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質問 # 21
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 CPT codes will be reported?
- A. 19081, 19283
- B. 19100, 76098
- C. 0
- D. 19101, 19283
正解：C
解説：
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 CPT Professional Edition (current year)
質問 # 22
Patient has cervical spondylosis with myelopathy. The surgeon performed a bilateral posterior laminectomy with facetectomies at each level and foraminotomies performed between interspaces C5-C6 and C6-C7.
Bilateral decompression of the nerve roots is achieved.
What CPT coding is reported?
- A. 63045, 63048
- B. 63050-50
- C. 0
- D. 63040-50, 63043, 63043
正解：A
解説：
* Cervical spondylosis with myelopathy: Condition requiring decompressive surgery.
* Bilateral posterior laminectomy, facetectomies, foraminotomies: Procedures performed to decompress nerve roots.
* Interspaces C5-C6 and C6-C7: Specific levels where the procedures were performed.
CPT code 63045 is used for the initial cervical laminectomy, and 63048 is for each additional segment. The combination covers the decompression across two interspaces.
References: AMA's CPT Professional Edition (current year)
質問 # 23
A Medicare patient is scheduled for a screening colonoscopy.
What code is reported for Medicare?
- A. G0105
- B. G0106
- C. G0121
- D. 0
正解：A
解説：
* Medicare provides specific codes for screening colonoscopy based on the patient's risk factors. For a Medicare patient scheduled for a screening colonoscopy who is at high risk (such as those with a history of intestinal polyps), the appropriate code is G0105.
* G0105 is used for colorectal cancer screening; colonoscopy on individuals at high risk.
References:
* HCPCS Level II, current year
* Medicare Guidelines for Colorectal Cancer Screening
質問 # 24
A 65-year-old gentleman presents for refill of medications and follow-up for his chronic conditions. The patient indicates good medicine compliance. No new symptoms or complaints.
Appropriate history and exam are obtained. Labs that were ordered from previous visit were reviewed and discussed with patient. The following are the diagnoses and treatment:
Hypokalemia - stable. Refill Potassium 20 MEQ
Hypertension - blood pressure remaining stable. Patient states home readings have been in line with goals. Refill prescription Lisinopril.
Esophageal Reflux - Patient denies any new symptoms. Stable condition. Continue taking over the counter Prevacid oral capsules, 1 every day.
Patient is instructed to follow up in 3 months. Labs will be obtained prior to visit.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
正解：A
質問 # 25
A patient presents with recurrent spontaneous episodes of dizziness of unclear etiology. Caloric vestibular testing is performed irrigating both ears with warm and cold water while evaluating the patient's eye movements. There is a total of three irrigations.
What CPT coding is reported?
- A. 92537-50
- B. 92538-50
- C. 92537-52
- D. 92537-50-52
正解：A
解説：
* Procedure: Caloric vestibular testing performed on both ears with three irrigations.
* CPT Code:
* 92537: Caloric vestibular test with recording, bilateral; bithermal (i.e., one warm and one cool irrigation in each ear).
* Modifier -50: Bilateral procedure.
* Code Selection Justification: The procedure performed was bilateral caloric vestibular testing with bithermal irrigation, appropriately coded with 92537 and modifier -50 for bilateral procedures.
References:
* AMA CPT Professional Edition (current year)
質問 # 26
A patient presents to the office with dysuria and lower abdominal pain. The physician suspects she has a UTI.
A non-automated urinalysis is done in the office and is negative. UTI is ruled out for the final diagnosis.
What CPT and ICD-10-CM codes are reported?
- A. 81000, R30.0, R10.30
- B. 81002, R30.0, R10.30
- C. 81000, N39.0
- D. 81002, N39.0
正解：B
解説：
1. Procedure and CPTCode Selection:
The urinalysis performed was non-automated and without microscopy.
CPTCode 81002 is appropriate for a non-automated urinalysis without microscopy. This code accurately reflects the test performed in the office.
2. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code R30.0 is used for dysuria, which was one of the patient's presenting symptoms.
ICD-10-CM Code R10.30 is used for lower abdominal pain, another presenting symptom.
Since the urinalysis ruled out a urinary tract infection, N39.0 (UTI) is not appropriate as a final diagnosis.
