Download Practice CPC Examination

Practice CPC Examination
The following Certified Professional Coder (CPC) practice exam was developed by Lisa Rae
Roper, MHA, CPC, an instructor for HCPro’s Certified Coder Boot Camp®, to help JustCoding
Platinum members interested in obtaining a CPC credential prepare for the exam.
Unless the question states otherwise, assume that a physician documented all the information
provided. You have two minutes to complete each question. You may not use any outside
materials for this exam other than the CPT, ICD-9-CM, and HCPCS Level II manuals.
Section 1
1. What parts of the body are examined during a sigmoidoscopy?
a.
b.
c.
d.
Rectum
Sigmoid colon
Portion of descending colon
All of the above
2. During a cheiloplasty, the physician is repairing what part of the body?
a.
b.
c.
d.
The cervix
The lip
The cecum
The liver
3. What procedure involves the destruction of kidney stones by directing shock waves
through liquid surrounding the patient?
a.
b.
c.
d.
Cystourethroscopy
Transurethral resection
Lithotripsy
Contact laser vaporization
4. What are the three layers of the skin?
a.
b.
c.
d.
Epidermis, dermis, and subcutaneous
Dermis, sweat gland, and dermis
Subcutaneous, reticular, and papillary
Dermis, subcutaneous, and exfoliative
5. What does the term epiphysis refer to?
a.
b.
c.
d.
The short end of a bone
The end of a long bone
The top of a flat bone
The edges of an irregular bone
6. Which term defines a swelling or mass of blood confined to an organ, tissue, or space
caused by a break in a blood vessel?
a.
b.
c.
d.
Hematuria
Hematoma
Hematemesis
Hemangioma
7. Which term describes a type of fracture?
a.
b.
c.
d.
Greenstick
Comminuted
Depressed
All of the above
8. How does Hodgkin’s lymphoma differ from Non-Hodgkin’s lymphoma?
a. The type of treatment the patient had in the past six weeks for an infarction.
b. Hodgkin’s is a respiratory disorder that is only non-cancerous.
c. It is staged as low-grade or high-grade bladder system disorder detected only
in males.
d. It is distinguished by the presence of Reed-Sternberg cells.
9. Which suffix means blood or blood condition?
a.
b.
c.
d.
emia
oma
pena
uria
10. What term refers to toward or nearer the midline?
a.
b.
c.
d.
Ventral
Distal
Dorsal
Medial
2
11. Which term describes an additional respiratory sound commonly referred to as wheezing?
a.
b.
c.
d.
Rale
Bruit
Rhonchus
Stridor
12. Which lung has three lobes?
a. Left lung
b. Right lung
13. What does the hard palate of the mouth form?
a.
b.
c.
d.
A separation between the interior and exterior portion of the nose
A barrier between the tonsils and the adenoids
The floor of the nasal cavity separating the nasal and oral cavities
The separation of the nasal septum
14. The nervous system can be grouped into what two major categories?
a.
b.
c.
d.
Parasympathetic and sympathetic nervous systems
Somatic and norepinephrine nervous systems
Efferent and peripheral nervous systems
Central and peripheral nervous systems
15. What are the main functions of the integumentary system?
a.
b.
c.
d.
Sensation, protection, thermoregulation, and secretion
Sensation, protection, secretion, and exchange of gases
Sensation, secretion, fluid exchange, and thermoregulation
Sensation, elimination of solid waste, and protection
16. The eyeball has which of the following?
a.
b.
c.
d.
Incus, ethmoid, sinoatrial node
Choroid, retina, vitreous
Retina, choroid, vitreous, and malleus
All of the above
3
17. True or false: The pineal gland is found in the brain near the thalamus and produces the
hormone melatonin, which assists with sleep patterns.
a. True
b. False
18. Mobilization of an organ by freeing adhesions is referred to as?
a.
b.
c.
d.
Irrigation
Fusion
Extraction
Lysis
19. Bleeding from the bladder is best described by which term?
a.
b.
c.
d.
Cystoptosis
Cystorrhagia
Cystorrhaphy
Cystorrhexis
20. Which term means the tissue death of an artery or arteries?
a.
b.
c.
d.
Atherostenosis
Arterosclerosis
Artherosclerosis
Arterionecrosis
21. Which term describes a surgical puncture of the eardrum?
a.
b.
c.
d.
Thoracentesis
Arthrocentesis
Tymponanocentesis
Pleurodesis
22. True or false: The musculoskeletal system includes all of the following: muscles, bones,
ligaments, tendons, joints, spinal cord, and cartilage.
a. True
b. False
4
23. While at church, Fred was standing on a chair when he fell. He suffered a closed Colles’
fracture and contusions to his right cheek, right elbow, right hand, and left leg. What codes
would you report for this injury?
a.
b.
c.
d.
813.41, 920, 923.10, 923.20, 924.4, E884.2, E849.6
813.41, 920, 923.11, 923.20, 924.5, E884.2, E849.6
813.51, 920, 923.11, 923.20, 924.5, E849.6
813.41, 920, 923.11, 923.20, 924.5, E884.2
24. Dr. Lloyd, Bill’s family physician, preformed a physical on Bill in December. Dr. Lloyd
noted Bill had swollen glands, changes in blood tests and on chest x-ray, as well as the
patient’s report of general fatigue and weight loss. Bill was scheduled to see a specialist the
following week. Dr. Schapiro, the specialist, examined Bill, performed tests, and told him
he had metastatic malignant melanoma from the left lateral chest wall to the cervical lymph
nodes. Today, Bill started treatment with Dr. Schapiro directed to his lymph nodes. What
are the correct diagnoses codes for Dr. Schapiro’s treatment?
a.
b.
c.
d.
195.1, 196.0
195.1, 196.2
196.9, 195.2
196.0, 195.1
25. Roger, a firefighter, was burned while fighting a forest fire. He is being treated in a burn
unit, with burns to 30% of his total body surface area. The burns are reported as thirddegree to 25% of his body. The remaining 5% are first- and second-degree burns of the
upper limb. How should you report the diagnoses codes?
a.
b.
c.
d.
948.32, 943.10, 943.20, E892
948.33. 945.20, E892
948.32, 943.20, E892
943.20, 948.32, 943.10, E892
26. Rosemary, a 52-year-old female, returned to her physician for treatment of glaucoma and
problems with peripheral angiopathy of her feet due to diabetes. She has had problems
controlling her diabetes and is insulin dependent. Which diagnosis codes best describe this
patient’s condition?
a.
b.
c.
d.
250.51, 250.71, 443.81, 365.44
250.73, 250.53, 443.81
250.51, 250.71, 443.81
250.53, 250.73, 365.44, 443.81
5
27. Karen, a 26-year-old healthy female, suffered a cardiac arrest with administration of
anesthetic during delivery. What are the correct diagnoses codes?
a.
b.
c.
d.
668.11, 427.5
427.5, 668.10
427.5, 668.11
668.10, 427.5
28. A patient is being treated for an infection from a deep laceration of the head that occurred
five weeks ago. The injury occurred during a motor vehicle accident. What codes would
you use to report this problem?
a.
b.
c.
d.
E929.0, 906.0, 139.8
136.0, 906.0, E929.0
139.8, 906.0, E929.0
E929.0, 958.3, 136.0
29. Thomas was seen in his primary care physician’s office for a chronic smoker’s cough.
Thomas currently smokes five packs of cigarettes per day but is trying to quit smoking. Dr.
Smith notes a chest x-ray reveals abnormal changes in his left lower lobe and designates
“rule out lung cancer” as a working diagnosis. How should Dr. Smith report the diagnoses
for this visit?
a.
b.
c.
d.
491.0, 305.11, 793.1
786.2, 305.11, 793.1
239.1, 491.0, 305.11, 793.1
239.1, 305.11, 793.1
30. Today, Dr. Arnold is treating Harry for a sprained ankle and foot. Harry injured himself
when he fell off a sidewalk curb at a local restaurant. Harry has HIV and is stable on his
current medications. How would Dr. Arnold report the diagnoses for this visit?
a.
b.
c.
d.
042, 845.00, E880.1, E849.6
845.00, 042, E880.1, E849.6
885.00, 042, E880.1, E849.9
E880.1, E849.6, 042, 845.00
6
31. Dr. Nancy prescribed Ibuprofen for Ben’s back pain. He took this medication as prescribed
for two weeks. He started to have stomach pains and followed up with his doctor. Dr.
Nancy noted “gastritis due to the medication” during the follow-up visit. What code(s)
would be correct for the follow-up visit?
a.
b.
c.
d.
535.50
965.61, E935.6
E935.6, 535.51
535.50, E935.6
32. Sherri presents for her regularly scheduled chemotherapy and radiation treatment. She is
being treated for cancer in situ of the bladder wall. How would you list the diagnoses codes
for this visit?
a.
b.
c.
d.
233.7, V5.0, V58.11
188.9, V58.11
V58.0, V58.11, 233.7
233.7, V58.11
33. Today, Daisy, a 72-year-old patient presents with chest pain due to an anterior wall
myocardial infarction that was treated 12 weeks ago. She started to have chest pain while
gardening and complains of a painful rash on her right leg due to contact with poison ivy.
How would the doctor list the diagnoses codes for this encounter?
a.
b.
c.
d.
414.8, 692.6
414.8, 786.50, 692.6
410.12, 692.6
410.12, 786.50, 692.6
34. Amy receives her new prosthetic wrist disarticulation, molded socket with expandable
interface, flexible elbow hinges, triceps pad with an upper extremity addition, disconnected
locking wrist unit. How would the facility report the HCPCS Level II codes?
a.
b.
c.
d.
