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Medical Tests American Academy of Professional Coders: Certified Professional Coder Sample Questions (Q36-Q41):

NEW QUESTION # 36
A patient is in labor with plans to deliver vaginally. An epidural is administered at 17:30. After several hours of pushing, the obstetrician determines that the cervix is swollen, and the baby must be delivered via a c-section. The patient consents, the baby is delivered, and both are discharged to the recovery room at 22:15. What CPT code(s) should the anesthesiologist report?

• A. 01967-23, 01968, 99140
• B. 01967, 01968, 99140
• C. 01967-23, 01968
• D. 01967, 01968

Answer: C

Explanation:
For a planned vaginal delivery with the use of an epidural, followed by a Cesarean delivery, the correct CPT codes are 10967 followed by add-on code 01968. CPT code 99140 is an add-on code portraying that the procedure was an emergency and that the patient and/or baby has a significant increase in the threat to life. The documentation gives no indication that these services were emergent Modifier 23 is reported for unusual anesthesia services. This would include-but is not limited to-the use of general anesthesia for a procedure that usually requires only a local anesthetic or none and/or a procedure extending more than 4 hours. In this case, the total procedure time was 4.75 hours, and modifier 23 is appended on the primary procedure code only.

 

NEW QUESTION # 37
V codes are related to which procedures/products?

• A. Enteral therapy
• B. Hearing services
• C. Durable medical equipment
• D. Orthotic procedures

Answer: B

Explanation:
Durable medical equipment is represented by E codes, orthotic procedures are L codes, and enteral therapy is inclusive to B codes in the HCPC manual.

 

NEW QUESTION # 38
A patient with a history of colon cancer was treated with radiation therapy. CT scans and blood tests show the malignancy has been eradicated. The patient is directed to take 81 mg of aspirin daily over the course of the next year to help prevent reoccurrence of the malignancy. What ICD-IO-CM code(s) should be reported by the provider on subsequent visits related to this patient's condition?

• A. C18.9
• B. Z85.038
• C. Z08, Z85.038
• D. Z48.3, C18.9

Answer: C

Explanation:
Regarding Z08, ICD-IO-CM guidelines state: "The follow-up codes are used to explain continuing surveillance following completed treatment of a disease. They imply that the condition has been fully treated and no longer exists." When using a follow-up code as the primary reason for an encounter, a history code indicating what condition the patient originally had should be assigned as secondary. Aftercare codes are used to describe the continued treatment of a disease. In this case, the malignancy has been eradicated, the disease no longer exists, and aspirin is being used merely as a preventative measure. History codes can never be reported as first listed; rather, a follow-up code or other current disease and/or condition should precede it.

 

NEW QUESTION # 39
A female patient experiencing swollen lymph nodes is seen for a follow-up to discuss the results of her open axillary biopsy that occurred last week The results are positive for diffuse large cell lymphom a. The patient is given multiple treatment options, including success rates, risks, and side effects. She opts to begin radiation treatment next week. What CPT and ICD-IO-CM codes should the provider report for this visit?

• A. 99214, (285.94
• B. 99024, C85.84
• C. 99213-24, C83.84
• D. 99214-24, 25, 99024, C83.34

Answer: D

Explanation:
To determine which services to report for this encounter, it is important to understand which services were rendered on the last. The patient had an open biopsy of the axillary lymph nodes (CPT 38525) last week This procedure has a postoperative 90-day global period. This means that any related services provided to the patient within that time are reported with zero-charge CPT
99024. Services such as biopsy results, follow-up incisional care, and any postoperative complications are all inclusive to this code. As the patient was given biopsy results, CPT 99024 should be reported for this encounter. However, CPT guidelines also state that when it comes to diagnostic procedures, "care of the condition for which the diagnostic procedure was performed...
is not included and may be listed separately." In this case, that care begins with the discussion of treatment options with their identified risks, and the decision to begin radiation. This level of moderate medical decision-making is reported by means of E/M CPT 99214. Modifier 24 is appended to indicate that is it unrelated to postoperative care, and modifier 25 is appended to indicate it is separately identifiable to CPT 99024. ICD-IO-CM crosswalk for lymphoma, diffuse large cell, is C83.34.

 

NEW QUESTION # 40
A primary care physician is requesting a second opinion to determine which strain of Ebolavirus the patient has. The specimen is sent to a pathologist, who carefully examines it.
A written report is sent promptly back to the primary care physician, confirming Zaire Ebolavirus and recommending immediate isolation and emergency care. What code should be reported by the pathologist?

• A. 0
• B. 1
• C. 2
• D. 3

Answer: D

Explanation:
A clinical pathology consultation was rendered at the request of the primary care physician.
The consultation is considered high based on the level of medical decision making. The CDC describes Ebola disease as a "rare and often deadly illness." Therefore, the number and complexity of problems addressed is high, as is the management ofthe disease due to the decision to escalate this case to hospital level care. E/M codes can be billed only when a patient themself is evaluated by the provider. In this case, the pathologist only evaluated a specimen.

 

NEW QUESTION # 41
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