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ANSWERS

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TransCode Mock Test No. 4 Answers

1. “d” The code 15852 includes “under anesthesia (other than local).” You can
find this code in the index of the CPT Professional Edition under Dressing,
Change, and Anesthesia. Modifier -LT provides additional information regarding
which side of the body was involved in the procedure.
2. “a” You would report this excision to a benign lesion. In the CPT Professional
Edition under the heading Excision – Benign Lesions, cystic lesion is given as an
example, (layered) intermediate closure should be reported in addition to the
excision. The local anesthesia is included per the CPT Surgery section guidelines.

3. “d” This is an Autograft (coming from one part of a patient’s body to another).
In the CPT Professional Edition under the Skin Replacement Surgery and Skin
Substitutes subsection in the Surgery/Integumentary System (15002–15431),
the guidelines state, “Procedures are coded by recipient site,” [which is the nose
in this question], further, the guidelines read, “…includes simple debridement of
granulation tissue.” There is no documentation of an additional office visit on the
day of the procedure.

4. “b” One way to find this procedure is in the index of the CPT Professional
Edition under Excision, Chest wall, Tumor. The parenthetical note under this
code indicates code 19272 should not be used in conjunction with 32503.

5. “c” Mohs surgery is reported by anatomic site. The code description includes
mapping, color coding of specimens, and routine stains. The first stage is
reported with code 17313, the two additional stages are reported with 17314 x 2,
and the additional blocks in stage two are reported with code 17315 x 2

6. “b” The CPT Professional Edition subcategory guidelines for Adjacent Tissue
Transfer or Rearrangement procedures under the Surgery/Integumentary
System, state, “excision (including lesion).”

7. “c” In the CPT Professional Edition under the heading for Repair (Closure), the
guidelines define simple, intermediate, and complex. The repair to the arm and
foot are classified to simple repairs and reported by the sum of lengths of repairs
for each group of anatomic site, 12006. The repair to the hand is classified as
intermediate (refer to the definitions) 12044. These guidelines also state, under
number two, multiple wounds, “When more than one classification of wounds is
repaired, list the more complicated as the primary procedure and the less
complicated as the secondary procedure, using modifier -51.”

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8. “c” In the CPT Processional Edition guidelines under Excision – Malignant
Lesions, the last sentence of the guidelines state, “Append modifier -58 if the re-
excision procedure is performed during the postoperative period of the primary
excision procedure.”

9. “b” This question asks how to report the biopsy procedure, not the excision.
Biopsies of different lesions or different sites on the same date as another
procedure are reported separately. Append Modifier -59 to identify that there
were two separate lesions.

10. “a” The primary procedure is a partial corpectomy (you can find this in the
CPT Professional Edition index under corpectomy). An arthrodesis was done in
addition to the definitive procedure; therefore modifier -51 is necessary (you
can find this in the subcategory guidelines under Arthrodesis). Do not attach
modifier -51 to add-on codes (see Appendix A for this definition). You would
report the code for a structural allograft.

11. “a” One way to find this answer is in the index of the CPT Professional Edition
under Fracture, Femur, Neck, Open Treatment. There is an illustration under the
code 27236 for a prosthetic replacement.

12. “a” You can find this answer in the CPT Professional Edition in the
main section guidelines for the Musculoskeletal System.

13. “d” One way to find this answer is in the index of the CPT Professional
Edition under Wound, Exploration, Back.

14. “b” Refer to the index of the CPT Professional Edition under Dislocation,
Patella closed treatment for a code range. It is necessary to look up the code
range and read the descriptions to select the correct code.

15. “c” This question asks for you to report the procedure. There is not enough
information to report the evaluation and management code. You can find the
procedure in the index of the CPT Professional Edition under Sequestrectomy,
Olecranon Process. The modifier -RT provides additional information.

16. “b” The code 20206 reports a needle biopsy of soft tissue. Use code 27324
to report a deep biopsy of soft tissue of the thigh or knee area.

