CPC Exam Dumps - Certified Professional Coder (CPC) Exam

TSH testing is reported with CPT84443. The scenario describes a workup for possible thyroid dysfunction, but there isno confirmed thyroid diagnosisprovided—only symptoms (fatigue and weight gain). In outpatient coding, when a definitive diagnosis is not established, you code thesigns/symptomsthat justify the test. Therefore, the correct ICD-10-CM codes areR53.83(other fatigue) andR63.5(abnormal weight gain), as offered. You shouldnotassign a thyroid disorder code such asE07.9(unspecified disorder of thyroid) unless the provider documents an actual thyroid disorder diagnosis; suspicion alone does not support it in the outpatient setting. Options C and D list84445, which is not the standard CPT code for TSH measurement in CPC exam coding. This question is testing both correct lab code selection and the outpatient guideline principle of codingsymptomswhen the diagnosis is not confirmed. Hence,84443 with R53.83 and R63.5is correct.

Penile prosthesis coding is determined by thetype of deviceand whether the procedure is asimple insertion, areplacement, or a more complex scenario. Anon-inflatable(malleable or semi-rigid) penile prosthesis is specifically reported withCPT 54416. Inflatable devices are coded differently (commonly with a different code family), and replacement/revision services may also have distinct codes depending on what is removed and replaced. In this question, the vignette is straightforward: erectile dysfunction treated with insertion of anon-inflatable prosthesis—no mention of prior implant, revision, or removal—so the correct code is the primary insertion code for that device type. The distractors include other penile procedures and prosthesis-related codes that do not match “non-inflatable insertion.” CPC exam tip: lock onto “non-inflatable” vs “inflatable,” and then confirm the action isinsertionrather than revision or replacement. That leads to54416.

For a follow-up examination after the removal of polyps with no new polyps found, the appropriate diagnosis codes are:

Z09: Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm.

Z86.010: Personal history of colonic polyps.

Using Z09 indicates that the follow-up exam is to check the patient after treatment, and Z86.010 indicates a history of colonic polyps, which is relevant to the patient ' s medical history.

ICD-10-CM guidelines

AMA ' s CPT® Professional Edition (current year)

Medicare Part B provides coverage for outpatient services, including physician services, preventive care, outpatient procedures, diagnostic tests, and durable medical equipment. Part B is a key component of Medicare, covering medically necessary services and some preventive services.

A. Part C (Medicare Advantage) includes all benefits and services covered under Parts A and B and often additional services, but it is provided through private insurance companies.

C. Part A covers inpatient hospital care, skilled nursing facility care, hospice, and some home health services.

D. Part D provides coverage for prescription drugs.

Therefore, the correct answer is B. Part B.

Colposcopy of the Cervix: This involves a visual examination of the cervix using a colposcope.

Biopsy and Endocervical Curettage: The procedures performed include taking a biopsy and scraping the lining of the cervical canal.

CPT Code 57454: This code represents a colposcopy of the cervix with biopsy and endocervical curettage.

45346 = Sigmoidoscopy with ablation (reported once)

K63.5 = Polyp of colon

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.

Moderate sedation codes are selected by (1)patient ageand (2) whether the sedation is provided by thesame physician performing the procedureor by a different provider. The stem states theorthopedist provides the sedation and the reduction, so the sedation is provided by thesame physicianwho performs the procedure. For age, the patient is5 years old, which falls into the≥5 yearscategory. Therefore, the correct initial moderate sedation code is99152(moderate sedation provided by the same physician/other qualified provider performing the procedure; patient age 5 years or older; initial 15 minutes). The documented time is21 minutes, which supports only theinitialcode (it does not reach the threshold needed to report an additional 15-minute increment add-on). Code99151is for patientsunder 5 years, so it does not apply. Codes99155/99156are for sedation provided by adifferentprovider than the one performing the procedure. CPC exam tip: age cutoffs matter—exactly 5years old uses the “5 years or older” code set.