1.
HCPCS CODING:Level II HCPCS codes for drugs are administered :
Correct Answer
D. All of the above
Explanation
The correct answer is "all of the above" because Level II HCPCS codes for drugs can be used for drugs that are administered intravenously, intramuscularly, or subcutaneously. This means that the codes can be used to bill for drugs that are given through any of these routes of administration.
2.
A male 62-year-old presents for a digital rectal exam and total prostate-specific antigen test (PSA), which code would be used?
Correct Answer
D. G0102, G0103
Explanation
The correct answer is G0102, G0103. G0102 is the CPT code for a digital rectal exam and G0103 is the CPT code for a total prostate-specific antigen test. These two codes would be used together to accurately represent the services performed during the patient's visit.
3.
A Medicare patient, 82-year-old female has an energy x-ray absorptiometry (SEXA) bone density study of two sites of the wrists.
Correct Answer
C. G0130
Explanation
The correct answer is G0130. G0130 is the correct code for a bone density study of two sites of the wrists using energy x-ray absorptiometry (SEXA) for a Medicare patient. The other codes listed (76071, 76075, and 76070) are not appropriate for this specific study or patient type.
4.
A 63-year-old male, Medicare recipient receives 30 minutes of individual diabetes outpatiself-management training :
Correct Answer
D. G0108
Explanation
G0108 is the correct answer because it is the Healthcare Common Procedure Coding System (HCPCS) code for individual diabetes self-management training (DSMT) services, which is what the patient received. This code is specifically used for Medicare patients and covers 30 minutes of individual DSMT. G0176 is the HCPCS code for a different type of DSMT service, group DSMT, so it is not the correct answer. 99213 is a Current Procedural Terminology (CPT) code for an office visit, which is not applicable to this scenario. G0109 is the HCPCS code for a different type of DSMT service, follow-up DSMT, so it is also not the correct answer.
5.
A Medicare recipient presents for an influenza and pneumococcal vaccination.
Correct Answer
C. G0008, G0009
Explanation
The correct answer is G0008, G0009. This answer is correct because G0008 represents the administration of the influenza vaccine, while G0009 represents the administration of the pneumococcal vaccine. Since the Medicare recipient is receiving both vaccinations, both codes G0008 and G0009 would be appropriate to use.
6.
General guidelines for HCPCS Level II Coding includes :
Correct Answer
B. Search for main terms and any applicable sub-terms
Explanation
The correct answer is "Search for main terms and any applicable sub-terms." This is because when coding using HCPCS Level II, it is important to search for the main terms and any applicable sub-terms in order to accurately assign the appropriate code. This ensures that the code chosen accurately reflects the specific procedure, supply, or service being provided. Code directly from the index and noting the reference codes are also important steps in the coding process, but the most crucial step is searching for the main terms and sub-terms.
7.
A patient received a 12 sq. cm. dermal tissue substitute of human origin, without other bioengineered elements, without metabolically active elements. This treatment was completed due to a burn on the abdomen. How would you report the supply?
Correct Answer
A. C1762
8.
During an emergency room visit, Sally was diagnosed with pneumonia. She was admitted to the hospital observation unit and treated with 500 mg of Zithromax through an IV route. How would you report the supply of this drug?
Correct Answer
A. J 0456
Explanation
J 0456 is the correct answer because it is the Healthcare Common Procedure Coding System (HCPCS) code for the supply of Zithromax. This code specifically refers to the IV route of administration, which is how Sally received the medication. The other options (Q0144, J1190 X 2, J2020 X 2) do not accurately represent the supply of Zithromax through an IV route.
9.
Report an initial Medicare Annual Wellness Exam (AWV) with a Established E & M visit , EPF Hx and Exam and LOW MDM (the CC was GERD and HTN)
Correct Answer
C. 99213, G0438-33
Explanation
The correct answer is 99213, G0438-33. In this scenario, the patient had a Medicare Annual Wellness Exam (AWV) along with an Established E & M visit, EPF Hx and Exam, and LOW MDM. The chief complaint (CC) was GERD and HTN. The code 99213 represents the level of service for the Established E & M visit, which is appropriate for a sick visit. The code G0438 represents the Medicare Annual Wellness Exam. Adding the modifier -33 to G0438 indicates that the service was preventive in nature. Therefore, the correct answer is to report both codes 99213 and G0438-33.
10.
Which code describes an addition to the lower extremity, knee disarticulation, and leather socket?
