CPT Final exam

CPT Category I codes are updated annually with additions, revisions, and deletions that become effective on January 1 of each year.
True False

CPT Category III codes are temporary codes that represent emerging medical technologies, services, and procedures that have not yet been approved for general use by the FDA, are not otherwise covered by CPT codes, and are composed of four numbers followed by the capital letter F.
True False

A physician can report any CPT code in the codebook for a procedure and/or
service regardless of physician specialty.
True False

Main entries in the Alphabetic Index of the CPT codebook are based on which of the following.
A. Conditions or diagnoses
B. Procedures, services, or examinations
C. Synonyms, eponyms, or abbreviations
D. Organs or other anatomic sites
E. All of the above

CPT and HCPCS codes apply to services provided and reported by which of the following
A. Physicians
B. Ambulatory surgery centers
C. Hospital-based inpatient 
D. Hospital-based outpatient
E. A, B, and D
F. All of the above

All of the following statements are true of CPT except
A. CPT stands for Current Procedural Terminology
B. CPT is published by the American Medical Association
C. CPT codebook includes CPT Category I, II, and III codes along with several additional appendices and an index of procedures.
D. CPT includes codes for injectable drugs, ambulance services, prosthetic devices, and selected provider services.
E. All of the above are true statements.

The symbol + before a code in CPT means
A. This is an add-on code.
B. This code can never be reported alone or first.
C. This code indicates that the use of moderate sedation is an inherent part of the procedure.
D. A and B
E. All of the above.

A modifier allows the provider to explain a special circumstance(s) that is/are not included in the basic definition of the CPT code reported and may or may not effect reimbursement.
True False

Modifier 73 is used to report a discontinued procedure by the physician because of risk to the patient’s health prior to surgical preparation or induction of anesthesia.
True False

Codes designated as “separate procedure” are considered an inherent component of the other more comprehensive or major surgical procedure performed and should not be separately reported unless it is performed independently, is related to the other procedure(s), or is a distinct procedural service which meets one of the criteria listed for use with modifier 59.
True False

If a procedure is included in the heading of an Operative Report but is not substantiated by documentation in the body the coder should do the following:
A. Assign the appropriate code as stated in the Procedure heading at the top of the Operative Report without further clarifying with the physician.
B. Do not assign the code and ask the physician for clarification.
C. If procedure was performed have the physician dictate an addendum to the Operative Report and then assign the appropriate code.
D. B & C
E. All of the above are true statements.

This modifier is used by both hospitals and physicians for a procedure that has been planned prospectively at the time of the original procedure, may be more extensive, or may be for therapy following a diagnostic surgical procedure.
A. Modifier 51
B. Modifier 58
C. Modifier 59
D. Modifier 22

Modifier 59 should be appended to a procedure/service in all of the following circumstance(s) except
A. Different procedure or surgery
B. Different site or organ system
C. Different session or patient encounter
D. To a code designated as a “separate procedure” when integral to the other major procedure(s) performed during the same operative session.
E. All of the above are true

Multiple wound debridements (i.e., debridement of an ulcer) should be summed together for those of the same depth and a separate code(s) should be assigned for debridements at different depths.
True False

When coding excision of lesions (benign or malignant), the total size of the excised area, including margins, are added together in order to determine the entire excised diameter; however, for asymmetrical lesions the greatest diameter of the lesion is used to determine the maximum size of the lesion, along with addition of any margins.
True False

Destruction of 16 premalignant lesions should be reported with codes 17000 and 17004.
True False

All of the following are true of adjacent skin graft codes except
A. These codes are categorized first by body part involved and then by size of defect in square centimeters.
B. Codes do not include the lesion excision and a separate code should be reported.
C. An additional code may be reported to describe any skin grafting required to close the secondary defect.
D. Z-plasty, W-plasty, and V-Y plasty are all tissue transfers, but differ depending on type of incision and how the tissue transfer is performed.
E. All of the above are true.

All of the following are true of wound repairs/closures except
A. When more than one classification of wounds is repaired, the most complicated repair is listed first, followed by the less complicated repairs.
B. When multiple wounds are repaired, you should add together the lengths of those in the same classification and from all anatomic sites that are grouped together into the same code descriptor.
C. An intermediate wound repair goes beyond a layer closure and requires that one or more of the deeper layers of the subcutaneous tissue and superficial fascia, as well as the skin, be closed in layers, and requires Debridement or retention sutures.
D. Debridement may be reported separately only when gross contamination requires prolonged cleansing, considerable amounts of devitalized or contaminated tissue are removed, or debridement is carried out separately without immediate primary closure.
E. All of the above are true

Non-segmental instrumentation such as a Harrington rod is a type of posterior instrumentation and can be reported alone with no other procedure codes.
True False

Manipulation refers to the attempted reduction or restoration of a dislocated joint or fracture and there are different codes to report if the fracture/dislocation is performed “with manipulation” or “without manipulation.”
True False

A casting or strapping application code can be reported in addition to the fracture treatment code such as a closed reduction without manipulation.
True False

All of the following are true of open fracture/dislocation treatment codes except
A. The open fracture treatment codes always includes internal and external fixation if performed.
B. Treatment of the fracture/dislocation includes exposing the site via a surgical incision.
C. Treatment of the fracture/dislocation can involve the fractured bone being opened remote from the fracture site in order to insert an intramedullary nail across the fracture site.
D. All of the above are true.

