Deck 11: Medicine

Question 1

PROGRESS NOTE PATIENT: TROHOSKE, RUBY
DATE: 12/14/2016
MEDICAL NOTE:
The patient was seen in the clinic today for a 5-year well-child exam. The physical exam was unremarkable; the patient was at normal growth and development for her age group. The following vaccines were recommended for the patient at this visit: DTaP, IPV, MMR, Varicella, and annual Influenza shot. What are the correct codes for this visit?

A)99393, 90471, 90700, 90471 (X4), 90713, 90707, 90716, 90658
B)99392, 90471, 90700, 90472 (X4), 90713, 90707, 90716, 90657
C)99393, 90471, 90700, 90472 (X4), 90713, 90707, 90716, 90658
D)99393, 90471, 90700, 90472, 90713, 90707, 90716, 90660

Answer 1

99393, 90471, 90700, 90472 (X4), 90713, 90707, 90716, 90658

Question 2

PROGRESS NOTE PATIENT: TROHOSKE, RUBY
DATE: 12/14/2016
MEDICAL NOTE:
The patient was seen in the clinic today for a 5-year well-child exam. The physical exam was unremarkable; the patient was at normal growth and development for her age group. The following vaccines are recommended for patient at this visit: DTaP, IPV, MMR, Varicella, and annual Influenza shot. The pediatrician counseled the patient and her parents on the health risks and side-effects associated with each recommended vaccination. What is the correct code for these vaccines?

A)90460, 90461 (X2), 90700, 90460, 90713, 90460, 90461 (X2), 90707, 90460, 90716, 90460, 90658
B)90460, 90461 (X8), 90700, 90713, 90707, 90716, 90658
C)90460 (X5), 90461 (X5), 90700, 90713, 90707, 90716, 90658
D)90461, 90460 (X2), 90700, 90461, 90713, 90461, 90460 (X2), 90707, 90461, 90716, 90461, 90658

Answer 2

90460, 90461 (X2), 90700, 90460, 90713, 90460, 90461 (X2), 90707, 90460, 90716, 90460, 90658

Question 3

The patient is a 20-month-old with end-stage renal disease receiving dialysis twice a week, awaiting a kidney transplant. The patient's parents receive weekly face-to-face counseling services regarding the patient's care and ESRD status. What is the correct code for the patient's dialysis care?

A)90951 (X4)
B)90951
C)90952
D)90954 (X4)

Answer 3

90951

Question 4

A 20-month-old with end-stage renal disease was receiving dialysis twice a week, awaiting a kidney transplant. During the last month of life, the patient received dialysis once per day. Dialysis was administered between June 1 and June 14. The patient's parents received daily face-to-face counseling regarding the patient's care and ESRD status. What is the correct code for the patient's dialysis care?

A)90968 (X14)
B)90960
C)90967 (X14)
D)90964

Question 5

An adolescent patient's hard contact lenses were shattering when a bouncy ball that he was playing with at school bounced up at hit him in the eye. The patient was transported to the emergency department where the on-call physician removed the contact lens fragments from his cornea, using a slit lamp. What is the correct code for the procedure?

A)65205
B)65210
C)65220
D)65222

Question 6

The physician removed the lens of a patient with severe cataracts via the pars plana approach, without a vitrectomy. During the operative session, the physician used viscoelastic agents and enzymatic zonulysis to aid in the procedure. How should the physician code for the procedure?

A)66852
B)66840
C)66983
D)66852, 66982

Question 7

The patient with severe strabismus visited the ophthalmologist clinic for a strabismus correction surgery. The ophthalmologist performed the surgery by correcting two horizontal muscles and one vertical muscle in the patient's right eye. The physician then used a transposition procedure on the superior oblique muscle in order to further correct the misalignment. What is the correct way to code for the procedure?

