This is second post of my next CPC Practice Questions 2017 series post. I will publish more questions in coming days. Do check these. Practice more and more these questions and find answers in the next post.
For previous post, see this :
- A 56 year old male patient had coronary artery bypass two months ag. He now presents for a re-operation for coronary bypass. Cardiopulmonary bypass machine will be used during this procedure and the patient will be placed under general anesthesia
- A male patient passes out while jogging in the park. Upon examination at the hospital he is found to have a wide complex tachycardia and undergoes and electrophysiologic study and radiofrequency ablation
- A 64 year old fell in the kitchen while mopping the floor and could not get up. The fall resulted in a broken hip. Upon examination of the break, the physician decides a hip replacement is needed. The patient is taken to the operating room where anesthesia is administered for the surgery of a total hip replacement
- A patient presents to the labor delivery department in the first stages of labor. The baby is in breech position so the physician decides to perform an external cephalic version to manipulate the fetus for a head presentation. The patient is taken to the operating room where she received anesthesia for this procedure.
C. 01967, 01968
- A 67 year old female in good physical health is having a cholecystectomy. The anesthesiologist begins to prepare this patient for surgery at 1000. The surgery begins at 10:15 and ends at 11:30. The anesthesiologist releases the patient to the PACU nurses at 11:45.
A. 1 hr 30mins, 00840
B. 1 hr 45mins, 00790
C. 1 hr 15mins, 00790
D. 2hrs 15mins, 00840
- Using ultrasound guidance an anesthesiologist injects an analegesic and a steroid mixture into the parsvertebral facet joint on both the right and left sides at L1-L2 and L2-L3. The procedure is done for pain management for the patient’s persistent pain secondary to spondylosis with myelopathy.
A. 64493, 64494, 77003-26
B. 0216T-50, 0217T-50
C. 64483-50, 64484-50, 77003-26 x2
D. 64493-50, 64494-50
- Patient is coming into surgery for total knee replacement due to worn down cartilage in the knee joint. When patient was taken to the recovery room, he still continued to have postoperative pain during recovery. The anesthesiologist came in and performed a left femoral block, which provided significant post-operative pain relief.
A. 01402, 64448, 01996
B. 01400, 64447
C. 01402, 64447
- A 15 year old male was seen this morning in his pediatrician’s office for controlling a nosebleed with cauterization. He returns to the office in the afternoon with a nosebleed continuing after initial cautery. This time the pediatrician uses Surgifoam and extensive cautery anteriorly in the left nose
- Preoperative Diagnosis: Acute MI, severe left main arteriosclerotic coronary artery disease
Postoperative Diagnosis: Acute MI, severe left main arteriosclerotic coronary artery disease
Procedure performed: Placement of an LABP right common femoral artery
Description of procedure: Patient’s right groin was prepped and draped in the usual sterile fashion. Access was obtained through the groin via opening the femoral artery. The tip of the balloon catheter was placed and then intra-aortic balloon pump was placed after the right common femoral artery had been dilated with the small dilator. The ballon pump had good waveform. The balloon pump catheter was secured to his skin after local anesthesia of 2cc of 1% Xylocaine was used to numb the area. 0 silk suture was used to secured the balloon pump. The patient had sterile dressing placed. The patient tolerated the procedure there were no complication.
- The cardiothoracic surgeon takes a patient to the operating room to perform an open balloon angioplasty of femoral pepriteal artery. During the same operative session, the surgeon performs an open transluminal peripheral atherectomy of the visceral artery.
A. 37224, 75964-26
B. 37224, 0235T
C. 37228, 37220
D. 37228, 0238T
- A lymphanglogram is performed on a patient with early onset of cervical cancer. Code the condition as well as the injection procedure with radiological imaging on one side.
A. 38790-50, 75807, 180.0.. can be this
B. 38792-50, 78195, 180.8
C. 38790, 75805, 180.9,
D. 38792, 76942, 180.0
- An eight year old male presents with multiple Ventrical Septai Defects (VSDs) and is in current heart failure. Under general anesthesia, the skin incision is made via median sternotomy. Cardiopulmonary bypass is initiated. Under epicardial guidance the muscular VSD is located. The guidewire is placed transmyocardially through the VSD. A new technology device is then delivered over guidance to close the VSD, after successful closure the guidewire is removed and the site is repaired. A chest tube is placed in the sternum.
