CPC Exam Review.LA.2.24.KEY

docx

School

Penn Foster College *

*We aren’t endorsed by this school

Course

Subject

Medicine

Date

Apr 3, 2024

Type

docx

Pages

Uploaded by luviahluv

CPC Exam Review 2.24.KEY 1. A 31-year-old male arrives at general surgery for a pilonidal cyst that has been unresponsive to antibiotic therapy at his primary care physician’s (PCP) office. There is a large amount of tenderness and edema at the site and the area is erythematic and warm to the touch. The patient’s pain has been increasing and, on palpation, the surgeon notes that the cyst is larger than six cm in diameter and appears to be deep. After discussion with the patient, it is decided to perform an incision and drainage (I&D) at the surgeon’s office, with no sedation other than local use of Lidocaine. The area was prepped and numbed with Lidocaine and an incision was made, allowing a large amount of purulent drainage to be expressed. The area was packed with gauze and the procedure was completed without any complications. The patient will follow up in the office in one week for recheck and is to continue on the antibiotic prescribed by his PCP. A. 10060 B. 10061 C. 10080 D. 10081 Answer: C – 10080 is correct because this was a straightforward I&D of a pilonidal cyst. There were no complications mentioned during the procedure. Codes 10060 and 10061 are incorrect because they are used for I&Ds of abscesses, but are not specific to pilonidal cysts. Code 10081 is incorrect because it is for a complicated I&D of a pilonidal cyst and the scenario specified that this was an uncomplicated procedure. 2. A 35-year-old male returns to the general surgeon’s office with recurrent episodes of infected pilonidal cysts. He has had the cyst incised and drained (I&D) once at this primary care physician’s office and once at the surgeon’s office. The last I&D was approximately four months ago. He returns to the office today to discuss further treatment. It is decided that he will undergo outpatient surgery so he can be sedated and the cyst will be excised with the base curetted. During surgery, it was noted that there was an extensive sinus tract. The wound will be packed open, requiring daily dressing changes and he will return to the postop clinic for a recheck in one week. A. 11771 B. 11772 C. 11770 D. 10080 Answer: A – 11771 is correct for an extensive procedure because it involved excising the cyst and curetting it. Code 11772 is not correct because, while extensive, the excision was not complicated. A complicated excision may include removal down to the sacral fascia or using the surgical technique called marsupialization. Code 11770 is incorrect because this pilonidal cyst was more complicated and

was not just a simple pilonidal cyst. Code 10080 is incorrect because this was a complicated pilonidal cyst and it required more than just an I&D because it was also excised. 3. A 6-year-old boy was bitten by a dog and sustained multiple lacerations as a result. He has a 5 cm laceration on his right lower arm, a 2 cm laceration on his left hand, and a 2.6 cm laceration to the right side of his lower cheek. While in the ER, the wounds were flushed, then the patient was sedated and the arm and hand lacerations were repaired. Intermediate repair was necessary for the facial laceration due to the depth of the wound and layered closure was performed. The patient was also given a tetanus shot and started on antibiotics. What CPT codes would you use for the laceration repairs of this child and what order is correct? A. 12002, 12013 B. 12002, 12013-59 C. 12052, 12002-59 D. 12032, 12002 Answer: C – Code 12052 is being used as the primary procedure code because this code is for 2.6-5 cm facial lacerations and was considered an intermediate repair. The total length of laceration for the arm and hand lacerations was 7 cm, so 12002 is also correct. Because this was for a simple repair that is less complicated than the other repair, it is listed as the secondary procedure code. Modifier -59 is used because there was more than one classification of wounds repaired on this patient. Code 12002 is correct but must be listed as the second code due to it being the less complicated repair. Code 12013 is incorrect because this code is for simple repair of a wound 2.6 cm to 5.0 cm in length of the simple repairs was a total of 7 cm. This code is also specific to the face, ears, eyelids, nose, lips and/or mucous membranes. 4. A patient was suffering from severe hallux valgus of the right foot. The physician excised extraneous bone from the lateral end of the proximal phalanx and the medial eminence of the metatarsal bone. The physician inserted the implant in the lateral end of the proximal phalanx. A. 28292 B. 28899 C. 28291 D. 28296 Answer: C – the correct CPT code for this procedure is 28291 (Correction, Hallux Vagus, with or without Sesamoidectomy; Resection of Joint with Implant). Code 28292 is only used for a simple resection without implant. Code 28899 is used for the removal of the lateral end of the proximal phalanx and the medial eminence of the metatarsal bone, but it does not include the implant. 5. A 25-year-old obese male has had right-sided flank pain for about two months and noticed a lump during work one day. He initially thought it was a muscle spasm and ignored it, but it has increased in size and has gotten more painful. He went through a CT scan, which showed an

