CPC Study Guide Sample Pages
CPC Study Guide Sample Pages
CPC Study Guide Sample Pages
CPC
®
CERTIFICATION
CERTIFIED PROFESSIONAL CODER
2021
Disclaimer
This course was current when it was published. Every reasonable effort has been made to assure the accuracy of the informa-
tion within these pages. The ultimate responsibility lies with readers to ensure they are using the codes, and following applicable
guidelines, correctly. AAPC employees, agents, and staff make no representation, warranty, or guarantee that this compilation of
information is error-free, and will bear no responsibility or liability for the results or consequences of the use of this course. This
guide is a general summary that explains guidelines and principles in profitable, efficient healthcare organizations.
US Government Rights
This product includes CPT®, which is commercial technical data and/or computer data bases and/or commercial computer soft-
ware and/or commercial computer software documentation, as applicable, which was developed exclusively at private expense
by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify,
reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or
computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995),as
applicable, for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/
or subject to the restricted rights provision of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any
applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
AMA Disclaimer
CPT® copyright 2020 American Medical Association. All rights reserved.
Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of
CPT®, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense
medical services. The AMA assumes no liability for data contained or not contained herein.
© 2020 AAPC
2233 South Presidents Dr. Suites F-C, Salt Lake City, UT 84120
800-626-2633, Fax 801-236-2258. www.aapc.com
Updated 12042020. All rights reserved.
Print ISBN: 978-1-646310-593
e-Book ISBN: 978-1-646311-255
CPC®, CIC™, COC™, CPC-P®, CPMA®, CPCO™, and CPPM® are trademarks of AAPC.
ii 2021 Official Study Guide CPC® Certification CPT ® copyright 2020 American Medical Association. All rights reserved.
Contributors:
Katherine Abel, CPC, CPB, CPMA, CPPM, CMRS, AAPC Approved Instructor
Paula Allard, CPC, CDEO
Quitrina Carter, CPC, CEMC, AAPC Approved Instructor
Berrie Corley, CPC, AAPC Approved Instructor
Lori A Cox, MBA, CPC, CPMA, CEMC, CGSC, CHONC, AAPC Approved Instructor
Brad Ericson, MPC, CPC, COSC
Cindy Hagle, CPC, CPMA, CRC
Christine Hall, CPC, CPB, CPMA, CRC, AAPC Approved Instructor
Ellen Hinkle, CPC, CPMA, CRC, CEMC, CFPC, CIMC, AAPC Approved Instructor
Carol Hoppe, CPC, CCS-P, AAPC Approved Instructor
Ngina Lynch, CPC, AAPC Approved Instructor
Rachelle Marting, JD, MHSA, CPC, CPMA, CEMC, RHIA, AAPC Approved Instructor
Danielle Price, CPC, RHIT, AAPC Approved Instructor
Gerald Robinson, CPC, AAPC Approved Instructor
Jacqueline J Stack, BSHA, CPC, CPB, CEMC, CFPC, CIMC, CPEDC, AAPC Approved Instructor
Peggy A Stilley, CPC, CPB, CPMA, COBGC, AAPC Approved Instructor
Toni Toone, CPC, CPMA, CRC, AAPC Approved Instructor
Kathy Ware, RN, CPC, CPB, RHIA, CCS, AAPC Approved Instructor
Essie White, CPC, COC, CPMA, CGSC, AAPC Approved Instructor
Renee Whiting, CPC, AAPC Approved Instructor
Wendy Willes
Kathryn L Williams, COC, CPC, CPMA, CRC, CANPC, COSC
Mary Wood, CPC, AAPC Approved Instructor
CPT ® copyright 2020 American Medical Association. All rights reserved. www.aapc.com iii
Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Chapter 1
The Business of Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Coding as a Profession. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
The Hierarchy of Providers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
The Different Types of Payers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Understanding RBRVS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Medical Necessity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
The Need for Privacy and Security. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Fraud and Abuse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Need for Compliance Rules and Audits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
The OIG Work Plan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
What AAPC Will Do for You. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Chapter 2
Medical Terminology and Anatomy Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Medical Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Integumentary System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Musculoskeletal System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Cardiovascular System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Lymphatic System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Respiratory System (Pulmonary System) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Digestive System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Urinary System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Reproductive Systems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Nervous System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Endocrine System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Hematologic (Hemic) System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Immune System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
CPT ® copyright 2020 American Medical Association. All rights reserved. www.aapc.com v
Contents
Chapter 3
Introduction to ICD-10-CM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Overview of ICD-10-CM Layout. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Steps to Look Up a Diagnosis Code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
ICD-10-CM Official Guidelines for Coding and Reporting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Chapter 22: Codes for Special Purposes (U00–U85). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Diagnosis Coding Guidelines for Outpatient Reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Chapter 4
Introduction to CPT®, Surgery Guidelines, HCPCS Level II, and Modifiers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Introduction to CPT® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
National Correct Coding Initiative (NCCI). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Sequencing CPT® Codes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
CPT® Assistant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
CPT® Category II Codes - Performance Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
CPT® Category III Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
CPT® Appendices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Surgery Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
HCPCS Level II. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
HCPCS Level II Modifiers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Modifiers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Chapter 5
Integumentary System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Anatomy and Medical Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
ICD-10-CM Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
CPT® Coding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Chapter 6
Musculoskeletal System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Anatomy and Medical Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
ICD-10-CM Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
CPT® Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
HCPCS Level II. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Modifiers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
vi 2021 Official Study Guide CPC® Certification CPT ® copyright 2020 American Medical Association. All rights reserved.