All of the following are true of knee arthroscopy codes except
A. Arthroscopic synovectomy (limited) of the left knee is coded to 29875-LT
B. There are three different or separate compartments of the knee which for coding purposes are the medial, lateral, and patellofemoral. If a procedure designated as a “separate procedure” in the code descriptor is performed in a separate compartment of the knee from the other major or comprehensive procedures performed during the same operative session which are not designated as a “separate procedure” modifier 59 is appropriate to use and should be appended to the code designated as a “separate procedure.”
C. When a diagnostic knee arthroscopy procedure is performed in addition to the surgical knee arthroscopy procedure a code should be reported for each arthroscopic procedure.
D. All of the above are true.

A bronchial alveolar lavage (BAL) is performed to collect cells from
peripheral lung tissue and is reported with code 32997.
True False

A diagnostic nasal/sinus endoscopy is not separately reported when performed
in conjunction with a surgical endoscopy.
True False

When an operating microscope is used during a laryngoscopy it should be separately reported in addition to the laryngoscopy code.
True False

All of the following are true of bronchoscopies except
A. surgical bronchoscopy includes a diagnostic bronchoscopy.
B. Bronchoscopy performed with or without cell washings is coded to 31622.
C. Transbronchial lung biopsy performed in two separate lobes should be reported with codes 31628 and 31632.
D. If fluoroscopic guidance is used
to perform a bronchial alveolar lavage a separate code should be reported
for the fluoroscopic guidance.
E. All of the above are true

Which type of laryngoscopy allows the physician to look directly at the larynx,
a microscope may also be used during the procedure, and the patient is usually placed under general anesthesia?
A. Indirect
B. Direct
C. Flexible fiberoptic
D.  Both A and B

A redo quadruple coronary bypass performed three (3) years post original procedure with a combination of three (3) saphenous veins and an internal mammary artery is coded as follows: 33533, 33518, 33530.
True False

Removal of central venous access devices should be coded; however, some catheters do not warrant a separate code when no surgical procedure is required and the catheter is simply pulled out.
True False

When reporting percutaneous thrombectomy of a graft assign code 36870. Additional procedures may be reported to identify the punctures of the graft. Two punctures are usually performed; however, code 36145 is reported only one time.
True False

The surgeon performs an open thrombectomy of an AV fistula, without revision of the dialysis graft. What is the correct code assignment?
A. 36832
B. 36833
C. 36831
D. 36870

All of the following are true regarding cardiac catheterizations except
A. Most cardiac catheterization procedures typically require only one CPT code to describe catheter placement, the injection procedure, and for imaging supervision and interpretation; however, in some cases more than one code may be necessary.
B. Certain procedures such as introduction, positioning, and repositioning of the catheter(s), recording of pressures, drawing blood samples for gases and/or dilution, and measuring cardiac output are performed during a cardiac catheterization and are considered inherent to the procedure.
C. Codes 93452 and 93567 should be reported for a combined right and left cardiac cath with left ventriculography and supravalvular ascending aortography.
D. Medications such as nitroglycerine which are often infused during cardiac catheterization procedures are considered an intrinsic part of the catheterization procedure and as a result a code for the infusion of the medications should not be assigned.
E. All of the above are true

An additional code should be assigned to identify a D&C when performed with a hysteroscopic biopsy and polypectomy.
True False

A therapeutic cystourethroscopy always includes a diagnostic cystourethroscopy.
True False

When a physician provides all maternity care for a patient from start to finish codes for antepartum visits, a labor and delivery code, and the postpartum visit should all be reported.
True False

All of the following are true in regards to female genital system coding except
A. Colposcopies are reported with codes 57420-57421 and 57452-57461 and are differentiated by the area visualized and additional procedures performed during the endoscopy.
B. A LAVH is a surgical procedure that uses a laparoscope to remove the uterus and/or fallopian tubes and ovaries through the vagina and is reported with codes 58550-58554.
C. Vaginal hysterectomy with salpingo-oophorectomy with a uterus weight of 250 g is reported with code 58262.
D. Laparoscopic removal of 2 fibroids is reported with codes 58545 and 58545-51.
E. All of the above are true

Patient was admitted to the hospital with sharp pelvic pains. A pelvic ultrasound was ordered and the results showed a possible ovarian cyst. The patient was taken to the OR where a laparoscopic destruction of two corpus luteum cysts was performed. Which of the following codes is correct?
A. 58925
B. 58662
C. 58561
D. 49321