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17. “a” Modifier -50 indicates a bilateral procedure. You can find this procedure in
the index of the CPT Professional Edition under Incision and Drainage,
Hematoma, Knee.

18. “a” One way to find this answer is in the index of the CPT Professional
Edition under Annuloplasty.” This procedure was done to more than one level,
which requires use of the add-on code 22527.

19. “d” You can find codes exempt from modifier -51 in Appendix E of the CPT
Professional Edition. You could also look up each code and locate the symbol
that indicates modifier -51 exempt.

20. “a” You can find the code 36905 in the index of the CPT Professional Edition
under Angioplasty, Venous, Percutaneous.

21. “b” Code 39000 is a cervical approach, code 39010 reports a transthoracic approach.

22. “a” This is a secondary rhinoplasty with major revision. The closure is bundled
with the surgical procedure. Modifier -78 isn’t required because the second
service was not performed within the postoperative period. Generally, the
maximum postoperative period is no more than 90 days.

23. “d” A surgical thorascopy always includes a diagnostic thorascopy. You can
find this note in the CPT Professional Edition under the Endoscopy heading.

24. “c” The code 33530 and 35572 are add-on codes and should not have
modifier -51 appended. Review modifier -51 in Appendix A of the CPT
Professional Edition for this note.

25. “a” You can find this statement under the heading of Endovascular Repair of
Descending Thoracic Aorta in the CPT Professional Edition. Read the guidelines
carefully and you will see the primary codes listed with this statement.

26. “a” The code 33210 reports a temporary transvenous single chamber
pacemaker. There is not enough information in the question to code for the
placement of the permanent system.
27. “d” When coding for this procedure, it is necessary to code for the removal
(33235) and then replacement of the leads (33217). Modifier -51 indicates
multiple procedures in the same anatomic site.

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28. “b” The code 36592 describes this procedure. You can find this answer in
the index of the CPT Professional Edition under Collection and Processing,
Specimen, Venous Catheter.

29. “b” The code 37186 is an add-on code and would be reported in addition to
the primary procedure. The guidelines preceding this procedure clearly state, do
not report 37184– 37185 with code 37186.

30. “b” This answer must have the diagnosis codes and procedure code. The
diagnoses codes report special screening for the colonoscopy, family history of
colon cancer, and benign polyps of the colon. The procedure code 45384 reports a
therapeutic procedure with removal of the polyps.

31. “d” You can find this answer in the index of the CPT Professional Edition
under Suture, Abdomen.

32. “d” You can find this answer in the index of the CPT Professional Edition under
Vestibuloplasty. You can find the definition of the vestibule of the mouth at the
beginning of the digestive system above code 40800. Modifier -50 isn’t necessary
because the code description states “bilateral.”

33. “a” You should append modifier -26 to the radiology code to indicate the
professional portion of this procedure. You can find this procedure in the index
of the CPT Professional Edition under Placement, Needle, Interstitial
Radioelement Application, Head.

34. “c” This is a replacement procedure via the same access site. The same
provider who does the procedure reports the moderate sedation codes.

35. “a” Use add-on code 49568 to report the implantation of the mesh in
addition to debridement and hernioplasty. Modifier -51 is not attached to add-
on codes (see Appendix A).

36. “c”.

37. “a” The parenthetical notes under code 43268 direct the use of code
43262 for the sphincterotomy.

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38. “a” Report modifier -52. This statement is printed in the CPT Professional
Edition under the code 44950. You can find this answer by looking up
appendectomy in the index and cross referencing the codes.

39.“c” Always review how the procedure is being performed – laparoscopy,


excision, etc. This is a key to finding and reporting the correct code.

40. “c” The code 50380 reports the auto-transplantation and re-implantation of
a kidney. The parenthetical note under this code directs the use of the code
for nephrectomy with modifier -51.

41. “b” The code 55875 represents the procedure and the code 77778 is the
clinical brachytherapy. Code 77778 includes admission to the hospital and daily
visits. You can find this rule in the subcategory guidelines for Clinical
Brachytherapy in the CPT Professional Edition.