Contents
Chapter 7
Respiratory, Hemic, & Lymphatic Systems; Mediastinum, and Diaphragm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Anatomy and Medical Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
ICD-10-CM Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
CPT® Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
HCPCS Level II. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Modifiers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Chapter 8
Cardiovascular System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Anatomy and Medical Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
ICD-10-CM Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
CPT® Coding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
Modifiers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142
HCPCS Level II. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142
Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Chapter 9
Digestive System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Anatomy and Medical Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
ICD-10-CM Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
CPT® Coding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
HCPCS Level II Coding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
Modifiers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
Chapter 10
Urinary System and Male Genital System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
Anatomy and Medical Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
ICD-10-CM Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
CPT® Coding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
HCPCS Level II. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170
Modifiers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170
Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
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Chapter 11
Female Reproductive System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Anatomy and Medical Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
ICD-10-CM Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
CPT® Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
HCPCS Level II Coding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Modifiers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Chapter 12
Endocrine and Nervous System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Anatomy and Medical Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
ICD-10-CM Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194
CPT® Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196
HCPCS Level II. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
Modifiers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205
Chapter 13
Eye and Ocular Adnexa, Auditory Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
Eye: Introduction and Anatomy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
Ear: Introduction and Anatomy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210
ICD-10-CM Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
CPT® Coding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
Medicine Codes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214
HCPCS Level II. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
Modifiers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
Chapter 14
Anesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
Types of Anesthesia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
Anesthesia Providers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
Anesthesia Coding Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
Postoperative Pain Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222
ICD-10-CM Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223
CPT® Coding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223
Anesthesia-Related Teaching Rules. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227
Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228
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Contents
Chapter 15
Radiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233
Anatomy and Medical Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233
ICD-10-CM Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233
CPT® Coding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234
Types of Radiological Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
The Components of a Radiology Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
Diagnostic Ultrasound. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236
Radiologic Guidance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236
Breast, Mammography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
Bone/Joint Studies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
Radiation Oncology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
Nuclear Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
HCPCS Level II Coding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
Modifiers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
Chapter 16
Pathology and Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
Anatomy and Medical Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
ICD-10-CM Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 246
CPT® Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
HCPCS Level II Coding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
Modifiers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Chapter 17
Evaluation and Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
Introduction and Objectives. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
E/M Services Defined. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
CPT® E/M Services Guidelines. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
E/M Service Categories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
Choosing the E/M Service Level. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262
Diagnosis Coding for E/M Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281
Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282
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Contents
Chapter 18
Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Anti-infective Immunizations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Vaccines and Toxoids. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Psychiatry. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288
Biofeedback. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288
Dialysis and End Stage Renal Disease Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288
Gastroenterology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
Ophthalmological Services & Special Otorhinolaryngologic Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
Cardiovascular Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
Noninvasive Vascular Diagnostic Studies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
Pulmonary Studies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290
Allergy and Immunology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290
Endocrinology & Neurology and Neuromuscular Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290
Medical Genetics and Genetic Counseling Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290
Central Nervous System Assessments/Tests. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290
Hydration, Therapeutic, Prophylactic, D
iagnostic Injections/Infusions and C
hemotherapy,
Highly Complex Drugs, or Highly Complex Biologic Agent Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290
Photodynamic Therapy & Special Dermatological Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Physical Medicine and Rehabilitation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292
Education and Training for Patient Self-Management. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293
Non-Face-to-Face Nonphysician Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293
Special Services, Procedures, and Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 294
Qualifying Circumstances for Anesthesia & Moderate (Conscious) Sedation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 294
Other Services and Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 294
Home Health Procedures and Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 295
Home Infusion Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 296
Medication Therapy Management Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297
Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297
Chapter 19
Tips for Taking an AAPC Certification Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303
CPC® Exam. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303
Preparing for Your Exam. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303
Exam Registration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 304
Day of the Exam. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 304
During the Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 304
Exam Completion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305
x 2021 Official Study Guide CPC® Certification CPT ® copyright 2020 American Medical Association. All rights reserved.
