Deck 9: Laboratory and Pathology

Question 1

A pediatric patient with hyperpyrexia, headache and nausea presented to the office for a sick visit. Upon examination, the pediatrician determined that the patient needed a Complete Blood Count (CBC) to check for the presence and the amount of bacteria in the blood. The first CBC came back with a highly elevated number of white blood cells indicating infection. The pediatrician then ordered a Dexamethasone antibiotic injection in the office and waited three hours and then repeated CBC to recheck the patient's white blood cell count. The repeat CBC showed a decrease in the number of white blood cells indicating that the antibiotic injection was effective. The pediatrician then released the patient. What is the correct code for the CBC only?

A)85025, 85025 -91
B)85025 -22
C)85025
D)85025 (X2)

Answer 1

85025, 85025 -91

Question 2

The patient presented to the physician's office for a comprehensive metabolic panel, but the physician was unable to obtain a sample of the patient's total calcium. What is the correct code for this laboratory service?

A)82040, 82247, 82310, 82374, 82435, 82565, 82947, 84075, 84132, 84155, 84295, 84460, 84450, 84520
B)80053
C)82040, 82247, 82374, 82435, 82565, 82947, 84075, 84132, 84155, 84295, 84460, 84450, 84520
D)82374, 82435, 84132, 84295

Answer 2

82040, 82247, 82374, 82435, 82565, 82947, 84075, 84132, 84155, 84295, 84460, 84450, 84520

Question 3

A patient was brought to the Emergency Department following a car accident. Suspecting that the patient had been drinking and driving, the physician ordered a _______________ alcohol pathology test. After determining that the patient did indeed have alcohol in their system, the physician then ordered a _______________ pathology test to check the amount of alcohol in the bloodstream.

A)Qualitative; quantitative
B)Quantitative; qualitative
C)Qualitative; cytopathological
D)Pathological; quantitative

Answer 3

Qualitative; quantitative

Question 4

An adolescent comes to the lab for drug testing. The lab tests the patient for three drug classes: alcohols, cocaine and metabolites and tetrahydrocannabinols. The laboratory uses the chromatographic method to test all three drug classes with one screening. The patient comes up positive for tetrahydrocannabinols, but negative for the remaining drug classes. A confirmation test is performed to confirm the positive test results. What is the correct code for this laboratory service?

A)80101 (X3), 80102
B)80100
C)80101, 80102
D)80100, 80102

Question 5

A 28-year-old woman presented to the OB/GYN stating that she tested positive on a home pregnancy test. The OB decides to perform a urine pregnancy test in the office for confirmation. What is the OB code for the pregnancy test only?

A)81003
B)81003, 81025
C)81002, 81025
D)81025

Question 6

What is the name of the regulations, which were passed in 1988, to ensure quality standards for all laboratory testing?

A)Pathology and Laboratory Standards Regulations (PLSR)
B)Clinical Laboratory Improvement Amendments (CLIA)
C)Clinical Pathology Regulations (CPR)
D)Molecular Diagnostic Measurement Amendments (MDMA)

Question 7

During the surgical session, the pathologist received and performed analyses on three separate biopsies from the vaginal wall and one from the cervix. How should the surgical pathologist code for this service?

A)88305, 88307
B)88305 (X3)
C)88305 (X4)
D)88305 (X3), 88307

Question 8

The surgical pathologist obtained three skin tags samples from in the patient's right axilla, as well as four samples of breast tissue from the surgical session. The surgical procedure was a radical bilateral mastectomy, including excision of regional lymph nodes and surrounding tissue. How should the surgical pathologist code for this service?

A)88304 (X7)
B)88304 (X3), 88307 (X4)
C)88305 (X3), 88307 (X4)
D)88304 (X3), 88309 (X4)

Question 9

A comprehensive metabolic panel and a general health panel is ordered and performed on a patient. What is the correct CPT coding for these laboratory orders?

A)80053, 80050
B)80050
C)80050, 80051
D)80050, 80048

Question 10

A 26 year old must have a drug screen performed in order to obtain a job at a local nursing home. The nursing home orders a 7-panel drug screen for amphetamines, benzodiazepines, cocaine, heroin, methadone, opiates, and oxycodone. If any of these come up positive by direct optical observation, then definitive drug testing is ordered as reflex testing. This patient did not have any positives on optical observation so no additional testing was performed. What is the correct CPT code for this drug screen?

A)80300
B)80301
C)80302
D)80303

Question 11

A patient who has been on Digoxin needs to have labs drawn to verify his response to the medication. A total Digoxin level is ordered. What is the correct CPT code for this test?