intramuscular mass consistent to the physical exam that is approximately 6 cm in diameter. Due to the size and presentation, it was decided to excise the tumor. A. 21931 B. 21932 C. 21933 D. 21935 Answer: C – 21933 is correct for the excision of a tumor that is 6 cm and is an intramuscular tumor. Code 21931 is incorrect because although the size is correct, this is not a subcutaneous tumor. Code 21932 is incorrect because the size is too small and 21935 is incorrect because this did not involve a radical resection. 6. A physician removed a 54-year-old male’s old pulse generator on a dual lead system cardioverter-defibrillator and replaced it with a new one. During the procedure, the surgeon determined that the electrodes need to be replaced as well and removed the old electrodes, replacing them with new ones. What are the correct codes for this surgical procedure? A. 33262, 33243-51, 33249-51 B. 33263, 33241-51, 33244-51 C. 33263, 33243-51, 33249-51 D. 33262, 33241-51, 33249-51 Answer: C – The correct codes for the surgical procedure are: 33263 (Removal and Replacement of the Pulse Generator of a Dual Lead System). Code 33243 needs to be included on the claim to indicate the removal of the dual chamber electrodes. The last code that needs to be included on the claim is 33249 (Replacement of the Dual Chamber Electrodes). The last two codes for the service, 33243 and 33249, need to be appended with modifier -51 to indicate that there were multiple procedures performed on the same date of service. 7. A physician performed a thromboendarterectomy with a patch graft on the common femoral artery of a 63-year-old female with advanced lower arterial plaque. A. 35301 B. 35302 C. 35355 D. 35371 Answer: D – the correct code for this procedure is 35371 (Thromboendarterectomy, including Patch Graft, if Performed; Common Femoral). Code 35301 is used for the same procedure, but for the carotid artery. Code 35302 is also used for the same procedure, but for the superficial femoral artery. Code 35355 is used for the iliofemoral artery.

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

8. A physician performed a lymphangiography with insertion of radioactive tracer for identification of sentinel node. A. 38790-50, 75803 B. 38790, 75801 C. 38792-50, 75803 D. 38792, 75801 Answer: D – The correct code for the procedure is 38792 (Injection Procedure; Radioactive Tracer for Identification of Sentinel Node) which is the primary procedure. Code 75801 (Lymphangiography, Extremity Only, Bilateral, Radiological Supervision and Interpretation) also needs to be reported to indicate the radiological guidance for the lymphangiography procedure. The procedure is not indicated as a bilateral procedure, which would exclude code 75803, which is a bilateral procedure and modifier - 50, which indicates that the procedure was bilateral. 9. A 10-year-old involved in a MVA lacerated his posterior tongue. Laceration was 2.4 cm in length. What code should be used for repair of this child’s tongue? A. 41250 B. 41251 C. 41252 D. 41599 Answer: B – 41251 is the correct code because this is for a laceration less than 2.5 cm and involves the posterior tongue. Code 41250 is incorrect because it involves the anterior tongue. Code 41252 is incorrect because the laceration is not more than 2.5 cm or complex. Code 41599 is incorrect because there is a listed code that works for this procedure. 10. What CPT code should be used for complicated abscess drainage of the parotid gland? A. 42300 B. 42305 C. 42310 D. 42320 Answer: B – 42305 is the correct code for complicated abscess drainage of the parotid gland. Code 42300 is incorrect because this is for a simple drainage of parotid gland abscess. Code 42310 is incorrect because this is for an intraoral drainage of an abscess in the sub maxillary or sublingual glands. Code 42320 is incorrect because this is for the external drainage of an abscess in the submaxillary gland. 11. A 64-year-old woman has a sublingual salivary cyst that needs to be removed. A. 42400 B. 42405

C. 42408 D. 42409 Answer: C – 42408 is the correct code for excision of a sublingual salivary cyst. Code 42400 is incorrect because this code is for a needle biopsy of the salivary gland. Code 42405 is incorrect because this is for an incisional biopsy of the salivary gland. Code 42409 is incorrect because this is for marsupialization for the sublingual salivary cyst and not for the removal of this cyst. 12. A pediatrician performed a routine circumcision on a newborn baby boy in a hospital setting. The physician anesthetized the area with dorsal penile block, clamped the foreskin away from the tip of the penis and excised the excess foreskin. A. 54160 B. 54150-47 C. 54150 D. 54160-47 Answer: C – the correct code for the circumcision is 54150 (Circumcision, Using Clamp or Other Device with Regional Dorsal Penile or Ring Block). Code 54160 is not correct because it is used for a circumcision without using a clamp or other device. You should not use modifier -47 (anesthesia by physician) because the anesthesia was included in the procedure description. Modifier -47 guidelines state that the modifier is not to be used with local anesthesia and a penile ring block is a local anesthetic. 13. A physician performed an orchiopexy via an inguinal approach for intra-abdominal testis. A. 54692 B. 54650 C. 54690 D. 54640 Answer: D – the correct code for this procedure is with code 54640 (Orchiopexy, Inguinal Approach, with or without Hernia Repair). Codes 54690 and 54692 are orchiopexy and orchiectomy codes, but are not appropriate because the procedure was not performed laparoscopically. Code 54650 is also incorrect because it is used for an orchiopexy performed via an abdominal approach not an inguinal approach. 14. PROCEDURAL NOTE PATIENT: Ray, Alexander AGE: 59 DATE: 02/15/20xx