Contents
Chapter 20
Test Your Knowledge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307
Appendix A
Answers and Rationalesfor Chapter Review Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325
Chapter 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325
Chapter 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 326
Chapter 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327
Chapter 4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 329
Chapter 5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 330
Chapter 6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 332
Chapter 7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 334
Chapter 8. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 335
Chapter 9. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 337
Chapter 10. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 338
Chapter 11. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 340
Chapter 12. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 342
Chapter 13. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 343
Chapter 14. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 344
Chapter 15. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 346
Chapter 16. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347
Chapter 17. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 349
Chapter 18. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 351
Appendix B
Answers and Rationalesfor Test Your Knowledge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 353
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 361
CPT ® copyright 2020 American Medical Association. All rights reserved. www.aapc.com xi
Introduction
The Official CPC® Certification Study Guide, (2021 edition) is l Knowledge of anatomy, physiology, and medical
organized to help you prepare for the exam certifying you as a terminology necessary to correctly code provider
professional medical coder. The Certified Professional Coder diagnoses and services
(CPC®) credential is awarded by AAPC, the primary organiza- l Skill in accurate medical coding for diagnoses,
tion of more than 190,000 medical coders, billers, scribes, and procedures, and services in physician-based settings
auditors.
l Proficiency across a wide range of services, which include
This study guide, developed in cooperation with AAPC staff evaluation and management, anesthesia, surgical services,
and members, can help you understand and practice the radiology, pathology, and medicine
concepts, elements, and rules of medical coding. Throughout l Sound knowledge of medical coding rules and regulations
the Official CPC® Certification Study Guide are easy-to-under- including compliance and reimbursement
stand explanations, examples, coding tips, and exercises meant l Understanding of issues such as medical necessity, claims
to help you prepare for your exam. denials, bundling, and charge capture
Medical coding continues to grow and mature as a profession. l Expertise of how to integrate medical coding
Medical coders report the diagnoses, procedures, and supplies and reimbursement rule changes into a practice’s
reported by physicians and other medical professionals to reimbursement processes
commercial and federal payers, such as Aetna or Medicare.
A CPC® successfully completes a 150-question examination
They work closely with medical staff and must master medical
in a 5-hour, 40 minute period. You should bring the latest
terminology, anatomy, and physiology and apply this to health-
CPT®, ICD-10-CM, and HCPCS Level II code books to the
care providers’ notes or operative reports.
exam for code and guideline look-up. More information about
As healthcare evolves so does medical coding. Medical coders the examination is available at www.aapc.com. A CPC® must
perform in a variety of situations for physicians and facilities. hold membership in AAPC to sit for the exam and maintain a
They may participate in the actual billing process or audit regimen of continuing education to keep the credential.
claims sent to payers. They may code in independent billing
companies. Medical coders often become the officers in charge The Study Guide
of compliance with federal and state medical billing and
The Official CPC® Certification Study Guide begins with a
coding regulations. They may work for the payers themselves
view of the business of medicine to help you understand the
as adjustors or auditors. Experienced coders often become
overall view of the medical office and how the coder fits in.
consultants, serving clients who need coding, billing, auditing,
After a review of anatomy, you will learn about ICD-10-CM
or compliance assistance.
guidelines with real life examples of how to apply them. Each
Medical coders will prove even more important as elements of body system is reviewed in its entirety, includes a review of the
healthcare reform and standardized electronic medical records anatomy, related ICD-10-CM diagnosis coding, CPT® coding,
are implemented. Coders will be instrumental as advisers, HCPCS Level II coding, and modifiers. End of chapter reviews
decision makers, technicians, medical coders, and auditors in provide certification questions similar to those you will find
the coming years. on the exam, along with operative notes for each section for
you to code. The study guide concludes with testing techniques
and a 50-question review to test your knowledge for the CPC®
CPC® Confirms Credibility certification exam.
