CPC Chapter 20- Medicine Review Questions

Question 1

A child was bitten by a dog that tested positive for rabies and is seen for an injection of rabies immune globulin. What are the appropriate procedure codes for this service?
A. 90396, 96365
B. 90375, 96372
C. 90384, 96369
D. 90389, 90471

Answer 1

B. 90375, 96372

Rationale: Code for the product and the administration of rabies immune globulin. In the CPT® Index, see Immune Globulins/rabies, you are directed to 90375-90376. Because there is no mention of heat-treated, 90375 is the appropriate code. Reading the guidelines for immune globulins, a code from 96365-96372, 96374, or 96375 is reported as appropriate for the administration. This is an injection, and 96372 is the appropriate code. In the CPT® Index, look for Injection/Intramuscular/Therapeutic.

Question 2

A diabetic patient visited a neighborhood clinic to receive influenza and pneumonia intramuscular immunizations. The patient received the influenza, trivalent (IIV3) spilt virus 0.5 mL and pneumococcal polysaccharide vaccine, 23-valent (PPSV23). What are the appropriate procedure codes for this service?
A. 90658, 90732, 90471, 90472
B. 90660, 90732, 90472
C. 90736, 90657, 90471, 90472
D. 90660, 90732, 90471

Answer 2

A. 90658, 90732, 90471, 90472

Rationale: The patient received two vaccines: influenza and pneumonia. Each is charged separately. In the CPT® Index, look for Vaccines and Toxoids/Influenza/for Intramuscular Use. A review of the code choices indicates 90658 is the correct code. For the pneumonia vaccine look in the index for Vaccines/and Toxoids/Pneumococcal/23-valent (PPSV23) which leads to 90732. Code 90471 describes injection of one vaccine. The add-on code +90472 describes each additional vaccine. Add-on codes (+) may not be reported independently but are a composite of the basic code. In the CPT® Index look for Administration/Immunization One Vaccine/Toxoid and Administration/Immunization/Each Additional/Vaccine/Toxoid.

Question 3

A 35-year-old patient plans to travel to a country with a high incidence of yellow fever. The patient receives the yellow fever immunization. What are the appropriate procedure codes for this service?
A. 90717, 90471
B. 90749, 90472
C. 90717, 90460
D. 90749, 90471

Answer 3

A. 90717, 90471

Rationale: Code for both the vaccine and the administration. Codes 90717 and 90471 describe the yellow fever vaccine and the immunization administration for one vaccine. In the CPT® Index look for Vaccines and Toxoids/Yellow Fever and Administration/Immunization One Vaccine/Toxoid.

Question 4

A patient is referred to a psychiatrist for management after displaying erratic and unusual behavior at work. The patient discloses a difficult family situation. The psychiatrist meets with the family and the patient for 50 minutes. What is the correct code for the family psychotherapy session?
A. 90849
B. 90833
C. 90847
D. 90853

Answer 4

C. 90847

Rationale: A family therapy session with patient present is reported with 90847. The payer may request documentation of those present and areas of discussion. In the CPT® Index look for Psychotherapy/Family of Patient. Code choice is based on with or without the patient present, and time.

Question 5

A patient receiving psychotherapy is ready to begin mainstream efforts into the community. The psychiatrist discusses the patient’s mental health history with a social agency that assists in locating employment and living arrangements. What is the correct code for this service?
A. 90887
B. 90882
C. 90889
D. 90875

Answer 5

B. 90882

Rationale: The services performed by the psychotherapist include environmental interventions by communicating with the social agency. In the CPT® Index locate Psychiatric Treatment/Environmental Intervention. Code 90882 describes intervention on a psychiatric patient’s behalf with agencies, employers, or institutions.

