CPC Certified Professional Coder 5 — Questions and Answers
Question 1: Which ICD-10-CM chapter covers mental, behavioral, and neurodevelopmental disorders?
- Chapter 4 (E00–E89)
- Chapter 5 (F01–F99) (Correct answer)
- Chapter 6 (G00–G99)
- Chapter 18 (R00–R99)
Correct answer: Chapter 5 (F01–F99)
ICD-10-CM Chapter 5, codes F01–F99, covers mental, behavioral, and neurodevelopmental disorders.
Question 2: A patient undergoes an excision of a benign lesion measuring 1.5 cm from the back. Which measurement determines the correct CPT code?
- The diameter of the lesion only
- The diameter of the lesion plus the narrowest margin required (Correct answer)
- The depth of the lesion
- The area of the lesion in square centimeters
Correct answer: The diameter of the lesion plus the narrowest margin required
For excision coding, the correct CPT code is determined by the lesion's diameter plus the narrowest margin excised in centimeters.
Question 3: Under ICD-10-CM, how is an encounter for chemotherapy for a malignant neoplasm coded?
- Malignant neoplasm code first, then Z51.11
- Z51.11 (encounter for antineoplastic chemotherapy) first, then the malignancy code (Correct answer)
- Only the neoplasm code is required
- Z51.11 only, neoplasm code is not needed
Correct answer: Z51.11 (encounter for antineoplastic chemotherapy) first, then the malignancy code
ICD-10-CM guidelines instruct that when the encounter is for chemotherapy, Z51.11 is sequenced first, followed by the code for the malignancy.
Question 4: Which modifier indicates that a procedure was performed by a resident under the supervision of a teaching physician?
- Modifier -GE
- Modifier -GC (Correct answer)
- Modifier -GT
- Modifier -GX
Correct answer: Modifier -GC
Modifier -GC is appended to indicate that a service was performed in part by a resident under the direction of a teaching physician.
Question 5: When a patient is seen for a routine annual wellness exam and the physician also addresses a new problem, how is the E/M visit coded?
- Only the preventive medicine code is reported
- Only the office visit code is reported
- Both the preventive medicine code and an office visit code with modifier -25 are reported (Correct answer)
- A single code is selected based on whichever takes more time
Correct answer: Both the preventive medicine code and an office visit code with modifier -25 are reported
When a significant, separately identifiable E/M service is performed in addition to the preventive visit, both codes are reported with modifier -25 on the additional E/M code.
Question 6: A coder encounters the instruction 'Code also' in ICD-10-CM. What does this instruction mean?
- The additional code is optional and rarely used
- Two codes may be required to fully describe the condition, and both should be reported (Correct answer)
- The second code replaces the first code
- Assign the additional code only for inpatient encounters
Correct answer: Two codes may be required to fully describe the condition, and both should be reported
'Code also' is an instructional note in ICD-10-CM indicating that a second code may be needed to fully describe a condition, and both codes should be reported when applicable.
Question 7: Which CPT add-on code is used to report each additional 30 minutes of prolonged office-based services beyond the first hour?
- +99356
- +99417 (Correct answer)
- +99358
- +99354
Correct answer: +99417
CPT add-on code +99417 is used to report each additional 15–30 minutes of prolonged outpatient E/M services beyond the required minimum time for the primary service.
CPC Certified Professional Coder 5
Which ICD-10-CM chapter covers mental, behavioral, and neurodevelopmental disorders?