AAPC CPC Chapter 20 Questions and Answers Graded A
A patient who has had two recent seizures administered sedation with a nurse assisting in
underwent a 3-hour EEG study. What CPT® monitoring the patient. In the CPT® Index look for
code is reported? - ANSWER -95813 Sedation/Moderate/with Independent
Observation and you are directed to code range
Rationale: In the CPT® Index look for EEG which 99151-99153. Code selection is based on age of
directs you to Electroencephalography (EEG). the patient and the length of time. Code 99152
Under Electroencephalography (EEG)/Monitoring describes an encounter using moderate sedation,
you are directed to 95812-95813, 95950-95953 and the physician or other qualified health care
and 95956. Code range 95812 - 95813 is based professional rendering the diagnostic or
on time. Code 95813 describes an EEG therapeutic service also manages the sedation.
(electroencephalogram), more than 1 hour. This This code is specific for the age of the patient
patient had a 3-hour study which is reported with and up to 15 minutes of time. Add-on 99153 is for
95813. each additional 15 minutes of intraservice time.
A 15 year-old underwent placement of a cochlear A new patient with cystic fibrosis underwent
implant 1 year ago. It now needs to be evaluation of lung function, including percussion,
reprogrammed. What CPT® code is reported for vibration and cupping to the chest wall to
the reprogramming? - ANSWER -92604 facilitate his lung function. What CPT® code(s)
is/are reported for this service? -
Rationale: Cochlear implants differ from hearing ANSWER -94667
aids; they bypass the damaged part of the ear.
The use of a cochlear implant involves relearning Rationale: In the CPT® Index look for
how to hear and react to sounds. In the CPT® Pulmonology/Therapeutic/Manipulation of Chest
Index look for Cochlear Device/Programming Wall or Chest Wall/Manipulation which directs
which directs you to codes 92602, 92604. The you to 94667-94668. 94667 is the correct code
code selection is based on the age of the patient since it includes the patient's first time, and it
and whether it is the initial programming or includes the evaluation.
subsequent reprogramming. Code 92604
describes subsequent reprogramming for a
patient age 7 or older. A patient was brought to the emergency
department in cardiac arrest. The physician
immediately initiated CPR. What CPT® code is
A 5 year-old fell on broken glass and required reported for CPR? - ANSWER -92950
suturing of a laceration. Due to the age and
combative behavior of the patient, the provider Rationale: Medical personnel usually begin
utilized moderate sedation while repairing the cardiopulmonary resuscitation (CPR) which
laceration. The provider gave the child 50 mg of provides artificial breathing and chest
Ketamine IM. A nurse monitored the patient compressions for a person in cardiac arrest. In
during the procedure which took 30 minutes. the CPT® Index you can look for either CPR or
What CPT® code is reported for moderate Cardiopulmonary Resuscitation or
sedation? - ANSWER -99152, 99153 Resuscitation/Cardiopulmonary. All indexed
items direct you to code 92950.
Rationale: Moderate sedation is often used for
pediatric patients in situations not normally
requiring sedation. In this case, the provider A patient with hypertensive cardiovascular
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, AAPC CPC Chapter 20 Questions and Answers Graded A
disease is admitted by his primary care provider. and you are directed to C92.1-. In the Tabular
What is/are the correct ICD-10-CM code(s) for List the 5th character of 0 is used to indicate
this encounter? - ANSWER -I11.9 there is no mention of having achieved remission.
Rationale: In the ICD-10-CM Alphabetic Index
look for Hypertension, A 49 year-old female was brought to the
hypertensive/cardiovascular/disease emergency department. She was lethargic, but
(arteriosclerotic) (sclerotic) which states to see awake. She is four years post liver transplant.