A)67311 (X2), 67320
B)67312, 67314, 67320
C)67312, 67314, 67318
D) 67312, 67314, 67320-51

Question 8

Mr. Longoria, a patient with an established cataract, was displeased with his current ophthalmologist so today he was seen by a new physician. The ophthalmologist performed an ophthalmoscopy and tonometry on Mr. Longoria, as well as an external examination of both eyes and a review of the patient's interval history. What is the correct code for Mr. Longoria's ophthalmology service today?

A)92002
B)92004
C)92012
D)92014

Question 9

The physician performed a bilateral tympanostomy with placement of drainage tubes, in a 4 year old male, who required general anesthesia. During the procedure a large abscess was noted on the right external auditory canal. The physician incised and drained the abscess, and placed ventilating tubes in each tympanum. How would you code for the procedure?

A)69436-50, 69020
B)69433, 69020
C)69436, 11000
D)69436-50, 69020-50

Question 10

A 58-year-old patient with decreased hearing decided to undergo bilateral cochlear device implantation in order to restore the gradual decline of his hearing, and prevent total deafness. Due to the position of the device and the size of the patient's mastoid bone that was partially occluding the patient's inner ear, the physician performed a modified mastoidectomy. A mastoidectomy was necessary for the completion of the cochlear device implantation procedure. The physician used an operating microscope throughout the cochlear implantation. How would you code for the procedure?

A)69930, 69505, 69990
B)69930, 69501, 69900
C)69930
D)69930-50, 69900

Question 11

A patient with a suspected cardiac arrhythmia was given a routine rhythm EKG with three leads in the cardiologist's office. The results of the EKG were sent to the patient's primary care physician, who interpreted the results and determined that the patient's arrhythmia was mild. What is the correct code for the cardiologist's office service only?

A)93040
B)93042
C)93041
D)93000

Question 12

Mr. Johnson was seen in his primary care physician's office today for an evaluation of chest pains. He has been experiencing shortness of breath as well as intermittent chest pains for the past week. He has also been experiencing tingling and numbness in his left hand and fingers. His primary care physician suspects a cardiac rhythm abnormality and performs a rhythm electrocardiogram in the office. After reading the ECG report, Mr. Johnson's physician determines that his heart rhythm needs more evaluation and refers him to a cardiac specialist. How should the electrocardiogram code be reported?

A)93000
B)93010
C)93042
D)93040

Question 13

The patient has a dual-chamber pacemaker and was recently seen by his physician for analysis and report of his implanted device. During the visit, the physician connected the system, evaluated its performance, and then disconnected it. What is the correct code for this service?

A)33213
B)93289
C)33208
D)93288

Question 14

The physician performed a right and left heart catheterization with a left ventriculography on 58-year-old male patient. During catheterization, the patient participated in a physiologic exercise study in the form of a bicycle ergometry. How should you code for this service?

A)93531, 93464
B)93451, 93452, 93464
C)93453, 93464
D)93453

Question 15

A pediatric patient presented to the office with a severe asthma attack. The pediatrician ordered a pulse oximetry to check the patient's blood oxygen saturation level and a spirometry to evaluate her lung capacity. The physician interpreted the results and ordered an albuterol nebulizer treatment and a post-spirometry to check the patient's responsiveness to the albuterol treatment. What are the correct codes for this office visit?

A)99214, 94060, 94760, 94640, A7015, A4616, J7630
B)99214, 94010 (X2), 94760, 94640, A7015, A4616, J7630
C)99214, 94060, 94640, A7015, A4616, J7630
D)99214, 94010, 94760, 94640, A7015, A4616, J7630

Question 16

The endocrine section in the CPT manual (60000 to 60699) does not include all of the glands in the endocrine system. Which of the following glands are missing from this section?

A)Testes and Ovaries
B)Pineal Gland
C)Pituitary Gland
D)All of the Above
E)Only Options B and C

Question 17

What is the correct code for the endocrinology service located in the medicine section that allows for the ambulatory continuous glucose monitoring of interstitial tissue fluid (includes the physician's reading and interpretation of the report's findings over a 72-hour period)?

