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| Section | Weight | Objectives |
|---|---|---|
| Compliance & Regulations | 8-10% | - HIPAA, fraud & abuse - Reimbursement rules |
| HCPCS Level II Coding | 5-7% | |
| ICD-10-CM Coding | 15-17% | - Diagnosis coding guidelines - Code selection & sequencing |
| Reimbursement & Revenue Cycle | 5-7% | |
| Medical Terminology & Anatomy | 8-10% | |
| CPT® Coding | 45-50% | - Surgery (10000–69999) - Evaluation & Management (E/M) - Radiology, Pathology/Laboratory, Medicine |
| Modifiers | 5-7% |
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NEW QUESTION # 442
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: C
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 # 443
A patient with a history of chronic venous embolism in the inferior vena cava has a radiographic study to visualize any abnormalities. In outpatient surgery the physician accesses the subclavian vein and the catheter is advanced to the inferior vena cava for injection and imaging. The supervision and interpretation of the images is performed by the physician.
What codes are reported for this procedure?
Answer: B
Explanation:
For the procedure involving access to the subclavian vein and advancing a catheter to the inferior vena cava for injection and imaging, the following codes are used:
36010 for the catheter placement.
75825-26 for the supervision and interpretation of the imaging.
Modifier -26 indicates the professional component of the radiological supervision and interpretation.
Reference:
AMA's CPT Professional Edition (current year)
ICD-10-CM (current year)
NEW QUESTION # 444 
Refer to the supplemental information when answering this question:
View MR 005271
What CPTcoding is reported?
Answer: D
Explanation:
* CPT Code 55706: Biopsy, prostate; needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance.
* This code accurately describes the procedure performed. The documentation clearly states that a stereotactic template was used to guide the biopsy needles, and multiple samples were taken (saturation biopsies). This code includes imaging guidance.
* CPT Code 76942: Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation.
* Although 55706 includes imaging guidance, code 76942 is also reported separately because the transrectal ultrasound provided initial diagnostic images and was then used for guidance during the biopsy. This is supported by the documentation which states "Using a B & K ultrasound probe, a transrectal ultrasound of the prostate was obtained. Once this was done...a biopsy needle is inserted into the prostate...under ultrasound guidance." This indicates distinct uses of the ultrasound.
Important Note: While some sources suggest that 76942 and the diagnostic transrectal ultrasound code (76872) are bundled, it's crucial to consult the latest National Correct Coding Initiative (NCCI) edits for the most up-to-date guidance.
References:
* CPT Code 55706: Biopsy, prostate; needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance
* CPT Code 76942: Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation
* AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.
* NCCI Edits: Always check the most current NCCI edits to confirm coding combinations.
NEW QUESTION # 445
Mr. Roland has difficulty breathing and congestion with a productive cough. The physician takes frontal and lateral view chest X-rays in the office (the equipment is owned by the physician group). The physician reads the X-rays and determines a diagnosis of walking pneumonia. The physician's interpretation is placed in the patient's chart.
How does the physician bill for the chest X-ray?
Answer: B
NEW QUESTION # 446
Patient is diagnosed with dacryocystitis, which is the inflammation of?
Answer: A
Explanation:
Dacryocystitis is the inflammation of the lacrimal sac, which is part of the tear drainage system located in the inner corner of the eye. The lacrimal sac is connected to the nasolacrimal duct, which drains tears into the nasal cavity. Inflammation in this area can cause pain, redness, and swelling near the inner corner of the eye.
ICD-10-CM, medical dictionaries
NEW QUESTION # 447
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