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CPC-Physician Based Medical Coding > CPC Review Questions > Flashcards

CPC Review Questions Flashcards

1
Q

Bronchoscopy: A patient presents for 4 ttransbronchial lung biopsies of 2 separate lobes performed via a bronchoscopy. Two biopsies are taken in one lobe and 2 biopsies in another lobe. Code als services.

A. 31628, 31632 x3
B. 31628
C. 31629, 31632
D. 31628, 31632

A

D. 31628, 31632

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2
Q

Sinus Endoscopy: A patient presents to the endoscopy suite for a diagnostic maxillary sinusotomy. During the sinusotomy. the physician observes some diseased tissue which needs to be removed. The physician decides to perform a maxillary antrostomy with tissue removal. Code all services.

A. 31267
B. 31231, 31267
C. 31254, 31256
D. 31256

A

A. 31267

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3
Q

Video-assisted Thoracoscopic Surgery VATS: Patient presents for scheduled for a diagnostic VATS. He has been complaining of difficulty breathing and mid chest pain. Under general anesthesia he was placed in left lateral decubitus position and a thoracoscope was inserted through a port site. The VATS exploration immediately revealed a mass of the left upper lobe. A biopsy was performed and sent to pathology. Code all services.

A. 32601
B. 32608
C. 32408
D. 32096

A

B. 32608

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4
Q

Postoperative Hemorrhage: A patient is treated for a postoperative hemorrhage following an endoscopic upper lobectomy. The provider performed a major thoracotomy. Code all services.

A. 32100
B. 32310
C. 32120
D. 32110

A

C. 32120

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5
Q

CABG: A paptient has a four-vessel autogenous (one venous, three arterial) coronary bypass, utilizing the saphenous vein, radial artery and the left and right internal mammary arteries. Code all services.

A. 33535, 33510-51
B. 33533, 33519, 35600
C. 33535, 33517, 35600
D. 33534, 33518-51, 33530

A

C. 33535, 33517, 35600

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6
Q

Choloecystectomy: Patient present for a cholecystectomy performed laparoscopically. The procedure was performed for recurrent bouts of acute cholecystitis. What is the correct CPT Code?

A. 47570
B. 47600
C. 47562
D. 47605

A

C. 47562

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7
Q

Colonoscopy: A patient presents for a diagnostic colonoscopy. When performing the service, the physician notes suspicious looking polyps and removes five of these to send to pathology for further testing using a snare technique. Which CPT code(s) is (are) reported?

A. 45378, 45385-51
B. 45378, 45380-51
C. 45380
D. 45385

A

D. 45385

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8
Q

Exchange of Stents:
Procedure- Endoscopic retrograde cholangiogram with balloon cholangiogram; stent exchange; antral biopsy

Description of Procedure- The patient was taken to the fluoroscopy suite in GI lab where he was found to be alert and oriented x3. After discussing risks and benefits of the procedure, informed consent was obtained. After that, the patient was kept in the semi prone position. After adequate conscious sedation, an Olympus side-viewing therapeutic scope was inserted through the mouth all the way to the second portion of the duodenum. Then, the common bile duct was cannulated and the cholangiogram was obtained. After the fluoroscopy evaluation of the cholangiogram, the old stent was removed and an 8.5 x 2 cm stent was deployed for biliary drainage. After that, the biopsy from the antrum was obtained. Which CPT code(s) is (are) reported?

A. 43260
B. 43276, 43261-51
C. 43261, 43273
D. 43264, 43261-51

A

B. 43276, 43261-51

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9
Q

External Hemorrhoid: Patient presents for an external hemorrhoidectomy. The provider performs a single column hemorrhoidectomy. What is the correct CPT code?

A. 46250
B. 46255
C. 46945
D. 46999

A

D. 46999

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10
Q

Inguinal Hernia:
Performed- Right inguinal hernia repair with mesh.
Operative Findings- Upon entering the right groin, a large inguinal sac was identifieed and was repaired with a large plug-and-patch technique. The male patient is 45-years-old.
Description of Procedure- After undergoing adequate general anesthesia and after DuraPrep prepping tghe left groin and draping with cloth towels and drapes, an oblique incision was made in the right groin through the subcutaneous tissue down to the external oblique. The external oblique was opened in the direction of its fibers and the spermatic cord and ilioinguinal nerve were placed out of the operagtive field. The spermatic cord was inspected very carefully and a large, inguinal hernia sac was identified and dissected down to the internal ring. The hernia sac was reduced into the abdominal cavity and was secured in place with a large plug, which was placed into the defect. It was sewn in place with #2-0 Vicryl sutures. The on lay patch was placed and was sewn in place with #2-0 Vicryl suture. The wound was irrigated with normal saline and 0.25%. The spermatic cord and ilioinguinal nerve were placed back in their anatomic position. The external oblique was exposed in a running fashion with #3-0 PDS, the subcutaneous tissues closed with running #4-0 Vicryl, and the skin edges were approximated with a running subcuticular #4-0 Vicryl. What is the correct CPT code?

