Exam Questions for CPT and HCPCS
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1 Exam Questions for CPT and HCPCS Name Directions: Use the appropriate coding manual to determine the correct choice for each situation. 1. To report ambulance services for a Medicare patient ordered by a physician, use modifier: -QM -QN -RC -RT 2. A patient underwent simple incision and drainage of an abscess on his thigh. The wound was packed with iodoform gauze (approximately 2 x 2). Select the correct codes for the procedure and the gauze A A A A HCPCS Level II codes are four-position alphanumeric codes used to represent items not represented in Level I (CPT) codes. 4. A patient is to undergo an IVP but has a severe reaction to the contrast material and the IVP procedure is discontinued. Which modifier is used to describe this situation? A patient was seen in the urgent care center with signs and symptoms of dehydration. She was observed for 8 hours while receiving IV normal saline infusion, 1000 cc. Select the correct HCPCS code for the infusion. J7030 J7040 J7050 J The L group of codes represents which procedures/products? pathology and laboratory drugs and enterals orthotics and prosthetics speech and language services 7. In CPT coding, the history, examination, and medical decision making are considered the key components in selecting the level of E/M services. 8. If a patient has trigger thumb release performed on the right, which modifier is used for the anatomic location? -F4 -F5 -F9 -FA Current Procedural Terminology 2007 American Medical Association. All Rights Reserved. 131
2 9. A nursing facility patient developed multiple decubitus ulcers after a hospital stay. Her physician readmitted her to the nursing facility did a detailed exam, developed a new plan of care, and ordered an air fluidized bed for treatment. Select the correct E/M and HCPCS codes E E E E The use of HCPCS codes is mandatory on all Medicare and Medicaid claims submitted for payment for services of allied health care professionals. 11. A patient was seen in consultation for possible surgery. The surgeon schedules the procedure for the following day. Which modifier would you choose to indicate the decision for surgery? Select the correct HCPCS code for an insertion tray without drainage bag or catheter. A4310 A4311 A4312 A Select the correct HCPCS code for surgical stockings, below-knee length. A4490 A4495 A4500 A In CPT coding, the definition of outpatient services would be those provided to a person who only stays in the hospital overnight. 15. A patient has incision and drainage of an abscess involving the left fourth toe. Identify the correct modifier. -T2 -T3 -T6 -T8 16. The patient was seen in the office for a facial chemical peel, epidermal only K codes in HCPCS represent the official codes for durable medical equipment. 18. The patient was seen in the emergency department for acute shortness of breath. During his observation in the emergency department, multiple arterial blood gas testing was performed to monitor his improvement. Which modifier would you choose to accurately code the multiple ABGs? Current Procedural Terminology 2007 American Medical Association. All Rights Reserved.
3 19. Select the correct HCPCS code for a tourniquet used by a dialysis patient. A4911 A4913 A4918 A Select the correct HCPCS code for a pair of aluminum underarm crutches. E0110 E0112 E0114 E Physical status modifiers in CPT are used to distinguish the varying levels of complexity of surgical services provided. 22. A Medicare patient received a wheelchair two months ago, but the beneficiary has not decided whether to purchase or rent. Which HCPCS modifier would you use? -BO -BP -BR -BU 23. A teenage patient, new to the practice, was seen for signs and symptoms of tonsillitis and pharyngitis. She was given an injection of azithromycin for her acute symptoms. Select the correct E/M code and the HCPCS code J J J J It is acceptable to code HCPCS from index entries only. 25. A patient was seen by her family doctor for a routine physical exam. During the exam, the patient was noted to have high blood pressure. The physician discussed the new finding with the patient, and the patient disclosed she has been under a great deal of stress due to the demands of her work and impending divorce. The high blood pressure was deemed stressrelated and the physician and the patient discussed stress-reduction techniques. As a result of the extended discussion with the patient, the visit was prolonged beyond the normally expected length for a routine physical exam. Which CPT modifier would you use to document the additional time spent with the patient? Select the correct HCPCS code for a surgically implanted electrical osteogenesis stimulator. E0748 E0749 E0760 E Select the correct HCPCS code to report a patient receiving an injection of amphotericin B, 50 mg. J0285 J0287 q = 5 J0288 q = 5 J0289 q = 5 Current Procedural Terminology 2007 American Medical Association. All Rights Reserved. 133
4 28. The general definition of the CPT surgical package includes the patient s preoperative evaluation on the day of the procedure, the surgical procedure and its usual components, and the patient s uncomplicated follow-up care. 29. The patient had a skin tag removed from her upper left eyelid. Which HCPCS modifier describes this location? -El -E2 -E3 -E4 30. An infant born with clubfoot on the right was seen in the pediatric orthopedic clinic as a new patient. The physician conducted a problemfocused history and examination and prescribed a clubfoot wedge for the patient. Select the correct codes for the visit and the wedge L3201-RT L3380-RT L3201-RT L3380-RT 31. The HCPCS route of administration abbreviation IT means the patient is receiving the drug intrathecally. 32. The patient was seen in the office for exercise stress testing. When the physician was placing the EKG leads, she noticed a suspicious mole on the patient s chest and excised the lesion. What CPT modifier would you use to indicate the additional procedure performed during this visit? A patient was seen in the office for acute hives. The doctor gave her a 25 mg. injection of hydroxyzine. Select the correct HCPCS code. J3400 J3410 J3470 J Select the correct HCPCS code for an orthopedic shoe insole made of felt and covered with leather. L3520 L3540 L3570 L To measure and code the removal of a lesion using CPT guidelines, the lesion size must be expressed in inches. 36. If a patient is prescribed oxygen therapy at 0.5 liters per minute, which HCPCS modifier describes this flow rate? -QE -QF -QG -QH 37. An established patient was seen in the office because of difficulty toileting after hip replacement surgery. The physician examined the patient and sent her home with a stationary commode chair with fixed arms to use during her recovery period. Select the appropriate codes E E E E Current Procedural Terminology 2007 American Medical Association. All Rights Reserved.
