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CPT PROCEDURE STUDYGUIDE (HOMEWORK & QUIZZES) Questions and Answers (2022/2023) (Verified Answers)

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CPT PROCEDURE STUDYGUIDE (HOMEWORK & QUIZZES) What appendix in the CPT Code Manual are all Modifiers listed? Appendix A Which coding system(s) is (are) used for claims submitted by physicians?... HCPCS/ Level I/II and ICD-9-CM/ ICD-10-CM Which coding system describes the reason for the patient visit or encounter? ICD-9-CM/ ICD- 10-CM Identify the CPT section in which the code 21310 is located. Surgery Identify the CPT section in which the code 99602 is located. Medicine Identify the CPT section in which the code 81000 is located. Pathology and Laboratory Identify the CPT section in which the code 0503F is located. Category II Identify the CPT section in which the code 99232 is located. Evaluation & Management Identify the CPT section in which the code 97001 is located. Medicine Identify the CPT section in which the code 70486 is located. Radiology Which symbol indicates that a procedure code is new in CPT? Bullet Refer to CPT codes 11100 and 11101. Assume that a surgeon performed a biopsy of two different skin lesions during the same procedure. Which code should be assigned? 11100, 11101 Which category of CPT codes is reserved for emerging technology? Category III What symbol is placed in front of a CPT code to indicate it is an add on code? A plus sign (+) What code set is considered HCPCS Level I? CPT Codes What modifier is used for anesthesia by the surgeon? 47 What letter of the HCPCS Level II codes set represents Durable Medical Equipment? E Where in the CPT Manual can you find a list of Modifier 51 exempt codes? Appendix E Where in the CPT Manual can you find clinical examples for reference to coding E/M services? Appendix C What is the percentage of the global work that CMS recognizes for a surgeon that performs only the intraoperative services? 70% What are the three components of RVU’s? Work, overhead, & malpractice What are the three things that HIPAA implemented? Privacy, security, portability What part of Medicare is a supplemental for professional services and outpatient services? Part B What is an example of a form of healthcare fraud? Routine waiver of a copayment What is an ERA? Electronic Remittance Advice WEEK 2) An 86-year-old patient presents with a CC of vomiting and dizziness. Yesterday, she became dizzy while getting ready to go to church. In addition, she vomited bile several times and complained of deafness in her left ear at the start of the dizziness. Based on this information, what level is this history of present illness (HPI)? Extended The CC is chest pain. The examination determined: respiration quiet and unlabored; skin with good color, warm and dry, and no rashes; mucous membranes moist; ears and throat clear; lungs with good breath sounds in all fields; rare expiratory wheeze, no rales, no rhonchi; heart regular rate and rhythm with normal heart sounds, no murmur; abdomen soft with no liver or spleen enlargement; and bowel sounds active. Based on this information, what is the level of examination? Expanded problem focused New patient presents to the office with a CC of nasal congestion and headache. ROS: Denies shortness of breath or fever, stiffness of neck, or visual disturbances. Past history: No drug allergies or other allergies were noted, nor any history of TB, COPD, or asthma. Last physical exam one year ago was unremarkable. Based on this information, what type of past, family, and/or social history exam was performed? Pertinent A patient was seen by their primary care physician after a fall from their bicycle. The patient was disoriented and dizzy upon exam. The physician provided a expanded problem focused history, expanded problem focused exam and medical decision making was low complexity. The patient was then prepped for the repair of a 2.0cm superficial laceration of the forehead with simple wound closures. The patient was sent home with a return appointment in one week for a wound check. What code(s) were used? 99213-25, 12011 A 58 year old patient with rectal bleeding was seen in the office of a gastroenterologist. The patient’s primary care physician requested that the gastroenterologist provide advice about this case. The specialist conducted a comprehensive history and exam, and medical decision making was high. The consultant documented his findings and communicated them via written report to the primary care physician. The patient has private insurance. What is the correct code? 99245 The patient underwent a percutaneous needle core biopsy of the left breast not using imaging. What is the correct code and modifier? 