The CPC® credential (and its derivative credentials: COC®,
for example) illustrates to employers and colleagues that you Unlike most coding certification study guides that focus on
understand the many facets of coding. A CPC® possesses the each code set, this one more realistically prepares the coder
following: not only for the examination but for the field, where each case
more likely will include at least two code sets and require
CPT ® copyright 2020 American Medical Association. All rights reserved. www.aapc.com 1
Chapter
1 The Business of Medicine
Proper code assignment is determined both by the content The Different Types of Payers
(documentation) in the medical record and by the unique rules Although some patients will pay in full for their own medical
that govern each code set in that instance. Coding rules also expenses, most patients will have some type of insurance
may vary depending on who pays for the patient care, such as coverage. There are two primary types of insurers: commercial
self-pay or health insurance. and government.
Coding is typically performed by either the physician or a Commercial carriers are private payers that may offer both
coder. When the physician performs the coding, the coder may group and individual plans. The contracts they provide vary,
take on the role of an auditor to verify that the documentation but may include hospitalization, basic, and major medical
supports the codes the physician selected. In some practices, coverage. For example, Blue Cross Blue Shield organizations
the coder will receive the medical record and code the services are private payers who usually operate in the state in which
based on what is documented in the notes. they are based.
If the medical record is inaccurate or incomplete, it will not The most significant government insurer is Medicare. Medi-
translate properly to the language of codes. The coder must care is a federal health insurance program — administered
evaluate the medical record for completeness and accuracy and by the Centers for Medicare & Medicaid Services (CMS) —
communicate regularly with physicians and other healthcare that provides coverage for people over the age of 65, blind
professionals to clarify diagnoses or to obtain additional or disabled individuals, and people with permanent kidney
patient information. failure or end-stage renal disease (ESRD). CMS regulations
determine the coding requirements for Medicare and non-
Outpatient coding focuses on physician professional services
Medicare payers alike. The Medicare program is made up of
and outpatient facility coding. Outpatient coders will focus on
several parts:
learning CPT®, HCPCS Level II, and ICD-10-CM codes. They
will work in physician offices, outpatient clinics, and facility l Medicare Part A helps cover inpatient hospital care, as
outpatient departments. Outpatient facility coders will also well as care provided in skilled nursing facilities, hospice
work with Ambulatory Payment Classifications (APCs). care, and home healthcare.
l Medicare Part B helps cover medically necessary
Hospital inpatient coding focuses on a different subset of skills, physicians’ services, outpatient care, and other medical
where coders will work with ICD-10-CM and ICD-10-PCS. services (including some preventive services) not covered
These coders also will assign medical severity diagnosis related under Medicare Part A. Medicare Part B is an optional
groups (MS-DRGs). benefit for which the patient must pay a premium, and
which generally requires a yearly deductible and co-
Regardless of the setting, code updates and insurance payment
insurance.
policies may change as often as quarterly. Coders require
continuing education to stay abreast of these changes.
CPT ® copyright 2020 American Medical Association. All rights reserved. www.aapc.com 3
Chapter
2 Medical Terminology and Anatomy Review
CPT ® copyright 2020 American Medical Association. All rights reserved. www.aapc.com 11
Chapter 2 Medical Terminology and Anatomy Review
Heart
Heart Flow
From upper body To upper body
Atrioventricular
node Left atrium
Mitral (bicuspid)
Right atrium
valve
Tricuspid valve Left ventricle
Chordae tendinae
Purkinje fibers
Right ventricle
Septum
Inferior vena cava Aorta
From lower body To lower body
Source: ShutterStock.com
CPT ® copyright 2020 American Medical Association. All rights reserved. www.aapc.com 21
Chapter 7 Respiratory, Hemic, & Lymphatic Systems; Mediastinum, and Diaphragm
ICD-10-CM Chapter 10: Diseases of the Respiratory System Other Diseases of the Upper Respiratory Tract (J30–J39)
has notes at the beginning of the chapter for reporting of respi- Most codes in this section pertain to chronic conditions and
ratory codes: include code J34.2 for an acquired deviated septum of the nose.
l A respiratory condition affecting more than one site, This condition is commonly caused by trauma. The septum is
and is not specifically indexed, the coder should classify the bone and cartilage that separates the right and left nostrils.
the condition to the lower anatomic site. For example, Note the code for a congenital deviated septum is Q67.4. Nasal
tracheobronchitis is classified to bronchitis. polyps (category J33) are sac-like growths inside the nose and
l An additional code is reported, when applicable, to are often associated with chronic sinusitis (category J32). Code
identify the patient’s exposure to, history of, or current selection will depend on which sinus is infected and inflamed.
use or dependence of tobacco (smoke).