Question 6

A patient experienced a stressful personal event and meets with her psychiatrist in his office for 45 minutes for the purpose of evaluating her potential to return to work. Which CPT® code accurately reports the service?
A. 90839
B. 90845
C. 90792
D. 90834

Answer 6

D. 90834

Rationale: Code 90834 describes a 45-minute outpatient/office encounter for psychotherapy. In the CPT® Index look for Psychotherapy/Individual Patient.

Question 7

A patient with long-time stress urinary incontinence undergoes biofeedback training for improvement of urine leakage. The physician spends 15 minutes one-on-one with the patient. Which CPT® code(s) accurately report(s) the service?
A. 90912
B. 90901
C. 53899
D. 90912, 90913

Answer 7

A. 90912

Rationale: Code 90912 describes biofeedback training for the urethral sphincter for the initial 15 minutes of provider time. In the CPT® Index, look for Biofeedback Training/Anorectal.

Question 8

An inpatient with ESRD is placed on a regular schedule of hemodialysis treatments. The patient receives dialysis at the hospital and is re-evaluated once by the physician for possible revision of the prescribed treatments. On re-evaluation, the physician determines no change in regimen is needed. What is the correct code for the dialysis and physician re-evaluation?
A. 90937
B. 90940
C. 90945
D. 90947

Answer 8

A. 90937

Rationale: Code 90937 describes hemodialysis requiring physician re-evaluation with or without substantial revision of dialysis. In the CPT® Index, look for Hemodialysis/Procedure/with Evaluation.

Question 9

An 18-year-old ESRD patient is receiving dialysis services and has had two face-to-face visits with her physician within 25 days. On the 26th day, she is admitted to the hospital for inpatient management without a complete assessment. She remains in the hospital until the end of the month. What is the code for the physician services for the 25 days?
A. 90969
B. 90960
C. 90969 X 25
D. 90957

Answer 9

C. 90969 X 25

Rationale: Code 90969 describes ESRD related services for dialysis less than a full month of service per day, for patients 12-19 years of age. This was not a full month of ESRD related services and 90969 is reported per day with 25 units, 1 unit for each day. See the example in CPT® under End Stage Renal Disease Services. In the CPT® Index, look for End Stage Renal Disease Services/Less than a full month.

Question 10

A patient with renal failure needs to begin dialysis treatments. He and his daughter both complete training for managing dialysis at home. What code is reported for this service?
A. 90993
B. 90966
C. 90989
D. 90997

Answer 10

C. 90989

Rationale: Code 90989 describes a completed course of dialysis training for the patient and a helper. In the CPT® Index, look for Dialysis/Patient Training/Completed Course.

Question 11

A patient visits her physician complaining of severe left lower leg pain and numbness. The left lower leg is pale compared to the right lower leg. There is no known injury. The physician evaluates for a possible blood clot before considering treatment. The physician orders a stat duplex scan of the arteries of the left leg. The scan indicates no evidence of a clot. What is the appropriate CPT® code for reporting this service?
A. 93970
B. 93930
C. 93971
D. 93926

Answer 11

D. 93926

Rationale: Code 93926 describes duplex scan, limited or unilateral study, of the lower extremity arteries, including digits. Pain and discoloration were present in the lower left leg, the only extremity scanned. In the CPT® Index, look for Duplex Scan/Arterial Studies/Lower Extremity.

Question 12

A dialysis patient undergoes a duplex scan of his hemodialysis access site to determine the pattern and blood flow in his arteries and veins. What is the appropriate CPT® code for reporting this service?
A. 93978
B. 93970
C. 93971
D. 93990

Answer 12

D. 93990

Rationale: Code 93990 describes a scan of hemodialysis access and includes arterial inflow, body of access, and venous outflow. In the CPT® Index, look for Hemodialysis/Duplex Scan of Access.

