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| Section | Weight | Objectives |
|---|---|---|
| Reimbursement & Revenue Cycle | 5-7% | |
| Compliance & Regulations | 8-10% | - Reimbursement rules - HIPAA, fraud & abuse |
| HCPCS Level II Coding | 5-7% | |
| Medical Terminology & Anatomy | 8-10% | |
| Modifiers | 5-7% | |
| ICD-10-CM Coding | 15-17% | - Code selection & sequencing - Diagnosis coding guidelines |
| CPT® Coding | 45-50% | - Evaluation & Management (E/M) - Radiology, Pathology/Laboratory, Medicine - Surgery (10000–69999) |
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NEW QUESTION # 317
A mother brings her 2-year-old son to the pediatrician's office because he stuck a bead up his left nostril. The pediatrician uses a nasal decongestant to open the blocked nostril and removes the bead with nasal forceps.
What CPT coding is reported?
Answer: B
Explanation:
Removal of a foreign body from the nose using forceps or other instrumentation is coded with CPT 30300. This code includes the use of local anesthesia, which aligns with the scenario where a nasal decongestant was used.
Reference:
AMA's CPT Professional Edition (current year)
NEW QUESTION # 318
What CPT coding is reported for a subtotal thyroidectomy for malignancy with radical neck dissection?
Answer: C
Explanation:
60254 = Subtotal thyroidectomy for malignancy with radical neck dissection
60260 = Total thyroidectomy
60220 = Partial thyroidectomy, benign
60252 = Total thyroidectomy with radical neck dissection
NEW QUESTION # 319
A patient presents to the office with dysuria and lower abdominal pain. The physician suspects she has a UTI.
A non-automated urinalysis is done in the office and is negative. UTI is ruled out for the final diagnosis.
What CPT and ICD-10-CM codes are reported?
Answer: A
Explanation:
1. Procedure and CPTCode Selection:
The urinalysis performed was non-automated and without microscopy.
CPTCode 81002 is appropriate for a non-automated urinalysis without microscopy. This code accurately reflects the test performed in the office.
2. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code R30.0 is used for dysuria, which was one of the patient's presenting symptoms.
ICD-10-CM Code R10.30 is used for lower abdominal pain, another presenting symptom.
Since the urinalysis ruled out a urinary tract infection, N39.0 (UTI) is not appropriate as a final diagnosis.
3. Rationale for Excluding Other Options:
Code 81000 (in options A and B) is for a urinalysis with microscopy, which was not performed here.
N39.0 is used when a UTI is confirmed, which is incorrect for this case since the urinalysis was negative, ruling out UTI.
4. AAPC and CPTCoding Guidelines:
AAPC guidelines recommend coding based on the symptoms when a specific diagnosis (such as UTI) is ruled out. Therefore, R30.0 and R10.30 are appropriate symptom codes for this encounter.
Thus, the correct answer is C. 81002, R30.0, R10.30.
NEW QUESTION # 320
A complete cardiac MRI for morphology and function without contrast, followed by contrast with four additional sequences and stress imaging, is performed on a patient with systolic left ventricular congestive heart failure and premature ventricular contractions.
What CPT and ICD-10-CM codes are reported?
Answer: B
NEW QUESTION # 321
A 10-year-old had a cochlear implant in his left ear few weeks ago. Today he sees the audiologist to initialize and program the implant.
What CPTcode is reported?
Answer: B
Explanation:
1. Procedure and CPTCode Selection:
The patient had a cochlear implant placed in the left ear and is now seeing the audiologist for initialization and programming of the implant.
CPTCode 92603 is specific for initial programming of a cochlear implant for patients younger than 12 years old. This includes the setup and initial adjustments required for the cochlear implant, making it the correct code.
2. Rationale for Excluding Other Options:
Code 92626 is used for evaluating auditory function with the cochlear implant, focusing on assessment rather than programming, and is therefore incorrect for this programming session.
Code 92630 is for aural rehabilitation following cochlear implant, which does not apply to the programming
/initiation stage.
Code 92604 is for subsequent programming sessions after the initial programming and is therefore not applicable for the first-time programming.
3. AAPC and CPTCoding Guidelines:
According to AAPC guidelines, 92603 is the appropriate code for initial programming of a cochlear implant in children under 12 years of age.
Therefore, the correct answer is D. 92603.
NEW QUESTION # 322
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