19100-LT Dr. Jones provides critical care services in the emergency department for a patient in respiratory failure and with congestive heart failure. Ventilator management is initiated. Dr. Jones spends an hour and 10 minutes providing critical care for this patient. What is the correct code? 99291 Dr. Michaels provides E/M services for a patient in acute hysteria who has been admitted to the emergency department. After performing a problem-focused history and examination with low complexity medical decision making, he determines that the patient is suffering from acute grief reaction secondary to the death of her granddaughter due to sudden infant death syndrome. At discharge, the patient is in complete control of her actions and is referred to a SIDS organization. What is the correct code? 99281 Dr. Gerald provides preventive medicine services to an established 45-year-old patient who is in good health and has no complaints. Dr. Gerald obtains a comprehensive history, performs a comprehensive examination, and counsels the patient on proper diet and exercise. What is the correct code? 99396 Dr. Hawthorne sees an established patient in his office for evaluation of insulin-dependent diabetes mellitus with nephropathy. In addition to a problem-focused history, he performs an expanded problem-focused examination that includes a limited exam of the genitourinary, immunologic, skin, and musculoskeletal systems, and documents all positive and negative findings. The patient’s status does not seem to have changed, and medical decision making is of low complexity. Dr. Hawthorne discusses the patient’s insulin dosage, diet, and exercise, and plans to see the patient in six months. What is the correct code? 99213 A patient undergoes carpal tunnel releases on both the left and right wrists. What is the correct code and modifier? 64721-50 In her office, Dr. Childers sees an established patient who complains of abdominal pain. She provides a problem-focused history and examination, which reveals the onset of abdominal pain beginning early that morning and characterized by a sharp, crampy feeling with some radiation to the back. Nausea and dry heaves are present, but no vomiting. The patient had a normal bowel movement in the morning. No fever or chills are noted, and bowel sounds are active. A rectal examination reveals hard stool in the rectal vault, guaiac negative. An x- ray of the abdomen is negative except for extensive gas. Dr. Childers tells the patient to take an enema and return if the pain is not relieved. A change in diet would involve increasing the intake of fiber. The impression is that the patient’s pain is the result of impacted feces. What is the correct code? 99212 A new patient sees Dr. Reynolds in his office complaining of diarrhea and watery stool the previous night, as well as nausea, vomiting, and crampy, lower abdominal pain. Dr. Reynolds provides a detailed history and examination, and medical decision making of moderate complexity. What is the correct code? 99203 Anesthesia services for closed treatment of fracture of humerus; patient is 85 years old, but healthy. Provide the code(s) and the physical status modifier. 07130-P1, 99100 A 26-year-old male patient undergoes an incisional hernia repair (lower abdomen). Assign the anesthesiology code only. 00832 Select the appropriate evaluation and management code for an established patient visit in which a comprehensive history and expanded problem-focused examination was performed and medical decision making was of low complexity. 99213 What services is included in conscious sedation? Assessment of the patient Per CPT guidelines, a concise statement describing the symptom, problem, condition, diagnosis, or other factor that is the reason for the encounter, usually stated in the patient's words, is the definition of the: Chief complaint Review of systems is described as an inventory of body systems obtained through a series of questions seeking to identify signs and symptoms that the patient may be experiencing or has experienced. Anesthesia services for direct CABG surgery of five vessels with pump oxygenator; patient has severe coronary artery disease as well as hypertensive end-stage renal disease requiring hemodialysis 00567-P4 Which of the following represents three of the six elements that a special report must contain? Nature, extent, mood What type of nurse can administer anesthesia under the direction of an anesthesiologist? CRNA Who publishes CPT? AMA Which coding scenario is an example of the appropriate use of Modifier 25? 99215-25 & 99395 Dr. Martin provided 1 hour and 20 minutes of critical care services to Jack Smithton (age 64), who is in the Intensive Care Unit with acute respiratory distress syndrome. What is the correct code(s)? 99291, 99292 What is the organization that is responsible for administering the Federal Medicare program? CMS What does the October edition of the Federal Register publish for providers? Hospital updates What is the benefit for a provider to sign a Quality Improvement Organization Agreement with Medicare? Faster process of claims As a coder, it is important to know that you must be truthful and accurate when coding services that are being billed to Medicare. What would you do if you are unsure of the charge? Query the physician or a supervisor for more information. Where is the specific coding information about each section located? Guidelines Codes ranging from 80047-89356 are found in which category of the CPT Manual? Category 1 Listing only a portion of the narrative description that follows the semicolon is done to Conserve space What section of CPT is code 69990 found? Sugery What section of CPT is code 95833 found? Medicine What section of CPT is code 87272 found? Laboratory and pathology Where is the code 0042T found? Category III code section CPT Manual Multiple modifiers are indicated with which modifier? -99 Which section is code 01630 found in? anesthesia WEEK 3) According to the CPT Manual what is a true about what should be contained in a surgery special report? Nature and extent of the procedure What is not included in the surgical package? E & M visit following surgery unrelated to surgery What is the global period for minor procedures? 