Coding Quiz 18
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Coding Quiz 18
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Question 1 of 10
1. Question
The NCCI Policy Manual for Medicare Services is updated:
Correct
The National Correct Coding Initiative (NCCI) Policy Manual for Medicare Services is updated annually. The new guidance becomes effective Jan. 1 of each year. NCCI edits are updated quarterly and are effective Jan. 1, April 1, July 1, and Oct. 1 of each year.
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Question 2 of 10
2. Question
What is the diagnosis code for reporting bilateral carpal tunnel?
Correct
ICD-10-CM breaks down carpal tunnel syndrome based on laterality. The codes are in Chapter 6, Diseases of the Nervous System: G56.00 Carpal tunnel syndrome, unspecified upper limb G56.01 Carpal tunnel syndrome, right upper limb G56.02 Carpal tunnel syndrome, left upper limb G56.03 Carpal tunnel syndrome, bilateral upper limb
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Question 3 of 10
3. Question
Which of the following is NOT a payment modifier?
Correct
Modifier 79 Unrelated procedure by the same physician during the postoperative period is not a payment modifier. Level I payment modifiers include: 26 Professional component 50 Bilateral procedure 53 Discontinued procedure 54 Surgical care only 55 Postoperative management only 56 Preoperative management only 62 Two surgeons 66 Surgical team 78 Unplanned return to operating/procedure room by the same physician or other qualified health care professional following an initial procedure for a related procedure during postoperative period 80 Assistant surgeon 81 Minimum assistant surgeon 82 Assistant surgeon (when qualified resident surgeon not available) 91 Repeat clinical diagnostic laboratory test
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Question 4 of 10
4. Question
The following are considered paired anatomic structures of the larynx/pharynx, and modifier 50 may be reported with the appropriate laryngoscopy code (31572-31574) when performed bilaterally:
Correct
CPT® states paired structures include true vocal cords, arytenoids, false vocal cords, ventricles, pyriform sinuses, and aryepiglottic folds.
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Question 5 of 10
5. Question
The correct laryngoplasty code (31551-31554) is chosen based on which parameter(s)?
Correct
Codes 31551-31554 reflect procedures for resection of laryngeal stenosis. These codes are differentiated by the age of the patient and whether an indwelling stent was placed. The graft harvest and placement is included and is not separately reported, even when performed through a separate incision.
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Question 6 of 10
6. Question
What is the minimum number of face-to-face minutes spent counseling/coordinating care needed to report 99204 based on counseling/coordination of care time?
Correct
To bill 99204 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family, more than 50 percent of the time must be spent counseling or care. Per the code descriptor, typically, 45 minutes are spent face-to-face with the patient. This means that 23 minutes or more are needed to exceed the 50 percent threshold.
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Question 7 of 10
7. Question
A nurse practitioner spent 20 minutes with an established patient in a physician office setting. Twelve of those minutes were spent counseling the patient. Which is the most appropriate procedure code to report?
Correct
To bill 99213 Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Typically, 15 minutes are spent face-to-face with the patient and/or family, more than 50 percent of the time must be spent counseling or coordinating care. Per the code descriptor, typically, 15 minutes are spent face-to-face with the patient. This means that eight minutes or more are needed to exceed the 50 percent threshold. The next-higher code (99214) has a 25-minute reference time, meaning at least 13 minutes would have to be spent on counseling and coordination of care to report based on time.
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Question 8 of 10
8. Question
A low-profile device with a plate that is integrated into the intervertebral device placed into the anterior cervical interspace is reported using which code(s)?
Correct
The most common code that spine surgeons will use is +22853 Insertion of interbody biomechanical device(s) (e.g., synthetic cage, mesh) with integral anterior instrumentation for device anchoring (e.g., screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure). This code may be used for anterior or posterior procedures; it is not limited to only anterior spine procedures. Code +22853 includes the placement of any anterior integral instrumentation (meaning the anterior plate is attached to the intervertebral device), when performed. The intervertebral device with an integrated anterior plate, also called a “low profile” or “stand-alone” device, is accurately reported using only +22853.
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Question 9 of 10
9. Question
Covered entities” under the HIPAA rule applies to all of the following, except:
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HIPAA rules apply specifically to “covered entities” and their “business associates.” Covered entities are defined as healthcare providers, health plans, and healthcare clearinghouses. Business associates are any third party a covered entity engages to help carry out its healthcare activities and functions (for example, a third-party billing service).
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Question 10 of 10
10. Question
Which is NOT a situation in which an ABN should be issued?