A discogram with radiologic supervision and interpretation performed at L2-3 and L3-4 should be reported with codes 62290 x 1 and 72295 x 1.
True False

Endovascular occlusion procedures for treatment of vessels can be permanent or temporary and depending on the code reported radiological supervision and interpretation is already included in the surgical CPT code and should not be separately reported with a radiology code.
True False

Injection of air into the anterior chamber of the right eye along with removal of a blood clot from the anterior segment of the same eye should be coded as: 65930-RT, 66020-RT.
True False

All of the following are true in regards to nervous system coding except
A. Transforaminal injections utilizes an anesthetic and/or steroidal agent that is injected into the epidural space through the nerve root foramen and is reported with codes 64479-64484.
B. Spinal cord neurostimulators can be placed percutaneously or open and components include the pulse generator or battery, a lead or leads, and electronic analysis and programming of the pulse generator.
C. Hemilaminectomy codes are based on the anatomic location of the specific interspace involved, are inherently unilateral so if performed bilaterally, modifier 50 should be appended to the code(s), and are reported with codes 63020-63044.
D. Paravertebral facet joint injections with an anesthetic and/or steroidal agent (64490-64495) and paravertebral facet joint nerve destruction by a neurolytic agent (64633-64636) are reported the same: one time per individual nerve treated.
E. All of the above are true.

A patient has metastatic brain lesions. The patient undergoes stereotactic radiosurgery gamma knife of two (2) simple lesions. Which of the following is the correct code assignment?
A. 61798, 61799
B. 61796, 61797
C. 61796, 61797
D. 63620, 63621

When reporting a code that includes radiologic supervision and interpretation in the code descriptor modifier 26 should not be appended to the procedure code because the code already describes the professional component in the code descriptor.
True False

All tests listed in a panel code must be performed in order for that code to be reported. When some, but not all, of the tests in the panel are performed, the individual CPT codes should be reported, rather than the panel code.
True False

A non-selective catheterization code(s) may be reported in addition to a selective catheterization procedure(s) if the non-selective cath necessitated a separate or different puncture and modifier 59 should be appended to the non-selective catheterization code(s).
True False

All of the following are true regarding coding for selective catheterizations except for which of the following.
A. Assign a code to the highest order catheter placement within the same vascular family.
B. Catheter placements in different vascular families should be separately reported and modifier 59 should be appended to the lesser order code(s).
C. Multiple catheterizations of additional 1st/2nd/3rd order placements within the same vascular should be separately reported with code 36218. 
D. Cervicocerebral angiographies via selective catheterization are reported with codes 36222-36228 and include both the catheter placement and angiography and should not be reported with selective catheterization codes 36215-36218.
E. All of the above are true.

A patient undergoes a retrograde urethrocystogram in the urologist’s office. The urologist performs both the injection and the supervision and interpretation. What is the correct code assignment for this physician?
A. 51610, 74450
B. 74450-26
C. 51610, 74450-26
D. 74450

A 6 year old girl presents to the pediatrician’s office with her mother for a routine well-child check which includes administration of several vaccines. The physician does not provide counseling and the nurse administers all appropriate vaccines. The pediatrician’s office would report the appropriate vaccine product codes in addition to administration codes 90460 and 90461 depending on the # of components included in each vaccine.
True False

Physician interprets and reads an EKG that was performed at the hospital. The appropriate code that should be reported by the physician for his part is 93010.
True False

Physical status modifiers should be appended to an anesthesia services code in order to communicate to the payer that anesthesia services were provided under difficult circumstances because of the patient’s condition, operative conditions, or unusual risk factors.
True False

All of the following are true of modifiers used in reporting anesthesia services except which of the following.
A. National code modifiers or HCPCS Level II modifiers such as AA, QK, QZ, etc should be appended to the anesthesia services code(s) depending upon the specialty of the provider administering and monitoring the anesthesia services.
B. Modifier 47 – Anesthesia by Surgeon is never used as a modifier for the anesthesia service codes section (00100-01999) in the CPT book.
C. A physical status modifier should be used in order to distinguish between various levels of complexity of the anesthesia service provided. For example a patient who has diabetes mellitus should be reported with physical status modifier P1.
D. Modifier 53 is appended to the appropriate anesthesia services code when the physician elects to terminate or discontinue a procedure, usually because of risk to the patient’s well-being.
E. All of the above are true.

All of the following are true when coding Infusions and Injections except for
A. Only one initial code should be used unless two separate IV sites are used and the initial code is based on the primary reason for the encounter.
B. An infusion of 15 minutes should be coded as a push.
C. Therapeutic, prophylactic, and diagnostic injection codes are differentiated based on route of administration and injection status (i.e., was it the initial service or subsequent).
D. Multiple substances mixed in one bag for an IV infusion should be coded with multiple codes for each substance and multiple codes for administration of the infusion.
E. All of the above are true statements.