A)80162
B)80163
C)80159
D)80178

Question 12

A patient is on two medications needing monitoring. She needs to have a free and total phenytoin drug assay performed. She also needs to have a Topiramate drug assay performed. What are the correct CPT codes for these tests?

A)80184, 80185, 80201
B)80183, 80184, 80185
C)80185, 80186, 80201
D)80185, 80186, 80200

Question 13

A patient is on Quinidine and needs to have therapeutic drug assay testing completed to verify that he is on the optimal dosage. What is the correct CPT code for this test?

A)80190
B)80194
C)80195
D)80197

Question 14

A patient needs to have an ACTH stimulation panel performed to assess adrenal insufficiency. What is the code for reporting the laboratory component of the testing protocol that should be used for this test?

A)80400, 82533
B)80400, 82533 x 2
C)80400, 82533 x 3
D)80400, 84143 x 2

Question 15

A patient needs to have a TRH (thyrotropin releasing hormone) stimulation panel performed over one-hour duration. What is the correct reporting code for the laboratory component of this testing panel?

A)80438, 84443 x 3
B)80438, 84443 x 2
C)80439, 84443 x 3
D)80439, 84443 x 4

Question 16

A patient needs to have an insulin tolerance panel done to assess ACTH insufficiency. What is the appropriate reporting code(s) for the laboratory component of this testing?

A)80432, 84681 x 5, 82947 x 5
B)80432, 84681 x 4, 82947 x 2
C)80434, 82533 x 5, 82947 x 5
D)80434, 82533 x 4, 82947 x 4

Question 17

A physician requests a clinical pathology consultation on one of his cancer patients on whom he would like to have an in-depth analysis done. He would like the pathology findings to be further defined in conjunction with that patient's medical history and records. The pathologist complies with an in-depth review and written report of his medical interpretive judgment. What is the correct code for this type of consultation?

A)80439
B)80500
C)80502
D)81000

Question 18

A pathologist has been requested to consult with general surgery about lymph node findings. He doesn't know the patient's medical history or have access to the medical records so this consultation is considered to be limited. What is the correct CPT code for this consultation?

A)80500
B)80502
C)81000
D)81005

Question 19

A primary care physician contacts the pathologist at the local hospital because of an anomaly on his patient's pathology report. He asks the pathologist to write a medical interpretive judgment, without ever seeing the patient or knowing more about the patient's history. The pathologist is happy to do this, reexamines the pathology sample and writes a report that he shares with the primary care physician for further clarification. What is the correct code for this type of a consultation?

A)80400
B)80402
C)80500
D)80502

Question 20

A patient is in his primary care doctor's office and needs to have a urinalysis done. They do a dip stick in the office that is not automated and doesn't require microscopy. What is the CPT code for this procedure?

A)81000
B)81001
C)81002
D)81003

Question 21

A young woman goes to her doctor's office to have a urine pregnancy test performed. They can do this test by visual color comparison only at the office. What is the correct CPT code for this test?

A)81000
B)81005
C)81015
D)81025

Question 22

A patient with a family history of breast cancer has a BRCA1 gene analysis ordered. The physician wants the full sequence analysis and common duplication/deletion variants to be assessed. What is the correct CPT code for this test?

A)81211
B)81212
C)81214
D)81216

Question 23

A patient's physician has had a hard time finding the correct drug to put the patient on. Thinking that it has to do with the way the patient's body metabolizes the drug, she orders a CYP2C19 gene analysis. What is the correct CPT code for this test?

A)81220
B)81225
C)81226
D)81227

Question 24

Due to a previous child having some fetal congenital abnormalities, the OB/GYN ordered a biochemical assay of four analytes (AFP, uE3, hCG, DIA) to assess for fetal congenital abnormalities of pregnancy #3. This is done by using the mother's blood and is reported with a risk score for the provider to interpret. What is the correct CPT code for this test?

A)81508
B)81509
C)81510
D)81511

Question 25

A 19 year old was given a lab slip to have a biochemical assay performed of seven analytes to assess for type 2 diabetes. What code should be used for this test?

A)81504
B)81506
C)81507
D)81508

Question 26

A patient needs to have an oncology biochemical assay of five proteins performed to assess for ovarian cancer. These proteins include CA-125, apolipoprotein A1, beta-2 microglobulin, transferring, and pre-albumin.

A)81500
B)81502
C)81504
D)81506

Question 27

A mother is going to have alpha-fetoprotein (AFP) testing done, using the amniotic fluid. What is the correct CPT code for this specific test?

