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Question 1. Which of the following is the primary factor used to differentiate a new patient from an established patient in office/outpatient E/M coding? A) Age of the patient B) Whether the patient has been seen in the last three years C) Presence of a referral source D) Whether the patient has a chronic condition Answer: B Explanation: A new patient is one who has not received any professional services from the physician or another physician of the same specialty in the same group practice within the past three years. Question 2. In the Emergency Department (ED) setting, which coding option is appropriate when the service is based solely on time and the physician spent 45 minutes in total face‑to‑face care? A) 99281 B) 99282 C) 99284 D) 99285 Answer: C Explanation: For time‑based ED coding, 99284 corresponds to 30‑59 minutes of total physician time. Question 3. The Medical Decision Making (MDM) component includes which three elements? A) History, Physical Exam, and Counseling B) Number of diagnoses, amount of data, and risk of complications
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C) Time, complexity, and documentation D) Procedure, anesthesia, and post‑operative care Answer: B Explanation: MDM complexity is determined by the number of problems addressed, the amount and complexity of data reviewed, and the risk of complications or morbidity/mortality. Question 4. For a prolonged service without direct patient contact performed after a level 4 office visit, which CPT code is used? A) 99354 B) 99355 C) 99356 D) 99357 Answer: B Explanation: 99355 reports prolonged services without direct patient contact lasting 30‑74 minutes after the primary service. Question 5. Which modifier indicates that a procedure was performed on the left side of the body? A) - RT B) - LT C) - 59 D) - 51
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Question 8. A surgeon performs an excision of a malignant melanoma of the trunk measuring 2.3 cm. Which code should be used? A) 11602 B) 11604 C) 11605 D) 11606 Answer: C Explanation: 11605 is for excision of malignant lesion 2 cm to <3 cm. Question 9. Which CPT code describes a percutaneous transluminal coronary angioplasty (PTCA) without stent placement? A) 92980 B) 92981 C) 92982 D) 92984 Answer: A Explanation: 92980 is for percutaneous transluminal coronary angioplasty, single vessel, without stent. Question 10. In radiology, which code is used for a limited ultrasound of the abdomen? A) 76700 B) 76705
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C) 76770
D) 76775
Answer: B Explanation: 76705 reports a limited ultrasound of the abdomen. Question 11. A pathology service processes a skin biopsy that includes immunohistochemical staining. Which level of surgical pathology code is appropriate? A) 88305 B) 88307 C) 88308 D) 88309 Answer: D Explanation: 88309 is for a skin specimen with immunohistochemistry, which is a Level IV (complex) pathology service. Question 12. Which CPT code represents a routine newborn screening panel? A) 83036 B) 83718 C) 82607 D) 83050
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Question 15. A patient undergoes a colonoscopy with removal of three polyps (each ≤1 cm). Which CPT code should be reported? A) 45378 B) 45380 C) 45385 D) 45385 with modifier - 59 Answer: B Explanation: 45380 includes colonoscopy with removal of up to three polyps ≤1 cm. Question 16. Which modifier is used to indicate a separate and distinct procedural service performed on the same day as another procedure? A) - 25 B) - 50 C) - 59 D) - 76 Answer: C Explanation: Modifier - 59 denotes a distinct procedural service. Question 17. In critical care coding, what is the minimum amount of time required to bill a 1‑unit critical care code? A) 30 minutes B) 45 minutes
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C) 60 minutes D) 90 minutes Answer: C Explanation: One unit of critical care (99291) requires at least 30 minutes of physician work; however, the code is defined as 30‑minute increments, so the minimum billing is 30 minutes. (Correct answer: A) Question 18. A patient receives an intra‑articular injection of corticosteroid into the knee. Which CPT code is appropriate? A) 20610 B) 20611 C) 20612 D) 20550 Answer: A Explanation: 20610 reports a therapeutic injection of a single tendon sheath, ligament, or bursa, which includes intra‑articular injections. Question 19. Which CPT code represents a diagnostic bronchoscopy without any associated procedures? A) 31622 B) 31624 C) 31625 D) 31628
