Category Archives: Medicine

Practice Questions For CPC Exam 2017 -Part 6

Hello Guys!!

This is fifth 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 :

Practice Questions For CPC Exam 2017 -Part 1

Practice Questions For CPC Exam 2017 -Part 2

Practice Questions For CPC Exam 2017 -Part 3

Practice Questions For CPC Exam 2017 -Part 4

Practice Questions For CPC Exam 2017 -Part 5

Continue reading Practice Questions For CPC Exam 2017 -Part 6

CPT Practice questions – Medicine



  1. Colin had a comprehensive audiometry threshold evaluation and speech recognition testing to the left ear. What code(s) capture this procedure?
  2. 92557-52
  3. 92553, 92556
  4. 92557
  5. 92700-59
  1. An adult patient had the following immunizations with administration:
  • Yellow fever vaccine, subcutaneous injection
  • Hepatitis B (adult dose) vaccine, intramuscular injection
  • Plague vaccine, intramuscular injection

How would you report these services?

  1. 90465, 90466 x 2, 90717-51, 90746-51, 90727-51
  2. 90471, 90472 x 2, 90717, 90746, 90727
  3. 90473, 90474 x 2, 90746, 90727, 90717
  4. 90471, 90472 x 2, 90727-51, 90746-51, 90717-51
  1. Sally suffered from dehydration after running a marathon. She was taken into her primary care doctor’s office. Dr. Small checked Sally and ordered hydration therapy with normal saline. The hydration lasted 45 minutes. How would you report this service?
  2. 96365, 96361
  3. 96369
  4. 96360
  5. 96360, 96361
  1. A patient had a bronchoscopy with destruction for relief of stenosis by laser therapy. During this procedure photodynamic therapy by endoscopic application of light was used to ablate abnormal tissue via activation of photosensitive drugs. The photodynamic therapy lasted 60 minutes. How would you report this procedure?
  2. 31645, 96567
  3. 96567 x 2
  4. 31643, 96570-51, 96571-51
  5. 31641, 96570, 96571 x 2
  6. Dr. George asked the local pharmacist to review Ann’s new medications with her when she picked them up. Ann is a new patient who just moved into the area and required several new medications. Ann is hard of hearing and had a difficult time understanding Dr. George when he called her. The pharmacist spent 35 minutes with Ann and documented a review of her history, recommendations for improving health outcomes, and treatment compliance. The pharmacist faxed this note back to Dr. George’s office. How would the pharmacist report his services?
  7. 99605, 99607×2
  8. 99605, 99607
  9. 99607 x 3
  10. 99213
  1. What code would report an internet assessment and management service provided by a qualified non-physician healthcare professional to an established patient not originating from a related assessment and management service provided within the previous seven days?
  2. 96150
  3. 99444
  4. 98969
  5. 96151
  1. Code 95904 could describe studies to which of the following nerves?
  2. Lateral antebrachial cutaneous sensory nerve and posterior femoral cutaneous sensory nerve
  3. Medial calcaneal sensory nerve and radial sensory nerve to digit one
  4. Both A and B
  5. None of the above
  1. Jane has a family history of skin melanoma. Her primary care doctor asked for a consult with Dr. John. During Jane’s first visit with her new dermatologist, Dr. John, he documented a comprehensive history, comprehensive examination, and medical decision-making of moderate complexity. Dr. John also performed a whole body integumentary photography for monitoring of Jane’s skin. Dr. John sent a report back to her PCP and told Jane she should return in one year or before then if anything should change on her skin. What code(s) would you use to report Dr. John’s services?
  2. 99244-25, 96904
  3. 99213
  4. 96904
  5. 99204, 96904
  1. What services can you report in addition to the general ophthalmological services or evaluation and management services?
  2. Intermediate ophthalmological services
  3. Special ophthalmological services
  4. Only new patient general ophthalmological services
  5. Only established patient general ophthalmoligical services
  1. Jim underwent a percutaneous transluminal coronary atherectomy with a balloon to the left main coronary artery. During the same session his physician placed three drug coated stents in the left circumflex artery. What code(s) should you use to report these services?
  2. 92980 x 3
