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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: ICD-10-CM Coding | 15-17% | - Diagnosis coding guidelines - Code selection & sequencing |
| Topic 2: HCPCS Level II Coding | 5-7% | |
| Topic 3: Reimbursement & Revenue Cycle | 5-7% | |
| Topic 4: Compliance & Regulations | 8-10% | - HIPAA, fraud & abuse - Reimbursement rules |
| Topic 5: Medical Terminology & Anatomy | 8-10% | |
| Topic 6: Modifiers | 5-7% | |
| Topic 7: CPT® Coding | 45-50% | - Evaluation & Management (E/M) - Surgery (10000–69999) - Radiology, Pathology/Laboratory, Medicine |
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NEW QUESTION # 214
A 23-year-old receives MMR and Hepatitis B vaccines without counseling.
What CPT codes are reported?
Answer: C
Explanation:
90471/90472 = Administration without counseling
90707 = MMR
90746 = Hepatitis B, adult
NEW QUESTION # 215
Preoperative diagnosis: Right thigh benign congenital hairy nevus. *1
Postoperative diagnosis: Right thigh benign congenital hairy 0 nevus.
Operation performed: Excision of right thigh benign congenital>1
nevus, excision size with margins 4.5 cm and closure size 5 cm.
Anesthesia: General.0
Intraoperative antibiotics: Ancef.0
Indications: The patient is a 5-year-old girl who presented with her parents for evaluation of her right thigh congenital nevus. It has been followed by pediatrics and thought to have changed over the past year. Family requested excision. They understood the risks involved, which included but were not limited to risks of general anesthesia, infection, bleeding, wound dehiscence, and poor scar formation. They understood the scar would likely widen as the child grows because of the location of it and because of the age of the patient. They consented to proceed.
Description of procedure: The patient was seen preoperatively in > I the holding area, identified, and then brought to the operating room. Once adequate general anesthesia had been induced, the patient's right thigh was prepped and draped in standard surgical fashion. An elliptical excision measuring 6 x 1.8 cm had been marked. This was injected with Lidocaine with epinephrine, total of 6 cc of 1% with 1:100,000. After an adequate amount of time, a #15 blade was used to sharply excise this full thickness.
This was passed to pathology for review. The wound required # limited undermining in the deep subcutaneous plane on both sides for approximately 1.5 cm in order to allow mobilization of the skin for closure. The skin was then closed in a layered fashion using 3-0 Vicryl on the dermis and then 4-0 Monocryl running subcuticular in the skin, the wound was cleaned and dressed with Dermabond and Steri-Strips.
The patient was then cleaned and turned over to anesthesia for S extubation.
She was extubated successfully in the operating room and taken S to the recovery room in stable condition.
There were no complications.
What E/M code is reported for this encounter?
Answer: B
Explanation:
Established patient with moderate MDM
99214 aligns with CPC exam standards
NEW QUESTION # 216
A provider orders liquid chromatography mass spectrometry (LC-MS) definitive drug test for a patient suspected of acetaminophen (analgesic) overdose. What CPT code is reported for the test?
Answer: D
Explanation:
Frozen section pathology coding rules:
88331 - Frozen section, first tissue block, each specimen
88332 - Frozen section, each additional tissue block, same specimen
Breakdown:
Specimen 1
Block 1 # 88331 × 1
Block 2 # 88332 × 1
Specimen 2
Block 1 # 88331 × 1
Block 2 # 88332 × 1
However, multiple frozen sections per tissue block are separately reportable:
Total first blocks = 4 frozen sections # 88331 × 4
Total additional blocks = 3 frozen sections # 88332 × 3
CPT pathology guidelines require coding by tissue block and specimen, not by polyp alone.
NEW QUESTION # 217
A provider performs a mastoidectomy and complete labyrinthectomy for right-sided peripheral vertigo.
What CPT and ICD-10-CM codes are reported?
Answer: D
Explanation:
69905 = Transmastoid labyrinthectomy
69990 = Operating microscope (separately reportable)
H81.391 = Peripheral vertigo, right ear
R42 (dizziness) is not reported when a definitive diagnosis exists
RADIOLOGY & IMAGING QUESTIONS
NEW QUESTION # 218
An 8-day-old newborn (3 kg) undergoes circumcision using a scalpel (no clamp).
What CPT coding is reported?
Answer: B
Explanation:
54160 = Circumcision using surgical excision other than clamp
Modifier -63 is not appended to circumcision codes (CPT exempt list)
54150 is for clamp technique (not used)
NEW QUESTION # 219
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