L6055, L6615
L6055, L6616
L6050, L6615
L6050, L6616
7
35. Bryce was burned on his left upper arm and requires a graft of nine sq. cm of tissue. He is
being treated with dermal and epidermal tissue substance of human origin, Apligraft. What
HCPCS Level II code should you report?
a.
b.
c.
d.
J7341 x 9
J7330
J7340
J7340 x 9
36. A 75-year-old patient with a history of malignant neoplasm of the lower gastrointestinal
trace presents for his follow-up colorectal cancer screening. Today, he has a colonoscopy.
What HCPCS Level II code describes this procedure?
a.
b.
c.
d.
G0104
G0105
G0120
G0121
37. Jose injured his eye while building a fence in his backyard. He sees his physician and is
told to keep his eye covered while it heals. The physician gave him five sterile eye pads.
What is the correct HCPCS Level II code for the eye pads?
a.
b.
c.
d.
A6411
A6411 x 5
A6410 x 5
A6410
38. What HCPCS Level II code would you report for an intramuscular administration of
Atropine 0.3 mg?
a.
b.
c.
d.
J7636 x 3
J7635
J0460 x 3
J0460
39. Stand-alone CPT codes have a full description; indented codes are listed under related
stand-alone codes. An indented code includes the portion of the stand-alone code
description, which precedes the semicolon. The semicolon is used in the CPT book to save
space. Words following the semicolon can specify which of the following?
a.
b.
c.
d.
Extent of the service, modifiers, specific anatomic site
Extent of the service, specific anatomic site, unlisted services
Extent of the service, specific anatomic site, alternative procedure
Unlisted services, alternative procedures, specific anatomic site
8
40. Physical status modifiers are appended to codes listed in which major section of the CPT
book?
a.
b.
c.
d.
Evaluation and Management
Anesthesia
Surgery
Medicine
41. The term “intraservice time” has been measured in studies and is predictive of the work
associated to E/M services. Intraservice times are defined as face-to-face time for office
and other outpatient visits and as unit/floor time for hospital and other inpatient visits.
What is included in the intraservice time for an office and other outpatient visits?
a. Time in which the physician obtains a history, performs an examination, provides
patient counseling
b. Time in which the physician establishes/reviews the patient’s chart and communicates
with other professionals regarding the patient’s family
c. Postoperative discussions, working with physical therapy departments, and
counseling
d. Counseling/coordinating care that dominates more than 50% of the time with a
patient
42. Panel tests in the Pathology and Laboratory section of the CPT book include all the codes
listed with the panel description. When a panel is performed and additional
pathology/laboratory tests are completed how should those additional tests be reported?
a. All tests are bundled when performed with a panel
b. Reporting additional tests is up-coding and could flag an audit that always leads to
financial penalties
c. Both a and b
d. The additional test should be reported separately in addition to the panel code
43. True or False: Moderate conscious sedation is included or “bundled” in codes listed in
Appendix G.
a. True
b. False
44. A patient presents for an incision and drainage of a pilonidal cyst. What is the correct code
for these services?
a.
b.
c.
d.
10060
10061
10080
10081
9
45. Heather presents for removal of three benign sebaceous cysts. The first lesion excised from
her leg is three cm (which requires a four cm incision). The second lesion excised from her
abdomen is five cm (which required a 5.5 cm incision). The third lesion excised from her
scalp is 0.5 cm (which required a one cm incision). The physician performed intermediate
layered closure to the wound on her abdomen. The other wounds were repaired by simple
closure. What are the correct code(s) for these services?
a.
b.
c.
d.
12032, 11406-59, 11403-59, 11420-59
12032, 11406-51, 11403-51, 11420-51
12032, 11406 x 2, 11402
12032, 11406-51, 11403-59, 11420-59
46. A splinter is removed from the subcutaneous tissue of a patient’s index finger through an
incision made by the physician. The medical record states that this was a complicated
procedure. How should the physician code this procedure?
a.
b.
c.
d.
10121
10120
11010
11011
47. On January 31st, Barbara had a two cm malignant lesion excised from her left foot. During
a postoperative check-up on February 2nd, a residual tumor was noted at the margin of the
original excision and the margins were re-excised. The re-excision included a three cm
excised diameter. How would the same physician code the re-excision?
a.
b.
c.
d.
11622, 11623-59
11626
11623-59
11623-58
48. Dr. Smith completed an extensive debridement due to infected skin. The patient was an 18year-old who was fully cooperative. The debridement included 13% of the total body
surface including portions of his abdominal wall. How would you code Dr. Smith’s
services?
a.
b.
c.
d.
11005, 11001-59
11000, 11001-52
11000, 11001
11005
10
49. Dr. Faye, a dermatologist specializing in Mohs, completed surgery on Howard’s right thigh
for an ill-defined skin cancer. Dr. Faye is acting as both the surgeon and pathologist for this
surgery. The surgery consisted of nine excised specimens prepared and examined during
stage one. Additionally, a total of seven excised specimens were prepared and examined
during stage two. How would you code Dr. Faye’s services?
a.
b.
c.
d.
17304, 17310-59
17304, 17305, 17310 x 6
17304, 17305-58, 17310-58
17304, 17305
50. A patient presents to the dermatologist’s office to have six benign foot lesions removed.
The dermatologist destroys these lesions by use of electrosurgery. How should the office
code these services?
a.
b.
c.
d.
17000, 17003-59
17004
17000, 17003 x 5
17000, 17003
51. Gavin, a 39-year-old male patient, underwent a mastectomy for gynecomastia. His
recovery was uneventful. What is the correct code to report the mastectomy?
a.
b.
c.
d.
19140
19160
19499
None of the above
52. A diabetic patient presents to Dr. Willard’s office with a severe infection of the left great
toenail. The patient requires a complete simple avulsion of the left great toenail plate.
During the exam the patient is found to have infection of two additional toenails, which
require partial simple avulsion. Digital blocks were used for this procedure. How should
you code Dr. Willard’s services?
a.
b.
c.
d.
11730, 11732 x 2, 01462
11730-TA, 11732 x 2
11730 x 3, 01462
11720
53. True or false: The procedures used for skeletal and skin traction are the same.
a. True
b. False
11
54. A surgeon performed a radical resection of both a malignant tumor from the soft tissue of
the scalp and a malignant tumor of the mandible. A bone graft was completed during the
same surgical session to the mandible. How would the surgeon code this procedure?
a.
b.
c.
d.
21015, 21215-51, 21045-51
21015, 21045-59, 21215-51
61501, 21045, 21215
61501, 21045-59, 21215-51
55. Dr. Rami, an orthopedic surgeon, removed prosthesis from Cindy’s left knee. Dr. Rami
inserted a spacer during the same surgery. How would you code for Dr. Rami’s services?
a.
b.
c.
d.
27445-LT
27310
27331
27488-LT
56. During a postpartum check-up, Kayla told Dr. Terry, her OBGYN, about a recurrent lump
on her right wrist. Kayla has a history of ganglion cysts on both wrists. Dr. Terry refers
Kayla to Dr. Eagen, a general surgeon, who excises the cyst. How would you code Dr.
Eagen’s services?
a.
b.
c.
d.
25112-RT
26160
25111
All services are included in postpartum care and should not be reported separately
57. A patient has been diagnosed with Treacher-Collins Syndrome. A surgeon performs LeFort
II to reconstruct the midface by anterior intrusion. How would you code for the surgeon’s
services?
a.
b.
c.
d.
21150-22
21141
21150
21151
12
58. Bart’s jaw needs to be set back. He consults with Dr. Todd, an orthopedic surgeon, and is
scheduled for the recommended procedure. Dr. Todd reconstructs the mandibular rami by
sagittal split with internal rigid fixation. She uses a saw to cut the mandible bone along the
inside, top, and outside surfaces. Then, she uses osteotomes to pry the mandible bone apart
along cuts in the sagittal plane. Once separated, she moves the mandible into the desired
position and stabilized the bone with screws. She repairs a one cm incision site of the skin
and mucosa membranes with sutures. How would you code for Dr. Todd’s services?
a.
b.
c.
d.
21196, 13131-51
21195
21196
21196, 12001
59. What code(s) would be used to report the transfer of tendons to restore intrinsic function on
all four fingers on the left hand with layered closure?
a.
b.
c.
d.
26498, 12041
26492
26498 x 4
26498-LT
60. Judy noticed swelling in both her hips. She is referred to Dr. Roy, an orthopedic surgeon,
who performs a fasciotomy on both hips. Prior to surgery, Dr. Roy obtains the patient’s
permission to have a resident observe the surgery. What is the correct code for Dr. Roy’s
services?
a.
b.
c.
d.
27025 x 2
27025-50
27025
27025-80
61. Zachery injured his back while playing tennis; his injury required surgery. He was taken to
the operating room where an orthopedic surgeon preformed an anterior osteotomy,
including diskectomy to three thoracic vertebral segments. Additionally, Zachery required
a structural bone graft obtained from a cadaver. How would you code this procedure?
a.
b.
c.
d.
22222, 22226 x 2, 20931
22226, 22222, 20931-51
22216, 22212, 20938
22212, 22216 x 2, 20938-51
13
62. A patient noticed a mass on his neck. He was referred to a general surgeon who determined
that the mass was a five cm soft tissue lipoma. The surgeon took the patient to the
operating room and removed the lipoma. The surgeon dictated in the operative report that
the procedure was deep. How would you code the surgeon’s services?
a.
b.
c.
d.
21556
21555
21556, 15819-51
21555, 15819-59
63. A bronchoscopy is
a.
b.
c.
d.
always a surgical procedure
always a diagnostic procedure
sometimes performed unilaterally or bilaterally
always performed bilaterally
64. Which code would be used to report a complete, primary, reshaping of the external nose
with elevation of the nasal tip?
a.
b.
c.
d.
