This is third 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 posts, see this :
- A patient is seen at the doctor’s office nausea, vomiting and abdominal pain. Labs came back indicating an increased WBC count. The physician determines the patient has an acute appendicitis. The physician scheduled an OR and took the patient to the operating room. An abdominal incision is made. The patient is also diagnosed with generalized peritonitis. An appendectomy is performed
- Operative Report
Preoperative Diagnosis: Incarcerated left inguinal hernia in 38 year old male
Postoperative Diagnosis: As above
Finding: Huge incarcerated left inguinal hernia containing bowel and ascetic fluid
Technique: The patient was placed on the operating room table in the supine position. IV sedation was administered without complications. Oxygen and monitoring were in place per protocol. Left groin and scrotum were prepped with Betadine and draped in a sterile fashion. Local anesthesia was infiltrated in the subcutaneous tissue in a field block using a mixture of lidocaine, Marcaine, Saline. The patient was placed general Trendelenburg position. The incision was made over the inguinal ligament and dissection was carried down sharply to the external oblique aponeurosis which was opened along the course of its fibers. Hernia and spermatic cord was encircled with a Penrose drain at the public tubercle. The ilioinguinal nerve was identified and carefully preserved, retracted superiorly. The incarcerated hernia sac was gendy dissected away from the vas and the testicular vessels with careful preservation of the vessels. The hernia was then reduced and the defect closed with an extra large Marlex mesh plug which was sutured in place at various points using 2-0 Vicryl suture. The mesh onlay patch was then placed as reinforcement. The Illoinguinal nerve was placed back in the canal. The onlay patch was sutured together lateral to the internal ring. External oblique was closed with running 2-0 Vicryl suture. Scarpus was closed with interrupted 2-0 Vicryl suture. Skin was closed with staples. Antibiotic ointment and sterile dressing were placed over the incision.
All sponge, instrument and needle counts were correct. The patient tolerated the procedure well. He was taken back to the recovery room in stable condition.
B. 49521, 49568
D. 49507, 49568
- 27 year old male has obesity with a BMI of 35. He has decided to have a Roux-En-Y gastric bypass. The patient is brought to the operating room and placed in supine position. A midline abdominal incision is made. The stomach is mobilized and the proximal stomach is divided and stapled creating a small proximal pouch in continuity with the esophagus. A short limb of the proximal bowel of 115cm is divided. It is brought up and anastomosed to the gastric pouch. The other end of the divided bowel is connected back into the distal small bowel to the short limb’s gastric anastomosis to restore intestinal continuity. The abdominal incision is closed.
- A patient suffering from diopathic dystonia is seen today and receives the following Botulinum injections three muscle injections in both upper extremities; seven muscles in the left leg and six muscles in the right leg and seven injections in paraspinal muscles.
A 64642 x 2, 64644 x 2, 64646
B. 64642, 64643, 64644, 64645, 64647
C. 64642, 64643, 64645, 64646, 64647
D. 64643, 64645, 64647
- recommends the patient have a laparoscopic cholecystectomy. He discusses the surgery with her and the possible complications. The patient agrees to the surgery and is scheduled for the surgery the next day. What code and modifier would be reported for these services.
- During a colonoscopy the provider is unable to advance to the splenic flexure due to an obstruction. Which modifier is appended to the code for the colonoscopy?
- The CPT manual provides full descriptions of medical procedures although some descriptions require the use of a semicolon (;) distinguish closely related procedures.
What is the full description of CPT code 35840?
A. Exploration for postoperative hemorrhage, thrombosis or infection; abdomen
B. Exploration for postoperative hemorrhage, thrombosis or infection; excluding abdomen
C. Exploration for postoperative hemorrhage, thrombosis or infection; neck and/or abdomen
D. Exploration for postoperative hemorrhage, thrombosis or infection; neck, chest, abdomen, and/or extremity
- The patient’s managed care plan requires that physicians counsel their patients about habits adverse to their health for data purposes. In this case, the patient is a heavy smoker (smoker than one pack of cigarettes/day) and the physician provides advice on the benefits of quitting the habit during an encounter for a preventive medicine service.
Which of the following codes is reported for the purposes of data collection?
- An established patient is seen today to discuss her diagnosis of gallstones. The physician reviews all the tests results. He recommends the patient have a laparoscopic cholecystectomy. He discusses the surgery with her and the possible complications. The patient agrees to the surgery and is scheduled for the surgery the next day.
- Which of the following would be paid under Part B for Medicare?
A. Clinic infusion services
B. Inpatient dialysis
C. Hospital nursing care
- Which of the following fraud and abuse scenarios is most certainly fraud?
A. Under documentation by the physician leading to under coding by the coder
B. Requiring an ABN if the service is not considered medically necessity
C. Intentional violation of incident to rules
D. Following whichever set of guidelines, 95 and 97, that leads to the highest paid code on the claim
- What form is used for billing physician services performed in an outpatient hospital facility?
- HIPAA was created with which goal in mind?
A. To identify provider who do not transmit claims electronically
B. To provide an incentive for providers who implement an electronic health record
C. To allow for standardized code set claims transmission
D. To provide an incentive for providers who maintain patient privacy
- A 75 year old established Medicare patient presents for her annual exam for cervical breast cancer screening. She has no past history of disease. Today, pelvic and clinical breast exam were performed and a Pap smear is obtained
- A 12-year old was burned on his left upper arm and requires a graft of 9 sq cm of tissue. He has been treated with dermal and epidermal tissue substance of human origin, apligraft.
A. Q4105 X9
D. Q4101 X 9
- A patient suffering from lower back pain receives a custom fabricated flexible lumbar-sacral orthotic. How would you code the HCPCS Level II service?
- A 75 year old Medicare patient presents for a colorectal cancer screening. He has no past history of disease. Today, he has colonoscopy
- A patient presents to the office for administration of ceftriaxone sodium. The nurse reviews the physician’s order and administers 1,000 mg of ceftriaxone sodium via IV
A. 96365, J0696 x4
B. 90473, J0696
C. 99211-25, 96372, J0696
D. 96372, J0696 x4
- Which statement is true about coding late effects?
A. Time is the most important consideration for coding late effects
B. A late effect is a residual condition
C. Late effect are assumed and never separately coded
D. Most late effects codes are E codes
Please do all these questions and ask your queries in the comments section.