CPC - Certified Professional Coder HCPCS Level II Coding Questions and Answers — Questions and Answers
Question 1: A patient with chronic obstructive pulmonary disease (COPD) is prescribed a new standard wheelchair for home use. Which HCPCS Level II code range would be used to report the wheelchair?
- A-codes (A4000-A8999)
- L-codes (L0100-L4999)
- E-codes (E0100-E8002) (Correct answer)
- J-codes (J0120-J9999)
Correct answer: E-codes (E0100-E8002)
HCPCS Level II E-codes are specifically designated for Durable Medical Equipment (DME), which includes items like wheelchairs, hospital beds, and oxygen equipment. A-codes are for medical and surgical supplies, L-codes for orthotics and prosthetics, and J-codes for drugs administered other than oral method.
Question 2: A 55-year-old male patient receives a 50 mg injection of a non-chemotherapeutic drug in the physician's office. The HCPCS Level II drug table lists the code for this drug as 'per 25 mg'. How should this be coded?
- Report the J-code with 1 unit
- Report the J-code with 2 units (Correct answer)
- Report the J-code with 50 units
- Do not report a J-code, as it's included in the administration
Correct answer: Report the J-code with 2 units
When the dosage administered is greater than the amount listed in the HCPCS code descriptor, the coder must report the appropriate number of units. In this scenario, since the code is for 25 mg and the patient received 50 mg, the J-code should be reported with 2 units (50 mg / 25 mg = 2).
Question 3: Which of the following HCPCS Level II modifiers is used to indicate that a colorectal cancer screening test was converted to a diagnostic test?
- Modifier 26
- Modifier TC
- Modifier 59
- Modifier PT (Correct answer)
Correct answer: Modifier PT
Modifier PT is a HCPCS Level II modifier specifically used to indicate that a service that began as a screening procedure (in this case, for colorectal cancer) was converted into a diagnostic or therapeutic procedure. The other modifiers have different purposes: 26 for professional component, TC for technical component, and 59 for a distinct procedural service.
Question 4: Which category of HCPCS Level II codes is used to report drugs administered by a non-oral method, such as injections and infusions?
- G-codes
- Q-codes
- J-codes (Correct answer)
- S-codes
Correct answer: J-codes
J-codes are used to identify drugs that are administered by routes other than oral, as well as chemotherapy drugs. G-codes are for temporary procedures, Q-codes are temporary codes for services not otherwise classified, and S-codes are used by private payers for items not in the national code set.
Question 5: A supplier provides a patient with a new, off-the-shelf ankle-foot orthosis. Which HCPCS Level II modifier should be appended to the L-code to indicate the item is new?
- RR - Rental
- LT - Left side
- NU - New equipment (Correct answer)
- KX - Requirements specified in the medical policy have been met
Correct answer: NU - New equipment
The NU modifier is used to indicate that the durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) item is new. RR is for rental equipment, LT specifies the left side of the body, and KX is an informational modifier related to medical necessity documentation.
Question 6: What is the primary purpose of HCPCS Level II codes?
- To report inpatient hospital procedures and diagnoses.
- To report professional services performed by physicians.
- To report products, supplies, and services not included in CPT®. (Correct answer)
- To report all preventive medicine services for commercial payers.
Correct answer: To report products, supplies, and services not included in CPT®.
HCPCS Level II is a standardized coding system used primarily to identify products, supplies, and services not included in the CPT (Level I) code set, such as ambulance services, durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS).
CPC - Certified Professional Coder HCPCS Level II Coding Questions and Answers
A patient with chronic obstructive pulmonary disease (COPD) is prescribed a new standard wheelchair for home use.
Which HCPCS Level II code range would be used to report the wheelchair?