CPC Practice 2 — Questions and Answers
Question 1: A patient undergoes an office visit for an established patient with a detailed history, detailed examination, and medical decision making of moderate complexity. Which E/M level is most appropriate?
- 99213
- 99214 (Correct answer)
- 99215
- 99212
Correct answer: 99214
99214 requires detailed history, detailed exam, and moderate complexity MDM for an established patient office visit.
Question 2: When coding a procedure with a modifier -51 (multiple procedures), which procedure should be listed first on the claim?
- The procedure with the lowest RVU
- The procedure performed last
- The procedure with the highest RVU or fee (Correct answer)
- The procedure that took the longest time
Correct answer: The procedure with the highest RVU or fee
The primary procedure with the highest relative value or fee is listed first; subsequent procedures use modifier -51.
Question 3: A surgeon performs a colonoscopy and removes a polyp via snare technique and another polyp via hot biopsy forceps. How should this be coded?
- Code only the snare polypectomy
- Code both techniques using appropriate colonoscopy codes with modifier -51 (Correct answer)
- Code only the hot biopsy
- Code a single colonoscopy with the most complex technique
Correct answer: Code both techniques using appropriate colonoscopy codes with modifier -51
When different removal techniques are used during the same colonoscopy session, each is coded separately with modifier -51 appended.
Question 4: Which section of CPT contains codes for Evaluation and Management services?
- Section I
- Section II
- The introductory pages before Section I (Correct answer)
- A separate standalone chapter
Correct answer: The introductory pages before Section I
E/M codes (99202–99499) appear in the introductory pages of the CPT manual before the Surgery section.
Question 5: A patient presents with chest pain. The physician documents a comprehensive history, comprehensive exam, and high-complexity medical decision making. The patient is new. Which code applies?
- 99205 (Correct answer)
- 99215
- 99204
- 99213
Correct answer: 99205
99205 is the highest-level new patient office visit requiring comprehensive history, comprehensive exam, and high-complexity MDM.
Question 6: Which modifier indicates a procedure was performed bilaterally?
- -50 (Correct answer)
- -51
- -52
- -53
Correct answer: -50
Modifier -50 is appended to indicate a procedure was performed on both sides of the body during the same operative session.
Question 7: Under the OPPS (Outpatient Prospective Payment System), which coding system is primarily used for reimbursement?
- ICD-10-PCS
- CPT and HCPCS Level II (Correct answer)
- DRGs
- MS-DRGs
Correct answer: CPT and HCPCS Level II
Hospital outpatient services billed under OPPS use CPT and HCPCS Level II codes grouped into Ambulatory Payment Classifications (APCs).
CPC Practice 2
A patient undergoes an office visit for an established patient with a detailed history, detailed examination, and medical decision making of moderate complexity.
Which E/M level is most appropriate?