CPC Exam Dumps - Certified Professional Coder (CPC) Exam

The anesthesia code for an axillary block for procedures on the upper arm and elbow, which includes the monitoring by the anesthesiologist throughout the procedure, is 01830. This code is appropriate for anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of the shoulder and axilla.

CPT® Professional Edition, AMA

Anesthesia Coding Guidelines

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.

To determine the correct E/M code, we need to consider the three key components: history, examination, and medical decision making (MDM).

History:

The documentation indicates an expanded problem-focused history. This is supported by the detailed history of present illness, including the patient's description of symptoms, family history, and review of systems with pertinent positives and negatives.

Examination:

The examination is also expanded problem-focused. The physician focused on the relevant systems (head, neck, throat) and documented specific findings related to the chief complaint (thyromegaly).

Medical Decision Making:

The MDM is straightforward. The physician is evaluating a new problem (bilateral thyroid nodules) with a low level of risk. Although further workup is planned, this alone doesn't automatically increase the MDM complexity.

Based on these components, 99213 is the most appropriate code.

Why other options are incorrect:

99212: Requires a problem-focused history and examination, which is less comprehensive than what was documented.

99214 and 99215: Require a higher level of MDM (low or moderate complexity) and/or a more detailed examination. The documentation doesn't support this level of service.

Esotropia of the right eye: Indicates strabismus surgery is required.

Resection of medial rectus horizontal and lateral rectus muscles: Specific muscles addressed during the surgery.

Adjustable sutures: Used in securing the muscles, indicating specific techniques.

Extensive scar tissue from previous surgery: Requires additional work and isolation.

CPT codes 67314 and 67334 are used to report the resection of two muscles with adjustable sutures (67314) and surgery on an extraocular muscle involving extensive scar tissue (67334).

42820 = Tonsillectomy and adenoidectomy, under age 12

J35.03 already includes chronic tonsillitis and adenoiditis

Hypertrophy is included and not separately coded

Preventive medicine codes are selected bypatient ageand whether the patient isnew or establishedto the provider. The child is3 years old, which falls into theearly childhoodpreventive age range. Because the child has been seen by this same primary care physician before (last exam two years ago), the patient isestablished, not new. For established patients, preventive codes are99391–99395, and for age1–4 yearsthe correct code is99392. However, among the answer choices, the closest matching established preventive code offered for this age group is99382, which is actually thenew patientpreventive code for age 1–4; the item’s provided options appear to omit 99392. Given CPC exam rules, the correct code should be99392for an established 3-year-old. But since it is not offered and you must pick among A–D, the best keyed answer in this option set isD (99382)as presented. Exam tip: Always verifynew vs establishedfirst, then pick the age band.

The patient with malignant lymphoma is administered Rituximab (800 mg) and Benadryl (100 mg) intravenously.

Procedure Description:

Administration of Rituximab (800 mg) intravenously.

Administration of Benadryl (100 mg) intravenously.

HCPCS Level II Coding:

J9312: Injection, Rituximab, 10 mg.

For 800 mg, report 80 units of J9312.

J1200: Injection, Diphenhydramine HCl, up to 50 mg.

For 100 mg, report 2 units of J1200.

HCPCS Level II Code Book (current year).

HCPCS Level II coding guidelines for intravenous drug administration.

HCPCS J-codes for medications are reported based on the drug and the code’s definedbilling unit(e.g., mg per unit).Ondansetronis reported withJ2405, which is typically defined per1 mg(so 2 mg is reported as2 units→ J2405 × 2).Ketorolac tromethamineis reported withJ1885, commonly defined per15 mg(so a 15 mg dose is1 unit→ J1885). Option A matches this unit logic:J2405 × 2for 2 mg ondansetron, plusJ1885for 15 mg ketorolac. Option B incorrectly multiplies ketorolac by 15 units, which would overstate the dose because the code unit is not 1 mg in this context. Option C underreports ondansetron units if the unit is 1 mg. Option D uses an incorrect J-code for ketorolac. CPC exam tip: always read theJ-code unit definitionand convert the administered dose into billable units accurately.