  3. 92981, 92996-51
  4. 92980, 92996
  5. 92995, 92982, 92981 x 3
  6. 4-year-old is getting over his cold and will be getting three immunizations in the pediatrician’s office by the nurse. The first vaccination administered is the Polio vaccine intramuscularly. The next one is the influenza (live) administered in the nose. The last vaccination is the Varicella (live) by subcutaneous route. What CPT® codes are reported for the administration and vaccines?
  1. 90713, 90658, 90716, 90460, 90461 x 2 B. 90712, 90656, 90716, 90460, 90461 x 1
  2. 90713, 90660, 90716, 90471, 90472, 90474 D. 90713, 90658, 90716, 90471, 90472, 90473
  1. A patient with chronic renal failure is in the hospital being evaluated by his endocrinologist after just placing a catheter into the peritoneal cavity for dialysis. The physician is evaluating the dwell time and running fluid out of the cavity to make sure the volume of dialysate and the concentration of electrolytes and glucose are correctly prescribed for this patient. What code should be reported for this service?
  1. 90935 B. 90937 C. 90947                               D. 90945
  1. An established patient had a comprehensive exam in which she has been diagnosed with dry eye syndrome in both eyes. The ophthalmologist measures the cornea for placement of the soft contact lens for treatment of this syndrome. What codes are reported by the ophthalmologist?
  1. 92014-25, 92070 B. 99214-25, 92325-50
  2. 92014-25, 92325-50 D. 92014-25, 92310
  1. A patient who is a singer has been hoarse for a few months following an upper respiratory infection. She is in a voice laboratory to have a laryngeal function study performed by an otolaryngologist. She starts off with the acoustic testing first. Before she moves on to the aerodynamic testing she complains of throat pain and is rescheduled to come back to have the other test performed. What CPT® code(s) should be reported?
  1. 99211, 92520 B. 92700 C. 92520-52 D. 99211, 92700-52
  2. A new patient is having a cardiovascular stress test done in his cardiologist’s office. Before the test is started the physician documents a comprehensive history and exam and moderate complexity medical decision making. The physician will be supervising and interpreting the stress on the patient’s heart during the test. What procedure code should be documented for this encounter?
A. 93015-26, 99204-25
B. 93016, 93018, 99204-25
C. 93015, 99204-25
D. 93018-26, 99204-25
  1. A cancer patient is coming in to have a chemotherapy infusion. The physician notes the patient is dehydrated and will first administer a hydration infusion. The infusion time was 1 hour and 30 minutes. Select the code(s) that should be reported for this encounter?
A. 96360
B. 96360, 96361
C. 96365, 96366
D. 96422
  1. A patient that has multiple sclerosis has been seeing a therapist for four visits. Today’s visit the therapist will be performing a comprehensive reevaluation to determine the extent of progress in parameters and if the patient is reaching his goals for common impairments associated with this neurologic condition, which includes performing activities of daily living, movement, muscle strength and reasoning abilities for independent living. What CPT® and ICD-9-CM codes should be reported?
A. 97004, V57.21, 340
B. 97002, V57.1, 340
C. 97003, V57.22, 340
D. 97004, V57.89, 340
18. Patient with hemiparesis on the dominant side due to having a CVA lives at home alone and has a therapist at his home site to evaluate meal preparation. The therapist observes the patient’s functional level of performing kitchen management activities within safe limits. The therapist then teaches meal preparation using one handed techniques along with adaptive equipment to handle different kitchen appliances. The total time spent on this visit was 45 minutes. Report the CPT® and ICD-9-CM codes for this encounter.

A. 97530 x 3, 436, 342.91
B. 97535 x 3, 342.91, 438.21
C. 97530 x 3, 438.21, 436
D. 97535 x 3, 438.21

19.10-year-old patient had a recent placement of a chochlear implant. She and her family see an audiologist to check the pressure and determine the strength of the magnet. The transmitter, microphone and cable are connected to the external speech processor and maximum loudness levels are determined under programming computer control. Which CPT® code should be used?

