CPC HCPCS Level II Coding 5 — Questions and Answers
Question 1: Which HCPCS Level II modifier indicates that a purchased item is new and different from a replaced item?
- NR
- NU (Correct answer)
- RB
- UE
Correct answer: NU
Modifier NU indicates a new DME item purchased (as opposed to used or rental), while UE indicates used durable medical equipment.
Question 2: A patient receives injectable epoetin alfa (Procrit) for anemia. Which HCPCS code category covers this drug?
- A-codes
- J-codes (Correct answer)
- Q-codes
- S-codes
Correct answer: J-codes
Epoetin alfa is classified under J-codes (specifically J0885/J0886), which cover drugs administered other than orally.
Question 3: The HCPCS Level II modifier 'GX' indicates:
- Notice of exclusion from Medicare benefits issued voluntarily under a statutory exclusion (Correct answer)
- General exclusion from coverage
- Group X classification for high-cost items
- Geographic exclusion for rural services
Correct answer: Notice of exclusion from Medicare benefits issued voluntarily under a statutory exclusion
Modifier GX indicates a voluntary ABN was issued for a service that is statutorily excluded from Medicare benefits.
Question 4: Which HCPCS Level II code range covers hearing services and hearing aids?
- S0618-S0622
- V5000-V5999 (Correct answer)
- A9270-A9279
- E2500-E2599
Correct answer: V5000-V5999
V5000-V5999 covers hearing services including hearing tests, hearing aids, and hearing aid accessories.
Question 5: A coder must assign HCPCS codes for Medicare Advantage plans. Which statement is true?
- Medicare Advantage plans are prohibited from using HCPCS Level II codes
- Medicare Advantage plans may require HCPCS Level II codes for DME and drugs (Correct answer)
- Only S-codes are used for Medicare Advantage billing
- Medicare Advantage uses ICD-10 codes instead of HCPCS
Correct answer: Medicare Advantage plans may require HCPCS Level II codes for DME and drugs
Medicare Advantage (MA) plans follow Medicare billing guidelines and typically require HCPCS Level II codes for DME, drugs, and other covered services.
Question 6: Which HCPCS Level II modifier is appended to indicate that a service was ordered by a clinical nurse specialist?
- AK
- AN (Correct answer)
- AS
- AU
Correct answer: AN
Modifier AN identifies services ordered by a clinical nurse specialist (CNS) when required for tracking and billing purposes.
Question 7: What is the correct HCPCS Level II code range for drugs, biologicals, and chemotherapy agents (non-oral)?
- C9000-C9999
- J0000-J9999 (Correct answer)
- Q0000-Q0099
- S0000-S0099
Correct answer: J0000-J9999
The J-code range (J0000-J9999) is designated for drugs administered other than oral method, including chemotherapy, biologicals, and immunosuppressives.
CPC HCPCS Level II Coding 5
Which HCPCS Level II modifier indicates that a purchased item is new and different from a replaced item?