TEST YOUR CODING SKILLS

Here are a few questions to help sharpen your coding skills. Read through each question carefully, make your choice, then click on the Answer link to see if you were right. Good luck!

1. An established patient is seen in the provider's office and is very ill. The decision is made to admit the patient and the patient is sent directly to the hospital from the provider's office. The correct coding for this patient's care on that day would be:

a. Visit and admission
b. Admission only
c. Visit only

ANSWER


2. When a patient has laboratory studies ordered/performed for screening purposes, the best diagnosis code to use would be:

a. V 72.6 - Laboratory exam (special investigations & examinations)
b. V71.8 - Observation for other specified/suspected condition
c. Either a or b, depending on the reason ordered

ANSWER


3. If a physician wants a fetal biophysical profile and a fetal non-stress test, the correct CPT codes to be used for billing:

a. 76818 only
b. 76818 and 59025
c. 59025 only

ANSWER


4. Case Study
A 45-year-old established patient is seen for an annual physical exam. The patient is found to have a few minor problems but nothing complicated enough to warrant any additional time or "work-effort" for the over-all visit. The focus of the visit was the annual exam. The examination is followed by a lengthy discussion regarding the findings, problems, risk factors, and treatment options. The provider feels that he/she has spent more than the typical amount of time with the patient. He/she should bill:

a. Preventive visit 99396 and 99401 Preventive Medicine Counseling
b. Preventive Medicine code 99396 only
c. Preventive visit 99396 and E/M code 99213

ANSWER


5. When billing for a DTaP immunization, the correct diagnosis code would be:

a. V20.2 Routine infant or child health check; Developmental testing of infant or child Immunizations appropriate for age; Routine vision and hearing testing
b. Diagnosis code V05.8 Need for prophylactic vaccination and inoculation against a single disease
c. Diagnosis code V06.1 Need for prophylactic vaccination and inoculation against combination of diseases

ANSWER


6. A 35 year old female patient presents to the office for genetic counseling, ultrasound and possible amniocentesis. This is the third pregnancy for the patient. The correct diagnosis code to use for the diagnostic tests would be:

a. 659.63 Elderly multigravida, antepartum condition or complication
b. 760.9 Unspecified maternal condition affecting the fetus or newborn
c. Neither of the above

ANSWER


7. A patient is seen for a routine follow-up of ongoing problems (diabetes, hypertension). During the visit the physician looks at a couple of lesions the patient is concerned about. It is decided that the patient should come back one week later to address the removal of the skin lesions. The patient returns and is prepped for the removal of the lesions. One lesion measuring .4 cm is removed from her arm and another lesion measuring .65 is removed from her neck. The correct billing for the second visit when the lesions are removed should be:

a. 99213 for the visit and codes 11400, 11401 for the lesion removal
b. Only Codes 11400 and 11401 for the lesion removal
c. Only codes 11400 and 11421 for the lesion removal

ANSWER


8. Case Study
Mrs. Jones presents to the Dr. America's office for prenatal care. Her pregnancy was diagnosed by the local health department and prenatal lab work was done at that time. Dr. America sees Mrs. Jones for 4 prenatal visits. The baby was subsequently delivered by another physician in another practice. The correct method for billing the four prenatal visits would be:

a. Bill the visit when pregnancy was established and 3 other visits using E/M codes
b. Bill the first three visits using E/M codes and the 4th visit using CPT 59425
c. Bill the 4 visits using CPT 59425

ANSWER


9. When billing for multiple procedures for the same patient on the same date of service, you should always:

a. List the procedures according to charge value, the highest priced procedure first, bill for all procedures coded by the surgeon.
b. Code all documented procedures. List the procedures according to Relative Value, check CCI for component codes or mutually exclusive procedures (bundled), and assign applicable modifiers. Bill only those procedures that are not bundled into any of the other procedures performed and coded. Always verify modifier ­51 exempt procedures.
c. List the procedures according to Relative Value, billed all procedures documented in the operative report, and assign applicable modifiers to all procedures.

