CPC Basic 3 — Questions and Answers
Question 1: When coding an outpatient encounter, what should be coded as the first-listed diagnosis?
- The most chronic condition
- The condition established after study to be chiefly responsible for the visit (Correct answer)
- The condition that required the most treatment
- The patient's primary insurance-covered diagnosis
Correct answer: The condition established after study to be chiefly responsible for the visit
For outpatient encounters, the first-listed diagnosis is the condition established after study to be chiefly responsible for the visit.
Question 2: A surgical package (global period) typically includes all of the following EXCEPT:
- Preoperative care 1 day before surgery
- Intraoperative services
- Postoperative complications requiring return to the OR (Correct answer)
- Routine follow-up care during the global period
Correct answer: Postoperative complications requiring return to the OR
Return trips to the operating room for complications are NOT included in the surgical package and should be billed separately.
Question 3: Which HCPCS Level II code range is used for durable medical equipment (DME)?
- A codes
- E codes (Correct answer)
- L codes
- V codes
Correct answer: E codes
HCPCS Level II E codes (E0100–E9999) are designated for durable medical equipment.
Question 4: What does the abbreviation NEC mean in ICD-10-CM?
- Not Elsewhere Classified (Correct answer)
- Non-Essential Condition
- No Established Code
- Not Especially Coded
Correct answer: Not Elsewhere Classified
NEC stands for 'Not Elsewhere Classified,' indicating the condition is not specifically described by any other available code.
Question 5: A physician performs a procedure and also provides the anesthesia. Which modifier should be appended to the anesthesia code?
- -AA
- -QZ
- -47 (Correct answer)
- -QK
Correct answer: -47
Modifier -47 indicates anesthesia by the surgeon, meaning the operating physician personally administered the anesthesia.
Question 6: In CPT, what does a bullet (•) symbol next to a code indicate?
- The code has been revised
- The code is new for the current year (Correct answer)
- The code has been deleted
- The code requires a modifier
Correct answer: The code is new for the current year
A bullet (•) symbol in the CPT codebook indicates that the code is new for the current edition.
Question 7: Which of the following is considered a Category III CPT code?
- 99213
- 27447
- 0042T (Correct answer)
- G0439
Correct answer: 0042T
Category III CPT codes are temporary codes for emerging technology and services, identified by a letter suffix 'T' (e.g., 0042T).
CPC Basic 3
When coding an outpatient encounter, what should be coded as the first-listed diagnosis?