30450
30410
30400
None of the above
65. Riley suffers from recurrent sinus infections. He underwent the following procedure to
remove pus from the right sphenoid sinus. His physician entered the sphenoid sinus
through the sphenoethmoidal recess in the superior nasal cavity. A flexible cannula was
inserted into the opening and the right sinus was irrigated with saline solution. What is the
correct code for this procedure?
a.
b.
c.
d.
31002-RT
31000-RT
31299
31002-50
66. True or false: The following coding combination 31526, 69990 are correct if reported
together?
a. True
b. False
14
67. How is an endoscopic diagnostic bronchoscopy coded if it is performed by the same
physician during the same session as a surgical bronchoscopy?
a.
b.
c.
d.
31622
31624
31625
Surgical bronschoscopy includes a diagnostic bronchoscopy when performed by the
same physician in the same session.
68. Mr. Garrett was seen by his cardiologist, Dr. Kelly. During the examination, Dr. Kelly
talked with Mr. Garret and his family about the need for a pacemaker and its benefits for
Mr. Garret’s condition. Mr. Garrett was scheduled for the procedure the following day. Dr.
Kelly inserted a permanent pacemaker, pulse generator, and placed a transvenous electrode
in the ventricle. What code indicates this service?
a.
b.
c.
d.
33207
33298
33210
33220
69. Polly had the battery changed for her single chamber permanent pulse generator, which
was inserted one year ago. This procedure was completed in the same session by the same
provider. How should the provider’s services be coded?
a.
b.
c.
d.
33233, 33212-59
33233, 33212-51
33234, 33213-59
33234, 33213-51
70. A physician performed an open biopsy of four deep cervical lymph nodes. How should the
office code this service?
a.
b.
c.
d.
38510 x 4
57500
38510
38500
15
71. A physician performs a lymphangiography bilaterally to the extremities. She also provides
the radiological supervision and interpretation for this procedure, which was completed in a
hospital setting. How would you code the physician services?
a.
b.
c.
d.
35000, 75801
38792, 78195
38790-50, 75803-26
38790-50, 75801-26
72. A physician performs a transluminal balloon angioplasty of the left iliac by inserting a
catheter through the skin. The balloon is inflated several times during this procedure. The
physician did not provide the radiological supervision and interpretation with this
procedure. Which code indicates this service?
a.
b.
c.
d.
35454
35473
35482
35492
73. Dr. Barns excised a four cm esophageal lesion with primary repair. To excise the lesion Dr.
Barns made an upper midline abdominal incision to access the esophagus. The surgical site
was closed with two layers of sutures. What code(s) indicate this service?
a.
b.
c.
d.
43116, 21720
43101, 11424-59, 12042-51
43116, 69990
43101
74. A patient presents with gastroesophageal reflux disease. To treat this disorder, the surgeon
performs a laparoscopic Nissen procedure. A diagnostic laparoscopy was completed during
the same session. What code(s) indicate this service?
a.
b.
c.
d.
43280
43289
43324
43280, 43324-52
16
75. A physician performs a V-excision of the lip with primary direct linear closure. This
procedure was completed to remove a lesion. What code(s) describe these services?
a.
b.
c.
d.
40510, 40520-51
40520
40510, 40525-51
40530
76. Sam, a healthy 32-year-old male, is scheduled for surgery. He has no systemic diseases,
doesn’t smoke, and regularly exercises. He is prepped and taken into the operating room.
The surgeon performs an endoscopic retrograde cholangiopancreatography with
endoscopic retrograde insertion of nasobiliary drainage tube. Within the same operative
session, the surgeon also performs a sphincterotomy. How would you code this service?
a.
b.
c.
d.
43267-P1
43260, 43267-51, 43262-51
43267, 43262-51
43262
77. A physician performs a Billroth II procedure, partial distal gastrectomy with
gastrojejunostomy, and a vagotomy. Which codes capture these services?
a.
b.
c.
d.
43631, 43635
43631, 43635-51
43632, 43635
43632, 43635-51
78. True or false: The following is an example of a correct code combination: The placement
of a nasogastric tube is reported with Evaluation and Management (E/M) critical care code.
a. True
b. False
17
79. Garret is diagnosed with ulcerative colitis. He is referred to a surgeon, Dr. Brown. He
performs a continent ileostomy as treatment. What code(s) captures this service?
a.
b.
c.
d.
44316
44310
44316, 44320-59
44799
80. Jim presents to Dr. Martin’s office with severe abdominal pain. Dr. Martin has not made a
definitive diagnosis. He schedules Jim for diagnostic laparoscopy that same afternoon. Dr.
Martin begins the operation with a diagnostic laparoscopy. He notices Jim has a vermiform
appendix. Dr. Martin removes the appendix laparoscopically. The final diagnosis is appendicitis.
What code(s) capture these services?
a.
b.
c.
d.
44950, 49320-51
49320
44970
44970, 49320-51
81. Dr. Mist performed the following procedures on a patient: a flexible diagnostic colonoscopy
with collection of eight specimens by brushing in the morning. Later the same day, the patient
had a diagnostic upper gastrointestinal endoscopy (EGD), including the esophagus, stomach, and
the jejunum with transmural drainage of a pseudocyst. These procedures were not staged or
related and occurred during different sessions. What codes capture these procedures?
a.
b.
c.
d.
45380 x 8, 43240-58
43239 x 8, 44388-59
45378, 43240-59
45355, 43235-59
82. Dean lost his teeth in an auto accident one year ago. He has had several facial surgeries to
restore his nasal functionand rebuild the orbit of his eye and cheek. Currently, he is scheduled for
a posterior complex vestibuloplasty with muscle repositioning. What code(s) capture the current
procedure?
a.
b.
c.
d.
40845
40843-52
40842, 40845
40899
18
83. A physician inserts a catheter into a renal abscess under radiologic guidance. The physician
then drains the abscess. The procedure was performed at the hospital. How should the
physician’s services be coded?
a.
b.
c.
d.
50020, 75989-26
50021, 75989-26
50021, 75989-TC
50020, 7598-TC
84. Mary underwent a bilateral vulvecomy with removal of 92% of the vulvar area. She also had
an inguinofemoral lymphadenectomy during the same operative session. What code(s) capture
these services?
a.
b.
c.
d.
56637-50
56637
56632
56625, 38760
85. A physician performs laser vaporization of the prostate with a vasectomy. The patient had
some postoperative bleeding that was controlled at the time of the procedure. What code(s)
capture this service?
a.
b.
c.
d.
52648
52601, 52648-51
52647-22
52601, 52448-51, 54162-59
86. A patient had a percutaneous cryoabliaton of two renal tumors. What code captures
this service?
a.
b.
c.
d.
53889
50592 x 2
0135T
50592-50
19
87. Cheryl is a 36-year-old established patient with Dr. Winn, an OBGYN. During Cheryl’s
annual physical examination, Dr. Winn noticed lesions on the perineum. After completing the
annual exam, Dr. Winn biopsies five lesions on the perineum. How should his office code the
service for the biopsy?
a.
b.
c.
d.
56605, 56606 x 4
99395, 56605, 56606 x 4
56606, 56606-51
99395, 56606, 56606-59
88. Mr. Bill has urinary incontinence. The urologist performs an anterior vesicourethropexy to
correct the incontinence. The physician documented that this was a complicated repair. What
code captures this service?
a.
b.
c.
d.
51840
51841
53440
53899
89. Dr. Joyce performs a bilateral corpora cavernosa-saphenous vein shunt. Select the correct
code(s) for this procedure.
a.
b.
c.
d.
54420
54420-50
54420, 54420
54430
90. True or false: A total abdominal hysterectomy and an oophorectomy performed within the
same surgical session should be reported separately.
a. True
b. False
91. A surgeon performed a complete transurethral resection of the prostate. During this surgical
session, a meatotomy was also performed. What code(s) capture these services?
a.
b.
c.
d.
52601, 53020-51
52612
53020
52601
20
92. How would Dr. Jay report her services for an injection procedure for retrograde
urethrocystography with radiological supervision and interpretation? She completed this
procedure in a hospital surgical suite.
a.
b.
c.
d.
51610
51610, 74430-26
51605, 74450-26
51610, 74450-26
93. Mrs. Jones is pregnant with twins. She has been with the same obstetrician, Dr. Green, for
her entire pregnancy. Now, Mrs. Jones is ready to deliver. Dr. Green helps Mrs. Jones deliver her
twins vaginally. What are the correct codes for these services?
a.
b.
c.
d.
59400, 59400-51
59400-22
59610-22
Both b and c
94. Todd was in a motorcycle accident. He suffered multiple fractures and lacerations. During
one surgical session, a surgeon elevated a depressed skull fracture. This procedure required
repair of the dura. What code(s) capture these services?
a.
b.
c.
d.
62010
62000
62005
62005, 6210
95. A physician obtains corneal tissue from an eye bank and sizes the tissue for transplant. The
physician then performs a lamellar keratoplasty. He removes the anterior layer of the diseased
cornea and replaces it with the prepared donor tissue. What are the correct codes for these
services?
a.
b.
c.
d.
65710
65755
65426, 20926-62
65710, 68371
96. A physician removed lens material for a cataract patient using an intracapsular technique and
injected saline to restore intraocular pressure. What code(s) correctly capture these services?
a.
b.
c.
d.
66930
66920
66920, 66020
66930, 66020
21
97. Fred, a 45-year-old patient, suffered a profound hearing loss due to an industrial accident and
had a cochlear device implanted without a mastoidectomy. The surgeon used an operating
microscope during this procedure. What are the correct code(s) for this service?
a.
b.
c.
d.
