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Medical Tests American Academy of Professional Coders: Certified Professional Coder Sample Questions (Q91-Q96):NEW QUESTION # 91
A 79-year-old female patient is admitted to a skilled nursing facility for continued monitoring as she completes her course of antibiotics for bronchitis. Upon admission, a nurse practitioner spends 20 minutes with the patient, performing an evaluation of recovery and rebuilding of stamin a. On day 3, the patient's physician completes an initial comprehensive assessment and determines the patient is recovering well on her current dosage of antibiotics. What CPT code should be reported on day 3?
Answer: B
Explanation:
CPT defines an initial nursing facility service (NFS) as "the first encounter with the patient by the admitting physician to nursing facilities." Although the patient can be evaluated and treated by other medical staff in the meantime, only the physician responsible for the admission may report the initial comprehensive visit (99304-99306). If other medical personnel do provide treatment, those visits would be reported using the subsequent nursing facility care encounter codes (99307-
99310). Nursing facility care services require a medically appropriate history and/or examination, and a review of medical decision making. In this scenario, the number and complexity of problems addressed at the encounter is low (one stable, acute illness), the amount and/or complexity of data reviewed or analyzed is straightforward (minimal or none), and the risk of complications and/or morbidity or mortality of patient management is moderate (prescription drug management). After considering that the patient is established, the level of complexity for the visit is considered low and the encounter should be reported with CPT code 99304.
NEW QUESTION # 92
A patient presents to physical therapy status post repair of a complete rotator cuff tear in the right shoulder due to a fall. After applying ice to the shoulder for 8 minutes, the physical therapist performs a soft-tissue massage to the infraspinatus muscle that lasts 23 minutes. Just prior to discharge, the therapist spends 20 minutes instructing the patient on isokinetic exercises to help improve range of motion. Which CPT and ICD-IO-CM code(s) should be used to accurately describe encounter?
- A. 97110, 97010, S46.011D, W19,XXXD
- B. 97010, 97140x2, 97530, M75.121
- C. 97010, 97140, 97530, S46.011A,W19XXXA
- D. 97110, 97140, 97010, Z48.89, S46.091A, W19XXXA
Answer: A
Explanation:
Although CPT code 97530 does describe therapeutic activities, the focus is directed at improving functional performance, whereas the correct CPT code 97110 works to develop range of motion. The CPT code for a soft tissue massage (or manual therapy 97140) is based on 15-minute increments, however, anything over 8 minutes prior to or after can be counted as a unit. Based on this, the 23 minutes spent can be counted as two units. Sequencing is based on highest RVU.
Coding crosswalk for a rotator cuff tear is classified as a muscle strain, so answer B, which specifies
"other injury," can be eliminated. Because the patient is in the recovery period of the injury, the seventh character would not be considered active but subsequent.
NEW QUESTION # 93
Dr. Black orders a hepatitis panel for a patient who has recently returned from traveling abroad and is now experiencing lower abdominal pain. The laboratory completed a hepatitis A antibody test, hepatitis B core antibody test, and a hepatitis C antibody test. Select the CPT and the ICD-IO-CM codes that the laboratory will report.
- A. 86709, 86705, 86803, RIO.30
- B. 86709, 86705, 86803, RIO.31, RIO.32
- C. 80074, RIO.30
- D. 80074-52, RIO.30
Answer: A
Explanation:
The hepatitis B surface antigen test was not performed, so the actual panel code in answer A was not completed, leaving each test to be reported separately. It would not be appropriate to add modifier 52 to 80074 in answer B. Because the provider did not specify which side the lower abdominal pain was on, it would be reported as unspecified with RIO.30, eliminating answer C.
NEW QUESTION # 94
A patient opts to replace his semi-rigid penile prosthesis with a multicomponent, inflatable penile prosthesis. What CPT code(s) should the urologist report if this was completed in one encounter?
- A. 54405, 54415-51
- B. 0
- C. 1
- D. 54415, 54405-51
Answer: B
Explanation:
Penile prosthesis procedure codes are based on the type of prosthesis being used. In this scenario, a semi-rigid prosthesis is being replaced by a multicomponent inflatable one. Currently, there are no CPT codes that encompass the removal of one type of prosthesis and insertion of another type. The most common course of action might be to code the removal and insertion separately and amend a multi-procedural modifier on the secondary code. However, CPT 54415 indicates that the prosthesis removed was not replaced by another, which is an inaccurate description of services rendered. In this case, only the insertion (CPT 54405) should be reported because it has the highest RVU value.
NEW QUESTION # 95
A gastroenterologist performs a gastric bypass surgery on an obese patient with a body mass index of 52. During the procedure, the size of the stomach is reduced by 77%; the intestine is bypassed from the duodenum and then attached to the ileum. The pylorus is preserved and left intact. Which CPT code best describes the surgery performed?
Answer: A
Explanation:
In this scenario, the gastroenterologist performed a procedure known as a biliopancreatic diversion with duodenal switch (BPD/DS). A BPD/DS removes a portion of the stomach and transfers parts of the duodenum and small intestine to the lower end of the large intestine in an effort to limit intestinal absorption for weight loss. CPT codes 43842-43843 describe gastric restrictive procedures without gastric bypass. However, gastric bypass was done in rearranging the small intestine to connect to the ileum.
NEW QUESTION # 96
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