Question 13

A patient with chronic gastrointestinal disturbances undergoes complete ultrasonic scanning of the intestinal vascular structure to determine if blood flow is adequate. What is the appropriate CPT® code for reporting this service?
A. 93976
B. 93975
C. 93931
D. 93981

Answer 13

B. 93975

Rationale: Code 93975 describes a complete scan of arterial inflow and venous outflow of the abdominal, pelvic, scrotal contents, and/or retroperitoneal organs. In the CPT® Index, look for Duplex Scan/Arterial Studies/Visceral.

Question 14

A patient with chronic skin rashes on the hands visits an allergist for evaluation and receives 12 percutaneous scratch tests with various household products. What is the correct code for the scratch test?
A. 95004 X 12
B. 95004
C. 95144
D. 95044 X 12

Answer 14

A. 95004 X 12

Rationale: Code 95004 describes scratch tests with allergenic extracts, immediate type of reaction. The code includes interpretation and report. Report the code with the correct number of units for the number of tests. In the CPT® Index, look for Allergy Tests/Skin Tests/Allergen Extract.

Question 15

A patient who suffers from nasal congestion, rhinitis, and facial swelling after being stung by honeybees undergoes allergen immunotherapy. The physician provides a single dose and injection of bee venom. What is the correct code for the service?
A. 95120
B. 95144
C. 95130
D. 95145

Answer 15

C. 95130

Rationale: Code 95130 describes provision of allergenic extract and injection of a single stinging insect venom. In the CPT® Index, look for Allergen Immunotherapy/Allergenic Extracts/Injection and Provision/Insect Venom.

Question 16

A patient exhibits severe allergic reaction to peanuts. An allergist prepares four vials of single-dose antigen to begin desensitization treatment to peanut products for the patient. What is the correct code for the service?
A. 95145 X 4
B. 95144 X 4
C. 95120 X 4
D. 95170 X 4

Answer 16

B. 95144 X 4

Rationale: Code 95144 describes preparation and provision of antigen for immunotherapy in single dose vials. Report 4 vials. In the CPT® Index, look for Allergen Immunotherapy/Antigens/Preparation and Provision.

Question 17

A genetic counselor met with a couple and their child who has Duchenne’s muscular dystrophy. The couple is considering another child but wants to know the potential risk of their future children being born with the same disorder. The session lasts 1.5 hours. How is this service reported?
A. 96040
B. 96040 X 4
C. 96040 X 2
D. 96040 X 3

Answer 17

D. 96040 X 3

Rationale: Code 96040 describes genetic counseling by a qualified counselor for each 30 minutes of face-to-face time. Report three units for the session lasting 1.5 hours. Report E/M codes if counseling is provided by a physician. In the CPT® Index, look for Medical Genetics.

Question 18

A patient needs a renal transplant. The patient has been on dialysis and is awaiting a suitable donor. A clinical psychologist meets with the patient to assess the patient’s ability to comply with the requirements and drug regimen if a donor match is found. The session lasts 2 hours. How is this service reported?
A. 96156
B. 96156 X 8
C. 96158, 96159 X 6
D. 96167, 91618 X 6

Answer 18

A. 96156

Rationale: Code 96156 describes the health behavior assessment or re-assessment. The encounter lasted two hours, but the code is not a time-based code and should only be billed with a quantity of 1. In the CPT® Index, look for Health Behavior/Assessment.

Question 19

A 4-year-old has not reached the expected developmental milestones for her age group. She was referred by her pediatrician for extensive developmental testing. The psychologist spends an hour administrating multiple function studies, using standardized instruments and reported the results to the child’s pediatrician. What is the code for the psychologist’s service?
A. 96116
B. 96125
C. 96112
D. 96121

Answer 19

C. 96112

Rationale: Code 96112 describes testing for developmental assessment, including interpretation and report. In the CPT® Index, look for Developmental Testing. Because the physician spent one hour, 96112 is reported.

