AAPC Updated CPC Exam Questions and Answers by aiza

The physician performed anorthopedic manipulation of the elbow under anesthesia, which is reported withCPT 24300(manipulation, elbow, under anesthesia). The anesthesia service is separately reported by theanesthesia provider(the anesthesiologist/CRNA) using an anesthesia CPT code, but the question asks specifically what is reportedfor the physicianperforming the manipulation—not the anesthesiologist. Therefore, you donotassign the anesthesia code (e.g., 01710) to the manipulating physician. Option A is incorrect because it includes anesthesia coding under the physician. Options B and D include24605, which represents a different service (not the correct manipulation-under-anesthesia code for this vignette). CPC exam strategy: identifywhois billing (surgeon vs anesthesiologist) and select the CPT code that describes the physician’s operative service. Here, the physician’s work is the manipulation itself, accurately captured by24300alone.

This scenario describes an anterior discectomy and arthroplasty at two levels (L3-L4 and L5-S1) using artificial discs. CPT® code 22857 describes total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), single interspace, lumbar. Since the procedure was performed at two levels, the code should be reported twice.

The patient was critically ill withhemodynamic instability, respiratory failure progression, and cardiac arrest, requiring intensive interventions (multiple IVs, large bolus,vasopressor infusion, resuscitation with CPR/defibrillation/medications, ABG management). The provider documents77 minutes of continuous critical care time. Critical care is reported with99291for thefirst 30–74 minuteson a date of service, and99292foreach additional 30 minutesbeyond that threshold. Because77 minutesexceeds 74 minutes, you report99291 + 99292(one unit of 99292 covers the additional time beyond the initial critical care window). You donotadditionally report an ED E/M code (e.g., 99285) on the same date for the same provider when critical care encompasses the ED evaluation and management during that time period; the critical care service is the appropriate E/M reporting. The scenario supports that critical care criteria are met: high probability of life-threatening deterioration and active physician management. Therefore, the correct E/M coding is99291, 99292.

Procedure Coding (CPT®):

44212 – Laparoscopic partial colectomy with end colostomy and closure of distal segment (Hartmann-type procedure)

Correct because:

Sigmoid/descending colon resection

Proximal colostomy created

Distal rectal stump closed

44213 – Laparoscopic mobilization of splenic flexure

Separately reportable because:

Mobilization was necessary to exteriorize colon for colostomy

Not bundled into 44212

Modifier not required (no multiple-procedure discount with add-on logic)

Diagnosis Coding (ICD-10-CM):

K57.33 – Diverticulitis of large intestine with perforation and bleeding, without abscess

Documentation supports:

Diverticulitis

Active bleeding

No abscess reported

Why Other Options Are Incorrect:

A / B – 44206 = colectomy with anastomosis (not performed)

A / B – K57.41 includes abscess (not documented)

C – Missing splenic flexure add-on explanation

CPT® & ICD-10-CM Guideline Alignment:

Hartmann procedure ≠ anastomosis

Bleeding elevates diagnosis specificity

Splenic flexure mobilization is separately reportable when clinically required