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

The patient has undergone a left total knee arthroplasty and subsequently received a femoral nerve block for postoperative pain management. CPT code 01402 is used for anesthesia for total knee arthroplasty. Code 64447-59-LT is for a femoral nerve block (single injection) for postoperative pain management, with modifier 59 indicating a distinct procedural service and LT indicating the left side. Therefore, the appropriate codes are 01402 and 64447-59-LT.References: CPT® Professional Edition (current year), AMA.

1. Procedure and CPT® Code Selection:

The patient underwent a pulmonary function test that included spirometry, vital capacity, breathing capacity, and flow volume measurements before and after bronchodilator administration.

CPT® Code 94060 is for spirometry, including the bronchodilator responsiveness testing, which involves capturing pre- and post-bronchodilator measurements. This code accurately reflects the testing performed.

CPT® Code 94010 is for spirometry testing without bronchodilator, which might be considered redundant in this case since 94060 encompasses spirometry testing with and without bronchodilator. However, some practices may code both, but generally, 94060 alone should suffice.

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

ICD-10-CM Code J45.901 is used for unspecified asthma with acute exacerbation. This code is appropriate given that the diagnosis indicates intermittent asthma with exacerbation.

J45.21 represents mild intermittent asthma without the specification of exacerbation, making it less accurate than J45.901 in this context.

3. Rationale for Excluding Other Options:

Code 94070 (options B and C) is for bronchospasm provocation testing, which does not apply to standard pulmonary function testing with bronchodilator responsiveness.

Option D includes J45.21, which does not capture the exacerbation aspect and is therefore incorrect.

4. AAPC and CPT® Coding Guidelines:

According to AAPC guidelines, 94060 should be used when pre- and post-bronchodilator spirometry is performed, and J45.901 is appropriate for asthma with exacerbation.

Therefore, the correct answer is A. 94060, 94010, J45.901.

1. Problem Type Selection:

Miranda is following up on her diabetes, which is a chronic condition. Her blood sugars are controlled, indicating that the condition is stable with her current medication regimen.

Stable, chronic illness is defined in the CPT® MDM (Medical Decision Making) Table as a chronic condition that is under control and not currently worsening, even if ongoing management is required. This aligns with the patient's diabetes being well-managed with her prescribed medications.

2. Rationale for Excluding Other Options:

A. Acute, uncomplicated illness or injury is not applicable as diabetes is a chronic condition, not an acute issue.

B. Minimal problem refers to conditions that are minor or self-limited and typically require little to no treatment, which does not apply to chronic conditions like diabetes.

D. Stable, acute illness would refer to an acute condition that has stabilized, whereas diabetes is a chronic condition, not acute.

3. AAPC and CPT® Coding Guidelines:

According to the CPT® MDM Table, a "Stable, chronic illness" is the correct classification for a follow-up encounter on a controlled chronic condition like diabetes.

Therefore, the correct answer is C. Stable, chronic illness.

The outermost protective layer of the skin is called the epidermis. It serves as a barrier to protect the body against environmental elements, pathogens, and helps to retain moisture. The epidermis itself is composed of several sub-layers, with the stratum corneum being the outermost layer.References: ICD-10-CM (current year), Chapter 12: Diseases of the Skin and Subcutaneous Tissue (L00-L99).

1. Procedure and CPT® Code Selection:

The procedure performed was an evisceration of ocular contents without the placement of an implant. The surgical microscope was used for enhanced visualization, but this does not require a separate code if the primary procedure code includes it inherently.

CPT® Code 65091 is used for an evisceration of the ocular contents without implant placement. This code correctly describes the procedure performed on the left eye.

2. Modifier:

Modifier LT is added to indicate that the procedure was performed on the left eye.

3. Exclusion of Code 69990:

Code 69990 is for the use of an operating microscope, but it should not be billed separately when it is used as part of a procedure where enhanced visualization is typical or expected, such as an evisceration procedure. According to CPT® guidelines, 69990 is not separately reported when the microscope is used for visualization in procedures where its use is considered part of the standard of care.

4. Rationale for Excluding Other Options:

Code 65093 is for an evisceration with implant placement, which does not apply since no implant was used.

Options B and C incorrectly include 69990, which is not separately reportable in this scenario.

5. AAPC and CPT® Coding Guidelines:

According to AAPC and CPT® coding guidelines, 65091 is sufficient to capture the procedure without the need to add code 69990 for the microscope.

Therefore, the correct answer is D. 65091-LT.

1. Procedure and CPT® Code Selection:

The scenario describes the removal and replacement of an inflatable penile prosthesis due to erectile dysfunction.

CPT® Code 54416 is specifically used for the removal and replacement of a multi-component inflatable penile prosthesis. This code accurately describes the procedure performed.

2. Rationale for Excluding Other Options:

Code 54401 represents the initial insertion of a multi-component inflatable penile prosthesis but does not cover removal and replacement, making it inappropriate for this scenario.

Code 54400 is for the insertion of a non-inflatable (malleable) penile prosthesis, which does not apply here as the prosthesis is inflatable.

