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Chapter 6 Test Review Question 1_ 4 out of 4 points What hernia repair codes can be reported with add-on code 49568? Selected Answer: a. 49560- Correct Answer: a. 49560- Response Feedback: Rationale: Look in your CPT® codebook for 49568. The parenthetical note under add-on code 49568 states to Use 49568 in conjunction with 11004-11006, 49560-49566. Question 2_ 4 out of 4 points Services provided in the home by an agency are considered Selected Answer: (^) c. Facility services Correct Answer: (^) c. Facility services Response Feedback: Rationale: The Introduction in the CPT® codebook (after the Table of Contents) includes instructions under the subheading Place of Service and Facility Reporting, which indicates services provided in the home by an agency are considered facility services. Question 3_ 4 out of 4 points A patient is in the OR for an arthroscopy of the medial compartment of his left knee. A meniscectomy is performed. What is the correct code used to report for the anesthesia services? Selected Answer: (^) c. 01400 Correct Answer: (^) c. 01400 Response Feedback: Rationale: In the CPT® Index, look for Anesthesia/Knee where there are multiple codes to choose from. Turn to these codes in the Anesthesia section and review them. Code 01400 represents anesthesia for a surgical arthroscopic procedure performed on the knee joint, not otherwise specified. Question 4_ 4 out of 4 points What is the full description for code 11001?
Selected Answer: c. Debridement of extensive eczematous or infected skin; each additional 10% of the body surface, or part thereof (List separately in addition to code for primary procedure) Correct Answer: c. Debridement of extensive eczematous or infected skin; each additional 10% of the body surface, or part thereof (List separately in addition to code for primary procedure) Response Feedback: Rationale: Look at code 11001 in the Integumentary numeric section of the CPT® codebook. The code description of an indented code includes the portion before the semicolon in the main code. In this example, the common portion of the code is shown in 11000 Debridement of extensive eczematous or infected skin; and the remaining portion of the code descriptor is in add-on code 11001 each additional 10% of the body surface, or part thereof. Question 5_ 4 out of 4 points What publications does the AMA copyright and maintain? Selected Answer: (^) c. CPT® codebook and CPT® Assistant Correct Answer: (^) c. CPT® codebook and CPT® Assistant Response Feedback: Rationale: CPT® (all three categories) and CPT® Assistant is published, copyrighted and maintained by AMA. Question 6_ 4 out of 4 points What is the correct CPT® code for a MRI performed on the brain first without contrast and then with contrast? Selected Answer: (^) b. 70553 Correct Answer: (^) b. 70553 Response Feedback: Rationale: In the CPT® Index, look for Magnetic Resonance Imaging (MRI)/Diagnostic/Brain. You are directed to see codes 70551-70555. Upon review of the codes in the Radiology numeric section, code 70553 represents an MRI performed on the brain first without contrast material, then with contrast material. Question 7_ 4 out of 4 points CPT® Category III codes reimburse at what level? Selected Answer: (^) b. Reimbursement, if any, is determined by the payer Correct Answer: (^) b.
Correct Answer: d. 50070 Response Feedback: Rationale: In the CPT® Index, look for Nephrolithotomy. You are directed to see codes 50060-
- In the Urinary numeric section, review the descriptions of these codes. Code 50070 represents a nephrolithotomy complicated by a congenital kidney abnormality. Question 12_ 4 out of 4 points What is the correct CPT® code for the wedge excision of a nail fold of an ingrown toenail? Selected Answer: (^) b. 11765 Correct Answer: (^) b. 11765 Response Feedback: Rationale: In the CPT® Index, look for Excision/Nail Fold referring you to 11765. Question 13_ 4 out of 4 points What does “non-facility” describe when calculating Medicare Physician Fee Schedule payments? Selected Answer: (^) d. Non-hospital owned physician practices Correct Answer: d. Non-hospital owned physician practices Response Feedback: Rationale: “Non-facility” location calculations are for private practices or non-hospital-owned physician practices. Reimbursement is higher for private practices because the practice incurs the full expense of providing the service. Question 14_ 4 out of 4 points What chapter in the HCPCS Level II codebook lists the code for Wheelchairs? Selected Answer: (^) d. Durable Medical Equipment (E0100-E8002) Correct Answer: (^) d. Durable Medical Equipment (E0100-E8002) Response Feedback: Rationale: A wheelchair is considered durable medical equipment. In the HCPCS index, look for the term Wheelchair. The majority of the codes listed are E codes. Question 15_ 4 out of 4 points What is the correct CPT® code for the extensive excision of nasal polyps?
