CPT PROCEDURE STUDYGUIDE (HOMEWORK & QUIZZES) Questions and Answers (2022/2023) (Verified Answers)

CPT PROCEDURE STUDYGUIDE (HOMEWORK & QUIZZES) What appendix in the CPT Code Manual are all Modifiers listed? Appendix A Which coding system(s) is (are) used for claims submitted by physicians? HCPCS/ Level I/II and ICD-9-CM/ ICD-10-CM Which coding system describes the reason for the patient visit or encounter? ICD-9-CM/ ICD- 10-CM Identify the CPT section in which the code 21310 is located. Surgery Identify the CPT section in which the code 99602 is located. Medicine Identify the CPT section in which the code 81000 is located. Pathology and Laboratory Identify the CPT section in which the code 0503F is located. Category II Identify the CPT section in which the code 99232 is located. Evaluation & Management Identify the CPT section in which the code 97001 is located. Medicine Identify the CPT section in which the code 70486 is located. Radiology Which symbol indicates that a procedure code is new in CPT? Bullet Refer to CPT codes 11100 and 11101. Assume that a surgeon performed a biopsy of two different skin lesions during the same procedure. Which code should be assigned? 11100, 11101 Which category of CPT codes is reserved for emerging technology? Category III What symbol is placed in front of a CPT code to indicate it is an add on code? A plus sign (+) What code set is considered HCPCS Level I? CPT Codes What modifier is used for anesthesia by the surgeon? 47 What letter of the HCPCS Level II codes set represents Durable Medical Equipment? E Where in the CPT Manual can you find a list of Modifier 51 exempt codes? Appendix E Where in the CPT Manual can you find clinical examples for reference to coding E/M services? Appendix C What is the percentage of the global work that CMS recognizes for a surgeon that performs only the intraoperative services? 70% What are the three components of RVU’s? Work, overhead, & malpractice What are the three things that HIPAA implemented? Privacy, security, portability What part of Medicare is a supplemental for professional services and outpatient services? Part B What is an example of a form of healthcare fraud? Routine waiver of a copayment What is an ERA? Electronic Remittance Advice WEEK 2) An 86-year-old patient presents with a CC of vomiting and dizziness. Yesterday, she became dizzy while getting ready to go to church. In addition, she vomited bile several times and complained of deafness in her left ear at the start of the dizziness. Based on this information, what level is this history of present illness (HPI)? Extended The CC is chest pain. The examination determined: respiration quiet and unlabored; skin with good color, warm and dry, and no rashes; mucous membranes moist; ears and throat clear; lungs with good breath sounds in all fields; rare expiratory wheeze, no rales, no rhonchi; heart regular rate and rhythm with normal heart sounds, no murmur; abdomen soft with no liver or spleen enlargement; and bowel sounds active. Based on this information, what is the level of examination? Expanded problem focused New patient presents to the office with a CC of nasal congestion and headache. ROS: Denies shortness of breath or fever, stiffness of neck, or visual disturbances. Past history: No drug allergies or other allergies were noted, nor any history of TB, COPD, or asthma. Last physical exam one year ago was unremarkable. Based on this information, what type of past, family, and/or social history exam was performed? Pertinent A patient was seen by their primary care physician after a fall from their bicycle. The patient was disoriented and dizzy upon exam. The physician provided a expanded problem focused history, expanded problem focused exam and medical decision making was low complexity. The patient was then prepped for the repair of a 2.0cm superficial laceration of the forehead with simple wound closures. The patient was sent home with a return appointment in one week for a wound check. What code(s) were used? 99213-25, 12011 A 58 year old patient with rectal bleeding was seen in the office of a gastroenterologist. The patient’s primary care physician requested that the gastroenterologist provide advice about this case. The specialist conducted a comprehensive history and exam, and medical decision making was high. The consultant documented his findings and communicated them via written report to the primary care physician. The patient has private insurance. What is the correct code? 99245 The patient underwent a percutaneous needle core biopsy of the left breast not using imaging. What is the correct code and modifier? 19100-LT Dr. Jones provides critical care services in the emergency department for a patient in respiratory failure and with congestive heart failure. Ventilator management is initiated. Dr. Jones spends an hour and 10 minutes providing critical care for this patient. What is the correct code? 99291 Dr. Michaels provides E/M services for a patient in acute hysteria who has been admitted to the emergency department. After performing a problem-focused history and examination with low complexity medical decision making, he determines that the patient is suffering from acute grief reaction secondary to the death of her granddaughter due to sudden infant death syndrome. At discharge, the patient is in complete control of her actions and is referred to a SIDS organization. What is the correct code? 99281 Dr. Gerald provides preventive medicine services to an established 45-year-old patient who is in good health and has no complaints. Dr. Gerald obtains a comprehensive history, performs a comprehensive examination, and counsels the patient on proper diet and exercise. What is the correct code? 99396 Dr. Hawthorne sees an established patient in his office for evaluation of insulin-dependent diabetes mellitus with nephropathy. In addition to a problem-focused history, he performs an expanded problem-focused examination that includes a limited exam of the genitourinary, immunologic, skin, and musculoskeletal systems, and documents all positive and negative findings. The patient’s status does not seem to have c