Test Your CPT Knowledge

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Multiple Choice

X 1.
Which answer is FALSE and not included in CPT Surgical Package?

a. CPT Surgical Package includes writing of orders and evaluating the patient in
post-anesthesia recovery area

b. E/M service subsequent to decision for surgery on the day before or day of
surgery per CPT Surgical Package

c. CPT surgical package is inclusive of a minimum of 45 to maximum of 90 days

post-op

d. Digital blocks, topical anesthesia are included in CPT Surgical Package

c is the correct answer. Per CPT Surgical Package there are no guidelines on
minimum or maximum days. The surgical packages which can be from 0 -90
days are determined by the procedure performed.

X 2.
Patient is seen by dermatologist for Mohs Micrographic Surgery for removal of
complex skin cancer on their face. During this encounter the dermatologist
removes a total of 4 blocks in the first stage and 3 blocks in the second stage. A
pathologist (in the same office) assesses the pathology of each lesion/block that
is removed. How would the Dermatiologist bill for the Mohs surgery?

a. 17311, 17312

b. 17311, 17312, 88314

c. 17311-TC, 17312-TC

d. Mohs cannot be billed by the dermatologist

d is the correct answer. The dermatologist cannot bill for Mohs micrographic
surgery. Per CPT guidelines it requires the individual function in two separate
and distinct capacities, surgeon and pathologist. If either of these responsibilities
 is delegated to another physician or qualified health care profession Mohs
Micrographic surgery cannot be reported.

X 3.
This 10 month-old baby is diagnosed with severe laryngomalacia. The surgeon
is performing a laser supraglottoplasty to remove lesions from the larynx. Dr.
Smith (anesthesiologist) was call to administer the anesthesia. Dr. Smith noted
the patient had severe systemic disease. How would the anesthesia be
reported for this procedure?

a. 31572, 00326-P3, 99100

b. 31572, 00326-P3

c. 00326-P3, 99100

d. 00326-P3

d is the correct answer. The question is asking how the anesthesia would be
reported for this procedure and not the surgeon. P3 physician status modifier
would be added as noted by the anesthesiologist. Code 99100 (qualifying
circumstance) is included in code 00326 and not charged separately.

X 4.
Physician performa a bronchoscopy with two transbronchial lung biopies
from a single (same) lobe. What is the correct CPT code(s) for this procedure?

a. 31632

b. 31628, 31628-51

c. 31628

d. 31628, 31632

c is the correct answer. a. Code 31632 is an add-on code and never used by itself.
b.31628 - Parentheticals below code indicated report only once regardless of how
many transbronchial lung biopsies are performed in a lobe. d. this is not an
additional lobe, taken from same lobe

X 5.
This 28 year-old patient was brought into the office for severe dehydration
from vomiting. The nurse started the IV and the patient was given 2 units or
1000 ml of normal saline for 1 hour and 40 minutes. What CPT code(s) would
be used to report this encounter?
 a. 96360, 96361, J7040 x 2

b. 96365, 96360, 96361, J7040 x 2

c. 96360, 96361

d. 96365, 96366

a is the correct answer. Code 96365 and 96366 are for administering drugs
intravenously. Hydration codes are 96360-96361. Use of local anesthesia, IV start,
access to indwelling IV, subcutaneous catheter or port, flush at conclusion of
infusion, standard tubing, syringes and supplies are included but can charge for
the normal saline.

X 6.
Marie has been going to her family physician, Dr. Johnson since a child. When
she became pregnant she wanted her family physician to deliver her child.
Marie had 10 visits with Dr. Johnson before going into labor. After 12 hours of
labor, the baby showed signs of fetal distress and an obstetrician, Dr. Cobb was
called in to perform a C-section. Dr. Johnson will perform the postpartum care.
How would Dr. Johnson and Dr. bill for their services?

a. Dr. Johnson - 59510 Dr. Cobb - 59514

b. Dr. Johnson - 59426 Dr. Cobb - 59515

c. Dr. Johnson - 59426, 59430 Dr. Cobb - 59514

d. Dr. Johnson - 59618, 59622 Dr. Cobb - 59620

c is the correct answer. The total OB package would not be charged by Dr.
Johnson because he did not perform the delivery. Dr. Johnson would only charge
the 59426 for the antepartum visits. Dr. Cobb would only charge for the c-section
because Dr. Johnson will perform the postpartum care. The total OB package
would not be charged by either physician because neither of them. Code 59618 is
for a cesarean delivery after a previous cesarean delivery.

X 7.
Codes 22849 - 22852, 22855 are subject to modifier 51 if reported with other
definitive procedure including.......

a. Insertion of anterior instrumentation, arthroplasty

 b. Vertebral segments, insertion of interbody biomechanical device

c. Arthrodesis, decompression and exploration of fusion

d. Total disc arthroplasty, internal spinal fixation

c is the correct answer.