PREOPERATIVE DIAGNOSIS: Prostate Cancer, Primary POSTOPERATIVE DIAGNOSIS: Same PROCEDURE: TURP A patient was placed in supine position on the operating table, draped and anesthetized accordingly. Using a resectoscope with light source, the physician located the prostate and resected the malignant prostatic tissue with electrocautery knife, leaving the appropriate margins. The physician removed the resectoscope and the patient was catheterized for drainage of his bladder contents and resected prostatic tissue. The patient tolerated the procedure well and was transferred to postoperative recovery. A. 52601-58 B. 52601 C. 52500 D. 52630 Answer: B – The correct code for this surgical procedure is 52601 (Transurethral Electrosurgical Resection of the Prostate including Control of Postoperative Bleeding, Complete). The procedure TURP stands for transurethral resection of the prostate, which is the procedure described in the procedural note. Code 52500 is only used for the resection of a bladder neck not the prostate. Code 52630 is used for the regrowth of prostatic tissue and modifier -58 is inappropriate because it is used for the primary procedure. 15. A 27-year-old pregnant woman presented to the hospital maternity ward to deliver her third baby. She was 39 weeks pregnant and has had no complications so far. The patient planned on a vaginal delivery. Her oldest child was born vaginally and her second was born via cesarean section. Her OB, who had provided her antepartum care, was able to successfully complete a vaginal delivery with no complications. Her OB also provided postpartum care to the patient. A. 59400 B. 59510 C. 59620 D. 59610 Answer: D – The OB should report code 59610 (Routine Obstetric Care Including Antepartum Care, Vaginal Delivery and Postpartum Care, after Previous Cesarean Delivery). Even though the patient’s first child was born vaginally, her second child was delivered by a cesarean section. This type of delivery is referred to as a vaginal birth after cesarean (VBAC). 16. A young man has to have a lumbar spinal tap performed to obtain cerebrospinal fluid. This will be done with a needle for diagnostic purposes so that the fluid can be tested. A. 62269

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

B. 62270 C. 62272 D. 62273 Answer: B – 62270 is the correct code for a diagnostic lumbar spinal puncture. Code 62269 is incorrect because this is the code for a biopsy of the spinal cord with a percutaneous needle. Code 62272 is incorrect because this is the code for a therapeutic spinal puncture for drainage of cerebrospinal fluid by needle or by catheter. Code 62273 is incorrect because this code is for the injection/epidural of blood or clot patch. 17. A patient needs to have a lumbar laminectomy without discectomy. A. 63001 B. 63003 C. 63005 D. 63011 Answer: C – 63005 is the correct code for lumbar laminectomy except when done for spondylolisthesis. Code 63001 is incorrect because this code is for cervical laminectomy. Code 63003 is incorrect because this is for thoracic laminectomy and code 63011 is incorrect because it is for sacral laminectomy. 18. A 53-year-old woman has been having significant sciatica. She is going to have a neuroplasty of the sciatic nerve. A. 64702 B. 64704 C. 64708 D. 64712 Answer: D – 64712 is the correct code for a neuroplasty of the sciatic nerve. Code 64702 is incorrect because this code is for a digital neuroplasty and 64704 is incorrect because this code is for a neuroplasty of a nerve in the hand or foot. Code 64708 is incorrect because this is for a neuroplasty of a major peripheral nerve of the arm or leg. 19. The tympanic membrane is often referred to as: A. A taste bud B. The ear drum C. The stirrup D. The inner ear Answer: B – the tympanic membrane is often referred to as the ear drum. Taste buds are on the tongue and have nothing to do with the auditory system. The stirrup or stapes is a small bone in the middle ear and the inner ear is the internal part of the auditory system.

20. What is a result of a nasal polyp? A. It will cause nose cancer in the affected patient B. It can change the shape of the nose and necessitate rhinoplasty C. It results in the release of histamine causing an allergic reaction D. It can obstruct the nasal passageway making it difficult to breathe Answer: D – a nasal polyp can obstruct the nasal passageway making it difficult to breathe. If this is the case, surgical removal of the nasal polyps may be necessary. They are normally benignant generally do not cause cancer in the patient. In addition, they are not large enough to change the shape of the nose or release histamines that cause allergic reactions, although they can develop as a result of chronic inflammation. 21. The term “alopecia” is commonly referred to as what? A. Athlete’s foot B. Hair loss C. Heat rash D. Head lice Answer: B – The term “alopecia” is commonly referred to as hair loss. Alopecia can be acute or chronic, resulting in baldness. It can be an inherited trait but can also be the result of chemotherapy, a hormonal imbalance, infections, severe stress, medication side-effect. 22. When a doctor manipulates a dislocated joint back into place, he: A. Reduces the subluxation B. Manipulates the fracture C. Suspends the dislocation D. Reduces the suspension Answer: A – when a doctor manipulates a dislocated joint back into place he reduces the subluxation. A subluxation is a joint dislocation and the manipulation of a joint back into place is commonly referred to as a reduction.

