AAPC Updated CPC Exam Questions and Answers by libby

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.

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

CPT® Assistant for detailed coding guidelines on cardiac procedures.

Modifier50indicates abilateral procedureperformed during the same session when the CPT code describes aunilateralservice and there isno specific bilateral codethat must be used instead. Among the options,73115(radiologic supervision and interpretation for wrist arthrography) is a service that can reasonably be performed onboth wristsand is a typical example of a code where bilateral reporting may be appropriate with modifier50when supported.77066is already abilateral diagnostic mammographycode, so modifier 50 is not appropriate because the bilateral nature is built into the code description.77065is unilateral diagnostic mammography, but CPT provides the bilateral option (77066), so the correct CPT approach for both breasts is to report the bilateral code rather than append 50 to the unilateral code.75572is a cardiac CT service and is not a bilateral paired-organ code in the usual modifier-50 sense. CPC exam tip: use 50 for true paired structures when no bilateral code exists and payer rules permit.

This is anestablished patientoffice visit coded byMDM(no total time documented). Problems addressed include achronic condition(multinodular goiter/thyroid nodules) requiring evaluation with malignancy risk considerations (family history of thyroid cancer and palpable mass). The plan includes apercutaneous biopsy, which is aminor procedureplanned, increasing management complexity compared with reassurance-only follow-up. Data reviewed includes at leastreview of an ultrasound from last weekshowing multiple thyroid masses consistent with multinodular goiter (outside test review), which supports data element involvement. Risk is at leastmoderatebecausedecision for a minor procedureis documented in the plan (with procedure-related risk assessment implicit). While ROS is largely negative and exam is not extensive enough alone to drive code selection, MDM supports amoderate leveloverall, aligning with99214for established patients. It is more complex than 99213 due to planned invasive diagnostic procedure and risk assessment, but does not reach 99215 because there is no high-risk management (e.g., major surgery decision, severe exacerbation, or intensive data complexity).

49190 = Excision of peritoneal tumor greater than 10 cm

C48.2 = Malignant neoplasm of peritoneum