Chronic Lower Respiratory Diseases (J40–J47)
In emphysema (category J43), the walls between the air sacs
Acute Respiratory Infections (J00–J06) are damaged causing them to lose their shape and elasticity.
Infection may be caused by a virus or bacteria. Viral infections Chronic obstructive pulmonary disease (COPD) is a progres-
usually are self-limiting. Bacterial acute respiratory infections sive disease that causes coughing, wheezing, shortness of
(ARIs) typically are treated with antibiotics (viral infections breath, and difficulty breathing. Most people who have COPD
are not). ICD-10-CM codes for ARIs are separated by the have both emphysema and chronic obstructive bronchitis. The
anatomy: nose, pharynx, larynx, bronchus, and bronchioles. number one cause of COPD is smoking.
Irritation and inflammation of the vocal cords cause laryngitis. Asthma is a chronic inflammatory disease of the airway. When
Category J04 includes both laryngitis and tracheitis. Tracheitis coding for asthma, the severity of the asthma physician docu-
codes are reported based on whether there is an obstruction. mented as intermittent, mild persistent, moderate persistent
and severe persistent. The codes in categories J44 Other chronic
Croup (J05.0) is a common, high pitched, barking cough found
obstructive pulmonary disease and J45 Asthma distinguish
in infants and children with nasal type symptoms. Croup
between uncomplicated cases and those in acute exacerbation,
usually is caused by parainfluenza viruses; however, respira-
which is a worsening or a decompensation of a chronic condition.
tory syncytial virus (RSV), measles, adenovirus, and influenza
all can cause croup. A milder form of croup, stridulus croup
(J38.5), also known as laryngismus stridulus or false croup, is Lung Diseases Due to External Agents (J60–J70)
a sudden onset of spasmodic laryngeal closure with crowing Pneumoconiosis (J60–J65) is a restrictive lung disease caused
inspiration. by inhalation of dust, causing irreversible scarring of the lungs.
Other ICD-10-CM codes in this section include exposure to
Pneumonia and Influenza (J09–J18) chemical fumes, vapors, solids, and liquids.
Pneumonia, like ARI, can be caused by a virus, fungi, or
bacteria. An acute respiratory infection can lead to pneumonia Respiratory Failure
if not treated. ICD-10-CM codes for pneumonia are based on The codes for respiratory failure are selected by acute, chronic,
the causative agent and may require you to report an addi- unspecified and if there is the presence of hypoxia or hyper-
tional code to describe the underlying disease. capnia. The sequencing of acute respiratory failure (ARF) is
determined by the reason for the encounter. If a patient is
Influenza is a viral infection that can be very serious. ICD- admitted for acute respiratory failure, a code from subcat-
10-CM coding is based on the influenza strain: Avian (J09.X2), egory J96.0 Acute respiratory failure or J96.2 Acute and chronic
H1N1/novel influenza A (J10.1), unspecified with pneumonia respiratory failure is sequenced first. If the patient is admitted for
or other respiratory manifestations. Code only confirmed cases multiple reasons, select the condition that required the most care.
of avian flu (see ICD-10-CM guideline 1.C.10.c).
Acute bronchitis (category J20) and acute bronchiolitis (cate- Other Diseases of the Respiratory System
gory J21) commonly are diagnosed when a patient presents Pulmonary edema is found in the ICD-10-CM Alphabetic
with symptoms of a severe or productive cough. Index by looking for Edema/lung and is reported with a code
from category J81.
Lower respiratory infections that are not otherwise specified
and are associated with documented COVID-19, are reported Interstitial lung disease (ILD), or diffuse parenchymal lung
with codes U07.1 COVID-19 and J22 Unspecified acute lower disease (DPLD), refers to a group of lung diseases affecting
respiratory infection. the interstitium (the tissue and space around the air sacs of
the lungs). ILD (category J84) often is the result of pulmonary
fibrosis from exposure to contaminants like asbestos.