Hypertension, heart. Look for Hypertension/heart Neurology was consulted who determined the
(disease) (conditions in I51.4-I51.9 due to patient was encephalopathic with altered mental
hypertension) directing you to I11.9. ICD-10-CM status. There was some question whether she
guideline, I.C.9.a.1., states code I11- is used had a seizure. An EEG and WADA test were
when a causal relationship is stated or implied. performed. What CPT® and ICD-10-CM codes
Tabular List confirms code I11.9 is correct as are reported? - ANSWER -95958, G93.40,
heart failure is not documented. R41.82, Z94.4
A patient with chronic respiratory failure is visited What ICD-10-CM code is reported when a flu
at home by a certified respiratory therapist to vaccine is administered? - ANSWER -Z23
manage his home oxygen therapy. What CPT®
and ICD-10-CM codes are reported? - Rationale: In the ICD-10-CM Alphabetic Index
ANSWER -99503, J96.10 look for Vaccination (prophylactic)/encounter for
Z23. Verification in the Tabular List confirms Z23
Rationale: In the CPT® Index look for Home is for an encounter for immunization. This code is
Services/Respiratory Therapy and you are nonspecific as to the type of vaccination that is
directed to 99503. In the ICD-10-CM Alphabetic given. The type of vaccination given (i.e.
Index, look for Failure, failed/respiration, influenza, MMR, DPT) will be specified by
respiratory/chronic and you are directed to procedure/HCPCS codes.
J96.10. Verification in the Tabular List confirms
code selection.
A 70 year-old patient with chronic obstructive
asthma is brought to the urgent care center with
A patient with chronic myeloid leukemia (CML), increased wheezing and coughing. The provider
BCR/ABL-positive has an implanted access port initiated an albuterol inhalation treatment, one
for delivery of chemotherapy. The device needs dose, delivered by nebulizer. After treatment, the
to be irrigated before receiving treatment. What patient's exacerbation was somewhat improved
ICD-10-CM and CPT® codes are reported for the but the provider determined a second treatment
irrigation? - ANSWER -96523, C92.10 was necessary. What codes are reported? -
ANSWER -94640, 94640-76, J7609 x 2,
Rationale: In the CPT® Index look for J44.1
Irrigation/Venous Access Device. Report code
96523 for irrigation of an implanted venous Rationale: In the CPT® Index look for Inhalation
access device. Treatment/for Airway Obstruction/Pressured or
Nonpressured and you are directed 94640.
In the ICD-10-CM Alphabetic Index look for Inhalation treatment was given therapeutically in
Leukemia/chronic myeloid, BCR/ABL-positive treating the acute airway obstruction. Two
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A patient who has had two recent seizures administered sedation with a nurse assisting in
underwent a 3-hour EEG study. What CPT® monitoring the patient. In the CPT® Index look for
code is reported? - ANSWER -95813 Sedation/Moderate/with Independent
Observation and you are directed to code range
Rationale: In the CPT® Index look for EEG which 99151-99153. Code selection is based on age of
directs you to Electroencephalography (EEG). the patient and the length of time. Code 99152
Under Electroencephalography (EEG)/Monitoring describes an encounter using moderate sedation,
you are directed to 95812-95813, 95950-95953 and the physician or other qualified health care
and 95956. Code range 95812 - 95813 is based professional rendering the diagnostic or
on time. Code 95813 describes an EEG therapeutic service also manages the sedation.
(electroencephalogram), more than 1 hour. This This code is specific for the age of the patient
patient had a 3-hour study which is reported with and up to 15 minutes of time. Add-on 99153 is for
95813. each additional 15 minutes of intraservice time.
A 15 year-old underwent placement of a cochlear A new patient with cystic fibrosis underwent
implant 1 year ago. It now needs to be evaluation of lung function, including percussion,
reprogrammed. What CPT® code is reported for vibration and cupping to the chest wall to
the reprogramming? - ANSWER -92604 facilitate his lung function. What CPT® code(s)
is/are reported for this service? -
Rationale: Cochlear implants differ from hearing ANSWER -94667
aids; they bypass the damaged part of the ear.