69930, 0073T
69930-50
69930, 69990
69930, 69990-51
98. Mr. Keller had a six cm neoplastic lesion at the base of the anterior cranial fossa excised. The
lesion was not connected to the dura matter. Dr. Roberts, a neurosurgeon, excised the lesion. Dr.
Reed preformed an extradural craniofacial approach to the anterior cranial fossa without orbital
exenteration. What is the correct code for the excision procedure?
a.
b.
c.
d.
61580, 61600-51
61600, 61580-58
61580
61600
99. A physician repairs a retinal detachment by depressing a hot probe over the outer layer of the
eyeball to seal the choroid to the retina. A scleral buckle is placed around the eyeball to support
the healing scar. What code captures this service?
a.
b.
c.
d.
67101
67015
67112
67107
100. Today, Terri had a re-exploration procedure of the thoracic region of her spine. This
procedure is rarely preformed, but has FDA approval. Terri has signed extensive consent forms
and understands the risks involved. She and her surgeon believe this procedure might offer her
pain relief. What is the correct code for this service?
a.
b.
c.
d.
64999
63003-52
63046
63271
22
101. Two-year-old Bobby was running through the house with a Popsicle when he fell, suffering
a three cm partial thickness laceration to his left upper eyelid. This injury involved the lid margin
and tarsus. Bobby was taken to an emergency room by his parents and the physician did a direct
layered closure. How would you code the physician’s service?
a.
b.
c.
d.
12052-E1
12002-LT
67935-E1
67930-E1
102. A physician excised multiple chalazions on bilateral eyelids. The procedure required
general anesthesia. At the same session, the physician excised another non-chalazion lesion on
the right eyelid, which required simple closure. What codes correctly capture the surgeon’s
services?
a.
b.
c.
d.
67808, 67805-51, 67840-51
67808-50, 67840-59
67805-50, 67808-50, 67840-59
67808, 67850-51, 67840-51, 11310-51
103. A patient under general anesthesia had a meatoplasty secondary to congenital atresia with
simultaneous tympanostomy. What code(s) correctly capture this service?
a.
b.
c.
d.
69310, 69433-59
69320, 69436-51
69631
69641, 69433
104. Dr. Todd, a primary care physician, examines Keith for a cough producing phlegm, a low
grade fever, and a headache. Keith has been a patient of Dr. Todd’s for several years. Keith had
knee surgery by an orthopedic surgeon less than a week ago. He was checked by his orthopedic
surgeon one day ago and is healing well from the procedure. His surgeon suggested that he see
his primary care physician regarding his other symptoms. Dr. Todd documents an expanded
problem-focused history and examination, decision-making of low complexity, with a
diagnosis of recurrent bronchitis. What code captures Dr. Todd’s service?
a.
b.
c.
d.
99213-24
99214
99213-59
99213
23
105. Mr. Fisher was referred by his internist to a surgeon’s office for a consultation regarding
hemorrhoids. The surgeon noted the request for consult in his medical record and sent a letter
back to the referring physician. The surgeon completed a detailed history, detailed
examination, and low decision-making. The surgeon recommended medical treatment and
prescribed two different ointments and an oral medication. He suggested re-evaluation if the
hemorrhoids caused Mr. Fisher problems in the future or if he continued to have active
symptoms. What code correctly captures the surgeon’s services?
a.
b.
c.
d.
99243
99241
99203
99214
106. Dr. Lyon was called to the critical care burn unit to see a 50-year-old patient who suffered
third-degree burns to 30% of her body. Dr. Lyon spent two hours and 40 minutes with this
patient, her family, and coordinating care with other specialists. He made several phone calls
from the unit on her behalf and consulted with the nursing staff. During this time, Dr. Lyon
provided ventilator management and gastric intubation. What codes correctly capture Dr.
Lyon’s services?
a.
b.
c.
d.
43752, 94656, 99291 x 1, 99292 x 3
99291 x 1, 99292 x 3
99291 x 2, 99292 x 2
43753, 94656-51, 99291 x 1, 99292 x 3
107. Edna, an 80-year-old patient, had a stroke with late effect hemiplegia to her dominant
side. She was transferred from the hospital to a nursing facility. Dr. George, an internist, is
called to see Edna and provides a multi-system examination, comprehensive history, and
reviews an extensive amount of data. She documents the high risk of complications due to
extensive medications and management of multiple systemic diseases. Dr. George talks with
the multidisciplinary rehabilitation team regarding Edna’s physical activities; including a plan
for physical therapy. What are the correct codes for Dr. George’s visit?
a.
b.
c.
d.
99306, 438.21
99306, 342.91
99305, 342.92
99306, 438.22
24
108. Alex moved back to the area after being out-of-state for six years. He returns as a patient
to Dr. Ben, his previous internist. Dr. Ben sees Alex in the office for an evaluation of his
asthma. Dr. Ben documents a detailed history, detailed examination, and decision-making of
low complexity. Several hours after Alex left the office he returns because he is having
difficulty breathing and has hives after using his new inhaler. Dr. Ben admits Alex to the
hospital. He dictates a comprehensive history, comprehensive examination, and high decisionmaking in the admission report. Additionally, Dr. Ben instructs his staff to fax a copy of his
office note to include in the hospital record for admission. What code(s) correctly capture Dr.
Ben’s service?
a.
b.
c.
d.
99203
99203, 99223
99223
99203-25, 99222
109. A healthy 22-year-old female is seen for her annual examination. She is new to this clinic
and this physician. She is taking no medication, has no family history of systemic disease, and
states that she is smoking but trying to stop. During her annual exam she asks the physician to
look at a mole on her upper right arm that has changed in appearance. The physician works up
the mole, taking an additional problem-focused history, problem focused examination, and
documenting straight-forward decision-making. The physician instructs her to watch the mole
carefully and report any further changes. What code(s) correctly capture this encounter?
a.
b.
c.
d.
99285
99385-25, 99201
99385, 99201-25
99203
110. Two weeks ago Mrs. Randy, a 62-year-old insulin dependent diabetic, trimmed her
toenails and cut the skin around her right great toe. She tried to keep the wound clean and
applied over-the-counter antibiotic cream for several days before the pain and inflammation
was too severe to wear shoes. Today, Dr. French admitted Mrs. Randy to the hospital. Dr.
French requested a consult from Dr. Wells, a surgeon, regarding possible amputation of the
toe. Dr. Wells saw Mrs. Randy and provided a comprehensive history, comprehensive
examination, and moderate decision-making. Her documentation included the request for
consult and a written statement back to Dr. French. After the toe was amputated Mrs. Randy
healed without further complications and was discharged by Dr. French. It took Dr. French
more than an hour to complete the discharge visit. What code(s) correctly capture the
discharge?
a.
b.
c.
d.
99254-25, 28820
99239
99239 x 2
99223
25
111. Donald’s family requested a consultation for a second opinion with Dr. Polson, an
oncologist. The family completed extensive research on the Internet and looked for an opinion
regarding a new type of lung cancer treatment. Donald’s current physician has recommended a
surgical and chemotherapy treatment approach to the metastasis of the lung. Dr. Polson has not
seen Donald in the past and evaluates him for throat and bilateral lung lesions. Dr. Polson
documented a comprehensive examination, comprehensive history, and reviewed extensive
management options, extensive data, and the high risk of complications and mortality. Dr.
Polson spends 90 minutes face-to-face with the patient, then an additional 45 minutes with the
patient and his family explaining their options. What codes correctly capture Dr. Polson’s
services?
a.
b.
c.
d.
99205, 99354
99245, 99354
99215, 99354-25
99255-21
112. Lilly, a 36-year-old female, made an appointment to talk with her physician about
prevention of sexually transmitted diseases including HIV. She saw the same physician three
months ago for a complete physical. She is asymptomatic at this time but has engaged in some
high-risk behavior. During this visit, Lilly discussed diagnostic and laboratory test results,
family issues, substance abuse, and sexual practices. The visit lasted 30 minutes. What code
correctly captures this encounter?
a.
b.
c.
d.
This service is bundled with the next office visit
99395
99078
99402
113. Dr. Parrish, a pediatrician, continues to follow Rachel, who is not critically ill but requires
intensive cardiac and respiratory monitoring, frequent checks of her vital signs, nutritional
adjustments, and oxygen monitoring. Rachel is 32-days-old with a current weight of 3,200
grams. Dr. Parrish saw Rachel three separate times on Tuesday. What code correctly captures
Tuesday’s services?
a.
b.
c.
d.
99294
99296
99300 x 3
99300
114. True or false: Pediatric critical care patient transport includes chest x-rays, cardiac output
measurement, and insertion of a biventricular pacing device.
a. True
b. False
26
115. A 25-year-old female presented to a physician’s office complaining of persistent
abdominal pain. This patient is new to this practice and this physician. The physician took a
comprehensive history and performed a comprehensive examination. Medical decision-making
was of moderate complexity. The physician spent approximately 50 minutes with the patient.
The physician spent 15 of those minutes counseling the patient on dietary changes. What code
correctly captures this encounter?
a.
b.
c.
d.
99205
99214
99204
99215
116. When does anesthesia time begin and end?
a. Time begins when the anesthesiologist begins to prepare the patient for the induction
of anesthesia in the operating room or in an equivalent area. Time ends when the
anesthesiologist is no longer in personal attendance and when the patient may be
safely placed under postoperative supervision.
b. Time begins when the anesthesiologist begins to prepare the patient for induction of
anesthesia in the operating room or chair side in a waiting area. Time ends when the
patient can respond to simple questions.
c. Time begins when the anesthesiologist starts to prepare the patient for induction of
anesthesia in the operating room or in an equivalent area. Time ends when the
anesthesiologist leaves the operating room.
d. Time begins when the patient is considered “under” anesthesia and ends when the
surgery site is closed.