A. 92601
B. 92603
C. 92562
D. 92626

20. A cardiologist pediatrician sends a four-week-old baby to an outpatient facility to have an echocardiogram. The baby has been having rapid breathing. He is sedated and a probe is placed on the chest wall and images are taken through the chest wall. A report is generated and sent to the pediatrician. The interpretation of the report by the pediatrician reveals the baby has an atrial septal defect. Choose the CPT® code the cardiologist pediatrician should report.

A. 93303
B. 93315-26
C. 93303-26
D. 93315

21. A patient presents to her oncologist’s office for schedule chemotherapy. The patient is severely dehydrated. The physician decides to schedule the chemotherapy for another day and orders hydration therapy to be performed today instead of the chemotherapy. The therapy is ordered and administered for one hour and 10 minutes. Select the code(s).

A. 96413-53, 96360                                                                           B. 96360

C. 96360, 96361                                                                 D. 96413, 96361

22. Left heart catheterization retrograde from the femoral artery with injection procedures for selective coronary angiography and selective left ventriculography, including imaging supervision and interpretation with report, are performed. The cardiologist performed all of the services at the hospital. The CPT® codes are:

A. 93458                                                                                               C. 93452, 93454

C. 93452, 93563                                                                 D. 93458, 93565

23. The correct code for OMT performed on the cervical, thoracic and sacral regions would be:

A. 97110                                                                                               B. 98941

C. 98926                                                                                               D. 97124

24. The patient is admitted to the hospital for an eight channel EEG to determine the focus of her cerebral seizures. The EEG is performed for 24 hours. Select the appropriate code.

A. 95813                                                                                               B. 95824

C. 95827                                                                                               D. 95950

25. A pediatrician is managing the care of a patient who is at home on a ventilator under the care of a home health agency. The patient has cystic fibrosis and is suffering from recurrent pneumonia. The MD did the initial plan of care for the home health agency and now is following this monitor vent management oversight on day 20. The provider has a total 45 minutes for this month how should he code?

A. 94002                                                                                               B. 94003

C. 94005                                                                                               D. 94004

26. A two-month-old comes in for a well check up and several shots (Rota, DTaP-Hib, PCV) with her pediatrician. He offers suggestions to the mom, completes the exam, and counsels her on the vaccinations. How should this be coded?

A. 99391-25, 90471, 90472 x 2, 90680, 90721, 90669
B. 99381-25, 90460, 90461 x 2, 90680, 90700, 90648, 90669
C. 99381-25, 90471, 90472 x3, 90680, 90700, 90645, 90669
D. 99391-25, 90460, 90461 x 2, 90680, 90721, 90669

27. Mary, who has food allergies, came to her physician for her weekly allergen immune therapy that consists of two injections prepared and provided by the physician. The correct code is:

A. 95125                                                                                               B. 95117

C. 95131                                                                                               D. 95146

28. Photodynamic therapy involving application of light externally to destroy premalignant lesions on the lower lip was provided to a 63-year-old patient. Code the encounter.

A. 96570                                                                                               B. 96999

C. 96567                                                                                               D. 96913

29. The patient presents to see the nurse for his scheduled vitamin B12 injection. The physician ordered the injection at the patient’s last visit. The physician is in the office seeing other patients. The nurse administers the 1000 mcg of vitamin B12 intramuscularly. She schedules the patient for his next appointment.

A. 99211-25, 96372, J3420                                                             B. 99211-25, J3420

C. 96372, J3420                                                                                  D. 96401, J3420

30. In the inpatient setting, the psychiatrist provides psychotherapy for 30 minutes to affect a change in the patient’s maladaptive behavior. What is the procedure code?

