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Medical Tests American Academy of Professional Coders: Certified Professional Coder Sample Questions (Q100-Q105):

NEW QUESTION # 100
A patient with a stab wound to the chest was taken to the operating room and put under general anesthesia for a thoracotomy. The anesthesiologist should report CPT 00520 with the total number of time units spent providing face-to-face care with the patient.

A. False
B. True

Answer: A

Explanation:
The statement is false. CPT 00520 is anesthesia services for closed-chest procedures.
However, a thoracotomy is an open procedure involving a surgical incision to the chest wall. The correct CPT code that should be reported is 00540 (anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum).

NEW QUESTION # 101
A provider places a catheter on the right side of the heart chamber via an incision made on the lower left side of the patient's chest while performing a transcatheter mitral valve replacement. How should this encounter be coded?

A. 0
B. 0484T, 93451-59
C. 0483T, 93451
D. 0484T

Answer: D

Explanation:
0484T describes a transcatheter mitral valve replacement via a thoracic approach. CPT code
33430 describes a mitral valve replacement in which cardiopulmonary bypass is initiated. CPT code
0483T describes a transcatheter mitral valve replacement with a percutaneous approach: however, the documentation identifies a transthoracic incision. Catheterization is bundled into the procedure and is not separately identifiable unless the provider documents extenuating circumstances (i.e. no prior study available, inadequate visualization, etc.).

NEW QUESTION # 102
Code the following procedure note:
A 45-year-old female was referred for a urodynamics study due to complaints of bladder pain and weak urination. The provider places a rectal catheter simultaneously with a urethral catheter and begins to fill the bladder with water.
Using calibrated equipment, cytometry was done with a medium fill rate of 40 cc/ minute. A strong desire to void occurred at 84 cc. and the patient is instructed to void. The provider determines that the maximum urinary flow rate is 12 cc per second with a voiding time of 45 seconds and a voided volume of 102 cc. She voided with a sustained detrusor pressure. An abdominal pressure measurement was also taken, indicating no urinary leaking with abdominal straining. EMG patches were placed on the anal sphincter and found to be elevated with increased intra- abdominal pressure. All catheters and EMG patches were removed, and the procedure was completed without complications. A report will be forwarded to the referring provider, who will provide the interpretation of the results to the patient.

A. 51728-TC, 51784-TC, 51797-TC, 51741-TC
B. 51726-TC, 51784-51-TC, 51797-51-TC
C. 51728-TC, 51784-TC, 51797-TC
D. 51726-TC, 51784-59-TC, 51797-59-TC, 51741-59-TC

Answer: A

Explanation:
A urodynamics study is a diagnostic test to evaluate the function of the bladder. When performed using calibrated equipment, it becomes known as a complex cystometrogram (51726-
51729). In CPT code 51728, a complex cystometrogram is performed in conjunction with voiding pressure studies. In the provider's documentation, the bladder is filled with water, and voiding times and volume are recorded, thus fulfilling the requirements for this code. CPT code 51726 in answers A and B only describe a complex cystometrogram without the voiding pressure studies.
Electromyography (EMG) studies were performed without a needle to evaluate pelvic floor activity and are represented by 51784. An intraabdominal voiding pressure study (51797) can be inferred in that the provider had earlier inserted a rectal catheter and, after instructing the patient to cough, obtained an abdominal pressure measurement. A complex urinary flow study (51741) was performed in obtaining the maximum urinary flow rate through calibrated equipment. This procedure is missing in answers B and C. Modifier TC (indicating only a technical component) is amended on all the procedures because the provider is not interpreting the results to the patient.
Modifiers 51 and/or 59 is not amended on any procedure (A and B) because these are routinely billed together.

NEW QUESTION # 103
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. 22612, 22614x 3, M51.36
B. 22533, M51.37
C. 22800, M51.37
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 # 104
A sternal closure using sutures is considered inclusive to CPT 33255 and should not be reported separately.

A. False
B. True

Answer: B

Explanation:
The statement is true. Regardless of how a sternal closure is performed, it would be considered integral to this, and any other open cardiac procedure, when a sternal approach is used as the method of exposure. If a sternal closure were performed as the only procedure to repair an injury, the closure would then be reported.

NEW QUESTION # 105
......

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