AAPC CPC Exam Questions 2025

A. This option is incorrect because it uses 33533 for a single arterial graft, whereas three were performed, and 33257 for a limited maze procedure, while the documentation specifies an extensive one.

C. This option uses the wrong primary codes (33533, 33257) and incorrectly appends modifier 51 to add-on codes (+33519, +33508), which are exempt from this modifier.

D. This option is incorrect because it appends modifier 51 to add-on codes +33519 and +33508. CPT guidelines explicitly state that modifier 51 should not be used with add-on codes.

1. American Medical Association. (2023). CPT® 2024 Professional Edition.

Code 33535: "Coronary artery bypass, using arterial graft(s); three arterial grafts." (p. 269)

Code +33519: "Coronary artery bypass, using venous graft(s) and arterial graft(s); three vein grafts (List separately in addition to code for primary procedure)." (p. 269)

Code 33259: "Operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure), with cardiopulmonary bypass, with concomitant cardiac procedure." (p. 259)

Code +33508: "Endoscopy, surgical, including video-assisted harvest of vein(s) for coronary artery bypass procedure (List separately in addition to code for primary procedure)." (p. 268)

Appendix A, Modifier 51: This appendix lists codes that are exempt from the use of modifier 51. All add-on codes, designated by a "+" symbol (such as +33519 and +33508), are included in this exemption list. (p. 965)

A. 49082, 76942: CPT® 49082 is for a paracentesis performed without imaging guidance, which contradicts the procedure described.

B. 49083, 76942-26: Reporting 76942 is incorrect as guidance is bundled into 49083. Modifier 26 is also inappropriate for an office setting.

D. 49082, 76942-26: CPT® 49082 is incorrect as it specifies the procedure was done without guidance, and modifier 26 is inappropriate.

1. American Medical Association. (2023). CPT® 2024 Professional Edition.

Page 418: The descriptor for code 49083 is "Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance."

Page 418: A parenthetical note directly below CPT® code 49083 explicitly states, "(Do not report 49083 in conjunction with 76942, 77002, 77012, 77021)." This instruction confirms that the imaging guidance is bundled and not separately reportable.

Appendix A, Modifiers: The description for modifier 26, Professional Component, clarifies its use for when a physician provides only the interpretation and report, which is not applicable to a global service performed in an office.

2. AAPC. (2023). CPC Certification Study Guide.

Chapter 11, Digestive System: The guide explains that CPT® codes 49082 and 49083 differentiate paracentesis based on the use of imaging guidance. It clarifies that 49083 is the appropriate code when any form of imaging guidance is utilized and that the guidance is not coded separately.

A. 47785: This code is for an anastomosis involving the intrahepatic (inside the liver) biliary ducts, not the extrahepatic ducts specified in the question.

C. 47740: This code describes an anastomosis of the gallbladder to the intestinal tract (cholecystoenterostomy), not the biliary duct.

D. 47760: This code is for a direct anastomosis of the extrahepatic biliary ducts, which is a different surgical technique than the specified Roux-en-Y anastomosis.

1. American Medical Association (AMA). CPT® 2024 Professional Edition. Chicago, IL: AMA Press, 2023.

Section: Surgery/Digestive System, Biliary Tract.

Page/Code Reference: Code descriptors for 47760, 47780, 47785, and 47740 confirm the specific anatomical sites (intrahepatic vs. extrahepatic ducts, gallbladder) and surgical techniques (direct vs. Roux-en-Y) that differentiate these codes.

A: CPT® codes 46320 (excision of thrombosed hemorrhoid) and 46945 (ligation) describe incorrect procedures; the hemorrhoids were not thrombosed, and the procedure was an excision, not ligation.

B: CPT® code 46250 is incorrect as it only accounts for the removal of external hemorrhoids, while the procedure included the removal of an internal hemorrhoid as well.

D: This option includes incorrect CPT® codes. 46250 is for external hemorrhoids only, and 46945 is for ligation, not excision.

1. American Medical Association. (2023). CPT® 2024 Professional Edition.

Page 415, Anus Procedures: Code 46255 is defined as "Hemorrhoidectomy, internal and external, single column/group." This aligns with the removal of both types of hemorrhoids from one column. In contrast, 46250 is for external hemorrhoids only.