Selected Answer: (^) d. 30115 Correct Answer: (^) d. 30115 Response Feedback: Rationale: In the CPT® Index, look for Excision/Polyp/Nose which directs you to 30110, 30115. You may also look in the CPT® Index for Excision/Nose/Polyp and get the same codes. Looking at the description for each code in the Respiratory numeric section, code 30115 is selected for extensive. If you look up Polyp/Nose/Excision/Extensive in the CPT® Index, code 30115 is listed. Question 16_ 4 out of 4 points What is the correct CPT® code to report a microscopic urinalysis? Selected Answer: (^) b. 81015 Correct Answer: (^) b. 81015 Response Feedback: Rationale: In the CPT® Index, look for Urinalysis/Microscopic. The code you are directed to use is 81015. Question 17_ 4 out of 4 points What does the acronym HCPCS stand for? Selected Answer: (^) a. Healthcare Common Procedure Coding System Correct Answer: (^) a. Healthcare Common Procedure Coding System Response Feedback: Rationale: HCPCS stands for Healthcare Common Procedure Coding System. Question 18_ 4 out of 4 points What is the code for partial laparoscopic colectomy with anastomosis and coloproctostomy? Selected Answer: (^) d. 44207 Correct Answer: d. 44207 Response Feedback: Rationale: In the CPT® Index, look for Laparoscopy/ Colectomy/Partial. You are directed to codes 44204-44208 and 44213. In the Digestive numeric section, upon review of the codes, 44207 represents a partial colectomy with anastomosis and coloproctostomy performed laparoscopically. Question 19_ 4 out of 4 points
Selected Answer: (^) c. 67312 Correct Answer: (^) c. 67312 Response Feedback: Rationale: In the CPT® Index, look for Strabismus/Repair/Two Horizontal Muscles referring you to 67312. Question 23_ 4 out of 4 points What is the correct code for the application of a short arm cast? Selected Answer: (^) d. 29075 Correct Answer: d. 29075 Response Feedback: Rationale: In the CPT® Index, look for Cast/Type/Ambulatory/Short Arm. The code you are directed to use is 29075. Question 24_ 4 out of 4 points What surgical status indicator represents the Global Surgical Package for endoscopic procedures (without an incision) where there is no postoperative period after the day of the surgery?? Selected Answer: (^) d. 000 Correct Answer: (^) d. 000 Response Feedback: Rationale: For endoscopic procedures (except procedures requiring an incision), there is no postoperative period. Surgical status indicator 000 = Endoscopic or minor procedure with related preoperative and postoperative relative values on the day of the procedure only included in the fee schedule payment amount; evaluation and management services on the day of the procedure generally not payable. Question 25_ 4 out of 4 points The Table of Drugs in the HCPCS Level II book indicates various medication routes of administration. What abbreviation represents the route where a drug is introduced into the subdural space of the spinal cord? Selected Answer: (^) b. IT Correct Answer: (^) b. IT Response Feedback: Rationale: In the HCPCS Level II codebook, there is an appendix that lists the abbreviations and acronyms and their meanings. IT stands for Intrathecal. IT is the route where a drug is