5 38. All HCPCS codes and descriptions are updated monthly by CMS. 39. Which CPT modifier would you choose to indicate a patient received a service or procedure that was less than originally intended? Select the correct HCPCS code that describes the reduction of an ocular prosthesis. V2623 V2625 V2626 V A patient was given an intramuscular injection of 2 mg. of Haldol in the physician s office. Select the correct HCPCS code. J1630 J1631 J3410 J When coding bilateral procedures in CPT, you must always include the code The mobile x-ray service came to the nursing facility to x-ray Mrs. Jones for possible hip fracture. The x-ray will be interpreted tomorrow by the radiologist. Which HCPCS modifier would you use for today s service? -TA -TC -TD -TE 44. A Medicare patient with diabetes saw the doctor for routine foot care: the trimming of three calluses and debridement of all 10 toenails S Laboratory services in HCPCS are listed in the P codes grouping. 46. Which CPT modifier would you use to indicate that an outside laboratory was used to process a patient s specimen? Select the correct HCPCS code for a patient receiving nonemergency minibus transportation in a mountain area. A0080 A0110 A0120 A Many radiology procedures include two parts: a technical component and a professional component. Current Procedural Terminology 2007 American Medical Association. All Rights Reserved. 135
6 49. The patient has used his wheelchair for nearly four years. Due to wear, he now needs a replacement for the right footrest. Which HCPCS modifier is used to indicate this replacement? -RC -RP -RR -RT 50. A patient was referred to the office of a wound care specialist for consultation regarding his nonhealing surgical wound. The physician spent approximately 30 minutes with the patient and sent him home on topical hyperbaric oxygen chamber therapy for wound healing. Select the correct codes A A A A Drugs listed in HCPCS are identified by both brand and generic names. 52. A patient underwent emergency cholecystectomy six days after having a lung biopsy. The same surgeon performed both procedures. Which CPT modifier is used on the second surgery to indicate this type of situation? Which of the following HCPCS code groups are listed for use only on a temporary basis? G, J, Q G, K, Q J, K, Q K, P, Q 54. A patient was seen for insertion of a temporary indwelling Foley urinary catheter. Select the correct codes A A A A According to CPT coding guidelines, a pathology consultation includes a medical interpretive report. 56. Dr. Wilkins amputated a patient s right lower extremity (BKA). His staff PA was the assistant during the procedure. Which HCPCS modifier would you choose to indicate the PA s role in this procedure? -AD -AM -AS -AT 57. Patient was seen by the nurse for a routine visit in the multiple sclerosis clinic. The patient received an injection of beta-1a interferon, 33 mcg., by the nurse in the clinic. Select the appropriate codes J J9212 q= J J HCPCS ambulance modifiers always include one alpha character and one numeric character. 136 Current Procedural Terminology 2007 American Medical Association. All Rights Reserved.