10 How are the subsections in the surgery section of the CPT Manual divided? Medical specialty and body system Open incisional biopsy of left breast (Medicare patient) 19101-LT Intermediate wound repair of a 2-cm laceration of the face 12051 Repair of primary open ruptured Achilles tendon. (Medicare patient) 27650 The definition of Debridement is: Removal of infected or damaged tissue from a wound In the CPT Manual codes 11200-11201 are for the removal of skin tags. What is the correct code(s) for removal of 16 skin tags? 11200, 11201 The patient had a delivered a cesarean delivery with antepartum & postpartum care following an attempted vaginal delivery after a previous cesarean delivery. The coder selected the following codes: 59618 and 59409-52. The assignment of these two codes together would be referred to as: Unbundling The patient was seen by their family doctor for a crushing injury to their left thumb. The physician repaired the nail bed of the thumb, which code(s) would be used? 11760-FA Arthroscopy of the left elbow with removal of loose body 29834-LT Simple drainage of abscess of left thumb and second finger 26010-FA, 26010-F1 A patient is seen in the emergency department following a bicycle accident. The physician documents that the left thigh wound measuring 8cm. required multiple layers and retention sutures to complete the closure. According to CPT definitions, this type of repair would be classified as: Complex How are the sections of the Surgery section divided? Body system Diagnostic and surgical arthroscopy of the right shoulder with complete synovectomy 29821-RT If a provider performs excision of multiple lesions, you would document the most complex lesion first and the subsequent lesions by using which modifier? 51 A patient is seen for a potential incision and drainage of a pilonidal cyst and I & D is performed. The physician decides after the I & D of the cyst it is medically necessary to remove the cyst. The code(s) submitted: 11770 Which term best describes the type of traction a physician performs using strapping, elastic wraps or tape? skin What is the type of graft often taken from the upper thigh area? Fascia lata One of the following is not considered an example of a fracture treatment: Replantation One of the terms below describes the chronic abscessing and subsequent infection of a sweat gland: Hidradenitis Closed treatment of distal fibular fracture without manipulation; the patient was in the postoperative period for an arthroscopy of the shoulder performed two weeks ago; the same physician performed both surgeries 27786-79 Microdermabrasion of the epidermis to remove tattoo of arm 15783 Excision of solar keratosis, face, .5 cm in diameter, with no significant margins 11440 In the Anesthesia section of the CPT manual, the codes are usually divided first by which of the following: Anatomic site Modifier-51, multiple procedure, is used on what type of services? Surgery Modifier-59, distinct procedure service, is used to indicate that: services that are usually bundled into one payment were provided as separate services. Provide the correct coding: release of trigger finger, right ring finger 26055-F8 Mrs. Smith presented to her physician’s office for an office visit for an upper respiratory infection. The physician examines the patient and prescribes antibiotics. The physician notices the patient has a suspicious looking mole. The physician examined the mole and determined that it should be removed. The mole was removed during the same office visit. The physician bills both an E/M code and a procedure code. Which modifier would you use on the E/M code -25 The modifier “-AA” is an example of what type of modifier? HCPCS The modifier that indicates only the professional component of the service was provided is 26 Bruising would be an element of review of which organ system? Hematologic Medical decision making (MDM) is based on the the physician must consider about the management of a patient’s condition. number of diagnoses, risk of morbidity, amount of data According to E/M guidelines, a(n) exam encompasses a complete single-specialty exam or a complete multisystem exam. Comprehensive Codes from the E/M subsection Nursing Facilities Service are used to report services provided in nursing facilities that used to be known as: Skilled nursing, long-term care, and intermediate care facility According to information in 99468, what is the age of a neonate? 28 days or younger The anesthesia formula is: (B+T+M)X C When a physician performs a preventive care service, the extent of the exam is determined by the: Age Can you assign a CPT anesthesia code and applicable modifiers for anesthesia services for a 9-month-old normal healthy child who received anesthesia for hernia repair in the lower abdomen? 