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NEW QUESTION # 20
Which service is NOT included in the central nervous system assessment?
Answer: A
Explanation:
A central nervous system assessment is comprised of multiple screenings that are reported with CPT codes 96105-96146 and includes, but is not limited to, the following elements: use of standardized instruments for staging and rating clinical dementia: evaluation for behavioral symptoms using standardized screening instruments; and development, updating, revision, and/or review of an Advance Care Plan. A review of high-risk medications is also included in the central nervous system assessment; however, if in the same encounter a prescription is issued, the clinician should document and report the treatment with an appropriate E/M.
NEW QUESTION # 21
The appendix is removed through an abdominal incision due to metastatic colon malignancy. How should this be reported?
Answer: A
Explanation:
An open appendectomy procedure is reported with CPT 44950. A metastatic colon malignancy is a cancer that began in the colon but has spread to other areas. In this scenario, that means that the primary malignancy is the colon, and the secondary malignancy is the appendix.
Additionally, ICD-IO-CM guidelines state that when "treatment is directed toward the metastatic site only, the metastatic site is designated as the principal/first-listed diagnosis. The primary malignancy is coded as an additional code." The malignancy codes do not specifically state
"appendix," but the ICD-IO-CM coding crosswalk in the neoplasm table assigns this diagnosis as C78.5 secondary malignant neoplasm of large intestine and rectum.
NEW QUESTION # 22
A physician inserts a chest tube through the right chest wall and into the pleural cavity to release trapped air in a 19-year-old patient with recurring pneumothorax. A second physician assists in providing moderate sedation. In total, the procedure took 8 minutes. What ICD-IO-CM and CPT codes should the provider report?
Answer: D
Explanation:
The code description "tube thoracostomy" is not clearly stated in the documentation, but CPT crosswalk for a 'tube placement" followed by "chest" leads the coder to CPT 32551. CPT 32550 describes the insertion of a catheter that allows the patient to drain pleural fluid in an outpatient setting. Moderate sedation can be separately billed but only by the provider administering the medication. The 193 series is circumstantial (e.g., spontaneous, acute). Even though the term
"recurrent" is not used, it does describe the background of the patient's condition and so would fall into the other specified diagnosis rather than unspecified.
NEW QUESTION # 23
The relative value units of a procedure are based on how much effort is involved, expenses that the practice will incur, and the level of risk associated with it.
Answer: B
Explanation:
The statement is true. An insurance carrier will use these three measures to determine what the RVU of a procedure should be. Then, based on that, a medical coder can determine what the expected payment should be. Generally, the higher the RVU of a procedure is, the higher the payment will be.
NEW QUESTION # 24
A 55-year-old patient is admitted into the hospital for dialysis to treat ESRD. On day 13, the admitting physician spends 25 minutes discussing new management options for the patient's hypertension before sending a nurse to initiate the hemodialysis procedure. What CPT and ICD-IO-CM codes should be reported?
Answer: D
Explanation:
CPT codes 90935-90937 require the presence of a physician. If a physician visits the patient prior to or after the dialysis treatment but does not document their presence during the hemodialysis services, bill only the appropriate evaluation and management code (CPT 99232).
Additionally, unless otherwise stated, diagnosis selection should reflect the causal relationship that exists bet'.veen hypertension and ESRD (112.-, N18.-)-they should not be reported as unrelated.
ICD-IO-CM Z99.2 is appended to indicate hemodialysis status.
NEW QUESTION # 25
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