2. World Health Organization. (2023). International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Clinical Modification (ICD-10-CM).

Tabular List, Chapter 11 (K00-K95): Code K64.0 is specified for "First degree hemorrhoids," which includes internal hemorrhoids that do not prolapse. Code K64.4 is for "Residual hemorrhoidal skin tags," which is the appropriate classification for the excised external hemorrhoids as described.

3. AAPC. (2023). CPC Official Certification Study Guide.

Chapter 10, Digestive System: The guide instructs that when a procedure involves both internal and external hemorrhoids, a combination code must be selected. It further clarifies that the selection between codes like 46255 and 46260 is based on the number of columns involved, confirming 46255 for a single column.

A. 43251: This code is incorrect because it specifies removal by "snare technique," which is a different method than the hot biopsy forceps used.

C. 43255: This code is for controlling active bleeding. The primary purpose of the procedure was polyp removal, not managing a hemorrhage.

D. 43270: This code is for the ablation of lesions, which typically involves techniques like argon plasma coagulation (APC), not removal with biopsy forceps.

1. American Medical Association. (2023). CPT® 2024 Professional Edition.

Section: Digestive System, Endoscopy, Esophagogastroduodenoscopy (Codes 43235-43270).

Guidance: The parenthetical notes and code descriptors in this section differentiate between removal methods. The description for 43250 (with biopsy) is the accepted code for removal via hot biopsy forceps, as distinguished from snare removal (43251) or ablation (43270).

2. AAPC. (2023). 2024 CPC® Official Study Guide.

Chapter: Digestive System.

Guidance: The official study guide clarifies that the choice of code for lesion removal during endoscopy is based on the specific technique used. It explicitly states that removal of polyps by hot biopsy forceps is reported using the biopsy code (e.g., 43250 for an EGD).

A. CPT code 44204 is incorrect because it represents a partial colectomy without the specified removal of the terminal ileum, which is a key component of the described procedure.

B. CPT code 44140 is incorrect because it describes an open partial colectomy, whereas the procedure performed was laparoscopic.

D. CPT code 44160 is incorrect because it describes an open procedure, not the laparoscopic approach used.

1. American Medical Association. (2023). CPT® 2024 Professional Edition.

Page 383: The descriptor for CPT code 44205 is "Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy." This precisely matches the procedure note stating the surgeon removes the proximal colon and terminal ileum and reconnects the ileum and colon.

Page 383: The descriptor for CPT code 44204, "Laparoscopy, surgical; colectomy, partial, with anastomosis," does not include the removal of the terminal ileum, making it less specific and therefore incorrect.

Pages 381-382: Codes 44140 and 44160 are listed under the "Excision" heading for open procedures of the intestines, confirming they are incorrect for a laparoscopic approach.

2. Centers for Disease Control and Prevention. (2023). ICD-10-CM Official Guidelines for Coding and Reporting FY 2024.

Section I.B.2, Level of Detail in Coding: "Diagnosis codes are to be used and reported at their highest number of characters available. A three-character code is to be used only if it is not further subdivided."

Section I.B.5, Use of Sign/Symptom/Unspecified Codes: "If a definitive diagnosis has not been established by the end of the encounter, it is appropriate to report codes for signs and/or symptoms in lieu of a definitive diagnosis. When sufficient clinical information isn’t known or available about a particular health condition to assign a more specific code, it is acceptable to report the appropriate 'unspecified' code (e.g., a diagnosis of pneumonia has been determined, but not the specific type)." In this case, "proximal colon" is not specific enough to select C18.0, C18.2, or C18.3, making C18.9 the correct choice.

B. CPT® 43644 is for a laparoscopic procedure, and Z68.43 is for a BMI of 50.0-59.9; the procedure was open and the BMI was 45.

C. ICD-10-CM code E66.9 is for unspecified obesity; E66.01 is more specific because the cause (high calorie diet) is documented.

D. CPT® 43645 is for a laparoscopic procedure, and ICD-10-CM code E66.8 (Other obesity) is less specific than E66.01.

1. American Medical Association (AMA). (2023). CPT® 2024 Professional Edition.

Page 358: Code 43847 is defined as "Gastric restrictive procedure with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption." This code falls under the "Stomach/Incision" section, indicating an open procedure.