42. “a” This is a lithotripsy, extracorporeal shock wave treatment. You


can find this procedure in the index of the CPT Professional Edition under
Lithotripsy.

43. “d” You can find this answer in the CPT Professional Edition index under
Excision, Lesion, Epididymis. Be careful with the index in this section and follow it
to lesion or you may use the incorrect code.

44. “a” You can find this procedure in the index of the CPT Professional Edition
under Repair, Penis, Injury. You would report modifier -79 for the unrelated
procedure during a post- operative period by the same physician.

45. “b” The code 58671 reports this procedure via a laparoscopic approach.
Modifier -50 is not necessary to report a bilateral procedure due to the code
description of oviducts (which is bilateral).
46. “c” The code 50385 includes the conscious sedation, radiological supervision,
and interpretation. The code defines a removal and replacement so there is one
code to describe the entire procedure.
47. “d” The code 51785 describes this procedure. The guidelines under
urodynamics indicate…“When the physician only interprets the results and/or
operates the equipment, a professional component, modifier -26, should be used
to identify physicians’ services.”
48. “b” You can find this code in the index of the CPT Professional Edition under
Prostate, Enucleation. The vasectomy procedure is bundled with code 52649.
49. “d” You can find this information in the CPT Professional Edition under the
Delivery After Previous Cesarean Delivery subsection.
50. “d” The code 50300 describes a donor nephrectomy (including cold
preservation); from a cadaver donor, unilateral or bilateral. Because the
procedure is described as a unilateral or bilateral procedure, you would not report
modifier -50.

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51. “a” The note under Prophylaxis indicate that these services are repetitive,
performed in multiple sessions, and are intended to include all services in a
defined treatment period. The parenthetical note under code 67229 states to use
modifier -50 for a bilateral procedure. The operating microscope is bundled into
this procedure. Refer to code 69990 for a list of bundled codes.
52. “d” One way to answer this question is to look in the index of the CPT
Professional Edition under the main heading of Tumor.
53. “b” The professional services for the CT should have a modifier -26. The
professional service is the procedure; therefore, there would be no modifier -
26 on code 60300.
54. “a” This question represents a subsequent tap. The code 61000 is reported
for an initial procedure. Modifier -50 is not necessary because it is inherently
included in the code description.
55. “b” Correct code for Tympanic neurectomy is 69676. You would attach
modifier -50 to indicate a bilateral procedure.
56. “c” Each surgeon should report the work he or she completed. Because Dr.
Martin completed the definitive procedure, use code 61606, which includes the
repair and graft.
57. “d” The code 63050 reports two or more vertebral segments, therefore, there
is no need to change the units. You could find this answer by looking in the index
of the CPT Professional Edition under Laminoplasty.
58. “a” You can find this answer by looking up Neuroplasty in the index
of the CPT Professional Edition and reading the definition under the sub-
heading.
59. “c” Code 64857 describes suturing of a major peripheral nerve in the leg
without transposition. The add-on code 64859 is used for the second major
peripheral nerve. The add-on code 64876 reports the shortening of the bone.

Add-on codes should not have modifier -51 attached (see Appendix A).

60. “a” The code 65273 is reported for hospitalization. The code 65272 is
for without hospitalization.

61. “b” A new patient is described as not receiving any professional serves in the
past three years. You can find this answer in the Evaluation and Management
Services Guidelines and on the Decision Tree for New vs. Established Patients
(same guidelines) in the CPT Professional Edition.
62. “d” Counseling and/or risk factor reduction intervention services are provided
to patients with symptoms or established illness.

63. “a” The guidelines for critical care have a list of services that are included
with critical care when performed by the physician providing the critical care
and these services should not be reported separately.

64. “c” This is an established patient visit and meets two of the three key
components for a 99214 level visit.