Question 20

A child displayed emotional outbursts, inability to interact appropriately with peers and his teacher, and was not effective in grasping lessons deemed suitable for his age. The school counselor requested psychological testing to determine if the child had been placed in classes appropriate to his abilities. Testing was administered by a clinical psychologist, who spent 10 hours face-to-face with the patient and 3 hours preparing the report of the results. How is the clinical psychologist’s service reported?
A. 96113
B. 96112
C. 96130 X 13
D. 96130, 96131 X12

Answer 20

D. 96130, 96131 X 12

Rationale: Code 96130 describes multiple testing, face-to-face time with the patient, and time interpreting and preparing the report, first hour of time. 96131 Is to be reported with the 96130 for each additional hour. Number of units reported is 12. The time must be documented in the psychologist’s record. In the CPT® Index, look for Neuropsychological Testing/Evaluation Services.

Question 21

A patient presents with vomiting and diarrhea lasting three days. The physician determines the patient is dehydrated and orders infusion of hydration fluids to run for two hours. How is the hydration service reported?
A. 96360, 96361
B. 96361 X 2
C. 96360, 96361 X 2
D. 96360 X 2

Answer 21

A. 96360, 96361

Rationale: Codes 96360 and 96361 describe hydration infusion for two hours. Code 96360 is the first hour and 96361 is the second hour. The add-on code +96361 cannot be reported independently, but only in addition to 96360. The fluids infused are separately reported, using the appropriate code from HCPCS Level II. In the CPT® Index, look for Infusion/Hydration.

Question 22

A patient has an implanted intravenous pump for prescribed drug delivery at preset intervals. The patient is seen by the physician, who provides maintenance and refills the pump with the medication. What is the code for this service?
A. 96523
B. 96522
C. 96521
D. 95990

Answer 22

B. 96522

Rationale: Code 96522 describes refill and maintenance of an intra-arterial or intravenous implanted pump for drug delivery. The drug is separately reported with HCPCS Level II codes. In the CPT® Index, look for Infusion Pump/Maintenance or Drug Delivery Implant/Maintenance and Refill/Intravenous.

Question 23

A cancer patient will receive chemotherapy by intrathecal delivery. A spinal puncture is necessary to accommodate the catheter. What code is reported for this service?
A. 96523
B. 96413
C. 96420
D. 96450

Answer 23

D. 96450

Rationale: Code 96450 describes intrathecal delivery of chemotherapy agents. The code includes the spinal puncture. The drugs are separately coded using HCPCS Level II codes. Spinal catheter placement is included in the technique. In the CPT® Index, look for Spine Chemotherapy/Administration.

Question 24

A patient sustained a severe ankle sprain playing basketball. The ankle is stiff and without complete range of motion. The physician refers the patient for physical therapy. Prior to treatment, the therapist evaluates the patient. The therapist documents a brief history and exam of the ankle and determines the sprain is uncomplicated with no other injury to the ankle. The therapist recommends an additional 5 sessions for strength and endurance and no basketball for two weeks. The clinical decision-making is of low complexity. The patient has a one-hour therapy session on the same day. How are these services reported?
A. 97161-GP, 97110-GP x 4
B. 97164-GP, 97112-GP x 4
C. 97110-GP x 4
D. 97530-GP

Answer 24

A. 97161-GP, 97110-GP x 4

Rationale: The therapist evaluates the patient and problem at the first visit and determines a treatment. Code 97161 is reported for an uncomplicated injury with low clinical decision making. In the CPT® Index, look for Physical Medicine/Therapy/Occupational Therapy/Evaluation/Physical Therapy. Code 97110 describes exercises performed to develop strength and range of motion, per 15 minutes. For one hour, report four units. In the CPT® Index, look for Physical Medicine/Therapy/Occupational Therapy/Procedures/Therapeutic Exercises.