3. Rationale for Excluding Other Options:
Code 81000 (in options A and B) is for a urinalysis with microscopy, which was not performed here.
N39.0 is used when a UTI is confirmed, which is incorrect for this case since the urinalysis was negative, ruling out UTI.
4. AAPC and CPTCoding Guidelines:
AAPC guidelines recommend coding based on the symptoms when a specific diagnosis (such as UTI) is ruled out. Therefore, R30.0 and R10.30 are appropriate symptom codes for this encounter.
Thus, the correct answer is C. 81002, R30.0, R10.30.
質問 # 27
A patient with Parkinson's has sialorrhea. The physician administers an injection of atropine bilaterally into a total of four submandibular salivary glands.
What CPT coding is reported?
- A. 0
- B. 64611-50
- C. 64611-52
- D. 64611 x 4
正解：A
解説：
* Injection of atropine: Atropine is administered to reduce sialorrhea.
* Bilateral submandibular salivary glands: The physician administers the injections into the salivary glands.
* Total of four glands: Indicates that multiple glands are treated in the same session.
CPT code 64611 accurately represents chemodenervation of the salivary glands, bilateral. The use of -50, -52, or x4 modifiers is not appropriate since CPT guidelines include bilateral procedures in this code without needing additional modifiers or codes.
References: AMA's CPT Professional Edition (current year)
質問 # 28
A 4-year-old, critically ill child is admitted to the PICU from the ED with respiratory failure due to an exacerbation of asthma not manageable in the ER. The PICU provider takes over the care of the patient and starts continuous bronchodilator therapy and pharmacologic support with cardiovascular monitoring and possible mechanical ventilation support.
What is the E/M code for this encounter?
- A. 0
- B. 1
- C. 2
- D. 3
正解：C
質問 # 29
Which entity offers compliance program guidance to form the basis of a voluntary compliance program for a provider practice?
- A. American Medical Association (AMA)
- B. Office of Inspector General (OIG)
- C. Office for Civil Rights (OCR)
- D. Centers for Medicare & Medicaid Services (CMS)
正解：B
解説：
The Office of Inspector General (OIG) provides compliance program guidance to form the basis of a voluntary compliance program for provider practices. This guidance is intended to help healthcare providers develop effective internal controls to monitor adherence to applicable statutes, regulations, and program requirements of Federal healthcare programs. The OIG issues various compliance guidelines and resources to assist organizations in establishing comprehensive compliance programs to prevent fraud, waste, and abuse.References: OIG Compliance Program Guidance, AMA's CPT Professional Edition, and healthcare compliance resources.
質問 # 30
A 57-year-old woman with a physical status of 3 received general endotracheal anesthesia for a panniculectomy. The anesthesiologist personally performed the entire anesthesia service.
What CPT@ coding is reported for the anesthesia?
- A. 00800-AA-P3
- B. 00802, 99140-AA-P3
- C. 00802-AA-P3
- D. 00800-P3, 99140-P3
正解：A
解説：
To code for anesthesia services, we select the correct CPTanesthesia code based on the procedure, modifiers, and physical status of the patient:
00800 represents "Anesthesia for procedures on the lower abdomen not otherwise specified," which includes procedures like a panniculectomy. The code 00802 is not appropriate here because it is used for lower abdominal procedures involving "major lower abdominal vessels," which does not apply to a panniculectomy.
AA Modifier indicates that the anesthesia services were personally performed by the anesthesiologist, as stated in the scenario.
P3 Modifier reflects a physical status of 3, which indicates a patient with a "severe systemic disease," matching the patient's documented condition.
The emergency modifier 99140 is not appropriate here, as there is no indication that the procedure was performed under emergency conditions.
Thus, the correct answer is 00800-AA-P3.
質問 # 31
View MR 007400
MR 007400
Radiology Report
Patient: J. Lowe Date of Service: 06/10/XX
Age: 45
MR#: 4589799
Account #: 3216770
Location: ABC Imaging Center
Study: Mammogram bilateral screening, all views, producing direct digital image Reason: Screen Bilateral digital mammography with computer-aided detection (CAD) No previous mammograms are available for comparison.
