AAPC Updated CPC Exam Questions and Answers by selina

1. Procedure and CPT® Code Selection:

The scenario describes the excision of a 5 cm tumor located in the left lower quadrant of the abdominal wall. The tumor was excised down to the dermis and subcutaneous layers and removed using electrocautery.

Code 22903 is appropriate for the excision of a soft tissue tumor in the abdominal wall greater than 5 cm, making it the correct CPT® code.

Code 22901 applies to the excision of a soft tissue tumor in the abdominal wall but only for tumors 5 cm or less. Given that the tumor in this case is exactly 5 cm, it meets the threshold for 22903, which is more appropriate here.

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

ICD-10-CM Code D49.2 is used for a neoplasm of unspecified behavior in the abdominal area, reflecting the fact that the pathology report is pending to determine if the tumor is malignant.

Code C76.2 would be incorrect because it is for malignant neoplasms of unspecified abdominal areas, which we cannot confirm based on the initial excision. Similarly, R19.04 (indicating a mass in the abdominal region) is a symptom code and is not appropriate for a definitive diagnosis when a neoplasm code (D49.2) exists.

3. AAPC and CPT® Coding Guidelines:

Per AAPC coding guidelines, the size of the tumor is critical in selecting the correct excision code for abdominal wall neoplasms. Additionally, if the tumor’s pathology is not confirmed as malignant, it is coded as a neoplasm of unspecified behavior until further details are known.

Therefore, based on CPT® and ICD-10-CM coding guidelines, the verified answer is B. 22903, D49.2.

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.

1. Procedure and CPT® Code Selection:

The patient underwent an appendectomy performed via laparoscopic approach. The procedure involved removal of the appendix using a scope inserted through an umbilical incision.

CPT® Code 44970 is specific for a laparoscopic appendectomy, which is the correct code for this procedure.

Code 44950 would be used for an open appendectomy, but since this case was performed laparoscopically, 44970 is appropriate.

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

The diagnosis given by the physician is chronic appendicitis.

ICD-10-CM Code K36 is used to report chronic appendicitis, which is the definitive diagnosis in this case.

Additional codes for symptoms such as nausea (R11.2) and right lower quadrant pain (R10.31) are not necessary because the primary diagnosis of chronic appendicitis (K36) fully explains the symptoms, according to ICD-10-CM guidelines on coding symptoms when a definitive diagnosis is available.

3. AAPC and CPT® Coding Guidelines:

AAPC guidelines indicate that when a definitive diagnosis is established, symptom codes should not be reported separately. The use of 44970 for laparoscopic appendectomy and K36 for chronic appendicitis is fully supported by these coding standards.

Therefore, the correct answer is C. 44970, K36.

93925 – Duplex scan of arteries, bilateral lower extremities; complete

Includes both legs → do not bill twice

Diagnosis Codes:

M79.604 – Pain in right leg

M79.605 – Pain in left leg

Why others are incorrect:

93926 × 2 – Unilateral only

I70.303 – Arteriosclerosis not confirmed