introduced into the subdural space of the spinal cord. (Additional Submission) Question 1_ 4 out of 4 points What is the CPT® code used to report a right heart cardiac catheterization for congenital anomalies? Selected Answer: (^) c. 93530 Correct Answer: (^) c. 93530 Response Feedback: Rationale: In the CPT® Index, Catheterization/Cardiac directs you to See Cardiac Catheterization. Cardiac Catheterization/Right Heart/Congenital Cardiac Anomalies directs you to code 93530. Question 2_ 4 out of 4 points What is the correct code for the administration of one vaccine given intramuscularly for a child under eight years of age when the physician counsels the parents? Selected Answer: (^) d. 90460 Correct Answer: (^) d. 90460 Response Feedback: Rationale: In the CPT® Index, look for Immunization Administration/One Vaccine/Toxoid/with Counseling. You are directed to use code 90460. Question 3_ 4 out of 4 points What is the correct CPT® code for level IV surgical pathology? Selected Answer: (^) b. 88305 Correct Answer: (^) b. 88305 Response Feedback: Rationale: In the CPT® Index, look for Pathology and Laboratory/Surgical Pathology/Gross and Micro Exam/Level IV. The code you are directed to use is 88305. Question 4_ 4 out of 4 points What is the correct HCPCS Level II code for a removable metatarsal foot arch support that is pre-molded? Selected Answer: a.
What is the correct CPT® code for the extensive excision of nasal polyps? Selected Answer: (^) b. 30115 Correct Answer: (^) b. 30115 Response Feedback: Rationale: In the CPT® Index, look for Excision/Polyp/Nose which directs you to 30110, 30115. You may also look in the CPT® Index for Excision/Nose/Polyp and get the same codes. Looking at the description for each code in the Respiratory numeric section, code 30115 is selected for extensive. If you look up Polyp/Nose/Excision/Extensive in the CPT® Index, code 30115 is listed. Question 9_ 4 out of 4 points What is the correct CPT® code for the excision of a benign lesion on the scalp with an excised diameter of 2. cm? Selected Answer: (^) a. 11423 Correct Answer: (^) a. 11423 Response Feedback:
Rationale: In the CPT® Index, look for Excision/Skin/Lesion, Benign or Skin/Excision/Lesion/Benign. You are directed to 11400-11471. Turn to these codes in the numeric section and, once reviewed, code 11423 is reported. This represents the excision of a benign lesion on the scalp, neck, hand feet or genitalia; 2.1-3.0 cm in diameter excised including margins. Question 10_ 4 out of 4 points How are ambulance modifiers used? Selected Answer: (^) d. They identify ambulance place of origin and destination. Correct Answer: d. They identify ambulance place of origin and destination. Response Feedback: Rationale: Transportation (ambulance) services utilize modifiers made up of two letters identifying the origin and the destination according to the HCPCS Level II guidelines at the beginning of section A, Transportation Services Including Ambulance A0021-A0999. Question 11_ 4 out of 4 points What is the correct CPT® code for strabismus corrective surgery performed on two horizontal muscles? Selected Answer: (^) d. 67312 Correct Answer: (^) d.