Clinical history: The patient has a positive family history (mother and sister) of breast cancer.
Mammogram was read with the assistance of GE iCAD (computerized diagnostic) system.
Findings: No dominant speculated mass or suspicious area of clustered pleomorphic microcalcifications is apparent Skin and nipples are seen to be normal. The axilla are unremarkable.
What CPT coding is reported for this case?
- A. 77066, Z80.3, Z12.31
- B. 77067-50, Z80.3, Z12.31
- C. 77067, Z12.31, Z80.3
- D. 77066-50, Z12.31, Z80.3
正解：C
質問 # 32 
Refer to the supplemental information when answering this question:
View MR 623654
What CPTO coding is reported for this case?
- A. 14001, 11606-51, 12034-51
- B. 0
- C. 14001, 11606-51
- D. 1
正解：D
質問 # 33
A woman at 36-weeks gestation goes into labor with twins. Fetus 1 is an oblique position, and the decision is made to perform a cesarean section to deliver the twins. The obstetrician who delivered the twins, provided the antepartum care, and will provide the postpartum care.
What CPT coding is reported for the twin delivery?
- A. 59510, 59515
- B. 59510, 59514, 59515
- C. 0
- D. 59510 x 2
正解：C
解説：
* Cesarean Delivery with Antepartum and Postpartum Care: The procedure involved the cesarean section delivery of twins, including antepartum and postpartum care.
* CPT Code 59510: This code is used for routine obstetric care including antepartum care, cesarean delivery, and postpartum care. The code is not reported per fetus but per delivery, even when delivering multiples.
References:
* AMA's CPT Professional Edition (current year)
質問 # 34
A 3-day-old died in her sleep. The pediatrician determined this was the result of crib death syndrome. The parents give permission to refer the newborn for a necropsy. The pathologist receives the newborn with her brain and performs a gross and microscopic examination. The physician issues the findings and reports they are consistent with a normal female newborn.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
正解：D
解説：
* Procedure: Gross and microscopic examination of a newborn autopsy.
* CPT Code:
* 88028: This code is for the autopsy, gross and microscopic examination of a stillborn or newborn.
* Code Selection Justification: The procedure described matches the comprehensive postmortem examination of a newborn.
References:
* AMA CPT Professional Edition (current year)
* ICD-10-CM (current year)
* HCPCS Level II (current year)
質問 # 35
Mr. Woolridge has had a suspicious lesion on his left shoulder for approximately eight weeks that is not healing. On the dermatologist's exam of left shoulder blade, there is excoriation and scabbing and the lesion not healing. Patient agrees and wishes to proceed with a punch biopsy of the lesion. A punch biopsy is taken of the lesion and sent to pathology. A simple repair is performed at the biopsy site.
What CPT and ICD-10-CM codes are reported?
- A. 11102, L98.9
- B. 11104,12001-51, L98.9
- C. 11102, 12001-51, D49.2
- D. 11104, D49.2
正解：C
解説：
CPT code 11102 is for punch biopsy of skin, including simple closure. CPT code 12001-51 is for simple repair of superficial wounds, with modifier 51 indicating multiple procedures. ICD-10-CM code D49.2 is used for a neoplasm of unspecified behavior of the bone, soft tissue, and skin. This coding accurately reflects the punch biopsy and simple repair performed on the lesion.References: AMA's CPT Professional Edition (current year), ICD-10-CM (current year)
質問 # 36
Patient has esotropia of the right eye and presents to operating suite for strabismus surgery. The physician resects the medial rectus horizontal and lateral rectus muscles of the eye and secures them with adjustable sutures. Extensive scar tissue is noted, due to a previous surgery involving an extraocular muscle. Extraocular muscle is isolated, and the muscle is freed from surrounding scar tissues.
What CPT codes are reported for this surgery?
- A. 67314, 67334
- B. 67316, 67335
- C. 67312, 67335
- D. 67311, 67334
正解：A
解説：
* Esotropia of the right eye: Indicates strabismus surgery is required.
* Resection of medial rectus horizontal and lateral rectus muscles: Specific muscles addressed during the surgery.
* Adjustable sutures: Used in securing the muscles, indicating specific techniques.
