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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Anatomy & Physiology | 10-15% | - Medical Terminology - Body Systems |
| Topic 2: Surgery Coding | 40-50% | - Digestive System - Respiratory System - Integumentary System - Nervous System - Cardiovascular System - Musculoskeletal System - Genitourinary System |
| Topic 3: E/M (Evaluation and Management) | 10-15% | - Office/Outpatient Visits - Emergency Department |
| Topic 4: ICD-10-CM (Diagnosis Coding) | 10-15% | - Conventions and Guidelines - Code Selection |
| Topic 5: Laboratory / Pathology | 5-10% | - Organ and Disease Panels |
| Topic 6: Radiology | 5-10% | - Diagnostic Imaging |
| Topic 7: Medicine | 5-10% | - Specialty Coding |
| Topic 8: HCPCS Level II | 5-10% | - Supplies and Equipment - Modifiers |
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NEW QUESTION # 303
A patient with jaundice was seen by the physician to obtain liver biopsies. A needle biopsy was taken using CT guidance for needle placement. The physician obtained two core biopsies, which were then sent to pathology. What CPTcodes are reported?
Answer: B
Explanation:
1. Procedure and CPTCode Selection:
The patient underwent a needle biopsy of the liver using CT guidance to obtain two core biopsy samples.
CPTCode 47000 is for a percutaneous needle biopsy of the liver, which covers the liver biopsy procedure.
CPTCode 77012 is the correct code for CT guidance for needle placement in soft tissue, which includes the guidance required to obtain accurate liver biopsy samples.
2. Rationale for Excluding Other Options:
Code 47001 in option A is an add-on code for a liver biopsy performed during another procedure (such as a laparoscopic or open procedure) and is not applicable in this case, as 47000 is sufficient for a percutaneous approach.
Code 76942 (in option A) represents ultrasound guidance, not CT guidance, and thus is incorrect.
Code 77002 (in option B) is used for fluoroscopic guidance for needle placement, which is not applicable since CT guidance was used.
Option C incorrectly includes 47001, which is not needed as 47000 fully covers the percutaneous needle biopsy.
3. AAPC and CPTCoding Guidelines:
According to AAPC guidelines, 47000 is used for percutaneous liver biopsies, and 77012 should be reported for CT guidance for needle placement in the liver.
Therefore, the correct answer is D. 47000, 77012.
NEW QUESTION # 304
A patient presents for a percutaneous needle biopsy of the liver with ultrasound guidance to assess the severity of his primary biliary cirrhosis.
What CPTand ICD-10-CM codes are reported?
Answer: A
Explanation:
1. Procedure and CPTCode Selection:
The patient underwent a percutaneous needle biopsy of the liver with ultrasound guidance to assess primary biliary cirrhosis.
Code 47000 is the CPTcode for a percutaneous liver biopsy. This code encompasses the biopsy procedure itself.
Ultrasound guidance is commonly inherent to biopsy procedures, and guidance is not separately reported if the main code (47000) includes the technique used.
2. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code K74.5 is the correct code for primary biliary cirrhosis, which is specifically indicated in this case.
K74.3 is the code for other specified cirrhosis of the liver but is less specific than K74.5, making K74.5 the appropriate choice here.
3. Exclusion of Other Codes:
Code 47100 (option A) is for an open liver biopsy, which does not apply to this percutaneous procedure.
Codes 10005 (biopsy with imaging guidance) and 76942 (ultrasound guidance) would be redundant or incorrect since the main procedure code, 47000, sufficiently describes a percutaneous liver biopsy.
4. AAPC and CPTCoding Guidelines:
AAPC guidelines state that guidance is included in certain biopsy codes when performed for the targeted organ, such as in 47000 for a liver biopsy.
Therefore, based on CPTand ICD-10-CM coding rules, the correct answer is C. 47000, K74.5.
NEW QUESTION # 305
View MR 099401
MR 099401
Established Patient Office Visit
Chief Complaint: Patient presents with bilateral thyroid nodules.
History of present illness: A 54-year-old patient is here for evaluation of bilateral thyroid nodules. Thyroid ultrasound was done last week which showed multiple thyroid masses likely due to multinodular goiter.
Patient stated that she can "feel" the nodules on the left side of her thyroid. Patient denies difficulty swallowing and she denies unexplained weight loss or gain. Patient does have a family history of thyroid cancer in her maternal grandmother. She gives no other problems at this time other than a palpable right-sided thyroid mass.
Review of Systems:
Constitutional: Negative for chills, fever, and unexpected weight change.
HENT: Negative for hearing loss, trouble swallowing and voice change.
Gastrointestinal: Negative for abdominal distention, abdominal pain, anal bleeding, blood in stool, constipation, diarrhea, nausea, rectal pain, and vomiting Endocrine: Negative for cold Intolerance and heat intolerance.
Physical Exam:
Vitals: BP: 140/72, Pulse: 96, Resp: 16, Temp: 97.6 °F (36.4 °C), Temporal SpO2: 97% Weight: 89.8 kg (198 lbs ), Height: 165.1 cm (65") General Appearance: Alert, cooperative, in no acute distress Head: Normocephalic, without obvious abnormality, atraumatic Throat: No oral lesions, no thrush, oral mucosa moist Neck: No adenopathy, supple, trachea midline, thyromegaly is present, no carotid bruit, no JVD Lungs: Clear to auscultation, respirations regular, even, and unlabored Heart: Regular rhythm and normal rate, normal S1 and S2, no murmur, no gallop, no rub, no click Lymph nodes: No palpable adenopathy ASSESSMENT/PLAN:
1) Multinodular goiter - the patient will have a percutaneous biopsy performed (minor procedure).
What E/M code is reported for this encounter?
Answer: A
Explanation:
The patient is an established patient presenting with bilateral thyroid nodules and has a detailed history and examination performed.
* Procedure Description:
* Detailed history and examination of bilateral thyroid nodules.
* Review of systems and physical examination.
* Assessment and plan for a percutaneous biopsy.
* CPT Coding:
* 99214: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making.
References:
* AMA's CPT Professional Edition (current year).
* CPT Assistant for detailed coding guidelines on evaluation and management services.
NEW QUESTION # 306
A patient who is 37 weeks' gestation is admitted to labor and delivery for a cesarean delivery. An external cephalic version was performed successfully several days ago and she now presents in labor, fully dilated, and the fetus has returned to a footling presentation.
What anesthesia code is reported?
Answer: A
Explanation:
To determine the correct anesthesia code for a cesarean delivery with specific conditions, we review the following codes:
01961 is defined as "Anesthesia for cesarean delivery only," which aligns with this scenario, as the patient is admitted for a cesarean section.
01960 refers to anesthesia for a vaginal delivery, which does not apply here as the delivery is via cesarean.
01967 is for "Anesthesia for planned vaginal delivery," which also does not apply due to the cesarean route.
01958 is used for planned vaginal delivery that may involve a complicated scenario, but since the procedure is a cesarean section, this code is not appropriate.
Given that the patient is in labor for a cesarean section and has had a previous external cephalic version,
01961 is the correct answer.
NEW QUESTION # 307
Which one of the following is a commercial or private payer?
Answer: D
Explanation:
Blue Cross Blue Shield is a commercial or private payer, which means it is an insurance company that provides health insurance plans to individuals and groups. In contrast, Medicare and Medicaid are government programs, and the Veterans Health Administration (VHA) is a federal healthcare system for military veterans.
AMA's CPT Professional Edition (current year), Appendix B: Payers and Reimbursement.
NEW QUESTION # 308
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