MBC 3100 CODING PREP ASSIGNMENT MEDICINE CODING ANSWERS AVAILABLE

MBC 3100 CODING PREP ASSIGNMENT MEDICINE CODING ANSWERS AVAILABLE 1. Hearing aid check, one ear. • 92594 • 92592 • 92585 • 92590 (Note: Assign 92592 for hearing aid check for one ear only. CPT code 92590 is not only for hearing aid exam but also for selection and, therefore, is not appropriate. The remaining selections are for testing only.) 2. Individual supportive psychotherapy, outpatient, 30 minutes. • 90834 • 90833 • 90836 • 90832. (Note: Thirty minutes psychotherapy is assigned 90832. The remaining selections are for 45 minutes of psychotherapy or psychotherapy performed in conjunction with an E/M service, which was not documented in this instance.) 3. Code 99070 is intended for. • Any supply/materials above those usually provided as part of the E/M service when carrier does not utilize HCPCS codes • Specific medications • Educational services • Specific supply items. (Note: CPT code 99070 is assigned for any supply/materials above those usually performed with an E/M service. It should only be utilized when the carrier does not utilize HCPCS Level II codes for these services.) 4. IV infusion, methotrexate, 50 mg, 1 hour 35 minutes (antineoplastic medication). • 96413, Chemo HCPCS Code • 96413, 96415, Chemo HCPCS Code • 96413, 96070 • 96440 (Note: IV chemotherapy infusion is assigned for IV infusion of methotrexate with code 96413 for first hour and 96415 for each additional hour (30 minutes minimum required) plus the appropriate J Code from HCPCS Level II. Two (2) codes will be necessary to answer this question, therefore, only two (2) of the selections could be valid. The remaining selection, 96413/96070 contains an invalid code (96070 is not a current valid code) and, therefore, cannot be correct.) 5. Chemotherapy infusion for 4 hours. • 96415 x 3 • 96413, 96415 × 3 • 96414 × 4 • 96413 × 4. (Note: Chemotherapy for 4 hours would be assigned code 96413 for the first hour and 96415 for three additional hours. Since the initial hour is assigned CPT code 96413 and CPT code 96415 is assigned for additional hours, two (2) codes would be necessary. Therefore, only one answer could be correct. The subsequent CPT code 96415 is assigned for “each” additional hour and, therefore, assigned as 96415 × 3 rather than listed individually.) 6. EEG, awake and drowsy. • 95822 • 95816 • 95810 • 95811. (Note: Awake and drowsy EEG is assigned code 95816. CPT code 95822 is also for an EEG, however, performed during coma or deep sleep only. The remaining selections are for polysomnography and, therefore, not appropriate.) 7. A patient presents with diagnosis of allergic sinusitis from his or her PCP for allergy testing. Twelve percutaneous scratch allergy tests with allergenic extracts are performed. • 95010 • 95004 × 12 • 99213, 95004 • 95004 (Note: Percutaneous scratch testing with allergenic extracts is assigned per test; therefore, 95004 should be assigned with 12 units. CPT code 95004 is assigned for patch testing, which was not performed in this instance and, therefore would be incorrect.) 8. IM injection of penicillin, IM. • 96374 • 96372 And HCPCS code for Penicillin • 96372 • 99070 (Note: Code 96372 and the appropriate HCPCS code would be assigned for the IM injection of penicillin. Since two (2) codes are required when injections of medications are provided, only one (1) selection would be correct.) 9. Administration of IM Toradol at 8:00 a.m., IM Versed at 8:30 a.m., and IV Levaquin from 9:00 a.m. to 9:45 a.m. • 96375, 96372 × 2 • 96365, 96361, 96372 × 2 • 96372 × 2 • 96365, 96372 × 2 (Note: IV infusion code 96365 is assigned for IV Levaquin (45 minutes meets minimum 30 minutes needed) as well as 96372 × 2 for two IM injections. Since the correct code must contain two units of IM injections and only one (1) unit of intravenous infusion, only 96365/96372 × 2 would be correct in this instance.) 10. Management of ventilation, hospital inpatient from 01/01 to 01/05. • 94003 × 4 • 94005 × 2 • 94003 • 94002, 94003 × 4. (Note: Ventilation management assigned by the day. Assign code 94002 for the first day and 94003 × 4 for four additional days. Since 94002 is intended for the initial day only, and CPT code 94003 for each subsequent day, only CPT codes 94002 for 01/01 and 94003 × 4 for 01/02 through 01/05 would be appropriate.) 11. ESRD services with one E/M service, February 1–16, age 7. • 90969 • 90968 • 90967 ×16 • 90968 × 16. (Note: When ESRD services/management are performed that include one face-to-face E/M, for 16 days during February on a child, age 7 code 90968 should be assigned with 16 units. The per-month codes may only be utilized when the entire calendar month has been performed. The remaining selections are also for less than a full month of ESRD services; however, they represent different age groups that do not include age 7.) 12. Dialysis procedures are coded utilizing. • Codes from the Medicine section • Anesthesia codes • Codes from the Surgery section • E/M codes (Note: Codes from the Medicine section are utilized for dialysis coding. Dialysis is not considered invasive or restorative, only therapeutic, since it does not eliminate the end- stage renal disease, it would be located in the Medicine section.) 13. A chemotherapy patient presents for antineoplastic chemotherapy. The patient is evaluated; however, it is determined that chemotherapy will not be performed at this time as the patient is diagnosed with pneumonia. Orders are given, and the patient is administered IV Rocephin from 1:00 p.m. until 2:45 p.m. • 96413 × 2 • 96413, 96415 • 96365 • 96365, 96366 (Note: The patient was not administered any anti-neoplastic medication on this date of service. Instead, IV infusion of antibiotics (Rocephin) was performed for 1 hour 45 minutes. Assign 96365 for the first hour and 96366 for additional 45 minutes. Since two (2) codes will be necessary to report these services, one for the initial code and one for the additional hours, only two (2) of the selections could be correct. The remaining selection with two (2) codes represents anti-neoplastic medications and, therefore, is not appropriate.) 