CPC Certified Professional Coder Final Certification The Complete Exam Preparation Mastery Manual: Advanced Study Guide, Extensive Test Bank Review, Full-Length Practice Questions, and Final Knowledge Assessment

CPC Certified Professional Coder Final Certification The Complete Exam Preparation Mastery Manual: Advanced Study Guide, Extensive Test Bank Review, Full-Length Practice Questions, and Final Knowledge Assessment A patient has Crohn’s disease involving the small intestine and develops an intestinal obstruction directly associated with the disease. How should the condition be reported in ICD-10-CM? A. Report Crohn’s disease first and intestinal obstruction separately. B. Report intestinal obstruction first and Crohn’s disease separately. C. Report one combination code describing both conditions. D. Report regional enteritis and omit the obstruction. Correct Answer: C. Report one combination code describing both conditions. Rationale: ICD-10-CM provides combination codes that identify both the location of Crohn’s disease and its associated complication, such as intestinal obstruction. Therefore, an additional obstruction code is generally unnecessary. The combination code captures the disease and its complication together. Question 2 A patient is diagnosed with irritable bowel syndrome, but the physician does not document whether diarrhea or constipation is present. Which ICD-10-CM code is most appropriate? A. K58.9 B. K59.2 C. K58.0 D. K59.8 Correct Answer: A. K58.9 Rationale: K58.9 represents irritable bowel syndrome without diarrhea and is used when no more specific manifestation is documented. K58.0 requires documented diarrhea. K59.2 identifies neurogenic bowel, while K59.8 describes other specified functional intestinal disorders. Coding must be based on provider documentation and should not assume undocumented manifestations. Question 3 A patient with chronic gallstones and hypertension is scheduled for same-day cholecystectomy. Before surgery, her cardiologist performs a cardiovascular examination specifically to determine whether she is medically suitable for the procedure. Which ICD-10-CM code sequence should the cardiologist report? A. Z01.810, K80.20, I10 B. I10, Z01.818, K80.20 C. K80.20, I10, Z01.810 D. K80.21, Z01.89, I10 Correct Answer: A. Z01.810, K80.20, I10 Rationale: Z01.810 is reported first because the primary purpose of the encounter is a preprocedural cardiovascular examination. K80.20 identifies the gallstone condition prompting surgery, while I10 identifies the coexisting hypertension. The other options either sequence the conditions incorrectly or use inappropriate diagnosis codes. Question 4 A patient’s ulcerative colitis is documented without a more specific anatomical site, and the patient has active rectal bleeding attributable to the disease. Which ICD-10CM code is appropriate? A. K51.511 B. K52.9 and K62.5 C. K51.911 D. K51.90 Correct Answer: C. K51.911 Rationale: K51.911 describes ulcerative colitis, unspecified, with rectal bleeding. It is a combination code that captures both the inflammatory disease and its associated bleeding. K51.90 does not include bleeding, while K52.9 represents noninfective gastroenteritis and colitis rather than ulcerative colitis. Question 5 During an upper gastrointestinal examination, a physician advances an endoscope through the esophagus, stomach, and duodenum. An acquired esophageal stricture is identified and dilated using a 20-mm balloon passed through the endoscope. Which CPT® and ICD-10-CM codes should be reported? A. 43235, K22.2 B. 43235, C15.9 C. 43248, Q39.3 D. 43249, K22.2 Correct Answer: D. 43249, K22.2 Rationale: CPT® 43249 describes transendoscopic balloon dilation of the esophagus using a balloon less than 30 mm in diameter. K22.2 identifies an acquired esophageal obstruction or stricture. Code 43235 represents diagnostic endoscopy only and is included in the therapeutic procedure. Q39.3 represents congenital esophageal stenosis rather than an acquired stricture. Question 6 A 65-year-old Medicare beneficiary with a family history of colorectal cancer undergoes a screening colonoscopy. The physician successfully advances the colonoscope to the cecum, and no therapeutic intervention is performed. Which codes should be reported? A. 45330, Z13.818, Z80.0 B. 45378, Z12.11, Z85.038 C. G0104, Z13.818, Z85.038 D. G0105, Z12.11, Z80.0 Correct Answer: D. G0105, Z12.11, Z80.0 Rationale: G0105 is used for a Medicare screening colonoscopy for a patient considered high risk because of a family history of colorectal cancer. Z12.11 identifies screening for malignant neoplasm of the colon, and Z80.0 documents the family history. G0104 represents screening sigmoidoscopy. Question 7 A patient has a 2-cm benign lesion involving the lip. The surgeon removes the lesion together with a full-thickness wedge of lip tissue and performs a single-layer closure. Which CPT® code should be reported? A. 40510 B. 11442, 12011-51 C. 40510, 12011-51 D. 11442, 40510 Correct Answer: A. 40510 Rationale: CPT® 40510 describes full-thickness wedge excision of the lip. The closure is integral to the excision and is not separately reported. Code 11442 applies to excision of a benign cutaneous lesion of the face rather than a full-thickness lip wedge. Separately reporting the simple repair would result in unbundling. Question 8 A physician begins an upper gastrointestinal endoscopy to evaluate possible peptic ulcer disease. After identifying a bleeding gastric ulcer and a perforated jejunal ulcer, the patient develops severe hypotension, and the physician terminates the procedure for safety. Which codes are appropriate? A. 43235-52, K25.4, K28.5 B. 43235-53, K25.4, K28.5 C. 43200-52, K25.5, K28.5 D. 43235-53, K25.4, K28.1 Correct Answer: B. 43235-53, K25.4, K28.5 Rationale: Modifier 53 is used when a procedure is discontinued because circumstances threaten the patient’s well-being. CPT® 43235 represents the upper gastrointestinal endoscopy that was initiated. K25.4 identifies a gastric ulcer with hemorrhage, while K28.5 identifies a gastrojejunal ulcer with perforation. Modifier 52 indicates reduced services rather than an urgently discontinued procedure. Question 9 A surgeon repairs a recurrent unilateral femoral hernia that is reducible and shows no evidence of obstruction or gangrene. Which CPT® and ICD-10-CM codes should be reported? A. 49550, K41.91 B. 49555, K41.21 C. 49505, K41.31 D. 49555, K41.91 Correct Answer: D. 49555, K41.91 Rationale: CPT® 49555 describes repair of a recurrent femoral hernia. K41.91 identifies a unilateral or unspecified femoral hernia without obstruction or gangrene that is recurrent. Code 49550 is used for an initial femoral hernia repair, while 49505 describes an inguinal rather than femoral hernia. Question 10 A 50-year-old patient with a family history of colorectal cancer undergoes a screening colonoscopy. Two transverse-colon polyps are removed using hot biopsy forceps, and three ascending-colon polyps are removed using a snare. Pathology later confirms benign neoplasms. Which coding combination is most appropriate? A. 45384 × 2, 45385 × 3, K63.5 B. 45384, 45385-59, K63.5, Z12.11, Z80.0 C. 45384 × 2, 45385 × 3, Z80.0, K63.5, Z12.11 D. 45384, 45385-59, Z12.11, D12.3, D12.2, Z80.0 Correct Answer: D. 45384, 45385-59, Z12.11, D12.3, D12.2, Z80.0 Rationale: Each colonoscopy technique is reported once regardless of the number of lesions removed using that technique. Modifier 59 distinguishes the snare removal from the hot biopsy removal. Z12.11 identifies the screening purpose, D12.3 and D12.2 identify benign neoplasms at the documented sites, and Z80.0 records the family history.