117. An anesthesiologist administers general anesthesia to a one-year-old healthy patient
undergoing a mediastinoscopy. What code(s) capture the anesthesia services?
a.
b.
c.
d.
00528-P1, 99100
00528, 99100-P1
00528
00528-P1
118. Anesthesia is administered, by an anesthesiologist, to a female patient with severe
systemic disease. She is scheduled to deliver via Cesarean section. The anesthesia is for the
delivery only. The delivery is uneventful with a healthy mother and baby at the end of the
procedure. What code(s) correctly capture the anesthesia services?
a.
b.
c.
d.
01961-P3
00850
01961-P2, 99100
01962
27
119. A five-year-old patient lacerated his forehead. He presents to the emergency room with
his parents. It is determined that the patient will need multiple sutures to repair the wound. The
patient has Down’s syndrome and is unable to cooperate with the medial staff. His parents
consent to general anesthesia for the wound repair. After general anesthesia intermediate
sutures are completed to repair the six cm wound. What code(s) correctly capture this service?
a.
b.
c.
d.
00190-23
12053-23
12053, 00190
00200-P1, 99100
120. Dr. Nicholas performed a diagnostic rigid esophagoscopy to a 72-year-old patient with
mild hypertension. This service was completed in Dr. Nicholas’s office. He administered
moderate conscious sedation. The intra-service time was 60 minutes. What code(s) capture the
physician’s services?
a.
b.
c.
d.
43200, 99144, 99145 x 2
43200-P2, 99100
43200-23
43200
121. A patient presents to the hospital with an embedded piece of wood in his left shoulder.
The patient stated that he was cutting down a tree when a limb fell and punctured his shoulder.
Dr. Weber, a surgeon, administered general anesthesia for removal of a foreign body to a
patient shoulder. What code captures the surgeon’s services?
a.
b.
c.
d.
23330-22
00450-P1
23330-47
00450-47
Radiology—Nine Questions
122. Dr. Jones owns the x-ray equipment in his office and serves as the employer to the
technologist. He ordered a three-view film of Paula’s zygomatic bone. He reviewed the films
and dictated a report while she was in the office. What code captures Dr. Jones’ services?
a.
b.
c.
d.
70150-26
70150
70150-TC
70150-52
28
123. Dr. White ordered an MRI of Jerry’s pelvis without contract. Jerry went to the local
outpatient imaging center for this study. The MRI was completed and read by a radiologist at
the imagining center. A complete report was sent back to Dr. White. What code captures the
radiology service?
a.
b.
c.
d.
72196
72195
72195-26
72198
124. Becky reported to her physician’s office after feeling a lump in her right breast. Dr. Sarah
had the results of Becky’s last screening mammography, which did not show any changes. Dr.
Sarah completed an exam and detected a lump in the right breast and abnormal changes in the
left breast. After a complete work-up Dr. Sarah ordered a bilateral diagnostic mammography
with computer aided detection. What code(s) correctly capture the mammography?
a.
b.
c.
d.
76090, 76092
76092, 76083
76091, 76082
0060T
125. A 45-year-old female patient had abdominal pain for several days. She had a
hysterectomy one year ago with no complications. During her office visit she had a complete
pelvic ultrasound. What code correctly captures this ultrasound?
a.
b.
c.
d.
76801
76816
76857
75856
126. Mr. Fredrick is in his second phase of radiation treatment for stomach cancer. Today, he
reports to the cancer treatment facility for his regularly scheduled treatment. He is given seven
MeV to a single area that requires a single port and a simple block. How should the facility
report this service?
a.
b.
c.
d.
77413 x 7
77408
77403
77408-TC
29
127. Tiffany is pregnant with twins after a successful IVF treatment. She is in her first
trimester of pregnancy. Her physician completed a transabdominal follow-up ultrasound to
evaluate the fetal size of both babies and review a suspected abnormality from a previous
ultrasound. What code(s) correctly capture this service?
a.
b.
c.
d.
76816, 76816-59
76816 x 2
76801, 76802 x 2
76811, 76812
128. What code best describes a CT scan of the abdomen with oral contrast?
a.
b.
c.
d.
74175
74170
74150
74160
129. Dr. Hernandez preformed an arthrography injection of the temporomandibular joint
(TMJ). He also completed the radiological supervision and interpretation for this procedure.
The procedure was completed in a hospital. What code(s) correctly capture Dr. Hernandez’s
services?
a.
b.
c.
d.
21116, 76003-26, 70332-26
70322-26
21116, 70332-26
21116
130. Which of the following statements are true regarding radiology services?
a. There is not a subsection for clinical treatment planning in the radiology section
b. Modifier -59 is never appended to codes in the 70000 series of codes
c. For spine examinations using computed tomography, magnetic resonance imaging,
magnetic resonance angiography, “with contrast” includes intrathecal or intravascular
injection
d. Special reports for radiology services never include complexity of symptoms, final
diagnosis, follow-up care, concurrent problems, pertinent physical findings, or
diagnostic and therapeutic procedures
30
Pathology/Lab—10 Questions
131. Dr. Bob verbally requested Dr. Heinz, a clinical pathologist, to provide a consultation for
one of his patients. Dr. Heinz provided a comprehensive consultation with review of the
patient’s history, medical records, and sent a written report back to Dr. Bob. Which code
correctly captures Dr. Heinz’s services?
a.
b.
c.
d.
80502
88321
88323
99255
132. Dr. Shaw performed an electrolyte panel on automated equipment in her office. The tests
she includes in this battery are sodium, potassium, chloride, carbon dioxide, and glucagon
tolerance test. How should she report these services?
a.
b.
c.
d.
82374, 82435, 84132, 84295, 82946
80051, 82946
80051
80053-52
133. A patient has been taking Digoxin, per his prescription, for several weeks. Two days ago
he ran out of his medicine and stopped. He knew he had an appointment with his physician and
decided to wait until his next checkup to get a new prescription. His physician ordered a
quantitative drug essay to check the therapeutic level of Digoxin still present in the patient’s
blood. What code correctly captures this service?
a.
b.
c.
d.
80100
80102
80101
80162
31
134. A patient presents to the hospital for a scheduled procedure to remove suspicious lesions
from the right side of her neck. The surgeon excised one lesion near the anterior portion of the
mandible, the second near the clavicle bone. A pathologist received two separately labeled
containers, container A-mandible, and container B-clavicle. The surgeon requests a consult
during surgery for immediate diagnosis. The pathologist examines each specimen, taking two
blocks from specimen A and three blocks from specimen B. Specimen A is further processed
into two frozen sections and B into five frozen sections. The blocks are examined
microscopically. What codes correctly capture the pathologist’s services?
a.
b.
c.
d.
88331, 88332-26 x 2
88331-26 x 2, 88332-26 x 3
88331, 88332 x 7
88329, 88331-47, 88332-26 x 2
135. Which CPT code describes a lab test for Prostate specific antigen (PSA); total?
a.
b.
c.
d.
86316
84154
84153
84152
136. A 22-year-old female presents in the emergency department in a coma. Her friends tell the
attending physician they were drinking and saw her take a couple of pills before she passed
out. She has a history of depression and anxiety and is being treated with prescription
medication. The physician orders a drug screen for alcohol, tricyclic antidepressants, opiates,
and barbiturates. The lab completes a single drug class screening for each analyte by means of
immunoassay methods. What code(s) correctly capture the lab services?
a.
b.
c.
d.
80100 x 4
80101 x 4
80102
80100, 80101-59 x 2
137. Which code range describes Bethesda System cytopathology?
a.
b.
c.
d.
88160–88162
88199–88299
88241–88143
88164–88167
32
138. Dr. Kim performed a fine needle aspiration of deep tissue under radiological guidance.
Two specimens were sent to the hospital laboratory for cytopathology evaluation to determine
adequacy of the specimens gathered. What code(s) correctly capture the lab services?
a.
b.
c.
d.
88173
88172
88173, 88333-91
88712 x 2, 88334-59
139. A breast biopsy was submitted for surgical pathology gross and microscopic evaluation of
the surgical margins. A comprehensive examination and report was completed on the
specimen. What code(s) correctly capture the laboratory services?
a.
b.
c.
d.
88307
88307, 88331, 88323-26
88305
88305, 88331, 88323-26
140. True or false: Venipuncture is a procedure to collect a specimen.
a. True
b. False
Medicine—10 Questions
141. The Medicine section of CPT has which of the following unlisted services or procedures?
a.
b.
c.
d.
99499, 90779, 96999, 68899
90779, 93799, 96999, 99600
99199, 99499, 96999, 99600
90779, 93799, 96999, 49999
142. Mr. North presented for his weekly therapeutic visit with his physician. During this visit
Mr. North had a comprehensive computer-based motion analysis study with videotaping and 3D kinematicis, with dynamic plantar pressure measurements during walking. This study was
completed to assist with major therapeutic decision-making for continued gait training and
rehabilitation after a stroke. What code(s) should correctly capture this procedure?
a.
b.
c.
d.
96001
99214, 96000
97116
97116, 96001-59
33
143. Dr. Edit preformed a percutaneous left heart catheterization with injection procedures for
coronary angiography and left ventriculography. Dr. Edit also completed the imaging
supervision interpretation and report. This procedure was completed in a hospital setting. How
should Dr. Edit code his services?
a.
b.
c.
d.
93527, 93543, 93545, 93555-26, 93556-26
93510, 93543-23, 93545-22, 93555-51, 93556-26
93510, 93543, 93545, 93555-26, 93556-26
93511, 93543-51, 93545-51, 93555, 93556
144. Jeffery, a six-year-old established patient, was given a measles, mumps, rubella, and
varcella (MMRV) vaccination. This vaccination was completed the same day as his regularly
scheduled annual pediatric checkup. The physician completed all necessary paperwork and
examination for Jeffery. The physician provided face-to-face counseling with Jeffery’s mother,
while she was in the exam room with Jeffrey. The physician stayed in the exam room during
the vaccine administration to continue to answer questions. What codes correctly capture the
physician’s services?
a.
b.
c.
d.
