Free AAPC CPC Practice Exam with Questions & Answers | Set: 2

Dr. Burns is providing initial hospital or birthing center care for the evaluation and management of a normal newborn infant. CPT code 99460 is used to report initial hospital or birthing center care, per day, for evaluation and management of a normal newborn infant. This includes a comprehensive history, examination, and medical decision-making. The description of the service provided fits this CPT code accurately. References: CPT® Professional Edition (current year), AMA.

Modifier selection for discontinued procedures depends onsettingandhow far the procedure progressed. In the CPT modifier framework,-53(Discontinued Procedure) is used when a physician terminates a procedure due toextenuating circumstances or those that threaten the well-being of the patientafter the procedure has begun. Here, anesthesia was given, the incision was made, and then respiratory distress occurred—clearly a patient safety issue requiring stopping the surgery. That matches modifier-53for the surgeon’s claim. Modifier-74is afacilitymodifier (commonly used by ambulatory surgery centers/hospitals for discontinued outpatient procedures after anesthesia), not the surgeon’s CPT modifier in the typical CPC context. Modifier-47indicates anesthesia by the surgeon, which is not the key fact here and does not represent discontinuation. Modifier-52is for reduced services when a service is partially reduced at the physician’s discretion, not terminated for patient safety. Therefore, the oral surgeon reports21060-53.

Dacryocystitis is the inflammation of the lacrimal sac, which is part of the tear drainage system located in the inner corner of the eye. The lacrimal sac is connected to the nasolacrimal duct, which drains tears into the nasal cavity. Inflammation in this area can cause pain, redness, and swelling near the inner corner of the eye.

ICD-10-CM, medical dictionaries

1. Procedure Details and CPT® Code Selection:

The patient is undergoing stage 2 treatment for double outlet right ventricle (DORV) with a removal of the pulmonary artery band and transposition repair of the great vessels.

Code 33779 is specific for correction of a double outlet right ventricle, with transposition of the great arteries. This code accurately reflects the procedure performed, including the complex repair involving the transposition of the pulmonary trunk and aortic root.

Code 33953 is used to report the initiation of extracorporeal membrane oxygenation (ECMO), which was used to maintain oxygenation during the procedure.

Code 33985 is for the termination of ECMO following the surgical repair once heart function has resumed. Both 33953 and 33985 accurately document the initiation and termination of ECMO during this complex heart repair.

2. Modifier Selection:

Modifier 78 (unplanned return to the operating room for a related procedure during the postoperative period) is appropriate here. This is a subsequent stage in the treatment plan, but due to the complexity and specific surgical intervention required, it is treated as a return to the OR for related procedure coding.

Modifier 58 (staged or related procedure during the postoperative period) would not be as suitable here because the procedure involves a new return to the OR.

3. AAPC and CPT® Coding Guidelines:

AAPC guidelines support the use of specific modifiers (78 for unplanned return) and appropriate ECMO codes (33953 and 33985) in complex cardiac cases requiring bypass and staged treatment.

Thus, the correct CPT® codes based on CPT® and AAPC coding standards are C. 33779-78, 33953-78, 33985-78.

The operative approach is explicitlyopen surgery, so the correct CPT procedure code is44950(appendectomy; open). Code44970is thelaparoscopicappendectomy code and is not supported because the scenario states “open surgery.” For diagnosis, the physician’s final diagnosis ischronic appendicitis, which is reported withK36(other appendicitis) in the context of this question’s choices;K35.80represents acute appendicitis (unspecified acute) and does not match “chronic.” You also do not report symptom codes (nausea/vomiting/abdominal pain) once a definitive diagnosis is established and documented as the reason for the surgery, unless a guideline or scenario specifically requires them as additional reporting (this question does not). Therefore, the correct pairing is44950withK36only. CPC exam tip: always matchapproach(open vs laparoscopic) and code thefinal confirmed diagnosisrather than presenting symptoms when the definitive diagnosis is known.

The patient is seeing a new doctor in the same specialty group for an enlarged goiter and is undergoing a medically appropriate history and exam, along with a fine needle aspiration biopsy.

Procedure Description:

Medically appropriate history and exam.

Review of TSH results and ultrasound.

Ordering of fine needle aspiration biopsy.

CPT® Coding:

99202: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making.

Since it has been two years since the last visit and the patient is being seen by a new doctor in the same specialty group, the encounter is considered a new patient visit.

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

CPT® Assistant for detailed coding guidelines on evaluation and management services.

The place of service code 22 is used for services performed in an outpatient hospital setting, including outpatient surgical floors. This code indicates that the procedure was done in a hospital but not requiring an inpatient admission.

AMA's CPT® Professional Edition (current year), Place of Service Codes.

CPT® code 69644 refers to a tympanoplasty with mastoidectomy, which includes canalplasty, middle ear surgery, and tympanic membrane repair. The specific procedure described by this code is performed with an intact or reconstructed canal wall and includes ossicular chain reconstruction. The use of a semicolon in the CPT® description helps distinguish between different variations of the procedure.

AMA's CPT® Professional Edition, specific code descriptions and guidelines.

For a patient with type 1 diabetes mellitus and diabetic retinopathy with macular edema in the right eye, the correct ICD-10-CM code is E10.3511. This code specifically captures:

E10: Type 1 diabetes mellitus.

35: Diabetic retinopathy with macular edema.

1: Right eye.

Each choice addresses different severities or eye specifications:

A. E10.3211: Indicates mild nonproliferative diabetic retinopathy with macular edema in the right eye, not the general diabetic retinopathy category.

B. E10.3519: Refers to diabetic retinopathy with macular edema without specification to the right eye.

D. E10.311: Refers to nonproliferative diabetic retinopathy without macular edema in the right eye.

Thus, the correct answer is C. E10.3511, as it fully captures type 1 diabetes with diabetic retinopathy with macular edema in the right eye.

Thelunulais the pale, crescent-shaped area visible at the base of some fingernails and toenails (most commonly the thumb). It is part of thenail unit, associated with the nail matrix where nail formation occurs. Because the lunula is anail structure, a biopsy “of the lunula” is anail biopsy, even though a punch tool is also commonly used in skin biopsies. CPC exam questions frequently test precise anatomical vocabulary, especially for integumentary structures (skin, nail, hair). The distractors “eye” and “brain” are unrelated, and “skin” is tempting because punch biopsies are typically skin procedures; however, the question specifically identifies thelunula, which is not a skin landmark. Coding and documentation accuracy depend on knowing these terms because nail procedures often have different code families and clinical considerations than routine skin biopsies. Correct identification starts by mapping the term to its anatomical system: lunula → nail apparatus.