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Basic Procedural Coding Final
Exam May 12,2014
Choose the best answer for each of the following questions. Questions 26-30 cover HCPCS
Level II coding.
1. The CPT manual is published and maintained by:
a. American Medical Association
b. Department of Health and Human Services
c.
Centers for Medicare and Medicaid Services
d. American Hospital Association
2. A patient was taken to the endoscopy suite. The endoscope was passed into the esophagus
and continued into the stomach and into the duodenal bulb. Based on this documentation,
what CPT code would be selected to represent this procedure?
a. 43200
b. 43234
c. 43235
d. 43260
3. The physician documents that she changed the cardiac pacemaker battery. In CPT, the
battery is called a(n}:
a. Generator
b.
Electrode
c.
Dual system
d.
Cardioverter
4. A patient undergoes a retrograde urethrocystogram . The same physician performs both
the injection and the supervision and interpretation. What is the correct CPT code
assignment for this physician?
a . 51610, 74450-26
b. 51610,74450
c. 74450-26
d. 74450
5. The pathologist performed a gross and microscopic examination of a kidney biopsy. What is
the correct CPT code assignment?
a. 88300,88305
b. 88305
c.
88307
d. 88300, 88307
6. A patient was seen by his family practitioner two years ago. A cardiologist in the same group
practice now sees this patient for the first time. For E/M code selection for the cardiologist,
the patient would be classified as:
a.
New
b. Established
7. Patient is seen by her primary care physician for headaches. The physician performs a physical
exam, reviews data, and outlines management options. Which of the following key components
is missing from this case?
a. Time
b. History
c.
Medical decision making
d. Coordination of care
8. The CPT book is updated:
a. As needed
b. For use in January
c. Monthly
d. For use in October
9. For the December 7,2012 patient encounter, the hospital will submit codes on what billing
form?
a.
UB-04
b. HCFA-1500
c.
CMS-1500
d. UHDDS
10. Reference codes 49491-49525 for inguinal hernia repair. What is the correct code for an initial
inguinal herniorrhaphy for incarcerated hernia (patient is 47 years old)?
a. 49496
b. 49501
c.
49507
d. 49521
11. The surgeon performed a procedure that is unfamiliar to the coder and he or she is having
trouble locating an appropriate CPT code. What should be the coder's next action?
11
a. Assign an Unlisted procedure" code
b. Call the insurance company
c.
Call the surgeon's office
d.
Research the description about the procedure
12. Arthrocentesis, ring finger of left hand. Appe nd the correct CPT/HCPCS modifier.
a. LT
b. 26
c.
F1
d. F3
13. What is the correct CPT code for electrosurgical removal of three (3) nevi of the arm (size
approximately
2.0cm,1.5cm,0.5cm)?
a. 11400, 11402, 11402
b. 11056
c.
11200
d. 17000,17003,17003
14. The patient has a total abdominal hysterectomy with bilateral salpingectomy. The coder
selected the following codes:58150 and 58700. The assignment of these two codes togethe r
would be referred to as:
a. Global packing
b.
Unbundling
c.
Maximizing
d. Optimization
15. A patient with Medicare undergoes a modified radical mastectomy. What would be the correct
CPT code assignment for the anesthesiologist's services?
a. 00474
b. 00406
c. 00404
d. 00400,00406
16. What is the correct code assignment for bilateral EMG of cranial nerves?
a. 95867
b. 95867 50
c. 95868
d. 95868 50
17. What is the correct CPT code assignment for IM injection of Leukine?
a. 96401
b. 96372
c. 96374
d.
96369
18. Which of the following is a key factor for selecting a correct code for preventive medicine
services?
a. Age of patient
b. Coordination of care
c.
Physician time
d.
Review of systems
19. The RBRVS system used for physician services reimbursement was developed with goals. Which
of the below is not one of the stated goals?
a. To establish a fair and equitable approach to compensating physicians
b. To enhance cost effective medical care
c.
To allow for quality measure payment incentives
d. To eliminate distortions in current fees
20. Select the appropriate CPT code(s) for the following surgical scenario:
Preoperative Diagnosis: Mass, superior aspect of the left breast
Postoperative Diagnosis: Benign mass, superior aspect of the left breast
Operation :Excision
The patient is a female who has had a lump palpable over the superior aspect of her left breast
for the past several months.
Surgical Technique:The patient was lying down supine. The left breast was scrubbed with
betadine scrub and paint and draped in the classical fashion. The patient has a transverse
incision near where we are feeling this lump,which was over about the 11o'clock position,high
up in the superior aspect of the left breast. A transverse incision was made underneath the
breast tissue and adipose tissue was completely taken out. Hemostatic was ascertained with
electrocoagulation. The wound was closed using interrupted 3 0 Vicryl sutures, the skin was
closed with subcuticular running 5-0 Dexon. Benzoin and Steri-Strips and a pressure dressing
were applied. All counts were normal.
a. 19120-LT
b. 19125-LT
c. 19120-LT, 12031
d.
