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NEW QUESTION # 118
A 25-year-old woman underwent percutaneous breast biopsy on the right breast with placement of a Gelmark clip. The procedure was performed using stereotactic imaging.
What CPTcodes will be reported?
- A. 0
- B. 19101, 19283
- C. 19081, 19283
- D. 19100, 76098
Answer: A
Explanation:
CPT code 19081 is used for percutaneous biopsy of breast(s) using stereotactic guidance, which includes the placement of a localization device and imaging of the biopsy specimen when performed. This accurately describes the procedure performed on the right breast with the placement of a Gelmark clip using stereotactic imaging. The other codes either describe open biopsies or separate procedures that are not applicable here.
References: AMA's CPTProfessional Edition (current year)
NEW QUESTION # 119
A 32-year-old vialled a provider due to skin itching and ongoing irritation and watering of the eyes.
Suspecting an allergy, the provider suspects an allergic reaction and decides to conduct allergy testing. A prick on the skin of the patient's forearm is performed by introducing a small amount of an allergen and monitored for signs of an allergic reaction.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: D
Explanation:
93280 - In-person interrogation device evaluation with programming; dual-chamber pacemaker Includes:
Full electronic analysis
Lead function
Battery status
Threshold testing
Programming changes
Why others are incorrect:
93281 - Single-chamber pacemaker
93283 / 93284 - ICD device codes
NEW QUESTION # 120
A patient is sent to the hospital by his family care provider for admission due to a high fever and neck pain The patient is admitted to the hospital to rule out bacterial meningitis. The hospitalist admits the patient and orders a CBC. CMR Blood culture, CT of the head and chest, and a lumbar puncture (spinal tap). After review of the results, he determines the patient has bacterial meningitis and starts the patient on IV antibiotics.
What CPT and ICD-10-CM codes are reported for the admission?
- A. 99264, R50.81.M54.2
- B. 99222, G00.9
- C. 99222, R50.81.M54.2
- D. 99284, G00.9
Answer: B
Explanation:
99222 = Initial hospital inpatient care, moderate MDM
Extensive diagnostic workup # moderate complexity
Final diagnosis established during admission
Diagnosis Coding:
G00.9 - Bacterial meningitis, unspecified
Do not code symptoms (fever, neck pain) once definitive diagnosis is confirmed Why others are incorrect:
99284 - ED visit
99264 - Inpatient consultation (deleted code)
Symptom-only diagnosis codes inappropriate
NEW QUESTION # 121
(A patient is diagnosed with agangrenous ulceron theright thighwith thefat layer exposedand is currently being treated. What ICD-10-CM coding is reported?)
- A. I96, L97.112
- B. I96, L97.102
- C. L97.112
- D. L97.112, I96
Answer: A
Explanation:
This scenario involves anon-pressure chronic ulcerwithgangrene. For non-pressure chronic ulcers of thethigh, ICD-10-CM usesL97.1-codes. "Fat layer exposed" indicatesseverity with fat layer exposed, which corresponds to the specific 6th character level (not just skin breakdown). The correct thigh code here isL97.
112(non-pressure chronic ulcer of right thigh with fat layer exposed). Because the ulcer is described asgangrenous, ICD-10-CM instructs tocode additional gangreneusingI96when gangrene is present with an L97 non-pressure ulcer. Sequencing places the ulcer code first (it fully describes site and depth), then the gangrene codeI96as additional. ThereforeI96 + L97.112are both required, and the correct option presented isI96, L97.112(Option C). Mnemonic:L97 = Location/Layer,I96 = Ischemic gangrene add-on.
NEW QUESTION # 122
An 87-year-old male with a history of atrioventricular block and prior dual-chamber pacemaker implantation presents to the cardiology clinic for an in-person device evaluation. The physician performs a full electronic analysis of the pacemaker system, assessing atrial and ventricular lead function, battery status, sensing thresholds, and pacing thresholds. After the assessment, the pacemaker settings are adjusted to optimize heart rate response. The patient tolerates the procedure well and is advised to return for routine follow-up.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: D
Explanation:
80324 - Drug test(s), definitive, qualitative or quantitative, LC/MS; acetaminophen LC-MS = definitive testing Acetaminophen is specifically identified by 80324 Why others are incorrect:
60143 / 80299 - Therapeutic drug assays (obsolete or nonspecific)
B0329 - HCPCS code (not appropriate here)
NEW QUESTION # 123
From a left femoral access, the catheter is placed within the proper hepatic artery, dye is injected, and imaging is obtained. A stenosis within this artery is identified. A percutaneous transluminal angioplasty is performed on the proper hepatic (visceral) artery in the outpatient radiology department.