Correct
According to the Medicare Advance Beneficiary Notice (ABN) booklet, an ABN must be issued “when you believe Medicare may not pay for an item or service; Medicare usually covers the item or service; and Medicare is expected to deny payment for the item and or service because it is not medically reasonable and necessary for this beneficiary in this case.
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Coding Quiz 17Time limit: 0
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Coding Quiz 16
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Coding Quiz 16
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Question 1 of 10
1. Question
Best practice for correct surgical coding begins by:
Correct
When coding surgeries, review the header of the operative report and then turn to the CPT® Index to identify code options. In reviewing these codes, look for the differences between them and the documentation required to support one service over another.
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Question 2 of 10
2. Question
Medicare will cover the new flu virus vaccine code 90682, but not until:
Correct
Code 90682 Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use will be payable by Medicare, but not until July 1. Medicare administrative contractors (MACs) have until Aug. 1 to implement the code, but will pay (at their discretion) claims for 90682 with dates of service between July 1 and July 31. Contact your local MAC to verify their policy.
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Question 3 of 10
3. Question
A patient with bipolar disorder reports to the clinic for the monthly psychotherapy session with the licensed professional counselor. A recent episode and potential non-compliance with the medication resulted in the individual’s sibling reporting the events to the therapist without the patient present for this portion. The therapy session then continued with the patient alone for 50 minutes. The provider uses cognitive behavioral therapy. How is the service reported?
Correct
The sibling acted as an informant and there was no focus on family dynamics — meaning neither 90846 Family psychotherapy (without the patient present), 50 minutes nor 90847 Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes is correct. Code 90836 Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure) is an add-on code and cannot be reported by itself. The only remaining code is 90834 Psychotherapy, 45 minutes with patient. The 50-minute individual psychotherapy session most accurately supports 90834.
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Question 4 of 10
4. Question
True or false: In practical terms, the most significant difference between the CMS 1995 and 1997 Documentation Guidelines for Evaluation and Management Services’ detailed exams is that the 1995 definition is qualitative and the 1997 is quantitative.
Correct
The 1995 guidelines define a detailed exam as an “extended exam of the affected area(s) and other symptomatic or related organ system(s).” Neither CPT® nor CMS defines the term “extended,” which is a qualitative, not quantitative, term. By contrast, 1997 guidelines define a detailed exam by counting bullet items (e.g., the definition is quantitative).
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Question 5 of 10
5. Question
The ICD-10-CM code for carpal tunnel syndrome is found in which chapter of the ICD-10-CM codebook?
Correct
Carpal tunnel is pressure on the nerve and is coded in Chapter 6, Diseases of the Nervous System.
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Question 6 of 10
6. Question
After conservative treatment, which procedures may a physician elect to perform?
Correct
The physician usually will inject to relieve symptoms, then perform either an endoscopic or open surgery. Therefore, all three options are correct.
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Question 7 of 10
7. Question
The Medicare MEDPAR data provides a good benchmark for what kind of CPT® code utilization analysis?
Correct
Although Medicare is for those aged 65 and over (and therefore not necessarily comparable to all patients in a practice), the “bell curve” that Medicare’s data illustrates for established and new patient visits is an industry-norm.
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Question 8 of 10
8. Question
A 72-year-old Medicare patient came in today for follow up. She had a screening mammogram in December last year, and the radiologist wanted her to come back for further bilateral study. Choose the correct code(s) for her mammogram order:
Correct
For 2017 professional (practitioner’s) claims to Medicare, mammography services should be reported using the G codes (G0202, G0204, G0206, G0279) or 77063. Be sure the service ordered and performed matches the description of the code. Medicare codes the diagnostic mammogram as either G0204 Screening mammography bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed or G0206 Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral. If a tomosynthesis is also ordered, add +G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to G0204 or G0206) to either G0204 or G0206, as appropriate.
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Question 9 of 10
9. Question
A 57-year-old patient with an employer-sponsored health plan came in today for her yearly physical. She needs an order for her yearly mammogram. She has a history of dense breast tissue. A screening tomosynthesis was done last year and will be repeated this year. Choose the correct code(s) for her order:
Correct
In 2017, commercial payers will likely use the new CPT® codes for breast mammography, A screening mammogram is coded as 77067 Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed. If tomosynthesis is also ordered, add +77063 Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure).
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Question 10 of 10
10. Question
Use modifier 99 if a single line item requires __ or more modifiers.
