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Medical Tests American Academy of Professional Coders: Certified Professional Coder Sample Questions (Q144-Q149):

NEW QUESTION # 144
Based on the following documentation for an established patient, which CPT code should be reported?
Number and complexity of problems addressed: Moderate
Amount or complexity of data to be reviewed and analyzed: Straightforward Risk of complications, morbidity, or mortality of patient management: Low Total time: 35 minutes

• A. 0
• B. 1
• C. 2
• D. 3

Answer: D

Explanation:
When leveling a visit based on the documentation, the lower of the two highest components should be used to determine the level of complexity. In this case, because the number and complexity of problems addressed is moderate and level of risk of complications and/or morbidity or mortality of patient management is low, the MDM is low. On the other hand, because total time is documented and would constitute a higher level of service, total time should be used to select CPT
99214.

 

NEW QUESTION # 145
If the dermatologist removes 17 skin tags from a patient's lumbar using local anesthesia and a sharp blade, which CPT code(s) should be reported?

• A. 0
• B. 11200, 11201, 00300
• C. 11200, 11201-51, 00300
• D. 11200, 11201

Answer: D

Explanation:
The CPT code 11201 is an add-on code and would not receive a modifier. Local anesthesia is included in the primary procedure code and would not be reported separately with CPT 00300.

 

NEW QUESTION # 146
A female patient presents to her obstetrical office 32 -weeks pregnant for a bi-weekly ultrasound. Code the following technician's report:
Fetal views obtained via transabdominal ultrasound as follows:
BPD: 32 mm
Femur Length: 63 mm
Head Circumference: 288 mm
Abdominal Circumference: 270 mm
BPP 8/8
NST from 11:15 to 12:17, showing 160 BPM and positive movement activity Doppler shows adequate systolic and diastolic flow velocities of the fetal umbilical artery.

• A. 76815, 78819, 76820
• B. 76815-TC, 76819-TC, 76820-TC
• C. 76816, 76818, 76820
• D. 76816-TC, 76816-TC, 76820-TC

Answer: C

Explanation:
CPT 76815 is a limited ultrasound, in which only the fetal heartbeat, position, placental location, and/or volume of amniotic fluid are evaluated. In this scenario, much more was done than a limited study. The ultrasound technician documented age-appropriate fetal measurements, which are supported by CPT 76816. A biophysical profile (BPP) was also done, which monitors the fetus's movements, tone, and breathing as well as evaluates the volume of amniotic fluid. Each of these elements counts as 2 units of grading to evaluate the general well-being ofthe fetus. The desired score of a BPP is 8/8. Because a fetal nonstress test (NST) was completed in conjunction with a BPP, report CPT 76818 instead of CPT 76819. Modifier TC is used to reflect that only a technical component of the procedure was completed. However, because the patient received these services in an obstetrical office that employs the physicians providing prenatal care and owns the ultrasound equipment the code should be submitted without modifiers TC or 26 to receive 100% reimbursement.

 

NEW QUESTION # 147
Code the following surgical note:
Patient is seen for an epidural injection into the following three levels: L3-L4, L4-L5 and L5-S1.
A 22 -gauge spinal needle is inserted into the zygapophyseal joint using fluoroscopic guidance. After confirming the needles placement at L3-L4 on the left side, 0.5 cc of a local anesthetic is injected into the joint. The whole process is repeated on the left side at the other two levels. The procedure was completed without any complications.

• A. 64493-LT, 64494-LT, 64495-LT
• B. 0216T-LT, 0217T-LT, 0218T-LT
• C. 0
• D. 64493-LT, 64494-59-LT, 64495-59u

Answer: A

Explanation:
64493 is used for the initial injection of an anesthetic, followed by 64494 and 64495 as add-on codes for the other Two levels. Because there are two sides of a facet joint, modifier LT would be amended to show the carrier that the procedure occurred on the left side of the spine.
In answer B, CPT codes 0216T-0218T exclude fluoroscopic guidance and refer the biller to codes
64490-64495. In general, modifier 59 would not be used on add-on codes, so answer C can be eliminated. Answer D describes an injection in the interlaminar epidural or subarachnoid space and is not the correct procedure code for this circumstance.

 

NEW QUESTION # 148
A patient relocates after receiving treatment for an arm fracture. The patient schedules an appointment with a new orthopedist to remove the cast. The orthopedic office should report the fracture diagnosis code with the seventh character A to indicate active treatment.

• A. True
• B. False

Answer: B

Explanation:
The statement is false. When a patient is in the healing and/or recovery phase of an injury, the seventh character would be D to indicate that the care is subsequent-whether the provider has treated the patient in the past or not.

 

NEW QUESTION # 149
......

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