1.
Patient is admitted to the hospital with acute abdominal pain. The attending medical physician requests a surgical consult. The consultant agrees to see the patient and conducts a comprehensive history and physical examination. The physician ordered lab work to rule out pancreatitis, along with an ultrasound of the gallbladder and abdominal x-ray. Due to the various diagnosis possibilities and the tests reviewed, a moderate medical decision was made.
Correct Answer
C. 99254
Explanation
FROM EVALUATION AND MANAGEMENT SECTION.
2.
An established patient returns to the physician's office for follow-up on his hypertension and diabetes. The physician takes the blood pressure and references the patient's last three glucose tests. The patient is still running above normal glucose levels, so the physician decides to adjust the patient's insulin. An expanded history was taken and a physical examination was performed.
Correct Answer
A. 99213
Explanation
The correct answer is 99213. This code represents an established patient visit where the physician takes the blood pressure, references the patient's last three glucose tests, adjusts the patient's insulin, and performs an expanded history and physical examination. The other options do not accurately reflect the level of complexity and work involved in this visit.
3.
Patient arrives in the emergency room via a medical helicopter. The patient has sustained multiple life-threatening injuries due to a multiple car accident. The patient goes into cardiac arrest 10 minutes after arrival. An hour and 30 minutes of critical care time is spent trying to stabilize the patient.
Correct Answer
B. 99291; 99292
Explanation
The correct answer is 99291; 99292. This is because the patient arrives in the emergency room with life-threatening injuries and goes into cardiac arrest shortly after. The critical care time spent trying to stabilize the patient for an hour and 30 minutes qualifies for both codes 99291 and 99292, which represent prolonged services in critical care.
4.
The physician provided services to a new patient who was in a rest home for an ulcerative sore on the hip. A problem-focused history and physical examination were performed and a straightforward medical decision was made.
Correct Answer
C. 99324
Explanation
The correct answer is 99324. This code represents an evaluation and management service for a new patient in a rest home. The physician performed a problem-focused history and physical examination, indicating that the patient's condition was not complex. Additionally, a straightforward medical decision was made, further supporting the use of this code.
5.
A doctor provides critical care services in the emergency department for a patient in respiratory failure. He initiates ventilator management and spends an hour and 10 minutes providing critical care for this patient.
Correct Answer
D. 99291
Explanation
The correct answer is 99291 because this code represents the provision of critical care services in the emergency department for a patient in respiratory failure. The doctor spent an hour and 10 minutes providing critical care for this patient, which meets the criteria for reporting code 99291. The other codes (99281, 99292, and 94002) do not accurately describe the level of care provided or the specific circumstances of the patient's condition.
6.
Services were provided to a patient in the emergency room after the patient twisted her ankle stepping down from a curb. The emergency room physician ordered x-rays of the ankle, which came back negative fora fracture. A problem-focused history and physical examination were performed and ankle strapping was applied. A prescription for pain was given to the patient. Code the emergency room visit only.
Correct Answer
C. 99281
Explanation
The correct answer is 99281 because this code is used for an emergency room visit where a problem-focused history and physical examination were performed, and ankle strapping was applied. The patient did not require extensive medical decision-making or high complexity care, which would warrant a higher-level code. The other options (99201, 99282, 99211) do not accurately reflect the level of care provided in this scenario.
7.
An established patient was seen in her primary physician's office. The patient fell at home and came to the physician's office for an examination. Due to a possible concussion, the patient was sent to the hospital to be admitted as an observation patient. A detailed history and physical examination were performed and the medical decision was low complexity. The patient stayed overnight and was discharged the next afternoon.
Correct Answer
D. 99218; 99217
Explanation
The correct answer is 99218; 99217. The patient was sent to the hospital to be admitted as an observation patient, which indicates that a higher level of care was required. The detailed history and physical examination were performed, suggesting a higher level of complexity. The patient stayed overnight, indicating a prolonged service. Therefore, the correct code would include both 99218 for the initial observation care and 99217 for the subsequent observation care.
8.
An out-of-town patient presents to a walk-in clinic to have a prescription refilled for a nonsteroidal anti-inflammatory drug. The physician performs a problem-focused history and physical examination with a straightforward decision.
Correct Answer
B. 99201
Explanation
The correct answer is 99201. This code represents an office or other outpatient visit for the evaluation and management of a new patient, which typically requires a problem-focused history and examination. The patient in this scenario is an out-of-town patient seeking a prescription refill, which suggests a straightforward case. Therefore, a level 1 evaluation and management code, such as 99201, would be appropriate.
9.
Code anesthesia for upper abdominal ventral hernia repair.
Correct Answer
C. 00752
Explanation
FROM ANESTHESIA SECTION.
10.