Correct
In practice, call on modifier 99 Multiple modifiers only if a single line item requires five or more modifiers. The reason is the standard 1500 Health Insurance Claim Form (or electronic equivalent) field 24D accommodates the entry of up to four modifiers
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Coding Quiz 15
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Coding Quiz 15.
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Question 1 of 10
1. Question
Ms. Sarah is an established patient with Dr. Peter. Dr. Peter leaves his current practice to join another practice. Is Ms. Sarah an established or a new patient, if she elects to see Dr. Peter at his new practice? Ms. Sarah sees Dr. Peter with a new complaint of joint pain. Dr. Peter refers her to Dr. Joe, an orthopedic specialist within the group practice. Is Ms. Sarah new or established with Dr. Joe?
Correct
Where the patient is seen doesn’t matter. If the provider treats a patient for a face-to-face service within the previous three years (in any location), that patient is established (in all locations). If another provider within the group practice has seen the patient within the past three years, but that provider was of a different specialty/subspecialty, report a new patient service.
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Question 2 of 10
2. Question
Within the context of determining a patient’s “new or established” status, professional services may include:
Correct
Solely within the context of evaluation and management (E/M) code selection, CPT® defines a professional service as “those face-to-face services rendered by physicians and other qualified health care professionals who may report evaluation and management services reported by a specific CPT code(s).” Medicare policy (the Centers for Medicare & Medicaid Services (CMS) Transmittal R731CP, Change Request 4032) confirms, “An interpretation of a diagnostic test, reading an X-ray or EKG etc., in the absence of an E/M service or other face-to-face service with the patient does not affect the designation of a new patient.”
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Question 3 of 10
3. Question
In general, who is permitted to supervise the technical component of a diagnostic test performed on a Medicare patient?
Correct
In general, non-physician practitioners (NPPs) are not permitted to supervise the technical component of a diagnostic test: Only physicians may do this unless an exception applies
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Question 4 of 10
4. Question
Which service cannot be billed to Medicare as a shared service?
Correct
Although the Medicare Claims Processing Manual clearly states that critical care cannot be billed as a shared service (99291 Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes), it’s best to check with your local Medicare administrative contractor about other time-based services. Local policies vary on whether a hospital discharge service (a time-based code) may be billed as a shared visit.
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Question 5 of 10
5. Question
What is the correct place of service code for a nursing home visit on a non-skilled patient?
Correct
Per the American Medical Association (AMA), place of service code 32 indicates a non-skilled nursing facility.
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Question 6 of 10
6. Question
When a PTP edit indicates a modifier status of 1, which code is reported with the appropriate modifier?
Correct
The column 2 code is the service that would be denied when the code pair is reported together for the same patient on the same date of service, making it necessary to add the modifier to this code to explain the circumstance for which it should be paid.
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Question 7 of 10
7. Question
When reporting a significant, separately identifiable E/M service with another procedure or service, there must be different diagnoses for the procedure or service and the E/M.
Correct
Both the procedure and the separate, same-day E/M service must be linked to a diagnosis substantiated in the medical record. The diagnoses supporting each service may be the same or different. Per CMS Transmittal R954CP, “The E/M service may be prompted by the symptom or condition for which the procedure and/or service was provided. As such, different diagnoses are not required for reporting of the E/M services on the same date” [emphasis added].
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Question 8 of 10
8. Question
An E/M service leads to the decision to perform a major surgical procedure later that same day. When reporting the E/M service, you must append which modifier?
Correct
A minor procedure is any procedure/CPT® code with a zero- or 10-day global period, as defined by the Medicare Physician Fee Schedule Relative Value File. Turn to modifier 57 Decision for surgery to report a separately identifiable E/M service that occurs on the same day, or on the day before, a major surgical procedure (a procedure or service with a 90-day global period), and that results in the physician’s decision to perform the surgery.
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Question 9 of 10
9. Question
Which is the proper coding to report a threaded bone dowel?
Correct
CPT® parenthetical instructions direct, “For application of an intervertebral bone device/graft, see 20930-20938.” Threaded bone dowel falls within this category, and is reported as a structural bone allograft (+20931 Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure).
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Question 10 of 10
10. Question
Which CPT® codes are appropriate for initial nursing facility visits?
Correct
Nursing facility service codes are: • 99304-99306 for the initial visit • 99307-99310 for any subsequent visits • 99315-99316 for the discharge • 99318 for an annual nursing facility assessment
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Coding Quiz 14
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Coding Quiz 14
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Question 1 of 10
1. Question
The provider sees a patient in the emergency department for adverse effects due to illegal drug use. The patient recovers without medical intervention; however, the provider spends an hour counseling the patient about his drug use, behavior modifications, treatment options, etc. Using time as a key component, which is the best choice?