90704, 90707, 90708
99213, 90471, 90710
99393, 90710, 90465
99383, 90710, 90465, 90466-51
145. Which services are included with hydration, therapeutic, prophylactic, and diagnostic
injections and infusions (excluding chemotherapy)?
a. Use of local anesthesia, IV start, access to indwelling IV, subcutaneous catheter
or port
b. Flush at conclusion of infusion
c. Standard tubing, syringes, and supplies
d. All of the above
146. A physician performed a spirometry graphic record, timed vital capacity, and expiratory
flow rate measurements with maximal voluntary ventilation. What code captures this service?
a.
b.
c.
d.
94010
94014
94016
94015
34
147. Joe, a 42-year-old construction worker, had hot packs applied to his knee and elbow and
ultrasound for 30 minutes. He is scheduled to have eight physical rehabilitation sessions to help
eliminate pain in his knee and elbow suffered when he fell from a ladder. This is his second
visit and reports some relief. What codes correctly capture these services?
a.
b.
c.
d.
97010 x 2, 97035
97010, 97035 x 2
97014, 97035
97010 x 2, 97035 x 2
148. Madison was attending a soccer camp when she complained of fatigue, dizziness, and a
headache. Her mother took her to Dr. Boyle’s office for a checkup that afternoon. Dr. Boyle
completed an expanded problem-focused history and examination, and then determined that
Madison was dehydrated. Madison received five hours of IV infusion. What codes capture
these services?
a.
b.
c.
d.
99203, 90760 x 2, 90761 x 2
99213, 90760, 90761 x 4
90760, 90761 x 4
99223, 90760 x 2, 90761 x 2
149. According to the CPT manual ophthalmology services are defined by which of the
following terms?
a.
b.
c.
d.
Intermediate, comprehensive, and special
Brief, intermediate, and extensive
Limited, intermediate, and advanced
Extensive, advanced, and enormous
150. A patient with known hearing loss in the left ear presents for an audiometry threshold
function test with speech recognition. Calibrated electronic equipment is used for this testing
procedure. What code(s) capture this procedure?
a.
b.
c.
d.
92557-22, 69990
92552-50, 69990
92555-47
92556-52
35
Practice CPC Examination Answers
Section 1
1.
“d” During a sigmoidoscopy, the entire rectum, sigmoid colon and possibly a
portion of the descending colon are examined. You can find this definition in the
digestive system, rectum, and endoscopy sections of the CPT Professional Edition.
2.
“b” Cheiloplasty is a repair of the lip. Refer to the CPT index under cheiloplasty to
find this answer.
3.
“c” Look up the term Lithotripsy, Kidney—there is an illustration listed with this
procedure in the CPT Professional Edition.
4.
“a” Epidermis, dermis, and subcutaneous.
5.
“b” Epiphysis is the end of a long bone. This answer cannot be found in the CPT or
ICD manuals. It is an example of knowing or memorizing terminology to answer a
question.
6.
“b” Hematoma.
7.
“d” You can find a list of fracture descriptions in the ICD-9 Official Guidelines
under fractures.
8.
“d” Hodgkin’s lymphoma is a malignancy of the lymphatic system that is
distinguished from non-Hodgkin’s lymphoma by the presence of Reed-Sternberg
cells. You can answer this question by carefully reading and eliminating statements
that are incorrect. Also, look up Hodgkin’s in ICD-9, which is listed under
malignant neoplasm of lymphatic and hematopoieti tissue.
9.
“a” Memorizing terminology will help you answer this question.
10.
“d” The CPT Professional Edition has a listing of direction and position in the
illustrations section.
11.
“a” You will know this answer if you memorize and study terminology.
12.
“b” The right lung has three lobes: an upper, middle, and inferior (lower) lobe. The
left lung has two lobes: an upper and inferior (lower) lobe. CPT Professional
Edition provides an illustration of the respiratory system.
36
13.
“c” Knowing the correct answer to this question involves studying anatomy and
terminology.
14.
“d” The nervous system can be grouped into two major categories: The central
nervous system (CNS), which is the control center and consists of the brain and
spinal cord, and the peripheral nervous system (PNS), which is subdivided into
several smaller units. The PNS consists of all the nerves that connect the brain and
spinal cord with sensory receptors, muscles, and glands.
15.
“a” The main functions of this system are sensation, protection, thermoregulation,
and secretion.
16.
“b” The CPT Professional Edition has an illustration of an eyeball that would assist
with answering this question.
17.
“a”
18.
“d” Lysis (intestinal) can be found in the CPT Professional Edition in the index
with the word “freeing” in the description.
19.
“b” The suffix—rrhagia—means bleeding, abnormal excessive fluid discharge.
20.
“d” The suffix—necrosis—means death.
21.
“c” The surgical term “centesis” means puncture.
22.
“b” The spinal cord is part of the nervous system, not a part of the musculoskeletal
system.
23.
“b” The question clearly states how the injuries occurred and the place of
occurrence, which makes two E codes necessary.
24.
“d” According to ICD-9 Official Guidelines, Chapter 2 section a, “Treatment
directed at the malignancy—if the treatment is directed at the malignancy, designate
the malignancy as the principal diagnosis.”
25.
“c” ICD-9 Official Guidelines, Chapter 17 c 1, “Sequence first the code that reflects
the highest degree of burn when more than one burn is present.” Additionally, the
guidelines direct that you should code burns of the same local site to the highest
degree recorded. Use Category 948 when there is mention that 20% or more of the
body has third-degree burns.
26.
“c” This question addresses more than one complication of diabetes. Code
diagnoses for each diabetic condition and complication.
37
27.
“a” Codes from Complications of Pregnancy, Childbirth, and the Puerperium in the
ICD-9 Official Guidelines (630-677) have sequencing priority over codes from
other chapters. Check the official guidelines under Chapter 11 for sequencing
priority.
28.
“c” This question deals with a late effect of an injury. To find the correct codes look
up “late effects” in the ICD-9 Official Guidelines and follow to infection, open
wound of head. In Section 3, E codes, look up “late” to find the correct motor
vehicle accident. Section 3, E codes are never reported as a primary diagnosis.
29.
“a” Lung cancer is not coded unless confirmed.
30.
“b” ICD-9 Official Guidelines Chapter 1, (a, 2, b) states, a “patient with HIV
disease admitted for unrelated conditions (such as traumatic injury), the code for the
unrelated condition should be the principal diagnosis. Other diagnoses would be
042, followed by additional diagnosis codes for all reported HIV-related
conditions.” Reporting how and where the injury occurred require two E codes.
31.
“d” Section 2–Table of Drugs and Chemicals of the ICD-9 Official Guidelines
states, “the adverse effect is to be identified by the appropriate code from Section 1,
Index of Diseases and Injuries. An external cause code can then be used to identify
the circumstances involved.” Read the description for Therapeutic use listed in
Section 2.
32.
“c” ICD-9 Official Guidelines Chapter 2, (e, 2), indicate that if a patient presents
solely for chemotherapy/radiation then, “The encounter for chemotherapy, should
be the first-listed or principal diagnosis. If a patient receives both chemotherapy and
radiation therapy services, list both codes, in either order of sequence.”
33.
“b” Notes under code 414.8 read, “Any condition classifiable to 410 specified as
chronic or presenting with symptoms after eight weeks from date of infarction,”
which is the case in this question. You would also code chest pain as well as the
rash.
34.
“a” To find the correct codes, reference the HCPCS Level II Index under
“Prosthesis upper extremity” and “Prosthetic additions upper extremity.”
35.
“d” To find the correct code, reference the HCPCS Level II index under “Tissue”
and then read carefully for number of units.
36.
“b” Notes under code G0105 are specific regarding conditions or diagnoses for
high-risk patients.
37.
“c” Report units when code indicates each.
38
38.
“d” Carefully review codes for route of administration.
39.
“c” Refer to the following codes as examples: Extent of the service, 10121; specific
anatomic site, 20101; alternative procedure, 19325.
40.
“b” The Anesthesia Guidelines and Appendix A of the CPT Professional Edition
provide explanations regarding physical status modifiers.
41.
“a” To find this information, refer to the Evaluation and Management Guidelines in
the CPT Professional Edition under the description of time.
42.
“d” CPT Professional Edition, under the subsection for organ or disease oriented
panel codes, contains guidelines for reporting additional tests.
43.
“a” Appendix G and a bulls-eye symbol were added to the CPT Professional
Edition in 2005 to identify codes that include moderate conscious sedation.
44.
“c” In the absence of documentation that identifies whether the cyst was simple or
complicated, the coder must select the simple code. However, a better course of
action would be to obtain supplementation documentation from the physician that
addresses the question of whether the cyst was simple or complicated.
45.
“d” The layered closure is coded first, presumably the most complex service
provided. Code 12032 describes the total length of the wound that required layer
closure. The excision of the five cm benign abdominal lesion is code 11406 with
modifier -51 “multiple procedure” performed during the same operative session.
Code 11403-59 is used to report the excision of the three cm benign leg lesion,
modifier -59 describes different lesions excised on the same day. Finally, 11420-59
reports the excision of the 0.5 cm benign scalp lesion. Simple closures are bundled.
46.
“a” One way to find this answer is to look in the CPT Professional Edition Index
under: “Removal, Subcutaneous Tissue.” Code 10121 is designated as complicated.
47.