23. A 17-year-old patient presented to the orthopedist office after having fallen off his skateboard. He suffered a closed fracture to the left tibia and fibula as well as a severe sprain to the right wrist. The patient was in severe pain so an anesthesiologist administered anesthesia on him, while the physician manipulated the fractures back into place and applied the cast to the lower left leg. What is/are the appropriate anesthesia code(s)? A. 01820, 01490 B. 01462 C. 01480, 01820 D. 01490 Answer: D – the correct code for the procedure is 01490 (Anesthesia for lower leg cast application, removal, or repair). The patient received anesthesia for the cast application, which was only administered in the lower leg. There were no other anesthesia services provided. 24. PROCEDURAL NOTE PATIENT: Lopez, Olga AGE: 76 years DATE: 11/05/2014 PATIENT DIAGNOSIS: Multiple skull lymphomas PROCEDURE: Craniotomy converted to craniectomy of left anterior cranial base ANESTHESIA: General endotracheal The patient was placed in supine position on operating table and anesthesia was successfully administered. The patient was then prepped in the usual manner. An incision was made on the midline of the patient’s anterior cranial base and the surgeon dissected the epidermal layer to reveal the skull. Three 2 to 4 cm lymphomas were then located and the skull bone was excised in one piece to remove the affected areas, leaving .1 cm margins. Halfway through the procedure the patient’s blood pressure dropped, which was difficult to control for the remainder of the procedure. Due to the patient’s drop-in blood pressure, the surgeon decided to convert the procedure to a craniectomy, therefore bone grafts were not placed. A drain was placed beneath the remaining skull base and the edges of the skin were then sutured back together using 4-0 Vicryl sutures. A sterile dressing was placed on the excision site. The patient was then removed from endotracheal anesthesia and remained under physician supervision until her blood pressure stabilized. She was then taken to the recovery room and scheduled for a bone graft at a later date. A. 00210, 99135 B. 00211, 99100 C. 00192, 99135, 99100 D. 00192, 99100

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

Answer: C – the correct codes are 00192 (Anesthesia for procedures on facial bones or skull; radical surgery), 99135, (Anesthesia complicated by utilization of controlled hypotension), and 99100 (Anesthesia for patient of extreme age, younger than 1 year or older than 70). 00211 (Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma) is not appropriate, in this case, because the craniectomy was not performed as a result of a hematoma. Also, because both qualifying circumstances codes apply, both of them must be appended to the anesthesia code. 25. When reporting the time involved for an anesthesia procedure, when do you start and stop the clock? What is the correct answer? A. Time starts when the patient is in the pre-operative waiting area before the anesthesiologist is present and ends at the end of the surgery time. B. Time starts when the patient is in the operating room and the anesthesiologist begins to prepare the patient for the induction of the anesthesia and ends in the operating room at the end of the surgery time. C. Time starts when the patient is in the operating room and the anesthesiologist begins to prepare the patient for the induction of the anesthesia and ends when the anesthesiologist no longer in attendance after reporting to the nurses in the PACU (post-anesthesia care unit). D. Time starts when the patient is in the operating room before the anesthesiologist is in attendance and ends in the PACU after the anesthesiologist gives report to the post- anesthesia care unit nurses. Answer: C – time starts when the anesthesiologist is present when he/she begins to prepare the patient for induction of anesthesia in the operating room (or equivalent area) and ends when the anesthesiologist is no longer in personal attendance. Answer A is incorrect because the anesthesiologist wasn’t present when the time first began and ended at the end of the surgery, not at the end of the anesthesiologist’s attendance. Answer B is incorrect because the time ended at the surgery end time and not at the end of the anesthesiologist’s attendance. Answer D is incorrect because the time started before the anesthesiologist was in attendance. 26. Mr. Jones was examined after a car accident as a requirement of his car insurance claim. Which modifier is appropriate to use on the claim? A. -22 B. -51 C. -99 D. -32 Answer: D – Modifier -32 is the appropriate modifier to use on the claim. Modifier -32, mandated services, is used when a procedure is performed because an official body such as a car or life insurance agency, requests it. Modifier -22 is appropriate for an unusual procedural service. Modifier -51 is used for multiple procedures, and Modifier -99 is used for multiple modifiers.

