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Question 1. Which structure is directly visualized during a fiberoptic intubation? A) Epiglottis B) Vocal cords C) Carina D) Tracheal bifurcation Answer: B Explanation: The fiberoptic scope is advanced through the mouth or nose until the vocal cords are seen, allowing guided placement of the endotracheal tube. Question 2. The ASA physical status modifier P3 corresponds to which patient condition? A) Healthy, no systemic disease B) Mild systemic disease C) Severe systemic disease, not incapacitating D) Severe systemic disease that is a constant threat to life Answer: C Explanation: P3 (ASA III) denotes a patient with severe systemic disease that limits activity but is not life-threatening. Question 3. In the anesthesia formula, which component reflects the duration of the procedure? A) Base units B) Time units C) Modifying units D) Relative value units Answer: B
Explanation: Time units are calculated based on the total minutes of anesthesia care, typically in 15-minute increments. Question 4. Which CPT code represents anesthesia for a laparoscopic cholecystectomy performed on a patient with an ASA-PS of 2? A) 01402 B) 01404 C) 01406 D) 01408 Answer: B Explanation: 01402 is for abdominal procedures; the “02” modifier indicates ASA-PS 2. Code 01404 is for laparoscopic procedures. Question 5. The add-on code 99135 is used for which qualifying circumstance? A) Extreme age B) Controlled hypotension C) Emergency case D) Hypothermia induction Answer: B Explanation: 99135 is reported when controlled hypotension is deliberately induced to reduce blood loss. Question 6. Which modifier indicates that an anesthesiologist provided medical direction for a MAC case performed by a CRNA? A) AA B) AD C) QK D) QS
D) Hypertension Answer: A Explanation: Succinylcholine can trigger malignant hyperthermia; it is contraindicated in patients with a known susceptibility. Question 10. The CPT code 01967 is used for which procedure? A) General anesthesia for abdominal surgery B) Neuraxial labor analgesia (epidural or spinal) C) Anesthesia for orthopedic joint replacement D) Monitored anesthesia care for endoscopy Answer: B Explanation: 01967 specifically describes neuraxial labor analgesia administered during childbirth. Question 11. Which of the following best describes the “discontinuous time” rule in anesthesia billing? A) Time is rounded up to the nearest 15 minutes regardless of gaps B) Only continuous minutes from start to end are counted, ignoring gaps longer than 5 minutes C) Gaps of less than 5 minutes are added to total time, longer gaps are excluded D) All time, including gaps, is always counted Answer: C Explanation: Small interruptions (<5 min) are added to total anesthesia time; longer interruptions are not counted. Question 12. The CPT code 01978 is used for anesthesia during which type of procedure? A) Cardiac bypass surgery
B) MRI under anesthesia C) Interventional radiology (IR) procedure D) Obstetric delivery Answer: C Explanation: 01978 is the add-on code for anesthesia provided during an interventional radiology procedure. Question 13. Which ICD- 10 - CM code would best justify anesthesia for a total knee replacement in a patient with osteoarthritis? A) M17. B) M25. C) M54. D) R57. Answer: A Explanation: M17.11 specifies primary osteoarthritis of right knee, the most common indication for total knee arthroplasty. Question 14. In the ASA Relative Value Guide, what is the base unit value for a thyroidectomy? A) 12 B) 14 C) 16 D) 18 Answer: B Explanation: The RVG assigns 14 base units to thyroidectomy procedures. Question 15. Which modifier should be appended when an anesthesiologist performs the same procedure on two patients simultaneously in the same operating room?
