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AAPC CPC Prüfungsplan:

ThemaEinzelheiten
Thema 1
  • Respiratory System: This section of the exam measures the skills of medical coders and evaluates the ability to code procedures involving the nose, sinuses, larynx, trachea, bronchi, and lungs. Attention is given to services like endoscopies, excisions, and resections within the respiratory tract.
Thema 2
  • Overview of ICD-10-CM: This section of the exam measures the skills of medical coders and introduces the structure, format, and usage of the ICD-10-CM coding system. It reviews the purpose of ICD-10-CM in diagnosis reporting and prepares candidates to interpret chapters, code ranges, and conventions embedded in the system.
Thema 3
  • Anesthesia: This section of the exam measures the skills of medical coders and involves coding anesthesia services based on surgical site, complexity, and time. It tests the understanding of anesthesia modifiers and the importance of linking anesthesia codes with the correct primary procedures.
Thema 4
  • Introduction to CPT®, HCPCS Level II, and Modifiers: This section of the exam measures the skills of coding specialists and introduces candidates to CPT® coding for procedures, HCPCS Level II for supplies and services, and the correct use of modifiers. It helps learners distinguish between different code sets and understand their place in medical billing.
Thema 5
  • Endocrine System and Nervous System: This section of the exam measures the skills of medical coders and assesses the ability to assign codes for surgeries involving glands, the brain, spinal cord, and peripheral nerves. Procedures like resections and electrical stimulation are part of the evaluated content.
Thema 6
  • Female Reproductive System and Maternity Care & Delivery: This section of the exam measures the skills of coding specialists and evaluates coding accuracy for gynecological and obstetric procedures. It includes deliveries, antepartum care, cesarean sections, and surgical procedures involving female reproductive anatomy.
Thema 7
  • Musculoskeletal System: This section of the exam measures the skills of coding specialists and focuses on coding procedures involving bones, joints, muscles, and tendons. It covers surgeries, reductions, arthroscopies, and fracture treatments, emphasizing accurate mapping of procedures to anatomical areas.
Thema 8
  • The Business of Medicine: This section of the exam measures the skills of medical coders and covers foundational knowledge regarding the healthcare system, reimbursement models, insurance payers, HIPAA compliance, and the ethical responsibilities coders hold within clinical and billing environments. It establishes the context in which coding decisions directly affect healthcare operations and financial outcomes.
Thema 9
  • Pathology & Laboratory: This section of the exam measures the skills of medical coders and includes lab tests, specimen analysis, and pathological examination procedures. It ensures that coders understand how to apply codes for chemistry panels, cultures, and histopathological diagnostics.
Thema 10
  • Accurate ICD-10-CM Coding: This section of the exam measures the skills of medical coders and focuses on the precise assignment of diagnosis codes using the ICD-10-CM system. The goal is to ensure accurate representation of patient conditions, proper sequencing, and a clear linkage between diagnoses and services.
Thema 11
  • Applying the ICD-10-CM Guidelines: This section of the exam measures the skills of coding specialists and covers how to apply official ICD-10-CM guidelines to real-world coding scenarios. It emphasizes the hierarchy of instructional notes, general and chapter-specific rules, and how to make judgment calls within compliant coding frameworks.
Thema 12
  • Cardiovascular System: This section of the exam measures the skills of coding specialists and addresses services related to the heart, arteries, and veins. It involves the coding of diagnostic and therapeutic procedures, including catheterizations, bypasses, and repairs.:
Thema 13
  • Evaluation & Management Services: This section of the exam measures the skills of coding specialists and covers office visits, hospital care, consultations, and other E
  • M services. It tests the understanding of time-based coding, medical decision-making, and history
  • exam components per current CMS guidelines.
Thema 14
  • Urinary System and Male Genital System: This section of the exam measures the skills of medical coders and assesses understanding of procedures on kidneys, bladder, ureters, prostate, and male reproductive organs. Proper use of CPT codes for surgical and diagnostic interventions is tested.

