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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: ICD-10-CM (Diagnosis Coding) | 10-15% | - Code Selection - Conventions and Guidelines |
| Topic 2: Radiology | 5-10% | - Diagnostic Imaging |
| Topic 3: E/M (Evaluation and Management) | 10-15% | - Office/Outpatient Visits - Emergency Department |
| Topic 4: Laboratory / Pathology | 5-10% | - Organ and Disease Panels |
| Topic 5: HCPCS Level II | 5-10% | - Supplies and Equipment - Modifiers |
| Topic 6: Medicine | 5-10% | - Specialty Coding |
| Topic 7: Anatomy & Physiology | 10-15% | - Medical Terminology - Body Systems |
| Topic 8: Surgery Coding | 40-50% | - Genitourinary System - Respiratory System - Musculoskeletal System - Cardiovascular System - Integumentary System - Nervous System - Digestive System |
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NEW QUESTION # 135
A patient with coronary artery disease due to lipid-rich plaque undergoes coronary artery bypass grafting. The surgeon performs a left internal mammary artery graft to the left anterior descending artery. Then performs saphenous vein grafts to the obtuse marginal artery, ramus intermedius, and posterior descending artery. An endoscopic saphenous vein harvest is performed.
What CPT coding is reported for the surgical procedure?
Answer: A
Explanation:
Procedure Coding (CPT):
33533 - CABG, arterial graft; single arterial graft (LIMA to LAD)
Correct for left internal mammary artery # LAD
33519 - CABG, venous grafts; three coronary venous grafts
Saphenous vein grafts placed to:
Obtuse marginal
Ramus intermedius
Posterior descending artery
Total = 3 venous grafts
33508 - Endoscopic harvest of saphenous vein
Separately reportable only when endoscopic
Add-on code (no modifier required)
Why Other Options Are Incorrect:
A / C - Incorrect arterial graft code (33536 = multiple arterial grafts) B - Incorrect venous graft count (33512 = two grafts) CPT Guideline Reference:
CABG codes are selected based on:
Type of conduit (arterial vs venous)
Number of distal anastomoses
Endoscopic harvest is add-on and separately reportable
NEW QUESTION # 136
In medical terminology, suffixes indicate the procedure, condition, disorder, or disease.
Which term contains a suffix?
Answer: B
Explanation:
The suffix in medical terminology provides information about a condition, procedure, disorder, or disease.
The term "neuralgia" contains the suffix "-algia," which refers to pain, indicating a painful condition of the nerves. In contrast:
A: malaise has no identifiable suffix related to a specific medical condition or disease.
B: ambidextrous has no suffix indicating a disease, condition, or procedure.
D: hypotension includes the prefix "hypo-" (indicating low), but the core term "tension" refers to pressure without an additional suffix specific to condition.
Thus, "neuralgia" is the correct answer as it directly includes a suffix ("-algia") that denotes a pain-related condition in medical terms.
NEW QUESTION # 137
Which one of the following is an example of a case in which a diabetes-related problem exists and the code for diabetes is never sequenced first?
Answer: A
Explanation:
When a patient experiences an underdose of insulin due to an insulin pump malfunction, the primary reason for the encounter would be the malfunction itself, which is coded first. The resulting hyperglycemia or hypoglycemia due to the pump failure is a secondary condition. According to ICD-10-CM guidelines, the code for the mechanical complication of the pump (T85.633-) is sequenced first, followed by a code for the diabetes with complication (E11.65 for type 2 diabetes with hyperglycemia).References: ICD-10-CM (current year), Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88), ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.4.
NEW QUESTION # 138
Which entity offers compliance program guidance to form the basis of a voluntary compliance program for a provider practice?
Answer: B
Explanation:
The Office of Inspector General (OIG) provides compliance program guidance to form the basis of a voluntary compliance program for provider practices. This guidance is intended to help healthcare providers develop effective internal controls to monitor adherence to applicable statutes, regulations, and program requirements of Federal healthcare programs. The OIG issues various compliance guidelines and resources to assist organizations in establishing comprehensive compliance programs to prevent fraud, waste, and abuse.References: OIG Compliance Program Guidance, AMA's CPT Professional Edition, and healthcare compliance resources.
NEW QUESTION # 139
A 1-year-old is with his mom to have his scheduled vaccinations. The physician provides counseling for routine immunizations and carries out measles, mumps, rubella and varicella (MMRV) subcutaneously and dose 3 of Hepatitis B intramuscularly without difficulty.
What CPTcodes are reported?
Answer: B
Explanation:
1. Procedure and CPTCode Selection:
The physician administered the MMRV (measles, mumps, rubella, and varicella) vaccine subcutaneously and dose 3 of Hepatitis B vaccine intramuscularly. The physician also provided counseling on routine immunizations.
CPTCode 90460 is used for immunization administration with counseling by the physician for patients 18 years or younger for the first or only component of each vaccine.
CPTCode 90461 is used for each additional component in a vaccine with counseling.
90710 is the code for the MMRV vaccine.
90744 is the code for the Hepatitis B vaccine (pediatric).
2. Application of 90460 and 90461:
For the MMRV vaccine (which has four components: measles, mumps, rubella, and varicella), 90460 is reported once for the first component, and 90461 is reported three times (once for each additional component).
For the Hepatitis B vaccine, 90460 is reported again since it is a separate vaccine with one component.
3. Rationale for Excluding Other Options:
Option A (90471, 90472 x 4, 90707, 90746) uses codes for vaccine administration without counseling and incorrect vaccine codes (90707 for MMR instead of MMRV and 90746 for adult Hepatitis B instead of pediatric).
Option B and Option D also contain incorrect vaccine codes and do not correctly apply the counseling administration codes.
4. AAPC and CPTCoding Guidelines:
According to AAPC guidelines, 90460 and 90461 are the appropriate administration codes for vaccines with counseling provided to pediatric patients, with each component of a multi-component vaccine coded separately.
Therefore, the correct answer is C. 90460 x 2, 90461 x 3, 90710, 90744.
NEW QUESTION # 140
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