A)95250
B)95251, 99091
C)95251
D)95250, 99091

Question 18

The patient was seen in the ER clinic for severe dehydration after a stomach virus. The patient received an intravenous infusion of fluids and electrolytes in the ER. Infusion was began at 3:00 PM and ended at 6:15 PM. What is the correct code for this infusion service?

A)96360, 96361 (X3)
B)96360, 96361 (X2)
C)96360 (X3)
D)96360, 96361 (X4)

Question 19

The physician ordered tests to evaluate a three-year-old patient for cystic fibrosis. The test results came back as suspicious so the physician ordered additional tests to confirm the diagnosis. The physician ordered his nurse to call the patient's parents to discuss the patient's results and any other recommended tests. The phone conversation lasted 20 minutes during which time the nurse scheduled a follow-up appointment for the next morning at 10:00 AM. How should you report the telephone services for this phone call?

A)No telephone consultation service code should be reported
B)98967
C)98968
D)99442

Question 20

The patient was seen in the after-hours clinic on a Monday evening at 5:30 PM due to a severe cough and trouble breathing. This is his normal clinic, which usually stays open late to accommodate patients so they do not have to go to the Emergency Room. What additional code should you append to the E&M service or any other services provided during the visit?

A)99050
B)99051
C)99053
D)99058

Question 21

A 6-year-old boy needs to have his influenza vaccine for the 2016 flu season. What is the correct CPT code(s) for nasal administration of the quadrivalent influenza vaccine, where the physician counsels the parents about the administration route?

A)90460, 90660
B)90471, 90672
C)90473, 90660
D)90460, 90672

Question 22

A psychiatrist is evaluating a patient in his office for an initial visit. The physician billed for a psychiatric diagnostic evaluation and he is using medical records and family reports to evaluate this patient, including ordering diagnostic studies. What is the CPT code for this visit?

A)90785
B)90791
C)90792
D)90832

Question 23

A patient is being admitted to a psychiatric facility for suicidal ideation. The patient undergoes psychotherapy for crisis and the doctor spends 70 minutes with this patient. What is the correct code(s) for this visit?

A)90839
B)90839, 90840
C)90839, 90840 x 2
D)90839, 90840 x 3

Question 24

A patient is undergoing hypnotherapy at the psychiatry office. What is the correct CPT code for this procedure?

A)90870
B)90875
C)90880
D)90885

Question 25

A patient undergoes biofeedback to help with chronic pain. What is the correct CPT code for this procedure?

A)90875
B)90876
C)90901
D)90911

Question 26

A patient with bowel incontinence undergoes anorectal biofeedback training. What is the correct CPT code for this procedure?

A)90875
B)90876
C)90901
D)90911

Question 27

A patient is undergoing heart variability biofeedback. What is the correct code for this type of biofeedback therapy?

A)90901
B)90911
C)90875
D)90876

Question 28

A patient who has dialysis three times a week as an outpatient goes in for a routine hemodialysis appointment. What is the correct code for this procedure where he only requires a single evaluation by a physician?

A)90935
B)90937
C)90940
D)90945

Question 29

A patient needs to have a gastric manometric (motility) study performed. What is the correct CPT code for this procedure?

A)91010
B)91013
C)91020
D)91022

Question 30

A patient who has been having chronic reflux is scheduled to have an acid perfusion test performed on the esophagus. This test is also known as the Bernstein test. What is the correct CPT code for this procedure?

A)91022
B)91030
C)91034
D)91035

Question 31

A patient needs to have a capsule endoscopy of the esophagus through the ileum. What is the correct CPT code for this test?

A)91040
B)91110
C)91111
D)91112

Question 32

A patient has been having difficulties swallowing. He is set up for a flexible fiberoptic endoscopy evaluation of swallowing by video recording. What is the correct CPT code for this procedure?

A)92610
B)92611
C)92612
D)92614

Question 33

A patient who undergoes hemodialysis three times a week needs to have his access scanned to make sure the blood flow is patent. What is the correct code for a duplex scan of hemodialysis access?

