FREE Certified Professional Coder Questions and Answers
One of the six main scapulohumeral muscles.
The temporomandibular joint is moved by the temporalis, which is a muscle in the jaw. From the occipital bone, the trapezius muscle descends along the thoracic vertebrae. The six main muscles of the scapulohumeral group include the teres, deltoid, and the four muscles that make up the rotator cuff. When relief is required, the trigone muscle, a triangular smooth muscle sensitive to expansion, sends a signal to the brain.
To alter refractive error, a procedure is carried out in which corneal tissue from a donor is frozen, reshaped, and implanted into the recipient's anterior corneal stroma.
This describes what CPT code?
The procedure known as keratoplasty, or CPT code 65710, involves removing the cornea's clear covering and replacing it with a transplant.
A procedure known as keratomileusis, CPT code 65760, alters the cornea's (the transparent tissue covering the eyeball) shape to enhance vision.
An artificial cornea is implanted during keratophakia surgery, which has the CPT code 65765. (The clear tissue that covers the eyeball). It fixes refractive vision errors like near- and farsightedness and difficulty focusing. The proper response is CPT code 65765.
An artificial cornea is implanted during keratoprosthesis surgery, which has the CPT code 65770. (the clear tissue that covers the eyeball). It fixes refractive vision errors like near- and farsightedness and difficulty focusing.
Since his surgery 4 months ago, a patient has been complaining of pain. When the doctor checks the shoulder, he or she finds a metal clamp that was left over from a previous surgery. For an arthroscopy, the doctor sends him to a surgeon who works outside of a hospital. The doctor takes the clamp off and closes the hole.
What CPT code(s) needs to be used by the doctor?
According to the guidelines for arthroscopy coding (found above CPT code 29800), diagnostic arthroscopies are part of surgical arthroscopies. If the surgeon has to do surgery as part of a diagnostic arthroscopy, he or she can only bill for the surgery. This gets rid of the CPT code 29805 from choices A and B.
Arthroscopy is the right way to remove a foreign body from the shoulder, which is what CPT code 29819 says. The patient is no longer inside his 90-day global period, therefore modifier 78 would not be included; moreover, it is not specified that the same surgeon conducted both procedures.
A 22-year-old female with AIDS who was experiencing dyspnea in the hospital was ventilator-dependent. With general anesthesia, the doctor takes a sample of a mass or nodule in the lung with a rigid or flexible fiberoptic endoscope. The doctor gives her a thoracoscopy to check if she has pneumonia. After seeing the test results, the doctor told the patient that he or she had Pneumocystis Carinii Pneumonia.
What CPT code(s) and ICD-10-CM code(s) are given?
Thoracoscopy, Diagnostic, with Biopsy may be found in the CPT Index. Check the Numeric list and find the right CPT service code. The right CPT code is 32608.
A lung nodule was biopsied, which is a unilateral procedure. If the service is done on both sides, some payers require that the service be reported twice, with the modifier 50 added to the second code, while others only require that the service be reported once, with the modifier 50 added. If a patient is hospitalized due to HIV-related diseases, as per ICD-10-CM recommendations I.C.1.a.2., the primary diagnosis should be B20, followed by further diagnostic codes for any documented HIV-related disorders. Find B59, Pneumocystis Carinii Pneumonia, in the ICD-10-CM Alphabetic Index.
Thoracoscopy, diagnostic (separate procedure); lungs, pericardial sac, mediastinal, or pleural space, without biopsy, CPT code 32601. The scenario states the process includes a biopsy.
Third-degree burns totaling 18 sq cm are being treated on a patient's left arm and leg. Three incisions are made with a #11 scalpel after the burns have been scrubbed clean and given anesthesia. After that, sterile gauze is used to redress the burns.
What CPT code(s) ought to the doctor use?
The Medicine chapter's CPT codes 97597 and 97602 describe active open wound care (e.g. decubitus ulcers). "For debridement of burn wounds, see 16020-16030," is noted beneath the Active Wound Care Management coding guidelines. The debridement and/or removal of dead tissue from second-degree (partial thickness) burns is indicated by the CPT code 16030. The patient in this case suffered third-degree burns. Only cleansing and incisions are mentioned; there is no mention of tissue removal. Since 16030 is incorrect.
Initial incision during an escharotomy is described by CPT code 16035. Thermal burns result in the formation of eschar, a leathery slough. The doctor cuts through the eschar-covered area and pulls it apart. A sufficient eschar incision allows the doctor to release the underlying tissue's motion. Report the first incision at 16035, and the subsequent ones at 16036. The first incision is described by CPT code 16035, and the second and third incisions are described by CPT code 16036 x2.
What Z code may only be recognized as a first listed code?
There is a list of Z codes that are only given as first listed diagnosis codes in the ICD-10-CM guidelines, I.C.21.c.16. We take choices A, B, and D off the list.
A 38-year-old woman goes to the doctor because she has been bleeding from her uterus for 17 days. The doctor discovered a mass that was 3 x 4 cm in size. On the right vaginal mucosa, the mass was firm and irregular. A biopsy was done, and a small piece of the mass's tissue was taken out and sent to the lab.
What CPT code is needed?
Biopsy/Vagina can be found in the CPT Index. Look at the listed code and find the list of CPT codes. CPT code 56605, vulva or perineum biopsy (separate procedure); 1 lesion. As the biopsy was done on the vaginal mucosa, this is inaccurate. The CPT code 57100, which is for a simple procedure, is for a biopsy of the vaginal mucosa. CPT code 57105 is a biopsy of the vaginal mucosa that is large and needs stitches (including cysts). The case did not say that the surgery needed stitches.