What CPTcoding is reported?
- A. 36247, 75736-26-59, 37248-51
- B. 36247, 75726-26-59, 37246-51
- C. 36253, 75726-26-59, 37246-51
- D. 36253, 75736-26-59, 37248-51
Answer: A
Explanation:
1. Procedure Details and CPTCode Selection:
The patient underwent a catheter placement in the proper hepatic artery (a visceral artery), followed by dye injection and imaging to identify a stenosis, and finally a percutaneous transluminal angioplasty of the artery.
Code 36247 is appropriate for selective catheter placement in the third-order or more selective branch of a visceral artery. Since the proper hepatic artery is a selective branch accessed from the left femoral artery, this code accurately describes the catheter placement.
Code 75736 is for angiography of a selective visceral artery following catheter placement, which matches the imaging procedure performed here.
Code 37248 describes a percutaneous transluminal angioplasty of a visceral artery, which is the therapeutic intervention performed to treat the stenosis in the proper hepatic artery.
2. Modifiers:
Modifier 26 is used with 75736 to denote the professional component of the imaging service.
Modifier 59 indicates that the imaging (75736) is a distinct procedural service, separate from the therapeutic angioplasty (37248).
Modifier 51 is applied to 37248 to indicate it was a secondary procedure in addition to the diagnostic imaging and catheter placement.
3. Exclusion of Other Options:
Code 36253 (in choices A and D) is for selective catheter placement in a different vessel and does not apply to the hepatic artery.
Code 75726 is for non-selective abdominal aortography, which does not match the specific selective imaging of the hepatic artery.
4. AAPC and CPTCoding Guidelines:
According to AAPC guidelines, each step in an angiographic and interventional radiology procedure is coded based on the level of vessel accessed, imaging performed, and therapeutic intervention completed, which is all accurately represented by 36247, 75736-26-59, and 37248-51.
Based on CPTand AAPC coding guidelines, the correct answer is C. 36247, 75736-26-59, 37248-51.
You said:
NEW QUESTION # 124
A 45-year-old patient comes In with chronic sinusitis that has not responded to medication. The physician decides to use a sinus stent implant to help alleviate the patients symptoms.
The physician inserts the implant into the ethmoid sinus using a delivery system. This implant is designed to keep the surgical opening clear, prop open the sinus, and gradually release a corticosteroid with anti-inflammatory properties directly to the sinus lining. The implant is not permanent and will dissolve over time.
What HCPCS Level II code is reported?
- A. C1877
- B. C2617
- C. SI091
- D. C9600
Answer: B
Explanation:
C2617 - Sinus implant, drug-eluting
Described implant:
Ethmoid sinus
Drug-eluting (corticosteroid)
Absorbable
Why others are incorrect:
C1877 - Vascular stent
S1091 - Temporary code
C9600 - Coronary intervention
NEW QUESTION # 125
A patient complains of tarry, black stool, and epigastric tightness. An esophagogastroduodenoscopy is recommended to evaluate the source of the bleeding. The endoscope is inserted orally. The esophagus appears normal on scope insertion. No evidence of bleeding in the stomach. The scope is then passed into the duodenum, where a polyp is found and removed with hot biopsy forceps. No evidence of bleeding post procedure.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: A
Explanation:
An esophagogastroduodenoscopy (EGD) was performed with the removal of a polyp using hot biopsy forceps.
* Procedure Description:
* An EGD was performed.
* A polyp was found in the duodenum and removed with hot biopsy forceps.
* CPT Coding:
* 43250: Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps.
References:
* AMA's CPT Professional Edition (current year).
* CPT Assistant for detailed coding guidelines on endoscopic procedures.
NEW QUESTION # 126
Which statement is NOT true regarding the ICD-10-CM coding guidelines for burns?
- A. If the patient has burns of varying degrees in the same anatomic site, assign separate codes for each degree burn.
- B. The burns codes are also for burns resulting from electricity and radiation.
- C. Necrosis of burned skin should be coded as a non-healed burn.
- D. Sequence first the code that reflects the highest degree of burn when more than one burn is present.
