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| Section | Objectives |
|---|---|
| Topic 1: CPT Coding | - Surgical, diagnostic, and procedural coding - CPT guidelines and conventions |
| Topic 2: Compliance and Regulatory Guidelines | - HIPAA and medical ethics - Fraud and abuse regulations |
| Topic 3: ICD-10-CM Diagnosis Coding | - ICD-10-CM guidelines - Diagnosis code selection and sequencing |
| Topic 4: Medical Terminology and Anatomy | - Human anatomy basics - Medical terminology structure |
| Topic 5: HCPCS Level II Coding | - Durable medical equipment and supplies - Medicare coding procedures |
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NEW QUESTION # 135
A 58-year-old male suffered an acute STEMI of the inferolateral wall while running a marathon on June 15 and had received treatment. Three weeks later, the patient presents to the ED complaining of SOB and left arm pain. An EKG is performed as well as blood tests. Patient is admitted for further evaluation.
What diagnosis code is reported for this encounter?
Answer: A
Explanation:
For this encounter, ICD-10-CM guidelines dictate that a myocardial infarction (MI) that occurs within four weeks (28 days) of an initial MI is considered to be in the acute phase. Therefore, the patient's condition should still be coded as an acute MI, as it is within the four-week period since the initial STEMI.
B: I21.29 is the correct code for an acute STEMI of the inferolateral wall occurring within the acute phase following the initial MI. The code I21.29 is specifically used for subsequent STEMI in the same four-week period.
Explanation of incorrect options:
A: I22.2 is incorrect because I22 codes are used for a second acute MI occurring after the initial one has resolved, which is not applicable here.
C: I21.19 and D. I21.3 are codes for different locations of STEMI that do not specify the inferolateral wall.
Therefore, the correct answer is B. I21.29 for a subsequent STEMI of the inferolateral wall within the acute phase.
NEW QUESTION # 136
The Medicare program has multiple parts covering different services. Which part provides coverage for outpatient physician charges?
Answer: D
Explanation:
Medicare Part B provides coverage for outpatient services, including physician services, preventive care, outpatient procedures, diagnostic tests, and durable medical equipment. Part B is a key component of Medicare, covering medically necessary services and some preventive services.
A: Part C (Medicare Advantage) includes all benefits and services covered under Parts A and B and often additional services, but it is provided through private insurance companies.
C: Part A covers inpatient hospital care, skilled nursing facility care, hospice, and some home health services.
D: Part D provides coverage for prescription drugs.
Therefore, the correct answer is B. Part B.
NEW QUESTION # 137
Which place of service code is submitted on the claim for a service that is performed in an outpatient surgical floor?
Answer: B
Explanation:
The place of service code 22 is used for services performed in an outpatient hospital setting, including outpatient surgical floors. This code indicates that the procedure was done in a hospital but not requiring an inpatient admission.References: AMA's CPT Professional Edition (current year), Place of Service Codes.
NEW QUESTION # 138
Dr. Carter sees Mrs. White at the Spring Valley Nursing Facility. He saw her last month after she was admitted to the facility. Today is a follow up visit. She is doing well. He documented a medically appropriate history and exam. The patient has osteoporosis, hypertension, dementia. CAD, CHF, and type 2 diabetes (moderate number and complexity of problems). He reviews 4 labs and a telemetry (Moderate data). He adds a Cardizem prescription for better control of her blood pressure which is a moderate risk. What CPT code does Dr. Carter report for the visit?
Answer: D
Explanation:
This is a subsequent nursing facility care visit.
MDM Analysis (2021+ E/M Guidelines):
Problems: Multiple chronic conditions # Moderate
Data: 4 labs + telemetry # Moderate
Risk: Prescription drug management # Moderate
99309 - Subsequent nursing facility care, moderate MDM
Why others are incorrect:
99307 / 99308 - Low complexity
99305 - Initial nursing facility care
NEW QUESTION # 139
(A 62-year-old with insulin-dependent diabetes mellitus has sudden hearing loss. The otolaryngologist administered atranstympanic injection of a steroidfor the sudden hearing loss ineach ear. How is this reported?)
Answer: C
Explanation:
Atranstympanic(intratympanic) injection involves placing medication through the tympanic membrane into the middle ear space. CPT69801is used to report this transtympanic injection/tympanocentesis-type service as represented in CPC-style questions. Because the physician performed the injection inboth earsduring the same session, the appropriate bilateral reporting method in this answer set ismodifier -50to indicate abilateral procedure. Reporting69801 ร 2is a common trap; many payers require either modifier 50 or RT/LT rather than two units, and the CPC exam typically follows modifier logic as presented in the options. Modifier-22 (increased procedural services) would require unusual extra work beyond typical complexity and is not supported by the vignette. Reporting only a single unilateral code (option A) would underreport the bilateral nature. Therefore, the best answer is69801-50, reflecting the same service performed on paired organs during the same encounter.
NEW QUESTION # 140
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