Correct Answer
B. L5640
Explanation
The code L5640 describes an addition to the lower extremity, knee disarticulation, and leather socket.
11.
A nursing home's x-ray machine was not working. A portable x-ray machine and personnel was transported to the nursing home to test nine patients. How would you report the transportation of equipment?
Correct Answer
D. R0075
Explanation
The correct answer, R0075, indicates that the transportation of equipment to the nursing home was reported using this code. This code specifically refers to the transportation of portable x-ray equipment.
12.
What modifier would most likely be used for a blepharoplasty to the upper right eyelid?
Correct Answer
C. E3
13.
An electric movable toilet chair is ordered for a patient who is mostly bed bound. What is the code for this DME?
Correct Answer
C. E0170
Explanation
The code E0170 is the correct answer for this question. This code represents an electric wheelchair, which is suitable for a patient who is mostly bed bound. This type of wheelchair is designed to provide mobility and support for individuals who have limited mobility or are unable to walk. It is a suitable choice for a patient who needs assistance with toileting and is unable to use a regular toilet.
14.
A patient is transferred via ambulance from the ESRD clinic at the University Medical Center to the nursing home. Which modifier should be appended to the Ambulance service that describes the pick-up origin and the destination for this trip?
Correct Answer
D. GN
Explanation
The correct modifier that should be appended to the Ambulance service to describe the pick-up origin and the destination for this trip is GN.
15.
If a procedure is performed on an 80 year old Medicare patient, a code from which code category is preferred for reporting?
Correct Answer
C. G Code
Explanation
For reporting a procedure performed on an 80-year-old Medicare patient, a code from the G Code category is preferred. G Codes are used specifically for reporting services and procedures provided to Medicare patients. These codes help in tracking and analyzing Medicare patient care and outcomes. Therefore, when reporting a procedure for an 80-year-old Medicare patient, it is appropriate to use a G Code.
16.
A nine-year old patient is seen in her physician's office with a laceration on her forearm. As this cut is not too deep, the physician decides to repair the wound with tissue adhesive. How would this be coded?
Correct Answer
B. G0168
Explanation
The correct answer is G0168. G0168 is the correct code for the repair of a laceration with tissue adhesive. This code is used when a physician uses tissue adhesive to close a wound that is not too deep. The other options (A4452, Q4106, A6250) are not applicable to this scenario.
17.
A patient who was in a skiing accident and broke both his left and right femur is going home from the hospital today. A wheelchair with swing-away and detachable, elevated leg rests, and full length arms is ordered for the patient.The physician is required to conduct a face-to-face examination of the patient and document a written order for the need of the mobile power device. What is the correct code for the physician's service?
Correct Answer
C. G0372
Explanation
The correct code for the physician's service is G0372. This code represents a face-to-face examination and written order for the need of a mobile power device. In this case, the physician is ordering a wheelchair with specific features for a patient who broke both his left and right femur in a skiing accident.
18.
What is thye correct HCPCS Level II code for Depo-Provera (medroxyprogesterone acetate) injection of 100 mg?
Correct Answer
B. J1050 X 100
Explanation
The correct HCPCS Level II code for Depo-Provera (medroxyprogesterone acetate) injection of 100 mg is J1050 X 100. This code represents the specific medication and dosage being administered, which is Depo-Provera at a dosage of 100 mg. The "X 100" indicates that the injection is being administered 100 times, likely for multiple patients or over a period of time.
19.
What is the correct code for 500 mg of lyophilized immune globulin?
Correct Answer
C. J1566
Explanation
The correct code for 500 mg of lyophilized immune globulin is J1566.
20.
The physician writes an order for 45 mm/Hg thigh high compression stockings. Which HCPCS Level II code is correct for this item?
Correct Answer
C. A6535
Explanation
The correct answer is A6535. This HCPCS Level II code represents thigh high compression stockings with a compression level of 30-40 mm/Hg. The physician's order specifies a compression level of 45 mm/Hg, which is not available in the given options. Therefore, none of the provided codes are a perfect match for the physician's order.
21.
What is the HCPCS Level II code for a pump with an alarm which delivers soy-based 100 calories/unit Pediatrics enteral nutrition?
