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| Section | Weight | Objectives |
|---|---|---|
| Modifiers | 5-7% | |
| Medical Terminology & Anatomy | 8-10% | |
| HCPCS Level II Coding | 5-7% | |
| Reimbursement & Revenue Cycle | 5-7% | |
| Compliance & Regulations | 8-10% | - HIPAA, fraud & abuse - Reimbursement rules |
| ICD-10-CM Coding | 15-17% | - Code selection & sequencing - Diagnosis coding guidelines |
| CPT® Coding | 45-50% | - Surgery (10000–69999) - Evaluation & Management (E/M) - Radiology, Pathology/Laboratory, Medicine |
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NEW QUESTION # 306
A 65-year-old man had a right axillary block by the anesthesiologist. When the arm was totally numb, the arm was prepped and draped, and the surgeon performed tendon repairs of the right first, second, and third fingers.
The anesthesiologist monitored the patient throughout the case.
What anesthesia code is reported?
Answer: B
Explanation:
* The anesthesia code for an axillary block for procedures on the upper arm and elbow, which includes the monitoring by the anesthesiologist throughout the procedure, is 01830. This code is appropriate for anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of the shoulder and axilla.
References:
* CPT Professional Edition, AMA
* Anesthesia Coding Guidelines
NEW QUESTION # 307
A patient who was experiencing severe abdominal pain underwent abdominal imaging and results showed several peritoneal tumors of various sizes.
The patient elected to have the tumors removed. An incision was made to access the intra-abdominal peritoneal cavity, where four tumors were identified, measured, and excised.
The largest was 2 cm, two were 1 cm each, and the smallest was 0.5 cm. Pathology report indicated the tumors were malignant.
What CPT and ICD-10-CM coding is reported7
Answer: B
Explanation:
Procedure Coding:
49186 - Excision or destruction of intra-abdominal tumors, 1-4 tumors
Four tumors excised → correct code selection
Size does not alter code selection once tumor count is determined
Diagnosis Coding:
C48.2 - Malignant neoplasm of peritoneum, unspecified
Pathology confirms malignancy
C76.2 is used for ill-defined sites, not appropriate when peritoneum is specified Why Other Options Are Incorrect:
B - 49187 is for 5 or more tumors
D - K66.8 = non-malignant peritoneal disorder
NEW QUESTION # 308
Patient with erectile dysfunction is presenting for same day surgery in removal and replacement of an inflatable penile prosthesis.
What CPTcode is reported for this service?
Answer: A
Explanation:
1. Procedure and CPTCode Selection:
The scenario describes the removal and replacement of an inflatable penile prosthesis due to erectile dysfunction.
CPTCode 54416 is specifically used for the removal and replacement of a multi-component inflatable penile prosthesis. This code accurately describes the procedure performed.
2. Rationale for Excluding Other Options:
Code 54401 represents the initial insertion of a multi-component inflatable penile prosthesis but does not cover removal and replacement, making it inappropriate for this scenario.
Code 54400 is for the insertion of a non-inflatable (malleable) penile prosthesis, which does not apply here as the prosthesis is inflatable.
Code 4417 does not exist in the CPTcoding system and is likely a typo or incorrect option.
3. AAPC and CPTCoding Guidelines:
According to AAPC and CPTguidelines, 54416 is the correct code when an inflatable prosthesis requires both removal and replacement, without the need for additional modifiers for this procedure.
Therefore, the correct answer based on CPTguidelines is D. 54416.
NEW QUESTION # 309
A patient with three thyroid nodules is seen for an FNA biopsy. Using ultrasonic guidance, the provider inserts a 25-gauge needle into each nodule. Nodular tissue is aspirated and sent to pathology.
What CPT coding reported?
Answer: C
NEW QUESTION # 310
What is the medical term for a procedure that creates an opening between the bladder and the rectum?
Answer: A
Explanation:
Breaking down the term:
Cyst/o = bladder
Proct/o = rectum
-stomy = creation of an opening
Cystoproctostomy is the surgical creation of an opening between the bladder and the rectum.
The other options involve different organs:
Gastroenterocolostomy - stomach to intestine
Colocholecystostomy - colon to gallbladder
Nephropyelostomy - kidney to renal pelvis
NEW QUESTION # 311
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