CPC Practice 4 — Questions and Answers
Question 1: Under ICD-10-CM guidelines, when should you code signs and symptoms as the principal diagnosis?
- Always, instead of a confirmed diagnosis
- When no definitive diagnosis has been established (Correct answer)
- Only for outpatient visits
- Only when the physician documents 'rule out'
Correct answer: When no definitive diagnosis has been established
Signs and symptoms are coded when a definitive diagnosis has not been confirmed by the provider.
Question 2: A patient is seen for a new patient office visit. The physician spends 45 minutes total time on date of encounter. Which E/M code applies under the 2021 guidelines?
- 99203
- 99204 (Correct answer)
- 99205
- 99202
Correct answer: 99204
Under 2021 AMA guidelines, 99204 corresponds to 45–59 minutes of total time on the date of service for a new patient.
Question 3: Which modifier is appended to indicate a service was reduced or eliminated at the physician's discretion?
- -52 (Correct answer)
- -53
- -22
- -32
Correct answer: -52
Modifier -52 indicates that a service or procedure was partially reduced at the physician's discretion.
Question 4: A patient is admitted with acute respiratory failure due to pneumonia. Which condition should be sequenced as the principal diagnosis?
- Pneumonia
- Acute respiratory failure
- Either can be principal diagnosis per ICD-10-CM guidelines (Correct answer)
- Hypoxia
Correct answer: Either can be principal diagnosis per ICD-10-CM guidelines
ICD-10-CM guidelines allow either the acute respiratory failure or the underlying cause (pneumonia) to be the principal diagnosis when both are present on admission.
Question 5: Which CPT code range covers Surgery of the Musculoskeletal System?
- 20000–29999 (Correct answer)
- 10000–19999
- 30000–32999
- 40000–49999
Correct answer: 20000–29999
CPT codes 20000–29999 cover musculoskeletal system surgeries including bones, joints, and soft tissues.
Question 6: A patient with Medicare is seen for an annual wellness visit. Which code is used?
- 99395
- G0438 (Correct answer)
- G0439
- 99213
Correct answer: G0438
G0438 is used for the Initial Preventive Physical Examination (IPPE), also called the 'Welcome to Medicare' visit for first-time beneficiaries.
Question 7: When a fracture is treated with closed reduction and casting, which type of fracture care code is typically reported?
- Open treatment code
- Closed treatment without manipulation
- Closed treatment with manipulation (Correct answer)
- Percutaneous skeletal fixation code
Correct answer: Closed treatment with manipulation
Closed reduction involves manipulating the fracture back into alignment, so a 'closed treatment with manipulation' code is appropriate.
CPC Practice 4
Under ICD-10-CM guidelines, when should you code signs and symptoms as the principal diagnosis?