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Medical Tests American Academy of Professional Coders: Certified Professional Coder Sample Questions (Q126-Q131):

NEW QUESTION # 126
Which procedure uses a thin tube to examine the abdominal organs through a small incision in the belly?

A. Laparotomy
B. Endoscopy
C. Gastroscopy
D. Laparoscopy

Answer: D

Explanation:
A gastroscopy is a procedure that uses an endoscope to examine the stomach and some parts of the intestinal tract An endoscopy uses a thin tube through a natural opening in the body to examine the digestive tract. A laparotomy is a large incision in the belly to gain access into the abdominal cavity.

NEW QUESTION # 127
What is/are the code(s) for the repair of an incarcerated hernia in the inner groin requiring mesh placement on a 32-year-old female patient?

A. 0
B. 1
C. 2
D. 3

Answer: A

Explanation:
There are several different types ofhernias that are categorized by their location. A hernia located in the inner groin is inguinal, and a hernia located on the outer groin is femoral. The repair of an incarcerated inguinal hernia on a 32 -year-old patient is coded to CPT 49507. Hernia mesh is used to reduce the risk of recurrence, and implantation of it is inclusive to an inguinal, umbilical, femoral, and laparoscopic hernia repair.

NEW QUESTION # 128
A patient presents to physical therapy status post repair of a complete rotator cuff tear in the right shoulder due to a fall. After applying ice to the shoulder for 8 minutes, the physical therapist performs a soft-tissue massage to the infraspinatus muscle that lasts 23 minutes. Just prior to discharge, the therapist spends 20 minutes instructing the patient on isokinetic exercises to help improve range of motion. Which CPT and ICD-IO-CM code(s) should be used to accurately describe encounter?

A. 97110, 97140, 97010, Z48.89, S46.091A, W19XXXA
B. 97110, 97010, S46.011D, W19,XXXD
C. 97010, 97140, 97530, S46.011A,W19XXXA
D. 97010, 97140x2, 97530, M75.121

Answer: B

Explanation:
Although CPT code 97530 does describe therapeutic activities, the focus is directed at improving functional performance, whereas the correct CPT code 97110 works to develop range of motion. The CPT code for a soft tissue massage (or manual therapy 97140) is based on 15-minute increments, however, anything over 8 minutes prior to or after can be counted as a unit. Based on this, the 23 minutes spent can be counted as two units. Sequencing is based on highest RVU.
Coding crosswalk for a rotator cuff tear is classified as a muscle strain, so answer B, which specifies
"other injury," can be eliminated. Because the patient is in the recovery period of the injury, the seventh character would not be considered active but subsequent.

NEW QUESTION # 129
A 79-year-old female patient is admitted to a skilled nursing facility for continued monitoring as she completes her course of antibiotics for bronchitis. Upon admission, a nurse practitioner spends 20 minutes with the patient, performing an evaluation of recovery and rebuilding of stamin a. On day 3, the patient's physician completes an initial comprehensive assessment and determines the patient is recovering well on her current dosage of antibiotics. What CPT code should be reported on day 3?

A. 0
B. 1
C. 2
D. 3

Answer: A

Explanation:
CPT defines an initial nursing facility service (NFS) as "the first encounter with the patient by the admitting physician to nursing facilities." Although the patient can be evaluated and treated by other medical staff in the meantime, only the physician responsible for the admission may report the initial comprehensive visit (99304-99306). If other medical personnel do provide treatment, those visits would be reported using the subsequent nursing facility care encounter codes (99307-
99310). Nursing facility care services require a medically appropriate history and/or examination, and a review of medical decision making. In this scenario, the number and complexity of problems addressed at the encounter is low (one stable, acute illness), the amount and/or complexity of data reviewed or analyzed is straightforward (minimal or none), and the risk of complications and/or morbidity or mortality of patient management is moderate (prescription drug management). After considering that the patient is established, the level of complexity for the visit is considered low and the encounter should be reported with CPT code 99304.

NEW QUESTION # 130
Which patient is receiving critical care services?

A. A 60-year-old male is admitted with an acute chronic heart failure exacerbation causinghypoxic respiratory failure. The patient is intubated, sedated, and started on 50 mg ofertapenem for a potential lung infection.
B. A 67 -year-old female receives chronic ventilator therapy after a cerebral infarction thatcaused hemorrhage in the brain.
C. A 47 -year-old female with a history of unrepaired chronic heart disease and anemia has anoxygen saturation level of 80. She is put on a nasal cannula and given a blood transfusion toimprove her oxygen-carrying capacity and oxygen saturation level.
D. A 93 -year-old male is admitted to the intensive care unit for monitoring after a coronaryangioplasty procedure that was performed to relieve symptoms of atherosclerosis.

Answer: A

Explanation:
CPT guidelines define critical care as an illness or injury that acutely impairs one or more vital organ systems, where there is a high probability of imminent or life-threatening deterioration in the patients condition. Additionally, to report a critical care service, the documentation should provide evidence of high-complexity medical decision-making (e.gendotracheal tube insertion, defibrillation, fluid administration for shock, Narcan, etc.). Answer B is the only option listed that contains documentation to support critical care services.
This male patient has Vyvo life-threatening conditions, in which emergent intervention is provided to prevent further deterioration. In ansvver A the female patient may have a life-threatening condition: however, administering oxygen via a nasal cannula and/or transfusing blood does not qualify as critical care. Management of a patient who receives chronic ventilator therapy is also not considered critical care because the medical decision-making involved in the therapy is quite low.
The care a patient receives after having surgery would be considered routine and postoperative, regardless of where they are sent, unless a complication arises in which one or more of the vital organ systems begins to deteriorate in a fashion that poses a threat to life.

NEW QUESTION # 131
......

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