Question 1

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?

Accepted Answer

43200 is the correct code for transoral flexible esophagoscopy. Code 96567 is the correct add-on code for photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drugs. Modifier -52 is correct because less than 23 minutes was spent doing this procedure.
Code 96567 is incorrect because this code is not involving an endoscopy. Add-on code 96571 is incorrect because this code is for each additional 15 minutes past the initial 30 minutes, and this patient's procedure took less than 30 minutes.

Question 2

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?

Accepted Answer

31622 is the correct code for bronchoscopy. Code 96570 is a correct add-on code for the first 30 minutes of photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drugs. Code 96571 is also a correct add-on code for each additional 15 minutes.
Code 31623 is incorrect because this is for a bronchoscopy with brushings.

Question 3

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?

Accepted Answer

96902 is the correct code for microscopic examination of hairs plucked or clipped by the examiner to determine telogen and anagen counts or structural hair shaft abnormalities.
Code 96900 is incorrect because this code is for actinotherapy. Code 96904 is incorrect because this code is for whole body integumentary photography for monitoring of high-risk patients with dysplastic nevus syndrome. Code 96910 is incorrect because this code is for Photochemotherapy, including tar and ultraviolet B, or petrolatum and ultraviolet B.

Question 4

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

Accepted Answer

96900 is the correct code for actinotherapy.
Code 96902 is incorrect because this code is for microscopic examination of hairs plucked to determine telogen and anagen counts. Codes 96910 and 96913 are both incorrect because these codes are used for photochemotherapy.

Question 5

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

Accepted Answer

97001 is the correct code for initial physical therapy evaluation.
Code 97002 is incorrect because this code is for re-evaluation for physical therapy. Codes 97003 and 97004 are both codes for occupational therapy evaluation.

Question 6

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?

Accepted Answer

97006 is the correct code for athletic training re-evaluation.
Codes 97001 and 97002 are both incorrect because these codes refer to physical therapy evaluations. Code 97005 is incorrect because this code is for the initial athletic training evaluation.

Question 7

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

Accepted Answer

Z51.89 "Enounter for other specified aftercare" is the correct code for all occupational therapy and physical therapy visits. Codes for diagnoses and reasons for care are specified separately.
Code Z51.5 is for palliative care and code Z51.81 is for therapeutic drug level monitoring, both of whichdo not apply. Code Z51.8 is a general code for other specified aftercare, so code Z51.89 is more accurate.

Question 8

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

Accepted Answer

97802 is the correct code for 15 minute of medical nutrition therapy for initial assessment and intervention for a single patient.
Code 97803 is incorrect because this code is for re-assessment and intervention for an individual patient. Code 97804 is incorrect because this code is for group therapy and 97810 is incorrect because this code is for acupuncture.

Question 9

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?

Accepted Answer

97804 is the correct code for group (2+) medical nutrition therapy lasting 30 minutes.
Codes 97802 and 97803 are both incorrect codes because these codes are for individual therapy and not for group therapy. Code 97810 is incorrect because this code is for acupuncture.

Question 10

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?

Accepted Answer

97803 is the correct code for medical nutrition therapy re-assessment and intervention for each 15 minutes.
Code 97802 is incorrect because this code is for initial assessment. Code 97804 is incorrect because this code is for group therapy, and 97810 is incorrect because this code is for acupuncture.

Question 11

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

Accepted Answer

98925 is the correct code for OMT of 1-2 body regions.
Code 98926 is incorrect because this code is for 3-4 body regions. Code 98927 is incorrect because this code is for 5-6 body regions and 98928 is incorrect because this code is for 7-8 body regions.

Question 12

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?

Accepted Answer

98927 is the correct code for OMT of 5-6 body regions.

Question 13

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?

Accepted Answer

98928 is the correct code for OMT for 7-8 body regions.
Code 98926 is incorrect because this code involves 3-4 body regions. Code 98927 is incorrect because this code is for 5-6 body regions and code 98929 is incorrect because this involves 9-10 body regions.

Question 14

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?

Accepted Answer

98941 is the correct code for chiropractic manipulative treatment of 3-4 regions of the spine.
Code 98940 is incorrect because this code is only for 1-2 regions of manipulation of the spine. Code 98942 is incorrect because this code is for all five regions of the spine and code 98943 is incorrect because this is for extraspinal regions.

Question 15

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

Accepted Answer

98943 is the correct code for extraspinal chiropractic manipulative treatment of one or more regions.
Codes 98940, 98941, and 98942 are all incorrect because these codes all refer to spinal manipulation and not the extraspinal region of the head.

Question 16

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?

Accepted Answer

98940 is the correct code for chiropractic manipulative treatment of the spine for 1-2 regions.
Codes 98941 and 98942 are incorrect codes because, although these are codes for manipulation of the spine, these codes involve more than just one region of manipulation. Code 98943 is incorrect because this code involves the extraspinal regions.

Question 17

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?

Accepted Answer

98962 is the correct code for patient self-management education and training for a group of 5-8 patients.
Code 98960 is incorrect because this code is for an individual patient. Code 98961 is incorrect because this code is for group training of 2-4 patients. Code 98966 is incorrect because this code is for telephone assessment and management services.

Question 18

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?

Accepted Answer

98960 is the correct code for individual patient training to promote self-management, which may or may not include family members or caregivers.
Codes 98961 and 98962 are incorrect codes because these both refer to group therapy for self-management education and training. Code 98966 is incorrect because this code is for telephone services.

Question 19

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?

Accepted Answer

98961 is the correct code for education and training for a group of 3-4 patients to promote self-management of a particular disease.
Code 98960 is incorrect because this code is for individual patient training/education. Code 98962 is incorrect because this code is for group training of 5-8 patients. Code 98966 is incorrect because this code refers to telephone services and not face-to-face training.

Question 20

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?

Accepted Answer

98966 is the correct code for a 5-10 minute telephone contact for a nonphysician healthcare professional. If the patient would have followed up within 24 hours or at the soonest available appointment, then this code would not be able to be used because this telephone service would be considered part of the patient's workup for that office visit.
Codes 98967 and 98968 are codes for 11+ minutes of telephone consultation services. Code 98969 is incorrect because this code is for online assessment and management services, not telephone services.

Quiz 11: Medicine