Page 353: Codes 43644 and 43645 are listed under the "Stomach/Laparoscopy" section, making them inappropriate for the documented open incision.

2. Centers for Medicare & Medicaid Services (CMS). (2023). ICD-10-CM Official Guidelines for Coding and Reporting FY 2024.

Section I.B.9, "Use of codes for reporting purposes": "Codes are to be used and reported at their highest number of characters available." This supports using E66.01 over E66.9, as the cause of obesity is specified.

Section I.C.21.c.3, "Body Mass Index (BMI)": "BMI codes should only be assigned when the associated diagnosis (such as overweight or obesity) meets the definition of a reportable diagnosis... The BMI codes should be assigned as a secondary diagnosis." This guideline validates the use of Z68.42 as a secondary code to E66.01.

3. World Health Organization (WHO). (2024). International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM).

Tabular List, Chapter 4: E66.01 is defined as "Morbid (severe) obesity due to excess calories."

Tabular List, Chapter 21: Z68.42 is defined as "Body mass index (BMI) 45.0-49.9, adult."

A. 57456 is incorrect because it specifies a loop electrode biopsy (LEEP), which is a different procedure from the standard biopsy performed.

B. 57420 is incorrect as it represents a colposcopy of the vagina only, without any biopsy or curettage performed.

C. 57455 is incorrect because it includes the colposcopy and cervical biopsy but omits the separately performed endocervical curettage.

1. American Medical Association. (2023). CPT® 2024 Professional Edition. Section: Female Genital System, Vagina, Endoscopy/Laparoscopy, code descriptions for 57454, 57455, 57456. The code descriptor for 57454 explicitly states, "Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage."

2. AAPC. (2023). 2024 CPC Study Guide. Chapter 11: Female Reproductive System. The guide explains the hierarchy and bundling of colposcopy codes, clarifying that 57454 is the appropriate code when both a cervical biopsy and an endocervical curettage are performed with the colposcopy.

A. 58976: This code is for the intrafallopian transfer of gametes, zygotes, or embryos, which is a different procedure that occurs after fertilization, not the initial egg retrieval.

B. 58974: This code describes the intrauterine transfer of an embryo, a subsequent step in the in vitro fertilization (IVF) process, not the oocyte retrieval itself.

C. 58999: This is an unlisted procedure code. It is incorrect to use this code because a specific CPT® code (58970) exists that accurately describes the service performed.

1. American Medical Association. CPT® 2024 Professional Edition. Chicago, IL: AMA, 2023. Code 58970, Female Genital System/Ovary. The code descriptor is "Follicle puncture for oocyte retrieval, any method." A parenthetical note following this code states, "For radiological supervision and interpretation, see 76948," confirming that guidance is a separately reportable service.

2. AAPC. 2024 CPC Exam Study Guide. Salt Lake City, UT: AAPC, 2023. Chapter 11: Female Reproductive System and Maternity Care and Delivery. The guide clarifies the distinct functions of IVF-related codes, assigning 58970 to oocyte retrieval and codes 58974 and 58976 to the transfer of embryos or gametes.

A. 52352 is incorrect because it describes the removal or manipulation of a calculus, not fragmentation via lithotripsy.

B. 52325 is incorrect as it does not include the ureteroscopy/pyeloscopy; the scope is not advanced into the ureter for this code.

C. This option incorrectly unbundles the procedures. The CPT® manual directs the use of 52356 when lithotripsy and stent insertion are performed together.

1. American Medical Association. (2023). CPT® 2024 Professional Edition. Section: Urinary System, Endoscopy-Ureter and Pelvis, Codes 52353, 52356. The code descriptor for 52356 explicitly states, "Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent..." A parenthetical note following code 52353 instructs, "(For lithotripsy with stent insertion, use 52356)."

2. AAPC. (2023). CPC® Official Study Guide. Chapter 13: Urinary System and Male Genital System. The guide explains the hierarchy of endoscopic procedures, emphasizing the use of comprehensive codes that include all components of a procedure, such as scope, treatment, and stent placement, as seen in code 52356.