Legit CPC Exam Download

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.

The correct ICD-10-CM coding for this patient is B20, M54.50. The first code, B20, is used for HIV disease, which is a confirmed diagnosis of HIV infection. It’s important to note that this code can be used regardless of whether the patient is symptomatic or asymptomatic, as long as the patient has been diagnosed with HIV.

The second code, M54.50, refers to low back pain, which would be used to report the loin pain described by the patient. " Loin pain " typically refers to pain in the lower back area, and this code specifically covers the general category of low back pain not otherwise specified.

The other options are not as accurate:

A (B20, M54.9) includes a nonspecific code for back pain (M54.9), which does not fully specify the pain’s location.

B (M54.51, B20) incorrectly includes a code for thoracic or lumbar radiculopathy (M54.51), which is not indicated here.

D (M54.50, B20) is similar to the correct answer, but it incorrectly lists the codes in reverse order. It is important to list the HIV diagnosis first in ICD-10-CM.

Reference topics: ICD-10-CM Coding for HIV Disease; Pain Coding

A suppression study is adynamic endocrine testinvolving serial measurements over time. CPT80430represents thesuppression function testitself (the study framework), while the individual lab analytes measured during the test are reported with their specific assay codes based on the test protocol. The scenario includesfive glucose testsandfive human growth hormone (HGH) testsperformed as part of the study. Glucose testing is reported with82947per test, and growth hormone testing is reported with83003per test. Because the stem specifiesfive of each, correct reporting includes80430plus82947 × 5and83003 × 5. Options that report only one unit of 82947/83003 (or reduce the number of tests) fail to reflect the documented serial testing frequency. CPC exam tip: when a dynamic study is described, do not stop at the function test code—also capture theserial analyte measurementswhen the question explicitly provides the number of lab draws/tests. Therefore, the correct coding is80430, 82947 × 5, 83003 × 5.