CPT ® copyright 2020 American Medical Association. All rights reserved. www.aapc.com 117
Endocrine and Nervous System Chapter 12
2. What are chemicals which relay, amplify, and modulate signals between a neuron and another cell?
A. Neurotransmitters
B. Hormones
C. Interneurons
D. Myelin
3. A 35-year-old has neuroplasty performed in the wrist for carpal tunnel syndrome. The palm is opened through a curved
incision, and further skin flaps are developed. The median nerve of the transverse carpal ligament is divided, decom-
pressing the carpal tunnel. Tension of the nerve is released, and the incision is sutured in layers. What CPT® code describes
this procedure?
A. 64721
B. 64719
C. 64708
D. 64704
4. A 30-year-old male has lumbar facet syndrome. Under fluoroscopic guidance, the affected nerve in the facet joints of the
lumbar region is destroyed by a neurolytic agent in the right segmental medial branches innervating facet joints L3–L4,
and L4–L5. What CPT® codes are reported?
A. 64493, 64494
B. 64635, 64636
C. 64483, 64484
D. 64633, 64634-50
5. A patient has spinal stenosis and disc displacement in the L3–L4 and L4–L5 interspaces and underwent a removal of the
posterior arch of a vertebra to provide additional space for the nerves and to widen the spinal canal. The back was prepped,
and an incision was made down to the deep fascia and the spinous processes of L5, L4 and L3 were identified performing
the laminectomy of L4 up to L3 and a resection of the flavum ligament. There was resection of the facet L3 and L4 on the
right and decompression was carried out laterally to the level of the medial border of the pedicle. Foraminotomies of L3–
L4 and L4–L5 the right was performed with the Kerrison punch and there was plenty of room for the nerve roots to exit in
these regions with no further stenosis above or below this area. What procedure code(s) is/are reported?
A. 63047, 63048
B. 63042, 63044
C. 63017
D. 63005
206 2021 Official Study Guide CPC® Certification CPT ® copyright 2020 American Medical Association. All rights reserved.
Chapter
13 Eye and Ocular Adnexa, Auditory Systems
Sclera
Lens
Vein
Conjunctiva
Rectus medialis
Ora serrata
Source: AAPC
The eyeball is composed of a tough membrane called sclera. contracts to enlarge the pupil and allow more light into the eye.
This white outer skin of the eye is covered with a thin protec- The threads holding the lens and the ciliary body to which they
tive layer of conjunctiva. Light first enters the eye through the are connected automatically tug at the lens to change its shape
cornea. The cornea has five layers; sometimes corneal defects to help focus on items near or far.
will be managed by removing one or two layers, rather than
full-thickness cornea. The cornea meets the sclera in a ring After the light has been bent by the crystalline lens, it enters
called the limbus, also known as the sclerocorneal junction. the vitreous humor, a gel-like mass that fills the large poste-
Behind the cornea is the anterior segment of the eye, which is rior chamber of the eye. The vitreous humor presses against
filled with a clear, salty fluid called aqueous humor. the inner layer of the eye, maintaining the eyeball’s shape
and keeping the blood-rich choroid layer in contact with the
Next, light from the aqueous humor enters the crystalline retina. The light is placed upon the retina’s rods and cones
lens, a convex disc suspended on threads just behind the iris. like a projected image at a movie theater, and these images are
The iris is a muscle that expands and contracts to regulate transmitted via the optic nerve to the brain.
the amount of light entering the posterior chamber of the eye
through the pupil. If the light is too bright, the iris expands so The eyeball’s shape affects the way light is focused and directed
the size of the pupil shrinks. If there is too little light, the iris (refraction). Any reduction in fluid within the eye will affect
CPT ® copyright 2020 American Medical Association. All rights reserved. www.aapc.com 209
Chapter 17 Evaluation and Management
EXAMPLE
Rationale: This patient is an established patient. The level is
CHIEF COMPLAINT: Right knee pain secondary to underlying selected based on the AMA CPT® Office or Other Outpatient
degenerative primary arthritis. E/M Services guidelines.
HISTORY OF PRESENT ILLNESS: This 70-year-old female returns to l The number and complexity of problems addressed –
schedule total knee arthroplasty. She was evaluated last week. moderate (chronic problem with exacerbation).
