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Ambulatory Care Coding 80 questions.

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This assignment requires Ambulatory Care Coding experience.
You CAN NOT google these questions for the answers.
Must be CPC, CCS, or RHIT certified coder.
Please check 40 that are answered, 40 that are unanswered.
Need by 09.16.2015
Ambulatory Care Coding

Patient had a left femoral hemiorraphy for a recurrent hernia, what is the correct code assignment?

C. 49555

A patient was taken to the endoscopy suite. The endoscopy was passed into the esophagus and continued into the duodenal bulb. Based on this documentation, what CPT code would be selected to represent this procedure?

43200

43234

43235

43260

Which of the following is not coded separately from the coronary artery bypass procedure?

Upper extremity artery

Upper extremity vein

Saphenous vein

Femoropoplitear segment of a vein

Which of the following CPT codes should be used for an emergency curettage due to retained placenta after normal vaginal delivery?

58120

59160

49320

59840

How do you code a retropubic subtotal prostatectomy?
B. 55831

Treatment of a missed abortion, completed surgically a 22 weeks is coded as?
C. 59821

Which of the following CPT codes describes the surgical removal of kidney stones through an incision in the body of the kidney.

                D.50060

The patient undergoes the closure of a nephrocutaneous fistula, how is this coded?

               B. 50520

The patient provides a kidney to a sibling who has renal failure. An open procedure is performed. How is this coded?
B. 50320

10. Principles of ICD-9-CM coding for ambulatory care encounters includes.
              A. Ambulatory care diagnoses should be coded to the highest of certainly at the conclusion of the encounter.
              B. Code suspected diagnoses as if the disease or injury existed.
C. conditions previously treated and no longer existing are coded.
D.Only the most significant diagnosis should be coded.

Level  2 codes of the HCPCS coding system are maintained by the:
D.Center for medicare and Medicaid services.

J1020 injection methylprednisolone acetate, 20 mg is an example of a
C. Level 2 code

Level one of HCPCS consists of

CPT codes

The inclusion of a code in COT indicates that the procedure is:

Commonly performed across the country

Endorsed by the AMA

Reimbursed by third party payers

The three key components used in defining the levels of E/M services are:

History, examination, medical decision making.

The differences between a new patient and an established patient is whether the patient received professional services from the physician or another physician of the same specialty who belongs to the same group of practice

Within the past three years

Mary Cole, who is recovering from pneumonia, returns to her physicians for follow up. Dr. Small reviews a recent x-ray, performs a problem focus examination followed by a short discussion of findings. CPT code assigned.

99212

Refer to the medical decision making table in your CPT book. Given the following information determine the type of medical decision making involved. Number of diagnoses/management options _ limited, amount and/ or complexity of data reviewed _ moderate risk of complications and / or morbidity or mortality high.

High complexity

Low complexity

Moderate complexity

Straightforward

Joan Harrington is required by required by her insurance company to obtain a second opinion consultation prior to undergoing a hysterectomy, she presents to Dr. Marks who conducts a comprehensive history and physical examination medical decision making is moderate. Dr. Marks concurs that the surgery is necessary. Dr. Marks assigns the following CPT code for the visit.
B. 99244

Which code is used to report anesthesia services for a Medicare patient undergoing a tranurethal resection of the prostate?

00914

Cystourethroscopy with fulguration of bladder tumor (2.5 cm inside) is coded.

52235

A biopsy of skin and subcutaneous tissue (3 lesions) would be coded.
C.11643

A debridement of the skin, subcutaneous tissue and muscle is coded.

C.11043
24. Bisch of procedure

63170

25. Open reduction of fracture of the distal fibula with internal fixation

27792

26. Transurethral resection of prostate following urethral dilation.

52601

27. Repeat cry cautery of the cervix.

57510

57511

57511, 57511

5713

28. Two facial lacerations are repaired with layer closure. One is 10 cm and the other is 3 cm.

12016

12035

12052, 12054

12055

29. Esophagoscopy for removal of foreign, body is coded.

43045

43200, 43215

43215

43247

30. Simple hemorrhoidectomy, internal and external with fistulectomy.

46255

43255, 46270

46257

46258

31. Arthroscopy of knew with synovial biopsy.

01382

27330

29870

29875

32. A patient develops difficulty during surgery and the physician discontinues the procedure, identify the modifier that may be reported by the physician to indicate that the procedure was discontinued.

-52

-53

-73

-74

33. EGD with laser destruction of a pedunculated polyp in the duodenum.

43250

43234, 43258

43239

43258

34. What is the correct code assignment for ligation of four hemorrhoids?
A. 46945, 46946
B. 46946
C. 46900, 46910
D. 46924
35. Which of the following is vital for determing why an insurance company paid less than expected?