Question 25

A patient underwent a knee arthroplasty (joint replacement) and now requires physical therapy to learn to walk with the artificial joint. The therapist evaluates the patient and documents a brief history and exam and initiates therapeutic exercises and gait training. The clinical decision-making is of low complexity. The exercises are for 45 minutes and the gait training is 15 minutes at this session. What codes are reported for the evaluation and therapeutic services?
A. 97161-GP, 97110-GP, 97116-GP
B. 97164-GP, 97116-GP
C. 97161-GP, 97110-GP X 3, 97116-GP
D. 97161-GP, 97116-GP

Answer 25

C. 97161-GP, 97110-GP X 3, 97116-GP

Rationale: The therapist evaluates the patient and problem at the first visit and determines a treatment plan. Gait training will be necessary and will likely increase in time at subsequent therapy sessions. Code 97161 is reported for an uncomplicated condition with low clinical decision making. In the CPT® Index, look for Physical Medicine/Therapy/Occupational Therapy/Evaluation/Physical Therapy. Code 97110 is for the exercises. In the CPT® Index, look for Physical Medicine/Therapy/Occupational Therapy/Procedures/Therapeutic Exercises. And, 97116 for the gait training. In the CPT® Index, look for Physical Medicine/Therapy/Occupational Therapy/Procedures/Gait Training. Report three units for the exercises to cover 45 minutes.

Question 26

A patient has a collapsed arch on her left foot. The physician prescribed a custom orthotic insert for the patient’s shoe to support the collapsed arch. The patient visits the physician to receive the orthotic and is instructed how to position it inside the shoe for maximum results. The patient walks around the treatment room and hallway to determine if there is a comfortable fit. The session lasts 15 minutes. What code is reported for the service?
A. 97760
B. 97761
C. 97763
D. 97116

Answer 26

A. 97760

Rationale: Code 97760 describes Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minutes. Report the orthotic device separately using HCPCS Level II codes. In the CPT® Index, look for Orthotics/Management and Training.

Question 27

An anorexic patient is experiencing signs of severe dietary deficiency and electrolyte imbalance. She will need medical nutrition therapy to treat these symptoms. The provider spends 30 minutes with the patient to discuss the seriousness of her eating disorder and the necessity of nutrition therapy. What code is reported for this initial assessment?
A. 97804
B. 97802
C. 97802 X 2
D. 97803 X 2

Answer 27

C. 97802 X 2

Rationale: Code 97802 describes the initial medical nutrition assessment interview per 15 minutes of face-to-face time. Report two units for the 30-minute session. In the CPT® Index, look for Nutrition Therapy/Initial Assessment.

Question 28

A patient with a long history of migraine headaches decides to try acupuncture to reduce the symptoms. The provider uses acupuncture with electrical stimulation during a 15-minute, face-to-face encounter with the patient. How are these services reported?
A. 97810
B. 97810, 97811
C. 97813
D. 97814

Answer 28

C. 97813

Rationale: Code 97813 describes a 15-minute encounter with one-on-one patient contact using acupuncture with electrical stimulation. In the CPT® Index, look for Acupuncture/with Electrical Stimulation.

Question 29

A patient with polyneuropathy in the feet undergoes osteopathic manipulation to improve tingling and numbness sensations. The provider manipulates both feet during the session. How are these services reported?
A. 98926
B. 98925
C. 98925, 98926
D. 98929

Answer 29

B. 98925

Rationale: Code 98925 describes manipulation of one to two body regions. Both feet were manipulated during the session. In the CPT® Index, look for Osteopathic Manipulation.

Question 30

A patient presents with a complaint of continuing left shoulder pain after falling from her patio onto a wooden step. No fracture was identified at the time of the fall. After assessing the patient, the chiropractor manipulates the shoulder region. How are these services reported?
A. 98943
B. 98940
C. 98943, 98940
D. 98942

Answer 30

A. 98943

Rationale: Code 98943 describes extraspinal manipulation, one or more regions. In the CPT® Index, look for Manipulation/Chiropractic.