A)93970
B)93975
C)93990
D)93998

Question 34

A patient needs a duplex scan of extracranial arteries. The vascular surgeon orders a complete bilateral study instead of a unilateral or limited study. What is the correct CPT code for this procedure?

A)93880
B)93882
C)93886
D)93888

Question 35

A patient with history of a small aortic aneurysm needs to have a complete duplex scan of the aorta, inferior vena cava, and iliac vasculature. What is the correct CPT code for this procedure?

A)93975
B)93978
C)93979
D)93980

Question 36

A patient who has been having shortness of breath on exertion is scheduled for a simple pulmonary stress test. What is the correct CPT code for this procedure?

A)94610
B)94620
C)94621
D)94640

Question 37

A patient is being set up with a continuous positive airway pressure (CPAP) machine upon arriving to the unit from the emergency department. What is the correct code for CPAP ventilation initiation and management?

A)94644
B)94645
C)94660
D)94662

Question 38

A pediatric patient with suspected food allergies is sent for allergy testing that involves scratch tests over his back. He is tested for eight different foods and there are two control tests performed. What is the correct code for percutaneous (scratch) tests with allergenic extracts?

A)95004
B)95017
C)95018
D)95024

Question 39

A three year old is going to have a peanut challenge performed in the allergist's office under direct supervision. The child is scheduled for three hours of testing, what is the correct code(s) for this testing?

A)95076
B)95076, 95079
C)95076, 95079 x 2
D)95076, 95079 x 3

Question 40

A patient is undergoing de-sensitivity for bee stings, which involves allergen immunotherapy with a single stinging insect venom. What is the correct code for this procedure?

A)95120
B)95125
C)95130
D)95131

Question 41

A patient needs to have continuous glucose monitoring for four days. What is the correct code for placement, hook up, calibration of the monitor, patient training and removal of sensor and printout of the findings? Patient will set up an additional appointment to have endocrinologist interpret and report the findings.

A)95180
B)95199
C)95250
D)95251

Question 42

A patient needs to have a sleep study performed to assess for sleep apnea. He will be spending the night at the center and have his ventilations, respiratory effort, ECG and oxygen saturation monitored. A technologist will be in attendance for this. What is the correct CPT code for this procedure?

A)95806
B)95800
C)95801
D)95807

Question 43

A patient is scheduled for an electromyography (EMG) of all four extremities to assess for myasthenia gravis. What is the correct code for this procedure?

A)95860
B)95861
C)95863
D)95864

Question 44

A patient needs to have an electroencephalography (EEG) performed while awake and asleep. What is the correct code for this procedure?

A)95816
B)95819
C)95822
D)95824

Question 45

A newborn with congenital malformations is undergoing genetic testing to try to identify the specific genes involved. The parents and infant have a 90-minute appointment scheduled with a geneticist to review the family genetic history and assessment for genetic concerns. What is the correct CPT code for this visit?

A)96040
B)96040 x 2
C)96040 x 3
D)96040 x 4

Question 46

A patient has a quick follow-up appointment with genetics for counseling services. His appointment only takes 20 minutes. What is the correct CPT code for this service?

A)96040
B)96040 x 2
C)96040 x 3
D)96040 x 4

Question 47

Parents of a two year old, who has been undergoing genetic testing, have a follow-up appointment scheduled to go over the newest labs and have genetic counseling. They spent 46 minutes for this appointment as they make a plan of action and begin getting referrals to child development services. What is the correct code for this visit?

A)96040
B)96040 x 2
C)96040 x 3
D)96040 x 4

Question 48

A patient has to have a neurobehavioral status examination. What is the correct code for this test?

A)96110
B)96111
C)96116
D)96118

Question 49

A pediatric patient, who is having difficulties in school and showing signs of being on the autism spectrum, needs to have developmental testing performed. What is the correct CPT code for this testing?

