2026年最新の保証された成功できるCPC問題集でAAPCのPDF問題
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AAPC CPC 認定試験の出題範囲：
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質問 # 210
(A provider states that all of their office visits should be reported asmoderate levelsbecause they treat patients with high-complexity problems. Would this be considered a compliance problem?)
- A. Yes, it is considered abuse
- B. No, high-complexity problems represent a low level
- C. No, a provider can bill for any level they choose
- D. Yes, it is considered waste
正解：A
解説：
Systematically billing all office visits at a predetermined level-without documentation supporting the requiredmedical decision making (MDM)ortime-is a classic compliance red flag and is generally treated asabuse(often described as upcoding when higher levels are billed than supported). E/M levels must reflect what was actually performed and documented for that encounter, using the E/M rules (MDM elements or total time, depending on code selection). Even if a provider treats complex patients, not every visit will meet the same level; stable follow-ups may be lower complexity than acute exacerbations or new problems. "Waste" generally refers to inefficient or unnecessary use of resources without intent to misrepresent; a blanket instruction to code moderate levels suggestssystematic misbillingrather than inefficiency. Option D is incorrect because providers cannot select any level at will-coding must be supported by documentation. This type of pattern is exactly what audits target, and it can trigger overpayment recoupment, penalties, and corrective action plans.
質問 # 211
An interventional radiologist performs an abdominal paracentesis in his office utilizing ultrasonic imaging guidance to remove excess fluid. What CPT coding is reported?
- A. 49082, 76942
- B. 49082, 76942-26
- C. 0
- D. 49083, 76942-26
正解：C
解説：
CPT code 49083 describes an abdominal paracentesis with imaging guidance, such as ultrasound. This code includes the imaging guidance as part of the procedure, so it is not necessary to separately report the ultrasonic guidance.
References:
* AMA's CPT Professional Edition (current year), Code 49083
質問 # 212
An interventional radiologist performs an abdominal paracentesis using fluoroscopic guidance to remove excess fluid. The procedure is performed in the hospital. What CPT coding is reported?
- A. 0
- B. 49083.77002-26
- C. 49083,77001-26
- D. 1
正解：D
解説：
49083 - Abdominal paracentesis, diagnostic or therapeutic; with imaging guidance This code includes imaging guidance (ultrasound or fluoroscopy).
Per CPT guidelines, do not separately report fluoroscopy or ultrasound guidance with 49083.
The procedure was performed in the hospital, but CPT coding does not change based on site of service.
Why Other Options Are Incorrect:
A (49082) - Used without imaging guidance
B / D - Imaging guidance codes (77001, 77002) are bundled into 49083 per CPT and NCCI edits Official CPT Guidance:
When a paracentesis is performed with imaging guidance, report 49083 only.
質問 # 213
A 4-year-old, critically ill child is admitted to the PICU from the ED with respiratory failure due to an exacerbation of asthma not manageable in the ER. The PICU provider takes over the care of the patient and starts continuous bronchodilator therapy and pharmacologic support with cardiovascular monitoring and possible mechanical ventilation support.
What is the E/M code for this encounter?
- A. 0
- B. 1
- C. 2
- D. 3
正解：A
解説：
The code 99471 is used for initial inpatient neonatal critical care, per day, for the evaluation and management of a critically ill infant or young child. Given the scenario where a 4-year-old critically ill child is admitted to the PICU and requires intensive care management, this code is appropriate as it reflects the critical care provided beyond the emergency department services. References: CPT Professional Edition (current year), AMA.
質問 # 214
An anesthesiologist medically directs two cases during EGD and colonoscopy in a PS III patient with severe bleeding risk.
What CPT codes are reported?
- A. 00731-QX-P3, 99100
- B. 00813-QK-P3, 99100, 99140
- C. 00731-QY-P3, 99140
- D. 00813-AA-P3, 99100, 99140
正解：B
解説：
00813 = Anesthesia for colonoscopy
QK = Medical direction of 2-4 cases
99100 = Extreme age
99140 = Emergency anesthesia
質問 # 215
Dr. Carter sees Mrs. White at the Spring Valley Nursing Facility. He saw her last month after she was admitted to the facility. Today is a follow up visit. She is doing well. He documented a medically appropriate history and exam. The patient has osteoporosis, hypertension, dementia. CAD, CHF, and type 2 diabetes (moderate number and complexity of problems). He reviews 4 labs and a telemetry (Moderate data). He adds a Cardizem prescription for better control of her blood pressure which is a moderate risk. What CPT code does Dr. Carter report for the visit?