Answer: A
Explanation:
According to ICD-10-CM burn guidelines:
When burns of different degrees occur at the same site, only the highest degree is coded, not separate codes.
The other statements are true:
Necrosis is coded as a non-healed burn
Burn codes include electrical and radiation burns
The highest degree burn is sequenced first
NEW QUESTION # 127
Which place of service code is submitted on the claim for a service that is performed in an outpatient surgical floor?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: B
Explanation:
The place of service code 22 is used for services performed in an outpatient hospital setting, including outpatient surgical floors. This code indicates that the procedure was done in a hospital but not requiring an inpatient admission.References: AMA's CPT Professional Edition (current year), Place of Service Codes.
NEW QUESTION # 128
The patient, who is at 32 weeks pregnant, has been hospitalized due to an infection of COVID-19.
What ICD-10-CM codes are reported?
- A. U07.1, R06.02, R50.81, Z33.1, Z3A.32
- B. U07.1, O98.513, Z3A.32
- C. O98.513, U07.1, Z3A.32
- D. O98.513, U07.1, R06.02, R50.81, Z3A.32
Answer: C
Explanation:
Pregnancy guidelines require O codes first.
O98.513 = COVID-19 infection complicating pregnancy, third trimester
U07.1 = COVID-19
Z3A.32 = 32 weeks gestation
Symptoms (SOB, fever) are not coded separately when integral to COVID-19.
Correct sequencing makes A correct.
NEW QUESTION # 129
A 44-year-old female patient with chest pains had a CT of her chest that identified a mass in her left lower lung. The patient currently has ovarian cancer with metastases to the liver. The radiologist suspects the cancer has spread to her lungs. The physician performed an outpatient bronchoscopic biopsy and the pathology report documents the mass as a tumor of uncertain behavior.
What ICD-10-CM codes are reported for this patient?
- A. R91.8, C56.9, C78.7
- B. C78.02, C22.9, C79.82
- C. D38.1, C56.9, C78.7
- D. C56.9, C78.7, C78.02
Answer: C
Explanation:
For a patient with a mass in the left lower lung suspected to be cancer that is currently documented as a tumor of uncertain behavior, with existing ovarian cancer with metastases to the liver, the ICD-10-CM codes are:
D38.1: Neoplasm of uncertain behavior of bronchus and lung.
C56.9: Malignant neoplasm of unspecified ovary.
C78.7: Secondary malignant neoplasm of liver and intrahepatic bile duct.
D38.1 is used because the behavior of the lung tumor is uncertain, and C56.9 and C78.7 are used to document the known primary and metastatic cancers.
ICD-10-CM guidelines
AMA's CPT Professional Edition (current year)
NEW QUESTION # 130
A patient complains of tarry, black stool, and epigastric tightness. An esophagogastroduodenoscopy is recommended to evaluate the source of the bleeding. The endoscope is inserted orally. The esophagus appears normal on scope insertion. No evidence of bleeding in the stomach. The scope is then passed into the duodenum, where a polyp is found and removed with hot biopsy forceps. No evidence of bleeding post procedure.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: A
NEW QUESTION # 131
(A 62-year-old with insulin-dependent diabetes mellitus has sudden hearing loss. The otolaryngologist administered atranstympanic injection of a steroidfor the sudden hearing loss ineach ear. How is this reported?)
- A. 0
- B. 69801 × 2
- C. 69801-50
- D. 69801-22
Answer: C
Explanation:
Atranstympanic(intratympanic) injection involves placing medication through the tympanic membrane into the middle ear space. CPT69801is used to report this transtympanic injection/tympanocentesis-type service as represented in CPC-style questions. Because the physician performed the injection inboth earsduring the same session, the appropriate bilateral reporting method in this answer set ismodifier -50to indicate abilateral procedure. Reporting69801 × 2is a common trap; many payers require either modifier 50 or RT/LT rather than two units, and the CPC exam typically follows modifier logic as presented in the options. Modifier-22 (increased procedural services) would require unusual extra work beyond typical complexity and is not supported by the vignette. Reporting only a single unilateral code (option A) would underreport the bilateral nature. Therefore, the best answer is69801-50, reflecting the same service performed on paired organs during the same encounter.