27. A physician performed a complex repair of the scalp measuring 7.2 cm and an intermediate repair of the arm measuring 3.4 cm. The repairs are different complexities, so they would be reported with separate repair codes, but you would need to add a modifier to indicate that they are two separate procedures performed on the same date of service. Which modifier would you use? A. -59 B. -51 C. -25 D. -24 Answer: A – the modifier that you would use to indicate that they were two separate procedures performed on the same date of service would be -59 (distinct procedure). In the description of modifier -59, it states that it is used to report two services that were performed on “different site or organ system(s), and as such, it is used to report a repair done on the same date, on two separate body areas (the scalp and arm). 28. What organizations make up the “cooperating parties” for the ICD-10-CM guidelines and who approved these guidelines? A. American Hospital Association (AHA), American Health Information Management Association (AHIMA), National Center for Health Statistics (NCHS), U.S. Federal Government’s Department of Health and Human Services (DHHS) B. American Hospital Association(AHA), National Center for Health Statistics (NCHS), World Health Organization (WHO), U.S. Federal Government’s Department of Health and Human Services (DHHS) C. American Hospital Association (AHA), American Health Information Management Association (AHIMA), Centers for Medicare & Medicaid Services (CMS), National Center for Health Statistics (NCHS) D. American Health Information Management Association (AHIMA), Centers for Medicare & Medicaid Services (CMS), National Center for Health Statistics (NCHS), World Health Organization (WHO) Answer: C – the organizations that approved the ICD-10-CM guidelines and who make up the Cooperating Parties are the American Hospital Association (AHA), American Health Information Management Association (AHIMA), Centers for Medicare and Medicaid Services (CMS), and the National Center for Health Statistics (NCHS). The ICD-10-CM is based on the ICD-10, which is the statistical classification of disease that is published by the World Health Organization. The U.S. Federal Governments Department of Health and Human Services is mentioned in the official Guidelines because two of its departments (CMS and NCHS) are part of the organizations that make up the Cooperating Parties for the ICD-10-CM.

29. Can you use signs, symptoms or unspecified codes in the ICD-10-CM instead of an actual diagnosis? A. Yes, symptom/sign codes can be used, but there are no unspecified codes in the ICD-10-CM. B. No, in ICD-10-CM the purpose of added codes is to prevent the use of signs, symptoms or unspecified codes. C. Yes, if a definitive diagnosis hasn’t been made by the end of the patient encounter, then unspecified codes or sign/symptom codes may be used to best describe the diagnosis at the end of the encounter. D. No, ICD-10-CM doesn’t even have unspecified codes as an option. Answer: C – Both sign/symptom and unspecified codes are appropriate to use when the actual diagnosis is unable to be made. In some cases, the infecting organism needs to be identified for a specific code to be used, so in these cases when the infecting organism isn’t known at the time of the patient’s encounter an “unspecified code is appropriate to be used. ICD-10-CM does have codes for signs and symptoms or “unspecified” codes. Although they are not listed for every possible diagnosis, if they are an option they are allowed to be used based on the information available at the time of the patient’s visit/encounter. 30. A pediatric patient with a history of asthma and pneumonia presented to the office with severe respiratory distress. The pediatrician performed a detailed history and comprehensive examination, and diagnosed the patient with status asthmaticus. A pulse oxygen level was taken and it was determined that the patient’s blood oxygen level was at 88%. The patient was started on a nebulizer treatment at 09:50 hours, which lasted until 10:15 hours. The physician then re-checked the patient and determined that the patient’s breathing had only slightly improved. A pulse oxygen level was taken again and it was determined that the patient’s breathing had only slightly improved. A pulse oxygen level was taken again and it was determined that patient was at 92%. The physician then ordered another nebulizer treatment, which was started at 10:32 and continued until 10:54. After this second breathing treatment, an additional pulse oxygen level was taken and the patient’s blood oxygen level had risen to 97%. The pediatrician then determined that the patient needed to be sent for chest x-rays to determine whether or not pneumonia was present in the lungs. Due to the resulting amount of data and risk, the pediatrician considered the MDM of high complexity. The total time spent with the patient was 1 hour 45 minutes. A. 99215, 99417 x 3 B. 99214, 99417 x 3 C. 99214, 99417 D. 99215, 99417