Correct
To report an E/M service using time as the key component, time must be references in the code descriptor by the statement “Typically, X minutes are spent face-to-face with the patient and/or family.” Emergency department visits do not specify a reference time, and therefore must be reported using the three key components of history, time, and medical decision-making.
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Question 2 of 10
2. Question
What is the ICD-10-CM code for reporting sepsis due to MRSA?
Correct
Either A49.02 or B95.62 usually is the first-listed code when a patient is treated for an MRSA infection. Exceptions include a patient with MRSA sepsis (A41.02 Sepsis due to Methicillin resistant Staphylococcus aureus) or MRSA pneumonia (J15.212 Pneumonia due to Methicillin resistant Staphylococcus aureus), which have specific codes.
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Question 3 of 10
3. Question
A qui tam action is:
Correct
Essentially, a whistleblower files a case on the government’s behalf, claiming fraud against the government. These cases, also called qui tam cases, often involve Medicare billing fraud (e.g., upcoding, double billing, and similar bad acts).
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Question 4 of 10
4. Question
Which of the following is not a requirement of HIPAA?
Correct
Encryption is not a HIPAA requirement; however, HIPAA (and state data breach laws) exempt encrypted data loss from data breach reporting (as long as the encryption keys were not taken with the data).
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Question 5 of 10
5. Question
The Watson scaphoid shift test is used to evaluate:
Correct
The Watson scaphoid shift test, which evaluates four progressive stages of carpal arthritis, is a popular test to detect scapholunate advanced collapse (SLAC).
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Question 6 of 10
6. Question
What is the ICD-10-CM code for reporting MRSA of a known site?
Correct
The two main codes for Methicillin-resistant Staphylococcus aureus (MRSA) infections are A49.02 Methicillin resistant Staphylococcus aureus infection, site unspecified (the infection site has not yet been determined) and B95.62 Methicillin resistant Staphylococcus aureus infection as the cause of diseases classified elsewhere (the infection site is known, and reported secondarily (e.g., skin of the groin)). One of the above two codes usually is the first-listed code when a patient is treated for a MRSA infection.
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Question 7 of 10
7. Question
The provider spends 45 minutes of a 60-minute visit with an established patient in the office, counseling and coordinating care for a new diagnosis of diabetes. If reporting this visit based on time, what is the appropriate E/M service code?
Correct
The reported E/M service must have a “reference time,” identified in the code descriptor by the statement, “Typically, X minutes are spent face-to-face with the patient and/or family.” The reference time provides an objective standard for determining whether “more than 50 percent” of the visit is spent in counseling and/or coordination of care.
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Question 8 of 10
8. Question
True or False: When calculating time for outpatient and office E/M services, the time must be face to face.
Correct
As outlined in the CPT® Evaluation and Management (E/M) Service Guidelines, in the context of office and other outpatient visits, “time” refers specifically to time spent face to face with the patient, as well as “time spent with parties who have assumed responsibility for the care of the patient or decision making whether or not they are family members.” Time may include floor/unit time in the hospital or nursing facility.
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Question 9 of 10
9. Question
The wrist, or carpus, contains how many carpal bones.
Correct
The wrist, or carpus, contains eight carpal bones. There are three bones in the proximal row (scaphoid, lunate, and triquetrum) and five bones in the distal row (trapezium, trapezoid, capitate, hamate, and pisiform).
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Question 10 of 10
10. Question
The wrist is a (n) ____ joint.
Correct
The wrist is classified as an “intermediate” joint, but consists of many intricate structures and bones of various shapes and sizes.
Incorrect
Coding Quiz 13
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Quiz 13
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Question 1 of 10
1. Question
A 50-year-old patient is admitted from the ED with chest pain, SOB, and a history of smoking. On the second day of admission, a diagnosis of NSTEMI MI is confirmed. He is discharged on day 4 with a principal diagnosis of NSTEMI MI. What is the POA indicator?
Correct
Yes: present on admission. This condition was not diagnosed prior to the admission, but clear signs/symptoms of the condition were present on admission (POA).
Incorrect
Yes: present on admission. This condition was not diagnosed prior to the admission, but clear signs/symptoms of the condition were present on admission (POA).