NEW QUESTION # 132
A patient arrives with stridor and in respiratory distress. The provider performs a micro laryngoscopy using a Parson's laryngoscope and magnifying telescope. A bronchoscopy was also performed using a 2.5 Stortz bronchoscope. The findings include subglottic web and stenosis with laryngeal edema suggestive of reflux. There was also significant collapse of the trachea at the carina and into the main bronchi bilaterally.
What CPT coding is reported?
- A. 31622, 31526-51, 69990
- B. 31622, 69990
- C. 31622, 31526-51
- D. 31629, 31526-51
Answer: C
Explanation:
1. Procedure and CPT Code Selection:
The provider performed both a bronchoscopy and a microlaryngoscopy to evaluate the patient's airway due to respiratory distress and stridor.
Code 31622 is used for a diagnostic bronchoscopy, which includes the inspection of the trachea, carina, and bronchial structures. Since the bronchoscopy was diagnostic and no additional therapeutic procedures were performed, this is the appropriate code.
Code 31526 is for direct laryngoscopy with the use of an operating microscope or telescope (microlaryngoscopy). This code is appropriate given the use of a Parson's laryngoscope and magnifying telescope to inspect the larynx.
2. Modifier 51:
Modifier 51 is added to 31526 to indicate that it was performed in conjunction with another procedure (31622, bronchoscopy). Modifier 51 denotes multiple procedures without the necessity of a separate incision.
3. Exclusion of Code 69990:
Code 69990 is used for the use of an operating microscope in microsurgery but is not coded separately when the procedure (such as microlaryngoscopy) already includes visualization with a microscope or telescope as part of the CPT descriptor. Thus, 69990 is not separately reported in this scenario, per CPT guidelines.
4. AAPC and CPT Coding Guidelines:
The guidelines specify that when visualization or microlaryngoscopy is inherently part of the procedure (as in 31526), 69990 should not be billed separately. Also, the use of Modifier 51 for multiple procedures in the same session is appropriate.
Therefore, the verified answer, following the CPT and AAPC coding rules, is A. 31622, 31526-51.
NEW QUESTION # 133
Day 1 - A provider admits the patient to observation care for type 2 diabetes mellitus with hyperglycemia.
The provider orders a HbA1c, a urine (microalbumin), and kidney function lab tests.
Blood sugar is high and poorly controlled. The provider discusses the case with the patient's endocrinologist.
The provider prescribes an IV insulin drip, along with SQ insulin and keeps the patient in observation overnight.
Day 2 - Patient is in observation care and the provider orders a blood glucose test. The patient's glucose levels have improved. The provider places an order for the dietitian to see the patient.
Provider
documents spending a total time of 25 minutes with the patient.
Day 3 - Patient has a blood glucose test. The patient's glucose level is back to normal. The provider documents spending 15 minutes with the patient. The provider discharges the patient.
What E/M coding is reported by the physician for the patient in observation care?
- A. 99235, 99231, 99238
- B. 99221, 99232, 99239
- C. 99222, 99231, 99238
- D. 99235, 99238
Answer: A
Explanation:
For a patient in observation care, selecting the correct E/M codes requires evaluating each day's service level and the provider's documentation.
Day 1: The patient was admitted for observation, and the physician prescribed IV and SQ insulin, noting diabetes with hyperglycemia requiring complex management. The CPTcode 99235 is appropriate here because it represents an initial observation or inpatient care for patients with high-complexity medical decision-making (MDM), which aligns with the patient's unstable glucose and the management requirements.
Day 2: The patient's glucose levels improved, and the provider documented spending 25 minutes with the patient in continued observation care. Since this is an established patient with continued observation, 99231 applies here, indicating subsequent observation care with low MDM complexity.
Day 3: The provider documented spending 15 minutes with the patient, whose glucose levels normalized, and then discharged the patient from observation care. Code 99238 is used for a discharge from observation care and is selected based on discharge times under 30 minutes.
These codes were selected based on CPTguidelines for observation care and the provider's time-based documentation. This matches the medical decision complexity documented per the case and code descriptions available for observation care management.
NEW QUESTION # 134
(An orthopedic surgeon evaluated a patient in the emergency room two months after a surgical repair of a right radius and ulnar shaft fracture. After reinjury, imaging shows a displaced proximal fixation screw andmalunion of only the radial shaft. The same surgeon performs surgery to repair the malunion using a graft from the hip. What CPT and diagnosis codes are reported?)