A)82103
B)82104
C)82105
D)82106

Question 28

A patient with a history of low B-12 needs to have this lab test repeated. What is the correct CPT code for Vitamin B-12 testing, which is also known as cyanocobalamin?

A)82607
B)82608
C)82610
D)82615

Question 29

A patient needs to have a specific clotting factor tested for von Willebrand disease. He needs factor VIII, multimetric analysis testing performed. What is the correct CPT code for this laboratory test?

A)85210
B)85245
C)85246
D)85247

Question 30

A patient's physician ordered a clot lysis time, involving whole blood dilution. What is the correct CPT code for this test?

A)85170
B)85175
C)85210
D)85300

Question 31

A patient's physician ordered an erythrocyte sedimentation rate (ESR) and requested that it be automated. What is the correct CPT code for this laboratory test?

A)85635
B)85651
C)85652
D)85660

Question 32

A patient needs to have a high sensitivity C-reactive protein test performed. What is the correct CPT code for this laboratory test?

A)86140
B)86141
C)86146
D)86147

Question 33

A patient has an order for an Islet cell antibody laboratory test. What is the correct CPT code for this particular test?

A)86336
B)86337
C)86340
D)86341

Question 34

A patient has an order for an absolute CD4 T-cell count. What is the correct CPT code for this test?

A)86359
B)86360
C)86361
D)86367

Question 35

A patient needs to have serologic blood typing performed for ABO. What is the correct laboratory code for this test?

A)86890
B)86900
C)86901
D)86902

Question 36

A patient needs to have an antihuman globulin test (Coombs test) performed, which needs to be done as a qualitative indirect test on each reagent red cell. What is the correct CPT laboratory code for this specific test?

A)86880
B)86885
C)86886
D)86890

Question 37

What is the correct CPT code for splitting of blood or blood products per unit?

A)86965
B)86975
C)86985
D)86999

Question 38

A patient needs to have a culture done of his stool looking for Salmonella and Shigella. This will be performed as an aerobic stool sample with isolation and preliminary examination. What is the correct CPT code for this laboratory test?

A)87040
B)87045
C)87046
D)87070

Question 39

A patient needs to have a stool sample done, looking for ova and parasites. What is the correct CPT code for this laboratory test involving direct smears for concentration and identification?

A)87169
B)87172
C)87177
D)87181

Question 40

A patient needs to have a culture done for chlamydia. What is the correct code for this laboratory testing?

A)87109
B)87110
C)87116
D)87118

Question 41

A physician who is performing an autopsy performed a gross examination with the brain and spinal cord. What is the correct CPT code for this necropsy procedure?

A)88000
B)88005
C)88007
D)88012

Question 42

A gross examination and microscopic examination was performed during an autopsy (necropsy) of an infant with the brain also examined. What is the correct CPT code for this procedure?

A)88012
B)88020
C)88028
D)88029

Question 43

The brushings from a bronchoscopy need to be tested. The ordering physician requests a cytopathology smear of the brushings with interpretation to be performed. What is the correct CPT code for this laboratory test?

A)88104
B)88106
C)88108
D)88112

Question 44

A patient needs to have forensic cytopathology run on his sperm. What is the correct laboratory CPT code for this test?

A)88125
B)88130
C)88140
D)88141

Question 45

A physician orders a flow cytometry to be performed for DNA analysis. What is the correct laboratory CPT code for this test?

A)88182
B)88184
C)88185
D)88187

Question 46

A patient is given a lab slip ordering chromosome analysis for breakage syndromes specifically for baseline Sister Chromatid Exchange (SCE) of 20-25 cells. What is the correct CPT code for this laboratory test?

A)88245
B)88248
C)88249
D)88261

Question 47

A patient has a laboratory order for interpretation and report of cytogenetics and molecular cytogenetics. What is the correct CPT code for this laboratory test?

A)88240
B)88241
C)88291
D)88299

Question 48

A physician needs to order a test for tissue culture for non-neoplastic disorders using amniotic fluid or chorionic villus cells. What is the correct CPT code for this laboratory test?

A)88230
B)88233
C)88235
D)88237

Question 49

A couple is trying to conceive. The man is given a laboratory order for semen analysis for volume, count, motility and differential using strict morphologic criteria (e.g., Kruger). What is the correct CPT code for this test?

A)89300
B)89320
C)89321
D)89322

Question 50

A woman wants to have her eggs cryopreserved. This is going to be done using mature oocytes. What is the correct CPT code for this procedure?

A)89335
B)89337
C)89352
D)89398

Question 51

What is the correct CPT code for the insemination of oocytes?

A)89264
B)89268
C)89272
D)89280