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Question 2 of 10
2. Question
In the ED. The patient fell and suffered a hip fracture in the ED. Since the fall occurred at the hospital ED, and not prior to arrival, the POA assigned should be:
Correct
The patient did suffer a fall after arriving at the hospital, but it was in the emergency department (ED). The ED is considered an outpatient hospital; therefore, the hip fracture occurred prior to inpatient admission.
Incorrect
The patient did suffer a fall after arriving at the hospital, but it was in the emergency department (ED). The ED is considered an outpatient hospital; therefore, the hip fracture occurred prior to inpatient admission.
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Question 3 of 10
3. Question
A provider performs a single injection of a corticosteroid into the lumbar spine under fluoroscopic guidance in the epidural space. How is the service reported?
Correct
Because the service was performed under fluoroscopic guidance, and fluoroscopy is an inclusive component of the service, neither A nor B is correct. In addition, 62322 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance is without imaging guidance, meaning it is not logical to report fluoroscopy with a code that indicates without imaging guidance. The two are mutually exclusive and contradictory. Although 62323 is under imaging guidance, fluoroscopy is included in the code, per instructions, and 62323 is not approved for use in conjunction with fluoroscopy code +77002 Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (List separately in addition to code for primary procedure). Finally, 62327 Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT) is for continuous infusion or indwelling catheter, but the documentation indicates this was a single injection, which does not support a continuous infusion.
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Because the service was performed under fluoroscopic guidance, and fluoroscopy is an inclusive component of the service, neither A nor B is correct. In addition, 62322 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance is without imaging guidance, meaning it is not logical to report fluoroscopy with a code that indicates without imaging guidance. The two are mutually exclusive and contradictory. Although 62323 is under imaging guidance, fluoroscopy is included in the code, per instructions, and 62323 is not approved for use in conjunction with fluoroscopy code +77002 Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (List separately in addition to code for primary procedure). Finally, 62327 Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT) is for continuous infusion or indwelling catheter, but the documentation indicates this was a single injection, which does not support a continuous infusion.
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Question 4 of 10
4. Question
Starting in 2017, all fluoroscopy codes are add-on services. What is the correct coding combination for fluoroscopy?
Correct
Neither A nor B comply with the instructions for appropriate use of CPT® +77003 Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (List separately in addition to code for primary procedure) under the fluoroscopy guidelines. Answer A is also against the instructions for the spinal injection services. Answer C is not a reportable code combination per the fluoroscopy guidance instructions for CPT® +77002. CPT® 62321 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy or CT) is a spinal injection and CPT® 77003 is for fluoroscopic guidance of needle placement for spinal injections, but the codes can’t be reported together per instructions for both codes. This means only answer D is correct; this is a proper coding combination per the instructions for CPT® +77002.
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Neither A nor B comply with the instructions for appropriate use of CPT® +77003 Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (List separately in addition to code for primary procedure) under the fluoroscopy guidelines. Answer A is also against the instructions for the spinal injection services. Answer C is not a reportable code combination per the fluoroscopy guidance instructions for CPT® +77002. CPT® 62321 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy or CT) is a spinal injection and CPT® 77003 is for fluoroscopic guidance of needle placement for spinal injections, but the codes can’t be reported together per instructions for both codes. This means only answer D is correct; this is a proper coding combination per the instructions for CPT® +77002.
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Question 5 of 10
5. Question
The following are considered paired anatomic structures of the larynx/pharynx, and modifier 50 may be reported with the appropriate laryngoscopy code (31572-31574) when performed bilaterally:
Correct
CPT® states paired structures include true vocal cords, arytenoids, false vocal cords, ventricles, pyriform sinuses, and aryepiglottic folds.
Incorrect
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Question 6 of 10
6. Question
Code for ablation of uterine fibroid(s) by surgical laparoscopy.
Correct
Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency for ablation (destruction) of uterine fibroids using radiofrequency. The procedure includes ultrasound guidance. Code 58674 replaces Category III code 0336T.
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Question 7 of 10
7. Question
The proximal row of carpal bones consists of all of the following, except:
Correct
The proximal row of carpal bones consists of the scaphoid, lunate, and triquetral bones, which articulate with the radius and the articular disk of the ulna. The distal row of carpal bones is made up of the trapezium, trapezoid, capitate, and hamate bones.
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Question 8 of 10
8. Question
An expanded problem-focused home visit for a new patient typically lasts how long, per CPT®?