- An oncologist performs a bone marrow aspiration and a bone marrow biopsy on the right posterior iliac spine. The procedures were performed during the same encounter. Select the appropriate code(s) for a Medicare patient.
A. 38221, 38220
C. 38221, G0364
D. 38220, G0364
- A catheter is placed into aortic arch from a right femoral arterial approach. The catheter is then guided into the right common carotid. Dye is injected and imaging of the ipsilateral extracranial carotid and bilateral external carotid is performed.
- Patient is a 26 year old female new to our group practice. She has symptoms indicative of gastritis with increasing abdominal bloating I have been contracted as a locum tenes to substitute for Dr. Allen while he is on vacation for two weeks.
- Patient is a 26 year old female in for one month follow up to our group practice for asthma. My partner Dr. Jones is unavailable today and this patient is new to me. She has no new complaint and no recurrence of dyspnea (see previous note). Blood pressure 120/84, RRR, NBS, lungs clear to auscultation. All question answered. No scheduled f/u. Return PRN. The MDM was straightforward.
- A patient presents to the oncology office for her scheduled chemotherapy. Uring the encounter she receives IV chemo medicationn for two hours and 16 minutes.
A 96413, 96415
B. 99211-25, 96413, 96417
C. 99211, 96413, 96411 X 2
D. 96413, 96365
- A 10 year old child that has regrowth of tonsil tissue is taken to the operating room for a tonsillectomy.
- A 34year old male is taken back to the OR for a takedown of his colostomy and reversal of his small intestines after six months of bowel rest for his colitis. The patient supine on the operating table and general endotracheal anesthesia is administered. His abdomen is prepped and draped in the usual sterile manner. The colostomy stoma was incised and dissected sharply from the abdominal wall. After the stoma was mobilized and taken down from the abdominal wall, it was closed with 0-0 chronic and 5-0 prolene. The abdominal incisions were closed in the usual fashion.
- A patient undergoes a laparoscopic partial colostomy of the transverse colon, including low pelvic anastomosis, due to cancer of the colon and rectum.
Please do all these questions and ask your queries in the comments section.
This is very first post of my next CPC Practice Questions 2017 series post. I will publish more questions in coming days. Do check these. Practice more and more these questions and find answers in the next post. Continue reading Practice Questions For CPC Exam 2017 -Part 1
I have prepared few questions based on ICD 10. These are based on previous year questions papers and very useful for CPC Exam 2017 and also for CIC , COC , CRC Exam 2017.
These questions are also very useful for beginner students to practice their ICD 10 coding knowledge and skills.
Here we go…
ICD 10 Practice Questions for CPC Exam 2017
- Mrs. Smith had a breast cancer was completely treated with chemotherapy and radiation therapy last year and it has been metastasis to bone.
- Metastatic lung
- Septic shock with respiratory failure
- Oral candidiasis secondary to HIV +ve
- Diabetic Neuropathy on long term Insulin
- DM, Osteomyelitis
- Diabetes and nephropathy
- Anemia of CKD
- Primary Open Angle Glaucoma
- HTN, CKD, CHF
- CHF due to diastolic dysfunction
- Pressure ulcer of Sacrum
- Asthma Exacerbation and Status asthmaticus
Continue reading ICD 10 Practice Questions for CPC Exam 2017
In this article, I will explain everything about bunion and coding of bunion surgery procedures (bunionectomies) important for AAPC coding Exam 2017. Go through the article, practice CPC exam questions and post your queries in comments section at the end of article.
Bunion or Halux Valgus
What is BUNION :
Halux – great toe
Valgus – angulation of toe away from the midline
- Bursa formed along the medial aspect of great toe.
- Enlargement of bone or tissue around the joint at the bottom of the big toe (known as the metatarsaophalangeal joint).
- It forms when your big toe pushes against your next toe, forcing joint of big toe to get bigger and stick out.
- Wearing tight, narrow shoes might cause bunions or make them worse
- Bunions also can result of an inherited structural defect.
- Stress on your foot or medical condition, such as arthritis.
What is Bunionectomy :
- Surgery to excise all the parts of bunion that involves removing soft tissue, tendones and bone and may also involve reallining the toe joint.
