CPC Exam Dumps : Certified Professional Coder (CPC) Exam

This is a subsequent nursing facility care visit.

MDM Analysis (2021+ E/M Guidelines):

Problems: Multiple chronic conditions → Moderate

Data: 4 labs + telemetry → Moderate

Risk: Prescription drug management → Moderate

99309 – Subsequent nursing facility care, moderate MDM

Why others are incorrect:

99307 / 99308 – Low complexity

99305 – Initial nursing facility care

This is anestablished patient office visitcoded byMDM(or time, but time is not provided). Problems:one acute, uncomplicated illness(URI) → supportslowproblem complexity. Data: no labs/imaging ordered or reviewed →minimal/nonedata. Risk: although a prescription is given, MDM level is determined by2 of 3elements (Problems, Data, Risk). Here, only the risk might approach moderate due to prescription management, butproblems and data remain low/minimal, so the overall MDM doesnotmeet moderate. Therefore, the visit is best supported atlow MDM, which corresponds to99213for an established patient. It is more than minimal (99212) because a focused exam and management plan are documented, but it does not meet the higher complexity required for 99214/99215 (multiple problems, significant data review, or high-risk management). CPC exam focus: don’t let a single element (like antibiotics) automatically “force” a higher code—MDM requires meeting the level intwo elements.

According to ICD-10-CM Guidelines, I11A.0 (Resistant hypertension) is used to indicate hypertension that remains uncontrolled despite the use of multiple antihypertensive medications. Resistant hypertension is coded to highlight the severity of the patient’s condition and the difficulty in managing their blood pressure. This code is added as a secondary code to reflect the persistent elevation of blood pressure despite medication.

A. I10 (Essential hypertension) is a general code for primary hypertension but does not specify resistance to treatment.

B. A code from category I27 is related to pulmonary heart diseases, not directly related to hypertension management issues.

D. A code from category I16 (Hypertensive crisis) is used for hypertensive emergencies or urgencies, which are acute episodes, not persistent uncontrolled hypertension despite treatment.

Thus, the correct answer is C. I11A.0, Resistant hypertension.