A. 90804                                                                                               B. 90816

C. 90845                                                                                               D. 90801

31. Mae’s physician asked her to wear a glucose monitoring device to obtain more accurate information about her blood sugars. She had sensors placed and was then hooked up to a calibrated wearable device. Once this was complete, the technician provided Mae with training for the noninvasive ambulatory continuous glucose monitoring device. After wearing the device for 72 hours, Mae’s physician’s office removed the device, printed recordings, and downloaded analyses reports to its computer system. Which code captures this service?

a. 99090

b. 99091

c. 95250

d. 95251

32. Edna, a 72-year-old patient, returned to her regular pulmonologist for a follow-up visit. Dr. Harry documented Edna’s chief complaint as fatigue after recovering from a minor flu. His documentation supports a past history of smoking, COPD, and well-controlled diabetes. Edna lives with her husband, maintains her weight with a balanced diet, and exercises in the warm weather but feels “shut in” during the winter. Dr. Harry noted a detailed examination, reviewed multiple treatment options, and reviewed moderate risks for complications. Dr. Harry completed a six-minute walking pulmonary stress test to evaluate distance, dyspnea, desaturation, and heart rate. The stress test was repeated with adequate rest walks, pre-/post-spirometry and oximetry, and interpretation and evaluation protocol for Edna’s entry into a pulmonary rehabilitative program. Which code(s) should Dr. Harry report for today’s services?

a. 99214-25, 94620

b. 99204-25, 94621

c. 94799

d. 99213-25, 94620 x 2

33. A 19-year-old patient received immunizations at her health clinic. The immunizations were administered by a medical assistant at the same clinic. The patient was seen two weeks ago but was unable to complete the immunizations due to a stomach virus. Today, she is symptom free and receives an intramuscular H1N1 influenza pandemic formulation, preservative-free vaccine and an intramuscular hepatitis A immunization. Which codes capture these services?

a. 99211-25, 90633, 90667, 90473-51, 90474-51

b. 99213-25, 90632-51, 90666-51, 90471-51, 90472-51

c. 90460, 90470, 90632-51, 90632-51

d. 90632, 90663, 90471, 90472

34. What codes are not reported in conjunction with the following code descriptor?

Comprehensive electrophysiologic evaluations including insertion and repositioning of multiple electrode catheters with indication or attempted induction of arrhythmia; with right atrial pacing and recording, right  ventricular pacing and recording, and His bundle recording

a. 93600, 93602, 93610, 93612, 93618, 93619

b. No codes are restricted from conjunction reporting with 93620

c. 93600-51, 93602-51, 93610-51, 93612-51, 93618-51, 93619

d. Both a & c

35. An 11-year-old female had one face-to-face visit with her physician and received three daily dialysis services during a one-month period prior to her kidney transplant. How should these services be reported?

a. 90945

b. 90968 x 3

c. 90964 x 3

d. 90956

36. Which codes should be reported for the following case?

Preoperative diagnosis: Coronary arteriosclerosis of native arteries, chronic occlusion of coronary arteries

Postoperative diagnosis: Same

Anesthesia: Conscious sedation by procedure physician with presence of trained observer

Procedure: The 64-year-old patient was prepped, draped, and positioned in the usual fashion. After adequate sedation was administered, an access site into the right femoral artery was achieved. The catheter devices were advanced into position. Extensive review of the current anatomy was completed along with review of the previous catheterization. The procedure continued as planned with placement of two drug-eluting stents in the left circumflex, PTCA to the right coronary artery, and atherectomy for occlusion in the left anterior descending artery. Adequate flow was reviewed and confirmed via angiograms upon completion of the procedures. The guiding catheter was withdrawn after flow confirmation. Total intraservice time was noted at 1 hour 30 minutes. The sheath was secured to the groin with a suture and the patient was moved to recovery in good condition. Standing orders were given for sheath removal when the heparin effects are noted as normal through blood tests. Normal pressure is to be applied at the groin as needed with placement of a sandbag or ice bag.

a. 414.01, 414.2, 92980-LC, 92984-RC, 92996-LD

b. 414.2, 424.0, 92980, 92984, 92996

c. 414.2, 424.0, 92980, 92982-51, 92995-51

d. 424.0, 414.2, 92980-LC, 92984-RC, 92996-LD, 99144, 99145 x 2

37. A patient suffering from nystagmus completed a basic vestibular function evaluation with testing and recording in five different positions with gaze fixation; optokinetic, bidirectional, foveal, and peripheral stimulation; and oscillation. An additional vertical electrode and vertical axis rotational testing was employed during testing. How should this procedure be reported?

