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Medical Tests American Academy of Professional Coders: Certified Professional Coder Sample Questions (Q83-Q88):

NEW QUESTION # 83
A urologist performs a laparoscopic adrenalectomy and excises a retroperitoneal mass in the same session. How should this be coded?

A. 60650, 49203-51
B. 0
C. 60650-22
D. 1

Answer: C

Explanation:
CPT 60650 describes a laparoscopic adrenalectomy with a biopsy but not the complete removal of a retroperitoneal mass. In contrast, adding modifier 22 indicates increased work and complexity and can be used because there is no CPT to describe a laparoscopic retroperitoneal mass resection. CPT 49329 represents an unlisted laparoscopy procedure that can be used to describe the removal of a retroperitoneal mass but would have to be used in conjunction with CPT
60650 to describe the adrenalectomy procedure. CPT 60545 describes an adrenalectomy with excision ofa retroperitoneal mass by means of an abdominal or posterior incision. CPT 49203 also does not describe the procedure because it involves an open excision of an intra-abdominal tumor.

NEW QUESTION # 84
A patient is referred to a radiology clinic with a diagnosis of chest bruising. A radiologist who works for the clinic performs a 3-view x-ray on the patient's ribcage bilaterally. The radiologist interprets images and determines that there is a right-sided stress fracture to one rib. Which ICD-IO-CM and CPT codes should be reported for this encounter?

A. 71110-26, M84.48XA
B. 71110-26, S22.31Y.A
C. 71110, M84.48XA
D. 71110, S22.31Y.4

Answer: C

Explanation:
Modifier 26, indicating only a professional component ofthe study, would be inappropriate because the radiologist who obtained the images and interpreted the results works for the clinic that owns the x-ray machines, By reporting the procedure without a modifier, the clinic is requesting 100% reimbursement of the study, which includes the technical and professional components. When searching the index in the ICD-IO-CM book a stress fracture is related to fatigue and is coded as a bone disorder as opposed to an injury.

NEW QUESTION # 85
Assign the appropriate CPT codes for the following surgical note: A 15-year-old patient is being treated for obstructive sleep apnea and adenoid tissue hypertrophy. After being placed under general anesthesia, a dental mirror is placed in the oropharynx to allow visualization of the nasopharynx. Suction electrocautery is used to remove the adenoid tissue that regrew after the initial adenoidectomy. Attention is then turned to the tonsils. The plane of tissue between the tonsillar capsule and the underlying muscles are cauterized, and the tonsils are removed. Bleeding is controlled by silver nitrate and gauze packing. Procedure is completed without complications, and patient is discharged to recovery.

A. 42821, G47.33, 135.2
B. 42826, 42831-59, 135.2, G47.33
C. 42999, 647.33, 135.2
D. 42826, 42836-51, 135.2, G47.33

Answer: A

Explanation:
An adenoidectomy and a tonsillectomy were performed in this surgical encounter (the root word -ectomy literally means the surgical removal of an anatomical structure). The adenoidectomy was done first and, if coded alone, would fall under one of Evo categories: primary (CPT 42830-
42831) or secondary (CPT 42835-42836). A primary adenoidectomy refers to the initial removal of the adenoid, whereas a secondary adenoidectomy occurs when adenoid tissue that was once removed has grown back. Because the documentation states that "the adenoid tissue ... regrew after the initial adenoidectomy," a coder can infer that this procedure is secondary. However, distinguishing betvveen the two procedures is not necessary when done in conjunction with a tonsillectomy because the procedures are bundled into two nonspecific CPT codes (42820 and
42821). Billing for an adenoidectomy and a tonsillectomy separately, as shown in answers A and C, is considered unbundling and is not allowed under the Correct Coding Initiative (CCI) edits.
Regarding the sequencing of the diagnoses, ICD-IO-CM guidelines state that when V,vo conditions meet the definition for principal diagnosis, either can be sequenced first In this scenario, J 35.2 or G47.33 could have been first listed because the procedures were to resolve both conditions in the same encounter.

NEW QUESTION # 86
Which option would best fall under a level II HCPC code?

A. Advanced life support
B. Diagnostic colonoscopy
C. A malignant neoplasm
D. Radiation treatment management

Answer: A

Explanation:
A level II HCPC code describes medical devices, supplies, medication, and/or other services that a provider and/or entity used during a service provided to a patient. Advanced life support (ALS) fits this description because it is a set of life-saving protocols administered in transit.
Radiation treatment management and a diagnostic colonoscopy describe a level I HCPC code, otherwise known as a CPT code. If the patient was asymptomatic and the colonoscopy was for screening purposes only, a level II HCPC code could be assigned. However, a diagnostic procedure implies a past medical/family history that puts the patient at risk and/or symptoms that warrant the procedure. A malignant neoplasm describes an ICD-IO-CM code because it is a diagnosis.

NEW QUESTION # 87
Code a polyp found in the transverse colon.

A. D12.3
B. K51.40
C. D12.6
D. K63.5

Answer: D

Explanation:
Coding crosswalk for a colon polyp would direct the coder to the benign neoplasm table.
However, careful examination of the guidelines reveals that if the documentation does not specifically state that a polyp was adenomatous and/or benign, or that a polyp was inflammatory, the most appropriate choice selection would be a code from K63.

NEW QUESTION # 88
......

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