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

NEW QUESTION # 100
Consultation codes 99242-99245 have been deemed as not medically necessary and are no longer reimbursed by Medicare. This decision would fall under which term?

• A. Local Coding Determination
• B. Governed Coding Determination
• C. National Coding Determination
• D. Carrier Coding Determination

Answer: C

Explanation:
Decisions regarding coverage are made through evidence-based processes and public opinion. National Coding Determination (NCD) is specific to Medicare coverage nationwide, whereas Local Coding Determination (LDC) is contractor and commercial specific. Carrier and Governed Coding Determinations do not exist.

NEW QUESTION # 101
If a patient is receiving hospice care in a physician's office, which place of service code should be reported on the claim?

• A. 0
• B. 1
• C. 2
• D. 3

Answer: D

Explanation:
Place of service (POS) codes "specify the entity where service(s) were rendered." In this case, hospice care was provided in an office, which would correspond to POS 11. POS 34 is hospice care provided in a facility, POS 71 is a public health clinic that provides ambulatory medical care, and POS 62 is an outpatient rehabilitation facility providing services that would include physical and occupational therapy.

NEW QUESTION # 102
The appendix is removed through an abdominal incision due to metastatic colon malignancy. How should this be reported?

• A. 44970, C78.5
• B. 44950, C78.5, C18.9
• C. 44950, C78.5
• D. 44970, C18.9, C78.5

Answer: B

Explanation:
An open appendectomy procedure is reported with CPT 44950. A metastatic colon malignancy is a cancer that began in the colon but has spread to other areas. In this scenario, that means that the primary malignancy is the colon, and the secondary malignancy is the appendix.
Additionally, ICD-IO-CM guidelines state that when "treatment is directed toward the metastatic site only, the metastatic site is designated as the principal/first-listed diagnosis. The primary malignancy is coded as an additional code." The malignancy codes do not specifically state
"appendix," but the ICD-IO-CM coding crosswalk in the neoplasm table assigns this diagnosis as C78.5 secondary malignant neoplasm of large intestine and rectum.

NEW QUESTION # 103
Code the following surgical note:
Patient is seen for an epidural injection into the following three levels: L3-L4, L4-L5 and L5-S1.
A 22 -gauge spinal needle is inserted into the zygapophyseal joint using fluoroscopic guidance. After confirming the needles placement at L3-L4 on the left side, 0.5 cc of a local anesthetic is injected into the joint. The whole process is repeated on the left side at the other two levels. The procedure was completed without any complications.

• A. 64493-LT, 64494-59-LT, 64495-59u
• B. 0216T-LT, 0217T-LT, 0218T-LT
• C. 0
• D. 64493-LT, 64494-LT, 64495-LT

Answer: D

Explanation:
64493 is used for the initial injection of an anesthetic, followed by 64494 and 64495 as add-on codes for the other Two levels. Because there are two sides of a facet joint, modifier LT would be amended to show the carrier that the procedure occurred on the left side of the spine.
In answer B, CPT codes 0216T-0218T exclude fluoroscopic guidance and refer the biller to codes
64490-64495. In general, modifier 59 would not be used on add-on codes, so answer C can be eliminated. Answer D describes an injection in the interlaminar epidural or subarachnoid space and is not the correct procedure code for this circumstance.

NEW QUESTION # 104
A sternal closure using sutures is considered inclusive to CPT 33255 and should not be reported separately.

• A. True
• B. False

Answer: A

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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