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

Answer: A – You would report this office visit with the E&M codes: 99215 (Established Patient Office Visit, Level Five), and 99417 (Prolonged Services). Code 99215 is established by the detailed history, comprehensive examination, and the MDM of high complexity. The appropriate prolonged service code is 99417 (each 15 minutes in addition to 54 minutes), which represents the time spent beyond what is allowed for the 99215 code and should be 99417 x 3 (rest of the time spent with the Patient), which in this case is a total of 1 hour and 45 minutes. 31. A 32-year-old married female presents to her OB/GYN office for diaphragm fitting. After performing a pelvic examination and routine physical, the OB measures the cervix and adjusts the diaphragm so that it fits neatly over the cervical opening. The OB then instructs the patient in how to place the diaphragm for most effective birth control, as well as how to remove, clean, and store the diaphragm. Satisfied that the patient understands how to use the device properly, she allows the patient to leave the office with a follow-up appointment schedule in one month. How should the OB/GYN code for this visit? A. 99395 B. 99395, 57170-59 C. 57170 D. 99395, 57170 Answer: B – the OB/GYN should code for this visit with 99395 (Routine Physical and Pelvic Examination). OB/GYNs are considered primary care physicians who can perform routine physical examinations. Code 57170 (Diaphragm or Cervical Cap Fitting with Instructions) also needs to be included on the claim because the OB performed an additional service. Furthermore, it is necessary to combine the modifier - 59 with code 57170 to indicate that there was a distinct procedural service provided to the patient on the same day as an E/M service, which in this case, is a routine physical and pelvic exam. 32. A patient admitted to the hospital three days ago is getting ready to be discharged this morning. The attending physician spent more than 30 minutes arranging home health services and talking with the patient and family regarding outpatient rehabilitation and care after right hip replacement. What code should be used for the discharge day management of this patient? A. 99235 B. 99236 C. 99238 D. 99239 Answer: D – 99239 is the correct code for hospital discharge day management that took more than 30 minutes. Codes 99235 and 99236 are both incorrect because these codes are for observation or inpatient hospital care not involving discharge. Code 99238 is incorrect because this code is for discharge requiring less than 30 minutes of management.

33. A preoperative patient needs to have an antibiotic started before his operation. He is given 500 mg Ceftriaxone sodium through his IV. What is the correct HCPCS code for this medication? A. J0696 x 2 B. J0715 C. J0696 D. J0697 Answer: A – J0696 x 2 is the correct code because this code is for Ceftriaxone sodium 250 mg. Because this patient received two times this amount of medication, this code needs to reflect this multiplication. Code J0715 is incorrect because this code is for 500 mg Ceftizoxime sodium. J0696 is incorrect unless doubled, because this code is only for 250 mg of Ceftriaxone sodium. Code J0697 is incorrect because this code is for 750 mg Cefuroxime sodium. All of these codes can be used for IM or IV administration. 34. A patient with acute lymphoblastic leukemia is currently undergoing chemotherapy and radiation therapy and develops anemia as a result. He requires admission and a blood transfusion because of this complication caused by the chemotherapy. A. C91.10, D64.81, T45.1X5A B. C91.00, T45.1X5A, D64.81 C. D64.81, C91.00, T45.1X5A D. T45.1X5A, D64.81, C91.00 Answer: C – D64.81, C91.00, T45.1X5A is the correct code sequence for a patient who was admitted for anemia requiring a blood transfusion due to the chemotherapy, from the treatment he is undergoing for acute lymphoblastic leukemia. The anemia code is the primary code and is specific to the chemotherapy. The secondary code is the type of the leukemia that he has; he is currently undergoing treatment, so he is not in remission. The last code is for an adverse effect of antineoplastic and immunosuppressive drugs, initial encounter. C91.10 is incorrect because this is not the right code for acute lymphoblastic leukemia. 35. A 35-year-old male with type 1 diabetes, who has an insulin pump, also has diabetic retinopathy without macular edema. He is admitted to the hospital with ketoacidosis without coma. A. E10.10, E10.319, Z79.4 B. E10.11, E10.319 C. E10.10, E10.311, Z179.4 D. E10.11, E10.311

Answer: A – E10.10 is the correct code for Type 1 diabetes mellitus with ketoacidosis without coma. E10.319 is the correct code for Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema. Code Z79.4 is the code used for patients who routinely use insulin and this patient has an insulin pump. Code E10.11 is incorrect because this code is for Type 1 diabetes mellitus with ketoacidosis with coma. Code E10.311 is incorrect because this code is for Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema. 36. A 33-year-old woman follows up with her psychiatrist for ongoing major depressive disorder that is considered moderate. She is on a daily medication for this disorder. She also follows up with him for generalized anxiety disorder. She smokes 1.5 packs of cigarettes per day and she reports that this helps her anxiety and, when she doesn’t smoke, her anxiety increases. A. F33.0, F41.9, F12.200 B. F33.1, F41.1, F17.210 C. F33.0, F41.1, F17.200 D. F33.1, F41.9, F17.210 Answer: B – F33.1, F41.1, F17.210 is the correct ICD code sequence for this patient. F33.1 is the correct code for moderate recurrent major depressive disorder. F41.1 is the correct code for generalized anxiety disorder and F17.210 is the correct code for nicotine dependency by cigarettes without complications. F33.0 is incorrect because this code is for mild recurrent major depressive disorder. F41.9 is incorrect because this code is for unspecified anxiety disorder. F17.200 is incorrect because this code is for unspecified uncomplicated nicotine dependence and this patient’s nicotine of choice is cigarettes. 37. The surgical pathologist obtained three skin tags samples from in the patient’s right axilla, as well as four samples of breast tissue from the surgical session. The surgical procedure was a radical bilateral mastectomy, including excision of regional lymph nodes and surrounding tissue. How should the surgical pathologist code for this service? A. 88304 x 7 B. 88304 x 3, 88307 x 4 C. 88305 x 3, 88307 x 4 D. 88304 x 3, 88309 x 4 Answer: D – the surgical pathologist should code for this service using codes 88304 with 3 units, to indicate the sampling of three separate skin tags. Code 88309 with 4 units should be used to indicate the four separate samples of breast tissue. Level VI codes (88309) are more appropriate than Level V codes (88307) because the procedure was a mastectomy with removal of regional lymph nodes. If the procedure had been a partial or simple mastectomy, then code 88307 (Level V) would have been the correct surgical pathology code.

