CPC Exam Dumps : Certified Professional Coder (CPC) Exam

For a patient in observation care, selecting the correct E/M codes requires evaluating each day's service level and the provider's documentation.

Day 1: The patient was admitted for observation, and the physician prescribed IV and SQ insulin, noting diabetes with hyperglycemia requiring complex management. The CPT® code 99235 is appropriate here because it represents an initial observation or inpatient care for patients with high-complexity medical decision-making (MDM), which aligns with the patient's unstable glucose and the management requirements.

Day 2: The patient's glucose levels improved, and the provider documented spending 25 minutes with the patient in continued observation care. Since this is an established patient with continued observation, 99231 applies here, indicating subsequent observation care with low MDM complexity.

Day 3: The provider documented spending 15 minutes with the patient, whose glucose levels normalized, and then discharged the patient from observation care. Code 99238 is used for a discharge from observation care and is selected based on discharge times under 30 minutes.

These codes were selected based on CPT® guidelines for observation care and the provider’s time-based documentation. This matches the medical decision complexity documented per the case and code descriptions available for observation care management.

1. Procedure and CPT® Code Selection:

The patient had a cochlear implant placed in the left ear and is now seeing the audiologist for initialization and programming of the implant.

CPT® Code 92603 is specific for initial programming of a cochlear implant for patients younger than 12 years old. This includes the setup and initial adjustments required for the cochlear implant, making it the correct code.

2. Rationale for Excluding Other Options:

Code 92626 is used for evaluating auditory function with the cochlear implant, focusing on assessment rather than programming, and is therefore incorrect for this programming session.

Code 92630 is for aural rehabilitation following cochlear implant, which does not apply to the programming/initiation stage.

Code 92604 is for subsequent programming sessions after the initial programming and is therefore not applicable for the first-time programming.

3. AAPC and CPT® Coding Guidelines:

According to AAPC guidelines, 92603 is the appropriate code for initial programming of a cochlear implant in children under 12 years of age.

Therefore, the correct answer is D. 92603.

Procedure Coding:

44970 – Laparoscopic appendectomy

Appendix removed via scope through umbilical incision, confirming laparoscopic approach

Diagnosis Coding:

K35.32 – Acute appendicitis with perforation and localized peritonitis, without abscess

Documentation supports ruptured (perforated) appendicitis

No abscess documented

Why Other Options Are Incorrect:

B – Signs/symptoms (R11.2, R10.31) not coded once definitive diagnosis is established

C – 44960 = open appendectomy (not performed)

D – 44950 = open appendectomy, diagnosis code incorrect

ICD-10-CM Guideline Reference:

Do not code symptoms when a definitive diagnosis is confirmed.