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Medical Tests American Academy of Professional Coders: Certified Professional Coder Sample Questions (Q118-Q123):
NEW QUESTION # 118
A surgeon performs a posterior fusion on the L2-L5 of the spine due to degenerative disc disease. CPT and ICD-IOOI code(s) should be reported?
- A. 22800, M51.37
- B. 22533, M51.37
- C. 22612, 22614x 3, M51.36
- D. 22612, 22614x2, MSI.36
Answer: D
Explanation:
The code for a joint fusion using a posterior approach is 22612. In this scenario, there are three fusion levels: L2-L3, L3-L4, and L4-L5. Following the primary code, 22614 would be billed tv;ice and with no modifier because it is an add-on code. ICD-IO-CM code M51.37 is for degenerative discs in the lumbosacral region; however, L2-L5 is considered the lumbar region.
NEW QUESTION # 119
CPT code 11102 is a column 2 code that has an NCCI edit of 1 when paired with CPT code 11402. How would this be interpreted?
- A. The two codes are exclusive of each other and can never be billed together.
- B. If being billed together, only report one unit of each.
- C. The two codes are inclusive of each other and can never be billed together.
- D. The two codes can be billed together with an appropriate modifier.
Answer: D
Explanation:
NCCI stands for National Correct Coding Initiative and was created by CMS to prevent unbundling and prevent incorrect payments. Column one represents a correct code when listed next to column two. There are three edits listed with the combination of the two columns: 0, 1, and
9. Edit 0 means that the two codes should never, under any circumstance, be reported together. Edit
1 means that the procedures may be coded together with the use of a modifier. Edit 9 means that the edit does nota I .
NEW QUESTION # 120
The base unit for anesthesia CPT code 00600 is 10 units. If an anesthesiologist spends 105 minutes in the procedure room with a patient, how many units should be reported for reimbursement?
- A. 17 units
- B. 14 units
- C. 12 units
- D. 11 units
Answer: A
Explanation:
To calculate the total number of units, it is important to understand that anesthesia time is measured in 15-minute intervals (or in fractions thereof). In this scenario, take the total number of minutes spent on the procedure (105) and divide it by 15. The total number of time units is 7. The time units are then added to the base unit (10) for a total of 17 units.
NEW QUESTION # 121
The laboratory collected blood to test the patient's carbon dioxide, chloride, potassium, sodium, and glucose levels. Select the CPT codes that the laboratory will report.
- A. 80051, 82947-59
- B. 80051, 82947
- C. 80053-52
- D. 80051, 80053
Answer: B
Explanation:
It would not be appropriate to add modifier 52 to 80053 in answer A In answer C, 80051 and
80053 would not be reported together because CPT guidelines state that "when or more panel codes include the same tests, report the panel with the highest number of tests in common." Because the glucose test is not included in 80051, 82947 would be added to 80051, with no modifier 59, because the procedures are routinely billed together, thus eliminating answer D.
NEW QUESTION # 122
The CPT code 76805 requires that multiple elements of the exam be documented, such as the evaluation of the amniotic fluid, umbilical cord insertion site, and placental location. If the provider documents most elements, he/she can bill the CPT code 76805.
- A. False
- B. True
Answer: A
Explanation:
The statement is false. Per ICD-IO-CM, "Results must be documented in the report for each of the elements described in the code description." If the provider does not document a given element, they must include a reason for non-visualization for the CPT to be reported.
NEW QUESTION # 123
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