Types of Bunionectomy procedures:
- There are different types of Bunionectomy procedures and it is very imprtant to know the type of procedure performed to select correct CPT code.
- Some common bunion procedures includes:
- Reverse Austin ,
- Reverdin-Green and
- Hohmann procedures,
- Akins procedures / phalanx osteotomy procedures.
- The most commonly performed bunionectomy procedures are the Austin and Akin procedures.
Must Visit this site for more information : http://www.surgerybunion.com/ Continue reading How to Code Bunionectomy
A healthy 11-month-old patient with bilateral cleft lip and palate undergoes surgery. The surgeon performs a bilateral cleft lip repair, single stage. Code the anesthesia service.
- 00170-P1, 99100
- 00102-P1, 99100
Answer – 00102-P1, 99100
A 78-year-old with lower back pain and leg pain is scheduled for a MRI of lumbar spine without contrast. Following the MRI, the patient is diagnosed with spinal stenosis of the lumbar region. What are the procedure and diagnosis codes?
- 72020-26, 724.2, 729.5, 724.02
- 72149-26, 724.03
- 72148-26, 724.02
- 72158-26, 724.02, 724.2, 729.5
Answer – 72148-26, 724.02
22-year-old driver loss control of her car and crashed into a light pole on the highway. She arrived to the hospital by ambulance in an unconscious state. She had CT scans without contrast of the brain and chest. She had X-rays of AP and PA views of her left ribs and AP and PA views of her right ribs with a posterioanterior view of the chest. The CT scan of the brain showed a fracture of the skull base with no hemorrhage of the brain. The CT of the lung showed no puncture of the lungs. The X-ray showed fractures in her second, third, and fifth ribs. What CPT® and ICD-9-CM codes should be reported.
- 70450-26, 71250-26, 71101-26, 803.02, 807.03, E815.0, E849.5
- 70460-26, 71260-26, 71110-26, 801.02, 807.13, E815.0, E849.5
- 70450-26, 71250-26, 71111-26, 71010-26, 801.06, 807.03, E815.0, E849.5
- 70450-26, 71250-26, 71111-26, 801.06, 807.03, E815.0, E849.5
Answer – 70450-26, 71250-26, 71111-26, 801.06, 807.03, E815.0, E849.5
Indications: 15-year-old boy was burned in a fire and assessed to have received burns to 75 percent of his total body surface area. He was transferred to a burn center for definitive treatment. Once stable, he was brought to the OR. Procedure: Due to extent of the patient’s burns and lack of sufficient donor sites, his full-thickness burns will be excised and covered with xenograft (skin substitute graft), and a split-thickness skin biopsy will be harvested for preparation of autologous grafts to be applied in the coming weeks, when available. After induction of anesthesia, extensive debridement of the full-thickness burns was undertaken. Attention was first directed to the patient’s face, neck, and scalp. A total of 500 sq cm in this area received full-thickness burns. The eschar involving this area was excised down to viable tissue. Hemostasis was achieved using electrocautery. Attention was then turned to the trunk. A total of 950 sq cm in this area received full-thickness burns. The eschar involving this area was excised down to viable tissue. Hemostasis was achieved. Attention was then turned to the arms and legs. A total of 725 sq cm received full-thickness burns. The eschar involving this area was excised down to viable tissue. Hemostasis was achieved. Attention was then turned to the hands and feet. A total of 300 sq cm in this area received full-thickness burns. The eschar involving this area was excised down to viable tissue. All involved areas were then covered with xenograft. Finally a split thickness skin graft of 0.015 inches in depth was harvested using a dermatome from a separate donor site. A total of 85 sq cm was recovered. What procedures codes would be reported service?
- 15200, 15201 x 123, 15004, 15005, 15002, 15003
- 15275, 15276 x 31, 15271, 15272 x 66, 15004, 15005 x 16, 15002, 15003 x 7
- 15277, 15278 x 7, 15273, 15274 x 16, 15004, 15005 x 7, 15002, 15003 x 16, 15040
- 15130, 15131 x 7, 15135, 15136 x 16, 15004, 15005 x 7, 15002, 15003 x 16
Answer – 15277, 15278 x 7, 15273, 15274 x 16, 15004, 15005 x 7, 15002, 15003 x 16, 15040
Please find answers for the Practice questions 2017 here.
