AAPC – CPB – CHAPTER 5 REVIEW EXAM – FULL QUESTIONS AND ANSWERS –
QUESTIONS 1 TO 25
QUESTION# 1
What is the CPT® code for a tonsillectomy for a 5-year-old?
A. Correct: 42825
B. 42821
C. 42820
D. 42826
Feedback: Look in the CPT® Index for Tonsillectomy code range: 42820-
42826. Code choice is based on whether an adenoidectomy was or was not
performed and the patient’s age.
QUESTION# 2
A 68-year-old Medicare patient presented for an annual examination and had
no complaints. Her claim, billed as 99387, was denied. Was this billed
correctly? If not, what is needed to bill this encounter correctly?
A. Yes, this was billed correctly.
B. No, G0101, Q0091 should be billed.
C. No, G0101-GA, Q0091-GA should be billed.
D. Correct: It will depend on the documentation.
Feedback: The code selection is based on the documentation. CPT® code
99387 will not be paid by Medicare. Medicare uses codes G0438 for initial
and G0439 for subsequent annual wellness visits. G0101 and Q0091 is billed
with modifier GA if an Advanced Beneficiary Notice (ABN) was completed and
documentation indicates the patient has a breast and pelvic exam with a
screening pap.
QUESTION# 3
An AP and lateral chest films were performed on a patient with X-ray
equipment owned by his physician in the office to rule out right pleural
effusion. The physician interprets the chest films and documents the finding
, in the patient’s chart. The physician bills 71046 for the X-ray. Is this billed
correctly? If not, what is billed?
A. Correct: Yes, the physician reported the code correctly.
B. No, the physician needs to report 71046-26.
C. No, the physician needs to report 71046-TC.
D. No, the physician needs to report 71046-26-TC.
Feedback: The chest films were taken in the physician’s office by his
physician who owns the equipment and who also interpreted the films. This
indicates a global service was performed in which no modifiers (26 or TC) are
appended to the radiology service. Modifier 26 is reported when the
physician does not own the equipment. The physician usually performs the
radiology service in a hospital or outpatient setting where only the physician
supervises and interprets the service. The TC modifier is appended to a
radiology service by the hospital or outpatient facility indicating the facility
owns the equipment that was used for the radiological service, but a non-
facility provider performed the supervision and interpretation of the service.
Modifiers 26 and TC are never reported on the same claim together, only one
or the other is reported.
QUESTION# 4
What is the correct CPT® code to use for testing stool for occult blood by
guaiac for a patient presenting with a chronic gastric ulcer and the provider
takes two specimens as part of the digital examination?
A. 82270
B. 82270 x 2
C. Correct: 82272
D. 82272 x 2
Feedback: Since the patient is not being tested for a colorectal neoplasm
screening, do not report code 82270. Code 82272 is reported when a single,
two or three specimens are obtained from a digital rectal examination to be
tested; do not report code 82272 twice. In the CPT® Index look for Occult
Blood leads you to 82270-82272.
QUESTION# 5
QUESTIONS 1 TO 25
QUESTION# 1
What is the CPT® code for a tonsillectomy for a 5-year-old?
A. Correct: 42825
B. 42821
C. 42820
D. 42826
Feedback: Look in the CPT® Index for Tonsillectomy code range: 42820-
42826. Code choice is based on whether an adenoidectomy was or was not
performed and the patient’s age.
QUESTION# 2
A 68-year-old Medicare patient presented for an annual examination and had
no complaints. Her claim, billed as 99387, was denied. Was this billed
correctly? If not, what is needed to bill this encounter correctly?
A. Yes, this was billed correctly.
B. No, G0101, Q0091 should be billed.
C. No, G0101-GA, Q0091-GA should be billed.
D. Correct: It will depend on the documentation.
Feedback: The code selection is based on the documentation. CPT® code
99387 will not be paid by Medicare. Medicare uses codes G0438 for initial
and G0439 for subsequent annual wellness visits. G0101 and Q0091 is billed
with modifier GA if an Advanced Beneficiary Notice (ABN) was completed and
documentation indicates the patient has a breast and pelvic exam with a
screening pap.
QUESTION# 3
An AP and lateral chest films were performed on a patient with X-ray
equipment owned by his physician in the office to rule out right pleural
effusion. The physician interprets the chest films and documents the finding
, in the patient’s chart. The physician bills 71046 for the X-ray. Is this billed
correctly? If not, what is billed?
A. Correct: Yes, the physician reported the code correctly.
B. No, the physician needs to report 71046-26.
C. No, the physician needs to report 71046-TC.
D. No, the physician needs to report 71046-26-TC.
Feedback: The chest films were taken in the physician’s office by his
physician who owns the equipment and who also interpreted the films. This
indicates a global service was performed in which no modifiers (26 or TC) are
appended to the radiology service. Modifier 26 is reported when the
physician does not own the equipment. The physician usually performs the
radiology service in a hospital or outpatient setting where only the physician
supervises and interprets the service. The TC modifier is appended to a
radiology service by the hospital or outpatient facility indicating the facility
owns the equipment that was used for the radiological service, but a non-
facility provider performed the supervision and interpretation of the service.
Modifiers 26 and TC are never reported on the same claim together, only one
or the other is reported.
QUESTION# 4
What is the correct CPT® code to use for testing stool for occult blood by
guaiac for a patient presenting with a chronic gastric ulcer and the provider
takes two specimens as part of the digital examination?
A. 82270
B. 82270 x 2
C. Correct: 82272
D. 82272 x 2
Feedback: Since the patient is not being tested for a colorectal neoplasm
screening, do not report code 82270. Code 82272 is reported when a single,
two or three specimens are obtained from a digital rectal examination to be
tested; do not report code 82272 twice. In the CPT® Index look for Occult
Blood leads you to 82270-82272.
QUESTION# 5