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CPT® includes average time in the description of home visits, to be used when counseling/coordination of care dominate the visit (e.g., comprises over 50 percent of total face-to-face time between the provider and patient), as follows: Code Description RVU Average Time 99341 Home visit new patient; problem focused 1.55 20 min. 99342 Home visit new patient; expanded 2.23 30 min 99343 Home visit new patient; detailed 3.66 45 min.. 99344 Home visit new patient; moderate 5.13 60 min. 99345 Home visit new patient; high 6.22 75 min. 99324 Domiciliary, rest home visit new patient; a problem focused 1.56 20 min. 99325 Domiciliary, rest home visit new patient; expanded 2.27 30 min. 99326 Domiciliary, rest home visit new patient; detailed 3.92 45 min. 99327 Domiciliary, rest home visit new patient; moderate 5.23 60 min. 99328 Domiciliary, rest home visit new patient; high 6.11 75 min.
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Question 9 of 10
9. Question
What is the ICD-10-CM code for benign neoplasm of ascending colon?
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The ICD-10 Code for benign neoplasm of ascending colon is D12.2.
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Question 10 of 10
10. Question
The ICD-10-CM code for rectal polyp is reported with:
Correct
The ICD-10-CM code for rectal polyp is K62.1.
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Coding Quiz 12
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Quiz 12
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Question 1 of 10
1. Question
A patient presents with onycholysis in her right middle finger for a follow-up, level 2 visit. The provider performs avulsion of the nail plate. Proper coding for such an encounter will be:
Correct
Explanation.The diagnosis (L60.1 Onycholysis) links to both the evaluation and management (E/M) service (99212 Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making.) and the avulsion (11730 Avulsion of nail plate, partial or complete, simple; single). Different diagnoses are not required to report the E/M service on the same date. Modifier 25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or another service must be appended to the E/M service to distinguish it as a significant, separately reported service.
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Explanation.The diagnosis (L60.1 Onycholysis) links to both the evaluation and management (E/M) service (99212 Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making.) and the avulsion (11730 Avulsion of nail plate, partial or complete, simple; single). Different diagnoses are not required to report the E/M service on the same date. Modifier 25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or another service must be appended to the E/M service to distinguish it as a significant, separately reported service.
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Question 2 of 10
2. Question
The provider trims non-dystrophic nails on the right hand (five fingers) and the left hand (two fingers), with debridement of the same fingers. Proper coding is:
Correct
Explanation: National Correct Coding Initiative (NCCI) edits bundle 11721 Debridement of a nail(s) by any method(s); 6 or more and 11719 Trimming of nondystrophic nails, any number. Report only 11719.
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Explanation: National Correct Coding Initiative (NCCI) edits bundle 11721 Debridement of a nail(s) by any method(s); 6 or more and 11719 Trimming of nondystrophic nails, any number. Report only 11719.
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Question 3 of 10
3. Question
All new, initial, and emergency department codes must meet how many of the three defined levels for history, exam, and MDM?
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Explanation: All new, initial, and emergency department codes must meet three of three defined levels for history, exam, and medical decision-making (MDM).
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Explanation: All new, initial, and emergency department codes must meet three of three defined levels for history, exam, and medical decision-making (MDM).
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Question 4 of 10
4. Question
Proper coding of Watchman™ implant is:
Correct
Explanation: As of Jan. 1, 2017, 33340 Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed; and radiological supervision and interpretation replaces deleted Category III code 0281T to describes transcatheter placement of an implant (e.g., Watchman™ implant) to close the left atrial appendage, as an alternative to long-term oral anticoagulants to deter emboli formation and prevent stroke.
Incorrect
Explanation: As of Jan. 1, 2017, 33340 Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed; and radiological supervision and interpretation replaces deleted Category III code 0281T to describes transcatheter placement of an implant (e.g., Watchman™ implant) to close the left atrial appendage, as an alternative to long-term oral anticoagulants to deter emboli formation and prevent stroke.
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Question 5 of 10
5. Question
Code the repair of an aortic valve via open approach with the patient on cardiopulmonary bypass. The procedure involves valvotomy, debridement, debulking, and simple commissural resuspension.
Correct
Explanation: The provider repairs an aortic valve (to treat aortic valve stenosis, or narrowing) via an open approach with the patient on cardiopulmonary bypass. Code 33390 Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; simple (i.e., valvotomy, debridement, debulking, and/or simple commissural resuspension) describes a “simple” procedure. Code 33391 Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; complex (i.e., leaflet extension, leaflet resection, leaflet reconstruction, or annuloplasty) describes a “complex” procedure.
