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| Section | Weight | Objectives |
|---|---|---|
| CPT® Coding | 45-50% | - Evaluation & Management (E/M) - Radiology, Pathology/Laboratory, Medicine - Surgery (10000–69999) |
| ICD-10-CM Coding | 15-17% | - Code selection & sequencing - Diagnosis coding guidelines |
| Reimbursement & Revenue Cycle | 5-7% | |
| Compliance & Regulations | 8-10% | - Reimbursement rules - HIPAA, fraud & abuse |
| Modifiers | 5-7% | |
| HCPCS Level II Coding | 5-7% | |
| Medical Terminology & Anatomy | 8-10% |
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NEW QUESTION # 104
A patient underwent a colonoscopy, where the gastroenterologist biopsied two polyps from the colon. Each polyp was sent to pathology as separately identified specimens. The gastroenterologist was requesting a pathology consult while the patient was still on the table. Tissue blocks and frozen sections were then prepared and examined as follows:
Specimen 1: First Tissue Block-Three Frozen Sections Second Tissue Block-One Frozen Section Specimen 2: First Tissue Block-Two Frozen Sections Second Tissue Block-One Frozen Section What CPT coding is reported?
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 # 105
Mr. Woolridge has had a suspicious lesion on his left shoulder for approximately eight weeks that is not healing. On the dermatologist's exam of left shoulder blade, there is excoriation and scabbing and the lesion not healing. Patient agrees and wishes to proceed with a punch biopsy of the lesion. A punch biopsy is taken of the lesion and sent to pathology. A simple repair is performed at the biopsy site.
What CPT and ICD-10-CM codes are reported?
Answer: B
NEW QUESTION # 106
Which one of the following is an example of a case in which a diabetes-related problem exists and the code for diabetes is never sequenced first?
Answer: A
Explanation:
When a patient experiences an underdose of insulin due to an insulin pump malfunction, the primary reason for the encounter would be the malfunction itself, which is coded first. The resulting hyperglycemia or hypoglycemia due to the pump failure is a secondary condition. According to ICD-10-CM guidelines, the code for the mechanical complication of the pump (T85.633-) is sequenced first, followed by a code for the diabetes with complication (E11.65 for type 2 diabetes with hyperglycemia).References: ICD-10-CM (current year), Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88), ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.4.
NEW QUESTION # 107
(A provider orders a liquid chromatography mass spectrometry (LC-MS) definitive drug test for a patient suspected ofacetaminophen (analgesic) overdose. What CPT code is reported for the test?)
Answer: D
Explanation:
Acetaminophen is a specific drug with a dedicated quantitative laboratory code. Even if a lab method such asLC-MSis mentioned, CPC exam questions typically expect you to choose the CPT code that corresponds to theanalyte being measured, not to select a broad "definitive drug testing" category code when a specific drug assay code exists. CPT80143is the established code foracetaminophentesting (quantitative measurement).
Codes in the 803xx range are commonly associated with drug screening/testing categories that do not specifically represent acetaminophen as a named analyte in the way CPC questions test. Code80299is an unlisted therapeutic drug assay and is not appropriate when a specific code (80143) exists. Therefore, the correct answer is80143. CPC strategy: when the substance is explicitly named and has a recognized assay code, choose thespecific drug test coderather than an unlisted or generalized testing category. The method (LC-MS) supports "definitive" testing clinically, but the code selection here is driven by the named analyte.
NEW QUESTION # 108
(A patient with abnormal growth had asuppression studythat includedfive glucose testsandfive human growth hormone tests. What CPT coding is reported?)
Answer: D
Explanation:
A suppression study is adynamic endocrine testinvolving serial measurements over time. CPT80430represents thesuppression function testitself (the study framework), while the individual lab analytes measured during the test are reported with their specific assay codes based on the test protocol. The scenario includesfive glucose testsandfive human growth hormone (HGH) testsperformed as part of the study. Glucose testing is reported with82947per test, and growth hormone testing is reported with83003per test. Because the stem specifiesfive of each, correct reporting includes80430plus82947 × 5and83003 × 5. Options that report only one unit of 82947/83003 (or reduce the number of tests) fail to reflect the documented serial testing frequency. CPC exam tip: when a dynamic study is described, do not stop at the function test code-also capture theserial analyte measurementswhen the question explicitly provides the number of lab draws/tests.
Therefore, the correct coding is80430, 82947 × 5, 83003 × 5.
NEW QUESTION # 109
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