CPC Procedure Coding & Documentation 5

Question 1

Which modifier is used when a procedure is performed on an infant weighing less than 4 kg?

Accepted Answer

-63

Answer

-22

Answer

-52

Answer

-53

Question 2

When a surgeon performs closure of a surgical incision as part of the same operative session, the closure is:

Accepted Answer

Included in the surgical package and not separately billed

Answer

Reported separately with the appropriate repair code

Answer

Reported with modifier -51

Answer

Reported only if closure time exceeds 30 minutes

Question 3

A physician bills for a 45-minute office visit using total time. The note documents 20 minutes face-to-face and 25 minutes reviewing outside records before the visit. Is this appropriate?

Accepted Answer

Yes — total time on the date of service includes pre-visit record review

Answer

No — only face-to-face time on date of service counts

Answer

No — pre-visit time is never counted

Answer

Yes — but only if the records were from another facility

Question 4

CPT code 99024 is used to report:

Accepted Answer

A postoperative follow-up visit included in the global package (no charge)

Answer

A new patient office visit during the postoperative period

Answer

An extended postoperative visit requiring additional E/M documentation

Answer

A telemedicine follow-up after surgery

Question 5

A physician performs a flexible sigmoidoscopy and a colonoscopy during the same session. How should these be coded?

Accepted Answer

Only the colonoscopy, as it is the more extensive procedure encompassing the sigmoid

Answer

Both codes reported with modifier -51 on the lesser procedure

Answer

Both codes reported with modifier -59

Answer

Only the sigmoidoscopy, as it was performed first

Question 6

Which of the following best describes 'unbundling' in procedure coding?

Accepted Answer

Billing multiple CPT codes for procedures that should be reported as a single comprehensive code

Answer

Splitting a single claim across multiple dates of service

Answer

Reporting an add-on code without its primary code

Answer

Using an unlisted code instead of an established CPT code

Question 7

When an operative report is dictated but not yet transcribed, a coder should:

Accepted Answer

Wait for the complete, signed operative report before coding

Answer

Code from the surgical schedule or verbal report

Answer

Code from the pre-operative diagnosis listed in the chart

Answer

Use an unlisted procedure code as a placeholder