Code 4417 does not exist in the CPT® coding system and is likely a typo or incorrect option.

3. AAPC and CPT® Coding Guidelines:

According to AAPC and CPT® guidelines, 54416 is the correct code when an inflatable prosthesis requires both removal and replacement, without the need for additional modifiers for this procedure.

Therefore, the correct answer based on CPT® guidelines is D. 54416.

The CPT® codes for skin biopsies depend on the method used and the location of each lesion. Here, the scenario includes:

1. Two punch biopsies on the trunk: CPT® code 11104 is used for a full-thickness punch biopsy of the skin, and 11104 x 2 is appropriate since two lesions on the trunk were sampled.

2. One partial-thickness shave biopsy on the forehead: CPT® code 11102 is used for a tangential (shave) biopsy, which captures a partial-thickness sample, appropriate for the forehead lesion.

Explanation of other options:

B. 11104, 11105, 11103: Incorrect, as 11105 is an add-on for additional punch biopsies at separate sites but not used here.

C. 11104, 11103 x 2: 11103 is an add-on code for additional shave biopsies, which does not apply to the punch biopsies on the trunk.

D. 11104, 11102 x 2: Incorrect, as 11102 is only used for the shave biopsy, not for the punch biopsies.

The Office of Inspector General (OIG) provides compliance program guidance to form the basis of a voluntary compliance program for provider practices. This guidance is intended to help healthcare providers develop effective internal controls to monitor adherence to applicable statutes, regulations, and program requirements of Federal healthcare programs. The OIG issues various compliance guidelines and resources to assist organizations in establishing comprehensive compliance programs to prevent fraud, waste, and abuse.References: OIG Compliance Program Guidance, AMA's CPT® Professional Edition, and healthcare compliance resources.

In ICD-10-CM coding, personal history codes are used to indicate a patient’s past medical conditions that no longer exist and are not receiving active treatment, but that may influence current care or require continued monitoring.

A. is correct because a personal history code can indeed be reported as a primary code if the encounter is specifically for screening due to a past condition.

B. is correct because personal history codes can be reported with follow-up codes to indicate that the patient is being monitored for recurrence of the past condition.

D. is correct because a personal history code is used when the patient no longer has or is being treated for that condition, but it remains relevant to the patient’s health history.

C. is false because a personal history code is not used indiscriminately on any medical record; it is only appropriate when the past condition is relevant to the current encounter or impacts current patient care.

Therefore, the correct answer is C. A personal history code is acceptable on any medical record regardless of the reason of the visit.

1. Procedure and CPT® Code Selection:

The patient underwent a bilateral excisional vasectomy for sterilization.

CPT® Code 55250 represents a bilateral vasectomy with excision, which includes postoperative care. The code already implies a bilateral procedure, so it is not necessary to add the -50 modifier for bilateral designation.

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

ICD-10-CM Code Z30.2 is used for encounter for sterilization and is the correct code to report for a planned sterilization procedure such as a vasectomy.

Code Z30.012 is specific to encounter for sterilization of a female patient, which does not apply in this male patient scenario.

3. Rationale for Excluding Other Options:

55250-50 (in options C and D) is unnecessary because the CPT® code 55250 inherently covers a bilateral vasectomy, and applying the -50 modifier is redundant.

Z30.012 (options B and D) is incorrect as it pertains to female sterilization procedures, not male.

4. AAPC and CPT® Coding Guidelines:

According to AAPC guidelines, 55250 is reported without a bilateral modifier, as the procedure inherently covers both sides. Additionally, Z30.2 is the correct ICD-10-CM code for male sterilization procedures.

Thus, the correct answer based on CPT® and ICD-10-CM guidelines is A. 55250, Z30.2.

1. Procedure and CPT® Code Selection:

The patient had a cochlear implant placed in the left ear and is now seeing the audiologist for initialization and programming of the implant.

CPT® Code 92603 is specific for initial programming of a cochlear implant for patients younger than 12 years old. This includes the setup and initial adjustments required for the cochlear implant, making it the correct code.

2. Rationale for Excluding Other Options:

Code 92626 is used for evaluating auditory function with the cochlear implant, focusing on assessment rather than programming, and is therefore incorrect for this programming session.

Code 92630 is for aural rehabilitation following cochlear implant, which does not apply to the programming/initiation stage.

Code 92604 is for subsequent programming sessions after the initial programming and is therefore not applicable for the first-time programming.

3. AAPC and CPT® Coding Guidelines:

According to AAPC guidelines, 92603 is the appropriate code for initial programming of a cochlear implant in children under 12 years of age.

Therefore, the correct answer is D. 92603.

The anesthesia code for an axillary block for procedures on the upper arm and elbow, which includes the monitoring by the anesthesiologist throughout the procedure, is 01830. This code is appropriate for anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of the shoulder and axilla.

References:

CPT® Professional Edition, AMA

Anesthesia Coding Guidelines

1. Procedure Details and CPT® Code Selection:

The patient underwent a catheter placement in the proper hepatic artery (a visceral artery), followed by dye injection and imaging to identify a stenosis, and finally a percutaneous transluminal angioplasty of the artery.

