CPC Exam Dumps - Certified Professional Coder (CPC) Exam

The National Correct Coding Initiative (NCCI) was developed by CMS to:

Prevent unbundling

Define procedure-to-procedure (PTP) edits

Identify when modifiers (such as -59) may be appropriate

NCCI edits are critical for accurate CPT® coding and proper reimbursement.

Burn coding requires (1) code each burn site bylocation, laterality, and degree, and (2) add aTBSAcode when appropriate. The patient hasthird-degree burnsof both thighs (right and left), so the correct site/degree codes areT24.311A(third-degree burn of right thigh, initial encounter) andT24.312A(third-degree burn of left thigh, initial encounter). He also hassecond-degree burnsof the right anterior chest wall and the upper back, reported withT21.21XA(second-degree burn of chest wall, initial encounter) andT21.23XA(second-degree burn of back wall, initial encounter). TBSA is24%(falls in the 20–29% category), andthird-degree is 10%(falls in the 10–19% third-degree category), so the correct TBSA code isT31.21. Option D matches the required site/degree codes and the correct TBSA/third-degree percentage code pairing.

This question is testing selection of the correcttherapy functional outcome/condition “M-code”used in certain therapy reporting contexts (commonly tied to claims-based data collection requirements and payer-specific reporting rules). The scenario states the patient haslumbar spine region cancerthat isactive and being treated. That points to the M-code option that corresponds tomalignancy affecting the lumbar spine region(as defined in the referenced reporting framework used in CPC-style questions). Among the listed options,M1037is the correct lumbar-spine-associated condition code foractive cancerinvolvement impacting the lumbar region. The key differentiator is “actively being treated,” which aligns with a current active condition, not history of cancer or a nonmalignant condition. The distractors (M1038, M1039, M1041) represent different lumbar-associated condition categories and are included to test whether you can map the clinical statement (active lumbar cancer) to the correct M-code. Therefore, the correct selection isM1037.

Procedure: Visual field examination of both eyes using Goldmann perimeter testing with four isopters.

CPT® Code:

92082: This code is for visual field examination with intermediate examination.

ICD-10-CM Code:

G43.009: Migraine without aura, not intractable, without status migrainosus.

Code Selection Justification: The visual field exam method and complexity align with 92082. The patient's diagnosis of non-intractable migraine without aura is coded as G43.009.

AMA CPT® Professional Edition (current year)

ICD-10-CM (current year)

This is aplanned stagedcongenital cardiac repair following prior pulmonary artery banding, so the correct postoperative modifier concept isstaged/related(modifier-58), not an unplanned return-to-OR modifier (-78). The operative service includesremoval of the pulmonary artery bandandarterial switch/transposition-type repairof the great vessels (captured in the 33778/33779 family in the answer choices). The case also describes use ofECMOwith central cannulation and management during the procedure, which is reported with the appropriate ECMO initiation/management codes shown as33955and the monitoring/assistant-related component represented by33985in the choices. Because this is thesecond stageof care and described as planned definitive repair, the -58 modifier is appropriate on the reported surgical services in these answer constructs. OptionDcorrectly pairs the staged modifier (-58) with the appropriate congenital repair and ECMO-related coding listed in the question’s options.

99291: This code is used for the first 30-74 minutes of critical care, evaluation, and management of the critically ill or critically injured patient.

99292: This code is used for each additional 30 minutes of critical care service beyond the first 74 minutes.

The documentation indicates that the patient received a total of 45 minutes of critical care, which involves continuous IV insulin for diabetic ketoacidosis, administration of antiemetics, and admission to the ICU. The critical care time documented justifies the use of 99291 for the first 30-74 minutes and 99292 for each additional 30 minutes.

CPT® Professional Edition, AMA

49083 – Abdominal paracentesis, diagnostic or therapeutic; with imaging guidance

This code includes imaging guidance (ultrasound or fluoroscopy).

Per CPT® guidelines, do not separately report fluoroscopy or ultrasound guidance with 49083.

The procedure was performed in the hospital, but CPT coding does not change based on site of service.

Why Other Options Are Incorrect:

A (49082) – Used without imaging guidance

B / D – Imaging guidance codes (77001, 77002) are bundled into 49083 per CPT® and NCCI edits

Official CPT® Guidance:

When a paracentesis is performed with imaging guidance, report 49083 only.