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| Section | Objectives |
|---|---|
| Topic 1: ICD-10-CM Diagnosis Coding | - ICD-10-CM guidelines - Diagnosis code selection and sequencing |
| Topic 2: CPT Coding | - CPT guidelines and conventions - Surgical, diagnostic, and procedural coding |
| Topic 3: Compliance and Regulatory Guidelines | - Fraud and abuse regulations - HIPAA and medical ethics |
| Topic 4: HCPCS Level II Coding | - Medicare coding procedures - Durable medical equipment and supplies |
| Topic 5: Medical Terminology and Anatomy | - Human anatomy basics - Medical terminology structure |
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NEW QUESTION # 200
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: C
NEW QUESTION # 201
(Full Case:Pre/Post-op diagnosis:Grade 1 endometrial cancer.Procedure:Radical hysterectomy and pelvic lymph node sampling.Anesthesia:General.EBL:400 mL.Complications:None.Specimens:pelvic washings; uterus; tubes; ovaries; pelvic lymph nodes.Fluids:2 L crystalloid.Operative details:frog-leg position; perineum prepped sterile; Foley placed; midline vertical incision umbilicus to symphysis; exploration shows normal upper abdomen and bowel; no paraaortic adenopathy; pelvis/perineum normal; washings collected; round ligaments transected; retroperitoneal spaces opened; ureters visualized; ovarian vessels isolated/ligated; bladder flap taken down; uterine arteries, uterosacral and cardinal ligaments clamped/ligated; uterus removed; vagina closed; lymph node sampling left then right with removal of lymphatic tissue from external/internal iliac bifurcation to circumflex iliac vein and down to obturator nerve; tumor ~40% endometrial surface with <
50% myometrial invasion; closure in layers; patient tolerated well.Question:What CPTcodes are reported?)
Answer: A
Explanation:
The operative note describes anopen radical hysterectomyfor endometrial cancer with removal of theuterus, tubes, and ovaries(specimens listed) and extensive dissection ofuterine arteries, uterosacral and cardinal ligaments, consistent with aradicalprocedure. The approach is clearlyabdominal/open(midline vertical incision and abdominal entry), not laparoscopic, so a laparoscopic radical hysterectomy code (such as 58548) is not appropriate. In the answer set,58210represents aradical abdominal hysterectomy(with appropriate extent for malignancy management). In addition, the surgeon performedpelvic lymph node samplingbilaterally, removing lymphatic tissue along the iliac vessels to the obturator nerve region. The correct code in the choices for pelvic lymphadenectomy/sampling is38770. Pelvic washings and extensive exploration are included in the primary surgical service and do not add separate CPT codes in this scenario. Therefore, the correct coding combination is58210 and 38770.
NEW QUESTION # 202
(A provider states that all of their office visits should be reported asmoderate levelsbecause they treat patients with high-complexity problems. Would this be considered a compliance problem?)
Answer: A
Explanation:
Systematically billing all office visits at a predetermined level-without documentation supporting the requiredmedical decision making (MDM)ortime-is a classic compliance red flag and is generally treated asabuse(often described as upcoding when higher levels are billed than supported). E/M levels must reflect what was actually performed and documented for that encounter, using the E/M rules (MDM elements or total time, depending on code selection). Even if a provider treats complex patients, not every visit will meet the same level; stable follow-ups may be lower complexity than acute exacerbations or new problems. "Waste" generally refers to inefficient or unnecessary use of resources without intent to misrepresent; a blanket instruction to code moderate levels suggestssystematic misbillingrather than inefficiency. Option D is incorrect because providers cannot select any level at will-coding must be supported by documentation. This type of pattern is exactly what audits target, and it can trigger overpayment recoupment, penalties, and corrective action plans.
NEW QUESTION # 203
A 5-year-old is brought to the QuickCare in the ED to repair two lacerations: a 3 cm laceration on her right arm and 2 cm laceration on her nose. Her arm is repaired with a simple one-layer closure with sutures. Her nose is repaired with a simple repair using tissue adhesive, 2-cyanoacrylate.
How are the repairs reported?
Answer: C
Explanation:
The CPT code 12002 is used for simple repair of superficial wounds of 2.5 cm or less. This code includes the repair of both the 3 cm laceration on the right arm and the 2 cm laceration on the nose as both are simple repairs. The other options suggest more complex repairs or multiple separate procedures, which are not necessary in this scenario.References: AMA's CPT Professional Edition (current year)
NEW QUESTION # 204
A comatose patient is seen in the ER. The patient has a history of depression. Drug testing confirm she overdosed on tricyclic antidepressant drugs doxepin, amoxapine, and clomipramine.
What CPT code is reported?
Answer: A
Explanation:
For a comatose patient who has overdosed on tricyclic antidepressant drugs (doxepin, amoxapine, and clomipramine), the correct CPT code is 80366. This code covers drug testing for tricyclic antidepressants, which includes the specific drugs mentioned in the scenario.
Reference:
AMA's CPT Professional Edition (current year)
NEW QUESTION # 205
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