A. 49550-RT
B. 49507-RT
C. 49505-RT
D. 49520-RT

A

C. 49505-RT

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11
Q

A patient presents with internal hemorrhoids and has elected to have them removed. The ligator and alligator forceps have been inserted through an anoscope. The physician identifies the most prominent hemorrhoid and ligates it at the base with a rubber band. Which CPT code is reported?

A. 46221
B. 46250
C. 46945
D. 46255

A

A. 46221

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12
Q

8-year-old female presents to a same day surgery unit for a tonsillectomy. During the surgery, the physician notices the adenoids are very inflamed and must be taken out as well. The adenoids, although not planned for removal, are also removed at the same surgery as the tonsillectomy. What CPT code(s) is/are reported for the procedure?

A. 42820
B. 42821
C. 42825, 42830
D. 42825, 42835

A

A. 42820

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13
Q

Patient has a recurrent reducible incisional hernia. He undergoes a laparoscopic hernia repair of a defect that is 4 cm. What CPT code is reported?

A. 49591
B. 49593
C. 49615
D. 49616

A

C. 49615

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14
Q

Bladder Tumor: Transurethral resection of a medium-size (4.0 cm) bladder tumor was performed in an outpatient setting. Code all services.

A. 52224
B. 52234
C. 52235
D. 52240

A

C. 52235

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15
Q

Circumcision: A clamp circumcision is performed with dorsal block on a new-born baby boy. Code all services.

A. 54150
B. 54160
C. 54161
D. 54150-52

A

A. 54150

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16
Q

Cystourethroscopy: Patient presents for a cystourethroscopy with ureteroscopy to fulgurate a ureteral lesion.

A. 52325
B. 52354, 52330-51
C. 52354
D. 52330

A

C. 52354

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17
Q

Orchiopexy: A 6 month-old patient presents for a right orchiopexy for an undescended testis. An inguinal incision was made that was approximately 2.5 to 3 cm in length. This was carried down through skin and subcutaneous tissues. Camper’s and Scarp’s fascia were incised. Once this was completed the testicle was then delievered into the operative field after taking cremasteric muscle down as well as the primitive gubemacular attachment. Once this was done the testicle was examined. The appendix testis was removed and then a tunnel created down through the inguinal area into the scrotum. An incision approximately 1.5 to 2 cm was made down through skin and subcutaneous tissues. A subdartos pouch was then created with a dull mosquito. Once this was done then the testicle was pexed at 3, 6 and 9 o’clock position with a 50 Prolene. Once this was completed the skin was closed with a 3-0 chromic in a continous fashion. The area was then cleansed with normal saline. Then the subcutaneous tissues were approximated with a 3-0 chromic suture and then using a 5-0 Vicryl to dose the skin. Once this was completed then the area was injected with 0.25% Marcaine with an expiration date of 11/11; 2.4 mL were injected into the scrotum as well as the inguinal incision. The patient then had dry sterile dressing, Telfa and Tegaderm applied to the incision along with Steri-Strips. Code all services.

A. 54600-RT
B. 54650-RT
C. 54660-RT
D. 54640-RT

A

D. 54640-RT

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18
Q

Penile Implant: Patient with erectile dysfunction, presents for penile implant. An inflatable penile prosthesis is inserted. Code all services.

A, 54400
B. 54401
C. 54408
D. 54416

A

B. 54401

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19
Q

Delivery: A pregnant patient presents to the hospital in active labor. The obstetrician providing her prenatal care is contacted to perform the delievery. The provider delivers twins vaginally. The obstetrician will also provide the postpartum care. What COT code(s) is (are) reported for the delivery?

A. 59510 x 2
B. 59400, 59409-51
C. 59430
D. 59409 x 2

A

B. 59400, 59409-51

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20
Q

Hysterectomy: A patient with seveere adenomyosis has a vaginal hysterectomy with bilateral salpingo-oophorectomy. After the uterus is removed it is weighed at 310 grams. What is the CPT code reported for this procedure?

A. 58290
B. 58291
C. 58292
D. 58262

A

B. 58291

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21
Q

Paravaginal Defect: Patient is diagnosed with a pelvic organ prolapse and cystocele. The paravaginal defect is repaired by entering the vagina and incising the anterior vaginal wall placing sutures in the weakened muscle and fascia, with an incision and plication of the pubocervical fascia. All the sutures placed are tied to close the defect. What procedure code(s) is (are) reported?

A. 57285
B. 57268, 57284
C. 57423
D. 57285, 57240

A

A. 57285

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22
Q

Twin Delivery: 28-year-old woman delivers twins by her regular obstetrician by cesarean delivery. Both are delivered without complications. Patient had antepartum care with this obstetrician and will have postpartum care in two weeks. What is/are the CPT code(s) reported for this service?

A. 59510
B. 59510, 59514-51
C. 59510, 59510-51
D. 59400

A

A. 59510

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23
Q

The patient presents with a recurrent infection of the Bartholin’s gland which has previously been treated with antibiotics and I&D. At this visit her gynecologist incises the cyst, draining the material and tacks the edges of the cyst creating an open pouch to prevent recurrence. What is the correct CPT code?