a. 92545, 92541-59, 92542-59, 92540-59

b. 92540, 92545, 92542, 92546, 92547

c. 92540, 92546, 92547

d. 92545, 92547-51

38. A patient underwent a left heart catheterization by transseptal puncture through an intact septum with image supervision and interpretation and intraprocedural injection for left ventriculography. During the procedure, pharmacologic agents were administered and measured. An arm ergometry was employed for exercise study to assess hemodynamics before and after the procedure. How should this procedure be reported?

a. 93458, 93462, 93463, 93464 x 2

b. 93452, 93566, 93462, 93463, 93464 x 2

c. 93452, 93566, 93462, 93463, 93464 x 2

d. 93452, 93462, 93463, 93464

39. A patient completed a diagnostic computerized ophthalmic scan of the retina on both eyes. The physician’s interpretation and report included changes to the retina in the right eye from a previous study. The left retina looked stable with no changes noted. The patient is scheduled for a follow-up study in three weeks to assess any new changes and treatment as needed. How should the physician report her services?

a. 92132-50, 92134-26

b. 92132

c. 92134

d. 92134-50

40. Cameron received 60 minutes of insight-oriented psychotherapy in an outpatient facility. During this same visit, Cameron complained of an upset stomach due to his new medications. The medications were reviewed and new medications were prescribed, a flare-up of his seasonal allergies was documented, and a persistent cough is noted. The documentation included the psychotherapy notes with an additional 35 minutes dedicated to a problem-focused history, problem-focused examination, and low-complexity decision-making. How would the physician services be reported?