“d” According to the subsection guidelines of the CPT Professional Edition listed
with Excision—Malignant Lesions states, “append modifier -58 if the re-excision
procedure is performed during the postoperative period of the primary excision
procedure.”
48.
“c” 11000 and 11001-52 seems to be the best answer based on a literal reading of
the CPT descriptions of these codes. However, in Principles of CPT Coding, the
American Medical Association states that you should report 11001 for “each
additional 10% of the body surface or fraction thereof.” Based on that
interpretation, the answer would be 11000 and 11001 without a modifier.
39
49.
“b” The CPT Professional Edition guidelines under the subsection for Mohs
Micrographic Surgery state that the physician must act in two capacities: Surgeon
and pathologist. Mohs surgery is not considered a “staged procedure” and does not
require a modifier -58; rather the surgery is completed in stages. Modifier -59
would not be necessary because there are not separate lesions in this question. Use
the add-on code 17310 to fully report each additional specimen, after the first five,
for each stage.
50.
“c” Code 17000 is reported for the first lesion, code 17003 is reported for each
additional lesion, and therefore, five units are necessary.
51.
“a” Code 19140 reports mastectomy for gynecomastia. Taber’s Cyclopedic
Medical Dictionary defines gynecomastia as, “abnormally large mammary glands
in the male; sometimes may secrete milk.”
52.
“b” Modifier -TA describes the left foot great toe. This modifier can be found on
the front flap and Appendix A of the CPT Professional Edition and in Appendix
two of the HCPCS Level II book. This question does not give specific information
about the additional toenails so no other modifiers are necessary to describe these
toes. A digital block is “included” with this procedure—see Surgery Guidelines
under CPT Surgical Package Definition for this information.
53.
“b” CPT guidelines for the Musculoskeletal System provide the following
definitions: “Skeletal traction is the application of a force to a limb segment through
a wire, pin, screw, or clamp that is attached to bone. Skin traction is the application
of a force to a limb using felt or strapping applied directly to skin only.”
54.
“b” Code 21015 reports the radical resection of the tumor in the soft tissue of the
scalp. Code 21045 reports the excision of the tumor, mandible. Modifier-59 is used
to indicate a separate lesion. Code 21215 reports the bone graft and modifier -51
indicates a multiple procedure.
55.
“d” Code 27488 describes the removal of a prosthesis with an insertion of spacer.
Modifier -LT is used to identify which knee was involved in the procedure. One
way to find this answer is in the CPT Professional Edition index is under knee,
removal, prosthesis.
56.
“a” Code 25112 reports a recurrent ganglion cyst. Modifier -RT is appended to
specify the wrist involved in the procedure.
57.
“c” With this procedure the physician reconstructs the maxilla to correct
developmental skeletal deformities.
40
58.
“c” Closure of a surgical site is “bundled” or included with the procedure, unless
the CPT Professional Edition indicates otherwise. One way to find this code is in
the index under reconstruction mandibular rami.
59.
“d” Modifier -LT indicates which hand was involved. Closure of a surgical site is
“bundled” or included with the procedure, unless the CPT Professional Edition
indicates otherwise. This question does not indicate the length of repair, which is
another clue that a repair code would not be part of the answer.
60.
“b” Code 27025 describes fasciotomy to the hip or thigh. A parenthetical note is
listed below this code, instructing the use of modifier -50 for a bilateral procedure.
61.
“a” Code 22222 describes an anterior approach with diskectomy. The parenthetical
notes following code 22226 indicate that you can use this add-on code with code
22222 for each additional vertebral segment. Add-on codes should not be listed
first; these codes are “added on” to a primary procedure. The subcategory
guidelines preceding code 22222 state that bone graft procedures should not append
modifier -51. Additionally, codes 20930–20938 have a symbol that indicates
exemption from modifier -51.
62.
“a” Code 21556 is reported for a deep, subfascial, or intramuscular procedure.
63.
“c” CPT Assistant suggests that a diagnostic bronchoscopy is typically a bilateral
procedure and a surgical bronchoscopy is typically a unilateral procedure. This
question is possibly unfair because it is difficult to answer from the coding manuals.
However, be prepared for this type of question on the exam. Answers that include
words like “always” or “never” are often the wrong answer.
64.
“b” This is a rhinoplasty procedure. If a medical term is not familiar to you, try to
break it into a prefix, word root, or suffix to help answer a question. Rhino means
nose. Plasty means surgical repair. One way to find this answer in the CPT
Professional Edition index is under nose, reconstruction, and primary.
65.
“a” One way to locate this procedure in the index of the CPT Professional Edition
is under irrigation. A second is cannulization, sinus, and sphenoid. A third is
sinuses, irrigating. The CPT index has listings of main terms with four primary
classes of main entries: procedure or service, organ or other anatomic site,
condition, and synonyms/eponyms and abbreviations.
66.
“b” The code 69990 is an operating microscope and should not be reported with
code 31526. Look up code 69990 and review all the coding combinations that are
not valid. Additionally, a parenthetical note below code 31526 indicates the coding
combination in this question is incorrect.
41
67.
“d” Review the subcategory guidelines listed with endoscopy procedures preceding
bronchoscopy. You’ll find the statement “surgical bronschoscopy always includes
diagnostic bronchoscopy when performed by the same physician.”
68.
“a” The code 33207 represents a complete system.
69.
“b” Code 33233 is reported for the removal and code 33212 is reported for the
reinsertion. Modifier -51 is appended to indicate multiple procedures were
completed at the same session by the same provider. The CPT Professional Edition
subcategory guidelines for Pacemaker or Pacing Cardioverter Defibrillator clearly
define how to code when a battery is changed.
70.
“c” Code 38510 is written for single or multiple node(s).
71.
“c” The code 75803 is bilateral and code 75801 is unilateral. Modifier -26 indicates
the professional component of the radiology services. A parenthetical note follows
code 38790 to append modifier -50 for a bilateral procedure.
72.
“b” Code 35473 is a percutaneous procedure, “through the skin.”
73.
“d” Code 43101 describes an abdominal approach for this procedure. The closure of
a surgical site is included or “bundled” with the procedure, unless otherwise stated
in CPT Professional Edition guidelines.
74.
“a” Code 43280 describes the laparoscopic fundoplasty Nissen procedure. Code
43324 describes an open esophagogastric fundoplasty Nissen procedure. Diagnostic
laparoscopy procedures are included with the surgical procedure.
75.
“b” This procedure describes removal of a lesion on the lip. A “V” shaped incision
is made around the lesion. The surrounding tissue and lesion are removed and then
the surgical wound is closed primarily. One way to find this code is to review the
code range in the CPT Professional Edition index under excision, lip.
42
76.
“c” The parenthetical note below code 43267 directs the use of code 43262 when
the procedure is done with sphincterotomy. Modifier -51 is appended to code 43262
to define a multiple procedure in the same session by the same provider.
77.
“c” Code 43635 is an add-on code; modifier -51 is not appended. Billroth I or II in
the index of the CPT Professional Edition refers back to gastrectomy, partial.
78.
“b” You can find this answer in two different ways. First, use the CPT Professional
Edition index. Look up placement, nasogastric tube, which lists code 43752. A
parenthetical note below this code indicates that this is not an accurate coding
combination. Another way is to reference the services included in the subcategory
guidelines listed with the E/M Critical Care Services.
79.
“a” An ileostomy is a procedure to create a passage through the abdominal wall into
the ileum. The patient then wears a bag on the abdomen for drainage of fecal
material.
80.
“c” An appendectomy performed by laparoscopy includes the diagnostic
laparoscopy.
81.
“c” Both codes are reported to describe these procedures. Code 45378 included
collection of single or multiple specimen(s), not a biopsy. Modifier -59 is appended
to 43240 to indicate the procedures were separate procedures on the same day, but
not during the same session.
82.
“a” A vestibuloplasty is a surgical modification of the mouth, typically to fit
dentures for patients without teeth. Code 40845 describes a complex procedure.
83.
“b” There is no mention of an open procedure. If the type of procedure is not clearly
defined in the question, select the more conservative code. In this question there is
reference to “inserts a catheter,” which implies percutaneous. Code 75989 is used to
report the radiological services. Modifier -26 reports the professional component of
this service.
84.
“b” Code 56637 describes the entire procedure. The definition for simple, radical,
partial, and complete vulvectomy is listed under the CPT Professional Edition
subcategory heading of Vulva, Perineum, and Introitus.
85.
“a” Code 52648 includes postoperative bleeding and vasectomy.
86.
“c” Category III guidelines state, “The following section contains a set of temporary
codes for emerging technology, services, and procedures.” Further directions
indicate, “If a category III code is available, this code must be reported instead of a
Category I unlisted code.”
43
87.
“a” Carefully read the questions. What services are we asked to code? Only the
procedure; therefore, the answers with the E/M codes would be incorrect. Code
56605 reports one lesion, the add-on code 56606 is reported for each additional
lesion.
88.
“b” Code 51841 describes a complicated procedure.
89.
“a” Modifier -50 is not used; the description of this code states unilateral or
bilateral.
90.
“b” Code 58150 describes a total abdominal hysterectomy, with or without removal
of tube(s), with or without the removal of ovary(s). Therefore, the oophorectomy
may not be reported separately when performed with a total abdominal
hysterectomy.
91.
“d” The meatotomy is included in code 52601.
92.
“d” Modifier -26 indicates the professional component of code 74450.
93.
“b” is the best answer for this question. There is no mention of previous births,
either vaginally or by Cesarean. According to the American Medical Association’s
Principles of CPT Coding, the preferred method of reporting the vaginal delivery of
twins is 59400-22 (or 59610-22). However, an alternate method is to report code
59400 (or 59610) for the first twin and 59409 (or 59612) for the second twin.
