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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Compliance & Regulations | 8-10% | - Reimbursement rules - HIPAA, fraud & abuse |
| Topic 2: ICD-10-CM Coding | 15-17% | - Diagnosis coding guidelines - Code selection & sequencing |
| Topic 3: CPT® Coding | 45-50% | - Evaluation & Management (E/M) - Surgery (10000–69999) - Radiology, Pathology/Laboratory, Medicine |
| Topic 4: Medical Terminology & Anatomy | 8-10% | |
| Topic 5: Reimbursement & Revenue Cycle | 5-7% | |
| Topic 6: Modifiers | 5-7% | |
| Topic 7: HCPCS Level II Coding | 5-7% |
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NEW QUESTION # 219
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: B
Explanation:
* Procedure: Cardiac stress test performed using hospital's equipment with the cardiologist providing supervision, interpretation, and report.
* CPT Codes:
* 93016: This code is for supervision only without provision of the equipment.
* 93018: This code is for interpretation and report only.
* Code Selection Justification: Since the cardiologist does not own the equipment, codes 93016 and
93018 correctly represent the supervision, interpretation, and report of the test.
References:
* AMA CPT Professional Edition (current year)
NEW QUESTION # 220
A three-year-old patient is in the operative suite for stage 2 of treatment for double right outlet syndrome. The patient previously had the pulmonary artery banded and is returning for removal of the pulmonary band and transposition repair of the great vessels via aortic pulmonary reconstruction.
The surgeon performs a time-out and pre-incision review of respiration and BP then the previous sternal incision site is inspected and lightly painted with povidone. Next, reopens the sternal cavity and inserts central cannulae in the IVC, SVC and ascending aorta for extra corporeal membrane oxygenation (ECMO) bypass, chemical cardioplegia is initiated, stopping the heart and ECMO is initiated. A physician assistant monitors vitals and oxygenation until heart function resumes. The surgeon carefully incised and removes the Dacron band encircling the pulmonary artery, with nominal need for dilation. A section of coronary ostia is removed and sutured to the root of the pulmonary trunk. The pulmonary trunk and aortic root are then transected and transposed to allow for ideal cardiac circulation. Once structural integrity is visually confirmed, the physician assistant is permitted to administer the cardioplegia reversal solution and the surgeon removes the central cannulae after heart function safely resumes. The sternotomy is closed and the patient is transported to the NICU.
What CPTcodes are reported for the surgery today?
Answer: D
Explanation:
1. Procedure Details and CPTCode Selection:
The patient is undergoing stage 2 treatment for double outlet right ventricle (DORV) with a removal of the pulmonary artery band and transposition repair of the great vessels.
Code 33779 is specific for correction of a double outlet right ventricle, with transposition of the great arteries.
This code accurately reflects the procedure performed, including the complex repair involving the transposition of the pulmonary trunk and aortic root.
Code 33953 is used to report the initiation of extracorporeal membrane oxygenation (ECMO), which was used to maintain oxygenation during the procedure.
Code 33985 is for the termination of ECMO following the surgical repair once heart function has resumed.
Both 33953 and 33985 accurately document the initiation and termination of ECMO during this complex heart repair.
2. Modifier Selection:
Modifier 78 (unplanned return to the operating room for a related procedure during the postoperative period) is appropriate here. This is a subsequent stage in the treatment plan, but due to the complexity and specific surgical intervention required, it is treated as a return to the OR for related procedure coding.
Modifier 58 (staged or related procedure during the postoperative period) would not be as suitable here because the procedure involves a new return to the OR.
3. AAPC and CPTCoding Guidelines:
AAPC guidelines support the use of specific modifiers (78 for unplanned return) and appropriate ECMO codes (33953 and 33985) in complex cardiac cases requiring bypass and staged treatment.
Thus, the correct CPTcodes based on CPTand AAPC coding standards are C. 33779-78, 33953-78,
33985-78.
NEW QUESTION # 221
A patient underwent a colonoscopy, where the gastroenterologist biopsied two polyps from the colon. Each polyp was sent to pathology as separately identified specimens. The gastroenterologist was requesting a pathology consult while the patient was still on the table. Tissue blocks and frozen sections were then prepared and examined as follows:
Specimen 1: First Tissue Block-Three Frozen Sections Second Tissue Block-One Frozen Section Specimen 2: First Tissue Block-Two Frozen Sections Second Tissue Block-One Frozen Section What CPT coding is reported?
Answer: C
Explanation:
Frozen section pathology coding rules:
88331 - Frozen section, first tissue block, each specimen
88332 - Frozen section, each additional tissue block, same specimen
Breakdown:
Specimen 1
Block 1 # 88331 × 1
Block 2 # 88332 × 1
Specimen 2
Block 1 # 88331 × 1
Block 2 # 88332 × 1
However, multiple frozen sections per tissue block are separately reportable:
Total first blocks = 4 frozen sections # 88331 × 4
Total additional blocks = 3 frozen sections # 88332 × 3
CPT pathology guidelines require coding by tissue block and specimen, not by polyp alone.
NEW QUESTION # 222
(Procedure date:01/12/20XX
Surgeon:MD |Assistant:PA
Preoperative diagnosis:Dry gangrene of the left foot in the setting of peripheral vascular disease. Non- pressure chronic ulcer on toe.
Postoperative diagnosis:Dry gangrene of the left foot in the setting of peripheral vascular disease. Non- pressure chronic ulcer on toe.
Procedure:Amputation at the metatarsophalangeal joint of the left third toe Indication:63-year-old female with peripheral vascular disease; vascular workup determined no further interventions to improve vascularity; third toe became progressively dusky; wound formed distally with chronic ulcer; amputation necessary; risks/benefits discussed.
Description:Left foot and third toe marked; 1 g Ancef given; general anesthesia; supine; calf tourniquet; timeout; tourniquet inflated (no Esmarch); total tourniquet time 5 minutes; tennis racquet incision with longitudinal arm over third metatarsal encircling joint proximal to closure; extensor/flexor tendons and collateral ligaments excised sharply; toe removed; tourniquet released; superficial bleeders cauterized; washed out; skin closed with 3-0 nylon; dry dressing; to PACU in good condition; signed 01/19/20XX 09:41.
Question:What CPT and ICD-10-CM coding is reported?)
Answer: C
Explanation:
The operative service is anamputation of the left third toe at the metatarsophalangeal (MTP) joint.
CPT28820describes toe amputationthrough the MTP joint, matching the "amputation at the metatarsophalangeal joint" language and the incision encircling the joint with removal of the toe after dividing tendons/ligaments. ModifierT2correctly identifies theleft foot, third digit. Diagnosis coding must capture the ischemic disease withgangreneplus thenon-pressure chronic ulceron the toe. In the answer set,I70.
262represents lower-extremity atherosclerosis/PVDwith gangrene(left side per the option). The chronic ulcer is separately reported using the providedL97.528non-pressure ulcer code for the left foot/toe severity category offered by the choices. Antibiotic prophylaxis (Ancef), anesthesia type, tourniquet use/time, and technique details support the procedure but do not change the core CPT/ICD-10-CM selection. Therefore, the correct combination is28820-T2, I70.262, L97.528.
NEW QUESTION # 223
A patient is diagnosed with sepsis due to enterococcus. What ICD-10-CM code is reported?
Answer: D
Explanation:
A41.52 = Sepsis due to Enterococcus.
When the organism is specified, a combination code is used.
No additional code for severe sepsis is documented.
NEW QUESTION # 224
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