Deck 6: Anesthesia

Question 1

MAC for a deep, complex, complicated, or markedly invasive surgical procedure is represented by modifier:

A) QS
B) G7
C) G9
D) G8

Answer 1

G8

Question 2

A patient with severe systemic disease that is a constant threat to life is denoted by using the physical-status modifier:

A) P6
B) P3
C) P4
D) P5

Answer 2

P4

Question 3

An otherwise-healthy five-year-old patient is identified in the pre-op area and brought back for surgical tonsillectomy. What physical-status modifier(s) and/or qualifying-circumstance modifier(s) would be used?

A) P1, P6, and 99100
B) P1 and 99100
C) P1
D) P6 and 99100

Answer 3

P1

Question 4

The acronym for the American Society of Anesthesiologists is:

A) ASAT
B) ASA
C) AmSA
D) AmSAn

Question 5

A forty-six-year-old patient is waiting to be induced into anesthesia. Two CRNAs were originally scheduled to administer anesthesia to this patient, under supervision of an anesthesiologist. The CRNAs are still attending to another patient and the supervising anesthesiologist has to administer anesthesia for this patient. This would be reported using the following anesthesia-specific modifier:

A) QY
B) QK
C) AD
D) AA

Question 6

For anesthesia services, time begins when:

A) The patient is identified in the pre-operating room
B) The patient's surgical procedure has begun
C) The patient is determined to be successfully under anesthesia administered by the anesthesiologist
D) The patient is being prepared for anesthesia by the anesthesiologist

Question 7

Attending to patients during the most demanding procedures of the anesthesia plan is a component of:

A) Monitored anesthesia care
B) Airway management
C) Post-anesthesia care
D) Medical direction

Question 8

MAC for a patient who has a history of a severe cardiopulmonary condition is communicated by using modifier:

A) QT
B) QS
C) G9
D) G8

Question 9

RVG stands for:

A) Relative Value Guide
B) Reasonable Value Guide
C) Relative Value Guidelines
D) Reasonable Value and Guidelines

Question 10

(T) is the abbreviation for:

A) Total base units
B) Total time of anesthesia care
C) Total modifying factors
D) Total time of procedure

Question 11

MAC-specific modifier QS indicates:

A) MAC airway management
B) MAC for a patient who has a history of a severe cardiopulmonary condition
C) MAC service with use of hypothermic induction
D) MAC service

Question 12

Physical status and Qualifying Circumstances are all of the following except:

A) Two types of modifiers
B) Modifying factors that have units of value assigned
C) Modifiers that extend the time of anesthesia services
D) Two categories of modifying factors

Question 13

Physical-status modifier P3 represents:

A) A declared-brain-dead patient whose organs are being removed for donor purposes
B) A patient with severe systemic disease
C) A patient with mild systemic disease
D) A normal, healthy patient

Question 14

A CRNA is:

A) An anesthesiologist who performs expanded duties
B) A nurse anesthetist acting under the direction of an anesthesiologist
C) Reimbursed at a higher rate than an anesthesiologist
D) An assistant to the specialty surgeon

Question 15

Anesthesia complicated by utilization of total body hypothermia is described by qualifying-circumstance modifier:

A) 99116
B) 99100
C) 99135
D) 99140

Question 16

Conscious, or moderate sedation codes are located in this section of the CPT manual:

A) Anesthesia
B) Surgery
C) Appendix C
D) Medicine

Question 17

The following is the correct range of physical-status modifiers that adds additional units to an anesthesia code:

A) P1-P6
B) P3-P6
C) P1-P5
D) P3-P5

Question 18

This method of anesthesia requires that the patient's airway is managed by the anesthesiologist or qualified person providing the service:

A) Conscious sedation
B) Monitored anesthesia care
C) General anesthesia
D) Qualified anesthesia services

Question 19

Qualifying-circumstances modifier 99135 adds _____ additional units to the anesthesia CPT code to which it is appended:

A) 1
B) 2
C) 5
D) 3

Question 20

Intraoperatively, a forty-two-year-old female patient's anesthesia service was converted from MAC to general anesthesia due to her inability to control her airway. This service is coded as:

A) Oxygen administration only
B) MAC with oxygen administration
C) MAC with the appropriate physical status and qualifying-circumstance modifiers
D) General anesthesia with the appropriate physical status and qualifying-circumstance modifiers

Question 21

Modifiers which identify the provider or level of supervision provided by an anesthesiologist are located in:

A) CPT (HCPCS Level I)
B) HCPCS Level II
C) Appendix A
D) Tabular List

Question 22

A patient with severe systemic disease is represented by physical-status modifier:

A) P2
B) P5
C) P3
D) P4

Question 23

Intubation is:

A) Removal of a flexible tube previously placed in the trachea for airway management
B) Placement of a flexible tube into the trachea to maintain an open airway or allow for ventilation of the lungs during anesthesia
C) The unit where the patient is monitored by a nurse specializing in postsedation care
D) Physician involvement with and direction of anesthesia carried out by a qualified provider

Question 24

Which of the following physical-status modifiers do not add any additional units to an anesthesia code to which it/they are appended?

