AAPC Updated CPC Exam Questions and Answers by nikolas

Procedure Coding (CPT®):

33533 – CABG, arterial graft; single arterial graft (LIMA to LAD)

Correct for left internal mammary artery → LAD

33519 – CABG, venous grafts; three coronary venous grafts

Saphenous vein grafts placed to:

Obtuse marginal

Ramus intermedius

Posterior descending artery

Total = 3 venous grafts

33508 – Endoscopic harvest of saphenous vein

Separately reportable only when endoscopic

Add-on code (no modifier required)

Why Other Options Are Incorrect:

A / C – Incorrect arterial graft code (33536 = multiple arterial grafts)

B – Incorrect venous graft count (33512 = two grafts)

CPT® Guideline Reference:

CABG codes are selected based on:

Type of conduit (arterial vs venous)

Number of distal anastomoses

Endoscopic harvest is add-on and separately reportable

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.

CPT code 99450 is used for the examination of a patient for the purpose of establishing medical baseline information or for insurance purposes. Since Eric's primary care provider completed the required physical exam documentation for his life insurance policy, this is appropriately reported with code 99450. References: CPT® Professional Edition (current year), AMA.

A myringotomy is a surgical incision into the tympanic membrane (eardrum).

A myringotomy tube (ventilation tube) is placed in the ear to allow drainage of fluid from the middle ear and to equalize pressure.

Therefore, the correct answer is A. Ear.