19125-LT,12031
21. A patient is seen in the emergency room with a foreign body in his right eye. A slit lamp exam
shows a foreign body approximately 2 to 3 o'clock on the edge of the cornea. This foreign body
appears metallic. Iris is intact. There are no cells in the anterior chamber. Two drops of Alcaine
were used in the right eye. Foreign body was removed without difficulty . Choose the
appropriate CPT code(s) .
a. 67938-RT
b. 65220-RT
c. 65235-RT
d. 65222-RT
22. The radiologist provides only the supervision and interpretation of a hysterosalpingography .
What is the correct CPT code assignment for the radiologist?
a . 74740
b. 74740-26
c. 58340, 74740
d. 58340, 74740-26
23. A physician draws blood to test for levels of T3 on a non-Medicare patient. The blood is sent to
an outside laboratory for analysis. When billing for the physician's services, which of the
following modifiers should be appended to the CPT code 84480?
a. 52
b. 59
c. 90
d. 91
24. An EGD:
a. involves an examination of the abdomen with a scope
b. involves an examination of the upper Gl tract with a scope
c.
involves an examination of the esophagus, stomach, and duodenum and/or jejunum
using a scope
d. all the above
25. According to the CPT, the concise statement generally in the patient's own words that describes
the reason for the encounter is known as:
a. Symptom
b. Chief complaint
c.
History
d.
Concurrent care
26. What is the correct HCPCS LevellI code for two feet of oxygen tubing?
a. A4615
b. A4616 X 2
c. A4615 X 2
d. A4616
27. Screening colonoscopy for a Medicare patient with history of colon
cancer. a. G0105
b. G0106
c. G0104
d. G0121
28. Pacemaker, single chamber, rate-responsive (implantable) with lead, pacemaker, other than
transvenous VDD single pass.
a.
C2620
b. C1786, C1898
c.
C1786
d. C1786,C1900
29. A HCPCS Level II code that is highlighted in yellow indicates what :
a.
There is a quantity alert related to the code
b.
The code is new
c.
The code should not be used
d.
The code may or may not be paid subject to a carrier's discretion
30. Injection,Heparin sodium, per 1000 units.
a.
Jl642
b.
Jl640
c. J1644
d. J1642 X 10
True or False
31.
32.
Compliance programs are important for ensuring cons istency in coding and billing.
When coding CPT it is ok to use a code that may not exactly describe the service or
procedure performed.
33.
Coding and chart reviews are never necessary.
34. Appendix D in CPT contains a comprehensive summary of CPT additions, deletions, and
revisions since last year.
35.
Physical status modifiers are for use only on anesthesia CPT codes.
36.
Modifier 59 can be used on any CPT code including unlisted codes such as 29999.
37.
CPT 99212 would be assigned if a patient is seen for a cough and sore throat. The physician
performs a problem-focused history, expanded problem-focused examination, and medical
decision-making is straightforward .
38.
CPT 15820-E2 would be assigned to a Medicare patient's bill when the physician
performs a blepharoplasty on the left upper eyelid.
39.
Provider and physician services are reported on the CMS-1500 form.
40.
When coding from CPT you should always identify what section the service will be coded from
and follow the guidelines for that section of CPT only.
Match the following:
41. Modifier P4
A . Instrument to view inside the body
42. 1119F Initial evaluation for condition
B. Indicates the CPT code includes moderate sedation
43. Modifier 73
C. Indicates that a particular event changed the service
44. Endoscope
D. Corrects abnormal alignment of eyes
45. Strabismus Surgery
E. Located in anesthesia section of CPT
46. L3381
F. Key component of E/M CPT code
47. Circled bullet
G.CPT modifier approved for only hospital outpatient
48. Medical decision making
H.Tempora ry codes representing emerging technology
49. . Category Ill codes
I. Category II code
50. Modifier
J . National code
Bonus Questions- code the following cases using CPT or HCPCS Level II as appropriate including
modifiers. You must get the entire case correct for bonus points to count.
1. Libby was thrown from a horse while riding along the side of the road;a truck that honked
the horn as it passed her startled her horse. The horse reared up, and Libby was thrown to
the ground. The condyle of her left tibia was fractured and required insertion of multiple
pins to stabilize the defect area. A Monticelli multiplane external fixation system was then
attached to the pins. Code the placement of the fixation device only.
2. Operative Report
Procedure: Excision of back lesion
Indications for Surgery: The patient has an enlarging lesion on the upper midback.
Findings at Surgery: There was a S-cm, upper midback lesion.
Operative Procedure: With the patient prone, the back was prepped and draped in the
usual sterile fashion. The skin and underlying tissues were anesthetized with 30mIof 1%
lidocaine with epinephrine. Through a S-cm transverse skin incision,the lesion was excised .
Hemostasis was ensured. The incision was closed using 3-0 Vicryl for the deep layers and
running 3-0 Prolene subcuticular stitch with Steri-Strips for the skin. The patient was
returned to the same-day surgery center in stable postoperative condition. All sponges,
needle,and instrument counts were correct. Estimated blood loss is Oml.
Pathology Report Indicates: Dermatofibroma, skin of back.
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