65. “b” The subcategory guidelines for Initial Hospital Care state, “When the
patient is admitted to the hospital as an inpatient in the course of an encounter

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in another site of service (e.g., hospital, emergency department, observation
status in a hospital, physician’s office, nursing facility) all evaluation and
management services provided by that physician in conjunction with that
admission are considered part of the initial hospital care when performed on the
same date as the admission. Therefore, the services are reported with the initial
hospital care code only. The office visit is a bundled service.

66. “b” These codes are included (bundled) and you can’t report them in addition
to the Continuing Intensive Care Services. In the subcategory guidelines for
these services it is noted, “…These codes include the same procedures that are
outlined in the Pediatric Critical care services section and these services should
not be separately reported.”

67. “a” This question deals with outpatient anticoagulant management. The
code 99363 gives specific parameters for reporting.

68. “d” Day one admission or initial hospital care is 99223. Days two and three
are subsequent hospital care services at 99232 and you should report them
separately. Day four is subsequent hospital care at level 99231. Day five is the
discharge service, which is based on time and code 99239 is reported for
services of more than 30 minutes, regardless of the actual time. Report this code
only once.
69. “a” Refer the page 21 in CPT manual.

70. “b” This is a new patient visit not a consultation. “A “consultation” initiated by
a patient and/or family, and not requested by a physician or other appropriate
source, …is not reported using the consultation codes but may be reporting using
the office visit, home service, or domiciliary/rest home care codes.” Report a
consultation code only when a request (written or verbal) is made by another
physician or appropriate source, an opinion is rendered, and a written report is
sent back to the “requestor.” In this case the patient initiated the visit.

71. “a” You can find this definition in the CPT Professional Edition under the
subcategory guidelines for Emergency Department Services.

72. “d” Preventive medicine services are based on new vs. established patient and age.
73. “b” You should report the anesthesia services with modifier -P2 for mild
systemic disease and qualifying circumstances due to the patient’s age.

74. “c” Refer to Appendix G in the CPT Professional Edition. This appendix lists the
codes that include moderate conscious sedation along with guidelines to assist
with reporting these services.

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75. “d” According to the Anesthesia Guidelines in the CPT Professional
Edition, the preoperative visit is “bundled” or included in the anesthesia
services.

76. “b” According to the Anesthesia Guidelines in the CPT Professional Edition,
“To report regional or general anesthesia provided by a physician also
performing the services for which the anesthesia is being provided, see modifier
-47 in Appendix A.” Appendix A describes the use of modifier -47 for a basic
service when the anesthesia is provided by the surgeon.

77. “a” According to the Anesthesia Guidelines in the CPT Professional Edition,
Swan-Ganz monitoring is not included.

78. “c” You can find the definition for Modifier -23 – Unusual Anesthesia in
Appendix A of the CPT Professional Edition.

79. “a” Report a screening mammography with computer-aided detection to code


77067.

80. “c” The code 76942 is the correct code to report this procedure According to
the CPT Assistant, Apr 05:15-16, “From a CPT coding perspective, code 76942
should be reported per distinct lesion that requires separate needle placement.
Therefore, if passes are made into two separate lesions in the same organ (i.e.,
two lesions in same breast), then code 76942 would be reported twice.”

81. “b” You can find this study in the index of the CPT Professional Edition under
DXA (with a cross reference).This study was completed on the axial skeleton.

82. “b” You can find this answer in the index of the CPT Professional Edition
under Proton Treatment Delivery.

83. “d”

84. “a” The fastest way to find these codes is to refer to the list in Radiology
Guidelines of the CPT Professional Edition. Or, refer to the index under Unlisted
Services and Procedures for a complete listing.

85. “a” You can find this answer by referring to the index of the CPT
Professional Edition under Magnetic Resonance Imaging (MRI), Heart. When
you cross reference the code set, the subcategory guidelines preceding these
codes define the difference in testing.

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86. “c” You can find his answer in the index of the CPT Professional Edition under
Brachytherapy, High Code Electronic. There is also a parenthetical note
preceding CPT Code 77750.

