Mixed Deck — All RCC Topics Flashcards
100 cards from real RCC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 20 Mixed Deck — All RCC Topics flashcards as text
Which radiopharmaceutical is most commonly used in thyroid uptake and scan studies?
Answer: Iodine-131 (I-131)
Iodine-131 is used for thyroid uptake, scan, and therapeutic ablation due to selective thyroid uptake.
A radiology claim denied as 'not medically necessary' should be appealed to which first level under Medicare?
Answer: Redetermination by the MAC
The first level of Medicare appeal is Redetermination, filed with the Medicare Administrative Contractor (MAC).
What is 'upcoding' in the context of radiology billing compliance?
Answer: Reporting a more complex or higher-paying code than the service actually performed
Upcoding is a fraudulent practice of reporting higher-paying codes than the documentation supports.
What ICD-10-CM code is used for a screening mammogram encounter?
Answer: Z12.31
ICD-10-CM Z12.31 designates an encounter for screening mammogram for malignant neoplasm of breast.
What does the modifier -TC indicate in radiology coding?
Answer: Technical component
The modifier -TC in radiology coding stands for the technical component. This component covers the costs associated with the equipment, supplies, facility, and the technologist's services involved in performing the diagnostic imaging procedure. It is used when the technical aspect of a radiology service is billed separately from the professional interpretation.
A chest X-ray is ordered for cough. The report shows pneumonia. Which diagnosis code is reported for radiology billing?
Answer: Pneumonia (J18.9)
When a definitive diagnosis is established from imaging, code the confirmed diagnosis rather than the symptom.
Which code set is used alongside ICD-10-CM to capture external causes for injury-related radiology studies?
Answer: V00–Y99 External Cause codes
External cause codes (V00–Y99) are used to document how, where, and the activity at time of injury.
Which CPT code represents a CT of the abdomen and pelvis performed WITH intravenous contrast material?
Answer: 74177
CPT 74177 describes a CT of the abdomen and pelvis with contrast; 74176 is without contrast, 74178 is without followed by with contrast, and 74182 is MRI abdomen with contrast.
What is 'balance billing' in radiology billing practices?
Answer: Billing the patient for the difference between the provider's charge and insurer's payment
Balance billing occurs when a provider bills the patient for the remaining balance after the insurer's payment, beyond the contracted amount.
A radiologist interprets a CT of the abdomen and pelvis with contrast. Which CPT code should be reported?
Answer: 74178
CPT 74178 describes combined CT abdomen and pelvis with contrast in a single examination.
Which modifier does an interpreting radiologist append to a CPT code when billing only for the professional component (interpretation and report)?
Answer: Modifier 26 (Professional Component)
Modifier 26 (Professional Component) is appended when the physician bills only for interpretation and report, separate from the facility's technical component.
A radiologist performs a fluoroscopy-guided joint injection and uses non-ionic iodinated contrast to confirm needle placement. The contrast volume used is 2 ml of ioversol 320 mg/ml. How should this contrast be coded?
Answer: Reported on the facility/technical claim using Q9966 × 2 units (per ml)
Ioversol 320 mg/ml (200-299 mg/ml range — wait, 320 falls in 300-399) falls in the 300-399 mg/ml range (Q9967), but the principle is that contrast is reported on the facility/technical claim using the correct HCPCS Q-code per ml used.
CPT 77261 describes which radiation oncology service?
Answer: Therapeutic radiology treatment planning — simple
CPT 77261 reports simple therapeutic radiology treatment planning with one treatment area and one port.
When a CT scan is performed both without and with contrast, what is the correct CPT coding approach when a dedicated combination code exists?
Answer: Use the single CPT code specifying 'without contrast followed by re-imaging with contrast'
CPT provides dedicated combination codes (e.g., 74178 for CT abdomen/pelvis without and with contrast) that must be used instead of unbundling into two separate procedure codes.
Which imaging modality uses ionizing radiation to create cross-sectional images of the body?
Answer: CT Scan
A CT (Computed Tomography) scan uses X-rays (ionizing radiation) from multiple angles to create detailed cross-sectional images of organs, bones, soft tissues, and blood vessels. Unlike MRI or ultrasound, CT scans rely on radiation to generate these images. This makes ionizing radiation a key characteristic of this imaging modality.
Which HCPCS code is specifically assigned to gadoxetate disodium (Eovist/Primovist), a hepatocyte-specific MRI contrast agent used for liver imaging?
Answer: A9578
A9578 is the HCPCS code for gadoxetate disodium (Eovist), a hepatocyte-specific MRI contrast agent, while A9576 is gadopentetate dimeglumine, A9577 is gadobenate dimeglumine, and A9579 is gadolinium NOS.
In revenue cycle management, what does 'clean claim' mean?
Answer: A claim submitted without errors that can be processed immediately
A clean claim contains all required information and no errors, allowing immediate adjudication by the payer.
Which HCPCS code set is used for Medicare-specific drugs and supplies used in radiology procedures?
Answer: HCPCS Level II (A–V codes)
HCPCS Level II codes (alpha-numeric A–V) capture Medicare-specific items including contrast agents and radiopharmaceuticals.
CT colonography for screening is reported with which CPT code?
Answer: 74263
CPT 74263 is used for CT colonography performed as a screening examination.
Which modifier is appended to indicate that a service was performed bilaterally?
Answer: Modifier 50
Modifier 50 indicates a bilateral procedure was performed during the same operative session.