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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: CPT® Coding | 45-50% | - Evaluation & Management (E/M) - Surgery (10000–69999) - Radiology, Pathology/Laboratory, Medicine |
| Topic 2: Reimbursement & Revenue Cycle | 5-7% | |
| Topic 3: ICD-10-CM Coding | 15-17% | - Code selection & sequencing - Diagnosis coding guidelines |
| Topic 4: Medical Terminology & Anatomy | 8-10% | |
| Topic 5: Modifiers | 5-7% | |
| Topic 6: HCPCS Level II Coding | 5-7% | |
| Topic 7: Compliance & Regulations | 8-10% | - HIPAA, fraud & abuse - Reimbursement rules |
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NEW QUESTION # 64
Patient is admitted in observation care on 12/2/20XX in the morning for acute asthma exacerbation. The ED physician requires the patient to stay overnight. Next day, 12/3/20XX the patient is discharged from observation care in the afternoon. Patient's total stay in observation was 16 hours.
What E/M categories and code ranges are appropriate to report?
Answer: C
Explanation:
1. E/M Code Category Selection:
The patient was placed in observation care on 12/2/20XX for an acute asthma exacerbation and stayed in observation for a total of 16 hours, with discharge occurring on 12/3/20XX.
The appropriate E/M category for patients in observation care for a period that includes both admission and discharge on separate calendar dates is "Hospital Inpatient or Observation Care Services", with specific codes for admission and discharge on different dates.
2. Code Range and Specific Codes:
Code Range 99234-99236 applies to cases where observation care includes both admission and discharge, particularly when they occur on different calendar days and the total duration of care is under 24 hours.
For discharge on the subsequent day, 99238-99239 (Hospital Inpatient or Observation Discharge Services) applies, depending on the time spent on discharge.
3. Rationale for Excluding Other Options:
Option B and Option D include Initial Hospital Inpatient or Observation Care codes (99221-99223), which are typically used for admissions to inpatient care rather than for observation care scenarios as presented here.
Option C incorrectly combines Subsequent Inpatient or Observation Care codes (99231-99233), which are used for follow-up days rather than discharge services.
4. AAPC and CPTCoding Guidelines:
According to CPTguidelines, the 99234-99236 code range is used when observation care requires both admission and discharge on different dates, and 99238-99239 is appropriate for discharge services.
Therefore, the correct answer is A. Hospital Inpatient or Observation Care Services (Including Admission and Discharge Services) (99234-99236) and Hospital Inpatient or Observation Discharge services (99238-99239).
NEW QUESTION # 65
(A 40-year-old woman with progressive sensorineural hearing loss in the right ear has acochlear implantplaced for the right ear. Anesthesia is provided by aCRNAwithmedical directionby an anesthesiologist who is concurrently directing 5 CRNAs. Physical status is3. What anesthesia CPT and ICD-10-CM codes are reported by theanesthesiologist?)
Answer: C
Explanation:
Cochlear implant surgery is anearprocedure and maps to anesthesia code00120in this question's option framework. The anesthesiologist ismedically directingCRNAs and is concurrently directing5CRNAs. Under anesthesia modifier rules, when an anesthesiologist is directingmore than fourconcurrent anesthesia procedures, the correct modifier isAD(medical supervision by a physician: more than four concurrent anesthesia procedures). Physical status is given asP3(severe systemic disease), so append-P3. The diagnosis is progressive sensorineural hearing loss in the right ear; in the options,H90.41represents unilateral sensorineural hearing loss (right ear) as provided. Options usingAAwould indicate the anesthesiologist personally performed anesthesia (not true here), andQY/QXrepresent medical direction structures but do not match the
"more than four" concurrency described (which specifically triggersADin these exam-style choices).
Therefore, the correct reporting by the anesthesiologist is00120-AD-P3, H90.41.
NEW QUESTION # 66
Which medical term refers to inflammation of the cornea?
Answer: B
Explanation:
Kerat/o = cornea
-itis = inflammation
Keratitis specifically means inflammation of the cornea, which is the transparent anterior portion of the eye.
Other options are incorrect because:
Blepharitis = inflammation of the eyelid
Conjunctivitis = inflammation of the conjunctiva
Scleritis = inflammation of the sclera
NEW QUESTION # 67
A cardiologist uses the hospital's equipment for a cardiac stress test as he doesn't own equipment for the test. He supervises the test and provides the interpretation and report of the test.
What CPT codes are reported?
Answer: C
NEW QUESTION # 68
A patient with three thyroid nodules is seen for an FNA biopsy. Using ultrasonic guidance, the provider inserts a 25-gauge needle into each nodule. Nodular tissue is aspirated and sent to pathology.
What CPT coding reported?
Answer: C
Explanation:
The CPT code 10005 is for fine needle aspiration biopsy, including ultrasound guidance, for the first lesion.
CPT code 10006 is for each additional lesion with ultrasound guidance. Since the provider aspirated tissue from three nodules, the coding should be 10005 for the first nodule and 10006 x 2 for the additional two nodules.
AMA's CPT Professional Edition (current year)
NEW QUESTION # 69
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