Deck 4: Foundations of CPT

Question 1

The CPT manual sections are divided into subsections based on:

A) Eponyms, procedures, conditions, and root procedures
B) Anatomical sites, procedures, conditions, eponyms, or descriptive headings
C) Descriptive headings, body systems, and root procedures
D) Anatomical sites, root procedures, body systems, and eponyms

Answer 1

Anatomical sites, procedures, conditions, eponyms, or descriptive headings

Question 2

Harry is being seen for follow up in the doctor's office today after sustaining a broken wrist three weeks ago. Harry suffered this injury by falling off a ladder while at work. His services are being covered under his employer's Workers' Compensation insurance. The coder should append a modifier _____ to each service Harry receives for this condition.

A) 62
B) 57
C) 32
D) 78

Answer 2

32

Question 3

A summary of resequenced CPT codes is found in Appendix:

A) N
B) F
C) G
D) A

Answer 3

N

Question 4

How often is the CPT manual updated?

A) annually
B) quarterly
C) monthly
D) bi-annually

Question 5

In CPT, the star symbol:

A) designates the use of moderate sedation is included in the code description and is not to be reported separately
B) designates a new code for the current edition of the manual
C) designates that a code is an additional code to be used with the primary procedure and never to be used alone
D) designates codes that may be used to report telemedicine services when appended with modifier 95

Question 6

In CPT, the facing triangles designate:

A) the verbiage preceding it in a stand-alone code is shared with all dependent codes that follow it
B) Modifier 51 is not to be used with the code
C) the portion of the text describing a guideline or note has been revised for the current edition of the manual
D) a code is an additional code to be used with the primary procedure and never to be used alone

Question 7

What is the description of Modifier 66?

A) Surgical team
B) Minimum assistant surgeon
C) Two surgeons
D) Assistant surgeon

Question 8

Each section of the CPT manual is divided into subsections based on all of the following except:

A) Anatomical site
B) Descriptive heading
C) Eponym
D) Routes of administration

Question 9

Patient is ordered to return to the operating room to treat an infection of the surgical wound from a surgery she had on the abdomen three days ago. The coder will assign modifier _____ to the procedure code describing the cleaning and debridement of the infected wound.

A) 77
B) 80
C) 78
D) 90

Question 10

CPT code updates occur in which quarter of each year?

A) Third
B) Fourth
C) First
D) Second

Question 11

Bilateral procedure is the description for which modifier?

A) 66
B) 80
C) 58
D) 50

Question 12

Staged or related procedure or service by the same physician during the postoperative period is modifier:

A) 58
B) 79
C) 80
D) 91

Question 13

Which organization is responsible for updates of the CPT manual?

A) American Hospital Association
B) American Medical Association
C) American Academy of Professional Coders
D) American Physicians Association

Question 14

In January, a coder is looking for a code in the Medicine section that she used last October to bill for a service the physician performed in the office. In looking through her new edition of the CPT manual, she can no longer locate the code she used last year. To see if this code has been deleted or revised, the coder would look in which Appendix of the CPT manual?

A) A
B) K
C) B
D) E

Question 15

Modifier 56, Preoperative care only, would be applicable in which situation:

A) A patient is diagnosed with acute appendicitis, and major surgery is performed the following day
B) A physician sees a patient in the office and by ordering lab work and diagnostic tests determines the patient needs a surgical procedure. The physician is located in a rural area where the procedure is not available and transfers the care of the patient to a surgeon
C) A patient presents with symptoms of hypoglycemia and is sent to the lab for a fasting blood glucose and then is sent back to the lab later on the same day to check on levels after treatment
D) Within the postoperative period of a hernia repair, the patient reherniates after moving furniture within his home. The patient is seen by a new surgeon who surgically repairs the hernia

Question 16

Modifier 57 represents:

A) Assistant surgeon
B) Distinct procedural service
C) Preoperative care only
D) Decision for surgery

Question 17

Distinct procedural service is represented by modifier:

A) 59
B) 79
C) 78
D) 58

Question 18

All of the following are major steps in locating the appropriate CPT code except:

A) Determine any modifying circumstances that require the use of a modifier
B) Review all section-specific instructional notes and guidelines
C) Locate the main term and subterm in the alphabetic index
D) Determine if any edits occur for which use of a modifier would guarantee reimbursement

Question 19

CPT is what level of the Healthcare Common Procedure Coding System?

A) II
B) IV
C) I
D) III

Question 20

A coder who codes primarily for an orthopedic surgeon who frequently performs nerve conduction studies in the office would reference which Appendix when assigning the appropriate CPT codes for the nerve conduction studies?