A) P1, P2, and P6
B) P2-P5
C) P1, P2, and P5
D) P1 and P5

Question 25

A female patient presents for scheduled otoscopy (00124), tympanotomy (00126) and middle ear biopsy (00120). The Base Unit Value for each code is as follows: 00120 - 5, 00124 - 4, 00126 - 4. Which of the following is the most appropriate code assignment to report the anesthesia required for the above procedures?

A) 00120, 00124, and 00126 may be reported
B) 00120 and 00124 may be reported
C) 00126 only may be reported
D) 00120 only may be reported

Question 26

Monitored anesthesia care is when:

A) The qualified provider remains bedside throughout the surgical procedure
B) An anesthesiologist provides the service
C) The patient's airway is managed by a qualified provider
D) The patient manages his/her own airway throughout the procedure

Question 27

CRNA service without medical direction by a physician is indicated by modifier:

A) QT
B) QZ
C) QX
D) QY

Question 28

Anesthesia-specific modifier AA is defined as:

A) Medical direction of 2, 3, or 4 concurrent anesthesia procedures involving qualified individuals
B) CRNA service with medical direction by a physician
C) Anesthesia services performed personally by an anesthesiologist
D) Medical supervision by a physician; more than 4 concurrent anesthesia procedures

Question 29

Qualifying-circumstance modifier 99135 describes anesthesia that is complicated by what condition being induced in the patient?

A) Hypothermia
B) Hypertension
C) Hypotension
D) Hyperthermia

Question 30

Qualifying-circumstance modifiers can be used to describe all of the following scenarios except:

A) extreme patient age
B) emergency situations in which a history of previous anesthesia response is not available
C) conditions under which a surgical procedure is performed
D) amount of surgeries performed at one time

Question 31

There are ____ anesthesia-specific modifiers:

A) 6
B) 7
C) 4
D) 5

Question 32

Codes used to report challenging circumstances in which anesthesia may be provided are called:

A) Physical-status modifiers
B) Qualifying-circumstance modifiers
C) Anesthesia-specific modifiers
D) Medical direction modifiers

Question 33

Qualifying-circumstance modifiers 99116 and 99135 add ____ additional units to an anesthesia CPT code.

A) 4
B) 6
C) 5
D) 8

Question 34

In the definition of qualifying-circumstance modifier 99100, "extreme age" is specified as:

A) Less than 6 months old and older than 75
B) Less than 1 year old and older than 70
C) Less than 6 months old and older than 70
D) Less than 1 year old and older than 75

Question 35

A condition defined as existing when delay in treatment would lead to significant increase in the threat of life or body part is called a(n):

A) emergency
B) ambulatory circumstance
C) triage
D) highly-stressful circumstance

Question 36

Reporting time as well as base units for the primary anesthesia service allows for capture of what?

A) Additional work provided by the anesthesiologist
B) Physical status and qualifying circumstances
C) Any modifying circumstances that would signify an increase in reimbursement
D) Additional work provided by the surgeon

Question 37

A moribund patient who is not expected to survive without the operation is denoted by using physical-status modifier:

A) P5
B) P4
C) P6
D) P3

Question 38

99135 is a qualifying-circumstances modifier that describes:

A) Anesthesia complicated by emergency conditions
B) Anesthesia complicated by utilization of total body hypothermia
C) Anesthesia for patient of extreme age: younger than 1 year old and older than 70
D) Anesthesia complicated by utilization of controlled hypotension

Question 39

A declared-brain-dead patient whose organs are being removed for donor purposes is represented by physical-status modifier:

A) P2
B) P1
C) P5
D) P6

Question 40

Removal of a flexible tube previously placed in the trachea for airway management is:

A) Extubation
B) Medical direction
C) Intubation
D) Moderate/Conscious sedation

Question 41

One remaining surgical procedure is scheduled in the surgical suite for the day. The attending anesthesiologist prepares the day's documentation while remaining available for one CRNA that provides anesthesia administration for today's last case. When billing for this anesthesia service, the coder should use modifier _______ to describe the anesthesiologist's role in providing anesthesia.

