NCCT EXAM STUDY GUIDE CPT EXAM QUESTIONS AND ANSWERS

NCCT EXAM STUDY GUIDE CPT EXAM QUESTIONS AND ANSWERS Patient undergoes a mitral valvuloplasty with a ring insertion and a prosthetic aortic valve replacement, open, on cardiopulmonary bypass. Which of the following is the correct CPT® code assignment? A. 33464, 33406-51 B. 33426, 33405-51 C. 33430, 33405-51 D. 33468, 33426-51 - Answer-33426, 33405-51 Rationale The procedure performed was a mitral valvuloplasy, which means repair of the mitral valve. In the index of the CPT® Index, the main term is Valvuloplasty. The choices below Valvuloplasty include mitral valve, code range CPT® . When reading the descriptions of these three codes, notice that CPT®33427 states "radical reconstruction..." This scenario does not state radical reconstruction, so that one is not the correct answer. CPT® 33426 is the correct answer because it is "Valvuloplasty, mitral valve, with cardiopulmonary bypass, with prosthetic ring. Next, in the Index, replacement, aortic valve. Under that heading, find "with Prosthesis" (for the prosthesis). CPT® 33405, are listed. Since CPT® are all "Transcatheter aortic valve replacements TAVR/TAVI... with percutaneous approach", these are not the correct codes. CPT®33405 is the correct code, as it reads "Replacement, aortic valve, open, with cardiopulmonary bypass; with prosthetic valve other than homograft or stent- less valve. The correct coding for the above scenario is CPT®33426, 33405-51. Modifier -51 is added to CPT® code 33405 because were performed. The established patient presents to the doctor's office for his monthly visit to have his glucose levels by checked by the nurse. Which of the following evaluation and management codes should be assigned? A. 99201 B. 99211 C. 99202 D. 99212 - Answer-99211 Rationale CPT® 99201 and CPT® 99202 would be used for a new patient or a patient that has not been to this provider for three years. This patient goes to this office monthly so these two codes would not be used. CPT® 99212 is a low office visit that requires documentation of PF history, PF exam, and SF MDM. None of those services were documented CPT® 99211 is used for low level E/M services typically used by the nurse. This is the correct code to use for this visit. A patient sees Dr. Smith for a consult at the request of his PCP, Dr. Long, for an ongoing problem with allergies. The patient has tried using Claritin and Alavert but feels his symptoms continue to worsen. Dr. Smith performs an expanded problem focused history and exam and discusses options with the patient on allergy management. The MDM is straightforward. The patient would like to be tested to possibly gain better control of his allergies. Dr. Smith sends a report to Dr. Long, thanking him for the referral and includes the date the patient is scheduled for allergy testing. Dr. Smith also includes his findings from the encounter. Which CPT® E/M code is reported? A. 99203 B. 99214 C. 99242 D. 99243 - Answer-99242 Rationale This appointment has all the criteria to code as a consultation. There are three requirements for consultations, request, render, and reply. request was made by the PCP, Dr. Long rendered the services, and Dr. Long. Consultation codes are grouped by place of service, office and other outpatient services and inpatient consultations. New vs. established patient does not matter for consultations. The appointment was an Expanded Problem Focused history and exam with the Medical Decision Making straightforward, which is code CPT® A patient arrives for skin tag removal. As previously noted in her other visit, she has 3 located on her face, 4 on her shoulder and 15 on her back. The physician removes all the skin tags with no complications. Which of the following CPT® codes should be reported for this encounter? A. 11201 B. 11201, 11201-51 C. 11200, 11201-52 D. 11200, 11201 - Answer-11200, 11201 Rationale This patient had a total of 22 skin tags removed. The codes CPT®11200 and CPT®11201 are the codes for skin tag removal, sequenced in that order. CPT® code 11200 represents the removal of the first 15 skin tags and CPT® code CPT®11201, an add-on code described as removal of skin tags, each additional 10 lesions. The CPT®modifier 51 would not be used with CPT®11201, since this is an add-on code and is CPT®modifier 51 exempt. The CPT®modifier 52 is for reduced services and would not be applicable to use on CPT® 11201. This established patient is in for her yearly physical and lab. The physician orders a comprehensive metabolic panel, a hemogram automated and manual differential WBC count (CBC), and a thyroid-stimulating hormone. Code the lab only. A. 99395, 80050 B. 80050-52 C. 80053, 80050 D. 80050 - Answer-80050 Rationale The test question specifies to code the lab tests only so the CPT® code 99395 for a Preventive Medicine Exam would not be coded. Although 80053 is a comprehensive metabolic panel. It does not include all th tests ordered by the physician. If CPT® codes 80053 and 80050 were coded, this would result in duplicate coding for some of the tests. CPT® code 80050 includes the comprehensive metabolic panel and the other three tests ordered by the physician 6. An established patient who is diagnosed with controlled diabetes mellitus II comes to the doctor's office for elevated BP. The doctor is busy and the patient is seen by the nurse for a five minute BP check. Which of the following is the procedure code for this situation? A. 99212 B. 99213 C. 99201 D. 99211 - Answer-99211 Rationale 99201 is for a new patient, and doesn't apply to this patient. CPT® are for established patient visits. The requirements for codes CPT®99212 and 99213 are not met. There was no medical history taken, no examination given, and medical decision making. This patient came in for a blood pressure check and did not need to be seen by the physician. The correct code for this service is CPT® 99211. The description of CPT® 99211, is that the time usually spent with the patient is about five minutes and the patient does not have to be seen by a physician or other qualified healthcare professional. The patient had a gastrojejunostomy performed. Which of the following is the correct coding for this surgery? A. 43820, 48150 B. 43820 C. 48150, 43820 D. 48150 - Answer-43820 Rationale In the CPT® Index, the main term is "gastrojejunostomy". Gastrojejunostomy without vagotomy is listed. The scenario did not mention a vagotomy. After confirming in the tabular list, CPT®43820 is the correct code for this surgery. Which of the following are considered key components when assigning a level of E/M services? (Select the three (3) correct answers.) A. Counseling B. History C. Time D. Examination E. Medical Decision Making - Answer-History, Examination, Medical Decision Making Rationale The 2018 CPT® manual indicates that the key components in the Evaluation and Management guidelines are the history, exam and medical decision making. Three weeks ago, a patient had a cast applied to his leg for treatment of a fracture. Today the patient returned to the same physician and had the cast removed. The physician also removed a cyst from the patient's neck. Which of the following is the correct code assignment? A. 29705 B. 10040 C. 29705, 10040 D. 10040, 29705 - Answer-10040 Rationale Per CPT® guidelines, the cast removal is included in the services of treatment of the fracture and is not a billable service. The cyst removal is a separate procedure and the provider can bill for this service using CPT® code 10040. A patient had coronary artery bypass grafting done, using the left internal mammary artery, a vein harvested from the right saphenous vein, and a vein harvested from the left saphenous vein. Which of the following codes should be listed? A. 33511, 33533, 33508 B. 33533, 33510 C. 33517, 33518, 33533 D. 33533, 33518 - Answer-33533, 33518