Quiz Tests CPT, HCPCS and Modifier Coding Knowledge
Patricia Maccariella, RHIA, CCS
As promised, this segment of CCS Prep! provides a brief multiple-choice exam to test your skills in CPT, HCPCS and modifier coding. See if you can answer in one or two minutes per question. Do not assign anesthesia codes. Try answering the non-coding assignment questions from memory. Accuracy and speed are important ingredients for a successful examination.
1. How many diagnosis codes are reported on the HCFA 1500 form?
2. A 4-year-old presents for a bilateral adenoidectomy; bilateral myringotomy and nasal antral windows under general anesthesia.
a.) 42835, 31020, 69421
b.) 42830-50, 31020-50, 69436-50
c.) 42830, 31020-50, 69421-50
3. Austin bunionectomy right first metatarsal with 0.062 K wire fixation and application of cast.
c.) 28296-T5, 29425-T5
4. Esophagogastroduodenoscopy with dilation of the esophagus over a guide wire at same operative episode.
a.) 43453, 43235
5. Excision of 3-cm inclusion cyst of left neck, closure of deep subcutaneous tissue just into the superficial fascia with 3-0 Vicryl; skin closed with 4-0 Maxon. Steri-strips were applied.
b.) 11423, 12042
6. A patient with lumbar vertebral fractures of the spine presents for a percutaneous vertebroplasty. A needle is inserted through the right pedicle of the L3 vertebral body defect and methyl methacrylate is injected.
7. Supervision and interpretation (professional component) for X-ray of right wrist, A/P and lateral views provided by the physician.
8. A muscle biopsy of the arm is performed on the patient in the physician's office. The specimen is sent to a pathologist for review and interpretation with microscopic examination. Which code(s) would the pathologist report?
b.) 80500, 88305
9. A patient complains of severe lower back and leg pain, which are not responding to conservative treatment. A lumbar caudal injection is given with three injections at the left L4-L5 level for pain relief.
d.) 62311-LT, 62311-LT, 62311-LT
10. Patient is admitted for Fowler-Stephens orchiopexy. Anesthesia is administered and the surgeon begins the abdominal incision. At that time, the patient experiences significant tachycardia. The surgeon de-cides to discontinue the procedure.
b.) 54650-52, 00928
c.) No code necessary as procedure was terminated
11. Which HCPCS level II modifier is used to indicate left foot, second digit?
a.) - T2
b.) - T1
c.) - LT
12. Which national code is used to report administration of Cisplatin, 50 mg to a chemotherapy patient?
13. Pena procedure, urethroplasty, vaginoplasty and formation of a double barrel colostomy. Proximal colon used for graft.
a.) 46746, 44320
b.) 44320, 57292, 53450
14. Which modifier is provided for a repeat clinical laboratory test?
15. Surgeon A performs a surgical procedure early in the morning. Later that day, the patient experiences complications, and Surgeon B repeats the entire procedure. What level I modifier would Surgeon B append to the surgical CPT code?
16. HCPCS Level II "G" codes represent:
a.) durable medical equipment
b.) temporary procedure and services codes prior to inclusion in CPT
c.) temporary medical and surgical supplies
17. Surgical procedures identified as "unilateral or bilateral" e.g., 52290, must not be used with level I modifier 50?
18. Which HCPCS level II codes are reserved for Vision, Hearing and Speech-Language Pathology Services?
a.) G codes
b.) H codes
c.) V codes
19. Which symbol indicates a new code in both the CPT and HCPCS coding books?
a.) a bullet
b.) a triangle
c.) a star
20. Strabismus surgery. Recession of medial rectus muscle of left eye; strabismus surgery on superior oblique muscle of right eye.
c.) 67311-LT, 67318-LT
21. Right total frontal ethmoidectomy (external approach with Lynch incision made between left internal canthus and the nasal ridge), right maxillary sinusotomy, sphenoidotomy.
a.) 31255-RT, 31256-RT, 31287-RT
b.) 31205-RT, 31020-RT, 31050-RT
c.) 31205-RT, 31256-RT, 31287-RT
22. A patient has several calculi of the right and left ureter. A laparoscopic surgical ureterolithotomy is performed and 2 calculi are taken from the left side, 3 from the right.
c.) 50945-LT, 50945-LT, 50945-RT, 50945-RT, 50945-RT
We hope this short quiz assists you in preparation for taking the CCS or CCS-P examinations. Remember that Part I of the CCS exam consists of 60 multiple-choice questions (1 hour), testing both inpatient and ambulatory care (ICD-9-CM). Part I of the CCS-P exam consist of 60 multiple-choice questions, testing physician-based coding (ICD-9-CM diagnosis only, CPT and HCPCS Level II procedure coding across all specialties). *
Patricia Maccariella is manager of coding services at United Audit Systems Inc. (UASI), a national consulting company offering multifaceted HIM and business office management services, headquartered in Cincinnati.
1. b.) 4 (The HCFA 1500 is for physician billing and allows for 4 diagnoses to be reported.)
2. c.) 42830, 31020-50, 69421-50 ( A 50 modifier is not necessary for the adenoidectomy as the procedure is inherently bilateral per CPT Assistant. See CPT Assistant February 1998, p. 11.)
3. a.) 28296-T5 (The cast is included in the procedure, no need to report separately; see the CPT instructions prior to code 29000.)
4. c.) 43248
5. b.) 11423, 12042 (no need for modifier as not contra-lateral, i.e., you have a left arm but not a left neck, just left side of the neck) (See HCFA Transmittal A-99-41, A-00-09)
6. c.) 22899 (This is per CPT Assistant 2000 Coding Symposium workbook. A code for this procedure is being researched for 2001.)
7. c.) 73100-RT-26
8. c.) 88305
9. b.) 62311-LT (The injection codes were revised in 2000; only one injection code is reported at a particular level. See CPT Assis-tant, January 2000, p. 3.)
10. a.) 54650-74 (Instructions for quiz state to not code anesthesia.)
11. b.) T1
12. b.) J9062
13. c.) 46746
14. c.) 91 (This was new for year 2000, it replaced QR.)
15. a.) 77
16. b.) temporary procedure and services codes prior to inclusion in CPT
17. a.) true
18. c.) V codes
19. a.) a bullet
20. c.) 67311-LT, 67318-LT
21. b.) 31205-RT, 31020-RT, 31050-RT
22. a.) 50945-50 (Per CPT 2000 symposium, report the code only once if calculus or calculi are removed. Use 50 if bilateral.)