* Extensive scar tissue from previous surgery: Requires additional work and isolation.
CPT codes 67314 and 67334 are used to report the resection of two muscles with adjustable sutures (67314) and surgery on an extraocular muscle involving extensive scar tissue (67334).
References: AMA's CPT Professional Edition (current year)
質問 # 37
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
正解：A
質問 # 38
A physician excises a 3.5 cm malignant lesion including margins from the back. Then a destruction of a 2.0 cm benign lesion on the right cheek of the face with cryosurgery.
What CPT@ and ICD-10-CM is reported?
- A. 11604, 11442, C76.8, C76.0
- B. 11604, 11642, C76.8, C76.0
- C. 11604, 17110, C44.509, D23.39
- D. 11404, 11442, C44.509, D23.39
正解：C
解説：
1. CPTCode 11604: This code is used for the excision of a malignant lesion on the back, with a size of 3.5 cm including margins. The 11600 series covers excision of malignant skin lesions, with 11604 being the correct code for a lesion size over 3.0 cm but not exceeding 4.0 cm.
2. CPTCode 17110: This code is appropriate for the destruction of a benign lesion on the face (right cheek) via cryosurgery. 17110 covers the destruction of benign lesions (up to 14 lesions).
3. ICD-10-CM Code C44.509: This code represents unspecified malignant neoplasm of skin of trunk (back).
4. ICD-10-CM Code D23.39: This code is used for a benign neoplasm of skin of other parts of the face (right cheek).
Explanation of other options:
A: 11604, 11442, C76.8, C76.0: Incorrect because 11442 is for excision of a benign lesion, not a malignant lesion.
B: 11404, 11442, C44.509, D23.39: Incorrect because 11404 is used for a benign lesion excision, not malignant.
D: 11604, 11642, C76.8, C76.0: Incorrect as 11642 would indicate a second malignant excision rather than the benign lesion destruction.
Thus, the correct answer is C. 11604, 17110, C44.509, D23.39.
質問 # 39
Eric is buying his first life insurance policy from XYZ Life Insurance Company. The company requires Eric have a physical exam prior to issuance of the policy. Eric sees his primary care provider who completes the required documentation and forms provided by the insurance company.
How does the primary care provider report his services?
- A. 0
- B. 1
- C. 2
- D. 3
正解：B
質問 # 40
A woman at 36-weeks gestation goes into labor with twins. Fetus 1 is an oblique position, and the decision is made to perform a cesarean section to deliver the twins. The obstetrician who delivered the twins, provided the antepartum care, and will provide the postpartum care.
What CPT coding is reported for the twin delivery?
- A. 0
- B. 59510, 59515
- C. 59510, 59514, 59515
- D. 59510 x 2
正解：C
質問 # 41
The mediastinum is:
- A. A small endocrine organ behind the heart
- B. Both the heart and lungs
- C. A location in the chest, bounded by the sternum, diaphragm, and lungs
- D. A part of the lymphatic system
正解：C
解説：
The mediastinum is an anatomical region located in the thoracic cavity. It is bounded by the sternum in front, the vertebral column at the back, and is situated between the lungs. It contains the heart, trachea, esophagus, thymus, and other structures, but it is not itself an organ. Therefore, the correct answer is that it is a location in the chest.References: ICD-10-CM, Medical Anatomy and Physiology textbooks
質問 # 42
A 30-year-old patient with a scalp defect is having plastic surgery to insert tissue expanders. The provider inserts the implants, closes the skin, and increases the volume of the expanders by injecting saline solution.
Tissue is expanded until a satisfactory aesthetic outcome is obtained to repair the scalp defect.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
正解：B
解説：
The CPT code 11960 is used for the insertion of tissue expanders for other than breast, which includes the scalp in this case. The procedure involves inserting the tissue expanders, closing the skin, and gradually increasing the volume of the expanders until a satisfactory outcome is achieved for repairing the scalp defect.
The other options do not accurately describe the procedure performed on the scalp.References: AMA's CPT Professional Edition (current year)
質問 # 43
The surgeon performs Roux-en-Y anastomosis of the extrahepatic biliary duct to the gastrointestinal tract on a
45-year-old patient.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
正解：B
質問 # 44
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