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| Section | Objectives |
|---|---|
| Topic 1: Compliance and Regulatory Guidelines | - HIPAA and medical ethics - Fraud and abuse regulations |
| Topic 2: HCPCS Level II Coding | - Medicare coding procedures - Durable medical equipment and supplies |
| Topic 3: Medical Terminology and Anatomy | - Medical terminology structure - Human anatomy basics |
| Topic 4: CPT Coding | - Surgical, diagnostic, and procedural coding - CPT guidelines and conventions |
| Topic 5: ICD-10-CM Diagnosis Coding | - Diagnosis code selection and sequencing - ICD-10-CM guidelines |
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NEW QUESTION # 451
(A patient presents with dysuria and lower abdominal pain. The physician suspects UTI. Anautomated urinalysis without microscopyis done in the office and isnegative. UTI is ruled out for the final diagnosis.
What CPT and ICD-10-CM codes are reported?)
Answer: D
Explanation:
The urinalysis performed is described asautomated, without microscopy, which corresponds to CPT81003 (urinalysis, automated, without microscopy). CPT81001includes microscopy and is not supported because the question explicitly states "without microscopy." For diagnosis coding, the providersuspecteda UTI, but the urinalysis is negative andUTI is ruled outas the final diagnosis. Under ICD-10-CM reporting principles, conditions documented asruled outarenot codedin the outpatient/office setting; instead, you code thesigns and symptomsthat prompted the visit and testing. The symptoms documented aredysuriaandlower abdominal pain, which are coded asR30.0andR10.30(as presented in the answer choices). Therefore, the correct combination is81003withR30.0andR10.30only. CPC exam tip: outpatient "rule out" # codesymptoms, not the excluded diagnosis.
NEW QUESTION # 452
The mediastinum is:
Answer: B
Explanation:
The mediastinum is an anatomical region located in the thoracic cavity. It is bounded by the sternum in front, the vertebral column at the back, and is situated between the lungs. It contains the heart, trachea, esophagus, thymus, and other structures, but it is not itself an organ. Therefore, the correct answer is that it is a location in the chest.References: ICD-10-CM, Medical Anatomy and Physiology textbooks
NEW QUESTION # 453
(Regarding the CPT Surgery Guidelines for a surgical code designated as a"Separate Procedure,"which statement isFALSE?)
Answer: A
Explanation:
In CPT, a code labeled"separate procedure"is typically a service that isnormally includedas part of a more comprehensive procedure andshould not be reported separatelywhen performed as an integral component.
However, itmaybe reported when performedindependentlyorunrelatedto the primary procedure-this supports options A, B, and C as true. The false statement isDbecause CPT doesnotinstruct that modifier79is specifically required to report a separate procedure with an unrelated primary service. Modifier selection depends on the actual circumstances and payer rules, and "separate procedure" logic is about whether the service isdistinct and not integral, often supported by documentation of a different site/session or separate clinical intent; when a modifier is needed, it is commonly adistinct procedural servicemodifier (e.g., 59 or X
{EPSU}) rather than automatically 79. Modifier79is a global surgery modifier used for anunrelated procedure during the postoperative period, which is a different concept than "separate procedure" designation.
NEW QUESTION # 454
A pediatrician removes impacted cerumen using irrigation in the right ear and instrumentation in the left ear.
What CPT coding is reported?
Answer: C
Explanation:
69209 = Cerumen removal using irrigation
69210 = Cerumen removal using instrumentation
Different techniques on different ears require separate codes with laterality modifiers
NEW QUESTION # 455
A patient presents for a percutaneous needle biopsy of the liver with ultrasound guidance to assess the severity of his primary biliary cirrhosis.
What CPTand ICD-10-CM codes are reported?
Answer: A
Explanation:
1. Procedure and CPTCode Selection:
The patient underwent a percutaneous needle biopsy of the liver with ultrasound guidance to assess primary biliary cirrhosis.
Code 47000 is the CPTcode for a percutaneous liver biopsy. This code encompasses the biopsy procedure itself.
Ultrasound guidance is commonly inherent to biopsy procedures, and guidance is not separately reported if the main code (47000) includes the technique used.
2. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code K74.5 is the correct code for primary biliary cirrhosis, which is specifically indicated in this case.
K74.3 is the code for other specified cirrhosis of the liver but is less specific than K74.5, making K74.5 the appropriate choice here.
3. Exclusion of Other Codes:
Code 47100 (option A) is for an open liver biopsy, which does not apply to this percutaneous procedure.
Codes 10005 (biopsy with imaging guidance) and 76942 (ultrasound guidance) would be redundant or incorrect since the main procedure code, 47000, sufficiently describes a percutaneous liver biopsy.
4. AAPC and CPTCoding Guidelines:
AAPC guidelines state that guidance is included in certain biopsy codes when performed for the targeted organ, such as in 47000 for a liver biopsy.
Therefore, based on CPTand ICD-10-CM coding rules, the correct answer is C. 47000, K74.5.
NEW QUESTION # 456
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