: Sent to the lab in saline for frozen section margin control.
Procedure: The patient was taken to our surgical suite, placed in a comfortable position, prepped and draped, and locally anesthetized in the usual sterile fashion. A #15 scalpel blade was used to excise the basal cell carcinoma plus a margin of normal skin in a circular fashion in the natural relaxed skin tension lines as much as possible The lesion was removed full thickness including epidermis, dermis, and partial thickness subcutaneous tissues. The wound was then spot electro desiccated for hemorrhage control. The specimen was sent to the lab on saline for frozen section.
Rotation flap repair of defect created by foil thickness frozen section excision of basal cell carcinoma of the back. We were able to devise a 12 sq cm flap and advance it using rotation flap closure technique. This will prevent infection, dehiscence, and help reconstruct the area to approximate the situation as it was prior to surgical excision diminishing the risk of significant pain and distortion of the anatomy in the area. This was advanced medially to close the defect with 5 0 Vicryl and 6-0 Prolene stitches.
What CPTcoding is reported for this case?

Answer: A

Explanation:
For the excision of an 11 cm lesion with a rotation flap repair, the appropriate CPT codes are 14001 for the adjacent tissue transfer or rearrangement (12 sq cm flap) and 11606-51 for the excision of a malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm. Modifier 51 indicates multiple procedures. The detailed operative report specifies the lesion size and the technique used, justifying these codes.References: CPTProfessional Edition (current year), AMA.


NEW QUESTION # 331
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