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CPT & HCPCS CODING CH 1-6 EXAM 1 QUESTIONS
WITH CORRECT ANSWERS
T/F
Chapter 1: The current edition of CPT is pocket-sized and contains approximately 4, codes. - ANSWER false T/F CPT is updated by CMS, and this occurs in May of each year. - ANSWER false T/F A circle is used to denote an add-on code in CPT. - ANSWER false True or False The semi-colon separates the main term, or common portion, of the CPT code from the additional, or unique portion, of the CPT code. - ANSWER true T/F CPT was first published by the American Health Information Management Association. True or False - ANSWER false HCPCS is the abbreviation for ______________________________________. - ANSWER Correct Healthcare Common Procedure Coding System Category II codes are not mandatory and are considered ________________ codes. - ANSWER tracking When a double triangle appears around information in the CPT manual, this means that the text is new or _______________. - ANSWER revised When the plus symbol appears before a code number, this indicates to the coder that the code is considered a(n) ___________________ code. - ANSWER add-on Clinical examples of the CPT codes for Evaluation and Management services are found in appendix ______ of the CPT manual. - ANSWER C
F/T
Chapter 2: A CPT modifier is a three-digit code that is appended to a code to indicate that a service or procedure has been altered. - ANSWER false T/F Modifiers are placed in item 24d of the CMS-1500 form. - ANSWER true T/F Third-party payers use different instructions for reporting modifiers. - ANSWER true T/F The CMS form contains three modifier fields. True or False - ANSWER false T/F When reporting more than one modifier, the modifiers must be ranked according to whether or not the modifier will affect the fee for service. - ANSWER true T/F A pricing modifier only increases the fee for the service - ANSWER false T/F When reporting more than one statistical modifier, with no other pricing modifiers, the modifiers can be reported in any order, with the exception of the QT, QW, and SF modifiers.
- ANSWER true T/F Modifier 26 is used to indicate the professional component. - ANSWER true T/F Modifier 52 indicates a reduced service. - ANSWER true T/F Procedure codes for procedures performed on neonates and infants less than 4 kg should be modified with modifier 63. - ANSWER true A statistical modifier, also known as a(n) __________________ modifier is used for
A detailed examination is the highest level of examination and consists of a multi-system or complete examination of the single organ system. - ANSWER false Information regarding major illnesses, surgeries, injuries, and hospitalizations is part of the _____________________________. - ANSWER past history of the patient The objective portion of a "SOAP" note contains the: - ANSWER exam of the patient Constitutional elements of an examination include all EXCEPT which of the following? - ANSWER inspection of the eyes Medical decision making is based on all the following EXCEPT: - ANSWER examination of the patient Which of the following is NOT considered a key component when selecting an evaluation and management code? - ANSWER coordination of care A chronological description of the patient's present illness is the ______________. - ANSWER history of present illness A complete PFSH includes: - ANSWER past patient history, family history, social history Which of the following codes would NOT be reported for an inpatient hospital encounter? - ANSWER 99213 Which of the following would be reported in a clinic? - ANSWER 99214 Which of the following statements is FALSE in regard to an emergency department service code? - ANSWER A distinction is made between new and established patients. An E and M nursing facility service involving an annual nursing facility assessment which
requires a detailed interval history, comprehensive examination and medical decision making that is of low to moderate complexity is reported with code _______________. - ANSWER 99318 A home visit E and M service that involved a problem focused history and examination of a new patient and straightforward medical decision making would be reported with code _____________. - ANSWER 99341 A smoking and tobacco use cessation counseling visit of 15 minutes would be reported with code _______________. - ANSWER 99407 Dr Jones is the admitting physician for patient Sally Smith. On the first day of hospitalization Dr Jones completes a comprehensive history and examination, and the medical decision making is of moderate complexity. - ANSWER 99222 Mr Hinds is a patient in the ICU who is listed in critical condition. Because of his condition, Dr Jones spends 1 hour in the evaluation of the patient and this is documented in the chart. During this time, Dr Jones reviewed X-rays that were taken, reviewed ECGs, and performed ventilation management - ANSWER 99291 Define the term observation status. - ANSWER The patient has NOT been admitted to the hospital as an inpatient, but needs to be admitted under "observation" for assessment. List and define the 3 Rs that are used for consultation codes. - ANSWER Request-dr receives request from another dr to see patient Render-dr renders an opinion Response or Report-dr responds to initial/requesting dr via written report