Correct Answer
D. B9002
Explanation
The HCPCS Level II code B9002 is the correct answer for a pump with an alarm which delivers soy-based 100 calories/unit Pediatrics enteral nutrition. This code specifically represents a pump that is used for enteral nutrition, which is the delivery of nutrients directly into the gastrointestinal tract. The alarm feature indicates that the pump has an alert system to notify the user of any issues or malfunctions. The code B9002 is the most appropriate choice for this specific scenario.
22.
What is the correct coding for a skin substitute graft to cover 10 sq cm of a badly burned leg on a 15-year-old patient, using Alloskin?
Correct Answer
D. Q4115 X 10
Explanation
The correct coding for a skin substitute graft to cover 10 sq cm of a badly burned leg on a 15-year-old patient, using Alloskin, is Q4115 X 10. This means that 10 units of Q4115, which represents the application of Alloskin, should be used to cover the 10 sq cm area.
23.
A patient presents for a blepharoplasty of the upper eyelid. Which Level II modifier would be appended to the procedure code?
Correct Answer
B. E1
Explanation
The correct answer is E1. The E1 modifier is used to indicate that the procedure was performed on an eyelid that has previously undergone surgery. In this case, the patient is presenting for a blepharoplasty of the upper eyelid, indicating that they have previously had surgery on that eyelid. Therefore, the E1 modifier would be appended to the procedure code to indicate this.
24.
A 19-Year old patient loses his eye in a tragic bass fishing accident. He presents today for implantation of a prosthetic eye. What is the correct HCPCS Level II code for the new eye?
Correct Answer
A. V2629
Explanation
The correct HCPCS Level II code for the new eye is V2629. This code is used for prosthetic eyes and is appropriate for the patient who lost his eye in the fishing accident. The other options, L8610 and V2623, are not applicable in this case. The statement "This supply would be included in the procedure code and not reported separately" indicates that the cost of the prosthetic eye is already included in the overall procedure code for the implantation, so it should not be reported separately.
25.
A patient who just moved to town is seen for his first comprehensive ophthalmologic exam. The physician provides PMMA bifocal lenses for the patient. He is instructed to follow up in 10 days to determine if the lenses are working well for his eyes. What is the correct coding for this scenario?
Correct Answer
D. 92004, V2502-RT, V2502-LT
Explanation
The correct coding for this scenario is 92004, V2502-RT, V2502-LT. The patient is receiving a comprehensive ophthalmologic exam (92004), and the physician is providing PMMA bifocal lenses (V2502) for the patient. The RT and LT modifiers indicate that the lenses are for the right and left eyes respectively. The patient is instructed to follow up in 10 days to determine if the lenses are working well for his eyes.
26.
A patient is coming in to see her oncologist due to the severe nausea and vomiting from her anti-cancer treatment. The oncologist orders one injection of 10 mg of Compazine, and another injection of 10 mg after three hours. How is this treatment reported?
Correct Answer
D. J0780 X 2
Explanation
The correct answer is J0780 X 2. This is the correct code for reporting the treatment. The patient is receiving two injections of Compazine, each containing 10 mg, with a three-hour interval between them. The code J0780 represents the injection of Compazine, and the "X 2" indicates that the injection is repeated twice.
27.
A six-year-old patient is seen in the physician's office for a penicillin shot to treat strep throat. The patient is given 500,000 units of penicillin G procaine. How is this service reported?
Correct Answer
A. 96372, J2510
Explanation
The correct answer is 96372, J2510. This code combination is used to report the administration of an injection, in this case, a penicillin shot. Code 96372 represents the therapeutic, prophylactic, or diagnostic injection administration, while code J2510 represents the specific medication administered, which is penicillin G procaine. Therefore, this combination accurately reflects the service provided in this scenario.
28.
A 55-year-old woman, G5, P5, is seen in the gynecologist's office for a pessary fitting. The physician inserts the pessary ring, asking the patient as to the comfort, and determines that this is a good treatment for the patient uterine prolapse. A #7 rubber pessary ring is given to the patient for use, once she has shown that she can insert and remove it on her own. What is the correct coding for this service?
Correct Answer
D. 57160, A4561
Explanation
The correct coding for this service is 57160, A4561. The code 57160 represents the fitting and insertion of a pessary ring, which is what the physician did in this case. The code A4561 represents the pessary itself, which was given to the patient for use once she can insert and remove it on her own.
29.
A 55-year-old Medicare patient is seen today for a colonoscopy screening. He is considered high-risk due to a strong family history of colon cancer. How would this be coded?