A) Appendix I
B) Appendix L
C) Appendix K
D) Appendix J

Question 21

Modifier 91, Repeat clinical diagnostic laboratory test, is used when:

A) After an open biopsy of a breast mass, the patient returns in the postoperative period for a total lumpectomy.
B) A provider sends the patient to a lab outside the clinic for testing. The lab has an agreement with the clinic to provide the service and will receive payment from the clinic.
C) A patient presents with symptoms of hypoglycemia and is sent to the lab for a fasting blood glucose and then is sent back to the lab later on the same day to check on levels after treatment.
D) During the same encounter, a patient has a biopsy of a suspicious lesion on the forearm and an excision of a mole on the chest.

Question 22

Main terms in the CPT index may be all of the following except:

A) condition
B) procedure
C) anatomical site
D) place of service

Question 23

The description "Assistant surgeon, when a qualified resident is unavailable," describes which modifier?

A) 91
B) 82
C) 99
D) 81

Question 24

All of the following are true of parenthetical notes except:

A) They are located above the code or code range to which the note applies
B) May inform the coder that the service or procedure described is part of the work of the code for the service or procedure code listed in the parenthetical note
C) They provide additional information regarding a code or code range
D) They are located below the code or code range to which the note applies

Question 25

Tracy, a coder for a large cardiology practice, has used the same CPT code to report EKG monitoring in the office for years. As she reviews her newly-revised edition of the CPT manual for the new year, she notes that this code now contains text enclosed in facing triangles. This means that:

A) Tracy may no longer report modifier 51 with this code when other services have been provided to the same patient in the office on that date of service
B) Moderate sedation may no longer be reported separately for this code
C) A portion of the text describing this code has been revised and Tracy must review the revised text carefully before assigning this code
D) This code is now an additional code that must be used with a primary procedure code; Tracy may no longer report this as a stand-alone code

Question 26

CPT code 36400 Venipuncture, younger than age 3 years, necessitating physician's skill, not to be used for routine venipuncture; femoral or jugular vein, is found in the ________ section.

A) Integumentary
B) Pathology and Laboratory
C) Medicine
D) Cardiovascular

Question 27

Modifier 53, Discontinued service, is appropriate in this scenario:

A) Patient, while away from home, fractures the bimalleolar, which is repaired surgically. Surgeon will not be following patient postoperatively.
B) Patient is receiving an organ transplant. One surgical team prepares the patient to receive the organ, and another team harvests and prepares the organ for transplant
C) After the start of a surgical procedure, the surgeon stops the procedure due to the patient's condition
D) After an open biopsy of a breast mass, the patient returns in the postoperative period for a total lumpectomy

Question 28

The acronym for Healthcare Common Procedure Coding System is:

A) HLCPCS
B) HPCS
C) HPC
D) HCPCS

Question 29

This Appendix contains a list of codes that have a lightning bolt symbol, indicating the product referenced in the code is pending FDA approval:

A) N
B) L
C) K
D) M

Question 30

Genetic testing code modifiers are found in Appendix:

A) N
B) The genetic testing code modifier appendix I has been deleted from the CPT manual.
C) G
D) M

Question 31

The CPT manual is made up of all of the following except:

A) Tabular List
B) Appendices
C) Category II codes
D) Category III codes

Question 32

When a local orthopedist follows up on a patient after his return home, following surgery while on vacation out of state, the following modifier would be applied to the service:

A) 25
B) 80
C) 55
D) 81

Question 33

Modifier 99 is described as:

A) Surgical team
B) Distinct procedural service
C) Multiple modifiers
D) Two surgeons

Question 34

Code 90935 Hemodialysis procedure with single physician evaluation is found in the ______ section of the CPT manual.

A) Medicine
B) Hemic and Lymphatic
C) Digestive
D) Endocrine

Question 35

To find a list of codes that are marked with a plus symbol, a coder would reference:

A) Alphabetic Index
B) Appendix D
C) Appendix K
D) Appendix A

Question 36

Appendix F includes:

A) Deleted CPT Codes
B) Product Pending FDA Approval
C) Summary of CPT Codes That Include Moderate (Conscious) Sedation
D) Summary of CPT Codes Exempt from Modifier 63

Question 37

The Radiology section is found in what code range?