When an anesthetic agent is administered directly into the bloodstream, it is known as ________________. - ANSWER injection The history and exam performed by the anesthesiology staff is part of which component of care? - ANSWER preoperative care During the administration of anesthesia, the case was complicated by emergency conditions. They type of code to report this occurrence with an addition to the anesthesia code would be __________________. - ANSWER qualifying circumstance code An anesthesiologist performed a history and physical exam that took 20 minutes to complete. The procedure required 80 minutes of anesthesia time. The time units used by the insurance company are calculated in 20 minute increments. How many units of time would be reported for this procedure? - ANSWER 4 Select the appropriate anesthesia CPT code(s). Patient: Tom Smith Age: 6 months Anesthesia: General Procedure: Hernia repair, lower abdomen - ANSWER 00834 Select the appropriate anesthesia CPT code(s). Anesthesia: General Procedure: Closed reduction of femur, lower one-third - ANSWER 01340 Select the appropriate anesthesia CPT code(s). Diganosis: Morbid obesity Anesthesia: General Procedure: Gastric bypass and restriction - ANSWER 00797 Select the appropriate anesthesia CPT code(s). Anesthesia: General Procedure: Second- degree burn excision with skin grafting for TBSA of 8 percent - ANSWER 01952 Select the appropriate anesthesia CPT code(s). Anesthesia: General Procedure:
Amniocentesis - ANSWER 00842 Select the appropriate anesthesia CPT code(s). Anesthesia: Regional Procedure: Corneal transplant - ANSWER 00144 T/F The Surgery chapter of the CPT manual is arranged by body system and types of procedures. - ANSWER true T/F Diagnostic procedures are completed to treat an established diagnosis. True or False - ANSWER false T/F Unbundling of codes is an accurate manner in which to report two procedures that are performed on the same date of service. True or False - ANSWER false T/F Fine needle aspiration is a type of aspiration by which a fine needle is inserted into the body site and then fluid is drawn from the site. True or False - ANSWER true T/F A biopsy is a procedure in which a sampling of tissue is removed for pathological examination. True or False - ANSWER true A(n) ________________ repair would be used to report a layered closure or to report extensive
Select the appropriate surgery CPT code(s). Procedure: Fine needle aspiration with imaging guidance - ANSWER 10022 Select the appropriate surgery CPT code(s). Diagnosis: Multiple lacerations Procedures: 2. cm intermediate repair of laceration of arm, 3.5 cm complex repair of laceration of forehead, and 3.4 cm intermediate repair of laceration of scalp - ANSWER 13132 and 12032 Select the appropriate surgery CPT code(s). Diagnosis: Second- and third-degree burns of 15% of total body surface Procedure: Subsequent dressing and debridement of partial- thickness burns - ANSWER 16030 Select the appropriate surgery CPT code(s). Procedure: Removal of tissue expander - ANSWER 11971 T/F Chapter 6 When imaging guidance is used to complete an injection made into a joint or bursa, additional CPT code(s) should be assigned to report the imaging guidance if the imagine guidance is not included in the primary CPT code. - ANSWER true T/F The application of force to a limb using felt that is appllied to the skin is known as skeletal traction. - ANSWER false Reduction, also known as _________________ , is completed to realign a bone. - ANSWER manipulation
ORIF is the abbreviation for ______________________________________________. - ANSWER open reduction internal fixation A(n) ____________________ is an endoscopic instrument used to visualize the interior structures of a joint. - ANSWER arthroscope Select the appropriate surgery CPT code(s). Procedure: Deep, open bone biopsy of femur - ANSWER 20245 Select the appropriate surgery CPT code(s). Diagnosis: Fracture of greater humeral tuberosity Procedure: Closed treatment with reduction of fracture - ANSWER 23625 Select the appropriate surgery CPT code(s). Procedure: Arthrodesis of metacarpophalangeal joint with internal fixation - ANSWER 26850 Select the appropriate surgery CPT code(s). Sharon Jones was in a motor vehicle accident and sustained a fracture of the ulna that required the placement of an external fixation device. Today, Dr Bones is removing the external fixation device under anesthesia. - ANSWER 20694 Select the appropriate surgery CPT code(s). Diagnosis: Trigger finger Procedure: Incision of tendon sheath - ANSWER 26055 Select the appropriate surgery CPT code(s). Radical resection of a malignant tumor of the soft tissue of the pelvis and hip area, 4 cm - ANSWER 27049 Select the appropriate surgery CPT code(s). Shoulder arthroscopy with lysis of and resection of adhesions - ANSWER 29825