A. 56405
B. 56420
C. 56440
D. 56740

A

C. 56440

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24
Q

A newborn baby has an elective circumcision before home discharge. The phyisican uses a ring block for the local anesthetic and the foreskin is placed over the glans. A clamp is selected for the size of the glans and a constricting circular ring is placed over the foreskin to compress and devascularize the foreskin. The devascularized foreskin is excised with a scalpel, the rine device is removed, and the penis is dressed. Which CPT code is reported?

A. 54150
B. 54160
C. 54161
D. 54150-52

A

A. 54150

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25
Q

Patient presents with a 3 cm laceration to the left scrotum. Through this opening the urologist explores the testis for damage and finds some tearing of the testicular tissue that needs suturing. The only other apparent injury is swelling and bruising. The urologist repairs the testicle, ehich requires a layered closure. What CPT code is reported?

A. 12001
B. 12042
C. 54600-LT
D. 54670-LT

A

D. 54670-LT

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26
Q

Chemodenervation: A 55 year-old male presents with spasmodic torticollis. The decision is made to inject 100 units of Botox in the cervical paraspinal, semispinalis capitis, and trapezius muscles using EMG guidance. What CPT code(s) is (are) reported?

A. 64616, 95874
B. 64617
C. 64615, 95874
D. 64616-50, 95874

A

A. 64616, 95874

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27
Q

Vertebral Corpectomy: A 50 year-old male patient presents to the OR for a partial corpectomy of three thoracic vertebrae. The surgeon performs the transthoracic approach and performs three vertebral nerve root decompressions. What are the correct CPT codes?

A. 63085, 63086
B. 63087, 63088
C. 63087, 63088 x 2
D. 63085, 63086 x 2

A

D. 63085, 63086 x 2

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28
Q

A 45 year-old male patient with chronic lumbago is seen by the physician to have an epidural injection at the sacral level. What CPT code is reported for this procedure?

A. 62320
B. 62326
C. 62360
D. 62322

A

D. 62322

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29
Q

Patient presents for a right thyroid lobectomy. An incision is made two cm above the sternal notch and carried through the platysma. The right thyroid was dissected free from the surrounding tissues. The isthmus was divided from the left thyroid lobe. The left thyroid lobe was explored revealing a single nodule. The right thyroid lobe was completely removed from the trachea and surrounding tissues. It was marked and sent off the table as a specimen. What CPT cide is reported?

A. 60220
B. 60240
C. 60200
D. 60210

A

A. 60220

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30
Q

A patient presents for the placement of two adjustable sutures during strabismus surgery involving the horizontal muscles. What CPT code(s) is (are) reported?

A. 67316, 67335-51
B. 67318
C. 67312, 67335
D. 67334, 67335-51

A

C. 67312, 67335

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31
Q

Anesthesia Modifier: 48-year-old patient was undergoing anesthesia in an ASC and began having complications prior to the administration of anesthesia. The surgeon immediately discontinued the planned surgery. What modifier best describes the extenuating circumstances?

A. 23
B. 53
C. 73
D. 74

A

C. 73

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32
Q

Anesthesia Start and Stop Times: Anesthesia start times is reported as 6:14 am, and the surgery began at 6:26 am. The surgery finished at 7:18 am abd the patient was turned over to PACU at 7:29 am, which was reported as the ending anesthesia time. What is the anesthesia time reported?

A. 6:26 am to 7:18 (52 minutes)
B. 6:26 am to 7:29 (63 minutes)
C. 6:14 am to 7:18 am (64 minutes)
D. 6:14 am to 7:29 am (75 minutes)

A

D. 6:14 am to 7:29 am (75 minutes)

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33
Q

Lower Abdomen: An infant 11 months old presents for an inguinal hernia repair. The procedure was performed under endotrachel general anesthesia. Report the anesthesia code(s) for this service.

A. 00834, 99100
B. 00834
C. 00832, 99100
D. 00830

A

B. 00834

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34
Q

Obstetric: What is the correct anesthesia code for an obstetric patient who had a planned general anesthesia for cesarean hysterectomy?

A. 01969
B. 01963
C. 01962
D. 01967

A

B. 01963

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35
Q

A patient presents for a shoulder arthroscopy, which became an open procedure, on the shoulder joint. What CPT code is reported for the anesthesia?

A. 01680
B. 01622
C. 01630
D. 01638

A

C. 01630

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36
Q

62 year-old patient is having surgery on the pericardial sac, without use of a pump oxygenator. The perfusionist placed an arterial line. What CPT code is reported for the anesthesiologist?

A. 00561
B. 36620
C. 00562
D. 00560

A

D. 00560

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37
Q

A patient presents to the OR for a craniotomy with evacuation of a hematoma. What is the CPT code for the anesthesiologist’s services?

A. 61314
B. 00211
C. 61312
D. 00210

A

B. 00211

38
Q

Angioplasty: 82-year-old female with a right leg medial malleolar non-healing ulcer elected to proceed with peripheral angiography. Using a RIM catheter, from a left femoral artery access, the contralateral right iliac artery was accessed and the catheter was gradually advanced to the right common femoral artery. The right lower extremity angiography was performed with both C02 injection and subsequently localized pictures of femoral distal bypass grafts were performed using contrast injections. This revealed the right superficial femoral artery is 100% occluded at its origin. Decision for angioplasty was made and intervention was performed through this area withh a 7 mm x 20 mm balloon inflated up to 7 atmospheres. The gradual inflation resulted in enlarging the artery to a more normal flow of blood. What CPT codes are reported?

