Mixed Deck — All CPC Topics Flashcards
100 cards from real CPC 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 CPC Topics flashcards as text
Which CPT range covers anesthesia for procedures on the perineum?
Answer: 00900–00952
CPT codes 00900–00952 cover anesthesia for procedures on the perineum.
In CPT coding, what is the significance of a 'semicolon' (;) in a code description?
Answer: The portion before the semicolon is shared by the parent code and all indented codes below it
In CPT, the common descriptor before the semicolon applies to the parent code and all indented child codes that follow.
The myocardium is the:
Answer: Middle muscular layer of the heart wall
My/o means muscle and cardi/o means heart, so the myocardium is the thick muscular middle layer of the heart wall.
Which CPT code describes a complete abdominal ultrasound that must include real-time imaging of liver, gallbladder, spleen, pancreas, and kidneys?
Answer: 76700
CPT 76700 is a complete abdominal ultrasound requiring documentation of all required organs including liver, gallbladder, common bile duct, pancreas, spleen, and both kidneys.
When reporting nail avulsion (partial or complete), which code is reported for a single nail?
Answer: 11730
CPT 11730 covers avulsion of nail plate, partial or complete, simple, for one nail; 11732 is the add-on for each additional nail.
A provider who is listed on the OIG Exclusion List is prohibited from:
Answer: Participating in federal healthcare programs including Medicare and Medicaid
Excluded individuals and entities are barred from participating in Medicare, Medicaid, and all other federal healthcare programs, and hiring them can result in significant penalties.
What does the term 'total time' mean in the context of 2021 office E/M coding?
Answer: Time spent on all work related to the encounter on that calendar date
Total time includes all physician work on the date of service — pre-visit review, face-to-face time, and post-visit documentation.
During a colonoscopy, the physician removes one polyp by hot biopsy forceps and another at a separate site by snare technique. How should this be coded?
Answer: Report 45338 as the primary code and 45333 with modifier -59
When different polypectomy techniques are used during the same colonoscopy, the higher-valued procedure (45338, snare) is listed first and the additional technique (45333, hot biopsy forceps) uses modifier -59 to indicate a distinct procedural service.
What does the 'three-year rule' determine in E/M coding?
Answer: Whether a patient is classified as new or established for office E/M purposes
A patient is considered new if no professional services have been provided by the physician or same-specialty group within the past three years.
Which of the following best describes Level III surgical pathology (CPT 88307)?
Answer: Appendix, gallbladder, fallopian tube, testis
CPT 88307 covers Level VI specimens such as appendix, fallopian tube removed for non-neoplastic conditions, and testis.
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?
Answer: G codes
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.
Which law imposes civil monetary penalties on providers who engage in improper claims submission to federal healthcare programs?
Answer: Civil Monetary Penalties Law (CMPL)
The Civil Monetary Penalties Law allows the OIG to impose penalties and exclusion on providers who submit false or fraudulent claims to federal programs.
Which CPT code describes a total abdominal colectomy without proctectomy with creation of an ileostomy?
Answer: 44150
CPT 44150 represents a total abdominal colectomy without proctectomy with ileostomy or ileoproctostomy, while 44155 includes proctectomy.
What does the 'Q' code range in HCPCS Level II represent?
Answer: Temporary codes for Medicare
Q codes are temporary national codes used by CMS/Medicare for drugs, biologicals, and services that don't yet have a permanent code assignment.
Which type of E/M visit is used when a physician is asked by the attending to evaluate a patient and provide a written report of findings and recommendations?
Answer: Inpatient consultation — but Medicare no longer recognizes consult codes
Medicare eliminated consultation codes in 2010; consultations for Medicare patients are reported using the appropriate new or established patient or inpatient E/M codes.
When coding fractures in ICD-10-CM, which 7th character extension indicates the initial encounter for a closed fracture?
Answer: A
The 7th character 'A' designates the initial encounter for active treatment of a fracture, regardless of whether it is the patient's first visit.
What is the difference between ICD and CPT codes?
Answer: ICD codes track diagnoses, and CPT codes track procedures
This is the core distinction between the two primary coding systems. ICD (International Classification of Diseases) codes describe the patient's medical condition or diagnosis, explaining *why* a service was performed. CPT (Current Procedural Terminology) codes, on the other hand, describe the specific medical, surgical, and diagnostic services or procedures *what* was done to treat the patient. Both are essential for complete and accurate medical billing.
A patient with diabetes receives insulin syringes from a DME supplier. Which HCPCS code category applies?
Answer: A codes
Insulin syringes and related diabetic supplies are reported using A codes (specifically A4206 and related supply codes).
The peritoneum is the membrane that lines which cavity?
Answer: Abdominal cavity
The peritoneum is the serous membrane lining the abdominal cavity and covering abdominal organs.
A patient undergoes a flexible sigmoidoscopy with removal of a polyp by snare technique. Which CPT code applies?
Answer: 45338
CPT 45338 specifically describes sigmoidoscopy with removal of tumor(s) or polyp(s) by snare technique, distinguishing it from 45333 which uses hot biopsy forceps.