Download CPT Exam Review Questions with 100% Correct Answers| Verified | Latest Update 2025 and more Exams Nursing in PDF only on Docsity!
CPT Exam Review Questions with 100%
Correct Answers| Verified | Latest Update
What three components contribute to the calculation of Relative Value Units? Physician work, Practice expense, Malpractice insurance Rationale: Per the Centers for Medicare & Medicaid Services (CMS), Relative value units (RVUs) capture the following three components of patient care: Physician work RVU, Practice Expense RVU, and Malpractice RVUs. What codes are voluntarily reported to payers and provide evidence-based performance-measure data? CPT® Category II codes Rationale: Per AMA, CPT® Category II codes are a set of supplemental tracking codes used for performance measurement. CPT® Category III codes reimburse at what level? Reimbursement, if any, is determined by the payer Rationale: Per AMA, there are no relative value units (RVUs) assigned to these codes. Payment for these services or procedures is based on the policies of payers. The Global Surgical Package applies to services performed in what setting?
Hospitals Ambulatory Surgical Centers Physician's offices Correct! All of the above Rationale: The services included in the global surgical package may be furnished in any setting, including hospitals, ASCs, and physicians' offices. Visits to a patient in an intensive or critical care unit are also included if made by the surgeon. What surgical status indicator represents the Global Surgical Package for endoscopic procedures (without an incision) where there is no postoperative period after the day of the surgery? 000 Rationale: For endoscopic procedures (except procedures requiring an incision), there is no postoperative period. Surgical status indicator 000 is for endoscopies or minor surgical procedures with no preoperative or postoperative period. Any related services on the day of the procedure are generally included in the fee schedule payment amount and not paid separately; including evaluation and management services on the day of the procedure. What does the acronym HCPCS stand for? Healthcare Common Procedure Coding System Rationale: HCPCS stands for Healthcare Common Procedure Coding System. What chapter in the HCPCS Level II code book lists the code for Wheelchairs?
Which statement is TRUE regarding the instruction for use of the CPT® codebook? Select the name of the procedure or service that accurately identifies the service performed. Rationale: CPT® Instructions for the use of the CPT® code book indicates to "select the name of the procedure or service that accurately identifies the service performed." Instructions for Use of the CPT code book is found in the front of the CPT codebook in the Introduction. What type of CPT® code is "modifier 51 exempt" even though there is no modifier 51 exempt symbol next to it? Add-on codes Rationale: Per CPT® guideline, "all add-on codes found in the CPT® codebook are exempt from the multiple procedure concept." What agency maintains and distributes HCPCS Level II codes? CMS Rationale: CMS maintains and distributes HCPCS Level II codes. 00:0301: When procedures are "mandated" by third party payers, what modifier would you use? 32 Rationale: Modifier 32 reports "mandated services".
HCPCS Level II includes code ranges that consist of what type of codes? Permanent national codes, miscellaneous codes and temporary national codes Rationale: HCPCS Level II codes consist of permanent national codes, miscellaneous codes, and temporary national codes. What publications does the AMA copyright and maintain? CPT® codebook and CPT® Assistant Rationale: CPT® codebook (all three categories) and CPT® Assistant is published, copyrighted and maintained by AMA. How often are HCPCS Level II permanent national codes updated? Annually Rationale: Permanent national codes are updated once a year in January. What does "non-facility" describe when calculating Medicare Physician Fee Schedule payments? Non-hospital owned physician practices Rationale: "Non-facility" location calculations are for private practices or non-hospital-owned physician practices. Reimbursement is higher for private practices because the practice incurs the full expense of providing the service. What is the correct anesthesia CPT® code for surgery performed on the frontal lobe of the brain?
Skin/Excision/Lesion/Benign. You are directed to 11400-11471. Turn to these codes in the numeric section and, once reviewed, code 11423 is reported. This represents the excision of a benign lesion on the scalp, neck, hand feet or genitalia; 2.1 to 3.0 cm in diameter excised including margins. What is the correct code for the application of a short arm cast? 29075 Rationale: In the CPT® Index, look for Cast/Type/Ambulatory/Short Arm. The code you are directed to use is 29075. What is the correct code for a total ankle arthroplasty with an implant? 27702 Rationale: In the CPT® Index, look for Arthroplasty/Ankle referring you to codes 27700-27703. Review the codes in the numeric section code 27702 is the correct code. What is the correct CPT® code for the extensive excision of nasal polyps? 30115 Rationale: In the CPT® Index, look for Excision/Polyp/Nose which directs you to 30110,
- You may also look in the CPT® Index for Excision/Nose/Polyp and get the same codes. Looking at the description for each code in the Respiratory numeric section, code 30115 is selected for extensive. If you look up Polyp/Nose/Excision/Extensive in the CPT® Index, code 30115 is listed.
