CPT Category I codes are updated annually with additions, revisions, and deletions that become effective on January 1 of each year.
CPT Category III codes are temporary codes that represent emerging medical technologies, services, and procedures that have not yet been approved for general use by the FDA, are not otherwise covered by CPT codes, and are composed of four numbers followed by the capital letter F.
A physician can report any CPT code in the codebook for a procedure and/or
service regardless of physician specialty.
Main entries in the Alphabetic Index of the CPT codebook are based on which of the following.
E. All of the above
CPT and HCPCS codes apply to services provided and reported by which of the following
E. A, B, and D
All of the following statements are true of CPT except
D. CPT includes codes for injectable drugs, ambulance services, prosthetic devices, and selected provider services.
The symbol + before a code in CPT means
D. A and B
A modifier allows the provider to explain a special circumstance(s) that is/are not included in the basic definition of the CPT code reported and may or may not effect reimbursement.
Modifier 73 is used to report a discontinued procedure by the physician because of risk to the patient’s health prior to surgical preparation or induction of anesthesia.
Codes designated as “separate procedure” are considered an inherent component of the other more comprehensive or major surgical procedure performed and should not be separately reported unless it is performed independently, is related to the other procedure(s), or is a distinct procedural service which meets one of the criteria listed for use with modifier 59.
If a procedure is included in the heading of an Operative Report but is not substantiated by documentation in the body the coder should do the following:
D. B & C
This modifier is used by both hospitals and physicians for a procedure that has been planned prospectively at the time of the original procedure, may be more extensive, or may be for therapy following a diagnostic surgical procedure.
A. Modifier 58
Modifier 59 should be appended to a procedure/service in all of the following circumstance(s) except
D. To a code designated as a “separate procedure” when integral to the other major procedure(s) performed during the same operative session.
Multiple wound debridements (i.e., debridement of an ulcer) should be summed together for those of the same depth and a separate code(s) should be assigned for debridements at different depths.
When coding excision of lesions (benign or malignant), the total size of the excised area, including margins, are added together in order to determine the entire excised diameter; however, for asymmetrical lesions the greatest diameter of the lesion is used to determine the maximum size of the lesion, along with addition of any margins.
Destruction of 16 premalignant lesions should be reported with codes 17000 and 17004.
All of the following are true of adjacent skin graft codes except
B. Codes do not include the lesion excision and a separate code should be reported.
All of the following are true of wound repairs/closures except
C. An intermediate wound repair goes beyond a layer closure and requires that one or more of the deeper layers of the subcutaneous tissue and superficial fascia, as well as the skin, be closed in layers, and requires Debridement or retention sutures.
Non-segmental instrumentation such as a Harrington rod is a type of posterior instrumentation and can be reported alone with no other procedure codes.
Manipulation refers to the attempted reduction or restoration of a dislocated joint or fracture and there are different codes to report if the fracture/dislocation is performed “with manipulation” or “without manipulation.”
A casting or strapping application code can be reported in addition to the fracture treatment code such as a closed reduction without manipulation.
All of the following are true of open fracture/dislocation treatment codes except
A. The open fracture treatment codes always includes internal and external fixation if performed.
All of the following are true of knee arthroscopy codes except
C. When a diagnostic knee arthroscopy procedure is performed in addition to the surgical knee arthroscopy procedure a code should be reported for each arthroscopic procedure.
A bronchial alveolar lavage (BAL) is performed to collect cells from
peripheral lung tissue and is reported with code 32997.
A diagnostic nasal/sinus endoscopy is not separately reported when performed
in conjunction with a surgical endoscopy.
When an operating microscope is used during a laryngoscopy it should be separately reported in addition to the laryngoscopy code.
All of the following are true of bronchoscopies except
A. surgical bronchoscopy includes a diagnostic bronchoscopy.
B. Bronchoscopy performed with or without cell washings is coded to 31622.
C. Transbronchial lung biopsy performed in two separate lobes should be reported with codes 31628 and 31632.
D. If fluoroscopic guidance is used
to perform a bronchial alveolar lavage a separate code should be reported
for the fluoroscopic guidance.
E. All of the above are true
D. If fluoroscopic guidance is usedto perform a bronchial alveolar lavage a separate code should be reportedfor the fluoroscopic guidance.
Which type of laryngoscopy allows the physician to look directly at the larynx,
a microscope may also be used during the procedure, and the patient is usually placed under general anesthesia?
