AAPC Updated CPC Exam Questions and Answers by salma

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 place of service code 22 is used for services performed in an outpatient hospital setting, including outpatient surgical floors. This code indicates that the procedure was done in a hospital but not requiring an inpatient admission.

AMA's CPT® Professional Edition (current year), Place of Service Codes.

When hypertension and chronic kidney disease (CKD) are documented together, ICD-10-CM assumes a cause-and-effect relationship.

I12.9 = Hypertensive chronic kidney disease with stage 1–4 CKD

N18.2 = CKD stage 2

I12.0 is only for CKD stage 5 or ESRD, which does not apply here.

Therefore, the correct code combination is I12.9, N18.2.

Thelunulais the pale, crescent-shaped area visible at the base of some fingernails and toenails (most commonly the thumb). It is part of thenail unit, associated with the nail matrix where nail formation occurs. Because the lunula is anail structure, a biopsy “of the lunula” is anail biopsy, even though a punch tool is also commonly used in skin biopsies. CPC exam questions frequently test precise anatomical vocabulary, especially for integumentary structures (skin, nail, hair). The distractors “eye” and “brain” are unrelated, and “skin” is tempting because punch biopsies are typically skin procedures; however, the question specifically identifies thelunula, which is not a skin landmark. Coding and documentation accuracy depend on knowing these terms because nail procedures often have different code families and clinical considerations than routine skin biopsies. Correct identification starts by mapping the term to its anatomical system: lunula → nail apparatus.