Question 18. For a pediatric patient under 1 year old undergoing a cleft palate repair, which add-on code is required? A) 99100 B) 99110 C) 99115 D) 99120 Answer: A Explanation: 99100 is the “extreme age” add-on for patients less than 1 year or over 70 years old. Question 19. When coding anesthesia for a coronary artery bypass graft (CABG) with cardiopulmonary bypass, which base code is appropriate? A) 01810 B) 01840 C) 01870 D) 01900 Answer: C Explanation: 01870 is the base code for anesthesia for coronary artery bypass grafting with cardiopulmonary bypass. Question 20. Which CPT modifier indicates that the anesthesia was performed by a resident under direct supervision? A) AA B) AD C) QK D) QS Answer: B Explanation: Modifier AD denotes that a resident performed the service under direct supervision of a teaching physician.
Question 21. The “time unit” calculation for a 78-minute anesthetic case results in how many time units? A) 4 B) 5 C) 6 D) 7 Answer: B Explanation: Time units are calculated in 15-minute increments; 78 min ÷ 15 = 5.2, rounded down to 5 units. Question 22. Which of the following is an indication for using a laryngeal mask airway (LMA) instead of an endotracheal tube? A) Anticipated prolonged surgery (>4 h) B) High risk of aspiration C) Routine for laparoscopic procedures D) When mask ventilation is adequate and airway protection is not critical Answer: D Explanation: LMAs are appropriate when airway protection is not a primary concern and mask ventilation is sufficient. Question 23. The code 01969 is used for anesthesia in which obstetric scenario? A) Labor analgesia B) Elective cesarean delivery C) Emergency hysterectomy after delivery D) Post-partum tubal ligation Answer: C
D) QK
Answer: A Explanation: Modifier QS is used when the anesthesiologist personally performed the monitored anesthesia care. Question 27. Which of the following is a common side effect of high-dose propofol infusion? A) Hypertension B) Bradycardia C) Hyperthermia D) Respiratory depression Answer: D Explanation: Propofol is a potent respiratory depressant; high doses can cause profound hypoventilation. Question 28. The “base unit” for a total hip replacement (CPT 27130) is: A) 12 B) 14 C) 16 D) 18 Answer: C Explanation: According to the ASA RVG, total hip replacement carries 16 base units. Question 29. When coding anesthesia for a pediatric bronchoscopy lasting 30 minutes, which time increment is used? A) 10-minute increments B) 15-minute increments
C) 20-minute increments D) 30-minute increments Answer: B Explanation: Anesthesia time is always calculated in 15-minute blocks, regardless of procedure length. Question 30. Which CPT code is used for anesthesia during a percutaneous vertebroplasty? A) 01971 B) 01973 C) 01975 D) 01977 Answer: B Explanation: 01973 is the add-on for anesthesia provided during percutaneous vertebroplasty. Question 31. A patient with ASA-PS 4 undergoing a coronary artery bypass without cardiopulmonary bypass should have which modifier appended to the base code? A) P B) P C) P D) P Answer: D Explanation: P4 corresponds to ASA-PS 4 (severe systemic disease that is a constant threat to life). Question 32. The term “subarachnoid space” is most directly accessed during which regional technique?
Question 35. For a patient receiving a transversus abdominis plane (TAP) block for postoperative analgesia, which CPT code is appropriate? A) 64447 B) 64450 C) 64452 D) 64455 Answer: A Explanation: 64447 describes a TAP block performed for postoperative analgesia. Question 36. Which of the following is an appropriate add-on code for anesthesia provided during a pediatric MRI? A) 99140 B) 99145 C) 99150 D) 99155 Answer: B Explanation: 99145 is the add-on for anesthesia provided for an MRI procedure. Question 37. In NCCI bundling edits, anesthesia for a peripheral nerve block is: A) Always bundled into the surgical global fee B) Never bundled; always reported separately C) Bundled only when performed by the same provider as the surgery D) Bundled when the block is used solely for postoperative analgesia Answer: B Explanation: Peripheral nerve blocks are separately billable and are not bundled into the global surgical package.