00834-P1 WEEK4) A surgical sinus endoscopy includes a sinusotomy (when appropriate) and a Diagnostic endoscopy A chest tube may be used as an indwelling method of the accumulated fluid in the pleural space. Draining The definition of Laryngotomy is the following: Incision over the larynx The definition of Tracheoplasty is the following: Repair of a damaged trachea The code for the simple excision of a nasal polyp: 30110 The 3 year old female patient was seen by her pediatrician with a marble lodged in her nose. The physician removes the marble with hemostats. Provide the coding: 30300 If the control of a nasal hemorrhage was performed bilaterally what CPT modifier would be used? 50 Within the cardiovascular system, what is compared to the branches of a tree? Vascular families What are the three sections of the CPT manual that you use to code many cardiovascular services? Surgery, radiology, medicine What does the abbreviation EP mean as it relates to cardiovascular services? Electrophysiology Arrhythmia ablation is a treatment for: bradycardia/tachycardia Which of the following modifiers does not identifiy a coronary artery? -RD The major division of the cardiovascular subsection is whether a procedure involved a vessel. coronary or noncoronary Pacemaker insertion codes are divided based on the surgical: approach The device that can be inserted into the body to electrically shock the heart into regular rhythm. cardioverter-defibrillator The number of postoperative days usually assigned for the global period following implantation of a pacemaker is: 90 The definition of transplantation is: grafting tissue from one source to another What code range can the mediastinum be found in the CPT Manual? 3900-39499 The diaphragm is a wall of muscle that separates the and the abdominal cavities. Thoracic The definition of lymphadenitis is: inflammation of the lymph nodes The physician performs an extensive drainage of a lymph node abscess, provide the correct coding. 38305 The physician performs a biopsy of a lymph node by fine needle aspiration without image guidance, provide the correct coding: 10021 The definition of Splenectomy is: Excision of the spleen The definition of Fundoplasty is: Repair of the bottom of an organ or a muscle What is the correct code for radioactive injection procedure for the identification of the sentinel node for a patient with a primary malignant neoplasm of the central portion of the right breast? 38792-RT When using an unlisted code a(n) must accompany the claim. Special report This information is placed after some codes in the CPT manual and contains helpful information Parenthetical information When the words “separate procedure” appear after the descriptor of a code, you know which of the following about that code? The procedure was a minor procedure that would only be reported if it was the only service provided. Excision defined as full thickness would be through the: Dermis Single-layered closure of heavily contaminated wounds that require extensive cleaning or removal of particulate matter constitutes what type of repair? Intermediate Which term describes reduction? Manipulation Which of the following is not a treatment method for a dislocation? External fixation The acronym ORIF stands for: Open reduction with internal fixation The correct code for an unlisted procedure for the breast is: 19499 When coding three biopsies of the skin, which were performed during the same visit, the reporting would be: 11100, 11101 × 2. Dermabrasion of the segmental face 15781 For mastectomy that is done for gynecomastia, the proper coding is: 19300 The proper coding for an excision of a pilonidal cyst that was a complicated procedure is: 11772 A patient presents with recurrent left foot / heel pain so the physician performs an endoscopic plantar fasciotomy. Provide the correct coding.29893-LT A patient has a total hip replacement for severe osteoarthritis. 27130 WEEK 5) The mucosal and tissue of the lips and cheeks are included in the oral cavity. Submucosal The CPT code 44701 can be found in which Appendix of the CPT Manual. Appendix D With the exception of and hernias, the use of mesh or other prosthesis is not separately reported when performing hernia repairs. Incisional and ventral What is a common abbreviation for endoscopic retrograde cholangiopancreatography. ERCP The gallbladder is removed under laparoscopic guidance. 47562 Repair of an initial reduced inguinal hernia; with a hydrocelectomy in a patient who is 28 months of age. 49500 Colotomy with removal of foreign body. 44025 Surgical repair of reducible inguinal hernia of a 4-month-old male, initial repair. 49495 Endoscopic procedures within the Urinary subsection, Kidney subheading, are often divided based on this unique factor: Existence of a stoma Urethral dilatation codes are often divided based on this factor: Initial or subsequent The Urinary System subsection is first arranged atanomically One of the most common conditions of the prostate is BPH When coding 51797 which modifier should be appended? None of the above The removal of a kidney is defined by which term nephrectomy The physician performed a urethral biopsy, provide the correct coding. 53200 A physician performed an Urethromeatoplasty with mucosal advancement, provide the correct coding. 