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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q383-Q388):
NEW QUESTION # 383
What modifier is appended to indicate when a procedure performed during the postoperative period is unrelated to the original surgery?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: C
Explanation:
Modifier -79 is used to indicate an unrelated procedure or service performed by the same physician during the postoperative (global) period.
-57 = decision for surgery
-25 = significant, separately identifiable E/M
-55 = postoperative management only
Modifier usage is a high-yield CPC exam topic.
NEW QUESTION # 384
A patient who was training for a marathon collapsed due to heat exhaustion on a very hot day. The patient is driven by his wife to a non-facility urgent care center for him to be treated. On examination, the physician diagnoses heat exhaustion and dehydration. The physician began IV therapy of normal saline that consists of pre-packaged fluid and electrolytes. The hydration lasts for 1 and 30 minutes.
What CPT coding is reported?
- A. 0
- B. 96365, 96366
- C. 96360, 96361
- D. 1
Answer: C
Explanation:
1. Procedure and CPT Code Selection:
The patient received IV hydration therapy with normal saline, which lasted for 1 hour and 30 minutes.
CPT Code 96360 is used for initial IV hydration for the first hour. This code applies to the first 31-60 minutes of hydration therapy.
CPT Code 96361 is used for each additional hour of IV hydration. Since the hydration lasted 1 hour and 30 minutes, 96361 should be reported once to cover the additional 30 minutes after the initial hour.
2. Rationale for Excluding Other Options:
Code 96365 is for initial IV infusion for therapeutic, prophylactic, or diagnostic purposes, rather than hydration, and is not applicable in this case.
Code 96366 is used for additional therapeutic, prophylactic, or diagnostic infusions and does not apply to hydration services.
Option A (96360) would only cover the initial hour of hydration, missing the additional 30 minutes, which is appropriately coded with 96361.
3. AAPC and CPT Coding Guidelines:
According to AAPC and CPT guidelines, 96360 should be used for the first hour of IV hydration, and 96361 should be used for each additional hour or portion of an hour beyond the initial 60 minutes.
Therefore, the correct answer is D. 96360, 96361.
NEW QUESTION # 385
A three-year-old patient is in the operative suite for stage 2 of treatment for double right outlet syndrome. The patient previously had the pulmonary artery banded and is returning for removal of the pulmonary band and transposition repair of the great vessels via aortic pulmonary reconstruction.
The surgeon performs a time-out and pre-incision review of respiration and BP then the previous sternal incision site is inspected and lightly painted with povidone. Next, reopens the sternal cavity and inserts central cannulae in the IVC, SVC and ascending aorta for extra corporeal membrane oxygenation (ECMO) bypass, chemical cardioplegia is initiated, stopping the heart and ECMO is initiated. A physician assistant monitors vitals and oxygenation until heart function resumes. The surgeon carefully incised and removes the Dacron band encircling the pulmonary artery, with nominal need for dilation. A section of coronary ostia is removed and sutured to the root of the pulmonary trunk. The pulmonary trunk and aortic root are then transected and transposed to allow for ideal cardiac circulation. Once structural integrity is visually confirmed, the physician assistant is permitted to administer the cardioplegia reversal solution and the surgeon removes the central cannulae after heart function safely resumes. The sternotomy is closed and the patient is transported to the NICU.
What CPT codes are reported for the surgery today?
- A. 33778-78, 33953-78, 33985-78
- B. 33778-58, 33955-58, 33985-58
- C. 33779-58, 33955-58, 33985-58
- D. 33779-78, 33953-78, 33985-78
Answer: D
Explanation:
1. Procedure Details and CPT Code Selection:
The patient is undergoing stage 2 treatment for double outlet right ventricle (DORV) with a removal of the pulmonary artery band and transposition repair of the great vessels.
Code 33779 is specific for correction of a double outlet right ventricle, with transposition of the great arteries. This code accurately reflects the procedure performed, including the complex repair involving the transposition of the pulmonary trunk and aortic root.
Code 33953 is used to report the initiation of extracorporeal membrane oxygenation (ECMO), which was used to maintain oxygenation during the procedure.
Code 33985 is for the termination of ECMO following the surgical repair once heart function has resumed. Both 33953 and 33985 accurately document the initiation and termination of ECMO during this complex heart repair.
2. Modifier Selection:
Modifier 78 (unplanned return to the operating room for a related procedure during the postoperative period) is appropriate here. This is a subsequent stage in the treatment plan, but due to the complexity and specific surgical intervention required, it is treated as a return to the OR for related procedure coding.
Modifier 58 (staged or related procedure during the postoperative period) would not be as suitable here because the procedure involves a new return to the OR.
3. AAPC and CPT Coding Guidelines:
AAPC guidelines support the use of specific modifiers (78 for unplanned return) and appropriate ECMO codes (33953 and 33985) in complex cardiac cases requiring bypass and staged treatment.
Thus, the correct CPT codes based on CPT and AAPC coding standards are C. 33779-78, 33953-78, 33985-78.
NEW QUESTION # 386
(A 1-year-old patient was born with twosupernumerary digits, one extending from the right pinky and one extending from the left pinky. The digit from his left pinky is larger and includes themetacarpal bone with a jointand is amputated. The one on the right is anubbinand containsno bony structure. The hand surgeon removes the extra digit containingsoft tissueby a simple excision. What is the CPT coding for the procedures performed?)
- A. 26951-50, 11200-50
- B. 26587-LT, 11200-RT
- C. 26910-50
- D. 26910-LT, 11200-RT
Answer: D
Explanation:
Supernumerary digit removal coding depends on whether the extra digit hasbone/jointor is asoft-tissue tag
/nubbin. The left-hand extra digit includes ametacarpal bone with a joint, so it is treated as removal of an accessory digit with bony involvement, reported with26910(removal of extra digit, hand/foot;withbone and joint reconstruction elements implied by the code family context). Because it is theleftside, append-LT. The right-hand extra digit is described as anubbin with no bony structure, removed bysimple excision-this aligns with askin tag-likeremoval code,11200, for removal of benign skin tags/lesions by simple excision (as represented in the answer options) with-RTfor laterality. You should not bill both sides with a single "-50" here because the procedures arenot the sameon each side (bony digit vs soft-tissue nubbin). Therefore,26910- LT and 11200-RTis correct.
NEW QUESTION # 387
Which entity offers compliance program guidance to form the basis of a voluntary compliance program for a provider practice?
- A. American Medical Association (AMA)
- B. Office for Civil Rights (OCR)
- C. Office of Inspector General (OIG)
- D. Centers for Medicare & Medicaid Services (CMS)
Answer: C
NEW QUESTION # 388
......
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