Mixed Deck — All CPCA Topics Flashcards
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Read the first 20 Mixed Deck — All CPCA Topics flashcards as text
Modifier 22 in dermatology is used to indicate:
Answer: Increased procedural services beyond what is usually required
Modifier 22 is appended when the work required to perform the procedure is substantially greater than typically required, justifying additional reimbursement.
Bilateral upper eyelid blepharoplasty is performed during the same session. How should this be reported?
Answer: 15822 with modifier 50
Bilateral blepharoplasty is reported with CPT 15822 and modifier 50 to indicate the procedure was performed on both upper eyelids.
When coding for hyaluronic acid filler injected into the nasolabial folds, which CPT code category is most appropriate?
Answer: Soft tissue augmentation (e.g., 11950-11954)
Soft tissue augmentation codes (11950-11954) cover injectable filler materials placed into subcutaneous tissue.
A patient presents for destruction of multiple actinic keratoses. Five lesions are treated. How are the additional lesions (beyond the first) coded?
Answer: Additional lesions are reported with add-on codes
CPT includes add-on codes (e.g., 17003) for each additional actinic keratosis destroyed beyond the first two, which do not require modifier 51.
When a planned outpatient surgical procedure is discontinued after anesthesia has been administered but before the skin incision is made, which modifier is appended?
Answer: -74
Modifier -74 is used for discontinued outpatient hospital/ASC procedures after the administration of anesthesia but before the procedure is completed, signaling a partial reduction in reimbursement.
Which word is spelled correctly in a medical context?
Answer: Hemorrhage
'Hemorrhage' is the standard American English spelling for excessive bleeding.
Which of the following best describes the concept of 'scoping' in a compliance audit?
Answer: Defining the systems, processes, and locations included in the audit
Scoping defines the boundaries of the audit by identifying which systems, processes, data types, and organizational units are included in the assessment.
A patient requests both dermal filler and neurotoxin injections at the same visit. The physician documents each procedure separately. How should these be reported?
Answer: Report both 11950 (filler) and 64615 (neurotoxin) as separate line items with appropriate diagnoses linked to each
Filler and neurotoxin injections are distinct procedures with separate CPT codes and can be reported together when each is fully documented.
Which HCPCS Level II code is used for methylprednisolone sodium succinate injections?
Answer: J2920
J2920 is the HCPCS code for methylprednisolone sodium succinate, 40 mg per unit.
The prefix 'leuko-' in dermatology terms such as 'leukoderma' means:
Answer: White
Leuko- is derived from the Greek word for white; leukoderma describes areas of skin with decreased or absent pigmentation.
A dermatologist uses a CO2 laser to resurface two anatomical areas: full face and bilateral hands. How should this be coded?
Answer: Report a separate code for each distinct anatomical area
Laser resurfacing CPT codes (15780–15783) are area-specific; each treated anatomical region is coded separately, with modifier 51 appended to the lower-valued procedure when payer rules require it.
Which of the following best describes the use of modifier 47 in dermatology?
Answer: Anesthesia by the operating surgeon
Modifier 47 indicates that regional or general anesthesia was provided by the operating surgeon, not a separate anesthesiologist.
Which sentence contains a dangling modifier?
Answer: Having reviewed the X-ray, a fracture was suspected.
A dangling modifier occurs when the implied subject of the modifier doesn't match the sentence's subject; 'a fracture' did not review the X-ray.
The term 'onychomycosis' refers to a fungal infection of which structure?
Answer: Nail
Onychomycosis is a fungal infection of the nail, derived from 'onycho' (nail) and 'mycosis' (fungal infection).
In medical documentation, what does the abbreviation 'PRN' stand for?
Answer: Pro re nata (as needed)
PRN is Latin for 'pro re nata,' meaning a medication or treatment is given as needed.
Which type of audit involves an independent third party evaluating an organization's controls against a defined standard?
Answer: External audit
An external audit is conducted by an independent third party to provide an objective assessment of an organization's compliance posture.
A hair transplant is performed using 20 punch grafts. Which CPT code applies?
Answer: 15776
CPT 15776 reports punch graft hair transplantation when more than 15 grafts are placed.
An auditor reviews an organization's change management process and finds that changes are being implemented without formal approval. Which ITIL process is being violated?
Answer: Change Management
Change Management requires formal approval through a Change Advisory Board (CAB) or similar process before implementing changes to production systems.
A hospital collects $1.2 million in revenue. If 6.5% goes to bad debt, how much is lost to bad debt?
Answer: $78,000
Bad debt = 6.5% × $1,200,000 = 0.065 × $1,200,000 = $78,000.
The term 'pruritus' describes which symptom?
Answer: Itching
Pruritus is the medical term for itching, a common symptom in many dermatological conditions.