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Explanation: The provider repairs an aortic valve (to treat aortic valve stenosis, or narrowing) via an open approach with the patient on cardiopulmonary bypass. Code 33390 Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; simple (i.e., valvotomy, debridement, debulking, and/or simple commissural resuspension) describes a “simple” procedure. Code 33391 Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; complex (i.e., leaflet extension, leaflet resection, leaflet reconstruction, or annuloplasty) describes a “complex” procedure.
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Question 6 of 10
6. Question
Code for complete exchange transfusions in a neonate:
Correct
Explanation: For complete exchange transfusions in a neonate, report 36450 Exchange transfusion, blood; newborn. Do not report 36456 Partial exchange transfusion, blood, plasma, or crystalloid necessitating the skill of a physician or other qualified health care professional, newborn with transfusion services 36430, 36440, or 36450.
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Explanation: For complete exchange transfusions in a neonate, report 36450 Exchange transfusion, blood; newborn. Do not report 36456 Partial exchange transfusion, blood, plasma, or crystalloid necessitating the skill of a physician or other qualified health care professional, newborn with transfusion services 36430, 36440, or 36450.
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Question 7 of 10
7. Question
Code for closed treatment of posterior pelvic ring fracture under general anesthesia:
Correct
Explanation: Codes 27193 and 27914 were deleted for 2017 and replaced with two new codes: 27197 Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; without manipulation and 27198 Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; with manipulation, requiring more than local anesthesia (ie, general anesthesia, moderate sedation, spinal/epidural).
Incorrect
Explanation: Codes 27193 and 27914 were deleted for 2017 and replaced with two new codes: 27197 Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; without manipulation and 27198 Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; with manipulation, requiring more than local anesthesia (ie, general anesthesia, moderate sedation, spinal/epidural).
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Question 8 of 10
8. Question
Code for closed treatment of anterior (vs. posterior) pelvic ring fracture:
Correct
Explanation: For closed treatment of anterior (vs. posterior) pelvic ring fracture and dislocation(s) of the pubic symphysis and superior/inferior rami (unilateral or bilateral), CPT® instructs you to report an appropriate E/M services code.
Incorrect
Explanation: For closed treatment of anterior (vs. posterior) pelvic ring fracture and dislocation(s) of the pubic symphysis and superior/inferior rami (unilateral or bilateral), CPT® instructs you to report an appropriate E/M services code.
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Question 9 of 10
9. Question
Which is proper coding for intramuscular injection of trivalent influenza vaccine (IIV3), 0.5 ml dosage?
Correct
Explanation: In 2017, eight influenza vaccine codes are reported by dosage, rather than patient age (deleted text is crossed out, new text is underlined): 90655 Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, when administered to children 6-35 months of age0.25 mL dosage, for intramuscular use 90656 Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, when administered to individuals 3 years and older0.5 mL dosage, for intramuscular use 90657 Influenza virus vaccine, trivalent (IIV3), split virus, when administered to children 6-35 months of age0.25 mL dosage, for intramuscular use 90658 Influenza virus vaccine, trivalent (IIV3), split virus, when administered to individuals 3 years of age and older0.5 mL dosage, for intramuscular use 90685 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, when administered to children 6-35 months of age0.25 mL dosage, for intramuscular use 90686 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, when administered to individuals 3 years of age and older0.5 mL dosage, for intramuscular use 90687 Influenza virus vaccine, quadrivalent (IIV4), split virus, when administered to children 6-35 months of age0.25 mL dosage, for intramuscular use 90688 Influenza virus vaccine, quadrivalent (IIV4), split virus, when administered to individuals 3 years of age and older0.5 mL dosage, for intramuscular use In this scenario, there is no mention of preservative- free vaccine.
Incorrect
Explanation: In 2017, eight influenza vaccine codes are reported by dosage, rather than patient age (deleted text is crossed out, new text is underlined): 90655 Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, when administered to children 6-35 months of age0.25 mL dosage, for intramuscular use 90656 Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, when administered to individuals 3 years and older0.5 mL dosage, for intramuscular use 90657 Influenza virus vaccine, trivalent (IIV3), split virus, when administered to children 6-35 months of age0.25 mL dosage, for intramuscular use 90658 Influenza virus vaccine, trivalent (IIV3), split virus, when administered to individuals 3 years of age and older0.5 mL dosage, for intramuscular use 90685 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, when administered to children 6-35 months of age0.25 mL dosage, for intramuscular use 90686 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, when administered to individuals 3 years of age and older0.5 mL dosage, for intramuscular use 90687 Influenza virus vaccine, quadrivalent (IIV4), split virus, when administered to children 6-35 months of age0.25 mL dosage, for intramuscular use 90688 Influenza virus vaccine, quadrivalent (IIV4), split virus, when administered to individuals 3 years of age and older0.5 mL dosage, for intramuscular use In this scenario, there is no mention of preservative- free vaccine.