A)96110
B)96111
C)96116
D)96118

Question 50

A patient is undergoing neuropsychological testing performed by a computer with qualified healthcare professional interpretation and report. What is the correct CPT code for this test?

A)96119
B)96120
C)96125
D)96127

Question 51

A patient has an initial 15-minute health and behavior assessment with the provider. What is the correct code for this initial assessment?

A)96150
B)96151
C)96152
D)96153

Question 52

A provider is meeting with a patient's family, without the patient present, to plan a health and behavior intervention. What is the correct code for this?

A)96152
B)96153
C)96154
D)96155

Question 53

Health and behavior interventions are planned and discussed with a group of four patients. What is the correct CPT code for this?

A)96152
B)96153
C)96154
D)96155

Question 54

A patient needs to have D5-1/2 normal saline + 30mEq KCl/liter given. However, it needs to be infused slowly and is given over 90 minutes. What is the correct code for this hydration procedure?

A)96360
B)96361
C)96360, 96361
D)96360, 96361 x 2

Question 55

A patient is given an intramuscular injection of Ancef prior to his procedure. What is the correct CPT code for the subcutaneous or intramuscular therapeutic, prophylactic or diagnostic injection?

A)96365, J0690
B)96369, J0690
C)96372, J0690
D)96374, J0690

Question 56

A patient needs to have an intravenous push of an initial dose of Versed. Five minutes later, he needs a second intravenous push of the same drug. What is the correct code for this procedure?

A)96372, J2250 x 2
B)96374, 96376, J2250 x 2
C)96374, 96375, J2250 x 2
D)96379, J2250 x 2

Question 57

A patient is receiving chemotherapy through her intra-arterial access port. She is scheduled for an infusion that will last about 50 minutes. This infusion will be for the drug methotrexate sodium and she will receive 50 mg. What is the correct code for this procedure?

A)96420, J9260
B)96422, J9260
C)96423, J9260
D)96425, J9260

Question 58

A patient with breast cancer is undergoing chemotherapy treatment with a drug called Fluorouracil and she receives 500 mg through her PICC line over a 4-hour timeframe. What is the correct code for this type of administration?

A)96420, J9190
B)96422, J9190
C)96423, J9190
D)96422, 96423 x 3, J9190

Question 59

A patient with acute lymphoblastic leukemia is being given a drug called Asparaginase. This is administered 1000 units intramuscularly. What is the correct code for this chemotherapy administration?

A)96401, J9019
B)96402, J9019
C)96405, J9019
D)96409, J9019

Question 60

A patient has a malignant lesion on his face with adjacent mucosa (lip) involvement. He is set to undergo photodynamic therapy by external application of light to destroy this malignancy. What is the correct code for this procedure?

A)96567
B)96570
C)96571
D)96900

Question 61

A patient needs to have a transoral flexible esophagoscopy to treat abnormal tissue in the esophagus. This will be done by providing photodynamic therapy applying light to ablate the abnormality by activating photosensitive drugs. This patient's procedure takes 22 minutes. What are the correct CPT codes for this procedure?

A)96567
B)43200, 96567, -52
C)43200, 96567
D)43200, 96571

Question 62

A patient has a bronchoscopy scheduled to ablate abnormal tissue by using photodynamic therapy by endoscopic application of light to activate photosensitive drugs. This patient's procedure takes 50 minutes to complete. What is the correct code(s) for this procedure?

A)31622, 96570
B)31622, 96570, 96571
C)31623, 96570
D)31623, 96570, 96571

Question 63

A patient has been losing a large amount of hair. The provider plucks a few hairs from the patient for microscopic evaluation to determine telogen and anagen counts. What is the correct code for this procedure?

A)96900
B)96902
C)96904
D)96910

Question 64

A patient with skin cancer is undergoing actinotherapy. What is the correct code for this procedure?

A)96900
B)96902
C)96910
D)96913

Question 65

A patient needs to have an initial evaluation for physical therapy. What is the correct CPT code for this evaluation?

