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| Section | Weight | Objectives |
|---|---|---|
| Medical Terminology & Anatomy | 8-10% | |
| HCPCS Level II Coding | 5-7% | |
| ICD-10-CM Coding | 15-17% | - Diagnosis coding guidelines - Code selection & sequencing |
| CPT® Coding | 45-50% | - Evaluation & Management (E/M) - Surgery (10000–69999) - Radiology, Pathology/Laboratory, Medicine |
| Reimbursement & Revenue Cycle | 5-7% | |
| Compliance & Regulations | 8-10% | - HIPAA, fraud & abuse - Reimbursement rules |
| Modifiers | 5-7% |
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NEW QUESTION # 163
A physician conducts a 15-minute phone call discussing medication management.
How is this reported?
Answer: B
Explanation:
98012 = Telephone E/M, 11-20 minutes
99447 is for interprofessional consults, not patient calls
HCPCS LEVEL II
NEW QUESTION # 164
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 # 165
Where is the hamstring located?
Answer: A
Explanation:
The correct answer is A. In the back of the upper leg between the hip and thigh. The hamstrings are a group of muscles located in the posterior thigh, meaning the back portion of the upper leg. Anatomically, the hamstring group includes the biceps femoris, semitendinosus, and semimembranosus muscles. These muscles extend from the pelvis region toward the knee and are primarily responsible for knee flexion and assisting with hip extension. In coding and medical terminology, identifying the correct anatomical location is important because musculoskeletal diagnoses, injuries, repairs, injections, imaging, and rehabilitation services depend on accurate body-region terminology.
The other options describe incorrect anatomical areas. The front of the upper leg is the anterior thigh, mainly associated with the quadriceps muscles. The front of the lower leg refers to the shin or anterior leg compartment. The back of the lower leg is the calf region, which contains muscles such as the gastrocnemius and soleus, not the hamstrings.
Reference topics: CPC Medical Terminology and Anatomy - Musculoskeletal System; Lower Extremity Anatomy; Muscle Groups and Body Regions.
NEW QUESTION # 166
A driver loses control of a vehicle and crashes into a guardrail on the side of the highway. The patient sustains a fracture of the anterior fossa cranial base. Imaging confirms Involvement of the sphenoid sinus, but no cerebrospinal fluid (CSF) leak is identified. The patient undergoes a surgical nasal sinus endoscopy with sphenoidotomy lo evaluate and treat the sinus injury. No CSF leak repair is performed.
What is the correct procedure and diagnosis coding combination to report this service?
Answer: B
Explanation:
Procedure Coding (CPT):
31287 - Nasal/sinus endoscopy, surgical; with sphenoidotomy
Correct because the surgeon performed a surgical endoscopic sphenoidotomy to evaluate and treat sphenoid sinus injury.
No CSF leak repair was performed, so codes 31290-31291 are not appropriate.
31231-59 - Nasal endoscopy, diagnostic
Diagnostic endoscopy is separately reportable because:
It was performed to evaluate traumatic injury
It is not bundled into the surgical service when it provides distinct diagnostic information Modifier -59 indicates a separate and distinct service per NCCI edits.
Diagnosis Coding (ICD-10-CM):
S02.109A - Unspecified fracture of base of skull, initial encounter for closed fracture The anterior cranial fossa fracture with sphenoid sinus involvement qualifies as a skull base fracture No CSF leak is documented Correct 7th character "A" for initial encounter Why Other Options Are Incorrect:
A - Incorrect format and duplicated CPT logic
B - 31267 = maxillary sinus, wrong sinus
D - 31291 includes CSF leak repair, which was not performed
NEW QUESTION # 167
View MR 002395
MR 002395
Operative Report
Pre-operative Diagnosis: Acute rotator cuff tear
Post-operative Diagnosis: Acute rotator cuff tear, synovitis
Procedures:
1) Rotator cuff repair
2) Biceps Tenodesis
3) Claviculectomy
4) Coracoacromial ligament release
Indication: Rotator cuff injury of a 32-year-old male, sustained while playing soccer.
Findings: Complete tear of the right rotator cuff, synovitis, impingement.
Procedure: The patient was prepared for surgery and placed in left lateral decubitus position. Standard posterior arthroscopy portals were made followed by an anterior-superior portal. Diagnostic arthroscopy was performed. Significant synovitis was carefully debrided. There was a full-thickness upper 3rd subscapularis tear, which was repaired. The lesser tuberosity was debrided back to bleeding healthy bone and a Mitek 4.5 mm helix anchor was placed in the lesser tuberosity. Sutures were passed through the subcapulans in a combination of horizontal mattress and simple interrupted fashion and then tied. There was a partial-thickness tearing of the long head of the biceps. The biceps were released and then anchored in the intertubercular groove with a screw. There was a large anterior acromial spur with subacromial impingement. A CA ligament was released and acromioplasty was performed. Attention was then directed to the supraspinatus tendon tear. The tear was V-shaped and measured approximately 2.5 cm from anterior to posterior. Two Smith & Nephew PEEK anchors were used for the medial row utilizing Healicoil anchors. Side-to-side stitches were placed. One set of suture tape from each of the medial anchors was then placed through a laterally placed Mitek helix PEEK knotless anchor which was fully inserted after tensioning the tapes. A solid repair was obtained. Next there were severe degenerative changes at the AC joint of approximately 8 to 10 mm. The distal clavicle was resected taking care to preserve the superior AC joint capsule. The shoulder was thoroughly lavaged. The instruments were removed and the incisions were closed in routine fashion. Sterile dressing was applied. The patient was transferred to recovery in stable condition.
What CPT coding is reported for this case?
Answer: D
NEW QUESTION # 168
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