What code represents a secondary rhinoplasty where a small amount of work is performed on the tip of the nose? 30430 Rationale: In the CPT® Index, look for Rhinoplasty/Secondary, which directs you to codes 30430 - 30450. Look at the codes in the Respiratory numeric section. Code 30430 represents a small amount of work for a secondary rhinoplasty when performed on the tip of the nose. What is the correct code for a radical maxillary sinusotomy? 31030 Rationale: In the CPT® Index, look for Sinusotomy/Maxillary, which directs you to codes 31020 - 31032. Look in the Respiratory numeric section and review the code descriptors. Code 31030 is reported. 31032 is not correct because there is no indication of removing antrochoanal polyps. The Table of Drugs in the HCPCS Level II book indicates various medication routes of administration. What abbreviation represents the route where a drug is introduced into the subdural space of the spinal cord? IT Rationale: In the HCPCS Level II code book, there is an appendix that lists the abbreviations and acronyms and their meanings. IT stands for Intrathecal. IT is the route where a drug is introduced into the subdural space of the spinal cord.
J0561 x 24 Rationale: In the HCPCS Level II Table of Drugs, look up Bicillin L-A, which directs you to code J0561. One unit of J0561 represents 100,000 U, so 24 units are reported for 2,400,000 U. What is the code for partial laparoscopic colectomy with anastomosis and coloproctostomy? 44207 Rationale: In the CPT® Index, look for Laparoscopy/Colectomy/Partial. You are directed to codes 44204-44208 and 44213. In the Digestive numeric section, upon review of the codes, 44207 represents a partial colectomy with anastomosis and coloproctostomy performed laparoscopically. What is the correct CPT® code for a complicated nephrolithotomy on a patient with a congenital kidney abnormality? 50070 Rationale: In the CPT® Index, look for Nephrolithotomy. You are directed to see codes 50060 - 50075. In the Urinary numeric section, review the descriptions of these codes. Code 50070 represents a nephrolithotomy complicated by a congenital kidney abnormality. What is the correct CPT® coding for a cystourethroscopy with brush biopsy of the renal pelvis? 52007 Rationale: In the CPT® Index, look for Cystourethroscopy/Biopsy/Brush referring you to 52007.
What is the correct CPT® code for strabismus corrective surgery performed on two horizontal muscles? 67312 Rationale: In the CPT® Index, look for Strabismus/Repair/Two Horizontal Muscles referring you to 67312. What is the correct CPT® code for a complete, four-view, chest X-ray with fluoroscopy? 71048 Rationale: In the CPT® Index, look for X-ray/Chest referring you to code range 71045-71048. Code 71048 is the correct code to report the four views. What is the correct CPT® code to report a microscopic urinalysis? 81015 Rationale: In the CPT® Index, look for Urinalysis/Microscopic. The code you are directed to use is 81015. What is the correct CPT® code for level IV surgical pathology? 88305 Rationale: In the CPT® Index, look for Pathology and Laboratory/Surgical Pathology/Gross and Micro Exam/Level IV. The code you are directed to use is 88305.
What is the correct CPT® code for a MRI performed on the brain first without contrast and then with contrast? 70553 Rationale: In the CPT® Index, look for Magnetic Resonance Imaging (MRI)/Diagnostic/Brain. You are directed to see codes 70551-70555. Upon review of the codes in the Radiology numeric section, code 70553 represents an MRI performed on the brain first without contrast material, then with contrast material. What is the appropriate modifier to use when two surgeons perform separate distinct portions of the same procedure? 62 Rationale: Modifier 62 is used when two surgeons work together as primary surgeons performing distinct part(s) of a procedure. Modifiers and their descriptions are found on the inside front cover and in Appendix A of your CPT® code book. Where is the starting point for selective catheter placement for the vascular families in Appendix L in the CPT® codebook? Aorta Rationale: Look in Appendix L of the CPT® code book. The guideline for Appendix L states the assumption is made that the starting point of catheterization is the aorta. What is the full description for code 11001?
Debridement of extensive eczematous or infected skin; each additional 10% of the body surface, or part thereof (List separately in addition to code for primary procedure) Rationale: Look at code 11001 in the Integumentary numeric section of the CPT® code book. The code description of an indented code includes the portion before the semicolon in the main code. In this example, the common portion of the code is shown in 11000 Debridement of extensive eczematous or infected skin; and the remaining portion of the code descriptor is in add- on code 11001 each additional 10% of the body surface, or part thereof. Services provided in the home by an agency are considered Facility services Rationale: The Introduction in the CPT® code book (after the Table of Contents) includes instructions under the subheading Place of Service and Facility Reporting, which indicates services provided in the home by an agency are considered facility services. What type of print indicates new additions and revisions in the CPT® codebook each year? Green print Rationale: New additions and revisions in the CPT® code book each year appear in green print. What hernia repair codes can be reported with add-on code 49568? 49560 - 49566
