CPC Exam Dumps : Certified Professional Coder (CPC) Exam

1. E/M Code Category Selection:

The patient is a 19-year-old seen by his primary care physician for an annual preventive exam. His last exam was four years ago, and he has no complaints, indicating a preventive rather than problem-focused visit.

CPT® Code 99385 is for a new patient preventive visit for ages 18-39. Since the patient’s last visit was four years ago, this qualifies him as a new patient by CPT® standards (a patient is considered new if they have not received any professional services from the physician within the past three years).

2. Rationale for Excluding Other Options:

Code 99395 is for an established patient preventive visit for ages 18-39, which does not apply here since the patient is considered new after four years.

Code 99394 is for a preventive visit for an established patient aged 12-17, which does not match the patient’s age.

Code 99384 is for a new patient preventive visit for ages 12-17, which also does not apply given the patient’s age of 19.

3. AAPC and CPT® Coding Guidelines:

According to CPT® guidelines, 99385 is appropriate for a new patient in the 18-39 age range for a preventive visit, especially when they have not seen the provider in over three years.

Therefore, the correct answer is A. 99385.

When a prior malignancy has been eradicated and the patient is no longer receiving treatment for the primary site, ICD-10-CM directs you to use apersonal history of malignant neoplasmcode rather than an active primary cancer code. Here, the breast cancer was treated successfully last year and no further therapy was required, so the breast cancer ishistory, not active. The new current condition ismetastatic cancer to the liver, which is coded as asecondary malignant neoplasm of liver and intrahepatic bile duct (C78.7). Because the primary breast cancer is not documented as active or under current treatment, you donotcode an active breast malignancy (C50.-). Instead, you addZ85.3 (personal history of malignant neoplasm of breast)to show the prior cancer history relevant to the current metastatic disease. Option A incorrectly codes a primary liver cancer. Option C incorrectly codes active breast cancer. Option D codes metastasis to the adrenal gland, not the liver.

Diabetic polyneuropathy is coded as E11.42, which indicates type 2 diabetes mellitus with diabetic polyneuropathy. The ICD-10-CM guidelines direct that when a patient has both diabetes and polyneuropathy, a single combination code is used to capture both conditions.

ICD-10-CM (current year), Chapter 4: Endocrine, Nutritional, and Metabolic Diseases (E00-E89), ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.4.a.6.