Free AAPC CPC Practice Exam with Questions & Answers | Set: 10

Modifier 53 is used to report a discontinued procedure. It indicates that a procedure was started but terminated due to the patient ' s well-being being at risk. In this scenario, the percutaneous transluminal coronary angioplasty was attempted but stopped because of an anatomical problem that created a risk for the patient, preventing the completion of the procedure.

AMA ' s CPT® Professional Edition, coding guidelines on the use of modifiers.

An esophagogastroduodenoscopy (EGD) was performed with the removal of a polyp using hot biopsy forceps.

Procedure Description:

An EGD was performed.

A polyp was found in the duodenum and removed with hot biopsy forceps.

CPT® Coding:

43250: Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps.

AMA ' s CPT® Professional Edition (current year).

CPT® Assistant for detailed coding guidelines on endoscopic procedures.

This question is testing recognition of amaxillofacial prosthetic servicerather than an ophthalmology procedure code. The vignette describesfabrication of a prosthesis using silicone materialswithmodificationsintended to restorecosmetic appearanceafter loss/damage of an eye. Among the provided options,21086is the CPT code that corresponds to fabrication of afacial prosthesis(commonly silicone-based) with the intent of external restoration. The other codes in this small cluster represent different facial/craniofacial repair or prosthetic services and do not match silicone prosthesis fabrication described in the scenario. CPC exam technique: focus on the key nouns—“fabricates a prosthesis,” “silicon materials,” “cosmetic appearance restoration”—which point away from repair codes and towardprosthetic fabrication. Also note the question is not about insertion of an ocular implant during enucleation/evisceration, but about crafting an external prosthetic device. Therefore, the correct selection is21086.

69200 – Removal of foreign body from external auditory canal; without anesthesia

Correct for simple removal using forceps

Patient tolerated procedure without anesthesia

Why Other Options Are Incorrect:

69110 / 69105 – Middle ear procedures

69205 – Removal with general anesthesia

Moderate sedation codes are selected by (1)patient ageand (2) whether the sedation is provided by thesame physician performing the procedureor by a different provider. The stem states theorthopedist provides the sedation and the reduction, so the sedation is provided by thesame physicianwho performs the procedure. For age, the patient is5 years old, which falls into the≥5 yearscategory. Therefore, the correct initial moderate sedation code is99152(moderate sedation provided by the same physician/other qualified provider performing the procedure; patient age 5 years or older; initial 15 minutes). The documented time is21 minutes, which supports only theinitialcode (it does not reach the threshold needed to report an additional 15-minute increment add-on). Code99151is for patientsunder 5 years, so it does not apply. Codes99155/99156are for sedation provided by adifferentprovider than the one performing the procedure. CPC exam tip: age cutoffs matter—exactly 5years old uses the “5 years or older” code set.

37267 = Iliac artery stent placement

Angioplasty is bundled into the stent code

For the injections, CPT® code 64642 is used for chemodenervation of one extremity; 64643 for each additional extremity, and 64647 for chemodenervation of muscles in the paraspinal region. The modifier -50 is added to 64642 and 64643 to indicate bilateral procedures. According to CPT® guidelines, when multiple sites are treated, each site is coded separately, and appropriate modifiers are used.

AMA ' s CPT® Professional Edition (current year), Surgery section, Nervous System.

When a prior malignancy has been eradicated and the patient is no longer receiving treatment for the primary site, ICD-10-CM directs you to use apersonal history of malignant neoplasmcode rather than an active primary cancer code. Here, the breast cancer was treated successfully last year and no further therapy was required, so the breast cancer ishistory, not active. The new current condition ismetastatic cancer to the liver, which is coded as asecondary malignant neoplasm of liver and intrahepatic bile duct (C78.7). Because the primary breast cancer is not documented as active or under current treatment, you donotcode an active breast malignancy (C50.-). Instead, you addZ85.3 (personal history of malignant neoplasm of breast)to show the prior cancer history relevant to the current metastatic disease. Option A incorrectly codes a primary liver cancer. Option C incorrectly codes active breast cancer. Option D codes metastasis to the adrenal gland, not the liver.

1. Procedure and CPT® Code Selection:

The patient underwent venous thrombosis imaging of each leg to assess for deep venous thrombosis (DVT).

CPT® Code 78457 is used for a venous thrombosis imaging study. This code is appropriate for imaging to detect DVT.

Modifier 50 is applied to indicate a bilateral procedure, as imaging was performed on both legs.

2. Diagnosis and ICD-10-CM Code Selection:

ICD-10-CM Code I82.403 is used for acute embolism and thrombosis of unspecified deep veins of bilateral lower extremities. This code accurately describes the finding of DVT in both legs.

Other ICD-10-CM options, such as I82.401 and I82.402, specify unilateral lower extremity involvement, which does not accurately reflect the bilateral findings in this case.

3. Rationale for Excluding Other Options:

Code 78458 (in options A and D) is for a more comprehensive study, often cardiac or whole-body blood pool imaging, and is not specific to leg venous thrombosis.

Option C, which lists 78457 with individual RT and LT modifiers, is incorrect as Modifier 50 is appropriate for bilateral imaging on both legs.

4. AAPC and CPT® Coding Guidelines:

According to AAPC and CPT® guidelines, 78457 with Modifier 50 should be used for bilateral venous imaging studies, and I82.403 correctly captures bilateral DVT.

Thus, the correct answer is B. 78457-50, I82.403.

For ERCP, CPT coding follows the rule that thetherapeutic ERCP code includes the diagnostic ERCP workperformed during the same session. In this case, the key performed service isstent insertion into the biliary duct, which is captured by43274(ERCP with placement of endoscopic stent into biliary or pancreatic duct). You donotseparately report the diagnostic ERCP code43260when the therapeutic service (stent placement) is performed, because the diagnostic component is considered part of the overall ERCP service. Code43276is used forstent removal and/or exchange, which is not described here. Option D is incorrect because it pairs another ERCP service with stent placement, and the scenario does not support multiple distinct ERCP therapeutic services beyond stenting. CPC exam tip: when a single ERCP session includes diagnostic evaluation plus a therapeutic intervention, report themost definitive therapeutic ERCP code—here,43274.