- A. 0
- B. 1
- C. 2
- D. 3
正解：C
解説：
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
質問 # 216
A patient with a history of chronic venous embolism in the inferior vena cava has a radiographic study to visualize any abnormalities. In outpatient surgery the physician accesses the subclavian vein and the catheter is advanced to the inferior vena cava for injection and imaging. The supervision and interpretation of the images is performed by the physician.
What codes are reported for this procedure?
- A. 36000, 75825-26
- B. 36010, 75827-26
- C. 36000, 75827-26
- D. 36010, 75825-26
正解：D
解説：
For the procedure involving access to the subclavian vein and advancing a catheter to the inferior vena cava for injection and imaging, the following codes are used:
* 36010 for the catheter placement.
* 75825-26 for the supervision and interpretation of the imaging.
Modifier -26 indicates the professional component of the radiological supervision and interpretation.
References:
* AMA's CPT Professional Edition (current year)
* ICD-10-CM (current year)
質問 # 217
A patient is diagnosed with sepsis and associated acute respiratory failure.
What ICD-10-CM code selection is reported?
- A. A41.9, R65.20, J96.00
- B. A41.9, J96.00
- C. A41.9
- D. A41.9, R65.21, J96.00
正解：B
質問 # 218
(Full Case:Preoperative diagnosis:Recurrent dysphagia.Postoperative diagnosis:Hiatal hernia with obstruction.
Procedure:EGD with dilation.Consent:PAR conference; informed consent signed; premedication given.
Position/monitoring:left lateral decubitus; monitored with BP cuff and pulse oximeter throughout.Topical:
Hurricaine spray to posterior pharynx.Scope passage:flexible endoscope passed under direct visualization through cricopharyngeus into esophagus; advanced with identification of EG junction into stomach; rugal folds visualized; advanced to antrum/pylorus; pylorus cannulated; duodenal bulb and second portion visualized; retroflexed views of cardia/fundus/lesser curvature.Dilation technique:guidewire placed in antrum; scope removed; wire positioned by markings;#14 French dilatorpassed into stomach area;esophageal dilation performed over guidewire.Findings:tortuous/shortened esophagus; large sliding hiatal hernia; EG junction
~30 cm; stomach abnormal with very large sliding hiatal hernia; duodenum normal.Question:What CPT coding is reported?)
- A. 0
- B. 43235, 43248
- C. 43235, 43249
- D. 1
正解：D
解説：
The documented service is an upper GI endoscopy (EGD) withesophageal dilationperformed using aguidewireand a passed dilator ("dilation performed over the guidewire"). In CPT, when a therapeutic endoscopic service is performed, you report thetherapeutic EGD code, not the separate diagnostic EGD code, because diagnostic visualization is inherent in performing the therapeutic procedure. Therefore,43235 (diagnostic EGD) is not additionally reported. The key distinction between the dilation codes offered is the method:43248describes EGD withesophageal dilation using a guidewire technique(bougie/dilator passed over a guidewire), which matches the narrative: guidewire placed in the antrum, scope removed, and a dilator passedover the guidewireinto the stomach area. Code43249generally reflects balloon dilation of the esophagus performed endoscopically; the note does not describe balloon inflation, diameter, or balloon equipment. The hiatal hernia findings and dysphagia indication support medical necessity but do not change code selection. Thus, the correct CPT code is43248alone.
質問 # 219
The gynecologist performs a colposcopy of the cervix including biopsy and endocervical curettage.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
正解：C
質問 # 220
A 6-French sheath and catheter is placed into the coronary artery and is advanced to the left side of the heart into the ventricle. Ventriculography is performed using power injection of contrast agent. Pressures in the left heart are obtained. The coronary arteries are also selected and imaged.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
正解：D
質問 # 221
The documentation states:
"A punch is placed and pushed downward to obtain a tissue sample for a biopsy of the lunula." What anatomical structure is being biopsied?
- A. Brain
- B. Skin
- C. Nail
- D. Eye
正解：C
解説：
The lunula is the whitish, crescent-shaped area at the base of the fingernail or toenail.
It is part of the nail anatomy, specifically associated with nail growth.
Therefore, a biopsy of the lunula is a nail biopsy, making B the correct answer.
質問 # 222
The surgeon performs Roux-en-Y anastomosis of the extrahepatic biliary duct to the gastrointestinal tract on a
45-year-old patient.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
正解：D
解説：
The Roux-en-Y anastomosis of the extrahepatic biliary duct to the gastrointestinal tract is a specific surgical procedure that involves connecting the biliary duct to the gastrointestinal tract.
Procedure Description: Roux-en-Y anastomosis of the extrahepatic biliary duct involves creating a direct connection between the biliary duct and the gastrointestinal tract.