An office consultation is performed for a postmenopausal woman who is complaining of spotting in the past 6 months with right lower quadrant tenderness. A detailed history and physical examination were performed with a low-complexity medical decision.
Correct Answer
B. 99243
Explanation
The correct answer is 99243. This code is appropriate because the patient's complaint of spotting and right lower quadrant tenderness requires a detailed history and physical examination, which is consistent with a moderate-complexity medical decision.
11.
Code anesthesia for total hip replacement
Correct Answer
D. 01214
Explanation
The correct answer is 01214. This code anesthesia for total hip replacement.
12.
Code anesthesia for vaginal hysterectomy
Correct Answer
B. 00944
13.
Code anesthesia for placement of vascular shunt in forearm.
Correct Answer
A. 01844
Explanation
The correct answer is 01844 because it specifically refers to the code for anesthesia during the placement of a vascular shunt in the forearm. This code is used to indicate the administration of anesthesia during this specific procedure, allowing for accurate billing and documentation.
14.
Code anesthesia for decortication of left lung.
Correct Answer
B. 00542
15.
Code anesthesia for total shoulder replacement.
Correct Answer
D. 01638
Explanation
The correct answer is 01638. This code represents the anesthesia for total shoulder replacement. Anesthesia is the administration of medication to prevent pain during a surgical procedure. Total shoulder replacement is a surgical procedure where the damaged parts of the shoulder joint are removed and replaced with artificial components. Therefore, anesthesia is necessary to ensure that the patient does not experience any pain or discomfort during the surgery.
16.
Code anesthesia for cesarean section.
Correct Answer
B. 01961
17.
Code anesthesia for procedures on bony pelvis.
Correct Answer
C. 01120
Explanation
The correct answer is 01120. This code represents the anesthesia for procedures on the bony pelvis. Anesthesia is often required for surgeries or procedures involving the pelvis to ensure that the patient remains comfortable and pain-free during the operation. Code 00400 is for anesthesia for procedures on the spine and spinal cord, 01170 is for anesthesia for procedures on the urinary system, and 01190 is for anesthesia for procedures on the female genital system. None of these codes specifically match the given scenario of procedures on the bony pelvis, making 01120 the correct answer.
18.
Code anesthesia for corneal transplant.
Correct Answer
A. 00144
19.
Administration of initial oral radionuclide therapy for hyperthyroidism.
Correct Answer
D. 79005
Explanation
FROM RADIOLOGY SECTION.
20.
Patient comes into the outpatient department at the local hospital for an MRI of the cervical spine with contrast. Patient status post automobile accident.
Correct Answer
B. 72142
Explanation
The correct answer is 72142. This code represents an MRI of the cervical spine without contrast. Since the patient is status post automobile accident, it is important to evaluate the cervical spine for any potential injuries or abnormalities. However, in this case, the MRI is performed without contrast, which means that no dye or contrast agent is used to enhance the visibility of certain structures or abnormalities. This code accurately describes the procedure performed in this scenario.
21.
Obstetric patient comes in for a pelvimetry with placental placement.
Correct Answer
A. 74710
Explanation
The correct answer is 74710. This code represents a pelvimetry procedure, which is a diagnostic test used to measure the dimensions of the pelvis. In this case, the obstetric patient is coming in for a pelvimetry with placental placement, indicating that the procedure will involve assessing the size and shape of the pelvis as well as determining the location of the placenta. The other codes listed are not relevant to this specific procedure.
22.
Patient comes into his physician's office complaining of wrist pain. Physician gives the patient an injection and sends the patient to the hospital for an arthrography. Code the complete procedure.
Correct Answer
D. 25246; 73115
Explanation
The correct answer is 25246; 73115. The patient is complaining of wrist pain and the physician decides to perform an arthrography, which is a procedure used to diagnose joint problems. The injection given by the physician is likely a contrast agent that will be used during the arthrography. The code 73115 represents the arthrography procedure itself, while 25246 represents the injection of contrast agent. Therefore, both codes are necessary to accurately code the complete procedure.
23.
Patient has carcinoma of the breast and undergoes proton beam delivery of radiation to the breast with a single port.
Correct Answer
C. 77520
Explanation
The correct answer is 77520 because it is the CPT code for "Proton treatment delivery; simple." In this scenario, the patient has carcinoma of the breast and is undergoing proton beam delivery of radiation to the breast with a single port. Therefore, 77520 is the appropriate code to represent this procedure.
24.
CT scan of the head with contrast.
Correct Answer
A. 70460
Explanation
The correct answer is 70460 because it is the correct CPT code for a CT scan of the head with contrast. The other options are not appropriate because they either do not specify the use of contrast or are incorrect codes for other procedures.
25.
Patient undergoes x-ray of the foot with three views.