a. 90822

b. 99213-25, 99354, 90815

c. 90809

d. 99213-25, 90809


  1. “a” The description under code 92557 lists the codes that are combined and should not be reported separately. In addition, the subcategory guidelines for the Audiologic Function Tests with Medical Diagnostic Evaluation state to add modifier -52 if studies are completed on one ear.
  1. “b” Administration of vaccines are reported according to the route and the age of the patient. These vaccines, all injections, were given to an adult patient; therefore, you would report the codes 90471 and 90472 x 2. The vaccines are reported for each type given or injected. According to the guidelines under the Vaccines, Toxoids subsection, do not report modifier -51 for the vaccines when performed with the administration procedures.
  1. “c” Use code 96360 to report hydration of 31 inutes to one hour.
  1. d” You can find this answer by looking in the index of the CPT Professional under Endoscopy, Bronchi, Stenosis.
  1. “a” Use the new 2008 codes for Medication Therapy Management Services. The guidelines for these codes indicate the documentation elements and times necessary to select a code.
  1. “c” Code 98969 is reportable for non-physician healthcare professionals.
  1. “c” You can find this answer in Appendix J under the code 95904.
  1. “a” The notes above the code 96904 indicate this service is typically consultative and the consultation evaluation and management code may be appropriate in addition to the special dermatological procedures. The other answers are incorrect due to the reporting of the evaluation and management code.
  1. “b” See the subsection Ophthalmology in the CPT Professional Edition under for the definition of special ophthalmological services, “…these services may be reported in addition….”
  1. “c” Code 92980 describes intracoronary stent(s) and describes one or more stents placed, therefore the units are not changed for the three stents in this question. The add-on code 92996 describes the arthrectomy, which is not bundled into the stent placement because there are different arteries involved in this procedure. The PTCA procedure is bundled into the athrectomy code. Add-on codes do not have modifier -51 attached.
  2. C The young child was administered the Poliovirus vaccine by intramuscular route guiding you to code 90713 eliminating multiple choice B. The influenza vaccine was for intranasal route is code 90660 eliminating multiple choices A and D. For the administration codes the vaccines were administered without face-to-face counseling eliminating multiple choice answers A and B. The first vaccination was administered by the intramuscular route guiding you to code 90471. The second vaccine (additional vaccine) was administered by the intranasal route guiding you to code 90474. The third vaccine (additional vaccine) is given by the subcutaneous route guiding you to code 90472.
  1. D Patient is having an evaluation for peritoneal dialysis eliminating multiple choices A and B. There is no documentation in the scenario where the physician repeated the dialysis evaluation of the patient due to a complication, eliminating multiple choice C.
  1. A Patient is having an ophthalmological evaluation service provided, eliminating multiple choice B. The contact lens is being fitted for a therapeutic use, eliminating multiple choice answers C and D. The description of 92070 states “fitting of contact lens”; therefore, modifier -50 is inappropriate.
  1. C The evaluation and management service (99211) would not be reported since the patient is being further evaluated and analyzed for a specific problem that relates to a special otorhinolaryngologic service in determining the patient’s therapeutic treatment, eliminating answers A and D. The patient is having a laryngeal function study in which an acoustic test was performed, eliminating multiple choice answer B. The aerodynamic testing was not performed on this visit so modifier 52 is appended since a parenthetical note states “For performance of a single test, use modifier 52“.
  2. C All three components are documented to report code 93015, in which the cardiologist is supervising, he owns the equipment (tracing), since the test is being performed in the office, and the physician interpreted the test. Modifier 26 would be inappropriate to append to code 93015 since it denotes the global service.
  1. A Patient is having a hydration infusion eliminating multiple choices C and D. The add-on-code is incorrect to report for this scenario. A parenthetical statement states: (Report 96361 for hydration infusion intervals of greater than 30 beyond 1 hour increments) meaning if the hydration infusion is 30 minutes or less you would not report 96361.
  1. A This patient is coming in for occupational therapy which helps a patient to improve basic motor functions and reasoning abilities for independent daily living. This eliminates multiple choice B. This is a re-evaluation visit eliminating multiple choice C. The diagnosis code V57.21 is correct to report since the patient is receiving occupational therapy, eliminating multiple choice D.
  2. D The therapist is at the patient’s home site to teach home management for self care, guiding you to code 97535. The patient has a residual effect of hemiparesis from having a CVA. According to ICD-9-CM guidelines Category 438 is used to indicate conditions classifiable to categories 430-437 as the causes of late effects (neurologic deficits), themselves classified elsewhere. These “late effects” include neurologic deficits that persist after initial onset of conditions classifiable to 430-437. The late effect codes for CVA’s are combination codes which means code 438.21 reports both the residual and cause in one code.
  1. B The patient is 10-years-old with a cochlear implant. The CPT index for Cochlear Device, Programming guides you to code 92603.
  1. C Infant is having the echocardiogram performed through the chest (transthoracic) not through the a device in the esophagus (transesophageal), eliminating multiple choices B and D. Modifier 26 needs to be appended since only the interpretation of the echocardiogram was performed by the pediatrician.
  2. B. Although the patient is scheduled for chemotherapy, only hydration therapy is performed. Hydration therapy codes are selected based on time. The total time for this procedure is one hour and 10 minutes. There is a parenthetical note following code 96361 which states “Report 96361 for infusion intervals greater than 30 minutes beyond one hour increments. Because there are only 10 additional minutes beyond the first hour, only 96360 is reported.
  1. A. Injection, catheterization, angiography and supervision and interpretation are included in 93458 itself. It is not necessary to code separately.
  1. C. OMT stands for “osteopathic manipulative treatment”. This was performed on three body regions (cervical, thoracic and sacral) which leads you to code 98926.
  1. D. The key to this encounter is time and monitoring of the cerebral seizures. 95950 is the correct code since it covers an eight channel EEG (electroencephalogrpahy) to measure and record the brain’s electrical activity, monitoring a 24-hour period evaluating her cerebral seizure.
  2. C. The site of service indicates the code to select. The physician is overseeing the home ventilator management care plan. There is one code for home ventilator care which is 94005. This code requires a minimum of 30 minutes. This physician has performed 45 minutes of care.
  3. D. We know this patient is established because she is seeing “her pediatrician.” The well check up is coded as a preventive service. The patient is two-months-old. The proper code is 99391. According to NCCI, modifier 25 is appended when a significant and separately identifiable E/M service is performed with other services at the same encounter. In this case vaccinations are performed. A vaccine administration for each is coded as well as the vaccine itself. In this case three vaccines are performed; rotavirus (90680), combination vaccine DTap-Hib (90721) and Pneumococcal (90669). The physician counsels the patient’s mother regarding the vaccinations. 90465is reported for the initial vaccine and 90466 is reported for the second and third vaccine.
  4. A. In this case the patient presents for allergen immune therapy for food allergies. The injections are prepared and provided by the physician, which is reported with 95125 for two injections. The therapy is not for an insect which makes 95131 and 95146 incorrect answers. 95117 does not include the provision of the extract so it is also incorrect.
  5. C. The photodynamic therapy is performed externally in this case which eliminates option A. Photochemotherapy is not used, which eliminates option D. The code description for 96567 reports the services provided for this patient.
  6. C. A nurse visit (99211) is not supported in this case. The patient presents for a scheduled injection, which is the only service performed. Injections are coded by route. In this case, the injection is given intramuscularly which is reported with 96372. The 1000 mcg of vitamin B12 is reported with J3420. The substance injected is not a chemotherapy medication; 96401 is an incorrect answer.