She continues to have constant pain with her activities for about l The amount and complexity of data to be reviewed and
7 months. Symptoms are present with both weight bearing and analyzed – none.
rest. She was found by recent radiograph to have tricompart- l The risk of complications and morbidity or mortality of
mental degenerative changes. patient management – moderate (elective major surgery).
PHYSICAL EXAMINATION: She is intact to sensation, has The moderate number and complexity of problems and
palpable pulses. There is bogginess of the synovium. She has moderate risk make 99214 the correct code.
retropatellar crepitation. There is tenderness through both the
medial and lateral joint line. There is valgus alignment of the
knee.
IMPRESSION: Right knee pain with underlying degenerative Time
arthritic changes. Time can be an element of code selection for a variety of E/M
services. Because different categories use time differently, it is
PLAN: We will proceed with surgical intervention for right
important to review the instructions for the use of time in each
total knee arthroplasty. Risks and benefits of surgery have
category of E/M service. In this section, we will discuss time as
been reviewed. These include the risks of anesthesia, infection,
it relates to Office or Other Outpatient Services. The amount
damage to nerve, vessel, soft tissue, residual loss of motion or
of time spent on the encounter must be documented by the
weakness, residual pain, blood clot, blood loss, knee instability,
provider.
fracture of bone. A complete history and physical obtained in
the office.
CPT ® copyright 2020 American Medical Association. All rights reserved. www.aapc.com 267
Chapter
20 Test Your Knowledge
The following 50 questions will test your comprehension of the information covered in this study guide. You should be able to
complete this exercise in approximately 115 minutes. Answers are found in Appendix B.
Important Note: Although this exercise is a useful assessment tool, the best means to gauge your preparedness to pass the CPC
exam is to take our online practice exams (found at https://www.aapc.com/training/practice-exams.aspx#cpc) which mirror the
actual test format and difficulty level. The practice exams are timed and are created by the CPC exam development team.
1. A 30-year-old is brought into the burn unit with burns covering 30% of his total body. He has third-degree burns to his
chest wall (10%), second-degree burns on his arm and both legs (15%), and first-degree burns on his face (5%).
What ICD-10-CM codes are reported for the burns?
A. T21.30XA, T22.239A, T24.231A, T24.232A, T20.10XA
B. T30.0, T21.60XA, T30.4
C. T21.31XA, T22.20XA, T24.201A, T24.202A, T20.10XA, T31.31
D. T20.10XA, T22.20XA, T21.31XA, T24.201A, T23.202A, T31.31
2. Two malignant lesions on the scalp measuring 1.1 cm and 2.0 cm, and one malignant lesion on the neck measuring 2.2 cm
were destroyed. Electrocautery was used for the first two lesions and laser was used for the third lesion.
What procedure code(s) is/are reported?
A. 17276
B. 17273, 17272-51
C. 17273, 17272-51, 17272-51
D. 17274, 17273-51
CPT ® copyright 2020 American Medical Association. All rights reserved. www.aapc.com 307
Appendix
Answers and Rationales
B for Test Your Knowledge
In the Tabular List, a 7th character is required on these injury codes to identify the episode of care. Based on the ICD-
10-CM guidelines for 7th characters, A is assigned for initial encounter (active treatment). For the codes that are less than
six characters in length, the X placeholders are required to maintain the 7th character in the seventh position.
4. C. 11056, L85.9
RATIONALE: In the CPT® Index, look for Paring/Skin Lesion/Benign Hyperkeratotic referring you to codes 11055-11057.
The procedure code for removal of the hyperkeratotic lesion is 11056 Paring or cutting of benign hyperkeratotic lesion; 2 to
4 lesions. The evaluation and management documentation is all related to the surgery and is not reported separately. In the
ICD-10-CM Alphabetic Index, look for Lesion(s)/hyperkeratotic - see Hyperkeratosis. Look for Hyperkeratosis referring
you to L85.9.
5. B. 20610, M10.062
RATIONALE: The knee is aspirated by drawing out fluid from the knee joint using a needle. In the CPT® Index, look for
Aspiration/Joint. Code selection is dependent on the size of the joint and if ultrasound guidance is used. Code 20610
CPT ® copyright 2020 American Medical Association. All rights reserved. www.aapc.com 353
Index
CPT ® copyright 2020 American Medical Association. All rights reserved. www.aapc.com 373
2021 Official Study Guide: CPC®