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NEW QUESTION # 77
Code a polyp found in the transverse colon.
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 # 78
Code the following physician's note:
A 14-year-old established patient is seen with mother to evaluate five 2 cm superficial lacerations to the left wrist. Patient admits to suicidal thoughts.
Lacerations were treated with Steri-Strips. Patient and mother counseled on suicide prevention and told to follow up with psych.
Answer: B
Explanation:
When the injury is treated with Steri-Strips or bandages, it should be reported with an E/M code and not a procedure code. Within the medical decision making, the number and complexity of problems addressed is low, the amount of data reviewed or analyzed is straightforward, and the risk of complications and/or morbidity or mortality of patient management from the injuries is low.
Therefore, the E/M is a 99213 because the medical decision-making is low. A suicide attempt would not be coded because the documentation is not specific as to whether the lacerations were an attempt at suicide.
NEW QUESTION # 79
An established female patient presents to a video conference with her internist with complaints of a nonproductive cough. She receives 15 minutes of counseling about the symptoms of COVID-19 and is directed to an unaffiliated testing site. What CPT and ICD-IO-CM codes should be reported?
Answer: D
Explanation:
When coding a telehealth encounter for an outpatient practice that occurs over audio-video technology (e.g. Skype), the appropriate office visit E/M would be reported with modifier 95. The patient must initiate the telehealth encounter. Although similar, CPT code 99442 is billed when a patient initiates communication with a provider through an online patient portal. ICD-IO-CM Z20.828 is reported only when a patient does not exhibit any symptoms of a disease the patient is suspected to have been exposed to.
NEW QUESTION # 80
An established 27-year-old female patient is seen with complaints of fatigue and muscle aches that began 3 days ago. The physician draws two vials of blood, collects a urine sample, and performs a pregnancy test. The patient is instructed to drink 8 ounces of water daily, rest, and follow up in 3 days for her results. What CPT codes should be reported for this encounter?
Answer: A
Explanation:
The documentation demonstrates that the number and complexity of problems addressed is low (fatigue and muscle aches are self-limited problems), the amount or complexity of data to be reviewed and analyzed is moderate (three unique tests), and the risk of complications, morbidity, or mortality of patient management is minimal (the patient was advised to drink more water). (To determine the final level of medical decision making, choose the lowest of the highest two elements. In this scenario, the final level of medical decision making is low, and the CPT code is
99213. Vihen reporting a routine venipuncture, use CPT code 36415. CPT code 36410(a) is reported when it is medically necessary for the physician to draw a patient's blood, and 36416 describes capillary blood collected through a skin prick-certainly not enough to fill two vials. CPT code 99000 can be used to report a specimen being transported to an outside laboratory, but that is unknown in this scenario. A generic urinalysis is reported with CPT code 81002 unless specifically stated that an automated analyzer (81005), a commercial kit (81007), and/or an agar test (81020) was utilized.
NEW QUESTION # 81
A urologist performs a laparoscopic adrenalectomy and excises a retroperitoneal mass in the same session. How should this be coded?
Answer: B
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 # 82
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