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| Section | Weight | Objectives |
|---|---|---|
| ICD-10-CM Coding | 15-17% | - Code selection & sequencing - Diagnosis coding guidelines |
| Reimbursement & Revenue Cycle | 5-7% | |
| Modifiers | 5-7% | |
| Compliance & Regulations | 8-10% | - HIPAA, fraud & abuse - Reimbursement rules |
| Medical Terminology & Anatomy | 8-10% | |
| HCPCS Level II Coding | 5-7% | |
| CPT® Coding | 45-50% | - Radiology, Pathology/Laboratory, Medicine - Surgery (10000–69999) - Evaluation & Management (E/M) |
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NEW QUESTION # 316
Refer to the exhibit.
Refer to the supplemental information when answering this question:
View MR 004813
What CPT and ICD-10-CM codes are reported?
Answer: C
Explanation:
CPT Code 43246: Esophagogastroduodenoscopy, with transoral insertion of intra-abdominal tube (e.g., gastrostomy or jejunostomy) This code describes the attempted PEG tube placement.
Modifier -52: Reduced services. This modifier is appended because the procedure was aborted and the PEG tube was not successfully placed.
ICD-10-CM Code K94.29: Other specified disorders of digestive system
This code captures the patient's chronic feeding requirement, which is the reason for the attempted PEG tube placement.
ICD-10-CM Code K44.9: Diaphragmatic hernia without obstruction or gangrene This code reports the small hiatal hernia that was found during the procedure.
Reference:
CPT Code 43246: Esophagogastroduodenoscopy, with transoral insertion of intra-abdominal tube (e.g., gastrostomy or jejunostomy) Modifier 52: Reduced services ICD-10-CM Code K94.29: Other specified disorders of digestive system ICD-10-CM Code K44.9: Diaphragmatic hernia without obstruction or gangrene AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.
NEW QUESTION # 317 
Refer to the supplemental information when answering this question:
View MR 354859
What CPTand ICD-10-CM coding is reported?
Answer: A
NEW QUESTION # 318
A patient undergoes lumbar puncture with catheter placement under CT guidance to drain CSF.
What CPT coding is reported?
Answer: C
Explanation:
62272 = Lumbar puncture with catheter for CSF drainage
77012 = CT guidance for needle placement
NEW QUESTION # 319
911 is called by the physician for an ambulance with non-emergency basic life support to pick up a patient from his office that had fainted. The patient was taken to the hospital. What HCPCS Level II coding is reported for the ambulance's service?
Answer: B
Explanation:
To select the correct HCPCS Level II code for a non-emergency ambulance service, we focus on the following components:
A0428 represents "Ambulance service, Basic Life Support (BLS), non-emergency transport," which is appropriate here as the patient was transported with non-emergency BLS following a fainting episode. This eliminates options B and D, which indicate "emergency" (A0429).
QM Modifier indicates "Ambulance service provided under arrangement by a provider of services," relevant when a physician arranges the ambulance transport.
PH Modifier specifies "Physician's office to hospital" transport, matching the scenario where the patient was taken from the physician's office to the hospital.
Thus, A0428-QM-PH accurately describes a non-emergency BLS transport arranged by a provider from a physician's office to the hospital, aligning with choice A.
NEW QUESTION # 320
View MR 099407
MR 099407
Emergency Department Visit
Chief Complaint: VOMITING.
This started just prior to arrival and is still present. He has had nausea and vomiting. No diarrhea, black stools, bloody stools or abdominal pain. Pt is diabetic and has been having elevated blood sugars (320 mg/dL).
REVIEW OF SYSTEMS: Unobtainable due to patient's altered mental status.
PAST HISTORY: Poorly controlled diabetes mellitus, with history of poor compliance.
Medications: See Nurses Notes.
Allergies: PCN.
SOCIAL HISTORY: Nonsmoker. No alcohol use or drug use.
ADDITIONAL NOTES: The nursing notes have been reviewed.
PHYSICAL EXAM
Appearance: Lethargic. Patient in mild distress.
Vital Signs: Have been reviewed-tachycardic.
Eyes: Pupils equal, round and reactive to light.
ENT: Dry mucous membranes present.
Neck: Normal inspection. Neck supple.
CVS: Tachycardia. Heart sounds normal. Pulses normal.
E D. Course: Insulin IV drip per protocol, at 10 units/hr.
Zofran 8 mg 01:33 Jul 13 2008 IVP.
Phenergan 25 mg IVP. 07:52. Discussed case with physician. Dr. X. Reviewed test results. Agreed upon treatment plan. Physician will see patient in hospital.
Total critical care time: 45 min.
Disposition: Admitted to Intensive Care Unit. Condition: stable.
Admit decision based on need for monitoring and IV hydration and medications.
CLINICAL IMPRESSION: Vomiting, diabetic ketoacidosis, probable diabetes insipidus.
What E/M code is reported for this encounter?
Answer: D
Explanation:
99291: This code is used for the first 30-74 minutes of critical care, evaluation, and management of the critically ill or critically injured patient.
99292: This code is used for each additional 30 minutes of critical care service beyond the first 74 minutes.
The documentation indicates that the patient received a total of 45 minutes of critical care, which involves continuous IV insulin for diabetic ketoacidosis, administration of antiemetics, and admission to the ICU. The critical care time documented justifies the use of 99291 for the first 30-74 minutes and 99292 for each additional 30 minutes.
CPT Professional Edition, AMA
NEW QUESTION # 321
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