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Medical Tests American Academy of Professional Coders: Certified Professional Coder Sample Questions (Q55-Q60):

NEW QUESTION # 55
An obstetrical patient carrying twins is seen. The physician performs a fetal non stress test on each fetus. How should the CPT code(s) be reported?

A. 59025-76
B. 59025-22
C. 0
D. 59025, 59025-59

Answer: D

Explanation:
Modifier 76 is used to identify a repeated procedure, but the test was performed on a separate fetus. Modifier 22 indicates increased procedural services: however, the services were not increased. Rather, a separate, identifiable test was rendered, and the modifier 59 would therefore apply to the second fetal nonstress test.

NEW QUESTION # 56
What would NOT be included in a global obstetrical package?

A. A patient complains of flu-like symptoms and is prescribed an antibiotic.
B. A patient with anemia comes in to check hemoglobin levels.
C. Contraception following delivery is discussed at length.
D. Sutures are removed from a first-degree perineal laceration during the delivery.

Answer: A

Explanation:
The treatment of flu-like symptoms is considered a non-obstetric service, and a separate E/M can be billed for reimbursement. All other answer choices would be included in the global obstetrical package as routine care.

NEW QUESTION # 57
A 15-year-old male patient is seen in the emergency department due to a dislocated left elbow, caused by a fall from his skateboard. The physician performs a comprehensive physical evaluation to check for other injuries before manually realigning the dislocation and placing a splint from the shoulder to wrist. The patient is informed to follow up in 4 weeks. Which CPT and ICD-IO-CM codes should the emergency department report?

A. 99283, 24600-LT, VOO.131A
B. 24600-LT, 29105, S53.195AVOO.131A
C. 24600-LT, S53.105A. VOO.131A
D. 99282-57, 24600-LT, S53.105A VOO.131A

Answer: D

Explanation:
An E/M is always billed when a patient is seen in the emergency department because it is unscheduled and urgent. In this case, the documentation encompasses a straightforward level of decision-making (one acute, uncomplicated injury, minimal or no data reviewed, superficial dressings that result in minimal risk or morbidity of the patient), which lead the coder to 99282.
Modifier 57 is appended to indicate that the decision for surgery was made just prior to the procedure and is not bundled. CPT coding crosswalk confirms that a closed treatment of a dislocated elbow is CPT code 24600. Application ofa splint is represented by CPT code 29105 but is not applicable when performed with a surgery to correct the dislocation. ICD-IO-CM crosswalk for dislocation of left elbow is S53.105A.

NEW QUESTION # 58
Code the excision of a large goiter extending into the chest cavity using a transthoracic approach.

A. 0
B. 1
C. 2
D. 3

Answer: D

Explanation:
A goiter is an abnormal enlargement of the thyroid gland. The removal of that gland is a thyroidectomy, represented by CPT codes 60240-60271. CPT 60270 is selected based on the approach used. CPT codes 21602 and 32900 are obtained by using the coding crosswalk for resection ofthe chest wall and describe the removal of a tumor and one or more ribs. CPT 32140 is a thoracotomy, which involves pulling apart the ribs to reach and remove a lung cyst.

NEW QUESTION # 59
A physician performs an esophagogastroduodenoscopy on a patient who has GERD. A single tissue sample is obtained from the upper gastrointestinal tract using biopsy forceps. A reflux test was also done and a bravo capsule temporarily attached to the esophageal wall to monitor pH levels. What procedures should the physician report?

A. 43235, 91035
B. 43235, 91034
C. 43239, 91034
D. 43239, 91035

Answer: D

Explanation:
To report an esophagogastroduodenoscopy, see CPT code range 43233-43259. In this scenario, the procedure is not considered diagnostic (43235) because the physician is stating the patient has GERD. Additionally, the tissue sample was obtained by means of biopsy forceps and not by brushing or washing. The secondary procedure is a reflux test and an esophageal pH test by means of a bravo capsule, which evaluates the level of acid refluxing into the esophagus. Although CPT 91035 doesn't specifically state a capsule in the description of the code, it would fall under a
"mucosal attached" placement. A nasal catheter was not used, so reporting CPT 91034 would be incorrect.

NEW QUESTION # 60
......

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