Procedure Specificity: The procedure is complex and involves extensive surgical technique and anastomosis.
Coding Decision:
CPT 47780 specifically describes the Roux-en-Y anastomosis of the extrahepatic biliary duct to the gastrointestinal tract.
AMA's CPT Professional Edition (current year).
CPT Assistant for detailed coding guidelines on biliary and gastrointestinal procedures.
質問 # 223
A patient presents with 26 skin tags on the neck and shoulder. The provider removes all using a scissoring technique.
What CPT coding is reported?
- A. 11200, 11201 ×25
- B. 11200, 11201-51
- C. 11200, 11201 ×2
- D. 11200, 11201
正解：C
解説：
11200 = removal of up to 15 skin tags
11201 = each additional 10 lesions or part thereof
26 lesions = 15 + 11 → 11201 ×2
質問 # 224
(A patient is in her otolaryngologist's office to receive therapeutic treatment forasthmatic bronchitis with status asthmaticus. A subcutaneous injection ofomalizumab (150 mg)is given in her left upper arm. What is the CPT and ICD-10-CM coding?)
- A. 90460, J2357 × 30, J45.52
- B. 90471, J2357 × 30, J45.902
- C. 96372, J2357 × 30, J45.902
- D. 96369, J2357 × 30, J45.52
正解：C
解説：
Omalizumab is a drug reported withHCPCS J2357, and the dose is converted into billable units based on the code's unit definition. In CPC-style questions,150 mgis commonly represented asJ2357 × 30 units(i.e., 5 mg per unit # 150/5 = 30). Administration is atherapeutic subcutaneous injection, reported with96372(therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular). Vaccine administration codes (90460
/90471) are not appropriate because omalizumab is not a vaccine. For diagnosis, the statement includesstatus asthmaticusbut does not specify severity category (mild/moderate/severe persistent). In the options provided, J45.902is the "unspecified asthma with status asthmaticus" concept, whereas J45.52 requires severe persistent asthma with status asthmaticus (not documented). Therefore, the correct pairing is96372 + J2357 × 30 + J45.
902. CPC exam tip: match administration code type (therapeutic injection vs immunization) and choose the most specific ICD-10-CM supported by documentation.
質問 # 225
A catheter is placed from the femoral artery into the right common carotid, with imaging of the ipsilateral extracranial carotid and bilateral external carotids.
Which CPT codes are reported?
- A. 36223, 36227 ×2
- B. 36224-50, 36227-51 ×2
- C. 36222, 36227 ×2
- D. 36225, 36227-51 ×2
正解：A
解説：
36223 = Selective catheterization of common carotid with imaging
36227 ×2 = Bilateral external carotid angiography
質問 # 226
A patient returns for embryo transfer. The lab thaws cryopreserved embryos and cultures them for two additional days.
What CPT coding is reported?
- A. 89258, 89250
- B. 89352, 89250
- C. 89342 ×3, 89250 ×3
- D. 89352 ×3, 89250 ×3
正解：A
解説：
89258 = Thawing of cryopreserved embryos
89250 = Culture of embryos, per day (reported once per encounter)
質問 # 227
(A 62-year-old with insulin-dependent diabetes mellitus has sudden hearing loss. The otolaryngologist administered atranstympanic injection of a steroidfor the sudden hearing loss ineach ear. How is this reported?)
- A. 69801 × 2
- B. 0
- C. 69801-50
- D. 69801-22
正解：C
解説：
Atranstympanic(intratympanic) injection involves placing medication through the tympanic membrane into the middle ear space. CPT69801is used to report this transtympanic injection/tympanocentesis-type service as represented in CPC-style questions. Because the physician performed the injection inboth earsduring the same session, the appropriate bilateral reporting method in this answer set ismodifier -50to indicate abilateral procedure. Reporting69801 × 2is a common trap; many payers require either modifier 50 or RT/LT rather than two units, and the CPC exam typically follows modifier logic as presented in the options. Modifier-22 (increased procedural services) would require unusual extra work beyond typical complexity and is not supported by the vignette. Reporting only a single unilateral code (option A) would underreport the bilateral nature. Therefore, the best answer is69801-50, reflecting the same service performed on paired organs during the same encounter.
質問 # 228
A 45-year-old patient presents with right shoulder pain. The provider administers three trigger point injections in the trapezius muscle and two in the pectoralis muscle.
What CPT coding is reported?
- A. 0
- B. 20552 ×5
- C. 1
- D. 20552 ×2
正解：A
解説：
20552 = Injection(s); single or multiple trigger points, 1-2 muscles
Total muscles injected = 2 (trapezius + pectoralis)
Number of injections does not determine code selection-number of muscles does
質問 # 229
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