A. 37224, 75710-26-59
B. 37220, 75710-26-59
C. 37224, 75716-26-59
D. 37220, 75716-26-59

A

A. 37224, 75710-26-59

39
Q

DXA: A 62-year-old patient on estrogen replacement therapy (ERT) receives a DXA study of the hips. What is the CPT code reported for the bone density study?

A. 77077
B. 77080
C. 77081
D. 77078

A

B. 77080

40
Q

Obstetric US: 28 year-old female in her last trimester of her pregnancy comes for a fetal biophysical profile (BPP). An ultrasound is used to first monitor the fetus’ movements showing three movements of the legs and arms (normal). There are two breathing movements lasting 30 seconds (normal). Non-stress test (NST) of 30 minutes showed the heartbeat at 120 beats per minute and increased with movement (normal or reactive). Arms and legs were flexed with fetus’ head on it chest, opening and closing of a hand. Two pockets of amniotic fluid at 3 cm were seen in the uterine cavity (normal). Biophysical profile scored 9 out of 10 points (normal or reassuring). What CPT code(s) is (are) reported?

A. 76815
B. 76818
C. 76819
D. 59025, 76818

A

B. 76818

41
Q

Radiation Oncology: An oncology patient is having weekly radiation treatments with a total of seven conventional fraactionated treatments. Two fractionated treatments daily for Monday, Tuesday and Wednesday and one treatment on Thursday. What radiology code(s) is/are appropriate for the clinical management of the radiation treatment?

A. 77427 x 2
B. 77427 x 7
C. 77427
D. 77427-22

A

C. 77427

42
Q

Selective Cath: In the cath lab, from a femoral artery access, the following procedures are performed: Catheter placed in the left renal, accessory left renal superior to the left renal, and in the celiac artery. Radiologic supervision and imaging performed in all locations. What CPT codes are reported?

A. 36252, 36245-59, 75726-26, 75774-26
B. 36222-LT, 36225-59, 75726-26
C. 36251-LT, 36245-59, 75726-26
D. 36224-LT, 36245-59, 75744-26

A

C. 36251-LT, 36245-59, 75726-26

43
Q

Transplanted Kidney: A kidney transplant patient with a diagnosis of Stage V chronic kidney disease receives an ultrasound with color duplex Doppler imaging to check the overall blood flow of the kidneys. What is the correct CPT code for this encounter?

A. 76775
B. 76776
C. 76700
D. 76705

A

B. 76776

44
Q

Ap and Lateral chest X-rays were performed for a cough. What CPT code is reported?

A. 71100
B. 71048
C. 71045
D. 71046

A

D. 71046

45
Q

A non-Medicare patient reports for a bilateral screening mammography with CAD. What CPT code is reported?

A. 77065
B. 77066
C. 77067
D. 77047

A

C. 77067

46
Q

A one-year post-thyroidectomy patient who had thyroid cancer is coming in for area imaging of the neck and chest to evaluate for metastases. What CPT code(s) is/are reported for the nuclear medicine exam?

A. 78013
B. 78014
C. 78015
D. 78015, 78020

A

C. 78015

47
Q

Drug Class and Definitive Drug Testing: A 28 year-old who is unconscious is brought to the ER for possible ingestion of opiates or methamphetamine. A drug screening is ordered and the lab performs a single drug class using discrete multichannel chemistry analyzers utilizing immunoassay. Confirmation was then performed for opiates. What codes should be used for reporting the testing and confirmation?

A. 80305, 80361
B. 80307, 80361
C. 80306, 80362
D. 80307 x 2, 80362

A

B. 80307, 80361

48
Q

Modifier 91: A type 2 diabetic patient presents feeling weak. The physician performs a stat glucose test in which a finger stick is done placing the drop of blood on a reagent strip. The test indicates the patient is hypoglycemic. The physician gives the patient some glucose supplements and performs another stat glucose test during the same lab test as before 30 minutes later. The second test shows the glucose levels returned to normal. How are the lab tests reported?

A. 82948, 82948-76
B. 82948, 82948-90
C. 82948, 82948-91
D. 82948, 82948-92

A

C. 82948, 82948-91

49
Q

Organ Panel: Lab analysy performs the following lab tests: electrolyte panel, comprehensive metabolic panel, and total serum cholesterol test. How are these lab tests reported?

A. 80053, 80061
B. 80051, 80053, 82465
C. 80053, 82465
D. 80051, 80053, 80061

A

C. 80053, 82465

50
Q

A 68 year-old cardiac patient must takke digoxin to treat his atrial fibrillation (Afib). This condition has been controlled for several years but the patient now presents to his physician with new complaints of irresgular heartbeats. The physician orders a total digoxin study to determine the total level of digoxin in order to measure the drug’s efficacy in treating his Afib. What CPT code is reported?