30.B. The services are provided in an inpatient setting which eliminates 90804. The physician performs 30 minutes of psychotherapy, which is reported with 90816. A diagnostic interview is not performed nor is psychoanalysis.

  1. c. The second parenthetical note below code 99090 directs the coder to report with more specific codes when possible. In this question, the patient wore a 72-hour ambulatory glucose monitoring device, which is reported with a specific code.
  2. a. Reporting an evaluation and management code with pulmonary stress testing is appropriate, according to the subcategory guidelines under the heading “Other Procedures” in the pulmonary medicine section of the CPT® Professional Edition. Additionally, CPT® Assistant, January 1999, Volume 9, Issue 1, indicates that pulmonary stress testing should be reported only once, even when repeated in the same session.
  3. d. Administration (route) of immunizations is reported along with the vaccines (drug). The subcategory guidelines in the CPT® Professional Edition under the heading “Vaccines, Toxoids” indicate that modifier -51 should not be appended to these codes.
  4. a. Analytical testing strategies should be employed when encountering this type of question. First, review the possible answers. Notice in answer b the code number is listed for the code descriptor. Second, look up the code 93620 and review the descriptor, then review the parenthetical notes listed below the code, which provide conjunction code reporting rules. Third, notice modifier -51 exempt statuses with codes listed, and finally, check off the codes listed in the test question to ensure proper exemption and/or reporting restrictions.
  5. b. The subcategory guidelines provided in the CPT® Professional Edition with end-stage renal disease services provide code selection criteria. Additionally, examples are provided to assist with proper code selection.
  6. a. The parenthetical notes in the CPT® Professional Edition with transcatheter placement of stent(s) indicate use of add-on codes for additional vessels treated with atherectomy or PTCA. In this question, three vessels/ arteries were treated, with modifiers applied to describe vessels/arteries treated. Review the procedures andanatomy for this question to select correct codes: two stents placed in left circumflex (report once per vessel regardless of the number of stent[s] placed), PTCA in the right coronary artery (add-on code), and atherectomy in the left anterior descending artery (add-on code). The procedure codes in this question include moderate sedation by the same provider. Additionally, review of the diagnosis codes and correct reporting order is important to answer selection.
  7. c. One way to find this answer in the index of the CPT® Professional Edition is under “Vestibular function tests.” Once this code range is located, review of the codes and parenthetical notes will help with code selection.
  8. d. The subcategory guidelines, codes, and reporting rules for cardiac catheterization have undergone extensive updates for 2011. Review of this section in the CPT® Professional Edition and CPT® Changes: An Insider’s View 2011 will help with correct reporting. For this question, review the primary procedure and then the add-on codes, with special attention to the parenthetical notes for correct code selection.
  9. c. The code descriptor includes services delivered bilaterally; therefore, modifier -50 is not required when reporting. Additionally, the anatomic location of the scan is important when selecting a code from this section.
  10. c. Psychiatric therapeutic procedure subcategory guidelines in the CPT® Professional Edition indicate appropriate code selection is based on type of service, place of service, face-to-face time spent, and whether evaluation and management services are furnished on the same date as psychotherapy services. The time spent with the patient includes both the psychiatric and evaluation and management services.