CPC AAPC Certified Professional Coder (CPC) Exam Free Practice Exam Questions (2025 Updated)

Procedure: The physician performed a liver biopsy using ultrasonic guidance.

CPT® Codes:

47000: This code is for the liver biopsy.

76942-26: This code is for ultrasonic guidance for needle placement, with modifier -26 indicating the professional component.

Code Selection Justification: The CPT® code 47000 specifically captures the liver biopsy, and 76942-26 accurately represents the ultrasonic guidance utilized during the procedure.

References:

AMA CPT® Professional Edition (current year)

ICD-10-CM (current year)

HCPCS Level II (current year)

To determine the correct E/M code, we need to consider the three key components: history, examination, and medical decision making (MDM).

History:

The documentation indicates an expanded problem-focused history. This is supported by the detailed history of present illness, including the patient's description of symptoms, family history, and review of systems with pertinent positives and negatives.

Examination:

The examination is also expanded problem-focused. The physician focused on the relevant systems (head, neck, throat) and documented specific findings related to the chief complaint (thyromegaly).

Medical Decision Making:

The MDM is straightforward. The physician is evaluating a new problem (bilateral thyroid nodules) with a low level of risk. Although further workup is planned, this alone doesn't automatically increase the MDM complexity.

Based on these components, 99213 is the most appropriate code.

Why other options are incorrect:

99212: Requires a problem-focused history and examination, which is less comprehensive than what was documented.

99214 and 99215: Require a higher level of MDM (low or moderate complexity) and/or a more detailed examination. The documentation doesn't support this level of service.

References:

CPT Codes 99211-99215: Office or other outpatient visit for the evaluation and management of an established patient

1995 and 1997 Documentation Guidelines for Evaluation and Management Services: These guidelines provide detailed criteria for selecting the appropriate E/M code based on history, examination, and MDM.

AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.

1. Procedure and CPT® Code Selection:

The scenario describes the fabrication of an ocular prosthesis due to a severe injury to the left eye. A prosthesis made from silicon materials was created and customized to restore cosmetic appearance.

Code 21088 is the correct CPT® code for facial prosthesis involving materials, such as silicone, specifically designed to address anatomical loss in the eye region. This code accurately reflects the custom fabrication of a prosthesis to replace or augment damaged eye structures for aesthetic purposes.

2. Ruling Out Other Options:

Code 21077 applies to the prosthetic augmentation or replacement of mandibular or maxillary bone, not ocular prostheses, so it does not apply here.

Code 21080 covers the fabrication of facial prosthetics but is not specific to the ocular area and is more generalized. Given the focused nature of the eye, 21088 is more appropriate.

Code 21086 pertains to the creation of orbital prostheses (used for areas surrounding the eye) but not specifically for an ocular prosthesis. Since this scenario involves an intraocular replacement, 21088 is the most precise choice.

3. AAPC and CPT® Guidelines:

According to AAPC guidelines, using codes for facial prosthetics requires matching the specific anatomical site and purpose of the prosthesis. CPT® 21088 is directly applicable to prosthetic replacements within the ocular region, making it the best fit.

Thus, based on the CPT® guidelines and coding standards, the verified answer is C. 21088.

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: CPT® Professional Edition (current year), AMA.

Open Roux-en-Y Gastric Bypass: The procedure involves creating a small gastric pouch and anastomosing it to the jejunum.

CPT Code 43847: This code describes a surgical gastric restrictive procedure with gastric bypass for morbid obesity, open.

ICD-10-CM Code E66.01: This code represents morbid (severe) obesity due to excess calories.

ICD-10-CM Code Z68.42: This code indicates a BMI of 45.

References:

AMA's CPT® Professional Edition (current year)

ICD-10-CM (current year)

CPT Code 55706: Biopsy, prostate; needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance.

This code accurately describes the procedure performed. The documentation clearly states that a stereotactic template was used to guide the biopsy needles, and multiple samples were taken (saturation biopsies). This code includes imaging guidance.  

CPT Code 76942: Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation.  

Although 55706 includes imaging guidance, code 76942 is also reported separately because the transrectal ultrasound provided initial diagnostic images and was then used for guidance during the biopsy. This is supported by the documentation which states "Using a B & K ultrasound probe, a transrectal ultrasound of the prostate was obtained. Once this was done...a biopsy needle is inserted into the prostate...under ultrasound guidance." This indicates distinct uses of the ultrasound.

Important Note: While some sources suggest that 76942 and the diagnostic transrectal ultrasound code (76872) are bundled, it's crucial to consult the latest National Correct Coding Initiative (NCCI) edits for the most up-to-date guidance.

References:

CPT Code 55706: Biopsy, prostate; needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance

CPT Code 76942: Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation  

AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.

NCCI Edits: Always check the most current NCCI edits to confirm coding combinations.

1. Procedure and CPT® Code Selection:

The patient underwent a 7-view X-ray of the lumbosacral spine, which included bending views. A complete set of views is captured.

