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| Section | Weight | Objectives |
|---|---|---|
| Reimbursement & Revenue Cycle | 5-7% | |
| CPT® Coding | 45-50% | - Surgery (10000–69999) - Evaluation & Management (E/M) - Radiology, Pathology/Laboratory, Medicine |
| ICD-10-CM Coding | 15-17% | - Code selection & sequencing - Diagnosis coding guidelines |
| Medical Terminology & Anatomy | 8-10% | |
| Modifiers | 5-7% | |
| Compliance & Regulations | 8-10% | - HIPAA, fraud & abuse - Reimbursement rules |
| HCPCS Level II Coding | 5-7% |
>> CPC Reliable Exam Topics <<
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NEW QUESTION # 156
A 42-year-old male is diagnosed with a left renal mass. An abdominal incision along with rib resection is made to expose and access the kidney. The left kidney is removed, along with surrounding fat, adrenal gland, lymph nodes in the area, and the incision site is sutured. What CPT code is reported for this procedure?
Answer: D
Explanation:
50230 - Radical nephrectomy, including removal of kidney, perirenal fat, adrenal gland, and regional lymph nodes Open approach with rib resection Correct for extensive removal beyond simple nephrectomy Why Other Options Are Incorrect:
50545 / 50543 - Laparoscopic/robotic approaches
50220 - Simple nephrectomy only
NEW QUESTION # 157
(A 6-month-old child was brought to the hospital with severe breathing difficulties. After testing, the child was diagnosed withtracheal stenosis present from birth. The pediatric surgeon performed atracheoplasty (surgical widening of the trachea). What CPT and ICD-10-CM codes are reported?)
Answer: B
Explanation:
The diagnosis "tracheal stenosis present from birth" is acongenital malformation, which is coded withQ32.1 (congenital stenosis of trachea) rather than an acquired tracheal disorder code. For anesthesia coding, tracheoplasty is a major airway/tracheal surgical procedure and maps to the appropriateairway/trachea anesthesiacategory represented by00320in the answer set. Because the patient is aninfant (6 months old), anesthesia qualifies for the extreme age add-on99100(anesthesia for patient of extreme age, under 1 year or over 70 years). Options includingJ39.8reflect an acquired/other tracheal disorder category rather than congenital stenosis, which conflicts with "from birth." Options that omit 99100 miss the age-related qualifying circumstance. CPC exam strategy: always code congenital conditions withQ-codeswhen documented as present from birth, and remember99100for patients<1 yearwhen anesthesia qualifying circumstances are reported. Therefore,00320, 99100, Q32.1is correct.
NEW QUESTION # 158
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?
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 # 159
The gynecologist performs a colposcopy of the cervix including biopsy and endocervical curettage.
What CPT code is reported?
Answer: B
Explanation:
Colposcopy of the Cervix: This involves a visual examination of the cervix using a colposcope.
Biopsy and Endocervical Curettage: The procedures performed include taking a biopsy and scraping the lining of the cervical canal.
CPT Code 57454: This code represents a colposcopy of the cervix with biopsy and endocervical curettage.
Reference:
AMA's CPT Professional Edition (current year)
NEW QUESTION # 160
Which one of the following is an example of a case in which a diabetes-related problem exists and the code for diabetes is never sequenced first?
Answer: C
Explanation:
When a patient experiences an underdose of insulin due to an insulin pump malfunction, the primary reason for the encounter would be the malfunction itself, which is coded first. The resulting hyperglycemia or hypoglycemia due to the pump failure is a secondary condition. According to ICD-10-CM guidelines, the code for the mechanical complication of the pump (T85.633-) is sequenced first, followed by a code for the diabetes with complication (E11.65 for type 2 diabetes with hyperglycemia).References: ICD-10-CM (current year), Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88), ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.4.
NEW QUESTION # 161
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