Mixed Deck — All COBGC Topics Flashcards
100 cards from real COBGC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 20 Mixed Deck — All COBGC Topics flashcards as text
What is the coding for ectopic pregnancy?
Answer: ICD-10 codes O00.x specify the site (tubal, ovarian, abdominal) of the ectopic pregnancy
Ectopic pregnancy codes identify the specific anatomical location of the abnormal implantation.
Under ICD-10-CM guidelines, the postpartum period is defined as:
Answer: The first 6 weeks (42 days) following delivery
ICD-10-CM defines the postpartum (puerperium) period as the first 6 weeks (42 days) following delivery.
When coding a radical hysterectomy with bilateral lymphadenectomy, what is the correct approach for the lymphadenectomy?
Answer: Bill it separately using an add-on code
Pelvic lymphadenectomy performed with radical hysterectomy is reported separately using the appropriate lymphadenectomy add-on or standalone code.
A patient who had a cesarean delivery is seen two weeks postoperatively for treatment of a urinary tract infection unrelated to her surgery. The appropriate modifier to append to the E&M code is:
Answer: Modifier 24
Modifier 24 is required to indicate that the E&M service (UTI management) is unrelated to the global surgical/OB period.
Under the Affordable Care Act, which women's preventive services must be covered by most non-grandfathered health plans WITHOUT cost-sharing?
Answer: Annual well-woman visits, gestational diabetes screening, BRCA counseling, and contraception
The ACA requires non-grandfathered health plans to cover HRSA-designated women's preventive services including well-woman visits, gestational diabetes screening, BRCA counseling, and FDA-approved contraceptive methods at no cost to the patient.
A gynecologist performs a laparoscopic hysterectomy and documents 'tolerated procedure well' as the entire operative note. A coder should:
Answer: Request a complete operative report before coding or claim submission
Coding without adequate documentation is a compliance violation; the coder must obtain a complete operative report that describes the procedure in sufficient detail to support the code.
When a procedure is performed during the global period of a prior surgery for an unrelated condition, which modifier is used?
Answer: Modifier 79
Modifier 79 indicates the service is unrelated to the original procedure and performed during its postoperative global period.
The term 'lochia' refers to:
Answer: The postpartum vaginal discharge composed of blood, mucus, and tissue
Lochia is the postpartum vaginal discharge that transitions from lochia rubra (bloody) to serosa to alba over several weeks.
A patient's OB chart documents smoking status but no counseling was provided or documented. The coder wants to bill 99406 for tobacco cessation counseling. This would be:
Answer: Fraudulent—services must be performed and documented before they are billed
Billing for a service that was not performed and is not documented in the medical record constitutes healthcare fraud regardless of the service's general appropriateness.
Which CPT code represents the global obstetric care package for a planned cesarean delivery, including antepartum and postpartum care?
Answer: 59510
CPT 59510 covers routine obstetric care including antepartum care, cesarean delivery, and postpartum care as a global package.
A patient is injured in a work-related accident that causes a miscarriage. Which payer should the OB/GYN provider bill for the related treatment?
Answer: Workers' compensation insurance
When an injury or condition is work-related and covered under workers' compensation, the workers' comp carrier is the appropriate primary payer for all treatment related to that injury.
When a second surgical procedure is performed during the same operative session, which modifier is typically appended to the secondary procedure?
Answer: Modifier 51
Modifier 51 indicates multiple procedures performed during the same surgical session, triggering reduced payment for secondary procedures.
The rectouterine pouch (pouch of Douglas) is formed by peritoneal reflection between which two structures?
Answer: Posterior uterus and rectum
The rectouterine pouch (cul-de-sac of Douglas) is the lowest point of the peritoneal cavity in females, located between the posterior uterus/upper vagina and the anterior rectum.
Audio-only telephone E&M services that do not include a video component are reported using which code set?
Answer: 99441–99443
CPT codes 99441–99443 are designated for physician telephone evaluation and management services conducted without a video component.
A patient is 10 weeks pregnant with her first pregnancy and presents for a routine prenatal visit with no complications. The principal ICD-10-CM code is:
Answer: Z34.01 – Encounter for supervision of first trimester of first normal pregnancy
Z34.01 applies to supervision of a normal first pregnancy in the first trimester (under 14 weeks); Z34.8x is reserved for second and subsequent normal pregnancies.
Which CPT codes are used when billing antepartum visits separately, outside of the global OB package?
Answer: 59425 and 59426
CPT 59425 covers 4-6 antepartum visits and 59426 covers 7 or more antepartum visits when reported separately from the global package.
A patient has a uterine leiomyoma (fibroid) described as intramural in location. The correct ICD-10-CM code is:
Answer: D25.1 – Intramural leiomyoma of uterus
D25.1 identifies a leiomyoma within the myometrium (uterine wall), as distinguished from submucous (D25.0, toward the uterine cavity) and subserosal (D25.2, toward the serosa).
Which ICD-10-CM code category covers preterm labor?
Answer: O60
Category O60 (Preterm labor) is used to report labor occurring before 37 completed weeks of gestation.
An Aetna member receives an out-of-network cesarean delivery due to an emergency. How will Aetna most likely process this claim?
Answer: Pay at the in-network benefit level because it was an emergency
Federal law (and most state laws) require commercial insurers to cover emergency services at the in-network benefit level, regardless of whether the provider is in-network.
In ICD-10-CM, the placeholder character 'X' is used to:
Answer: Hold a position in a code when a character is not required but a later character is needed
The placeholder 'X' fills a position in the code structure so that a required character (such as a 7th character) can be placed in its correct position.