Question 38. Which of the following ICD- 10 - CM codes best captures a postoperative respiratory failure requiring mechanical ventilation? A) J96. B) J96. C) J96. D) J96. Answer: C Explanation: J96.91 denotes “respiratory failure, unspecified, with acute respiratory failure,” appropriate for postoperative ventilation. Question 39. The ASA RVG assigns how many modifying units for a “controlled hypotension” circumstance? A) 2 B) 4 C) 6 D) 8 Answer: C Explanation: Controlled hypotension adds 6 modifying units to the base and time units. Question 40. Which CPT code is used for anesthesia during a liver transplant? A) 01880 B) 01886 C) 01890 D) 01896 Answer: B
Answer: C Explanation: 01406 is the base code for breast surgery, including mastectomy with reconstruction. Question 44. In the anesthesia formula, if a case has 12 base units, 6 time units, and 4 modifying units, what is the total unit count? A) 20 B) 22 C) 24 D) 26 Answer: B Explanation: Total units = Base (12) + Time (6) + Modifying (4) = 22 units. Question 45. Which of the following is the correct ICD- 10 - CM code for malignant hyperthermia? A) T88.1XXA B) E87. C) G95. D) R68. Answer: D Explanation: R68.84 is the code for malignant hyperthermia, a postoperative complication. Question 46. A patient undergoing a thoracoscopic lung resection receives one-lung ventilation. Which add-on code should be reported? A) 99130 B) 99131 C) 99132
D) 99133
Answer: B Explanation: 99131 is the add-on for one-lung ventilation during thoracic surgery. Question 47. When coding anesthesia for a patient who receives both a spinal block and a peripheral nerve block in the same encounter, how many anesthesia codes should be reported? A) One, with a modifier indicating multiple blocks B) Two separate anesthesia codes, each with its own base units C) Only the block with the higher base units is reported D) Neither is reported; they are bundled into the surgical code Answer: B Explanation: Each distinct anesthetic service (spinal and peripheral block) is reported with its own CPT anesthesia code. Question 48. Which of the following drugs is classified as a “non-depolarizing” neuromuscular blocker? A) Succinylcholine B) Rocuronium C) Ketamine D) Propofol Answer: B Explanation: Rocuronium is a non-depolarizing agent; succinylcholine is depolarizing. Question 49. The CPT code 01973 is used for anesthesia during which interventional radiology procedure? A) Embolization of hepatic tumor
Question 52. Which CPT modifier indicates that anesthesia was performed in a facility where the anesthesiologist was not physically present? A) QX B) QY C) QZ D) AA Answer: B Explanation: Modifier QY is used when the anesthesiologist provides medical direction from a remote location. Question 53. Which of the following is the correct CPT code for anesthesia during a diagnostic colonoscopy performed under MAC? A) 00810 B) 00812 C) 00820 D) 00830 Answer: B Explanation: 00812 is the code for anesthesia (MAC) for diagnostic colonoscopy. Question 54. The “ASA Physical Status” modifier P5 corresponds to which patient condition? A) Healthy with no systemic disease B) Mild systemic disease C) Severe systemic disease that is a constant threat to life D) Moribund patient not expected to survive without the operation Answer: D
Explanation: P5 (ASA V) indicates a moribund patient who is not expected to survive without the operation. Question 55. Which ICD- 10 - CM code would be most appropriate for a patient receiving anesthesia for a knee arthroscopy due to a meniscal tear? A) M23. B) M24. C) M25. D) M17. Answer: A Explanation: M23.21 specifies a meniscal tear of the right knee, the clinical indication for arthroscopy. Question 56. Which of the following is the correct add-on code for anesthesia in a patient under 3 months of age? A) 99100 B) 99110 C) 99115 D) 99120 Answer: B Explanation: 99110 is the “extreme age” add-on for patients less than 3 months old. Question 57. The “Swan-Ganz catheter” is primarily used to monitor which hemodynamic parameter? A) Central venous pressure B) Pulmonary artery pressure and cardiac output C) Arterial blood pressure D) Intracranial pressure
