CPC Certified Professional Coder MCQ 3

Question 1

Which of the following is the correct way to report a bilateral procedure when the CPT code descriptor does not specify bilateral?

Accepted Answer

Either A or B depending on payer requirements

Answer

Bilateral procedures can be reported with modifier -50 or with separate line items using -RT and -LT modifiers; the approach depends on specific payer requirements.

Question 2

What is the purpose of the National Correct Coding Initiative (NCCI) edits?

Accepted Answer

To prevent improper payment of procedures that should not be billed together

Answer

NCCI edits, developed by CMS, prevent improper payment when two or more procedure codes are submitted together that are mutually exclusive or represent components of a more comprehensive code.

Question 3

A surgeon performs an open reduction and internal fixation (ORIF) of a closed distal radius fracture. The correct ICD-10-CM fracture code should indicate:

Accepted Answer

Type of fracture, laterality, and encounter type

Answer

ICD-10-CM fracture codes capture specificity including fracture type (displaced/nondisplaced), laterality, and the appropriate 7th character for encounter type.

Question 4

When a physician provides care to a patient in a skilled nursing facility (SNF), which code set is used for subsequent care visits?

Accepted Answer

99307-99310

Answer

CPT codes 99307-99310 are used for subsequent nursing facility care visits based on the level of medical decision making or time.

Question 5

Which of the following conditions would be coded as an 'uncertain diagnosis' in the outpatient setting?

Accepted Answer

Chest pain listed as the chief complaint

Answer

In the outpatient setting, uncertain diagnoses (probable, suspected, possible) are not coded; instead, the presenting sign or symptom — such as chest pain — is coded.

CPC - Certified Professional Coder Practice Test

CPC - Certified Professional Coder Practice Test

CPC Certified Professional Coder MCQ 3