For Questions – Practice Questions For CPC Exam 2017 – Part One
Answers for Part 1 (Ans 1 -25)
For Questions – Practice Questions For CPC Exam 2017 – Part Two
Answers for Part 2 (Ans 26 – 50)
- 15100, 15002
- 13132, 13133 x 3, 13101, 13102, 12052
- 17000, 17003 x 4, 17110
- 24579, 812.42
- 33249, 76000-26
- 43274, 43261-51
- 58925, 58720-59
- 59870, 630
- 55700, 76942-26
- 67916-E4, 67914-E2
- 99284, 592.0
- 99214, 99354
- 00540-QK, 00540-QX
- 01810, 64417-59
- 00322, One hour
- 80061, 82947
- Inflammation of testis
- Paratubal cysts
- Newborn with pneumonia
- Nose, heart
- 0, 174.9, E930.7
- 01, 760.0, 763.82, 764.96, 765.29
- G0108 x 2
- Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure)
- Reporting a biopsy and excision performed on the same skin lesion during the same encounter.
- Use both ____ and ____ when locating and assigning a diagnosis code.
- Alphabetic Index and Appendix C
- ICD-9-CM code book and Dictionary
- Alphabetic Index and Tabular List
- Tabular List and Index to Procedures
- When a patient has a condition that is both acute and chronic and there are separate entries for both, how is it reported?
- Code only the acute code
- Code both sequencing the acute first
- Code both sequencing the chronic first
- Code only the chronic code
- How many days does it take for CMS to implement HCPCS Level II Temporary Codes that have been reported as added, changed, or deleted?
What temporary HCPCS Level II codes are required for use by Outpatient Prospective Payment System (OPPS) Hospitals?
- C codes
- H codes
- G codes
- Q codes
What agency maintains and distributes HCPCS Level II codes?
- CPT® Assistant
HCPCS Level II includes code ranges which consist of what type of codes?
- Category II codes, temporary national codes, and miscellaneous codes.
- Dental codes, morphology codes, miscellaneous codes, and permanent national codes.
- Permanent national codes, dental codes, category II codes.
- Permanent national codes, miscellaneous codes, and temporary national codes.
- How often is HCPCS Level II permanent national codes updated?
- three times a year
Laboratory and Pathology
- What is/are the code(s) for thawing 4 units of fresh frozen plasma?
- 86927 x 4
- 86931 x 4
- The code for sweat collection by iontophoresis can be found in what section of the Pathology Chapter of CPT®?
- Other Procedures
- A patient will be undergoing a transplant and needs HLA tissue typing with DR/DQ multiple antigen and lymphocyte mixed culture. How will these services be coded?
- 86805-26, 86817
- 86817, 86821
- 86816-26, 86821
- 86806-26, 86817
- A physician orders a quantitative FDP. What CPT® code is reported?
- A patient’s mother and sister have been treated for breast cancer. She has blood drawn for cancer gene analysis with molecular pathology testing. She has previously received genetic counseling. Blood will be tested for full sequence analysis and common duplication or deletion variants (mutations) in BRCA1, BRCA2 (breast cancer 1 and 2). What CPT® code is reported for this molecular pathology procedure?
- A patient with AIDS presents for follow up care. An NK (natural killer cell) total count is ordered. What CPT® code(s) is/are reported?
- 86361, 86359
- A patient has partial removal of his lung. The surgeon also biopsies several lymph nodes in the patient’s chest which are examined intraoperatively by frozen section and sent with the lung tissue for Pathologic examination. The pathologist also performs a trichrome stain. What CPT® codes are reported for the lab tests performed?
- 88309 x 2, 88313
- 88307, 88305×2, 88332
- 88309, 88305, 88313, 88331
- 88309, 88307, 88313
- A couple with inability to conceive has fertility testing. The semen specimen is tested for volume, count, motility and a differential is calculated. The findings indicate infertility due to oligospermia. What CPT® and ICD-9-CM codes are reported?
- 89310, 89320, V26.21
- 89320, 606.1
- 89257, 606.9, V26.21
- 89264, 606.1
- In a legal hearing to determine child support there is a dispute about the child’s paternity. The court orders a paternity test, and a nasal smear is taken from the plaintiff and the child. The plaintiff is confirmed as the father of the child. Choose the CPT®, ICD-9-CM codes and modifier for the paternity testing.