CPT code book

The explanation of benefits

Knowledge of the insurance regulation

Talking to the patient

36. To properly link the diagnosis to the service what should be listed in box 24 of the CMS_1500 claim form?

The place of service code

One linking reference number from box 21

The CPT code number

The ICD_9-CM code number

37. Which set of percentages is correct for initial hospital services, 99221 65, 99222 296, 99223 362, 99231 261, 99232 410, 99233 174

4%, 19%, 23%

13%, 45%, 42%

9%, 41%, 50%

36%, 57%, 24%

38. A claim is denied because the CPT code and place of service code do not match. Where would the coder look to solve this problem for the future?
B. Fee schedule database
39. A patient presents with a closed fracture of the supracondylar humerus and receives open treatment with intercondylar: How should this be coded?
D.24546
40. Red blood cell count, differential white blood cell count, and platelet count automated, is coded as?
C. 85041, 85004, 85049
41. An asthmatic patient is treated with two nebulizer inhalation treatment on the same day by the same physician, using prefilled vials of 0.5 mg of albuterol and 2.5 mg normal saline. How is this coded?

94640, 94640-76, J7611, J7611

94664-76

94664, 94664-22, J7611x6

94640, 94640

42. A catheter is placed into the renal pelvis for injection. The same physician perfors both the injections and the supervision and interpretation. How is this coded?

50392, 74475-26

50392, 74475

74475-26

74475

43. Magnetic resonanceimagaing cholangiopancreatograpy on a 25 year old male

74185

76498

58037

58042

44. A rapid influenza test is performed with a commercial test kit. When complete, the technician visually reads the results as positive, how is this procedure coded?

87275

87276

87400

87804

45. Some reconstructive plastic surgical procedures are performed in multiple stages. What modifier should the surgeon report when the patient is returned to sugery for a planned stage procedure?
C. 58
46. Accu-check home blood glucose monitor

A4258

E0607

A4253

E0607, A4253

47. CT of maxillofacial area, with and without contrast.

70488

70487

70450

70486, 70487

48. Two- view x-ray of sacrum and cocoyy
D. 82607, J3420
49. What is the correct code for a nonabsorption vitamin B_12 level?

82608

82607

J3420

82607, J3420

50. RS&I of bilateral extremity angiograph

75716

51. When clinical laboratory tests are reported on the same day, what modifier should be assigned?
B. 91
52. In addition to the claim submitted by the surgeon, the assistant surgeon bills for his or her services. What modifier does the assistant surgeon attach to the procedure code?

62

52

81

80

53. A female patient about undergo chemo, decided to harvest and store eggs for later attempts at pregnancy. How is the laboratory service of storage coded?

89342

89346

89343

89528

54. Visual acuity screening

99173

55. Comprehensive opthalmology evaluation for a new patient.

99204

92012

92004

92002

56. Binaural hearing aid check

92539

92591

92590

92591, 92539

57. Individual interactive psychotherapy, outpatient, 50 minutes.
                D. 90834, 90784
58. EEG, awake and sleep
                 B. 95819
59. With the use of imaging, the patient had a percutaneous needle core biopsy of the left brest.
                 D. LT
60. Barium enema with KUB
               C. 74270
61. Planned sigmoidoscopy with removal of foreign body under conscious sedation, procedure not completed due to hypotension. How would the physician report this?
               C. 53
62. Comprehensive oral examination

D0150

D0145

D0502

D0121

63. A radiologist interprest x-ray for a community hospital. The equipment belongs to the hospital. What modifier should the radiologist append to his CPT code?

26

TC

59

52

64. Replacement of a nonprogrammable epidural drug infusion pump

62360

62362

62360, 62361

62361

65. Initiation and management of continuous positive airway pressure ventilation

94660

66. Removal of foreign body from cornea using a slit lamp

65205

65222

65205, 65222

65220

67. Cervical collar, foam, un-adjustable

L0150

L0180

E0856

L0120

68. Hearing aid, monaural, behind the ear.

V5241

V5298

V5160

V5060

69. The physician provides a patient covered by commercial insurance with a peak flow meter to use at home.
                     D.   58096
70. The physician performs an arthroscopic debridement of the shoulder, extensive, with chondroplasty and abrasion, arthroplasty. An arthroscopic mumford procedure is also performed. How is this coded?

11044-RT, 23120-RT

29823-RT, 29824-RT

11044-RT, 29824-RT

29823-RT, 23120-RT

71. The modifier used to report therapeutic interventional procedures on the right coronary artery is.

RT

RC

50

LC

72. The physician performs an open repair of the medical meniscus of right knee: How is this coded.
C. 27403-RT
73. Modified radical mastectomy

19307

74. The physician treats a patient who has osteomyelitis of the left scapula following a past injury. A piece of dead bone is removed from the body of the scapula. How is this coded?
                    A. 23172-LT
75. The physician performed a partial avulsion of the nail plate of the left thumb.
A. FA
76. Surgical sinus endoscopy with spenoidotomy
                      C. 31287
77. Percutaneous thrombectomy of AV Fistual Graft

36870

35331

92973

35363

78. Prosthetic aortic value placement, using CP bypass
                     C. 33405
79. Diagnostic lumber puncture
                     A. 62270
80. Catheterization of Eustachian tubes, tympanic approach

69631

69405

69405-50

69400