Question 31

A patient continues to have low back pain after lifting a heavy bin while cleaning the basement. The chiropractor manipulates both the lumbar and sacral areas. What code is reported for the service?
A. 98941
B. 98943
C. 98940
D. 98942

Answer 31

C. 98940

Rationale: Code 98940 describes manipulation of one to two spinal regions. In the CPT® Index, look for Manipulation/Chiropractic.

Question 32

A patient receives manipulations in the cervical, thoracic, and lumbar spine by a chiropractor. How are these services reported?
A. 98941
B. 98940
C. 98943
D. 98940 X 2

Answer 32

A. 98941

Rationale: Three regions of the spine were manipulated. Code 98941 describes manipulation of three to four regions. In the CPT® Index, look for Manipulation/Chiropractic.

Question 33

A registered dietician provided diabetes management education to seven patients for 90 minutes. How are these services reported?
A. 99078
B. 98961
C. 98960 X 3
D. 98962 X 3

Answer 33

D. 98962 X 3

Rationale: A Registered Dietician is a nonphysician practitioner that is qualified to educate at-risk patients in diet management. Code 98962 describes five to eight patients. Report three units for 90 minutes. In the CPT® Index, look for Special Services/Group Education/Self-Management.

Question 34

A diabetic patient who has not been successful managing his diet meets personally with a registered dietician for one hour to develop a diet plan. How are these services reported?
A. 98961
B. 98960 X 2
C. 98961 X 2
D. 98962

Answer 34

B. 98960 X 2

Rationale: Code 98960 describes face-to-face education and training with one patient for 30 minutes. Report two units for one hour. In the CPT® Index, look for Special Services/Individual Education/Self-management.

Question 35

A patient calls her physician to discuss the refill of a current prescription. She speaks with the registered nurse who discusses the patient’s current status and advises that the prescription is to be called into her pharmacy. The call lasts 12 minutes. What code is reported for the service?
A. 98966
B. 98968
C. 99442
D. 98967

Answer 35

D. 98967

Rationale: Code 98967 describes a telephone discussion with a nonphysician qualified healthcare professional for 11-20 minutes. The discussion did not lead to an appointment within the next 24 hours or the soonest available appointment and was not related to an E/M service within the previous seven days. In the CPT® Index, look for Telephone/Evaluation and Management/Nonphysician.

Question 36

A patient in a rural setting with limited travel resources visits his physician for a physical examination. Lab work is done. The physician advises the patient that if the results are negative, he does not need to return to the office. The nurse emails the patient that the results were negative, and the patient does not need to return for six months unless new symptoms appear. One month later, the patient emails the office with a request to change his current medication to a less-expensive generic version. The nurse answers the email, advising one of his medications could be changed to a generic version and refills will be called to the pharmacy as needed. She also responds to several additional questions the patient has about his general health conditions. She spends a total of 25 minutes conferring with the provider, responding to the patient, and entering this information. What code is reported for the nurse’s service?
A. 98971
B. 98972
C. 98970
D. 99423

Answer 36

B. 98972

Rationale: Code 98972 describes an online evaluation and management service of 21 minutes or more provided by a nonphysician qualified healthcare professional. In the CPT® Index, look for Case Management Services/Online.

Question 37

A physician provides medical testimony in a suspicious death case. What code is reported for the service?
A. 99026
B. 99080
C. 99056
D. 99075

Answer 37

D. 99075

Rationale: Physicians may be called upon to give a medical opinion about cause of death in a court proceeding. Code 99075 is designated for medical testimony. In the CPT® Index, look for Medical Testimony.

Question 38

A hospital must provide an on-call radiology technician trained in MRI services for emergent cases presenting to the emergency department from 6 p.m. until 7 a.m. The technician is required to return to the hospital within 40 minutes of notification. How are these services reported?
A. 99060
B. 99027 X 13
C. 99026 X 13
D. 99058

Answer 38

B. 99027 X 13

Rationale: Code 99027 describes mandated on-call service, out of the hospital, per hour. In the CPT® Index, look for Mandated Services/On Call Services.