A) QK
B) AD
C) AA
D) QY

Question 42

To identify that the service was provided by an anesthesiologist, a coder should append modifier:

A) AA
B) AD
C) QY
D) QK

Question 43

When an anesthesiologist is supervising the concurrent anesthesia procedures of 2, 3, or 4 procedures involving qualified individuals it is denoted by using:

A) An anesthesia-specific HCPCS Level II modifier
B) A HCPCS Level II code
C) A qualifying-circumstances modifier
D) A physical-status modifier

Question 44

Physical-status modifier P1 signifies:

A) A patient with mild systemic disease
B) A declared-brain-dead patient whose organs are being removed for donor purposes
C) A normal, healthy patient
D) A patient with severe systemic disease

Question 45

Physical-status modifier P2 signifies:

A) A patient with mild systemic disease
B) A declared-brain-dead patient whose organs are being removed for donor purposes
C) A normal, healthy patient
D) A patient with severe systemic disease

Question 46

The key to understanding when to report general anesthesia and when to report MAC is knowing:

A) The extent of the surgical procedure performed
B) The modifiers that apply to the circumstances of the service
C) The patient's airway management
D) The specialty of the anesthesia care provider

Question 47

Qualifying-circumstance modifier 99100 is defined as:

A) Anesthesia complicated by utilization of controlled hypotension
B) Anesthesia complicated by utilization of total body hypothermia
C) Anesthesia for patient of extreme age: younger than 1 year old and older than 70
D) Anesthesia complicated by emergency conditions

Question 48

Preoperative and postoperative visits:

A) May be coded separately from a routine anesthesia service
B) Do not have separate CPT codes in the manual
C) Are typically not coded separately from a routine anesthesia service
D) Are only coded when procedures are performed for postoperative pain management

Question 49

The acronym for a Certified Registered Nurse Anesthetist is:

A) CNA
B) CRNA
C) CRU
D) CRNAN

Question 50

All forms of sedation - moderate (conscious), general, and monitored anesthesia - will have documentation of ________________ during anesthesia.

A) Oxygen status
B) Unplanned activity
C) Catheterization
D) Hypotension utilization

Question 51

The two types of anesthesia sedation services reported with an Anesthesia section code of the CPT manual are:

A) general and monitored
B) general and moderate (conscious)
C) monitored and conscious
D) general and endotracheal

Question 52

When an anesthesiologist is supervising the concurrent anesthesia procedures of 2, 3, or 4 procedures involving qualified individuals it is denoted by using:

A) QZ
B) QX
C) AD
D) QK

Question 53

A normal, healthy patient is represented by physical-status modifier:

A) P1
B) P3
C) P4
D) P2

Question 54

All of the following are considered part of the work of an anesthesia service and are not coded separately except:

A) Usual monitoring services
B) Insertion of Swan-Ganz
C) Administration of fluids and/or blood
D) Preoperative and postoperative visits

Question 55

Physical-status modifier P5 signifies which of the following about the patient:

A) A patient with severe systemic disease
B) A patient with mild systemic disease
C) A moribund patient who is not expected to survive without the operation
D) A declared-brain-dead patient whose organs are being removed for donor purposes

Question 56

The name of the physician whose specialty is to administer medication to achieve loss of sensation is:

A) Anesthetizer
B) Anesthesiologist
C) Pharmacologist
D) Anesthetist

Question 57

The type of anesthesia used is determined by the:

A) condition of the patient and availability of nurse anesthetists
B) condition of the patient and age of the patient
C) surgical procedure and condition of the patient
D) surgical procedure and specialty of the surgeon

Question 58

Medical direction, as it applies to anesthesia services, is:

A) Physician involvement with and direction of anesthesia carried out by a qualified provider
B) CRNA formulation of an anesthesia treatment plan
C) Formal treatment planning between the surgical provider and anesthesia provider
D) Preparing a surgical site for tracheotomy carried out by a qualified provider

Question 59

Anesthesia-specific modifier QY signifies:

A) Medical direction of 2, 3, or 4 concurrent anesthesia procedures involving qualified individuals
B) Medical direction of one CRNA by an anesthesiologist
C) Medical supervision by a physician; more than 4 concurrent anesthesia procedures
D) CRNA service with medical direction by a physician