14. Electrocardiogram is performed four times in the same day by the same physician, interpretation and report only. • 93000-76, 93000-76, 93000-76, 93000-76 • 93010-77, 93010-77, 93010-77, 93010-77 • 93010, 93010-76, 93010-76, 93010-76 • 93000 × 4. (Note: Code 93010 should be assigned, and subsequent EKGs on the same day should be assigned 93010-76. Since the services performed were EKG interpretation and only, CPT code 93010 would be assigned as opposed to CPT code 93000 for a complete electrocardiogram. Since CPT code 93010 does not state “each tracing,” the code would be “repeated” and a modifier -76 is appended when performed subsequently by the same physician.) 15. When procedures are performed bilaterally, how are they coded? • List twice, both with modifier -50 • Append modifier -51 • List procedure with modifier -RT, and then list procedure with modifier -LT • List procedure with modifier -50 appended. (Note: Modifier -50 is appended to the CPT code when services are performed bilaterally.) 16. A patient with new onset vertigo presents for vestibular function testing. Recording equipment was placed and patient was placed in a total of four positions. Warm water was introduced into the ear canal on the left side, and nystagmus was observed and recorded. The same procedure was performed on the right ear with same results. • 92544, 92544-59, 92544-59, 92544-59 • 92542 • 92544 • 92541 X4. (Note: Assign code 92542 for vestibular function testing up to four positions; therefore, only one unit of 92542 is appropriate. The remaining selection, 92544 is for optokinetic nystagmus testing, which was not stated in this instance.) 17. Services for patient-initiated 30-day spirometry for physician review and interpretation only. • 94014-26 • 94015 • 94010 • 94016 (Note: Assign code 94016 for interpretation only of 30-day spirometry testing. Modifier -26 is not necessary in this instance as the code descriptor indicates the service is already for review and interpretation only by physician. CPT code 94014-26 is also a patient-initiated service, however, represents the performance of the testing, as well as the interpretation and report. Appending modifier -26 is code 94014 would be inappropriate since there is a specific CPT code that reports the exact service as performed. The remaining CPT codes are for non-patient-initiated spirometry services and, therefore, would not be appropriate.) 18. Nonselective wound therapy. • 97598 • 97597 • 97602 • 97605 (Note: Code 97602 is assigned for nonselective wound therapy when non-excisional. Since the wound therapy was specified as “nonselective” CPT code 97602 only would be appropriate.) 19. Subcutaneous injection only of antibiotics. • 96376 • 96372 • 96374 • 96375. (Note: Subcutaneous injections are assigned code 96372. The remaining selections are for intravenous injections and, therefore, not appropriate since CPT code 96372 is for subcutaneous and intramuscular injection.) 20. Fitting of glasses (spectacles), bifocal. • 92341 • 92340 • 92353 • 92342. (Note: Assign code 92341 for bifocal glasses from Ophthalmology section when bifocal spectacles are fitted. The remaining selections are for multifocal lenses (CPT codes 92353 and 92342) and monofocal (CPT code 92340) and, therefore, not appropriate.) 21. When a cast is applied by other than the surgeon performing the interventional surgical service or fracture repair, what would be assigned? • Cast code • Cast code, modifier -79 • Cast code, modifier -59 • Repair code with modifier -57. (Note: Cast code only would be assigned as the application is being performed by a provider who has not coded/billed the global service.) 22. Administration of hydration fluids from 10:00 a.m. until 11:45 a.m. • 96360, 96361 × 1 • 96365, 96366 × 1 • 96360, 96361 × 2 • 96360 (Note: Hydration is assigned code 96360 for the first hour, and 96361 for second 45 minutes (at least 1/2 of code 30 minutes was met). Hydration services are assigned codes 96360/96361 only, therefore, CPT codes 96365/96366 would not be appropriate.) 23. Constant attendance physical therapy is as follows: ultrasound, 20 minutes followed by subsequent electrical stimulation, 30 minutes. • 97035, 97032 • 97032 • 97035, 97032 × 2 • 97035 (Note: Ultrasound (CPT code 97035) is assigned one unit only as minimum of 8 additional minutes are required for second unit of 15 minutes not met, 30 minutes of electrical stimulation is assigned 97032 × 2 units. Therefore, only one choice contains the correct units of service and could be appropriate. Also, keep in mind that the answers are not driven on carrier-specific guidelines, as some carriers do not reimburse for multiple modalities performed during the same session. Guidelines for the CPC exam are based on CPT guidelines only.) 24. A patient present to the physician's office and has electromyogram of the left extremity performed as well as two nerve conduction studies. • 95860 • 95860, 95907 • 95907, 95907-51 • 95907 × 2 (Note: Assign code 95860 for EMG and 95907 for one to two nerve conduction studies. Two (2) distinct services were performed and, therefore, only a selection with two (2) separate CPT codes would be appropriate.) 25. Tetanus toxoid and diphtheria immunization age 6. • 90700, 90471 • 90700 • 90702, 90471 • 90471, 90715. (Note: Assign code 90471 for the administration of vaccination and code 90702 for diphtheria and tetanus vaccine. Since two (2) codes are required for the services performed, CPT code 90700 would not be appropriate. The remaining selections all contain CPT code 90471 for the administration of the vaccine, therefore, the correct answer would be determined by the immunization administered. CPT codes 90700 and 90715 are for diphtheria, tetanus, and pertussis (DTap), which would not be appropriate in this instance.)