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

38. A 26-year old must have a drug screen performed in order to obtain a job at a local nursing home. The nursing home orders a 7-pnael drug screen for amphetamines, benzodiazepines, cocaine, heroin, methadone, opiates, and oxycodone. If any of these come up positive by direct optical observation, then definitive drug testing is ordered as reflex testing. This patient did not have any positives on optical observation so no additional testing was performed. What is the correct CPT code for this drug screen? A. 80305 B. 80306 C. 80307 D. 80375 Answer: A – 88305 is the correct code for direct optical observation drug testing of any number of drug classes from Drug Class A. Because no additional testing was performed, there is no need for additional codes. Code 80306 is incorrect because this is for a drug class using instrumented tests systems. Code 80307 is incorrect because this code is for tests by instrument chemistry analyzers and 80375 is incorrect because this code is used for definitive qualitative tests. 39. A patient who has been on Digoxin needs to have labs drawn to verify his response to the medication. A total Digoxin level is ordered. A. 80162 B. 80163 C. 80159 D. 80178 Answer: A – 80162 is the correct code for a total Digoxin level. Code 80163 is incorrect because this code is for a free Digoxin level. Code 80159 is incorrect because this code is for the therapeutic drug assay for clozapine and code 80178 is the code for a lithium therapeutic drug assay. 40. A patient is on two medications needing monitoring. She needs to have a free and total phenytoin drug assay performed. She also needs to have a Topiramate drug assay performed. A. 80184, 80185, 80201 B. 80183, 80184, 80185 C. 80185, 80186, 80201 D. 80185, 80186, 80200 Answer: C – 80185 and 80186 are the correct codes for total and free Phenytoin, and code 80201 is the correct code for4 Topiramate therapeutic drug assay tests. Code 80184 is incorrect because this code is for the drug Oxcarbazepine and code 80200 is incorrect because this code is for the drug Tobramycin.

41. This organ is a five-inch tube located behind the mouth that helps close the nasopharynx and larynx when swallowing food. This organ keeps your food out of your respiratory tract and in your digestive tract. What is it called? A. Esophagus B. Pharynx C. Nasopharynx D. Trachea Answer: B – this organ is called the pharynx. The esophagus is the tube that arises from the pharynx, the organ that carries food through the diaphragm into the stomach. The trachea is not a digestive organ; it is the respiratory organ that connects the nose to the mouth and the mouth to the lungs. 42. Within the male genital system, the pair of tubular glands located above the prostate and behind the bladder that lubricate the duct system, nourish the sperm, and contribute fluid to the ejaculate are called: A. Seminal Vesicles B. Testes C. Vas Deferens D. Epididymis Answer: A – the pair of tubular glands located above the prostate and behind the bladder that lubricate the duct system, nourish the sperm, and contribute fluid to the ejaculate is called seminal vesicles. The testes produce and store sperm cells. The vas deferens transports semen from the epididymis to the pelvis. The epididymis is a coiled tube that connects the testicles to the vas deferens. 43. One of the most common prostatic disorders is , which is an enlargement of the prostate gland. This disorder may require a transurethral resection of the prostate (TURP). A. Lower Urinary Tract Symptoms (LUTS) B. Benign Prostatic Hyperplasia (BPH) C. Elevated Prostate Specific Antigen (PSA) D. Prostatic Intraepithelial Neoplasia III (PIN III) Answer: B – One of the most common prostatic disorders is benign prostatic hyperplasia (BPH), which is an enlargement of the prostate gland. This disorder may require a transurethral resection of the prostate (TURP). Benign prostatic hyperplasia is caused by the excessive growth of prostatic nodules. BPH can compress the urethra, leading to partial or complete obstruction of the urethra, urinary hesitancy, frequency, dysuria, urinary retention and an increased risk of urinary tract infections.

