Final Exam with 200 accurate and verified
questions covering medical coding guidelines,
CPT, ICD-10-CM, HCPCS Level II, compliance,
and coding scenarios.
A qualified genetics counselor is working with a child who has
been diagnosed with fragile X syndrome. After extensive
research about the condition, she meets with the parents to
discuss the features of the disease and the child's prognosis.
The session lasted 45 minutes. What CPT® and ICD-10-CM
codes are reported?
a. 96040, Q99.9
b. 96040 x 2, Q99.2
c. 96040 x 2, Q99.8
d. 96040, Q99.2 - __100% correct answer as d. 96040,
Q99.2
,Rationale: In the CPT® Index look for Medical Genetics which
directs you to 96040. The genetics counseling session is
reported as face-to-face time per 30 minutes. Report 1 unit for
the first 30 minutes. Since the remaining time is 15 minutes, it
is not reported separately per the Medical Genetics and
Genetic Counseling Services guidelines. Fragile X syndrome is a
congenital chromosomal anomaly that may include mental
retardation. In the ICD-10-CM Alphabetic Index look for
Syndrome/fragile X. The condition is reported with code Q99.2.
Verification in the Tabular List confirms code selection.
d. 29881 - __100% correct answer as This 56-year-old
female presented with a degenerative posteromedial meniscal
flap tear of the right knee. After appropriate preoperative
evaluation, the patient was taken to the operating room where
general anesthesia was instituted. The patient was placed
supine on the operating table. The right lower extremity was
sterilely prepped and draped for arthroscopic surgery. The leg
was exsanguinated and the tourniquet inflated. The
arthroscope was introduced first through the anterolateral
portal with medial suprapatellar portal utilized. The lateral
compartment looked fairly good. There were some minimal
medial degenerative changes. In the medial compartment there
was a full-thickness area of osteochondral degeneration with a
flap of cartilage noted. It was possible to remove this with a
bleeding bony bed with beveled edges of cartilage. The
,ligament itself was intact. The retropatellar area was normal
with Grade I chondromalacia changes noted. The medial joint
was inspected and there was a tear at the junction of the
middle and posterior portions of the meniscus, a flap tear was
based more anteriorly. This was shaved with a combination of
small baskets and punches, and the meniscus debrided back to
a smooth stable rim. There was additional synovitis in the
medial aspect of the intercondylar notch and this was removed
with the curved automated meniscal incisor. What CPT® code(s)
should be reported?
a. 29880, 29879-51
b. 29882
c. 29881, 29875-59
d. 29881
b. 99291
Rationale: CPT®: In the CPT Index locate Critical Care
Services/Evaluation and Management 99291-99292. 99291 is
used for critical care services 30-74 minutes of duration. The
patient is documented as critically ill with multiple system
organ failure indicating a critically ill patient. The age of the
patient requires the use of critical care codes in the 99291-
, 99292 range. - __100% correct answer as ICU - CC:
Multi-system organ failure
INTERVAL HISTORY: Patient remains intubated and sedated.
Overnight events reviewed. Tolerating tube feeds. Systolic
pressures have been running in the low 90s on LEVOPHED.
Cultures remain negative. Kidney function has worsened, but
patient remains non-oliguric.
PHYSICAL EXAM: BP 96/60, Pulse 112, Temp 100.8. Lungs have
anterior rhonchi. Heart RRR with no MRGs. Abdomen is soft
with positive bowel sounds. Extremities show moderate
edema.
LABS: BUN 89, creatinine 2.6, HGB 10.2, WBC 22,000. ABG:
7.34/100/42 on 50% FiO2. CXR shows RLL infiltrate.
IMPRESSION
Hypoxic respiratory failure
Community acquired pneumonia
Septic shock
Non-oliguric acute renal failure