A. 80299
B. 80163
C. 80162
D. 82542

A

C. 80162

51
Q

An autopsy is performed to gain evidence for the police investigation and any subsequent trial on a 21-year-old female who dies of a gunshot wound. What CPT code is reported?

A. 88005
B. 88045
C. 88025
D. 88040

A

D. 88040

52
Q

A patient with a history of drug abuse presents to the ED in a stupor. Drug screens are ordered to check for amphetamines, cocaine, opiates, and barbiturates. The laboratory performs multiplex dipstick testing read by instrument-assisted direct optical observation for multiple drug classes. What CPT coding is reported?

A. 80305 x 4
B. 80306 x 4
C. 80306
D. 80324, 80345, 80353, 80361

A

C. 80306

53
Q

Cardiac Cath: A patient with angina decubitus that lasted for 30 minutes and was admitted to the Coronary Care Unit with a diagnosis of R/O MI. The cardiologist takes her to the cardiac catheterization suite at the local hospital for a left heart catheterization. Injection procedures for selective coronary angiography and left ventriculography were performed and imaging supervision and interpretation for the selective coronary angiography and left ventriculography was provided. What CPT code(s) is/are reported for the services?

A. 93453-26, 93462
B. 93453-26
C. 93452-26
D. 93458-26

A

D. 93458-26

54
Q

Chemotherapy: A patient with chronic myeloid leukemia (CML), BCR/ABL-positive has an implanted access port for delivery of chemotherapy. The device needs to be irrigated before receiving treatment in two days. What CPT code is reported for the irrigation?

A. 96523
B. 96522
C. 96521
D. 96450

A

A. 96523

55
Q

Extremity Doppler: A patient is at the hospital radiology clinic for numbness and tingling in the lower right and left legs. The physician wants to rule out a blockage. The radiologist performs a Doppler waveform analysis at 2 levels. What procedure code is reported for the professional services for this encounter?

A. 93922-50-TC
B. 93922-52-26
C. 93922-26
D. 93923-26

A

C. 93922-26

56
Q

Immunizations: A young child received a mumps, measles, rubella and varicella (MMRV) injection with physician counseling. What CPT codes are reported?

A. 90710, 90460
B. 90707, 90716, 90471, 90472 x 3
C. 90710, 90460, 90461 x3
D. 90707, 90716, 90460, 90461 x 3

A

C. 90710, 90460, 90461 x 3

57
Q

Moderate Sedation: 3-year-old fell and requires suturing of a laceration. Due to the patient’s age and combative behavior, the physician utilized moderate sedation while repairing the laceration. The physician gave the child 50 mg of Ketamine IM. A nurse monitored the patient during the procedure which took 30 minutes. What CPT code is reported for moderate sedation?

A. 99152, 99153
B. 99151, 99153
C. 99156, 99153
D. 99155, 99153

A

B. 99151, 99153

58
Q

A patient suspected to have a congenital heart defect is seen by the neonatologist who ordered a transthoracic echocardiogram (TTE). TTE is showing a shunt between the right and left ventricles. The neonatologist read and interpreted the study and indicated the patient has a ventricular septal defect (VSD). What is the CPT code for the TTE read?

A. 93312
B. 93303
C. 93312-26
D. 93303-26

A

D. 93303-26

59
Q

Patient presents with localized edema in his legs. He has a history of hypertension and congestive heart failure and is currently on medication for both conditions. The physician ordered a complete venous duplex scan of his lower extremities. The femoral, superficial femoral, posterior tibial and popliteal veins were assessed. There was no evidence of thrombus. The study was normal. What CPT code is reported?

A. 93970
B. 93975
C. 93925
D. 93931

A

A. 93970

60
Q

12 year-old is brought in to see an allergist for generalized urticaria. The family just recently visited a family member that had a cat and dog. The child’s skin was scratched with two different allergens. The physician waited 15 minutes to check the results. There was a flare up reaction to the cat allergen, but there was no flare up to the dog allergen. The physician included the test interpretation and report in the record. What is the CPT code reported?

A. 95018 x 2
B. 95004 x 2
C. 95027 x 2
D. 95024 x 2

A

B. 95004 x 2

61
Q

Critical Care: An infant is born six weeks premature and the pediatrician in attendance intubates the child and administers surfactant in the ET tube while waiting in the ER for the air ambulance. During the 45 minute wait, he continues to bag the critically ill patient on 100 percent oxygen while monitoring VS, ECG, pulse oximetry and temperature. The infant is in a warming unit and an umbilical vein line was placed for fluids and in case of emergent need for medications. How is this coded?

A. 99291-25, 31500, 36510, 94610
B. 99291
C. 99471
D. 99471-25, 94610, 36510

A

A. 99291-25, 31500, 36510, 94610

62
Q

Emergency Room: A male patient is brought to ED by EMS for nausea and vomiting. Patient has elevated blood sugars and the ED physician is unable to get a history due to patient’s altered mental status. An eight organ system exam is performed and the MDM is high. The patient was stabilized and transferred to ICU where another doctor will take over the care. The ED physician documents total critical care time 25 minutes. What CPT code should be reported for the ED physician?

