AAPC CERTIFIED PROFESSIONAL
CODER (CPC) ADVANCED PRACTICE
EXAM QUESTIONS AND ANSWERS
1. A patient presents for a follow-up visit for hypertension and Type 2 diabetes. The physician
spends 25 minutes in total time, with a medically appropriate history and exam. The medical
decision making involves two stable chronic illnesses and a prescription drug management.
What is the correct E/M code for this office visit?
A. 99212
B. 99214
C. 99213
D. 99215
Answer: B
Conceptual Explanation: Per 2023-2024 CPT guidelines, 99214 requires a Moderate level
of MDM or at least 30 minutes of time. However, two stable chronic illnesses and
prescription drug management meet the Moderate MDM criteria, making 99214 the
appropriate choice for an established patient even if time is only 25 minutes.
,2. A 45-year-old patient undergoes an excision of a 2.5 cm malignant lesion on the back. The
physician performs an intermediate repair of the 4.0 cm resulting wound. How should this be
coded?
A. 13101, 11603-51
B. 11403, 12032
C. 11603
D. 11603, 12032-51
Answer: D
Conceptual Explanation: Malignant lesion excisions (11603 for 2.1-3.0 cm on trunk) do
not include intermediate or complex repairs. An intermediate repair of 4.0 cm on the back
is coded 12032. Modifier -51 is used for multiple procedures.
3. A patient with chronic kidney disease (CKD) Stage 4 also has hypertensive heart disease
with heart failure. Which ICD-10-CM codes should be assigned?
A. I11.0, N18.4
B. I13.2, I50.9, N18.9
C. I10, N18.4, I50.9
D. I13.0, I50.9, N18.4
Answer: D
, Conceptual Explanation: ICD-10-CM guidelines state that conditions classified to I11 and
I13 assume a causal relationship between hypertension and heart/kidney disease. I13.0 is
used for hypertensive heart and CKD with heart failure. I50.9 identifies the type of heart
failure, and N18.4 identifies the CKD stage.
4. During a screening colonoscopy, a physician identifies a polyp in the sigmoid colon and
removes it using a cold snare. A second polyp in the descending colon is removed by hot
biopsy forceps. How is this reported?
A. 45385, 45384-XS
B. 45388, 45380-59
C. 45385, 45385-59
D. 45385, 45384-51
Answer: A
Conceptual Explanation: CPT 45385 is for snare removal and 45384 is for hot biopsy
forceps. Since they were at different sites, both are billed. Modifier -XS (or -59) is appended
to the second procedure to indicate it was at a different site.
5. Which modifier is used to indicate that a procedure was planned or staged at the time of
the initial procedure?
A. -78
B. -58
C. -79
CODER (CPC) ADVANCED PRACTICE
EXAM QUESTIONS AND ANSWERS
1. A patient presents for a follow-up visit for hypertension and Type 2 diabetes. The physician
spends 25 minutes in total time, with a medically appropriate history and exam. The medical
decision making involves two stable chronic illnesses and a prescription drug management.
What is the correct E/M code for this office visit?
A. 99212
B. 99214
C. 99213
D. 99215
Answer: B
Conceptual Explanation: Per 2023-2024 CPT guidelines, 99214 requires a Moderate level
of MDM or at least 30 minutes of time. However, two stable chronic illnesses and
prescription drug management meet the Moderate MDM criteria, making 99214 the
appropriate choice for an established patient even if time is only 25 minutes.
,2. A 45-year-old patient undergoes an excision of a 2.5 cm malignant lesion on the back. The
physician performs an intermediate repair of the 4.0 cm resulting wound. How should this be
coded?
A. 13101, 11603-51
B. 11403, 12032
C. 11603
D. 11603, 12032-51
Answer: D
Conceptual Explanation: Malignant lesion excisions (11603 for 2.1-3.0 cm on trunk) do
not include intermediate or complex repairs. An intermediate repair of 4.0 cm on the back
is coded 12032. Modifier -51 is used for multiple procedures.
3. A patient with chronic kidney disease (CKD) Stage 4 also has hypertensive heart disease
with heart failure. Which ICD-10-CM codes should be assigned?
A. I11.0, N18.4
B. I13.2, I50.9, N18.9
C. I10, N18.4, I50.9
D. I13.0, I50.9, N18.4
Answer: D
, Conceptual Explanation: ICD-10-CM guidelines state that conditions classified to I11 and
I13 assume a causal relationship between hypertension and heart/kidney disease. I13.0 is
used for hypertensive heart and CKD with heart failure. I50.9 identifies the type of heart
failure, and N18.4 identifies the CKD stage.
4. During a screening colonoscopy, a physician identifies a polyp in the sigmoid colon and
removes it using a cold snare. A second polyp in the descending colon is removed by hot
biopsy forceps. How is this reported?
A. 45385, 45384-XS
B. 45388, 45380-59
C. 45385, 45385-59
D. 45385, 45384-51
Answer: A
Conceptual Explanation: CPT 45385 is for snare removal and 45384 is for hot biopsy
forceps. Since they were at different sites, both are billed. Modifier -XS (or -59) is appended
to the second procedure to indicate it was at a different site.
5. Which modifier is used to indicate that a procedure was planned or staged at the time of
the initial procedure?
A. -78
B. -58
C. -79