53450 The code 59400 doesn’t include: A cerciage For medical complications of pregnancy the physician would report his additional professional services using codes from what section or subsection? E/M Antepartum care includes: initial and subsequent history, physical exams, recording of weight, blood pressures, fetal heart tones, and routine UA According to the text, vulvectomy codes are divided based on the and extent of vulvar area removed during the procedure. size This term describes an incision of the vagina to gain access to the pelvic cavity to explore or to drain an abscess: colpotomy A fetal non-stress test is completed on a 36-week pregnancy. The correct code would be: 59025 Biopsy of the vaginal mucosa code is: 57100 Artificial insemination performed via intrauterine is reported using: 58322 A Colpotomy is an incision into the vagina Provide the medical coding for catheterization with bronchial brush biopsy. 31717 A 47-year-old female patient is undergoing a rigid bronchoscopy for the evaluation of chronic hemoptysis. Provide the correct coding. 31622 A patient has collapsed in the emergency room and the physician performs cardiopulmonary resuscitation. Provide the correct coding. 92950 A patient underwent a complete aorta duplex scan of the aorta. Provide the correct coding. 93978 A 69-year-old patient received a coronary artery bypass using a saphenous vein graph. Provide the correct coding. 33510 A patient underwent a complete axillary lymphadenectomy. Provide the correct coding. 38745 The physician performed an imbrication of the diaphragm for eventration, transabdominal, nonparalytic. Provide the correct coding. 39545 The patient underwent allogeneic bone marrow transplant. Provide the correct coding. 38240 What is the method that a physician uses to control a nosebleed? Pacing, ligation, cauterization Which modifier would you use if polyps were removed from both the left and the right sides of the nose? -50 What is the name of the surgical procedure for the rearrangement of the nasal septum? Septoplasty Endoscopic procedures are reported on the place(s) to which the scope is advanced. Farthest A(n) is a mass of undissolved matter that is present in blood and is transported by the blood. Embolus The pulse generator of a pacemaker is also referred to as: The battery This bone marrow is taken from a close relative, so there is a genetic similarity. Allogenic WEEK 6) There are glands in the endocrine system of the body. 9 The peripheral nervous system refers to the nervous structures outside of the: Central nervous system What procedure is often performed with a laminectomy? Arthrodesis What procedure is often performed with a laminectomy? Decompression of intact nerves The physician removes the entire thyroid. 60240 The physician anesthetizes the vagus nerve. 64408 Diagnostic lumbar spinal puncture. 62270 When reporting a craniectomy/craniotomy procedure, it is common to also code procedures. Grafting Cataract and lens replacement uses different approaches. 3 Strabismus surgery: Corrects the muscle misalignment Removal of impacted cerumen from both ears. 69210-50 The transparent part of the eye is the cornea Removal of a superficial foreign body in the external left eye. 65205-LT Bilateral repair of blepharoptosis with frontalis muscle technique. 67901-50 Otoplasty of the right ear, with size reduction.69300-RT Sclera lesion excision, left eye. 66130-LT The modifier reported when a physician component is reported separately is:-26 A procedure is one that is performed independently of, and not immediately related to, another service separate What is the standard measure of energy in radiation treatment? MeV What is the modifier used to identify the technical component of a radiologic procedure? –TC Codes 76801 and 76802 include determination of the number of gestational sacs and fetuses, gestational sac/fetal measurements appropriate for gestation <14 weeks 0 days and: All of the above Ultrasound bone density measurement and interpretation, peripheral sites, any method. 76977 Radiologic examination, nasal bones, complete, minimum of three views. 70160 Identify the correct term for the following definition: Away from the midline of the body (to the side) lateral Identify the correct term for the following definition: Away from the head or the lower part of the body; also known as caudad or cauda inferior When a diagnostic colonoscopy is coded, the code includes: All of the above What two words are important factors in coding hernia repair? Incarcerated/strangulated A is an exam of the entire colonoscopy The type of treatment used to treat prostate cancer by placing the radioactive elements directly into the prostate is called: brachytherapy Within the Male Genital System, the greatest numbers of codes fall under what category? Penis When coding a total abdominal hysterectomy with an anterior/posterior colporrhaphy, the correct modifier to add to the second procedure would be: -51 The anatomy in the Female Genital System subsection starts with the vulva and progresses upward to the: ovary The anatomy in the Female Genital System subsection starts with the vulva and progresses upward to the: inroduction A diagnostic esophagoscopy was performed. During the procedure, an esophageal polyp was found and removed by hot biopsy forceps. Provide the correct coding. 43216 A physician is placing a nasogastric tube using fluoroscopic guidance. Provide the correct coding. 43752 Provide the correct coding for a fulguration of a urethral prolapse. 53275 Radical orchiectomy by inguinal approach due to a tumor 54530 Colposcopy of the vulva with biopsy 56821 Partial removal of the vaginal wall, vaginectomy 57106 Code the treatment of a septic abortion that was completed surgically. 59830 [Show More]

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