Question 60

Physical-status modifier P6 signifies:

A) A declared-brain-dead patient whose organs are being removed for donor purposes
B) A patient with severe systemic disease
C) A moribund patient who is not expected to survive without the operation
D) A normal, healthy patient

Question 61

A patient with mild systemic disease is represented by physical-status modifier:

A) P2
B) P5
C) P3
D) P4

Question 62

The formula B + T + M is known as the:

A) relative value unit
B) base unit conversion
C) anesthesia reimbursement formula
D) physician reimbursement formula

Question 63

All of the following are requirements of Medical Direction except:

A) Set the anesthesia plan
B) Complete preanesthetic examination and evaluation
C) Remain physically present and available for emergencies
D) Attend to patients throughout the entirety of the surgical procedure

Question 64

For anesthesia services, time ends when:

A) The anesthesiologist is no longer attending the patient
B) The patient's surgical procedure has ended
C) The anesthesiologist determines the patient is successfully under anesthesia
D) The surgeon is no longer attending the patient

Question 65

The abbreviation for postanesthesia care unit is:

A) PCU
B) PACU
C) PC Unit
D) PTACU

Question 66

Qualifying-circumstance modifier 99100 will add _____ additional units to an anesthesia CPT code:

A) 5
B) 4
C) 2
D) 1

Question 67

What is the appropriate abbreviation for base units?

A) B
B) BaU
C) Bun
D) BU

Question 68

A fourteen-year-old patient is brought to the Emergency Room by his mother after his foot was caught in the lawnmower blade while mowing the yard. Upon emergent examination, it was determined that reattachment surgery had to be performed immediately on digits T3 and T4 to prevent loss of the digits. The anesthesia provided for this service would be described by the appropriate anesthesia CPT code and qualifying-circumstance modifier:

A) 99100
B) 99135
C) 99116
D) 99140

Question 69

99140 is the only qualifying-circumstances modifier that adds _____ additional units to the anesthesia CPT code to which it is appended:

A) 4
B) 3
C) 5
D) 2

Question 70

Qualifying-circumstance modifier 99116 adds how many additional units to an anesthesia code when appended?

A) 5
B) 6
C) 3
D) 4

Question 71

Per ASA recommendation, _______ minutes equal 1 unit:

A) 25
B) 30
C) 15
D) 35

Question 72

The three components of the reimbursement formula of time-based general anesthesia services are:

A) Total time of anesthesia care, modifying factors, and physician specialty
B) Basic units, total time of surgery, and physician specialty
C) Base units, total time of anesthesia care, and modifying factors
D) Modifying factors, total time of surgery, and basic units

Question 73

Qualifying-circumstance modifier 99116 describes anesthesia that is complicated by what condition being induced in the patient?

A) Hypotension
B) Hyperthermia
C) Hypertension
D) Hypothermia

Question 74

The following qualifying-circumstance modifier(s) add(s) one (1) additional unit to an anesthesia CPT code:

A) 99140 and 99100
B) 99135
C) 99100
D) 99140

Question 75

Modifiers that are used with all anesthesia procedure codes to rank the physical condition of the patient and the level of anesthesia complexity inherent to each ranking are:

A) post-anesthesia care units
B) physical-status modifiers
C) status modifiers
D) qualifying circumstances

Question 76

The component of the reimbursement formula that begins when the patient is being prepared for anesthesia and ends when the patient is no longer being attended by the anesthesiologist is:

A) Relative Value Unit
B) Time
C) CPT code
D) Base unit

Question 77

A seventy-five-year-old patient is identified in the pre-op room and brought to the surgical suite for bypass coronary artery surgery. The anesthesia provided for this service would be described by the appropriate anesthesia CPT code and qualifying-circumstance modifier:

A) 99116
B) 99100
C) 99140
D) 99135

Question 78

All of the following are not considered to be part of an anesthesia service and should be billed and coded in addition to the anesthesia service documented except:

A) Procedures performed for postoperative pain management
B) Insertion of an intra-arterial catheter
C) Insertion of central venous catheter
D) Administration of fluids and/or blood

Question 79

Qualifying-circumstances code 99140 is used to describe situations that are:

A) not covered by Medicare/Medicaid
B) emergencies
C) not otherwise reportable due to third-party payer guidelines
D) affected by the availability of an appropriate specialist

Question 80

The units of value which are the beginning of the formula for assigning a cost/revenue value to an anesthesia service are:

A) qualifying circumstances
B) medical direction
C) base unit
D) relative value guide