A redo quadruple coronary bypass performed three (3) years post original procedure with a combination of three (3) saphenous veins and an internal mammary artery is coded as follows: 33533, 33518, 33530.
Removal of central venous access devices should be coded; however, some catheters do not warrant a separate code when no surgical procedure is required and the catheter is simply pulled out.
When reporting percutaneous thrombectomy of a graft assign code 36870. Additional procedures may be reported to identify the punctures of the graft. Two punctures are usually performed; however, code 36145 is reported only one time.
The surgeon performs an open thrombectomy of an AV fistula, without revision of the dialysis graft. What is the correct code assignment?
All of the following are true regarding cardiac catheterizations except
C. Codes 93452 and 93567 should be reported for a combined right and left cardiac cath with left ventriculography and supravalvular ascending aortography.
An additional code should be assigned to identify a D&C when performed with a hysteroscopic biopsy and polypectomy.
A therapeutic cystourethroscopy always includes a diagnostic cystourethroscopy.
When a physician provides all maternity care for a patient from start to finish codes for antepartum visits, a labor and delivery code, and the postpartum visit should all be reported.
All of the following are true in regards to female genital system coding except
D. Laparoscopic removal of 2 fibroids is reported with codes 58545 and 58545-51.
Patient was admitted to the hospital with sharp pelvic pains. A pelvic ultrasound was ordered and the results showed a possible ovarian cyst. The patient was taken to the OR where a laparoscopic destruction of two corpus luteum cysts was performed. Which of the following codes is correct?
A discogram with radiologic supervision and interpretation performed at L2-3 and L3-4 should be reported with codes 62290 x 1 and 72295 x 1.
Endovascular occlusion procedures for treatment of vessels can be permanent or temporary and depending on the code reported radiological supervision and interpretation is already included in the surgical CPT code and should not be separately reported with a radiology code.
Injection of air into the anterior chamber of the right eye along with removal of a blood clot from the anterior segment of the same eye should be coded as: 65930-RT, 66020-RT.
All of the following are true in regards to nervous system coding except
D. Paravertebral facet joint injections with an anesthetic and/or steroidal agent (64490-64495) and paravertebral facet joint nerve destruction by a neurolytic agent (64633-64636) are reported the same: one time per individual nerve treated.
A patient has metastatic brain lesions. The patient undergoes stereotactic radiosurgery gamma knife of two (2) simple lesions. Which of the following is the correct code assignment?
B. 61796, 61797
When reporting a code that includes radiologic supervision and interpretation in the code descriptor modifier 26 should not be appended to the procedure code because the code already describes the professional component in the code descriptor.
All tests listed in a panel code must be performed in order for that code to be reported. When some, but not all, of the tests in the panel are performed, the individual CPT codes should be reported, rather than the panel code.
A non-selective catheterization code(s) may be reported in addition to a selective catheterization procedure(s) if the non-selective cath necessitated a separate or different puncture and modifier 59 should be appended to the non-selective catheterization code(s).
All of the following are true regarding coding for selective catheterizations except for which of the following.
C. Multiple catheterizations of additional 1st/2nd/3rd order placements within the same vascular should be separately reported with code 36218.
A patient undergoes a retrograde urethrocystogram in the urologist’s office. The urologist performs both the injection and the supervision and interpretation. What is the correct code assignment for this physician?
B. 51610, 74450
A 6 year old girl presents to the pediatrician’s office with her mother for a routine well-child check which includes administration of several vaccines. The physician does not provide counseling and the nurse administers all appropriate vaccines. The pediatrician’s office would report the appropriate vaccine product codes in addition to administration codes 90460 and 90461 depending on the # of components included in each vaccine.
Physician interprets and reads an EKG that was performed at the hospital. The appropriate code that should be reported by the physician for his part is 93010.
Physical status modifiers should be appended to an anesthesia services code in order to communicate to the payer that anesthesia services were provided under difficult circumstances because of the patient’s condition, operative conditions, or unusual risk factors.
All of the following are true of modifiers used in reporting anesthesia services except which of the following.
C. A physical status modifier should be used in order to distinguish between various levels of complexity of the anesthesia service provided. For example a patient who has diabetes mellitus should be reported with physical status modifier P1.
All of the following are true when coding Infusions and Injections except for
D. Multiple substances mixed in one bag for an IV infusion should be coded with multiple codes for each substance and multiple codes for administration of the infusion