A. 99236
B. 99291
C. 99285
D. 99223

A

C. 99285

63
Q

Pediatric Critical Care: 3 year-old critically ill child is admitted by the same physician to the PICU from the ER with respiratory failure due to an exacerbation of asthma not manageable in the ER. The physician starts continous bronchodilator therapy and pharmacologic support along with cardiovascular monitoring and is thinking about the need for possible mechanical ventilation support. The physician documents a comprehensive history and exam and orders are written after treatment is initiated. What is the CPT code for this encounter?

A. 99475
B. 99291
C. 99284
D. 99476

A

A. 99475

64
Q

Visti with Injection: A 65 year-old non-Medicare established patient sees his regular primary care provider for a physical screening prior to joining a group home. He has no new complaints. The patient has an established diagnosis of Cerebral Palsy and type 2 Diabetes and is currently on his meds. Split virus, preservative free flu vaccine is given. Patient already had had a vision exam. What CPT codes are reported?

A. 99215, 90658, 90471
B. 99397, 90662, 90471
C. 99214, 90662, 90471
D. 99387, 90658, G0008

A

B. 99397, 90662, 90471

65
Q

A pediatrician is asked to be in the room during the delivery of a baby at risk for complications. The pediatrician is in the room for 45 minutes. The baby is born and is completely healthy, not requiring the services of the pediatrician. What CPT code(s) is/are reported by the pediatrician?

A. 99360
B. 99219
C. 99252
D. 99360 x2

A

A. 99360

66
Q

After moving to a new state a mother took her two-year-old daughter to a new pediatric clinic for an annual physical. The provider completed an age/gender appropriate history, exam, and provided anticipatory guidance. He ordered no additional tests or immunizations. What CPT code is reported?

A. 99391
B. 99392
C. 99381
D. 99382

A

D. 99382

67
Q

Mr. Latham has a diagnosis of early stage of Alzheimer’s. Hispast medical history includes COPD and arthritis. He and his wife met with Dr. Woodward on March 1 to discuss management of his chronic conditions. At that time Mr. Latham agreed to the establishment of a care plan to include 24/7 access to physicians and practitioners, non-face-to-face consultations, overseeing medication self-management, and coordination of care with community-based clinical service providers.

During March, Dr. Woodward’s Clinical Nurse Specialist (CNS), Mary, spends 40 minutes implementing the comprehensive care plan. Mary provides Mr. and Mrs. Latham with the phone number for 24/7 access to care, schedules appointments with a pulmonologist and a physical therapy evaluation and arranges for monitoring medications. What CPT coding is reported for the CNS services?

A. 99491, 99437
B. 99218
C. 99490, 99439
D. 99490 x 2

A

C. 99490, 99439

68
Q

Patient presents with upper arm abscess in the subcutaneous tissue. An incision and drainage technique are performed. Pus is expressed and dry gauze dressing is applied. What CPT® code is assigned?

A. 10060
B. 10061
C. 10180
D. 23930

A

A. 10060

69
Q

Patient is having a right index trigger finger repair. An incision was made over the A1 pulley in the right distal transverse palmar crease, about an inch in length. This is taken through the skin and subcutaneous tissue. The A1 pulley is identified and released in its entirety. The wound is irrigated with antibiotic saline solution. The subcutaneous tissue is injected with Marcaine without epinephrine. The skin is closed with 4-0 Ethilon sutures. Clean dressing is applied. What is the correct CPT® code?

A. 26055-F6
B. 20553-F6
C. 20552-F6
D. 26020-F6

A

A. 26055-F6

70
Q

A cardiologist performed an angioplasty and atherectomy on the right popliteal artery by percutaneous approach from the left femoral artery. What is the CPT® coding?

A. 37227
B. 37225
C. 37224, 37225
D. 37228, 37229

A

B. 37225

71
Q

8-year-old female presents to a same day surgery unit for a tonsillectomy and removal of her adenoids which are very inflamed. What is the CPT® coding reported for the procedure?

A. 42820
B. 42821
C. 42825, 42830
D. 42825, 42835

A

A. 42820

72
Q

A pregnant patient presents to the hospital in active labor. The obstetrician providing her prenatal care is contacted to perform the delivery. The provider delivers the twins vaginally. The obstetrician will also provide the postnatal care. What is the correct CPT® coding?

A. 59409 X 2
B. 59409-51 X2, 59410-51 X 2
C. 59409, 59410
D. 59400, 59409-51

A

D. 59400, 59409-51

73
Q

A patient presents for a right thyroid lobectomy. An incision is made two cm above the sternal notch and carried through the platysma. The right thyroid was dissected free from the surrounding tissues. The isthmus was divided from the left thyroid lobe. The left thyroid lobe was explored revealing a single nodule. The right thyroid lobe was completely removed from the trachea and surrounding tissues. It was marked and sent off the table as a specimen. What CPT® code is reported?

A. 60220
B. 60240
C. 60200
D. 60210

A

A. 60220

74
Q

A non-Medicare patient reports for a bilateral screening mammography with CAD. What CPT® code is reported?