Response Feedback: Rationale: In the CPT® Index, look for Strabismus/Repair/Two Horizontal Muscles referring you to 67312. Question 12_ 4 out of 4 points How many days does it take CMS to implement HCPCS Level II Temporary Codes that have been reported as added, changed or deleted? Selected Answer: (^) d. 90 Correct Answer: (^) d. 90 Response Feedback: Rationale: Per CMS, temporary codes can be added, changed or deleted on a quarterly basis. Once established, temporary codes are usually implemented within 90 days, the time needed to prepare and issue implementation instructions and to enter the new code into CMS's and the contractors' computer systems and initiate user education. This time allows instructions, such as bulletins and newsletters, to be sent to suppliers providing them with information and assistance regarding the implementation of temporary codes. Question 13_ 4 out of 4 points What is the correct code for the performance measure for moderate rheumatoid arthritis disease activity? Selected Answer: (^) d. 3471F Correct Answer: (^) d. 3471F Response Feedback: Rationale: In the CPT® Index, look for Performance Measures/Rheumatoid Arthritis/ Diagnostic/Screening Processes or Results/Rheumatoid Arthritis Disease Activity Assessment. You are directed to see codes 3470F-3472F. Upon further review, code 3471F represents the measurement of moderate disease activity in a patient with rheumatoid arthritis. Question 14_ 4 out of 4 points What is the correct CPT® code for the wedge excision of a nail fold of an ingrown toenail? Selected Answer: (^) d. 11765 Correct Answer: (^) d. 11765 Response Feedback: Rationale: In the CPT® Index, look for Excision/Nail Fold referring you to 11765. Question 15_ 4 out of 4 points
What type of CPT® code is “modifier 51 exempt” even though there is no modifier 51 exempt symbol next to it? Selected Answer: (^) b. Add-on codes Correct Answer: (^) b. Add-on codes Response Feedback: Rationale: Per CPT®, “all add-on codes found in the CPT® codebook are exempt from the multiple procedure concept.” Question 20_ 4 out of 4 points What is the correct CPT® code for a complicated nephrolithotomy on a patient with a congenital kidney abnormality? Selected Answer: (^) a. 50070 Correct Answer: (^) a. 50070 Response Feedback: Rationale: In the CPT® Index, look for Nephrolithotomy. You are directed to see codes 50060-
- In the Urinary numeric section, review the descriptions of these codes. Code 50070 represents a nephrolithotomy complicated by a congenital kidney abnormality. Question 21_ 4 out of 4 points What surgical status indicator represents the Global Surgical Package for endoscopic procedures (without an incision) where there is no postoperative period after the day of the surgery?? Selected Answer: d. 000 Correct Answer: (^) d. 000 Response Feedback: Rationale: For endoscopic procedures (except procedures requiring an incision), there is no postoperative period. Surgical status indicator 000 = Endoscopic or minor procedure with related preoperative and postoperative relative values on the day of the procedure only included in the fee schedule payment amount; evaluation and management services on the day of the procedure generally not payable. Question 22_ 4 out of 4 points What chapter in the HCPCS Level II codebook lists the code for Wheelchairs? Selected Answer: c. Durable Medical Equipment (E0100-E8002) Correct Answer: (^) c. Durable Medical Equipment (E0100-E8002)
Response Feedback: Rationale: A wheelchair is considered durable medical equipment. In the HCPCS index, look for the term Wheelchair. The majority of the codes listed are E codes. Question 23_ 4 out of 4 points What does the acronym HCPCS stand for? Selected Answer: (^) b. Healthcare Common Procedure Coding System Correct Answer: (^) b. Healthcare Common Procedure Coding System Response Feedback: Rationale: HCPCS stands for Healthcare Common Procedure Coding System. Question 24_ 4 out of 4 points Which statement is TRUE regarding the instruction for use of the CPT® codebook? Selected Answer: a. Select the name of the procedure or service that accurately identifies the service performed. Correct Answer: a. Select the name of the procedure or service that accurately identifies the service performed. Response Feedback: Rationale: CPT® Instructions for the use of the CPT® codebook indicates to “select the name of the procedure or service that accurately identifies the service performed.” Instructions for Use of the CPT codebook is found in the front of the CPT codebook in the Introduction. Question 25_ 4 out of 4 points What is the correct anesthesia CPT® code for surgery performed on the frontal lobe of the brain? Selected Answer: (^) b. 00210 Correct Answer: b. 00210 Response Feedback: Rationale: In the CPT® Index, look for Anesthesia/Brain. Here you are directed to see codes 00210-00218, 00220-00222. Review the codes in Anesthesia section. Code 00210 represents anesthesia for intracranial (brain) procedures, not otherwise specified.