Correct Answer
A. G0105
Explanation
This would be coded as G0105. G0105 is the CPT code for a colorectal cancer screening; colonoscopy on an individual at high risk. Given that the patient is 55 years old and has a strong family history of colon cancer, he falls into the high-risk category, making G0105 the appropriate code for this scenario.
30.
A 12 year-old boy with frequent episodes of asthma is prescribed 1 mg of Albuterol inhalant. The Albuterol ordered is noncompounded but concentrated. What is the correct HCPCS Level II code for this medication?
Correct Answer
B. J7611
Explanation
The correct HCPCS Level II code for the noncompounded and concentrated Albuterol inhalant prescribed to the 12-year-old boy with frequent episodes of asthma is J7611.
31.
Which of the following Testosterone drug codes is not delivered intramuscularly?
Correct Answer
C. S0189
Explanation
The correct answer is S0189 because it is the only drug code listed that is not delivered intramuscularly. The other three drug codes, J3140, J3120, and S0187, are all delivered intramuscularly.
32.
Patient is in 5 days post-op period from an open heart surgery and is getting ready to go home from the hospital today. His physician, who is stuck behind a nine-car pile-up on I-20, cannot get to the hospital. He calls into the hospital and speaks with his patient about how he is feeling, and goes over his care and medication in depth. 25 minutes later the conversation is over, and the patient is ready for discharge. How would you code the physician's services from his care over the phone?
Correct Answer
B. G0407
Explanation
The correct answer is G0407, which is the correct code for a telephone evaluation and management service provided by a physician to a patient in the post-operative period. In this scenario, the physician is unable to physically be present at the hospital due to a traffic jam, but still provides care and goes over the patient's condition and medication in detail over the phone. This code accurately represents the physician's services in this situation.
33.
A patient has a home health aide come to his home to clean and dress a burn on his lower leg. The aide uses a special absorptive, sterile dressing to cover a 20 sq. cm. area. She also covers a 15 sq.cm. area with a self-adhesive sterile gauze pad.
Correct Answer
C. A6252, A6219
Explanation
The correct answer is A6252, A6219. A6252 is the correct code for the special absorptive, sterile dressing used to cover the 20 sq. cm. area. A6219 is the correct code for the self-adhesive sterile gauze pad used to cover the 15 sq. cm. area.
34.
A 12-year-old arrives in his pediatrician's office after colliding with another player during a soccer game. He is complaining of pain in his right wrist. The physician orders an x-ray and diagnoses him with a hairline fracture of the distal radius. He has a short arm fiberglass cast applied and discharges him with follow up instructions.
Correct Answer
D. Q4010
Explanation
The correct answer, Q4010, is likely the CPT code for "Application of short arm fiberglass cast (forearm to hand)" which is appropriate for the scenario described in the question. The physician ordered an x-ray and diagnosed the patient with a hairline fracture of the distal radius. The application of a short arm fiberglass cast is a common treatment for this type of fracture. The answer choice Q4010 aligns with the procedure performed and is the most suitable option.
35.
A patient with Hodgkin's disease takes Neosar as part of his chemotherapy regiment. He receives 100 mg once a week through intravenous infusion.
Correct Answer
C. J9070
Explanation
J9070 is the correct answer because it is the Healthcare Common Procedure Coding System (HCPCS) code for Neosar, also known as Cyclophosphamide, which is a chemotherapy drug commonly used in the treatment of Hodgkin's disease. The patient receives 100 mg of Neosar once a week through intravenous infusion, and J9070 accurately represents this medication and dosage.
36.
A patient with diabetes is fitted for custom molded shoes. What is the code range for such a fitting?
Correct Answer
B. A5500-A5513
Explanation
The code range A5500-A5513 is the correct answer for a patient with diabetes who is fitted for custom molded shoes. These codes specifically pertain to the fitting and supply of therapeutic shoes for individuals with diabetes. The range includes various codes for different types of shoes, such as depth-inlay shoes, custom molded shoes, and custom molded shoe inserts. These codes are used for billing and reimbursement purposes when providing this specialized service to diabetic patients.
37.
A 300 lb. paraplegic needs a special sized wheelchair with fixed arm rests and elevating leg rests.
Correct Answer
B. E1222
Explanation
E1222 is the correct answer because it is the HCPCS code for a special sized wheelchair with fixed arm rests and elevating leg rests. This code specifically identifies the type of wheelchair that the paraplegic needs, taking into account their weight and specific requirements. The other codes listed do not match the description of the wheelchair needed.