Read the guidelines under Spinal Instrumentation

X 8.
Physician is performing a therapeutic colonoscopy on a 62 year-old male
patient. He was able to obtain a biopsy in the splenix flexure but unable to
advance the scope to the cecum.  What is the correct CPT code for this
procedure?

a. 45380 - 52

b. 45331 - 52

c. 45380 - 53

d. 45331 - 53

a is the correct answer.

See colonoscopy decision tree in digestive system for a therapeutic procedure

beyond splenic flexure but not to the cecum.  Modifier 52 is added to the procedure
of removal of biopsy.

X 9.
Which answer is TRUE for definiton of physician or other quealified health
care professional?

a. These individual are physicians or other qualified health care professionals to

include doctors, PA, NP, MA or nurses with documented license to perform and
report services independently

b. These are individuals that are qualified by education, training, licensure and
report the professional services independently

c. These are individual such as medical assistant who works under the
supervision of a physician and reports the professional services they perform
 d. These individuals are clinical staff members who report professional services
performed

b is the correct answer.

X 10.
Patient comes into the office for a 0.2 wound on their face.  Physician closed
the wound using adhesive strips.  How is this encounter coded?

a. 12011

b. Appropriate E/M code for office visit

c. 12020

d. 12001

b is the correct answer.

Per CPT guidelines for repair when the sole repair is done using adhesive strips use
E/M codes and not repair codes.

X 11.
This 5 year-old child comes into the office for a routine follow-up of their
asthma. The physician recommend the child have a flu shot due to their
history of asthma, and is also due for second MMRV. The physician answered
all the questions of the mother and the decision was made to perform both
vaccines.  The mother also requested the flu vaccine by given intranasal
(LAIV).  How would these vaccines administered be coded?

a. 90471, 90472 x 2, 90664, 90707

b. 90471, 90472, 90473, 90664, 90713

c. 90460, 90461, 90473, 90664, 90710

d. 90460, 90461 x 4, 90664, 90710

d is the correct answer.

Counseling was performed which are codes 90460, 90461 and includes any route of
administration. MMRV and influenza virus are considered a total of 5 components. 
90713 is for a MMR and not a MMRV.
X 12.
Paatient is diagnosed with a lung mass. The surgeon performs a biopsy and
sends the specimen to pathology for a microscopic examination.  The
pathology report identifies the mass as a malignant, wedge biopsy.  How is this
coded by the pathologist?

a. 88307

b. 88305

c. 32096, 88307

d. 32096, 88305

a is the correct answer.

Question is asking how the pathologist would code and not the surgeon.  Code 88305
is for a transbronchial biopsy.

C 13.
Patient had a spinal tap performed in the am by his surgeon.  That evening
they presented to the Emergency Department with a severe headache.  The ED
doctor diagnosed them with a leak from the spinal puncture and an epidural
injection of a blood patch was performed.  What is the code(s) for this
procedure? 

a. 62273

b. 62272, 62320

c. 62270, 62273, 62320

d. 62273, 62320

a is the correct answer.

Code 62310 is for injection of a therapeutic substance and this is not identifed in the
documentation.  Code 62272 and 62270 are for a spinal puncture and this is a
procedure for a blood patch. 

X 14.
Patient is admitted to the hospital on Sunday for chest pain and is discharged
on Wednesday.
 Sunday - Physician perform a comprehensive history, comprehensive exam
with high medical decision making.

Monday - Physician performs a expanded problem focused history, detailed

exam and medical decision making is high

Tuesday - Physician performs a problem focused history, expanded problem

focused exam and medical decision making is moderate

Wednesday - Physician performs a problem focused history, expanded

problem focused exam and medical decision making is low. He documented 40
minutes of discharge services.

How would these hosptial visits be charge by the physician. 

a. 99220, 99226, 99225,99224, 99239

b. 99223, 99233, 99232, 99239

c. 99223, 99232, 99232, 99231, 99239

d. 99223, 99233, 99231, 99239

b is the correct answer.

This is an admission and proper codes are 99221 - 99233. 99220 codes are for
observation only.  Admission codes are 3 of 3 components and subsequent visits are
2 of 3 components.  You cannot charge a subsequent visit with a discharge code.

C 15.
What is the difference between observation codes 99218 - 99226 and
observation codes 99234 - 99236?

a. 99218 - 99226 are for admit discharge on the same day in observation. Codes
99234 - 99236 are used for patients in observation over a calendar day.

b. 99218 - 99226 are for patients in observation over a calendar day. Codes 99234
- 99236 are used for patients admitted and discharged on the same day.

c. 99218 - 99226 are only used for outpatient consultations in observation for
Medicare patients. 99234 - 99236 are used for admission to observation for
Medicare patients.

d. The only difference in these codes is where the patient is located in the
hospital for observation.