A) 70000-79999
B) 70010-78999
C) 70000-78999
D) 70010-79999

Question 38

In CPT, the ____ symbol designates a new code for the current edition of the manual:

A) bull's-eye
B) triangle
C) bullet
D) null zero

Question 39

The Evaluation and Management section is within the following code range:

A) 10021-69990
B) 61000-64999
C) 60000-60300
D) 99202-99499

Question 40

Multiple procedures are represented by modifier:

A) 51
B) 50
C) 58
D) 59

Question 41

Modifier 62 is assigned in which scenario:

A) During an anterior thoracic spine procedure, the neurosurgeon requests that a thoracic surgeon create the approach to the spine
B) A neurosurgeon requests the assistance of a nonresident surgeon for a difficult and extensive procedure for which no available residents are qualified to assist
C) During coronary artery bypass, the cardiothoracic surgeon gains access to the site while the assisting surgeon harvests the saphenous vein
D) During coronary artery bypass, the cardiothoracic surgeon gains access to the site while the assisting surgeon harvests the saphenous vein and provides additional assistance as needed throughout the entire procedure

Question 42

What is the description of Modifier 76?

A) Unrelated procedure or service by the same physician during postoperative period
B) Return to operating room for a related procedure during postoperative period
C) Repeat procedure by another physician
D) Repeat procedure by same physician

Question 43

All of the following are common CPT coding errors except:

A) Lack of supporting medical necessity for the provided services
B) Inaccurate or incomplete coding of the services or procedures provided
C) Appropriate use of modifiers with CPT Level I codes
D) Inaccurate or incomplete capture of medical documentation

Question 44

Modifier 81 is used to describe:

A) Assistant surgeon, when a qualified resident is not available
B) Minimum assistant surgeon
C) Multiple modifiers
D) Assistant surgeon

Question 45

Accurate translation of the medical record into codes accomplishes all of the following except:

A) Decides reimbursement
B) Guarantees reimbursement
C) Creates an insurance profile for the patient
D) Gathers statistical and research data

Question 46

The following scenario would require use of modifier 47, Anesthesia by surgeon:

A) During an anterior thoracic spine procedure, the neurosurgeon requests that a thoracic surgeon create the approach to the spine
B) Surgeon performs a neuroplasty procedure and administers a nerve block
C) While in the postoperative period of a tonsillectomy, the patient falls from a slide and fractures the left ulna, requiring surgical repair
D) A neurosurgeon requests the assistance of a nonresident surgeon for a difficult and extensive procedure for which no available residents are qualified to assist

Question 47

The Musculoskeletal section is in the code range 20100- __________:

A) 29999
B) 25999
C) 28999
D) 29599

Question 48

The process of supporting the medical necessity of the CPT code(s) with the ICD code(s) is called:

A) documentation
B) justification
C) cross-reference
D) linkage

Question 49

There are ______ Appendices labeled by an alpha character in the CPT manual:

A) 12
B) 16
C) 14
D) 15

Question 50

The description for Modifier 26 is:

A) Two surgeons
B) Distinct procedural service
C) Assistant surgeon
D) Professional Component

Question 51

In CPT, an addition to the code that is used to show that the service or procedure performed was altered in some way is a(n):

A) extender
B) modifier
C) qualifier
D) reporter

Question 52

The Digestive section is found in which code range?

A) 40490-49999
B) 0019T-0259T
C) 54000-55899
D) 50010-53899

Question 53

In the CPT manual, the _____ symbol designates that a code has been revised.

A) semicolon
B) facing triangles
C) bull's-eye
D) triangle

Question 54

Code range 00100-01999 comprises what section of the CPT manual?

A) Maternity Care and Delivery
B) Integumentary
C) Anesthesia
D) Endocrine

Question 55

According to HCPCS guidelines, which of the following is true of Level I - CPT codes?

A) They contain four alphabetic and numeric characters
B) They contain category II and category III codes
C) They are categorized as national codes
D) All codes in Level I contain alphabetic and numeric characters

Question 56

In CPT, the _____ symbol designates that a code is an additional code to be used with the primary procedure and never to be used alone.

A) bullet
B) bull's-eye
C) triangle
D) plus sign

Question 57

The CPT manual tells the ______ about the patient's encounter.

A) What
B) Where
C) Why
D) Who

Question 58

The description for Modifier 90 is:

A) Assistant surgeon
B) Repeat clinical diagnostic laboratory test
C) Reference outside laboratory
D) Unrelated procedure or service by the same physician during postoperative period

Question 59

Modifier 22, Increased procedural service, is used when:

A) A patient presents to the office with poison ivy and while there has a wart on the plantar surface of the foot removed.
B) A morbidly obese patient requires additional time, resources, and anterior instruments to perform surgery on the posterior spine
C) A bilateral service is performed unilaterally (i.e. eye exam) on a patient with absent left eye
D) A surgeon performs a neuroplasty procedure and administers a nerve block

Question 60

A coder would reference Appendix ____ when he/she is looking for the third order of the brachial family.