- 89190-32, V26.39
- 86900, V70.4
- 86910-32, V70.4
- 86910, V26.39
- A virus is identified by observing growth patterns on cultured media. What is this type of identification is called?
- A female patient fell on the floor as she got out of bed. She has no known head trauma. She noticed some slight stiffness in her joints and weakness in her lower extremity muscles, with slight stiffness in her arm joints. The physician decided to test for possible multiple sclerosis (MS). She was sent to a clinic providing somatosensory studies. The testing included upper and lower limbs. What CPT® codes are reported?
- 95925, 95926
- 64-year-old patient came to the emergency department complaining of chest pressure. The physician evaluated the patient and ordered a 12 lead EKG. Findings included signs of acute cardiac damage. Appropriate initial management was continued by the ED physician who contacted the cardiologist on call in the hospital. Admission to the cardiac unit was ordered. No beds were available in the cardiac unit and the patient was held in the ED. The cardiologist left the ED after completing the evaluation of the patient.
Several hours passed and the patient was still in the ED. During an 80-minute period, the patient experienced acute breathing difficulty, increased chest pain, arrhythmias, and cardiac arrest. The patient was managed by the ED physician during this 80-minute period. Included in the physician management were a new 12 lead EKG, endotracheal intubation and efforts to restore the patient’s breathing and circulation for 20 minutes. CPR was unsuccessful, the patient was pronounced dead after a total of 44 minutes critical care time, exclusive of other separately billable services. What CPT® codes are reported by the physician?
- 99285-25, 93010 x 2, 31500, 92950
- 99291-25, 31500, 93000, 92950
- 99291-25, 99292-25, 93005-59 x 2, 31500
- 99291-25, 31500, 92950
- A patient with Sickle cell anemia with painful sickle crisis received normal saline IV, 100 cc per hour to run over 5 hours for hydration in the physician’s office. She will be given Morphine & Phenergan, prn (as needed). What codes are reported?
- 96360, 96361 x 4, J7050 x 2
- 96360, 96361 x 3, J7030
- 96360 x 5, J7050
- 96360, J7030
- A patient with bilateral sensory hearing loss is fitted with a digital, binaural, behind the ear hearing aid. What HCPCS Level II and ICD-9-CM codes should be reported?
- V5140, 389.11, V53.2
- V5140, 389.22
- V5261, V53.2, 389.11
- V5261, V72.11, 389.11
- 5-year-old is brought in to see an allergist for generalized urticaria. The family just recently visited a family membe that had a cat and dog. The mother wants to know if her son is allergic to cats and dogs. The child’s skin was scratched with two different allergens. The physician waited 15 minutes to check the results. There was a flare up reaction to the cat allergen, but there was no flare up to the dog allergen. The physician included the test interpretation and report in the record.
- 95024 x 2
- 95027 x 2
- 95004 x 2
- 95018 x 2
- 42-year-old patient presented to the urgent care center with complaints of slight dizziness. He had received services at the clinic about 2 years ago. The patient related this episode happened once previously and his 51-year-old brother has a pacemaker. A chest X-ray with 2 views and an EKG with rhythm strip were ordered (equipment owned by the urgent care center). The physician detected no obvious abnormalities, but the patient was advised to see a cardiologist within the next 2 – 3 days. The physician interpreted and provided a report for the rhythm strip and Chest X-ray. What CPT® and ICD-9-CM codes are reported for the physician employed by the urgent care center who performed a Level 3 office visit in addition to the ancillary services?
- 99213-25, 71020, 93040
- 99283-25, 71010-26, 93010,
- 99213-25, 71020-26, 93042
- 99203-25, 71010, 93000
- 55-year-old male has had several episodes of tightness in the chest. His physician ordered a PTCA (percutaneous transluminal coronary angioplasty) of the left anterior descending coronary artery. The procedure revealed atherosclerosis in the native vessel. It was determined a stent would be required to keep the artery open. The stent was inserted during the procedure.
- 92920-LD, 92928
- 92920-LD, 92929-59
- 92920-LD, 92928-59
- A pregnant female is Rh negative and at 28 weeks gestation. The child’s father is Rh positive. The mother is given an injection of a high-titer Rho (D) immune globulin, 300 mcg, IM. What CPT® codes are reported?