87. “c” The common part of the code 78130 (the part before the semicolon) is
considered part of the code 78135.

88. “a” You can find this answer at the beginning of the Pathology and Laboratory
Guidelines of the CPT Professional Edition.

89. “d” The tests reported are listed under the basic metabolic panel code
80047. When reporting a panel, all the tests listed in the panel must be
completed. If one test is missing, then you should not report a panel. If a panel
is completed and there are additional test(s), then you would report the panel
and the code(s) for the additional test(s). Do not add modifier -52 to panel
codes to indicate that not all the tests in the panel were completed.

90. “b” The first parenthetical note following codes 88331 and 88334 give
reporting instructions (us both codes).There are two tumor sites in this
question.

91. “a” Genetic Testing Modifiers are listed in Appendix I of the CPT Professional
Edition. The note under the subcategory Cytogenetic Studies refers to Appendix I.

92. “a” The math calculations are included (bundled) with chemistry tests. You
can find this note in the last paragraph under the Chemistry subsection of the
CPT Professional Edition.

93. “a” The code 80502 reports a comprehensive clinical pathology consultation.
The patient was not present; therefore you would not report an evaluation and
management consultation code.

94. “B”

95. “a” You can find this code in Category II codes.

96. “d” The code 82272 states, “…performed for other than colorectal neoplasm screening.”

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97. “c” You can find this test in the CPT Professional Edition under Calprotectin, fecal.

98. “a” The description under code 92557 lists the codes that are combined and
should not be reported separately. In addition, the subcategory guidelines for
the Audiologic Function Tests with Medical Diagnostic Evaluation state to add
modifier -52 if studies are completed on one ear.

99. “b” Administration of vaccines are reported according to the route and the
age of the patient. These vaccines, all injections, were given to an adult patient;
therefore, you would report the codes 90471 and 90472 x 2. The vaccines are
reported for each type given or injected. According to the guidelines under the
Vaccines, Toxoids subsection, do not report modifier -51 for the vaccines when
performed with the administration procedures.

100. “c” Use code 96360 to report hydration of 31 minutes to one hour.

101. d” You can find this answer by looking in the index of the CPT
Professional under Endoscopy, Bronchi, Stenosis.

102. “a” Use the codes for Medication Therapy Management Services. The
guidelines for these codes indicate the documentation elements and times
necessary to select a code.

103. “c” Code 98969 is reportable for non-physician healthcare professionals.

104. “c” You can find this answer in Appendix J under the code 95904.

105. “a” The notes above the code 96904 indicate this service is typically
consultative and the consultation evaluation and management code may be
appropriate in addition to the special dermatological procedures. The other
answers are incorrect due to the reporting of the evaluation and management
code.

106. “b” See the subsection Ophthalmology in the CPT Professional Edition
under for the definition of special ophthalmological services, “…these services
may be reported in addition….”

107. “c” Code 92980 describes intracoronary stent(s) and describes one or more
stents placed, therefore the units are not changed for the three stents in this

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question. The add-on code 92996 describes the arthrectomy, which is not
bundled into the stent placement because there are different arteries involved in
this procedure. The PTCA procedure is bundled into the athrectomy code. Add-on
codes do not have modifier -51 attached.

108. “a” You can find this answer by studying or knowing medical terminology.

109. “a” You can find this answer in the index of the CPT Professional Edition.
Once you locate the term, cross reference the code(s) to determine the type
of procedure.

110. “d”

111.“c” This question is an example of an answer that you could not find in the
source materials allowed for the CPC exam. This type of question is based on
general knowledge of medical specialties.

112. “c” The degree of a burn is determined by the layers of skin involved. A
third degree burn, also known as a full thickness burn, involves damage to all
three layers of skin and possibly the muscle.

113.“b” You can find this answer in the CPT Professional Edition in the
illustrations of anatomical and procedural review at the front of the book. You
could also find this answer by looking in the in the CPT index under Choroid and
then cross referencing the procedures.