>> CPC Originale Fragen <<

CPC PrüfungGuide, AAPC CPC Zertifikat - Certified Professional Coder (CPC) Exam

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AAPC Certified Professional Coder (CPC) Exam CPC Prüfungsfragen mit Lösungen (Q59-Q64):

59. Frage
A patient arrives with stridor and in respiratory distress. The provider performs a micro laryngoscopy using a Parson's laryngoscope and magnifying telescope. A bronchoscopy was also performed using a 2.5 Stortz bronchoscope. The findings include subglottic web and stenosis with laryngeal edema suggestive of reflux. There was also significant collapse of the trachea at the carina and into the main bronchi bilaterally.
What CPT coding is reported?

Antwort: D

Begründung:
1. Procedure and CPT Code Selection:
The provider performed both a bronchoscopy and a microlaryngoscopy to evaluate the patient's airway due to respiratory distress and stridor.
Code 31622 is used for a diagnostic bronchoscopy, which includes the inspection of the trachea, carina, and bronchial structures. Since the bronchoscopy was diagnostic and no additional therapeutic procedures were performed, this is the appropriate code.
Code 31526 is for direct laryngoscopy with the use of an operating microscope or telescope (microlaryngoscopy). This code is appropriate given the use of a Parson's laryngoscope and magnifying telescope to inspect the larynx.
2. Modifier 51:
Modifier 51 is added to 31526 to indicate that it was performed in conjunction with another procedure (31622, bronchoscopy). Modifier 51 denotes multiple procedures without the necessity of a separate incision.
3. Exclusion of Code 69990:
Code 69990 is used for the use of an operating microscope in microsurgery but is not coded separately when the procedure (such as microlaryngoscopy) already includes visualization with a microscope or telescope as part of the CPT descriptor. Thus, 69990 is not separately reported in this scenario, per CPT guidelines.
4. AAPC and CPT Coding Guidelines:
The guidelines specify that when visualization or microlaryngoscopy is inherently part of the procedure (as in 31526), 69990 should not be billed separately. Also, the use of Modifier 51 for multiple procedures in the same session is appropriate.
Therefore, the verified answer, following the CPT and AAPC coding rules, is A. 31622, 31526-51.


60. Frage
Refer to the supplemental information when answering this question:
View MR 903096
What CPT and ICD-10-CM coding is reported?

Antwort: B

Begründung:
CPT Code 62290: Discography, lumbar, single or multiple levels, radiological supervision and interpretation This code accurately describes the procedure performed. The documentation indicates a lumbar discography was performed at a single level (L3-4) with radiological supervision (C-arm visualization).
ICD-10-CM Code M54.50: Low back pain, unspecified
This code is the most appropriate diagnosis based on the documentation. The preoperative diagnosis states
"Low back pain possible spinal stenosis L3-4." While spinal stenosis was considered, it was not confirmed.
The postoperative diagnosis indicates no evidence of spinal stenosis or discogenic pathology. Therefore, the definitive diagnosis is low back pain.
Why other options are incorrect:
62292: This code is for a discography with injection of contrast and/or medication for therapeutic purposes.
The documentation doesn't indicate any therapeutic injection was performed.
M48.061 and M48.07: These codes represent spinal stenosis, which was not confirmed in the postoperative diagnosis.
References:
CPT Code 62290: Discography, lumbar, single or multiple levels, radiological supervision and interpretation ICD-10-CM Code M54.50: Low back pain, unspecified AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.


61. Frage
(Full Case:Procedure:Excision of6.0 cm malignant lesionof theright forearmwithadjacent tissue transferusing arotation flap.Pre/Post-op Dx:Basal cell carcinoma, right forearm.Anesthesia:local (1% Xylocaine with epi).
Defect size:8 sq cm.Specimen:sent forfrozen section margin control; margins confirmed clear.Closure:rotation flap from adjacent healthy tissue,total area 8 sq cm, secured with layered closure (5-0 Vicryl/6-0 Prolene).
Question:What CPT coding is reported?)