- 90384, 96372
- 90384, 90471
- 90386, 96372
- 90386, 90471
- A patient with hypertensive end stage renal failure, stage V, and secondary hyperparathyroidism is evaluated by the physician and receives peritoneal dialysis. The physician evaluates the patient once before dialysis begins. What CPT® and ICD-9-CM codes are reported?
- 90945, 401.9, 585.5, 588.81
- 90945, 403.91, 585.6, 588.81
- 90947, 403.91, 588.81
- 90947, 403.91, 585.5
- A patient with congestive heart failure and chronic respiratory failure is placed on home oxygen. Prescribed treatment is 2 L nasal cannula oxygen at all times. A home care nurse visited the patient to assist with his oxygen management. What CPT® and ICD-9-CM codes are reported?
- 99503, 428.0, 518.83
- 99504, 428.40, 518.83
- 99503, 428.9, 518.82
- 99503, 428.0, 518.82
- The meaning of the root “blephar/o” is:
- The meaning of heteropsia (or anisometropia) is:
- Blindness in half the visual field
- Unequal vision in the two eyes
- Double vision
- Blindness in both eye
- The radiology term “fluoroscopy” is described as:
- Technique using magnetism, radio waves and a computer to produce images
- An X-ray procedure allowing the visualization of internal organs in motion
- A scan using an X-ray beam rotating around the patient
- Use of high-frequency sound waves to image anatomic structures
- Sialography is an X-ray of :
- Salivary glands
- Ventricles of the brain
- A projection is the path of the X-ray beam. If the projection is front to back it would be:
- Cytopathology is the study of:
- The process of preserving cells or whole tissues at extremely low temperatures is known as:
- Cryotherapy c. Cryalgesia b. Cryopexy d. Cryopreservation
- A gonioscopy is an examination of what part of the eye:
- Anterior chamber of the eye c. Lacrimal duct b. Interior surface of the eye
- Posterior segment
- Which cells produce hormones to regulate blood sugar?
- Pancreatic islets
- Target cells
- Which part of the brain controls blood pressure, heart rate and respiration?
- What are chemicals which relay, amplify and modulate signals between a neuron and another cell?
- Which of the following conditions results from an injury to the head? The symptoms include headache, dizziness and vomiting.
- Parkinson’s disease
- Lacrimal glands are responsible for which of the following?
- Production of tears
- Production of vitreous
- Production of zonules
- Production of mydriatic agents
- Which of the following does NOT contribute to refraction in the eye?
- A patient diagnosed with glaucoma has:
- A lens that is no longer clear
- Abnormally high intraocular pressure
- Bleeding vessels on the retina
- Corneal neovascularization
- Which of the following is true about the tympanic membrane?
- It separates the middle ear from the inner ear
- It separates the external ear from the middle ear
- It sits within the middle ear
- It sits within the inner ear
- Dr. Inez discharges Mr. Blancos from the pulmonary service after a bout of pneumococcal pneumonia. She spends 45 minutes at the bedside explaining to Mr. Blancos and his wife the medications and IPPB therapy she ordered. Mr. Blancos is a resident of the Shady Valley Nursing Home due to his advanced Alzheimer’s disease and will return to the nursing home after discharge. On the same day Dr. Inez re-admits Mr. Blancos to the nursing facility. She obtains a detailed interval history, does comprehensive examination and the medical decision making is moderate complexity. What is/are the appropriate evaluation and management code(s) for this visit?
- 99238, 99305
- 99239, 99304
- 37-year-old female is seen in the clinic for follow-up of lower extremity swelling.
HPI: Patient is here today for follow-up of bilateral lower extremity swelling. The swelling responded to hydrochlorothiazide.
DATA REVIEW: I reviewed her lab and echocardiogram. The patient does have moderate pulmonary hypertension.
Exam: Patient is in no acute distress.
- Bilateral lower extremity swelling. This has resolved with diuretics, it may be secondary to problem #2.
- Pulmonary hypertension: Etiology is not clear at this time, will work up and possibly refer to a pulmonologist.
PLAN: Will evaluate the pulmonary hypertension. Patient will be scheduled for a sleep study.