Correct Answer
C. 73630
Explanation
The correct answer is 73630. This code represents a radiographic examination of the foot with three views. It is used when the patient undergoes an x-ray procedure that captures images of the foot from different angles to provide a comprehensive view of the area. This code accurately describes the specific type of imaging study performed on the patient's foot.
26.
Unilateral mammogram with computer-aided detection with further physician review and interpretation.
Correct Answer
D. 77055, 77051
Explanation
The correct answer is 77055, 77051. This answer is correct because it includes both codes necessary for a unilateral mammogram with computer-aided detection and further physician review and interpretation. Code 77055 is used for the mammogram itself, and code 77051 is used for the physician's review and interpretation of the results.
27.
Pregnant female comes in for a complete fetal and maternal evaluation via ultrasound.
Correct Answer
C. 76811
Explanation
The correct answer is 76811. This code represents a complete fetal and maternal evaluation via ultrasound. It is used when a pregnant female undergoes an ultrasound examination to assess both the fetus and the mother's health. This code covers a comprehensive evaluation and is appropriate for this scenario.
28.
Ultrasonic guidance for the needle biopsy of the liver. Code the complete procedure.
Correct Answer
A. 47000; 76942
Explanation
The correct answer is 47000; 76942. This code combination indicates that the procedure performed was an ultrasonic guidance for needle biopsy of the liver. The code 47000 represents the needle biopsy procedure, while the code 76942 represents the ultrasonic guidance used during the procedure.
29.
What code is used for a culture of embryos less than 4 days?
Correct Answer
D. 89250
Explanation
FROM PATHOLOGY AND LABORATORY SECTION.
30.
Basic metabolic panel (calcium, total) and total bilirubin.
Correct Answer
A. 80048; 82247
Explanation
The correct answer is 80048; 82247. The basic metabolic panel (calcium, total) and total bilirubin are both included in this panel. The code 80048 represents the basic metabolic panel, which includes tests for glucose, calcium, electrolytes, and kidney function. The code 82247 represents the test for total bilirubin, which measures the level of bilirubin in the blood and helps diagnose liver or gallbladder problems. These two codes together cover the tests mentioned in the question.
31.
Huhner test and semen analysis.
Correct Answer
D. 89300
32.
Chlamydia culture.
Correct Answer
A. 87110
33.
Partial thromboplastin time utilizing whole blood.
Correct Answer
B. 85730
Explanation
The correct answer is 85730 because it is the correct CPT code for partial thromboplastin time (PTT) testing using whole blood. PTT is a laboratory test used to evaluate the blood's ability to clot properly. The code 85732 is incorrect because it is for prothrombin time (PT) testing, not PTT. The codes 85245 and 85246 are also incorrect as they are not related to PTT testing.
34.
Pathologist bills for gross and microscopic examination of medial meniscus.
Correct Answer
D. 88304
Explanation
The correct answer, 88304, refers to the billing code for the microscopic examination of the medial meniscus. This code is used when a pathologist examines the tissue sample of the meniscus under a microscope to make a diagnosis or identify any abnormalities. It is important to bill for both the gross examination (88300) and the microscopic examination (88304) to ensure accurate reimbursement for the services provided.
35.
Cytopathology of cervical Pap smear with automated thin-layer preparation utilizing computer screening and manual rescreening under physician supervision.
Correct Answer
A. 88175
36.
Pathologist performs a postmortem examination including brain of an adult. Tissue is being sent to the lab for microscopic examination.
Correct Answer
B. 88025
Explanation
The correct answer is 88025. This code represents the microscopic examination of brain tissue. In a postmortem examination, the pathologist examines the tissues to determine the cause of death and identify any underlying diseases or conditions. By performing a microscopic examination of the brain tissue, the pathologist can further investigate any abnormalities or diseases that may have contributed to the individual's death.
37.
Clotting factor VII.
Correct Answer
D. 85230
38.
IV push of one antineoplastic drug.
Correct Answer
B. 96409
Explanation
FROM MEDICINE SECTION : INJECTION AND INTRAVENOUS INFUSION CHEMOTHERAPY AND OTHER HIGHLY COMPLEX DRUG OR HIGHLY COMPLEX BIOLOGIC AGENT ADMINISTRATION.
39.
One-half hour of IV chemotherapy by infusion followed by IV push of a different drug.
Correct Answer
B. 96413; 96411
Explanation
The correct answer is 96413; 96411. This code combination represents the administration of two different drugs through intravenous (IV) methods. The first code, 96413, denotes the infusion of one drug over a half-hour period. The second code, 96411, represents the IV push administration of another drug. This combination accurately reflects the scenario described in the question.
40.
Caloric vestibular test using air.