A deep needle bone biopsy was done on the femur by a doctor. A CT scan was used to see and guide the trocar, and an interpretation was given.
What CPT code(s) needs to be used by the doctor?
CPT code 20245 refers to a deep, open, bone biopsy (e.g., humeral shaft, ischium, femoral shaft). CPT code 20225 is for a biopsy, bone, trocar, or needle; deep for the bone biopsy (e.g., vertebral body, femur). The scenario mentions that the femur's biopsy was done using a deep needle, ruling out options B and D.
A manometric study is carried out because there may be a gastric outlet obstruction. The doctor uses nuclear medicine to track how long it takes food to move through the patient's stomach, how long it takes for the stomach to empty completely into the small intestine, and how quickly it empties.
What CPT code(s) ought to be applied?
Esophageal motility (manometric analysis of the esophagus and/or gastroesophageal junction study with interpretation and report) is covered by CPT code 91010. Since the patient's stomach was used for the manometric study in this scenario, it is incorrect.
Gastric motility (manometric) studies to find issues with the muscles involved in food digestion are covered by CPT code 91020.
Because it refers to a study about movement through the duodenum (the first part of the small intestine), not the stomach in the small intestine, CPT code 91022 is incorrect.
A 35-year-old man who has internal hemorrhoids visits the doctor to have the hemorrhoids removed. Through an anoscope, the ligator and alligator forceps have been inserted. The doctor locates the largest hemorrhage and uses a rubber band to ligate it at the base.
Which CPT code is appropriate to use?
Look for Hemorrhoidectomy/Ligation in the CPT Index. Hemorrhoidectomy, external, 2 or more columns/groups, CPT code 46250, is intended for external use. Hemorrhoidectomy, single column/group, external CPT code 46999, is also external. If 46221, hemorrhoidectomy, internal, by rubber band ligation(s), wasn't available, the right response might be 46255, hemorrhoidectomy, internal and external, single column/group. The ligation of the rubber band(s) is part of 46221.
Due to a ruptured tubal pregnancy, a pregnant woman who is 17 weeks along is hurried into the operating room. She experiences an urgent laparoscopic tubal ligation that necessitates anesthesia because she is hemorrhaging severely.
What CPT code(s) needs to be used by the doctor?
The "Anesthesia Physical Status Modifiers" (found in Appendix A) that start with the letter P are only for informational purposes.
A typical, healthy patient is the modality P1.
Patient with mild systemic disease (Modifier P2).
Patient with severe systemic disease, P3 modifier.
Patient with severe systemic illness constantly faces life-threatening situation (Modifier P4).
Modifier P5 - A patient in a terminal condition who is not anticipated to survive without surgery.
Modifier P6: A patient who has been pronounced brain dead and whose organs are being removed for donation.
As a result of the patient's severe hemorrhage and the need for an operation, we can conclude that the physical status in the scenario most closely matches status P5.
Anesthesia for incomplete or postponed abortion procedures is covered by CPT code 01965. This CPT code is incorrect because neither the fetus' death nor an incomplete or missed abortion was mentioned in the scenario.
The correct CPT code is 00880, which is for anesthesia for procedures on major lower abdominal vessels when nothing else is specified.
Which act applies when health privacy and the relationship between an employer and an employee come together?
The Americans with Disabilities Act (ADA) can be used when health privacy and the relationship between an employer and an employee come together.
How certain conditions with an underlying etiology and multiple body system manifestations as a result of the underlying etiology should be coded during procedures. The ICD-10-CM has a coding convention for these conditions that mandates the underlying condition be
The ICD-10-CM Official Guidelines recommend that underlying conditions be sequenced first, if applicable, followed by the manifestation in "Section I. Conventions, general coding guidelines, and chapter-specific guidelines."
What part of the body is referred to as the midsagittal plane?
The diagrams in the CPT code book's front can be used to find the solution. It helps to be familiar with medical terms in this situation. The word "mid" here simply means in the middle.
A 17-year-old female patient complains of nausea, vomiting, and weight gain in her family doctor's office. These symptoms have been sporadic over the past two weeks. Her sixth week of pregnancy has been confirmed by an examination of her urine, which displays a positive pregnancy test and hCG levels of 12500 mIU/ml.
Which CPT code(s) must the physician use?
Urine protein, glucose, and bacterial analyses is described by the CPT code 81005. The urinalysis that was conducted during this test, which is frequently administered with a dip stick and may be accompanied by a microscopic inspection, was accurate. We can rule out options B and C.
For a urine pregnancy test using visual color comparison techniques, use CPT number 81025. Gonadotropin, chorionic (hCG); qualitative is denoted by CPT number 84702. Testing for free beta chain and chorionic gonadotropin (hCG) is done using CPT number 84704. We can rule out option A because the scenario makes no mention of the urine that was performed to check for the free beta biochemical marker.
Which organ system does the spleen belong to?
An anatomical diagram of each organ system can be found in the introduction section of the CPT codebook. In this case, the Hemic and Lymphatic codes' Table of Contents contains a skeleton diagram (38100-38999). If you don't have this diagram, try searching for "spleen" in the CPT or ICD-10-CM index to see if you can find a code or a few codes that are close to that term. Look for a diagram by searching the codes.