114. “a” This question is best answered by studying or knowing medical


terminology. However you could also discover the correct answer by using the
CPT Professional Edition index and looking up procedures that begin with
enter/o.

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115.“a” You can find the answer in the index of the CPT Professional Edition by
looking up ERG.

116. “b” This answer comes from studying medical terminology. You can break
down the term anorectal (an/o – anus, rect – rectum, and –al pertaining to).

117. “d” Sciatica is an inflammation of the sciatic nerve that results in pain,
burning, and tingling along the course of the nerve through the thigh and leg.

118. “c”

119. “b” You can find the answer by breaking down the medical term
cystopexy (cyst/o – urinary bladder, pexy – surgical fixation). The CPT
Professional Edition lists a few surgical procedure suffixes in the front of the
book, which are helpful for learning medical terminology.

120. “b” You can find this answer in the index of the CPT Professional Edition
under the procedure Episiotomy, then cross referencing the code. You could
also reference the list in the front of the book that describes surgical
procedures (suffix otomy– cutting into or incision).

121. “b” This is an example of an answer that you may not be able to find in the
resource material available for the CPC exam. Studying or knowing anatomy and
medical terminology is the best way to answer this type of question.

122. “b” The aorta is an artery not a vein. There are four types of valves that
regulate blood flow through the heart.
1. The tricuspid valve regulates blood flow between the right atrium and right ventricle.
2. The pulmonary valve controls blood flow from the right ventricle into the
pulmonary arteries, which carry oxygen-poor blood to the lungs to pick up
oxygen.
3. The mitral valve lets oxygen-rich blood from the lungs pass from the left
atrium into the left ventricle.
4. The aortic valve opens to allow oxygen-rich blood to pass from the left
ventricle into the aorta, the largest artery, where this blood is delivered to the
rest of the body.

123. “d”

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124. “a” This is an example of an answer that you may not be able to find in the
resource material available for the CPC exam. Studying and knowing anatomy
and medical terminology is the best way to answer this question. The lower
respiratory tract consists of the trachea, bronchi, bronchioles, alveoli, and
capillaries of the lungs.

125. “c” You can find this answer by looking up uvula in the CPT Professional
Edition and cross referencing the codes listed. This will provide information
about where the uvula is located in the body.

126. “a” This is an example of an answer that you may not able to find using
the resource material available for the CPC exam. Studying and learning
anatomy and medical terminology is the best way to answer this question.

127. “d” This is an example of an answer that you may not be able to find in the
resource material available for the CPC exam. Studying and knowing anatomy
and medical terminology is the best way to answer this question. Break down
the word (leuk/o – white and cytes – cell).

128. “b” This is an example of an answer that you may not be able to find in
the resource material available for the CPC exam. Studying and knowing
anatomy and medical terminology is the best way to answer this question.
Read the answers carefully. Both the use of vaccination and immunoglobulins
harvested are “artificial” not “natural” means of immunity.

129. “a” You can find this answer in the CPT Professional Edition in the index
under Olecranon Process. If you cross reference the codes, you will discover
the answer is the elbow.

130. “c” The Q35 Cleft palate, unspecified category is only for cleft palate, and the
Q36 Cleft lip is for only cleft lip. The Q37 Cleft palate with cleft lip category
specifies cleft palate and lip.

131. “d” You can find this answer in the ICD-10-CM coding guidelines under
Chapter 4, Type of diabetes mellitus not documented. The section states, “If the
type of diabetes mellitus is not documented in the medical record the default is
type II.”

132. “c” You can find this answer in the ICD-10-CM coding guidelines under
Chapter 15, Codes from Chapter 15 and sequencing priority, which states, “. . .
Chapter 15 codes have sequencing priority over codes from other chapters.

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Additional codes from other chapters may be used in conjunction with Chapter
11 codes to further specify conditions.”

133. “c” In ICD-9-CM, both childhood-type schizophrenia not otherwise specified


(NOS) and schizophrenic syndrome of childhood NOS are reported using the
subcategory of unspecified pervasive developmental disorder (PDD). In ICD-10-
CM, these conditions are reported using subcategory F84.5 Asperger’s syndrome.