- 45-year-old established, female patient is seen today at her doctor’s office. She is complaining of severe dizziness and feels like the room is spinning. She has had palpitations on and off for the past 12 months. For the ROS, she reports chest tightness and dyspnea but denies nausea, edema, or arm pain. She drinks two cups of coffee per day. Her sister has WPW (Wolff-Parkinson-White) syndrome. An extended exam of five organ systems are performed. This is a new problem. An EKG is ordered and labs are drawn, and the physician documents a moderate complexity MDM. What CPT® code should be reported for this visit?
- 33 year-old male was admitted to the hospital on 12/17/XX from the ER, following a motor vehicle accident. His spleen was severely damaged and a splenectomy was performed. The patient is being discharged from the hospital on 12/20/XX. During his hospitalization the patient experienced pain and shortness of breath, but with an antibiotic regimen of Levaquin, he improved. The attending physician performed a final examination and reviewed the chest X-ray revealing possible infiltrates and a CT of the abdomen ruled out any abscess. He was given a prescription of Zosyn. The patient was told to follow up with his PCP or return to the ER for any pain or bleeding. The physician spent 20 minutes on the date of discharge. What CPT® code is reported for the 12/20 visit?
- 60-year-old woman is seeking help to quit smoking. She makes an appointment to see Dr. Lung for an initial visit. The patient has a constant cough due to smoking and some shortness of breath. No night sweats, weight loss, night fever, CP, headache, or dizziness. She has tried patches and nicotine gum, which has not helped. Patient has been smoking for 40 years and smokes 2 packs per day. She has a family history of emphysema. A limited three system exam was performed. Dr Lung discussed in detail the pros and cons of medications used to quit smoking. Counseling and education was done for 20 minutes of the 30 minute visit. Prescriptions for Chantrix and Tetracylcine were given. The patient to follow up in 1 month. A chest X-ray and cardiac work up was ordered. Select the appropriate CPT code(s) for this visit.
- 99203, 99354
- 99214, 99354
- A pre-anesthesia assessment was performed and signed at 10:21 a.m. Anesthesia start time is reported as 12:26 pm, and the surgery began at 12:37 pm. The surgery finished at 15:12 pm and the patient was turned over to PACU at 15:26 pm, which was reported as the ending anesthesia time. What is the anesthesia time reported?
- 10:21 am to 15:12 pm (291 minutes)
- 12:26 am to 15:12 pm (146 minutes)
- 12:26 am to 15:26 pm (180 minutes)
- 12:37 am to 15:26 pm (169 minutes)
- Code 00350 Anesthesia for procedures on the major vessels of the neck; not otherwise specified has a base value of ten (10) units. The patient is a P3 status, which allows one (1) extra base unit. Anesthesia start time is reported as 11:02 am, and the surgery began at 11:14 am. The surgery finished at 12:34 am and the patient was turned over to PACU at 12:47 am, which was reported as the ending anesthesia time. Using fifteen-minute time increments and a conversion factor of $100, what is the correct anesthesia charge?
- Code 00940, anesthesia for vaginal procedures, has a base value of three (3) units. The patient was admitted under emergency circumstances, qualifying circumstance code 99140, which allows two (2) extra base units. A pre-anesthesia assessment was performed and signed at 2:00 a.m. Anesthesia start time is reported as 2:21 am, and the surgery began at 2:28 am. The surgery finished at 3:25 am and the patient was turned over to PACU at 3:36 am, which was reported as the ending anesthesia time. Using fifteen-minute time increments and a conversion factor of $100, what is the correct anesthesia charge?
- 94-year-old patient is having surgery to remove his parotid gland, with dissection and preservation of the facial nerve. The surgeon has requested the anesthesia department place an arterial line. What CPT® code(s) is/are reported for anesthesia?
- 00300, 36620
- 00100, 99100
- 00100, 36620, 99100
- 5- year-old patient is experiencing atrial fibrillation with rapid ventricular rate. The anesthesia department is called to insert a non-tunneled central venous (CV) catheter. What CPT® code is reported?
- 43-year-old patient with a severe systemic disease is having surgery to remove an integumentary mass from his neck. What CPT® code and modifier are reported for the anesthesia service?
- An 11-month-old patient presented for emergency surgery to repair a severely broken arm after falling from a third story window. What qualifying circumstance code(s) may be reported in addition to the anesthesia code?