A)97001
B)97002
C)97003
D)97004

Question 66

A patient is referred to an athletic trainer and began a specific plan of care. About one month into the care, he needs to be re-evaluated. What is the correct code for athletic training re-evaluation?

A)97001
B)97002
C)97005
D)97006

Question 67

A patient needs to have an initial assessment by occupational therapy after suffering from a stroke. What is the correct code for this evaluation?

A)Z51.5
B)Z51.8
C)Z51.81
D)Z51.89

Question 68

A patient receives 15 minutes of face-to-face medical nutrition therapy. What is the correct CPT code for this?

A)97802
B)97803
C)97804
D)97810

Question 69

A provider is doing a 30-minute group session for medical nutrition therapy to cover the basis of nutrition needs in patients with congestive heart failure. What is the correct CPT code for this type of therapy?

A)97802
B)97803
C)97804
D)97810

Question 70

A patient who has had medical nutrition therapy in the past and is struggling to retain the information, is scheduled for re-assessment and intervention. The appointment is only scheduled for 15 minutes. What is the correct code?

A)97802
B)97803
C)97804
D)97810

Question 71

A patient is receiving osteopathic manipulative treatment (OMT) of the thoracic and lumbar regions. What is the correct CPT code for this procedure?

A)98925
B)98926
C)98927
D)98928

Question 72

A patient is undergoing osteopathic manipulative treatment (OMT) of her head, cervical, thoracic, lumbar and sacral regions. What is the correct CPT code for this treatment?

A)98925
B)98926
C)98927
D)98928

Question 73

A patient has been having pain in his legs and arms and is undergoing osteopathic manipulative treatment (OMT). He is having this focused on his lower extremities, upper extremities, cervical region, thoracic region, lumbar region, sacral region and pelvic regions. What is the correct CPT code for this procedure?

A)98926
B)98927
C)98928
D)98929

Question 74

A patient went to a chiropractor to have specific regions of his back manipulated. He needed to have his cervical, thoracic and lumbar region manipulated. What is the correct CPT code for this procedure?

A)98940
B)98941
C)98942
D)98943

Question 75

A patient needs to have his head manipulated by a chiropractor. What is the correct code for this area of manipulation?

A)98940
B)98941
C)98942
D)98943

Question 76

A pregnant patient is having problems with her round ligaments and increasing pain in her pelvic region. She visits a chiropractor who performed chiropractic manipulation of the pelvic region. What is the correct CPT code for this procedure?

A)98940
B)98941
C)98942
D)98943

Question 77

A nurse practitioner is doing a chronic disease self-management course for a group of six patients. This is a standardized course and occurs over the course of six weeks for 30 minutes each week. Diabetes, congestive heart failure, hypertension, hyperlipidemia, and chronic obstructive pulmonary disease are some of the topics that are covered in this curriculum. What is the correct code for education for the patient to promote self-management?

A)98960
B)98961
C)98962
D)98966

Question 78

A patient with diabetes is given a 30-minute course on initial diabetes self-management. Following a specific curriculum, the physician sees this patient in his office with the patient's daughter and husband to make sure everyone has been given the same information to assist the patient at home. What is the correct CPT code for this type of training/education?

A)98960
B)98961
C)98962
D)98966

Question 79

A group of patients on the rehabilitation unit are given a self-management course about congestive heart failure because all of these patients have had exacerbations of this disease. A total of three patients are able to attend these classes. The classes take 30 minutes and are given twice weekly. What is the correct code for this type of self-management training?

A)98960
B)98961
C)98962
D)98966

Question 80

A patient calls his primary nurse practitioner because he is having abdominal pain and diarrhea. He speaks with his her for five minutes and after obtaining more signs and symptoms, the nurse practitioner suspects the patient is suffering from a gastrointestinal virus. The patient is recommended to proceed with supportive care, and if not improving in 48-72 hours, to follow up in the physician's office. The patient improved, so did not have to follow up in the office. What is the correct CPT code for this type of telephone service?

A)98966
B)98967
C)98968
D)98969