Correct Answer
C. 92700
Explanation
The correct answer is 92700. The given information indicates a series of codes, and the correct answer is the last code in the sequence.
41.
Patient presents to the emergency room with chest pains. The patient is admitted as a 23-hour observation. The cardiologist orders cardiac workup and the patient undergoes left heart catheterization via the left femoral artery with visualization of the coronary arteries and left ventriculography. The physician interprets the report. Code the heart catheterization.
Correct Answer
C. 93458
Explanation
The correct answer is 93458. This code is appropriate because the patient underwent left heart catheterization via the left femoral artery with visualization of the coronary arteries and left ventriculography. Code 93458 specifically represents left heart catheterization including coronary angiography, ventriculography, and left heart catheterization.
42.
Patient with hematochromatosis had a therapeutic phlebotomy performed on an outpatient basis.
Correct Answer
A. 99195
Explanation
The correct answer is 99195. In this scenario, the patient with hematochromatosis underwent a therapeutic phlebotomy, which involves the removal of blood to reduce the iron overload in the body. The code 99195 specifically represents a phlebotomy performed on an outpatient basis, making it the most appropriate choice in this case. The other options (36522, 36514, 99199) do not accurately describe the procedure or the setting in which it was performed.
43.
A physician performs a PTCA with drug-eluting stent placement in the left anterior descending artery and angioplasty only in the right coronary artery.
Correct Answer
B. 92928-LD; 92920-RC
Explanation
The correct answer is 92928-LD; 92920-RC. This answer indicates that the physician performed a PTCA with drug-eluting stent placement in the left anterior descending artery (LAD) and angioplasty only in the right coronary artery (RCA). The codes 92928-LD and 92920-RC specifically represent these procedures, with LD indicating the LAD and RC indicating the RCA.
44.
Transesophageal echocardiography (TEE) with probe placement, image, and interpretation and report.
Correct Answer
D. 93312
Explanation
The correct answer, 93312, refers to the performance and interpretation of a transesophageal echocardiography (TEE) procedure. TEE involves inserting a probe into the esophagus to obtain detailed images of the heart and surrounding structures. The procedure provides valuable information about the structure and function of the heart, allowing for the diagnosis and monitoring of various cardiac conditions. The code 93312 includes both the placement of the probe and the interpretation and reporting of the images obtained during the procedure.
45.
Which code listed below would be used to report an esophageal electrogram during an EPS?
Correct Answer
B. 93615
Explanation
The code 93615 would be used to report an esophageal electrogram during an EPS.
46.
Cardioversion of cardiac arrhythmia by external forces.
Correct Answer
C. 92960
Explanation
The correct answer is 92960 because it is the only code that specifically refers to cardioversion of cardiac arrhythmia by external forces. The other codes listed are not related to cardioversion.
47.
Osteopathic manipulative treatment to three body regions.
Correct Answer
A. 98926
Explanation
The correct answer is 98926. This code represents osteopathic manipulative treatment to three body regions. Osteopathic manipulative treatment is a hands-on approach used by osteopathic physicians to diagnose, treat, and prevent illness or injury. In this case, the treatment is focused on three specific body regions. The other codes listed (98941, 97110, 97012) are not relevant to osteopathic manipulative treatment or do not specify the number of body regions being treated.
48.
Patient presents to the Respiratory Therapy Department and undergoes a pulmonary stress test. CO2 production with O2 uptake with recordings was also performed.
Correct Answer
D. 94621
Explanation
The correct answer is 94621. This code represents the performance and interpretation of a pulmonary stress test, which includes measurements of CO2 production and O2 uptake. The other codes listed are not specific to pulmonary stress tests or do not include the necessary components for this particular scenario.
49.
Patient presents to the hospital for debridement of a diabetic ulcer of the left ankle. The patient has a history of recurrent ulcers. Medication taken by the patient includes Diabeta and the patient was covered in the hospital with insulin sliding scales. The decubitus ulcer was debrided down to the bone.
Correct Answer
C. 11044
Explanation
The correct answer is 11044 because this code represents the debridement of a full-thickness skin and subcutaneous tissue ulcer. The patient's ulcer was debrided down to the bone, which indicates a deep tissue ulcer. The other codes listed do not accurately represent the depth of the ulcer or the extent of the debridement.
50.
Patient presents to the emergency room following a fall from a tree. X-rays were ordered for the left upper arm, which showed a fracture of the humerus shaft. The emergency room physician performed a closed reduction of the fracture and placed the patient in a long term spica cast. Code the diagnoses and procedures, excluding the x-ray.
Correct Answer
A. 24505-LT
Explanation
The correct answer is 24505-LT. This code represents the closed reduction of the fracture of the humerus shaft performed by the emergency room physician. The addition of "LT" indicates that the procedure was performed on the left side.