- 99100, 99140
- 59-year-old patient is having surgery on the pericardial sac, without use of a pump oxygenator. The perfusionist placed an arterial line. What CPT® code(s) is/are reported for anesthesia?
- 00560, 36620
- 41-year-old male is in his doctor’s office for a follow up of an abnormality, which was noted, on an abdominal CT scan. He is to have a chest X-ray due to chest tightness. He otherwise states he feels well and is here to go over the results of his chest X-ray (PA and Lateral) performed in the office and the CT scan performed at the diagnostic center. The results of the chest X-ray were normal. CT scan was sent to the office and the physician interpreted and documented that the CT scan of the abdomen showed a small mass in his right upper quadrant. What CPT® codes are reported for the doctor’s office radiological services?
- 71020-26, 74150-26
- 71020-26, 74150
- 71020, 74150
- 71020, 74150-26
- A patient has a history of chronic venous embolism in the superior vena cava (SVC) and is having a radiographic study to visualize any abnormalities. In outpatient surgery the physician accesses the subclavian vein and the catheter is advanced to the superior vena cava for injection and imaging. The supervision and interpretation of the images is performed by the physician. What codes are reported for this procedure?
- 36010, 75827-26
- 36000, 75827-26
- 36000, 75820-26
- 36010, 75820-26
- 70-year-old female presents with a complaint of right knee pain with weight bearing activities. She is also developing pain at rest. She denies any recent injury. There is pain with stair climbing and start up pain. An AP, Lateral and Sunrise views of the right knee are ordered and interpreted. They reveal calcification within the vascular structures. There is decreased joint space through the medial compartment where she has near bone-on-bone contact, flattening of the femoral condyles, no fractures noted. The diagnosis is right knee pain secondary to underlying localized degenerative arthritis. What CPT® codes are reported?
- Myocardial Perfusion Imaging—Office Based Test
Indications: Chest pain.
Procedure: Resting tomographic myocardial perfusion images were obtained following injection of 10 mCi of intravenous cardiolite. At peak exercise, 30 mCi of intravenous cardiolite was injected, and post-stress tomographic myocardial perfusion images were obtained. Post stress gated images of the left ventricle were also acquired.
Myocardial perfusion images were compared in the standard fashion.
Findings: This is a technically fair study. There were no stress induced electrocardiographic changes noted. There are no significant reversible or fixed perfusion defects noted. Gated images of the left ventricle reveal normal left ventricular volumes, normal left ventricular wall motion, and an estimated left ventricular ejection fraction of 50%.
Impression: No evidence of myocardial ischemia or infarction. Normal left ventricular ejection fraction. What CPT® code(s) is/are reported?
- 78451, A9500
- 78451, A9500 x 30
- After intravenous administration of 5.1 millicuries Tc-99m DTPA, flow imaging of the kidneys was performed for approximately 30 minutes. Flow imaging demonstrated markedly reduced flow to both kidneys bilaterally. What CPT® code is reported?
- An oncology patient is having weekly radiation treatments with a total of seven conventional fractionated treatments. Two fractionated treatments daily for Monday, Tuesday and Wednesday and one treatment on Thursday. What radiology code(s) is/are appropriate for the clinical management of the radiation treatment?
- 77427 x 2
- 77427 x 7
- Magnetic resonance imaging of the chest is first done without contrast medium enhancement and then is performed with an injection of contrast. What CPT® code(s) is/are reported for the radiological services?
- 71550, 71551
- A CT scan confirms improper ossification of cartilages in the upper jawbone and left side of the face area for a patient with facial defects. The CT is performed with contrast material in the hospital. What CPT® code is reported by an independent radiologist contracted by the hospital?
- A patient is positioned on the scanning table headfirst with arms at the side for an MRI of the thoracic spine and spinal canal. A contrast agent is used to improve the quality of the images. The scan confirms the size and depth of a previously biopsied leiomyosarcoma metastasized to the thoracic spinal cord. What CPT® codes are reported?
- A young child is taken to the OR to reduce a meconium plug bowel obstruction. A therapeutic enema is performed with fluoroscopy. The patient is in position and barium is instilled into the colon through the anus for the reduction. What CPT® code is reported by the independent radiologist for the radiological service?