Chapter 5 Quiz Flashcards
Anesthesia procedures 00830 (4 base units) and 00832 (6 base units) are both performed. How are these reported on the claim form?
(A) 00830, 00832 with the time units per procedure.
(B) 00830, 00832-51 with the time units per procedure.
(C) 00830 with the time units for both procedures.
(D) 00832 with the time units for both procedures.
(D) 00832 with the time units for both procedures.
When reporting multiple anesthesia procedures during one surgical session, the anesthesia code with the most anesthesia base units is reported with the time units for both procedures.
Which reporting option below is correct for immunization administration for vaccines or toxoids?
(A) 90460, 90474.
(B) 90471, 90473.
(C) 90461, 90474.
(D) 90472, 90474,
(A) 90460, 90474.
Read the parenthetical instructions in this section. Under 90474, there is a parenthetic instruction stating 90474 can be reported in conjunction with codes 90460, 90471, or 90473. 90461, 90472, and 90474 are all
add-on codes and require a primary code be reported in addition.
Which reporting option below is correct use of the modifier 50?
(A) 19318-50.
(B) 36251-50.
(C) 36252-50.
(D) 69801-50.
(A) 19318-50.
There is guidance under the Integumentary System/Breast/Repair and/or Reconstruction heading that states to append modifier 50 when the procedures are performed bilaterally. 36251 is a unilateral procedure but there is an option for the same procedure to be performed bilaterally (36252). 36252 is a bilateral procedure and therefore should not have modifier 50 appended. 69801 has a parenthetic instructions stating not to report it more than once per day, using modifier 50 would equate to performing the procedure twice in one day.
A 43-year-old established patient is seen for his annual preventive exam by the family physician. A medically appropriate history and exam, and medical decision making of low complexity are performed. What E/M code is reported?
(A) 99213.
(B) 99396.
(C) 99386.
(D) 99402.
(B) 99396.
Look in the CPT® Index for Evaluation and Management/Preventive Services and you are directed to 99381–99429.Established patient preventive services are reported from range 99391–99397. The patient is
43 making 99396 the correct code.
A provider orders a lipid panel. According to the practice standards, this includes a complete blood count (85027), total cholesterol (82465), HDL cholesterol (83718), and
triglycerides (84478). What is reported on the claim form?
(A) 80061.
(B) 80061, 85027.
(C) 80053, 82465, 83718, 84478.
(D) 85027, 82465, 83718, 84478.
(B) 80061, 85027.
The lipid panel by CPT® defnition includes total cholesterol (82465), HDL cholesterol (83718), and triglycerides (84478). The CBC (85027) is reported separately, in addition to, the lipid panel (80061).
What is the full descriptor for CPT® code 35632?
(A) Ilio-celiac.
(B) Aortoceliac, aortomesenteric, aortorenal, ilio-celiac.
(C) Bypass graft, with other than vein; ilio-celiac.
(D) Bypass graft, with other than vein; common carotid-ipsilateral internal carotid, ilio-celiac.
(C) Bypass graft, with other than vein; ilio-celiac.
To find the primary/parent code, look up through the codes until the indentations stop. Sometimes, this can be several columns of codes. 35601 is the primary code for code 35632. The full description includes the portion before the semi-colon for code 35601 and all of 35632 -
Bypass graft, with other than vein; ilio-celiac.
What CPT® code is reported for an MRI of the brain without contrast?
(A) 70350.
(B) 70551.
(C) 70552.
(D) 70553.
(B) 70551.
Look in the CPT® Index for Magnetic Resonance Imaging
(MRI)/Diagnostic/Brain which directs you to 70551–70555. In the numeric section of CPT®, 70551 indicates without contrast.
A patient is seen for a follow-up visit in the hospital. A problem focused interval history, an expanded problem focused exam, and MDM of low complexity. What E/M code is reported?
(A) 99213.
(B) 99224.
(C) 99231.
(D) 99241.
(C) 99231.
Look in the CPT® Index for Evaluation and Management/Hospital and you are directed to 99221–99233. A follow-up visit in the hospital is coded as subsequent hospital care making a code from code range
99231–99233 appropriate. This section requires only two of three key components be met. Because there is a problem focused interval history and low medical decision making, the highest level of service that can be
reported is 99231.
What CPT® coding is reported for removal of two skin tags?
(A) 11200.
(B) 11200 x 2.
(C) 11200, 11201.
(D) 11201 x 2.
(A) 11200.
Look in the CPT Index for Skin/Tags/Removal which directs you to 11200-11201.11200 is for up to and including 15 lesions and is only be reported once for both lesions. 11201 is an add-on code that is reported for each
additional 1-10 lesions after the first 15 lesions.
A patient is seen by his family provider at the provider’s office. The patient last saw the provider four years prior. Which range of codes would a code be selected from?
(A) 99202-99215.
(B) 99202-99205.
(C) 99211-99215.
(D) 99221-99233.
(B) 99202-99205.
The patient has not seen the provider in over three years. Look in theCPT® Index for Evaluation and Management/Office and Other Outpatient which directs you to 99202-99215. In the Evaluation and
Management section of the CPT® codebook, the Office and Other Outpatient codes are further broken down into new and established patient. New patient codes are reported from the range 99202-99205.