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Question 10 of 10
10. Question
Report the intramuscular administration of quadrivalent influenza vaccine for a 67-year-old Medicare patient
Correct
Explanation: Medicare requires G0008 Administration of influenza virus vaccine for the administration of a flu vaccination. Note also that Medicare pays for a single influenza virus vaccination per influenza season.
Incorrect
Explanation: Medicare requires G0008 Administration of influenza virus vaccine for the administration of a flu vaccination. Note also that Medicare pays for a single influenza virus vaccination per influenza season.
Coding Quiz 11
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Test your coding skills with our basic quiz 11
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Question 1 of 10
1. Question
What is the appropriate code assignment for chronic (viral) hepatitis C?
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Question 2 of 10
2. Question
What is the appropriate code assignment for food poisoning due to staphylococcus?
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Question 3 of 10
3. Question
What is the appropriate code assignment for infectious gastroenteritis?
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Question 4 of 10
4. Question
What is the appropriate code assignment for pulmonary tuberculosis?
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Question 5 of 10
5. Question
What is the appropriate code assignment for Streptococcal sepsis, unspecified?
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Question 6 of 10
6. Question
What is the appropriate for Hepatitis B Carrier?
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Question 7 of 10
7. Question
What is the appropriate code assignment for Personal history of breast CA?
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Question 8 of 10
8. Question
What is the appropriate code assignment for Personal history of colon polyps?
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Question 9 of 10
9. Question
What is the appropriate code assignment for a Screening Mammogram for malignant neoplasm of the breast?
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Question 10 of 10
10. Question
What is the appropriate code assignment for Pregnancy state incidental?
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Coding Quiz 10
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Coding Quiz 10
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Question 1 of 10
1. Question
ICD-10 PCS will be used to report:
Correct
The ICD-10 Procedure Coding System (ICD-10-PCS) is an international system of medical classification used for procedural coding. ICD-10-PCS is a replacement for ICD-9-CM, Volume 3.
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The ICD-10 Procedure Coding System (ICD-10-PCS) is an international system of medical classification used for procedural coding. ICD-10-PCS is a replacement for ICD-9-CM, Volume 3.
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Question 2 of 10
2. Question
Meningitis due to ECHO virus will be coded as:
Correct
Applicable To
Coxsackievirus meningitis
Echovirus meningitisIncorrect
Applicable To
Coxsackievirus meningitis
Echovirus meningitis -
Question 3 of 10
3. Question
Nosocomial infectious mononucleosis will be coded as:
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Question 4 of 10
4. Question
What will be the correct code for coding Genital herpes:
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Question 5 of 10
5. Question
What will be the ICD-10 code for AIDS:
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Question 6 of 10
6. Question
Acute salpingitis due to gonococcal infection will be coded as:
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Question 7 of 10
7. Question
The first digit of an ICD-10 CM diagnosis code is:
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Question 8 of 10
8. Question
What is the designated placeholder character for ICD-10-CM?
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Question 9 of 10
9. Question
How many characters comprise an ICD-10 PCS procedure code?
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Question 10 of 10
10. Question
Cystic fibrosis, unspecified is:
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Quiz 9
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Test your coding skills with our basic quiz 9, 10 questions
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Question 1 of 10
1. Question
Which of the following describes Brachytherapy?
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Question 2 of 10
2. Question
Physician A introduces contrast via lumbar puncture and Physician B performs radiological supervision and interpretation for cervical and lumbar myelogram, followed by CT of the same regions. Which is the correct coding for physician B?
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Question 3 of 10
3. Question
Risk adjustment means:
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Question 4 of 10
4. Question
Payers typically bundle or will not separately reimburse monitored anesthesia care performed in a non-facility place of service.
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Question 5 of 10
5. Question
What will be the proper ICD-10-CM code to report Kanner’s syndrome?
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Question 6 of 10
6. Question
Place of service 11 stands for:
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Question 7 of 10
7. Question
The suffix -emia means:
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Question 8 of 10
8. Question
The key components in selecting the level of E/M services are:
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Question 9 of 10
9. Question
Medicare does not accept consultation codes:
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Question 10 of 10
10. Question
Rift valley fever will be coded as:
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