Code 36247 is appropriate for selective catheter placement in the third-order or more selective branch of a visceral artery. Since the proper hepatic artery is a selective branch accessed from the left femoral artery, this code accurately describes the catheter placement.

Code 75736 is for angiography of a selective visceral artery following catheter placement, which matches the imaging procedure performed here.

Code 37248 describes a percutaneous transluminal angioplasty of a visceral artery, which is the therapeutic intervention performed to treat the stenosis in the proper hepatic artery.

2. Modifiers:

Modifier 26 is used with 75736 to denote the professional component of the imaging service.

Modifier 59 indicates that the imaging (75736) is a distinct procedural service, separate from the therapeutic angioplasty (37248).

Modifier 51 is applied to 37248 to indicate it was a secondary procedure in addition to the diagnostic imaging and catheter placement.

3. Exclusion of Other Options:

Code 36253 (in choices A and D) is for selective catheter placement in a different vessel and does not apply to the hepatic artery.

Code 75726 is for non-selective abdominal aortography, which does not match the specific selective imaging of the hepatic artery.

4. AAPC and CPT® Coding Guidelines:

According to AAPC guidelines, each step in an angiographic and interventional radiology procedure is coded based on the level of vessel accessed, imaging performed, and therapeutic intervention completed, which is all accurately represented by 36247, 75736-26-59, and 37248-51.

Based on CPT® and AAPC coding guidelines, the correct answer is C. 36247, 75736-26-59, 37248-51.

You said:

Laminectomy and Facetectomy (63047 and 63048): The laminectomies at L4 and L5 with facetectomies fall under CPT codes 63047 (for the initial segment) and 63048 (for each additional segment).

Posterior Arthrodesis (22612 and 22614 x 3): The posterior arthrodesis from L1-L5 is coded with 22612 for the primary segment (L4-L5) and 22614 for each additional segment (L1-L4).

Placement of Pedicle Screws (22842): The placement of pedicle screws at L2, L3, and L4 is captured under CPT code 22842 for segmental instrumentation.

References:

AMA's CPT® Professional Edition (current year)

ICD-10-CM (current year)

HCPCS Level II (current year)

1. Procedure and CPT® Code Selection:

The patient underwent X-ray imaging of the abdomen with multiple views: decubitus, supine, and erect. This is a comprehensive study that includes different positioning to evaluate the abdomen.

CPT® Code 74022 is appropriate for an abdominal X-ray with a minimum of three views. This code accurately reflects the multiple views taken in this scenario.

2. Modifier 26:

Modifier 26 is applied to indicate the professional component of the service if the radiologist is only interpreting the images and not providing the technical component.

3. Rationale for Excluding Other Options:

Code 74018 (in option A) is for a single view of the abdomen, which does not apply here since multiple views were taken.

Code 74019 (in option C) covers two views of the abdomen, which is insufficient for this three-view study.

Code 74021 (in option D) represents an abdominal X-ray with more limited or focused views and does not align with the comprehensive three-view study described.

4. AAPC and CPT® Coding Guidelines:

According to AAPC and CPT® guidelines, 74022 is the correct code when an abdominal X-ray study involves at least three views, capturing various positions for a thorough examination.

Therefore, the correct answer is B. 74022-26.

The adenoids, tonsils, appendix, and spleen are all part of the lymphatic system, which plays a crucial role in immune function and the filtration of pathogens. These organs contribute to the body's defense by trapping and eliminating bacteria and other pathogens.

Adenoids and tonsils are lymphatic tissues located in the throat and help prevent infection by filtering pathogens from inhaled or ingested particles.

The appendix contains lymphoid tissue and is thought to play a role in gut immunity.

The spleen filters blood, removing old or damaged blood cells and producing lymphocytes for immune response.

The other options are unrelated:

B. Gastrointestinal: Involved in digestion, but not specifically immune response.

C. Cardiovascular: Involved in blood circulation, not immune response.

D. Nervous: Coordinates sensory and motor functions, unrelated to lymphatic tissue.

Therefore, the correct answer is A. Lymphatic.

Removal of a foreign body from the nose using forceps or other instrumentation is coded with CPT 30300. This code includes the use of local anesthesia, which aligns with the scenario where a nasal decongestant was used.

References:

AMA's CPT® Professional Edition (current year)

For initial fracture care of a closed scaphoid fracture, code 25622 is used, which includes treatment and initial casting. The application of the cast is part of the fracture care and is not reported separately. CPT® guidelines specify that casting or strapping performed as part of the fracture care is included in the fracture care code.References: AMA's CPT® Professional Edition (current year), Surgery section, Musculoskeletal System.

The Schede thoracoplasty for empyema is accurately described by CPT code 32905, which covers the radical procedure involving the resection of multiple ribs and often the obliteration of the pleural cavity to treat chronic empyema.

References:

AMA's CPT® Professional Edition (current year)