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| Section | Weight | Objectives |
|---|---|---|
| Reimbursement & Revenue Cycle | 5-7% | |
| HCPCS Level II Coding | 5-7% | |
| Medical Terminology & Anatomy | 8-10% | |
| Compliance & Regulations | 8-10% | - HIPAA, fraud & abuse - Reimbursement rules |
| ICD-10-CM Coding | 15-17% | - Code selection & sequencing - Diagnosis coding guidelines |
| Modifiers | 5-7% | |
| CPT® Coding | 45-50% | - Radiology, Pathology/Laboratory, Medicine - Surgery (10000–69999) - Evaluation & Management (E/M) |
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406. Frage
The provider orders a bilirubin test for a patient with bowel flora disturbance. The lab determines the presence of bilirubin in a fecal sample.
What CPT code is reported for the test?
Antwort: D
Begründung:
82252 = Bilirubin, feces
82247/82248 = Serum bilirubin
82239 = Fecal fat
407. Frage
Patient has a 5 cm tumor in the left lower quadrant abdominal wall. A horizontal skin incision is made directly over the tumor in the patient's left lower quadrant and dissection was carried down through the dermis and subcutaneous tissue. The tumor is located and completely excised using electrocautery. The specimen is sent immediately to pathology to rule out cancer. What CPTand ICD-10-CM codes are reported?
Antwort: A
Begründung:
1. Procedure and CPTCode Selection:
The scenario describes the excision of a 5 cm tumor located in the left lower quadrant of the abdominal wall.
The tumor was excised down to the dermis and subcutaneous layers and removed using electrocautery.
Code 22903 is appropriate for the excision of a soft tissue tumor in the abdominal wall greater than 5 cm, making it the correct CPTcode.
Code 22901 applies to the excision of a soft tissue tumor in the abdominal wall but only for tumors 5 cm or less. Given that the tumor in this case is exactly 5 cm, it meets the threshold for 22903, which is more appropriate here.
2. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code D49.2 is used for a neoplasm of unspecified behavior in the abdominal area, reflecting the fact that the pathology report is pending to determine if the tumor is malignant.
Code C76.2 would be incorrect because it is for malignant neoplasms of unspecified abdominal areas, which we cannot confirm based on the initial excision. Similarly, R19.04 (indicating a mass in the abdominal region) is a symptom code and is not appropriate for a definitive diagnosis when a neoplasm code (D49.2) exists.
3. AAPC and CPTCoding Guidelines:
Per AAPC coding guidelines, the size of the tumor is critical in selecting the correct excision code for abdominal wall neoplasms. Additionally, if the tumor's pathology is not confirmed as malignant, it is coded as a neoplasm of unspecified behavior until further details are known.
Therefore, based on CPTand ICD-10-CM coding guidelines, the verified answer is B. 22903, D49.2.
408. Frage
An established patient presents with fever and sore throat. Rapid strep test is positive.
What CPT and ICD-10-CM codes are reported?
Antwort: C
Begründung:
99213-25 = E/M with separate procedure
87880 = Rapid strep test
J02.0 = Streptococcal pharyngitis
Symptoms are not reported with definitive diagnosis
409. Frage
A patient that delivered her second child vaginally has a history of having a previous cesarean delivery for the first child.
What CPT code is reported for the delivery of the second child with antepartum care and postpartum care with the same provider?
Antwort: A
Begründung:
1. Procedure and CPT Code Selection:
The patient delivered her second child vaginally after having a previous cesarean delivery for her first child. This scenario describes a Vaginal Birth After Cesarean (VBAC).
CPT Code 59610 is specific for a vaginal delivery after a previous cesarean delivery, including antepartum and postpartum care with the same provider, which matches this case exactly.
2. Rationale for Excluding Other Options:
Code 59410 covers only vaginal delivery with postpartum care but does not include a history of previous cesarean delivery, so it is not appropriate for a VBAC.
Code 59400 is for routine vaginal delivery with antepartum and postpartum care but, again, does not account for a previous cesarean, so it does not apply in this VBAC scenario.
Code 59614 is for a VBAC but does not include antepartum care, making it incomplete for this scenario since the question specifies that antepartum, delivery, and postpartum care were provided by the same provider.
3. AAPC and CPT Coding Guidelines:
AAPC and CPT guidelines indicate that 59610 should be used for a complete VBAC service that includes antepartum, delivery, and postpartum care by the same provider.
Therefore, based on CPT guidelines, the correct answer is B. 59610.
410. Frage
A 30-year-old patient with a scalp defect is having plastic surgery to insert tissue expanders. The provider inserts the implants, closes the skin, and increases the volume of the expanders by injecting saline solution.
Tissue is expanded until a satisfactory aesthetic outcome is obtained to repair the scalp defect.
What CPT code is reported?
Antwort: C
Begründung:
The CPT code 11960 is used for the insertion of tissue expanders for other than breast, which includes the scalp in this case. The procedure involves inserting the tissue expanders, closing the skin, and gradually increasing the volume of the expanders until a satisfactory outcome is achieved for repairing the scalp defect.
The other options do not accurately describe the procedure performed on the scalp.
AMA's CPT Professional Edition (current year)
411. Frage
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