Antwort: D

Begründung:
The operative report documents amalignant lesion excision(basal cell carcinoma) on theright forearmfollowed by reconstruction with anadjacent tissue transfer (rotation flap)afterfrozen sectionconfirmed clear margins. In CPT, when a defect is repaired withadjacent tissue transfer/rearrangement, the flap code includes the work ofexcision (including necessary undermining and preparation of the recipient site)performed as part of creating and closing the defect; therefore the malignant excision code (e.g.,11606) isnot separately reportedin this same session when the excision is integral to the flap repair. Code selection for adjacent tissue transfer is based on theanatomic siteand thetotal defect area (primary + secondary defects). The documentedtotal area is
8 sq cm, and the site is theforearm (arm/leg grouping). For arms/legs,10 sq cm or lessis reported with14020.
Codes14040apply to a different anatomic region grouping and do not match the forearm. Frozen section pathology/margin control does not change the primary surgical coding here. Therefore, report14020 only.


62. Frage
(Procedure date:01/12/20XX
Surgeon:MD |Assistant:PA
Preoperative diagnosis:Dry gangrene of the left foot in the setting of peripheral vascular disease. Non- pressure chronic ulcer on toe.
Postoperative diagnosis:Dry gangrene of the left foot in the setting of peripheral vascular disease. Non- pressure chronic ulcer on toe.
Procedure:Amputation at the metatarsophalangeal joint of the left third toe Indication:63-year-old female with peripheral vascular disease; vascular workup determined no further interventions to improve vascularity; third toe became progressively dusky; wound formed distally with chronic ulcer; amputation necessary; risks/benefits discussed.
Description:Left foot and third toe marked; 1 g Ancef given; general anesthesia; supine; calf tourniquet; timeout; tourniquet inflated (no Esmarch); total tourniquet time 5 minutes; tennis racquet incision with longitudinal arm over third metatarsal encircling joint proximal to closure; extensor/flexor tendons and collateral ligaments excised sharply; toe removed; tourniquet released; superficial bleeders cauterized; washed out; skin closed with 3-0 nylon; dry dressing; to PACU in good condition; signed 01/19/20XX 09:41.
Question:What CPT and ICD-10-CM coding is reported?)

Antwort: D

Begründung:
The operative service is anamputation of the left third toe at the metatarsophalangeal (MTP) joint.
CPT28820describes toe amputationthrough the MTP joint, matching the "amputation at the metatarsophalangeal joint" language and the incision encircling the joint with removal of the toe after dividing tendons/ligaments. ModifierT2correctly identifies theleft foot, third digit. Diagnosis coding must capture the ischemic disease withgangreneplus thenon-pressure chronic ulceron the toe. In the answer set,I70.
262represents lower-extremity atherosclerosis/PVDwith gangrene(left side per the option). The chronic ulcer is separately reported using the providedL97.528non-pressure ulcer code for the left foot/toe severity category offered by the choices. Antibiotic prophylaxis (Ancef), anesthesia type, tourniquet use/time, and technique details support the procedure but do not change the core CPT/ICD-10-CM selection. Therefore, the correct combination is28820-T2, I70.262, L97.528.


63. Frage
A provider orders liquid chromatography mass spectrometry (LC-MS) definitive drug test for a patient suspected of acetaminophen (analgesic) overdose. What CPT code is reported for the test?

Antwort: A

Begründung:
Frozen section pathology coding rules:
88331 - Frozen section, first tissue block, each specimen
88332 - Frozen section, each additional tissue block, same specimen
Breakdown:
Specimen 1
Block 1 → 88331 × 1
Block 2 → 88332 × 1
Specimen 2
Block 1 → 88331 × 1
Block 2 → 88332 × 1
However, multiple frozen sections per tissue block are separately reportable:
Total first blocks = 4 frozen sections → 88331 × 4
Total additional blocks = 3 frozen sections → 88332 × 3
CPT pathology guidelines require coding by tissue block and specimen, not by polyp alone.


64. Frage
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