A) N
B) G
C) D
D) L

Question 61

Linkage is:

A) Connecting the service provided with the appropriate fee schedule
B) Supporting the charges of the service provided
C) Identifying the number of units of each service provided
D) Supporting the medical necessity of the service provided with the diagnosis

Question 62

A patient undergoes carpal tunnel decompression on the right hand on 6/3/12 with Dr. Smith. On 6/7/12, the patient calls Dr. Smith's office complaining of severe cramping and tingling in his right hand. Dr. Smith's partner, Dr. Curry, is available that afternoon and performs a repeat carpal tunnel decompression on the right hand. What modifier will need to be appended to the second carpal tunnel surgery code?

A) 81
B) 80
C) 77
D) 78

Question 63

Modifier 54 communicates:

A) Preoperative care only
B) Surgical care only
C) Postoperative care only
D) Distinct procedural service

Question 64

Appendix M contains:

A) Deleted and renumbered CPT codes
B) Clinical examples of Evaluation and Management services
C) Summary of resequenced CPT codes
D) Summary of CPT add-on codes

Question 65

What does Appendix F contain?

A) Genetic testing code modifiers
B) Alphabetic clinical topics listing
C) Deleted CPT codes
D) Summary of CPT codes exempt from modifier 63

Question 66

Code 60240 Thyroidectomy, total or complete is from the ______ section of the CPT manual.

A) Male genital
B) Parathyroid, Thymus, Adrenal Glands, Pancreas, and Carotid Body
C) Pathology and Laboratory
D) Endocrine

Question 67

An unrelated Evaluation and Management service by the same physician during the postoperative period is represented by modifier:

A) 62
B) 26
C) 79
D) 24

Question 68

Code range 50010-53899 represents what section of the CPT manual?

A) Nervous system
B) Respiratory
C) Urinary system
D) Male genital

Question 69

Modifier 25 describes:

A) Provider interprets and reports on x-ray findings of films taken by the facility
B) Same procedure identified by the same CPT code is performed on the right and left during the same operative session
C) Patient presents to the office with poison ivy and while there has a wart on the plantar surface of the foot removed
D) After the start of a surgical procedure, the surgeon stops the procedure due to the patient's condition

Question 70

Category III codes are listed in the 0042T-______ range:

A) 0713T
B) 7025F
C) 0001F
D) 7025T

Question 71

The description for modifier 23 is:

A) Professional component
B) Discontinued service
C) Reduced service
D) Unusual anesthesia

Question 72

Appendix N is:

A) Clinical examples
B) Deleted CPT Codes
C) Genetic Testing Code Modifiers
D) Summary of Resequenced CPT Codes

Question 73

Which index includes instructions on the use of the CPT index?

A) Appendix index F
B) Appendix index N
C) Alphabetic Index
D) Appendix index A

Question 74

0001F-9007F are Category ____ codes:

A) II
B) I
C) IV
D) III

Question 75

Appendix C contains information about:

A) Clinical examples of Evaluation and Management services
B) Vascular families
C) Summary of CPT codes exempt from Modifier 63
D) Product pending FDA approval

Question 76

Modifiers are found in which Appendix?

A) A
B) E
C) N
D) M

Question 77

The proper name of the person who first identified the condition or disease, the physician who first developed the treatment or procedure for the condition, or the first patient diagnosed with the condition, is called a(n):

A) Pseudonym
B) Antonym
C) Eponym
D) Homonym

Question 78

A four-year-old girl presents to the provider's office complaining of severe right ear pain. Upon examination, impacted cerumen is present in both the right and left ears. The physician removes the impacted cerumen bilaterally using instrumentation. The coder identifies the following codes to describe this visit: 69210 Removal of impacted cerumen, unilateral 69209 Removal impacted cerumen using irrigation/lavage ,unilateral The coder should:

A) Report code 69209 -50
B) Report code 69209 only
C) Report code 69210 only
D) Report code 69210 -50

Question 79

All of the following are true of parenthetical notes except:

A) They are located below the code or code range to which the note applies
B) They provide additional information regarding a code or code range
C) They are located above the code or code range to which the note applies
D) May inform the coder that the service or procedure described is part of the work of the code for the service or procedure code listed in the parenthetical note

Question 80

The Digestive section is found in which code range?

A) 50010-53899
B) 54000-55899
C) 40490-49999
D) 0019T-0259T