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Question 22. Which CPT code describes a simple repair of a scalp laceration 0.8 cm in length? A) 12001 B) 12002 C) 12004 D) 12005 Answer: A Explanation: 12001 is for simple repair of scalp, neck, and posterior trunk lacerations 0 cm to <2.5 cm. Question 23. A patient undergoes a percutaneous renal biopsy. Which CPT code is appropriate? A) 50200 B) 50210 C) 50220 D) 50230 Answer: A Explanation: 50200 reports percutaneous renal biopsy. Question 24. Which code is used for a complete (full) abdominal ultrasound? A) 76700 B) 76705 C) 76770
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D) 76775
Answer: A Explanation: 76700 is for a complete abdominal ultrasound. Question 25. For a patient receiving a flu vaccine administered by a pharmacist, which CPT code should be reported? A) 90471 B) 90473 C) 90460 D) 90471 with modifier - 25 Answer: A Explanation: 90471 reports vaccine administration regardless of provider type. Question 26. Which CPT code includes a diagnostic endoscopy of the upper gastrointestinal tract with biopsy? A) 43235 B) 43239 C) 43240 D) 43241 Answer: B
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A) 92980
B) 92981
C) 92982
D) 92984
Answer: B Explanation: 92981 is PTCA with stent placement. Question 30. A physician documents a comprehensive metabolic panel (14 tests). Which CPT code should be reported? A) 80048 B) 80053 C) 80057 D) 80061 Answer: B Explanation: 80053 is the comprehensive metabolic panel. Question 31. Which modifier indicates that a service was performed on the same day as a prior identical service? A) - 25 B) - 76 C) - 59
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D) - 91
Answer: B Explanation: Modifier - 76 denotes repeat procedure or service by the same physician on the same day. Question 32. In the inpatient setting, which code corresponds to the initial hospital observation care? A) 99218 B) 99224 C) 99234 D) 99254 Answer: C Explanation: 99234 is for initial observation care, per admission, hospital. Question 33. A physician performs a simple excision of a benign nevus of the forearm measuring 1.2 cm. Which CPT code applies? A) 11400 B) 11401 C) 11402 D) 11403 Answer: B
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A) 77055
B) 77056
C) 77057
D) 77058
Answer: A Explanation: 77055 is for diagnostic mammography, unilateral, limited compression. Question 37. A surgeon performs a total hip arthroplasty (THA) with cemented components. Which CPT code is appropriate? A) 27130 B) 27132 C) 27134 D) 27135 Answer: A Explanation: 27130 is for total hip arthroplasty. Question 38. Which code is used for a percutaneous transluminal renal artery angioplasty without stent? A) 37231 B) 37232 C) 37233
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D) 37234
Answer: A Explanation: 37231 is for percutaneous transluminal angioplasty of renal artery, without stent. Question 39. In pathology, which code level is used for a simple skin biopsy without special stains? A) 88304 B) 88305 C) 88307 D) 88308 Answer: B Explanation: 88305 is a Level II (intermediate) pathology service for skin biopsy without special stains. Question 40. Which CPT code represents a 60‑minute EEG monitoring study? A) 95816 B) 95819 C) 95820 D) 95822 Answer: C Explanation: 95820 reports continuous EEG monitoring, each additional 30 minutes; the base code is 95816 (30 minutes).
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B) 99305
C) 99306
D) 99307
Answer: B Explanation: 99305 is for a new patient comprehensive nursing facility assessment. Question 44. Which CPT code is used for a percutaneous needle biopsy of the lung? A) 32405 B) 32407 C) 32408 D) 32410 Answer: C Explanation: 32408 reports percutaneous needle biopsy of lung, single lesion. Question 45. A physician provides a 20‑minute telephone evaluation of a patient’s medication regimen. Which CPT code is appropriate? A) 99441 B) 99442 C) 99443 D) 99444
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Answer: A Explanation: 99441 reports telephone evaluation and management service, 5‑10 minutes; however, the call is 20 minutes, so 99442 (10‑20 minutes) is correct. Question 46. Which CPT code represents a diagnostic CT scan of the abdomen and pelvis with contrast? A) 74150 B) 74160 C) 74170 D) 74178 Answer: B Explanation: 74160 is CT abdomen and pelvis with contrast. Question 47. In a hospital inpatient setting, which code is used for the initial hospital care of a new patient? A) 99221 B) 99231 C) 99251 D) 99291 Answer: A Explanation: 99221 is for initial hospital care of a new patient.