Question 39

An independent laboratory charges a fee to transport medical specimens from physicians’ offices to the laboratory for testing. What code is reported for the service?
A. 99000
B. 99056
C. 99050
D. 99002

Answer 39

A. 99000

Rationale: Physicians often contract with an outside laboratory to handle specimens and provide reports. The laboratory will arrange for courier pick up and charge the physician a handling fee. In the CPT® Index, look for Handling/Specimen Transport.

Question 40

A physician agrees to meet a patient at the office on Sunday afternoon to assess a repeat problem. Special equipment in the physician office is needed to evaluate the condition. Normal office hours are Monday-Friday. What code is reported for the encounter?
A. 99058
B. 99056
C. 99060
D. 99050

Answer 40

D. 99050

Rationale: Code 99050 describes services provided on holidays and weekends that are outside of normal business hours. In the CPT® Index, look for After Hours Medical Services.

Question 41

A patient ingested a toxic substance and was administered ipecac in the Emergency Department to empty the stomach. What code is reported for the service?
A. 99195
B. 43755
C. 99199
D. 99175

Answer 41

D. 99175

Rationale: Code 99175 describes administration of ipecac to induce emesis for emptying the stomach. In the CPT® Index, look for Ipecac Administration/for Poisoning.

Question 42

A physician performs a magnified anogenital examination on a young child to determine if assault occurred. What code is reported for the service?
A. 99175
B. 99170
C. 99174
D. 99195

Answer 42

B. 99170

Rationale: Code 99170 describes a magnified anogenital examination on a child for suspected trauma. In the CPT® Index, look for Anogenital Region—See Perineum. Locate Perineum/Anogenital Examination/with Magnification and Image/Recording.

Question 43

A post-surgical patient is discharged from the hospital to home. The patient still has a urinary catheter needing attention for the next several days. The physician arranges for patient care through a home care agency. What code is reported for the non-physician healthcare professional’s service?
A. 99505
B. 99509
C. 99512
D. 99507

Answer 43

D. 99507

Rationale: Patients discharged from hospital care may still need some assistance with their medical condition. The physician typically arranges the care with a home care agency by sending a qualified person to the patient’s home to provide that assistance. Code 99507 describes home care for maintenance of catheters. In the CPT® Index, look for Home Services/Catheter Care.

Question 44

A patient was discharged recently from the hospital following a colon resection with colostomy. A nurse makes a home visit to assist with the patient’s colostomy. What code is reported for the nurse’s visit?
A. 99505
B. 99509
C. 99511
D. 99512

Answer 44

A. 99505

Rationale: Code 99505 describes a home care visit from a nonphysician practitioner to manage stomas and ostomies. In the CPT® Index, look for Home Services/Stoma Care.

Question 45

A nurse visits a patient in the home to manage infusion of a thrombolytic agent for two hours. How is the nurse’s service reported?
A. 99512
B. 99605
C. 99601, 99602
D. 99601

Answer 45

D. 99601

Rationale: Code 99601 describes home infusion of a specialty drug per visit, up to two hours. In the CPT® Index, look for Home Services/Home Infusion Procedures.

Question 46

An established patient on multiple prescriptions had concerns about possible drug interactions with a new prescription. She requested consultation from the local pharmacist before leaving the pharmacy. The pharmacist met with her for 23 minutes to discuss possible interactions with her current medications and assured her that it was not likely the new medication would cause significant side effects. How are the pharmacist’s services reported?
A. 99605
B. 99606
C. 99605, 99607
D. 99606, 99607

Answer 46

D. 99606, 99607

Rationale: Code 99606 describes the initial 15-minute consultation with a pharmacist for an established patient. Code 99607 describes an additional 15 minutes. Both are reported for the 23-minute encounter. In the CPT® Index, look for Medication Therapy Management/Pharmacist Provided.