A. 77065
B. 77066
C. 77047
D. 77067

A

D. 77067

75
Q

An autopsy is performed to gain evidence for a police investigation and any subsequent trial on a 21-year-old female to determine the cause of death. What CPT® code is reported?

A. 88005
B. 88045
C. 88025
D. 88040

A

D. 88040

76
Q

12-year-old is brought in to see an allergist for generalized urticaria. The family just recently visited a family member that had a cat and dog. The child’s skin was scratched with two different allergens. The physician waited 15 minutes to check the results. There was a flare up reaction to the cat allergen, but there was no flare up to the dog allergen. The physician included the test interpretation and report in the record. What is the CPT® code reported?

A. 95018 X 2
B. 95004 X 2
C. 95027 X 2
D. 95024 X 2

A

B. 95004 X 2

77
Q

A patient presents to the OR for a craniotomy with evacuation of a hematoma on the brain. What is the CPT® code for the anesthesiologist’s services?

A. 00220
B. 00211
C. 00190
D. 00210

A

B. 00211

Rationale: The correct code is 00211 because the procedure is intracranial in evacuating a hematoma that was on the brain. Codes 00220 is for a procedure that is for a cerebral fluid shunting which was not performed. Code 00190 is for the skull, but the procedure was intracranial or with in the skull. Code 00210 is for is for intracranial procedures not otherwise specified however we know the procedure is a craniotomy with evacuation of a hematoma which eliminates this answer.

78
Q

Which one of the following are supplemental tracking codes that are used for performance-measure data and are not required for correct coding?

A. HCPCS Level II codes
B. CPT® Category III codes
C. CPT® Category I codes
D. CPT® Category II codes

A

D. CPT® Category II codes

79
Q

A patient is seen in your clinic. Her husband calls later in the day to ask for information about the visit. The practice pulls the patient’s privacy authorization to see if they can speak to the husband about the wife’s medical information. Which one of the following does this action fall under?

A. HIPAA
B. Social Security Act
C. ADA
D. OIG

A

A. HIPAA

80
Q

After moving to a new state, a mother took her two-year-old daughter to a new pediatric clinic for an annual physical. The provider completed an age/gender appropriate history, exam, and provided anticipatory guidance. He ordered no additional tests or immunizations. What CPT® code is reported?

A. 99391
B. 99392
C. 99381
D. 99382

A

D. 99382

81
Q

A patient is seen in the physician’s office for a 2,400,000 U injection of Bicillin LA. What is the code to represent this drug?

A. J0558 X 24
B. J0561 X 24
C. J2510 X 4
D. J2540 X 4

A

B. J0561 X 24

Rationale: In the HCPCS Level II Table of Drugs and Biologicals, look for Bicillin L-A, which directs you to code J0561. Because J0561 is for 100,000 U, 24 units are reported for 2,400,000 U. Code J0558 is for is for an injection of Bicillin C-R which eliminates this answer. Code J2510 is for Penicillin G Procaine which eliminates this answer. Code J2540 is for Pfizerpen G which eliminates this answer.

82
Q

65-year-old comes into the ER with severe shortness of breath. Patient is diagnosed with exacerbation COPD and asthma with status asthmaticus. What ICD-10-CM coding is reported?

A. J44.1, J45.902
B. J44.1
C. J44.9, J45.902
D. J45.902

A

A. J44.1, J45.902

83
Q

Patient presents for a muscle biopsy. After a local anesthetic a small-bore needle is then introduced through the skin into the muscle, about 3 inches deep, and a muscle biopsy is taken. What is the correct CPT® code?

A. 20205
B. 20206
C. 20225
D. 27324

A

B. 20206

Rationale: The biopsy is taken through the skin using a needle, or percutaneously. Although the biopsy is deep, it is performed percutaneously, which is reported with 20206.

84
Q

A 46-year-old male is seen in the emergency room with severe epistaxis. He said this is a common occurrence for him during the cold dry months of winter and therefore he is here for the third time this week. Extensive bilateral posterior cautery and packing is again required to control the posterior hemorrhage. What CPT® code is reported for the procedure?

A. 30905-22
B. 30903-50
C. 30905-50
D. 30906-50

A

D. 30906-50

Rationale: Epistaxis is the term for nasal hemorrhage. Code selection is determined by whether the procedure is posterior or anterior. This is a posterior nasal packing and is a subsequent visit making the correct code 30906. Modifier 50 is appended because the procedure was performed bilaterally. Code 30905 is also for a posterior nasal packing but it is reported for the initial packing. This is the patient’s third time during the week for the posterior nasal packing making it a subsequent treatment. Code 30903 is for control hemorrhage anterior and the question indicates it is posterior hemorrhage which eliminates this answer.

85
Q

A patient presents with internal hemorrhoids and has elected to have them removed. The ligator and alligator forceps have been inserted through an anoscope. The physician identifies the most prominent hemorrhoid and ligates it at the base with a rubber band. Which CPT® code is reported?

