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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: HCPCS Level II | 5-10% | - Supplies and Equipment - Modifiers |
| Topic 2: Laboratory / Pathology | 5-10% | - Organ and Disease Panels |
| Topic 3: Surgery Coding | 40-50% | - Nervous System - Digestive System - Musculoskeletal System - Cardiovascular System - Integumentary System - Genitourinary System - Respiratory System |
| Topic 4: Medicine | 5-10% | - Specialty Coding |
| Topic 5: ICD-10-CM (Diagnosis Coding) | 10-15% | - Conventions and Guidelines - Code Selection |
| Topic 6: Anatomy & Physiology | 10-15% | - Body Systems - Medical Terminology |
| Topic 7: E/M (Evaluation and Management) | 10-15% | - Office/Outpatient Visits - Emergency Department |
| Topic 8: Radiology | 5-10% | - Diagnostic Imaging |
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NEW QUESTION # 118
A patient is seen at the doctor's office for nausea, vomiting, and sharp right lower abdominal pain. CT scan of the abdomen is ordered. Labs come back indicating an increased WBC count with review of the abdominal CT scan. The physician determines the patient has chronic appendicitis. The physician schedules an appendectomy and takes the patient to the operating room. The appendix is severed from the intestines and removed via scope inserted through an umbilical incision. What CPTand diagnosis codes are reported?
Answer: B
Explanation:
1. Procedure and CPTCode Selection:
The patient underwent an appendectomy performed via laparoscopic approach. The procedure involved removal of the appendix using a scope inserted through an umbilical incision.
CPTCode 44970 is specific for a laparoscopic appendectomy, which is the correct code for this procedure.
Code 44950 would be used for an open appendectomy, but since this case was performed laparoscopically,
44970 is appropriate.
2. Diagnosis and ICD-10-CM Code Selection:
The diagnosis given by the physician is chronic appendicitis.
ICD-10-CM Code K36 is used to report chronic appendicitis, which is the definitive diagnosis in this case.
Additional codes for symptoms such as nausea (R11.2) and right lower quadrant pain (R10.31) are not necessary because the primary diagnosis of chronic appendicitis (K36) fully explains the symptoms, according to ICD-10-CM guidelines on coding symptoms when a definitive diagnosis is available.
3. AAPC and CPTCoding Guidelines:
AAPC guidelines indicate that when a definitive diagnosis is established, symptom codes should not be reported separately. The use of 44970 for laparoscopic appendectomy and K36 for chronic appendicitis is fully supported by these coding standards.
Therefore, the correct answer is C. 44970, K36.
NEW QUESTION # 119
The gastroenterologist performs a simple excision of three external hemorrhoids and one internal hemorrhoid, each lying along the left lateral column. The operative report indicates that the internal hemorrhoid is not prolapsed and is outside of the anal canal.
What CPTand ICD-10CM codes are reported?
Answer: B
Explanation:
CPTcode 46255 describes the excision of both internal and external hemorrhoids, which matches the procedure described. The ICD-10-CM codes K64.0 (First degree hemorrhoids) and K64.4 (Residual hemorrhoids) describe the conditions treated.
References:
* AMA's CPTProfessional Edition (current year), Code 46255
* ICD-10-CM (current year), Codes K64.0, K64.4
NEW QUESTION # 120
A 32-year-old vialled a provider due to skin itching and ongoing irritation and watering of the eyes.
Suspecting an allergy, the provider suspects an allergic reaction and decides to conduct allergy testing. A prick on the skin of the patient's forearm is performed by introducing a small amount of an allergen and monitored for signs of an allergic reaction.
What CPT code is reported?
Answer: C
Explanation:
93280 - In-person interrogation device evaluation with programming; dual-chamber pacemaker Includes:
Full electronic analysis
Lead function
Battery status
Threshold testing
Programming changes
Why others are incorrect:
93281 - Single-chamber pacemaker
93283 / 93284 - ICD device codes
NEW QUESTION # 121
(Which punctuation is used in the ICD-10-CM Tabular List to denotesynonyms, alternative wording, or explanatory phrases?)
Answer: B
Explanation:
In the ICD-10-CM Tabular List,parentheses ( )are used to enclosenonessential modifiers, also described assupplementary words. These are words thatmay be present or absentin the diagnostic statement without affecting code assignment. This is exactly why parentheses are associated with synonyms, alternative wording, or explanatory phrases. If the provider documents the core diagnosis and the parenthetical term is missing, the code can still be correct; if the parenthetical term is present, it still points to the same code. By contrast, acolon (:)is used after an incomplete term that needs one or more additional terms to make it assignable.Brackets [ ]have other specific functions (such as enclosing synonyms in certain contexts and used with instructional content), but the standard CPC-tested definition for "synonyms/alternative wording
/explanatory phrases" in the Tabular List points toparenthesesas nonessential modifiers. Knowing this distinction supports accurate code selection and reduces errors when provider wording varies.
NEW QUESTION # 122
A 45-year-old male, with no prior history of heart disease, has been diagnosed having atherosclerotic heart disease with unstable angina. He is in the cardiologist's office for a cardiac MRI test to determine the morphology and function of his heart under stress. First images obtained are without contrast and then contrast is administered for the next set of images. Then the physician injects medicine to increase the heart rate and checks the coronary arteries for narrowing or blockage. Physician interprets the test and the results and images are in the medical record.
What radiology CPT and ICD-10-CM codes are reported?
Answer: A
Explanation:
1. Procedure and CPT Code Selection:
The patient underwent a cardiac MRI to assess the morphology and function of the heart under stress, involving both non-contrast and contrast-enhanced imaging. Additionally, pharmacological stress testing was performed to evaluate the coronary arteries.
CPT Code 75563 is appropriate for a cardiac MRI with both stress and rest imaging, including morphology and function studies with contrast and pharmacologic stress testing. This code accurately captures the entire scope of the MRI study described in this case.
Modifier 26 is applied to indicate the professional component of the service if the cardiologist is providing only the interpretation and not the technical component.
2. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code I25.118 is used for atherosclerotic heart disease with unstable angina. This code accurately reflects the diagnosis provided in the scenario.
3. Rationale for Excluding Other Options:
Code 75559 (option B) represents a cardiac MRI without stress testing, which does not cover the pharmacologic stress component performed here.
Code 75557 (in option D) is for a limited cardiac MRI that does not include both stress and non-stress imaging, so it is incorrect for this comprehensive test.
ICD-10-CM Code I25.110 (in options C and D) is for atherosclerosis with angina pectoris without unstable angina, making I25.118 more appropriate given the diagnosis of unstable angina.
4. AAPC and CPT Coding Guidelines:
AAPC and CPT guidelines support the use of 75563 for comprehensive cardiac MRI studies with stress testing, both with and without contrast.
Therefore, the correct answer is A. 75563-26, I25.118.
NEW QUESTION # 123
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