The use of a cochlear implant involves relearning Rationale: In the CPT® Index look for
how to hear and react to sounds. In the CPT® Pulmonology/Therapeutic/Manipulation of Chest
Index look for Cochlear Device/Programming Wall or Chest Wall/Manipulation which directs
which directs you to codes 92602, 92604. The you to 94667-94668. 94667 is the correct code
code selection is based on the age of the patient since it includes the patient's first time, and it
and whether it is the initial programming or includes the evaluation.
subsequent reprogramming. Code 92604
describes subsequent reprogramming for a
patient age 7 or older. A patient was brought to the emergency
department in cardiac arrest. The physician
immediately initiated CPR. What CPT® code is
A 5 year-old fell on broken glass and required reported for CPR? - ANSWER -92950
suturing of a laceration. Due to the age and
combative behavior of the patient, the provider Rationale: Medical personnel usually begin
utilized moderate sedation while repairing the cardiopulmonary resuscitation (CPR) which
laceration. The provider gave the child 50 mg of provides artificial breathing and chest
Ketamine IM. A nurse monitored the patient compressions for a person in cardiac arrest. In
during the procedure which took 30 minutes. the CPT® Index you can look for either CPR or
What CPT® code is reported for moderate Cardiopulmonary Resuscitation or
sedation? - ANSWER -99152, 99153 Resuscitation/Cardiopulmonary. All indexed
items direct you to code 92950.
Rationale: Moderate sedation is often used for
pediatric patients in situations not normally
requiring sedation. In this case, the provider A patient with hypertensive cardiovascular
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, AAPC CPC Chapter 20 Questions and Answers Graded A
disease is admitted by his primary care provider. and you are directed to C92.1-. In the Tabular
What is/are the correct ICD-10-CM code(s) for List the 5th character of 0 is used to indicate
this encounter? - ANSWER -I11.9 there is no mention of having achieved remission.
Rationale: In the ICD-10-CM Alphabetic Index
look for Hypertension, A 49 year-old female was brought to the
hypertensive/cardiovascular/disease emergency department. She was lethargic, but
(arteriosclerotic) (sclerotic) which states to see awake. She is four years post liver transplant.
Hypertension, heart. Look for Hypertension/heart Neurology was consulted who determined the
(disease) (conditions in I51.4-I51.9 due to patient was encephalopathic with altered mental
hypertension) directing you to I11.9. ICD-10-CM status. There was some question whether she
guideline, I.C.9.a.1., states code I11- is used had a seizure. An EEG and WADA test were
when a causal relationship is stated or implied. performed. What CPT® and ICD-10-CM codes
Tabular List confirms code I11.9 is correct as are reported? - ANSWER -95958, G93.40,
heart failure is not documented. R41.82, Z94.4
A patient with chronic respiratory failure is visited What ICD-10-CM code is reported when a flu
at home by a certified respiratory therapist to vaccine is administered? - ANSWER -Z23
manage his home oxygen therapy. What CPT®
and ICD-10-CM codes are reported? - Rationale: In the ICD-10-CM Alphabetic Index
ANSWER -99503, J96.10 look for Vaccination (prophylactic)/encounter for
Z23. Verification in the Tabular List confirms Z23
Rationale: In the CPT® Index look for Home is for an encounter for immunization. This code is
Services/Respiratory Therapy and you are nonspecific as to the type of vaccination that is
directed to 99503. In the ICD-10-CM Alphabetic given. The type of vaccination given (i.e.
Index, look for Failure, failed/respiration, influenza, MMR, DPT) will be specified by
respiratory/chronic and you are directed to procedure/HCPCS codes.
J96.10. Verification in the Tabular List confirms
code selection.
A 70 year-old patient with chronic obstructive
asthma is brought to the urgent care center with
A patient with chronic myeloid leukemia (CML), increased wheezing and coughing. The provider
BCR/ABL-positive has an implanted access port initiated an albuterol inhalation treatment, one
for delivery of chemotherapy. The device needs dose, delivered by nebulizer. After treatment, the
to be irrigated before receiving treatment. What patient's exacerbation was somewhat improved
ICD-10-CM and CPT® codes are reported for the but the provider determined a second treatment
irrigation? - ANSWER -96523, C92.10 was necessary. What codes are reported? -
ANSWER -94640, 94640-76, J7609 x 2,
Rationale: In the CPT® Index look for J44.1
Irrigation/Venous Access Device. Report code
96523 for irrigation of an implanted venous Rationale: In the CPT® Index look for Inhalation
access device. Treatment/for Airway Obstruction/Pressured or
Nonpressured and you are directed 94640.
In the ICD-10-CM Alphabetic Index look for Inhalation treatment was given therapeutically in
Leukemia/chronic myeloid, BCR/ABL-positive treating the acute airway obstruction. Two
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