2021 CPC Exam Study - Coding Guidelines

2021 CPC Exam Study - Coding Guidelines A0429 ✔✔Ambulance Service, BLS Emergency Transport square centimeters. ✔✔The size of a skin graft is measured in 69209 ✔✔When impacted cerumen is removed by irrigation only, wh ...

2021 CPC Exam Study - Coding Guidelines A0429 ✔✔Ambulance Service, BLS Emergency Transport square centimeters. ✔✔The size of a skin graft is measured in 69209 ✔✔When impacted cerumen is removed by irrigation only, what code(s) would be appropriate? GA ✔✔Medicare patient requests EKG/blood work for which there is no documentation to support medical necessity An Advance Beneficiary Notice (ABN) is signed by the patient prior to proceeding with the requested services. What modifier should be appended to these services? Without contrast ✔✔When a radiology service is performed with oral contrast, how should it be coded? written request, referring physician, and written report for each consultant, as well as specific reason each unique specialist is seeing patient ✔✔Multiple consultations were performed by multiple specialists during the same hospitalization. In order for each of these services to be considered for payment, what information must be documented and coded? 96365, 96366 x 3 units ✔✔When an intravenous infusion of medication is documented from 8:00 AM to 12:15 PM, what code(s) should be assigned? 97602 ✔✔When nonexcisional debridement is performed to an entire wound area, what code(s) are assigned? Rule of Nines ✔✔What guidelines are utilized in ICD-10-CM when determining the extent of body surface area? Append modifier -25. ✔✔Per CPT guidelines, would it be appropriate to code a procedure or service on the same date of service as an E/M service that is significantly separately identifiable. If so, what modifier should be appended? Colonoscopy with biopsy only ✔✔When a diagnostic colonoscopy and colonoscopy with biopsy are performed during the same surgical session, what code(s) are reported? 96365, 96375 ✔✔When an intravenous medication infusion is performed for 1 hour as well as an intravenous injection (IVP) during the same encounter, how are these services reported? 45385, 45384-59 ✔✔When snare polypectomy is performed on one polyp during the course of a colonoscopy as well as polypectomy by hot biopsy forceps to another polyp during the same session, what service(s) are reportable? 97597 ✔✔When non-excisional debridement is performed to a selected area of a wound that is less than 20 sq cm, what code(s) are assigned? 45385 only ✔✔When multiple polypectomies by snare are performed at two different sites during the course of a colonoscopy, what code(s) should be reported? Two ✔✔What is the minimum number of codes that should be assigned when two lesions are excised through two separate excision sites? 25600-54-RT ✔✔Patient presents to the ED where a diagnosis of closed fracture of the right distal radius was made by the ED physician. The orthopedic surgeon performs closed treatment of the fracture. The patient is referred to an orthopedist in his hometown for postoperative care. Assign the appropriate CPT code(s)/modifier(s) for the procedures performed by the surgeon in the ED. Evaluation and Management ✔✔The application of steri-strips should be assigned what category of codes? Append modifier -57 to consultation code. ✔✔A 47-year-old patient with commercial insurance is seen in consultation the morning the MD performs an abdominal hysterectomy. The consultation was coded but denied as "included in global service." What corrections, if any, should be made to the consultation code? -78 ✔✔Patient who had an A&P colporrhaphy performed four days prior was taken to the OR for bright red vaginal bleeding, which revealed a bleeding site. The same surgeon who performed the colporrhapy controlled the bleeding with placement of sutures. What modifier(s) would be appropriate for this service? No, code 43235 should be corrected to 43239 as biopsies were performed. ✔✔A scope was introduced into the esophagus and advanced to the stomach and duodenum. Multiple erosions were biopsied through the scope. The remainder of the EGD was normal. With the patient repositioned in the left lateral position, a scope was introduced into the rectum and advanced through the colon to the cecum. With the exception of hemorrhoids, the scope was normal. The practice coded 43235 and 45378 for these services. Are the codes submitted correct, and, if not, what correction needs to be made? surgical arthroscopy procedure only ✔✔When a diagnostic arthroscopy is performed followed by a surgical arthroscopic procedure, what service(s) are reportable? -LC ✔✔When performing an angioplasty on the left circumflex coronary artery, what modifier(s) should be appended for these services? 96360, 96361 x 3 ✔✔When hydration is performed for a total of 4 hours, what code(s) should be assigned? two units only ✔✔When physical therapy that is reported in 15-minute increments is performed for 35 minutes, how many units of service should be reported?