1. Procedure and CPT® Code Selection:

The obstetric panel ordered includes the following tests: syphilis screening (non-treponemal), automated CBC with manual differential WBC count, HBsAg, rubella antibody, serum antibody screen, and ABO/Rh blood typing.

CPT® Code 80055 is for a comprehensive obstetric panel that includes all these components. This code is intended to report the entire panel of tests as a bundled service rather than itemizing each individual test.

2. Rationale for Excluding Other Options:

Option B lists the individual component codes for each test in the obstetric panel (e.g., 85027, 85007, 87340, etc.), but using 80055 is more appropriate because it provides a single code to report the full obstetric panel and follows CPT® bundling guidelines.

Option C also lists the individual tests separately, which is unnecessary when 80055 includes all these components.

Option D lists 80081, which is for an obstetric panel that includes HIV testing. Since HIV testing is not part of the tests described in this scenario, 80081 is incorrect.

3. AAPC and CPT® Coding Guidelines:

AAPC guidelines recommend using the single code 80055 when all components of an obstetric panel are ordered together, as itemizing each test individually is not necessary.

Therefore, the correct answer is A. 80055.

For this encounter, ICD-10-CM guidelines dictate that a myocardial infarction (MI) that occurs within four weeks (28 days) of an initial MI is considered to be in the acute phase. Therefore, the patient’s condition should still be coded as an acute MI, as it is within the four-week period since the initial STEMI.

B. I21.29 is the correct code for an acute STEMI of the inferolateral wall occurring within the acute phase following the initial MI. The code I21.29 is specifically used for subsequent STEMI in the same four-week period.

Explanation of incorrect options:

A. I22.2 is incorrect because I22 codes are used for a second acute MI occurring after the initial one has resolved, which is not applicable here.

C. I21.19 and D. I21.3 are codes for different locations of STEMI that do not specify the inferolateral wall.

Therefore, the correct answer is B. I21.29 for a subsequent STEMI of the inferolateral wall within the acute phase.

1. Procedure and CPT® Code Selection:

The patient underwent a cardiac MRI to assess the morphology and function of the heart under stress, involving both non-contrast and contrast-enhanced imaging. Additionally, pharmacological stress testing was performed to evaluate the coronary arteries.

CPT® Code 75563 is appropriate for a cardiac MRI with both stress and rest imaging, including morphology and function studies with contrast and pharmacologic stress testing. This code accurately captures the entire scope of the MRI study described in this case.

Modifier 26 is applied to indicate the professional component of the service if the cardiologist is providing only the interpretation and not the technical component.

2. Diagnosis and ICD-10-CM Code Selection:

ICD-10-CM Code I25.118 is used for atherosclerotic heart disease with unstable angina. This code accurately reflects the diagnosis provided in the scenario.

3. Rationale for Excluding Other Options:

Code 75559 (option B) represents a cardiac MRI without stress testing, which does not cover the pharmacologic stress component performed here.

Code 75557 (in option D) is for a limited cardiac MRI that does not include both stress and non-stress imaging, so it is incorrect for this comprehensive test.

ICD-10-CM Code I25.110 (in options C and D) is for atherosclerosis with angina pectoris without unstable angina, making I25.118 more appropriate given the diagnosis of unstable angina.

4. AAPC and CPT® Coding Guidelines:

AAPC and CPT® guidelines support the use of 75563 for comprehensive cardiac MRI studies with stress testing, both with and without contrast.

Therefore, the correct answer is A. 75563-26, I25.118.

1. Procedure and CPT® Code Selection:

The patient underwent a suppression study involving five glucose tests and five human growth hormone tests.

CPT® Code 80430 represents a suppression panel specifically for growth hormone studies, which includes various assessments for diagnosing abnormal growth.

CPT® Code 82947 is used for each glucose test performed, and since five glucose tests were conducted, it should be coded as 82947 x 5.

CPT® Code 83003 is used for each human growth hormone test performed, and since five tests were conducted, it should be coded as 83003 x 5.

2. Rationale for Excluding Other Options:

Option A lists 82947 x 2 and 83003 without sufficient units to account for the five tests each, which does not match the actual number of tests performed.

Option B omits the suppression panel code 80430, which is necessary for documenting the overall suppression study.

Option D does not provide the correct quantity of glucose and growth hormone tests, which were each performed five times.

3. AAPC and CPT® Coding Guidelines:

According to AAPC guidelines, when a suppression panel includes multiple components that are performed more than once, the specific panel code 80430 should be used along with the correct number of individual component codes.

