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| Section | Weight | Objectives |
|---|---|---|
| Anatomy & Physiology | 10-15% | - Body Systems - Medical Terminology |
| Medicine | 5-10% | - Specialty Coding |
| E/M (Evaluation and Management) | 10-15% | - Office/Outpatient Visits - Emergency Department |
| Radiology | 5-10% | - Diagnostic Imaging |
| HCPCS Level II | 5-10% | - Modifiers - Supplies and Equipment |
| Surgery Coding | 40-50% | - Respiratory System - Musculoskeletal System - Genitourinary System - Cardiovascular System - Digestive System - Nervous System - Integumentary System |
| Laboratory / Pathology | 5-10% | - Organ and Disease Panels |
| ICD-10-CM (Diagnosis Coding) | 10-15% | - Conventions and Guidelines - Code Selection |
今日、It-Passports市場での競争は過去のどの時代よりも激しくなっています。 良い仕事を見つけたいなら、あなたは良い能力と熟練した主要な知識を所有していなければなりません。 そのため、CPC最高の学習教材を提供するため、AAPC認定を取得する必要があります。 当社のAAPC試験トレントは高品質で効率的であり、CPCテストに合格するのにCertified Professional Coder (CPC) Exam役立ちます。
質問 # 42
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?
正解：B
解説：
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.
質問 # 43
An interventional radiologist performs an abdominal paracentesis using fluoroscopic guidance to remove excess fluid. The procedure is performed in the hospital. What CPT coding is reported?
正解：C
解説：
49083 - Abdominal paracentesis, diagnostic or therapeutic; with imaging guidance This code includes imaging guidance (ultrasound or fluoroscopy).
Per CPT guidelines, do not separately report fluoroscopy or ultrasound guidance with 49083.
The procedure was performed in the hospital, but CPT coding does not change based on site of service.
Why Other Options Are Incorrect:
A (49082) - Used without imaging guidance
B / D - Imaging guidance codes (77001, 77002) are bundled into 49083 per CPT and NCCI edits Official CPT Guidance:
When a paracentesis is performed with imaging guidance, report 49083 only.
質問 # 44
(A provider states that all of their office visits should be reported asmoderate levelsbecause they treat patients with high-complexity problems. Would this be considered a compliance problem?)
正解：D
解説：
Systematically billing all office visits at a predetermined level-without documentation supporting the requiredmedical decision making (MDM)ortime-is a classic compliance red flag and is generally treated asabuse(often described as upcoding when higher levels are billed than supported). E/M levels must reflect what was actually performed and documented for that encounter, using the E/M rules (MDM elements or total time, depending on code selection). Even if a provider treats complex patients, not every visit will meet the same level; stable follow-ups may be lower complexity than acute exacerbations or new problems. "Waste" generally refers to inefficient or unnecessary use of resources without intent to misrepresent; a blanket instruction to code moderate levels suggestssystematic misbillingrather than inefficiency. Option D is incorrect because providers cannot select any level at will-coding must be supported by documentation. This type of pattern is exactly what audits target, and it can trigger overpayment recoupment, penalties, and corrective action plans.
質問 # 45
A patient is taken to the radiology department for a radiological cardiac catheterization. An acute MI of the left anterior descending coronary artery is found. The cardiologist performs a suction thrombectomy, followed by atherectomy and a stent to the artery. A CRNA provides MAC for this patient, who is status P5.
What code/modifier combination would you report for the services of the CRNA?
正解：A
解説：
The patient is undergoing a cardiac catheterization with a CRNA providing monitored anesthesia care (MAC).
Code 00520 is for anesthesia for heart catheterization procedures. Modifier QX indicates CRNA service with medical direction by a physician, QS indicates MAC, and P5 indicates a patient with a severe systemic disease that is a constant threat to life. Thus, the correct code and modifier combination is 00520-QX-QS-P5.
References: CPTProfessional Edition (current year), AMA.
質問 # 46
A patient is seen at the doctor's office for nausea, vomiting, and sharp right lower abdominal pain. CT scan of the abdomen is ordered. Labs come back indicating an increased WBC count with review of the abdominal CT scan. The physician determines the patient has chronic appendicitis. The physician schedules an appendectomy and takes the patient to the operating room. The appendix is severed from the intestines and removed via scope inserted through an umbilical incision. What CPT and diagnosis codes are reported?
正解：D
解説：
1. Procedure and CPT Code Selection:
The patient underwent an appendectomy performed via laparoscopic approach. The procedure involved removal of the appendix using a scope inserted through an umbilical incision.
CPT Code 44970 is specific for a laparoscopic appendectomy, which is the correct code for this procedure.
Code 44950 would be used for an open appendectomy, but since this case was performed laparoscopically, 44970 is appropriate.
2. Diagnosis and ICD-10-CM Code Selection:
The diagnosis given by the physician is chronic appendicitis.
ICD-10-CM Code K36 is used to report chronic appendicitis, which is the definitive diagnosis in this case.
Additional codes for symptoms such as nausea (R11.2) and right lower quadrant pain (R10.31) are not necessary because the primary diagnosis of chronic appendicitis (K36) fully explains the symptoms, according to ICD-10-CM guidelines on coding symptoms when a definitive diagnosis is available.
3. AAPC and CPT Coding Guidelines:
AAPC guidelines indicate that when a definitive diagnosis is established, symptom codes should not be reported separately. The use of 44970 for laparoscopic appendectomy and K36 for chronic appendicitis is fully supported by these coding standards.
Therefore, the correct answer is C. 44970, K36.
質問 # 47
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