134. “d” Sinusitis has three documentation concepts that are required in ICD-
10-CM code selection: Anatomy Maxillary Frontal Ethmoidal Sphenoidal
Pansinusitis Temporal factors Acute Chronic Acute on chronic Contributing
factors Exposure to environmental tobacco smoke History of tobacco use
Occupational exposure to environmental tobacco smoke Tobacco dependence
Tobacco use.

135. “a” In ICD-10-CM, Kanner’s syndrome is listed as inclusive of F84.0 Autistic disorder.

136. “a” According to ICD-10-CM guidelines in Chapter 17, c, 3, “Non-


healing burns are coded as acute burns.”

137. “b” In this example, the physician documented severe sepsis. The default
codes for severe sepsis, A41.9, R65.20, pneumonia (J18.9 Pneumonia) and
chronic obstructive pulmonary disease (COPD) exacerbation J44.1.

138. “c” In ICD-10-CM, systemic inflammatory response syndrome (SIRS) due to


infection can no longer be coded as sepsis. The term “sepsis” will need to be
documented by the physician

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to use code A41.9 Sepsis, unspecified organism. The urinary tract infection (UTI)
is coded as unspecified, N39.0 Urinary tract infection, site not specified. The
code for the specific organism, B96.20 Unspecified Escherichia coli [E. coli] as
the cause of diseases classified elsewhere, would be added. The guidelines state
that if the patient has clinical evidence of sepsis in the documentation, even
though blood cultures are negative, the physician should be queried.
Encephalopathy, unspecified is reported using G93.40.

139. “b” Answer A is incorrect because only a code for the most severe burn in a
given anatomical location should be reported. Answer C is incorrect because
the codes reflect burns on the left side of the body, while the scenario indicates
the burns were on the right side. Answer D is incorrect because the codes are
for reporting corrosions. The correct answer is B, which correctly reports a code
for each location burned.

140. “c” The fourth character should reflect the total body surface area burned,
while the fifth character should reflect the percentage with third degree burns.
Answer A is incorrect because the question indicates the patient had burns on 36
percent of his body surface with third-degree burns on 27 percent of his body
surface. The fourth character (2) supports burns on only 20-29 percent of the
body surface, not 36 percent of his body surface, as indicated. In answer B the
fourth character (7) indicates burns on 70-79 percent of the patient’s body
surface. Answer D is incorrect because the T32 category is used for corrosions.

141. “c” You can find this answer by referring the HCPCS Level II manual.

142. “a” You can find this answer by referring to the Table of Drugs in the
HCPCS Level II manual.

143. “a” You can find this answer in the index of the HCPCS Level II manual
under Helmet, head.

144. “b” You can find this answer in the index of the HCPCS Level II manual
under Prosthetic additions, lower extremity. Once you find this code range,
review the codes to determine the correct code.

145. “d” You can find this answer in the index HCPCS Level II manual under
Transportation, x-ray (portable). Review of code R0075, indicates “. . . more
than one patient seen.”

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146. “c” Modifier -E3 describes upper right eyelid. You can find this modifier in
the HCPCS Level II manual or the front inside cover of the CPT Professional
Edition.

147. “a” You can find the four primary classes of main entries listed at the
beginning of the index section in the CPT Professional Edition.

148. “d” The coding concepts for modifiers are complicated. In this question none
of the codes and modifier combinations are correct. All of the codes listed in this
question are add- on codes. Modifier descriptors are also incorrect with the codes
listed: -25 could be attached only to an evaluation and management code, -21
could only be appended to the highest level evaluation and management code
within a given category, and modifier -51 should not be attached to add-on
codes. See the definitions of these modifiers in Appendix A of the CPT
Professional Edition.

149. “b”

150. “b” You can find this answer in the CPT Professional Edition under Liver
Transplantation subcategory guidelines.

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