Therefore, the correct answer is C. 80430, 82947 x 5, 83003 x 5.

Procedure Coding:

49186 – Excision or destruction of intra-abdominal tumors, 1–4 tumors

Four tumors excised → correct code selection

Size does not alter code selection once tumor count is determined

Diagnosis Coding:

C48.2 – Malignant neoplasm of peritoneum, unspecified

Pathology confirms malignancy

C76.2 is used for ill-defined sites, not appropriate when peritoneum is specified

Why Other Options Are Incorrect:

B – 49187 is for 5 or more tumors

D – K66.8 = non-malignant peritoneal disorder

CPT® code 69644 refers to a tympanoplasty with mastoidectomy, which includes canalplasty, middle ear surgery, and tympanic membrane repair. The specific procedure described by this code is performed with an intact or reconstructed canal wall and includes ossicular chain reconstruction. The use of a semicolon in the CPT® description helps distinguish between different variations of the procedure.

AMA ' s CPT® Professional Edition, specific code descriptions and guidelines.

The key is the root and suffix:orch/o(or orchi/o) refers to thetestis/testicle, and-ectomymeanssurgical removal. Therefore,orchiectomyis the surgical removal of atesticle(one or both, depending on context). The distractors are nearby male reproductive structures that commonly appear in anatomy questions: thescrotumis the external sac that houses the testes (procedures there might be scrotoplasty or scrotal surgery, not orchiectomy). Theepididymisis the structure attached to the testicle where sperm mature and are stored (removal would be epididymectomy). Theprostateis a gland at the base of the bladder (removal would be prostatectomy). On the CPC exam, terminology questions often use anatomic proximity to tempt you into picking a “nearby” structure—always lock onto the combining form first (orch = testis), then confirm the procedure suffix (-ectomy = removal).

Procedure Coding (CPT®):

31287 – Nasal/sinus endoscopy, surgical; with sphenoidotomy

Correct because the surgeon performed a surgical endoscopic sphenoidotomy to evaluate and treat sphenoid sinus injury.

No CSF leak repair was performed, so codes 31290–31291 are not appropriate.

31231-59 – Nasal endoscopy, diagnostic

Diagnostic endoscopy is separately reportable because:

It was performed to evaluate traumatic injury

It is not bundled into the surgical service when it provides distinct diagnostic information

Modifier -59 indicates a separate and distinct service per NCCI edits.

Diagnosis Coding (ICD-10-CM):

S02.109A – Unspecified fracture of base of skull, initial encounter for closed fracture

The anterior cranial fossa fracture with sphenoid sinus involvement qualifies as a skull base fracture

No CSF leak is documented

Correct 7th character “A” for initial encounter

Why Other Options Are Incorrect:

A – Incorrect format and duplicated CPT logic

B – 31267 = maxillary sinus, wrong sinus

D – 31291 includes CSF leak repair, which was not performed

Procedure Coding (CPT®):

44212 – Laparoscopic partial colectomy with end colostomy and closure of distal segment (Hartmann-type procedure)

Correct because:

Sigmoid/descending colon resection

Proximal colostomy created

Distal rectal stump closed

44213 – Laparoscopic mobilization of splenic flexure

Separately reportable because:

Mobilization was necessary to exteriorize colon for colostomy

Not bundled into 44212

Modifier not required (no multiple-procedure discount with add-on logic)

Diagnosis Coding (ICD-10-CM):

K57.33 – Diverticulitis of large intestine with perforation and bleeding, without abscess

Documentation supports:

Diverticulitis

Active bleeding

No abscess reported

Why Other Options Are Incorrect:

A / B – 44206 = colectomy with anastomosis (not performed)

A / B – K57.41 includes abscess (not documented)

C – Missing splenic flexure add-on explanation

CPT® & ICD-10-CM Guideline Alignment:

Hartmann procedure ≠ anastomosis

Bleeding elevates diagnosis specificity

Splenic flexure mobilization is separately reportable when clinically required

99222: This code is used for initial hospital care, per day, for the evaluation and management of a patient, which requires a detailed or comprehensive history, a detailed or comprehensive examination, and medical decision making of moderate complexity.

The documentation shows a detailed history (including HPI, ROS, PMH, SH, and FH) and a detailed examination (covering multiple organ systems). The medical decision making involves the management of an acute asthma exacerbation, which includes admitting the patient to observation status, administering oral steroids, and planning for further diagnostic testing.

CPT® Professional Edition, AMA