CPC - Certified Professional Coder HCPCS Level II Codes Questions and Answers

Question 1

A physician administers an injection of a specific chemotherapy drug in the office. Which section of HCPCS Level II would contain the code for the drug itself?

Accepted Answer

J codes (Drugs Administered Other Than Oral Method)

Answer

J codes are used to report specific drugs and their dosages that are administered through non-oral routes, such as injections and infusions. A codes are for supplies, E codes for DME, and L codes for orthotics/prosthetics.

Question 2

A patient is fitted for and receives a new, standard manual wheelchair for home use. Which HCPCS Level II modifier must be appended to the wheelchair code to indicate that it is new equipment?

Accepted Answer

NU (New equipment)

Answer

The modifier NU is specifically used to designate new durable medical equipment (DME). The RR modifier indicates the equipment is being rented, and UE indicates it is used. LT is an anatomical modifier specifying the left side of the body.

Question 3

The maintenance of the HCPCS Level II code set, including the addition, deletion, and revision of codes, is managed by which organization?

Accepted Answer

Centers for Medicare & Medicaid Services (CMS)

Answer

The Centers for Medicare & Medicaid Services (CMS) is responsible for maintaining the HCPCS Level II code set. The American Medical Association (AMA) maintains CPT (HCPCS Level I).

Question 4

A podiatrist performs routine foot care by trimming a patient's toenails. This service is considered statutorily non-covered by Medicare. Which modifier should be appended to the procedure code to inform Medicare that the service is statutorily excluded and will not be covered?

Accepted Answer

GY (Item or service statutorily excluded)

Answer

The GY modifier is used to inform Medicare that an item or service is statutorily excluded or does not meet the definition of a Medicare benefit. This indicates the service is never covered. The GA modifier is used when a service might be denied as not reasonable and necessary and an ABN is on file. GZ is used when denial is expected but no ABN was obtained. Modifier 59 is a CPT modifier.

Question 5

Which of the following HCPCS Level II code ranges is designated for temporary national codes for professional services and procedures that do not yet have a permanent CPT or national code?

Accepted Answer

G codes

Answer

G codes are temporary codes used by CMS to identify professional healthcare procedures and services that are under review or do not have a CPT code. They are often used for new or emerging technologies and services. J codes are for drugs, L codes are for orthotics/prosthetics, and E codes are for durable medical equipment.

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CPC - Certified Professional Coder HCPCS Level II Codes Questions and Answers