- A. 25405-78, T84.122A, S52.301P
- B. 25420-58, T84.124A, S52.301P
- C. 25415-76, T84.124A, S52.301A
- D. 25400-78, T84.122A, S52.301A
Answer: A
Explanation:
This is areturn to the operating room during the postoperative period(two months after the original fracture repair) by thesame surgeon, and the new surgery is related to the original condition/hardware, so a postoperative modifier is needed. The scenario describes a complication-related problem (hardware displacement with malunion) requiring operative correction, which aligns withmodifier -78(unplanned return to the OR for a related procedure during the postoperative period). Diagnosis coding includes a complication of internal orthopedic device:T84.122Acorresponds todisplacement of internal fixation device of bones of forearm(initial encounter for the complication). The fracture condition being treated is amalunionof the right radius shaft; malunion is captured with the fracture code and the 7th characterPfor subsequent encounter for fracture with malunion:S52.301P. Among options,25405-78is the correct procedural selection provided for repair of malunion in this context (as tested by the item), paired withT84.122AandS52.301P. Therefore, optionBis correct.
NEW QUESTION # 135
A patient presents to the ER with a large sacral pressure ulcer measuring 7 cm. The provider excised the ulcer with 3 mm margins, removed muscle and segmental bone, and performed a layered skin flap closure.
What CPT and ICD-10-CM coding is reported?
- A. 15937, L89.156
- B. 15931, L89.153
- C. 15933, L89.153
- D. 15935, L89.156
Answer: A
Explanation:
Pressure ulcer excision with bone involvement # CPT 15937 (sacral, with ostectomy) Stage 4 pressure ulcer # L89.156 (sacral region with necrosis of bone)
NEW QUESTION # 136
A patient with suspected gynecologic malignancy undergoes laparoscopic staging including bilateral pelvic lymphadenectomy, periaortic lymph node sampling, peritoneal washings, peritoneal and diaphragmatic biopsies, and omentectomy.
What CPT coding is reported?
- A. 38573-50
- B. 38572-50, 38573-50
- C. 38571, 38573
- D. 0
Answer: D
Explanation:
38573 includes comprehensive laparoscopic staging with bilateral pelvic lymphadenectomy and paraaortic sampling All listed components are bundled into this code
NEW QUESTION # 137
Which statement is FALSE in reporting a personal history ICD-10-CM code?
- A. A personal history code can be reported as a first-listed code when the reason for encounter is for a screening.
- B. A personal history code is acceptable on any medical record regardless of the reason of the visit.
- C. A personal history code is reported when the patient's condition is no longer present or being treated.
- D. A personal history code can be reported with follow-up codes.
Answer: B
Explanation:
In ICD-10-CM coding, personal history codes are used to indicate a patient's past medical conditions that no longer exist and are not receiving active treatment, but that may influence current care or require continued monitoring.
A: is correct because a personal history code can indeed be reported as a primary code if the encounter is specifically for screening due to a past condition.
B: is correct because personal history codes can be reported with follow-up codes to indicate that the patient is being monitored for recurrence of the past condition.
D: is correct because a personal history code is used when the patient no longer has or is being treated for that condition, but it remains relevant to the patient's health history.
C: is false because a personal history code is not used indiscriminately on any medical record; it is only appropriate when the past condition is relevant to the current encounter or impacts current patient care.
Therefore, the correct answer is C. A personal history code is acceptable on any medical record regardless of the reason of the visit.
NEW QUESTION # 138
A 42-year-old male is diagnosed with a left renal mass. Patient is placed under general anesthesia and in prone position. A periumbilical incision is made and a trocar inserted. A laparoscope is inserted and advanced to the operative site. The left kidney is removed, along with part of the left ureter. What CPT code is reported for this procedure?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: A
Explanation:
* Laparoscopic nephrectomy: A minimally invasive surgical procedure to remove a kidney.
* Part of the ureter: Removal includes part of the ureter.
* 50220: Nephrectomy (open procedure), which doesn't apply since the procedure was laparoscopic.
* 50548: Nephrectomy, partial, laparoscopic, which doesn't match the full nephrectomy performed.
* 50543: Laparoscopy, surgical; nephrectomy with total ureterectomy.
50543 is the correct CPT code for the laparoscopic removal of the kidney along with part of the ureter, fitting the scenario described.
References:
* AMA's CPT Professional Edition (current year)
* ICD-10-CM (current year), HCPCS Level II (current year)
NEW QUESTION # 139
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