ANSWER


10. A physician removes 12 benign lesions from a patient during the same visit. The appropriate way to bill for this would be:

a. CPT code 17003 (removal of 2nd through 12th lesion.)
b. CPT code 17000 (removal of first lesion) would be used with a units/studies of 12
c. CPT code 17000 would be used for the 1st lesion and code 17003 would be used for the 2nd through the 12th lesion.

ANSWER


11. A patient arrives at the ER at 10 P.M. and wants to see their primary care physician instead of the emergency room physician. The primary care physician is phoned at home and agrees to see the patient. The primary care physician's visit in the ER could be coded as follows:

a. An ER visit code from the range 99281-99285 (Emergency Dept. Services), based on level of care given and documented.
b. An outpatient consultation from code range 99242-99245.
c. An ER visit code from the range 99281-99285 (Emergency Dept. Services and CPT code 99052 for services requested between 10 pm and 8 am in addition to basic service.

ANSWER


12. Case Study
New patient, a 25-year old Female, who had a tray fall on right wrist at work today, comes to the office. She has persistent pain exacerbated with moving the wrist and hand. Describes pain as very severe. Right wrist is swollen and sore to touch. Her past medical history is noncontributory and she has NKA (no known allergies). Provider performed an expanded problem focused examination. An x-ray was ordered and showed no acute fractures. Dx: right wrist sprain. Patient was placed in padded splint and given prescription for Darvocet. She was asked to return in one week. The level of E/M that should be billed is:

a. 99201
b. 99202
c. 99203
d. 99204
e. 99205

ANSWER


13. Dr. Q is a new physician joining XYZ Group. Dr Q sees Mrs. M for the first time, although Mrs. M is an established patient with the XYZ group. Can Dr. Q bill for a new patient visit since Mrs. M is a new patient to him?

a. Yes, Dr. Q can bill Mrs. M as a new patient since he has never seen her as a patient before.
b. No, Dr. Q cannot bill Mrs. M as a new patient because she is already an established patient within the group.
c. Yes, Dr. Q can bill Mrs. M as a new patient if she has not been seen by any of the other physicians in the group for 3 years.
d. b & c are correct.

ANSWER


14. How many diagnosis codes are necessary per CPT code?

a. Can only use one per code
b. As many as affect treatment of the patient
c. Two or three

ANSWER


15. Case Study
An established patient presents in the office for a recheck of the problem from a previous visit. The physician spends about 10 minutes reviewing the previous problem and would have been finished with the patient. However, the patient begins to talk about another problem he/she has been having. The discussion takes approximately 25 minutes and was regarding options and risks involved, possibility of medications and other forms of treatment. The patient's visit has lasted a total of 35 minutes. The physician would code the visit as:

a. 99213
b. 99403
c. 99214
d. None of the above

ANSWER


16. Guidelines for billing an E/M visit and a procedure on the same date of service include:

a. both E/M and procedure are billed when the decision to perform the procedure was made during another visit.
b. both services are billable only if the diagnosis for the E/M is different from the diagnosis for the procedure. Modifier -25 is used with the E/M code.
c. the procedure and the E/M visit may both be billed with the same diagnosis code and during the same encounter, if the decision to perform the procedure was made at the time of the encounter. Modifier -25 is used with the E/M code.
d. only the procedure may be billed if the decision to perform the procedure was made during the same encounter as the E/M visit.

ANSWER


17. Elements of a preventive medicine service include:

a. a chief complaint, comprehensive history and exam, ordering lab and/or diagnostic procedures.
b. comprehensive history and exam, ordering lab and/or diagnostic procedures, counseling and/or risk factor reduction and is based on the age of the patient.
c. an HPI, risk factor reduction, and comprehensive exam and medical decision making.

ANSWER


18. Documentation of the patient's history requires:

a. a review of systems, history of present illness, and past, family, and/or social history
b. a chief complaint
c. a low level of medical decision making
d. a and b

ANSWER


19. Case Study
A new patient comes in with complaints of diarrhea and watery stool the previous night, as well as nausea, vomiting, and lower abdominal pain. The physician provides a detailed history and examination, with moderate medical decision making. The correct level of E/M visit that should be billed is:

a. 99201
b. 99202
c. 99203
d. 99204
e. 99205

ANSWER