94.
“a” You can find code 62010 in the CPT Professional Edition index under skull,
fracture. The CPT index lists codes in several different ways, therefore, there might
be more than one way to find a correct code. Look under fracture, skull. The code
range 62000–62010 is listed in both places.
95.
“a” Lamellar means to arrange in thin pieces or scales. This method of transplant
removes the anterior layer of a diseased cornea. Codes for “penetrating”
keratoplasty are full-thickness replacement of the cornea.
96.
“b” Code 66920 includes injection of saline. See the subcategory guidelines
preceding this code.
97.
“c” Review carefully the codes included with the operating microscope. The code
69930 is not listed as an included code.
98.
“d” Code 61600 reports the definitive procedure, the excision of the lesion. The
code 61580 reports the approach procedure, the method to obtain exposure to the
lesion. CPT Professional Edition guidelines for Surgery of Skull Base provide
definitions for these surgeries and information regarding modifier use. Additionally,
each physician reports only those codes that apply to the work they completed.
44
99.
“d” Code 67107 describes this procedure. CPT Professional Edition provides
anatomic and procedure illustrations as learning aids. This procedure has an
illustration of a scleral buckle procedure.
100.
“a” No CPT code exists for “re-exploration” of the spine. An unlisted code would
be the correct way to report this service.
101.
“d” Code 67930 defines suture of recent wound eyelid partial thickness. Appending
modifier -E1 defines the upper left eyelid was repaired.
102.
“b” Code 67808 describes use of general anesthesia for the removal of the
chalazions, appending modifier -50 indicates a bilateral procedure. Code 67840 is
reported for non-chalazion lesion. Modifier -59 indicates a separate lesion.
103.
“b” Notice code 69436 has general anesthesia as part of the description.
104.
“d” This is an established patient visit that meets two of the three key components.
Modifier -24 is not appended because Dr. Todd did not do the knee-surgery.
Modifier -24 would be necessary if the “same physician who completed the
surgery” was seeing the patient during a postoperative period for an unrelated E/M
service.
105.
“a” The surgeon documented the request for consult and sent this information by
written report to the requesting physician. The surgeon completed three key
components to qualify for an office consultation.
106.
“b” The guidelines for critical care in the CPT Professional Edition feature a list of
codes that are included. Codes 43752 and 94656 are listed and should not be
reported separately.
107.
“a” The diagnosis code 438.21 is specific to the dominant side. The E/M guidelines
must be used to identify code 99306 as the correct E/M Level. Use Table 2, in the
E/M guidelines of the CPT Professional Edition to determine the level of decisionmaking. The guidelines state that “two of the three elements in Table 2 must be met
or exceeded” to qualify for a certain level of decision-making. Also listed in the
guidelines is a definition for examination performed. Review these definitions for
the use of the term “multi-system.”
108.
“c” Review the subcategory guidelines of the CPT Professional Edition for Initial
Hospital Care. E/M services provided by the same physician in conjunction with an
admission are considered part of the initial hospital care when completed on the
same day.
45
109.
“c” According to the subcategory guidelines of the CPT Professional Edition for
Preventive Medicine Services, you can report both E/M codes. Modifier -25 is
appended to indicate that a significant or separately identifiable E/M service was
performed on the same day by the same physician.
110.
“b” Hospital discharge services are based on time.
111.
“a” The subcategory guidelines CPT Professional Edition for Consultations
provides the following information, “consultation initiated by a patient and/or
family, and not requested by a physician, is not reported using the consultation
codes but may be reported using the office visit codes, as appropriate.” You can
report prolonged services for the additional time in this question.
112.
“d” Code 99402 is reported for patients who are not asymptomatic.
113.
“d” Continuing intensive care service guidelines provide information related to
reporting visits per calendar day, weight, and codes that are included.
114.
“b” Insertion of a biventricular pacing device is not included or “bundled” with
these codes. Review the guidelines for codes 99289–99290 for services included in
the codes.
115.
“c” This was a new patient encounter. All three of the key components are listed in
this test question to qualify for a 99204 level of service.
116.
“a” See Anesthesia Section Guidelines of the CPT Professional Edition under Time
Reporting for this information.
117.
“a” Code 00528 reports the anesthesia procedure. Modifier -P1, a physical status
modifier, indicates a normal healthy patient. A qualifying circumstance code is
necessary due to the age of the patient.
118.
“a” Code 01961 describes the anesthesia procedure. Modifier -P3 defines the
physical status of the patient.
119.
“b” Refer to Appendix A in the CPT Professional Edition for a definition of
modifier -23. Intermediate sutures to the forehead usually require local anesthesia,
because of unusual circumstances the procedure was completed under general
anesthesia.
120.
“d” Refer to Appendix G in the CPT Professional Edition. This appendix lists the
codes that include moderate conscious sedation along with guidelines to assist with
reporting these codes. Additionally, code 43200 has a “bulls-eye” symbol that
indicates moderate conscious sedation is included.
46
121.
“c” Modifier -47 should not be appended to anesthesia codes. Refer to Appendix A
of the CPT Professional Edition for a definition of this modifier.
Radiology—Nine Questions
122.
“b” In this question the physician provided both the professional and technical
components of the service.
123.
“b” This service was an MRI not an MRA.
124.
“c” Code 76091 is a bilateral diagnostic mammography. The add-on code 76082
reports the computer aided detection process.
125.
“d” The ultrasound is nonobstetric.
126.
“c” Codes 77401–77416 recognize the technical component. The -TC modifier does
not need to be appended to this set of codes.
127.
“a” Code 76816 describes a “follow-up” or “re-evaluation” ultrasound. The
parenthetical note listed below this code instructs use of modifier -59.
128.
“c” Refer to the Radiology guidelines under Administration of Contrast Material(s)
in the CPT Professional Edition. Administration of oral/rectal contract does not
qualify for a study with contrast.
129.
“c” The parenthetical note below code 21116 provides direction to the correct codes
in the radiology section. Modifier -26 appended to a code identifies the professional
component.
130.
“c” Refer to Radiology guidelines under Administration of Contrast Material(s) of
the CPT Professional Edition for information related to spine examinations. Notice
items that “may be” included under the section for Special Reports. Use of modifier
-59 is included under the Separate Procedures section of these guidelines. Clinical
treatment planning does have subsection in the radiology section.
Pathology/Lab—10 Questions
131.
“a” This question does not include the three key components necessary to qualify
for an E/M consultation. There is no mention of Dr. Heinz seeing the patientonly
the records. One way to locate this answer is in the CPT Professional Edition index
under Consultation, Clinical Pathology.
132.
“b” Guidelines listed under Organ or Disease Oriented panels indicate that tests
performed in addition to a panel should be separately reported.
47
133.
“d” Quantitative studies measure the amount of a substance present.
134.
“b” According to Principles of CPT Coding, and CPT Assistant July 2000, code
88331 is used once per specimen (separately submitted specimens) not per surgery;
therefore, report multiple units.
135.
“c ” This type of question requires quick reference to each code to review the
description or reference to the CPT Professional Edition index to find a specific
listing for this test.
136.
“b” Code 80101 is reported with four units. each single drug class is reported
separately.
137.
“d” One way to select an answer is to refer to the CPT Professional Edition index
under Bethesda System. The correct code range is listed. The Bethesda System is a
method for reporting uniform diagnostic terminology regarding cervical-vaginal
smears. This reporting system was developed to lessen errors in communication
between the laboratory and the clinician.
138.
“b” According to Principles of CPT Coding, code 88172 is used to report microscopic specimen examination to ensure that diagnostic material is present. Frequently, this is done to render a diagnostic assessment to avoid a repeat operative
procedure. Regardless of the number of specimens reviewed, report code 88172
once. Review the code description. The word “specimen(s)” indicate one or more.
139.
“a” Code 88307 requires microscopic evaluation of surgical margins. Refer to the
guidelines CPT Professional Edition under this subcategory that indicate accession,
examination, and reporting are included.
140.
“a” Refer to the index of the CPT Professional Edition. Look up venipuncture and
review codes listed to ensure the validity of this statement.
Medicine—10 Questions
141.
“b” Medicine section guidelines of the CPT Professional Edition have a complete
list of the unlisted services or procedures. When faced with a question like this,
look for the differences in the code string and eliminate answers with any code that
is not part of the Medicine section, such as codes 68899, 99499, and 49999.
142.
“a” One way to find this procedure in the CPT Professional Edition index is under
Motion Analysis.
48
143.
“c” Code 93510 describes the left heart catheterization. Review the subcategory
guidelines for codes 93543 and 93545. These guidelines indicate that injection
procedures represent separate services and may be coded in conjunction with one
another when appropriate. A parenthetical note below code 93545 directs the use of
code 93555 for supervision and interpretation. Additionally, code 93556 is reported
to complete the procedure. Modifier -26 is reported with the imaging codes to
indicate professional component.
144.
“c” The vaccination code 90710 is a combination injection; therefore, reporting
vaccines separately would be “unbundling” and incorrect.
145.
“d” All of these services are included. A list of included services is provided in the
subcategory guidelines of the CPT Professional Edition.
146.
“a” This code can be found in the index of CPT Professional Edition under
Spirometry.
147.
“b” The hot and cold packs in code 97010 indicate one or more areas, which means
the unit does not change when more than one is applied. Code 97035 is listed in 15minute increments. To report 30 minutes of constant attendance, two units are
reported.
148.
“c” There is not enough information to select an office visit code. There is no
mention of new or established patient and no documentation of the level of
decision-making.
149.
“a” You can find these definitions in the Medicine section of the CPT Professional
Edition under the heading Ophthalmology.
150.
“d” Subcategory guidelines for this test indicate the use of modifier -52 if one ear is
tested.
49