44. A 58-year-old patient with decreased hearing decided to undergo bilateral cochlear device implantation in order to restore the gradual decline of his hearing, and prevent total deafness. Due to the position of the device and the size of the patient’s mastoid bone that was partially occluding the patient’s inner ear, the physician performed a modified mastoidectomy. A mastoidectomy was necessary for the completion of the cochlear device implantation procedure. The physician used an operating microscope throughout the cochlear implantation. A. 69930, 69505, 69990 B. 69930, 69501, 69900 C. 69930 D. 69930-50, 69900 Answer: D – You would code this procedure with 69930-50 (Bilateral Cochlea Device Implantation, With or Without Mastoidectomy). You would use this code because it refers to the cochlear device implantation procedure and it includes the mastoidectomy. The two procedures do not need to be reported separately. Code 69900 also needs to be included to the report to indicate that the physician used an operating microscope to aid in the procedure. 45. A patient with suspected cardiac arrhythmia was given a routine rhythm EKG with three leads in the cardiologist’s office. The results of the EKG were sent to the patient’s primary care physician, who interpreted the results and determined that the patient’s arrhythmia was mild. What is the correct code for the cardiologist’s office service only? A. 93040 B. 93042 C. 93041 D. 93000 Answer: C – the correct code for the cardiologist’s office is 93041 (Rhythm ECG, 1-3; Tracing Only without Interpretation and Report). The interpretation of the ECG was performed by the patient’s primary care physician, therefore the cardiologist can only bill for the technical component of the ECG, which in this case is the tracing only. The primary care physician’s office, on the other hand, can only bill for the interpretation of the report, because the PCP only interpreted the test results and diagnosed the patient.

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

46. Mr. Johnson was seen in his primary care physician’s office today for an evaluation of chest pains. He has been experiencing shortness of breath as well as intermittent chest pains for the past week. He has also been experiencing tingling and numbness in his left hand and fingers. His primary care physician suspects a cardiac rhythm abnormality and performs a rhythm electrocardiogram in the office. After reading the ECG report, Mr. Johnson’s physician determines that his heart rhythm needs more evaluation and refers him to a cardiac specialist. How should the electrocardiogram code be reported? A. 93000 B. 93010 C. 93042 D. 93040 Answer: D – the electrocardiogram should be reported with the code 93040 (Rhythm ECG, 1-3 Leads; Interpretation and Report). Codes 93000 and 93010 should not be reported because the ECG was a rhythm ECG, not a routine ECG. Code 93042 (Rhythm ECG, 1-3 Leads; Interpretation and Report Only) also should not be reported because the physician performed the ECG, interpreted and reported the results of the ECG, instead of just interpreting the results. 47. The physician performed a right and left heart catheterization with a left ventriculography on 58-year-old male patient. During catheterization, the patient participated in a physiologic exercise study in the form of a bicycle ergometry. How should you code for this service? A. 93531, 93464 B. 93451, 93452, 93464 C. 93453, 93464 D. 93453 Answer: C – The correct codes for this service are 93453 (Combined Right and Left Heart Catheterization including Intraprocedural Injection(s) for Left Ventriculography, Imaging Supervision and Interpretation, when performed) and 93464 (Physiologic Exercise Study (e.g. Bicycle or Arm Ergometry). Code 93531 is only reported when the combined catheterization is performed for congenital cardiac anomalies and codes 93451 and 93452 are only used for either a right or left heart catheterization. 48. A pregnant woman needs to have a fetal echocardiogram performed. This will be done in real time with image documentation (2D) with M-mode recording. A. 76820 B. 76825 C. 76826 D. 76827

Answer: B – 76825 is the correct code for fetal echocardiography in real time with image documentation (2D) with M-mode recording. Code 76820 is incorrect because this code is for fetal Doppler velocimetry. Code 76826 is incorrect because this code is for a follow-up or repeat fetal echocardiogram and code 76827 is incorrect because this code is for fetal Doppler echocardiography with pulsed wave and/or continuous wave with spectral display. 49. A patient needs to have an epidural and, due to compressed discs, this procedure is done under fluoroscopic guidance. A. 77002 B. 77003 C. 77011 D. 77012 Answer: B – 77003 is the correct code for fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid). Code 77002 is incorrect because this code is for flu0rscopic guidance for needle placement (biopsy, aspiration, injection, localization device). Code 77011 is incorrect because this code is for computed tomography guidance for stereotactic localization. Code 77012 is incorrect because this code is for computer tomography guidance for needle placement, radiological supervision and interpretation. 50. A 56-year-old woman is undergoing a bilateral screening mammogram. What is the correct code for this procedure where there is a computer-aided detection? A. 77054 B. 77066 C. 77067 D. 77067, 77052 Answer: C – 77067, is the correct code sequence for this procedure. 77067 is the correct code for a screening mammography, bilateral with 2-view film study of each breast and 77052 is the correct code for computer-aided detection during a screening mammography. Code 77054 is incorrect because this code is for a mammary ductogram or galactogram. Code 77066 is incorrect because this is for a bilateral mammography, but not for a screening mammography.

CPC Exam Review.LA.2.24.KEY

Related Documents