A. 46221
B. 46250
C. 46945
D. 46255

A

A. 46221

Rationale: The hemorrhoid was removed (ligated) using a rubber band selecting code 46221 as the correct answer. Code 46250 is incorrect because that is for removal of external hemorrhoids not internal. Code 46945 is incorrect because that is for internal hemorrhoids with ligation other than by rubber band. The procedure performed was done using a rubber band which eliminates 46945. Code 46255 is for hemorrhoidectomy internal and external and the hemorrhoid removed was only internal which eliminates this answer.

86
Q

A 45-year-old male patient with chronic lumbago is seen by the physician to have an epidural injection at the sacral level. What CPT® code is reported for this procedure?

A. 62320
B. 62326
C. 62360
D. 62322

A

D. 62322

Rationale: A single injection was given at the sacral level. Neither a catheter nor a device is documented as being used. Single injection codes are selected based on the level of the spine injected. The lumbar sacral area is 62322.
Using process of elimination, code 62320 is not the correct code because the procedure is for cervical or thoracic and the patient had a sacral level injection. Code 62326 can be eliminated because that is for an injection with an indwelling catheter placement. The patient did not have a catheter placed. Code 62360 is not correct because that is for an insertion or replacement of a subcutaneous reservoir which was not performed on this patient.

87
Q

A one-year post-thyroidectomy patient who had thyroid cancer is coming in for area imaging of the neck and chest to evaluate for metastases. What is the correct CPT® coding for the nuclear medicine exam?

A. 78013
B. 78014
C. 78015
D. 78015, 78020

A

C. 78015

Rationale: The patient is having thyroid imaging for carcinoma (cancer) metastases limited to the chest and neck only. A thyroid uptake is a test to measure the thyroid function in determining how much iodine the thyroid will take up. This is not performed; therefore, add-on code 78020 is not reported. Code 78015 is the correct code when an imaging scan is for thyroid cancer metastases. Codes 78013 and 78014 is to examine the structure and function of the thyroid gland.

87
Q

A patient with a history of drug abuse presents to the ED in a stupor. Drug screens are ordered to check for amphetamines, cocaine, opiates, and barbiturates. The laboratory performs multiplex dipstick testing read by instrument-assisted direct optical observation for multiple drug classes. Provide the procedure code(s) for this encounter.

A. 80305 X 4
B. 80306
C. 80324, 80345, 80353, 80361
D. 80306 X 4

A

B. 80306

Rationale: This is a presumptive drug screening for classes of drugs, not a definitive drug testing, which identifies individual drugs, eliminating the answer choice that lists each drug separately. Code 80306 is correct, because the drug testing is read by instrument assisted direct optical observation. Codes 80305-80307 are only reported once no matter how many drugs are tested.

88
Q

A patient suspected to have a congenital heart defect is seen by the neonatologist who ordered a complete transthoracic echocardiogram (TTE). TTE is showing a shunt between the right and left ventricles. The neonatologist read and interpreted the study and indicated the patient has a ventricular septal defect (VSD). What is the CPT® code for the TTE read?

A. 93312-26
B. 99307-26
C. 93304-26
D. 93303-26

A

D. 93303-26

Rationale: Codes 93303 and 93304 is based on whether it is a complete study, follow up or limited study. Code 93303 is the correct code for a complete transthoracic echocardiogram. This eliminates 93304. When reading the code descriptions for codes 99312 and 99307 those studies were note performed. Because only reading and interpretation were performed by the neonatologist, modifier 26 is appended.

89
Q

Which one of the following statements is TRUE in appending Modifier 51?

A. Modifier 51 is never reported on add-on codes.
B. The pound (#) symbol in front of a code means the code is modifier 51 exempt.
C. Modifier 51 is reported on Evaluation and Management (E/M) codes (example, 99201-99205).
D. Modifier 51 is reported on vaccines

A

A. Modifier 51 is never reported on add-on codes.

Rationale: Per CPT® coding guidelines indicate, all add-on codes in the CPT code set are exempt from the multiple procedure concept. The forbidden symbol in front of a code indicates that the code is modifier 51 exempt. Refer to code 31500 that shows the forbidden symbol and refer to the legend at the bottom of the page in the CPT® code book. In Appendix A modifier 51 is defined and indicates that E/M services and vaccines does not require modifier 51.

90
Q

A patient presents experiencing dizziness with nausea and vomiting. The physician documents auditory vertigo of both ears, possible Meniere’s disease. What ICD-10-CM coding is reported?

A. H81.313
B. H81.311, H81.312, R42, R11.2
C. H81.03
D. R42, R11.2

A

A. H81.313

Rationale: In the ICD-10-CM Alphabetic Index, look for Vertigo/auditory referring you to see Vertigo, aural directing you to H81.31-. In the Tabular List, the sixth character 3 is selected because the condition is bilateral. Codes H81.311 and H81.312 are not reported, because there is combination code for both ears. Refer to ICD-10-CM Coding Guideline I.B.9. The Meniere’s disease is a possible diagnosis and is not reported which eliminates code H81.03. Refer to Coding Guideline I.IV.H.
Dizziness, nausea and vomiting are symptoms of the vertigo and are not reported separately which eliminates the answers that had codes R42 and R11.2. Refer to coding guideline I.B.5.

CPC-Physician Based Medical Coding (52 decks)

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