CPT® Code 72114 is appropriate for a complete lumbosacral spine X-ray with a minimum of six views. This code includes comprehensive imaging, such as bending and other specialized views, which were taken in this scenario.

2. Rationale for Excluding Other Options:

Code 72020 is for a single-view X-ray of the spine, which is not adequate to describe a 7-view series.

Code 72080 is for a two- or three-view X-ray of the thoracolumbar spine, which does not cover the full set of seven views described in this scenario.

Code 72084 represents a complete thoracic spine study with multiple views but does not specifically cover the lumbosacral spine, which is the focus of this X-ray examination.

3. AAPC and CPT® Coding Guidelines:

According to AAPC and CPT® guidelines, 72114 is the correct choice for a complete lumbosacral spine study involving multiple views, including specialized views like bending.

Therefore, the correct answer is C. 72114.

1. Procedure and CPT® Code Selection:

The test ordered is a bile acid quantitation using an enzymatic method. This test measures the total bile acids in a patient with chronic hepatitis.

CPT® Code 82248 is specific for quantitation of bile acids, total, which is the correct code for a bile acid test using any method, including enzymatic.

2. Rationale for Excluding Other Options:

Code 82247 is used for the measurement of bilirubin, not bile acids, making it inappropriate for this test.

Code 82239 is for measuring an amino acid (gamma-glutamyl transferase), which is unrelated to bile acid quantitation.

Code 82252 is for a fecal bile acid screening, which is different from a quantitation of bile acids in serum or plasma.

3. AAPC and CPT® Coding Guidelines:

According to AAPC guidelines, 82248 should be selected for total bile acid quantitation regardless of the specific analytical method used.

Therefore, the correct answer is A. 82248.

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.

The procedure involved the placement of an intra-aortic balloon pump (IABP) through the right common femoral artery for a patient with acute MI and severe left main arteriosclerotic coronary artery disease.

Procedure Description:

Placement of an intra-aortic balloon pump (IABP).

Right common femoral artery approach.

Confirmation of good waveform and securement of the catheter.

CPT® Coding:

33975: Insertion of intra-aortic balloon assist device, percutaneous.

References:

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

CPT® Assistant for detailed coding guidelines on cardiac procedures.

The emergent endovascular repair of an infrarenal abdominal aortic aneurysm with an aorto-aortic tube endograft is coded with CPT 34702. This code includes the deployment of the endograft and the necessary balloon angioplasty for sealing the proximal and distal attachment zones.

References:

AMA's CPT® Professional Edition (current year)

For a complete bilateral mastectomy with insertion of breast prosthesis performed during the same surgical session, the correct CPT® codes are:

1. 19303-50: This code represents a complete mastectomy (removal of breast tissue) performed bilaterally (indicated by the -50 modifier).

2. 19340-50: This code is for the immediate insertion of a breast prosthesis following mastectomy, also performed bilaterally.

Explanation of other options:

A. 19303-50, 19342-50: Incorrect because 19342 is for the insertion of a breast implant, which differs from a prosthesis.

B. 19305-50, 19340-50: 19305 describes a modified radical mastectomy, which is more extensive than what is documented here.

C. 19325-50: This code represents a breast augmentation procedure, not a mastectomy with prosthesis insertion.

Thus, the correct answer is D. 19303-50, 19340-50, which accurately describes a bilateral mastectomy with prosthesis insertion.

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.

References:

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

CPT® Assistant for detailed coding guidelines on endoscopic procedures.

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.

1. Procedure and CPT® Code Selection:

The procedure described is a craniectomy to access and remove a supratentorial intracerebral hematoma using a suction device.

CPT® Code 61314 is specific for a craniectomy or craniotomy for evacuation of a hematoma, supratentorial (within the upper portion of the brain), and includes any required dural repair and closure. This code precisely describes the procedure performed to remove the hematoma.

2. Rationale for Excluding Other Options:

Code 61154 is used for a burr hole procedure for the evacuation of a hematoma, which is a less invasive approach and does not involve a craniectomy.

Code 61313 is for a craniectomy or craniotomy to evacuate an infratentorial hematoma, which is located in the lower portion of the brain (posterior fossa) and is not applicable here.

Code 61312 is for evacuation of an epidural or subdural hematoma and does not apply to an intracerebral hematoma as described in this case.

3. AAPC and CPT® Coding Guidelines:

According to AAPC guidelines, 61314 is the appropriate code for craniectomy procedures aimed at removing supratentorial intracerebral hematomas, as it covers the full scope of the documented procedure.

Thus, the correct answer is A. 61314.

Injection of atropine: Atropine is administered to reduce sialorrhea.

Bilateral submandibular salivary glands: The physician administers the injections into the salivary glands.

Total of four glands: Indicates that multiple glands are treated in the same session.

CPT code 64611 accurately represents chemodenervation of the salivary glands, bilateral. The use of -50, -52, or x4 modifiers is not appropriate since CPT guidelines include bilateral procedures in this code without needing additional modifiers or codes.

References: AMA's CPT® Professional Edition (current year)

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