7 59. If a patient suddenly refuses to have surgery performed after being prepped for the procedure, which CPT modifier would you use to indicate the change in plans? none of the above 60. Select the correct HCPCS code for a drainable rubber ostomy pouch with a faceplate attached. A4375 A4376 A4377 A Select the correct HCPCS code for replacement handgrip for a cane that the patient owns. A4635 A4636 A4637 A In CPT coding, when the patient receives an immune globulin product, you must also include an administration code as appropriate. 63. An ambulance was called to come to the aid of a choking patient; however, the patient expired before the ambulance arrived on the scene. Which HCPCS modifier would you use to document this circumstance? -QK -QL -QM -QP 64. Patient underwent unattended sleep study with monitoring of oxygen saturation. The patient was not able to sleep adequately throughout the study and therefore the study was equivocal. The patient was provided with a recording apnea monitor for home use. Select the appropriate codes E E E E The two levels of national HCPCS codes can be applied to both inpatients and outpatients. 66. Which CPT modifier is used to indicate a repeat procedure performed by a different physician? Select the correct HCPCS code for a hydrogel dressing with an adhesive border used to cover a wound, measuring 24 square inches. A6242 A6243 A6246 A Select the correct HCPCS code for home mix parenteral nutritional additives, to include electrolytes. B4197 B4199 B4216 B4220 Current Procedural Terminology 2007 American Medical Association. All Rights Reserved. 137
8 69. When coding in CPT, no distinction is made between new and established patients in the emergency department. 70. The patient was seen in the contraceptive clinic two weeks after delivery of her child. She was fitted with a copper intrauterine device. Select the codes for the fitting and the device J J J J Select the correct HCPCS code for a brake attachment for wheeled walker. E0143 E0147 E0155 E Select the correct HCPCS code for a patient admitted as an inpatient to a residential addiction program for acute alcohol detoxification. H0009 H0011 H0012 H A patient was fitted with a 2-lead TENS unit for pain control after suffering a fractured radius. Select appropriate codes E E E E Select the correct HCPCS code for an injection of methylprednisolone acetate, 40 mg. J1020 q = 2 J1030 J1040 J The patient came to the office to have a B12 level analysis and to receive her weekly B12 shot. Select the correct codes J J J J Select the HCPCS code that correctly identifies a unit of leukocyte-reduced platelets. P9019 P9020 P9031 P Select the correct HCPCS code for 1 mg. of inhaled dexamethasone in concentrated form. J1094 J1100 J7637 J A patient who is status post left-sided CVA was seen for weight loss and other symptoms indicative of dysphagia. She received dysphagia screening and her first treatment for the swallowing dysfunction. Select the correct codes V V V V Current Procedural Terminology 2007 American Medical Association. All Rights Reserved.
9 79. Select the correct HCPCS code for a non-heated humidifier used with a positive airway pressure device. A7039 E0550 E0560 E The physician spent 30 minutes with the patient and family to discuss discharge plans on the day of discharge, as well as the patient s immediate at-home care. The patient had undergone his second below-knee amputation, and was given a transfer board for use at home. Select the codes for the discharge visit and the transfer board E E E El Select the correct HCPCS code that reflects the supply of one vial of technetium Tc 99m disofenin. A9500 A9502 A9510 A Identify the HCPCS code that describes a fullleg, segmental pneumatic appliance with compressor. E0650 E0660 E0667 E Select the HCPCS code for a 50 mg. intravenous infusion of cisplatin in the physician s office. J0743 J0770 J9060 J To report the services of a CRNA directed by the anesthesiologist for the fifth procedure supervised by that physician, use modifier: -QS -QX -QY -QZ 85. To report the services of the physician in question 84, use modifier: -AA -AD -QK -QY 86. As part of the preschool program, the 4-yearold boy had a topical fluoride application. D1120 D1203 D1204 D A patient was fitted with a custom-made compression burn garment for severe burns of the chest and upper back. A6501 A6509 A6510 A The patient with a fractured femur and tibia had a trapeze and grab bar attached to a hospital bed in his home. E0910 E0920 E0940 E0941 Current Procedural Terminology 2007 American Medical Association. All Rights Reserved. 139
10 89. Five patients participated in the group psychotherapy session and received educational materials A 68-year-old male received a drainable ostomy pouch with an attached barrier. A5051 A5054 A5061 A The patient got a replacement for a lost gas permeable bifocal contact lens. V2430 V2502 V2512 V The codes in HCPCS that should not be reported to Medicare are the ones that begin with the letters: B, E, H, S D, G, H, T D, H, S, T H, K, S, T 93. A defined formula (100 calories to a unit) to meet a special metabolic need when administered through a feeding tube is reported with code: B4150 B4152 B4153 B Dr. Johnson serves a large rural area and some patients request their E/M services via the Internet. These documented encounters would be reported with code: The infant with a left club foot was treated by manipulation and a short leg cast LT LT LT LT 96. Mrs. Johnson was given a half-leg nonsegmental pneumatic appliance to use at home with her pneumatic compressor. E0655 E0660 E0666 E A shoe store specializing in diabetic shoes supplied the patient with a pair that had a metatarsal bar. A5500 q = 2 A5503 q = 2 A5504 q = 2 A5505 q = Following his hospitalization, the patient went home with cervical traction equipment that fit over a door. E0840 E0850 E0860 E Current Procedural Terminology 2007 American Medical Association. All Rights Reserved.
11 99. The patient was authorized to receive a new 12 volt battery charger. L7360 L7362 L7364 L The patient received 1 g. of liquid immune globulin intravenously from the nurse in his doctor s office J J J J1568 q=2 Current Procedural Terminology 2007 American Medical Association. All Rights Reserved. 141
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13 Name Answers to Exam Questions: CPT and HCPCS
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