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Medical Tests American Academy of Professional Coders: Certified Professional Coder Sample Questions (Q77-Q82):

NEW QUESTION # 77
A 74-year-old male patient recently had a bone marrow transplant due to aplastic anemi a. At his follow-up visit with the doctor, his blood is drawn and sent to the laboratory to determine if the engraftment was successful. The laboratory evaluates the immature reticulocyte fraction (IRF) using an automated cell counter and total reticulocyte by way of a manual count. What codes should the laboratory report?

A. 85046, D61.9
B. 85046, 85044, D61.9, Z94.81
C. 85046, 85044, D61.9
D. 85046, D61.9, Z79.89

Answer: A

Explanation:
When a hematologr procedure that could be billed alone is encompassed in another code, only the most complex of the tvo should be reported. Because CPT 85046 includes the reticulocyte count billing CPT 85044 as secondary despite using a different method would be considered an unbundling of services. Per ICD-IO-CM guidelines, an organ or tissue transplant status code is for use "only if there are no complications or malfunctions of the organ or tissue replaced." As the testing is to determine whether the engraftment was successful, a bone marrow transplant status code would not be appropriate until deemed by the provider.

NEW QUESTION # 78
Assign the appropriate CPT codes for the following surgical note: A 15-year-old patient is being treated for obstructive sleep apnea and adenoid tissue hypertrophy. After being placed under general anesthesia, a dental mirror is placed in the oropharynx to allow visualization of the nasopharynx. Suction electrocautery is used to remove the adenoid tissue that regrew after the initial adenoidectomy. Attention is then turned to the tonsils. The plane of tissue between the tonsillar capsule and the underlying muscles are cauterized, and the tonsils are removed. Bleeding is controlled by silver nitrate and gauze packing. Procedure is completed without complications, and patient is discharged to recovery.

A. 42999, 647.33, 135.2
B. 42821, G47.33, 135.2
C. 42826, 42836-51, 135.2, G47.33
D. 42826, 42831-59, 135.2, G47.33

Answer: B

Explanation:
An adenoidectomy and a tonsillectomy were performed in this surgical encounter (the root word -ectomy literally means the surgical removal of an anatomical structure). The adenoidectomy was done first and, if coded alone, would fall under one of Evo categories: primary (CPT 42830-
42831) or secondary (CPT 42835-42836). A primary adenoidectomy refers to the initial removal of the adenoid, whereas a secondary adenoidectomy occurs when adenoid tissue that was once removed has grown back. Because the documentation states that "the adenoid tissue ... regrew after the initial adenoidectomy," a coder can infer that this procedure is secondary. However, distinguishing betvveen the two procedures is not necessary when done in conjunction with a tonsillectomy because the procedures are bundled into two nonspecific CPT codes (42820 and
42821). Billing for an adenoidectomy and a tonsillectomy separately, as shown in answers A and C, is considered unbundling and is not allowed under the Correct Coding Initiative (CCI) edits.
Regarding the sequencing of the diagnoses, ICD-IO-CM guidelines state that when V,vo conditions meet the definition for principal diagnosis, either can be sequenced first In this scenario, J 35.2 or G47.33 could have been first listed because the procedures were to resolve both conditions in the same encounter.

NEW QUESTION # 79
What describes a surgical procedure that removes a portion of the vertebral body to relieve pressure on the spinal cord and nerves?

A. Insertion of interspinous process stabilization device
B. Laminectomy
C. Corpectomy
D. Spinal fusion

Answer: C

Explanation:
The insertion of an interspinous process stabilization device is done to increase the space within the neural foramen, release nerve pressure that causes physical pain, and create spinal stabilization. A spinal fusion is a surgical procedure that permanently joins Nto or more vertebrae into one solid bone so that no space exists between them. A laminectomy is a surgical procedure that removes the lamina to enlarge the spinal canal and relieve pressure on the spinal cord and/or nerves.

NEW QUESTION # 80
Which statement is true regarding the diaphragm?

A. It separates the thoracic cavity from the abdominal cavity.
B. It is a collection of organs held together by connective tissue.
C. It performs an important function in blood flow.
D. It forms tendons, ligaments, cartilage, and fat.

Answer: A

Explanation:
The diaphragm separates the thoracic cavity from the abdominal cavity by means of skeletal muscle. When the diaphragm contracts, air is drawn into the lungs. It therefore plays a key role in respiration. The mediastinum is surrounded by loose connective tissue and contains several anatomical structures including the heart. Connective tissue is distributed throughout the body to form tendons, ligaments, cartilage, and fat.

NEW QUESTION # 81
If a physician administers cyclophosphamide over 154 minutes, irinotecan over 72 minutes, and panitumumab over 15 minutes intravenously to a patient with pancreatic cancer, how should this be reported?

A. 96413, 96413-59, 9641512, 96417
B. 96413, 96413-59x2, 96415, 96417
C. 96413, 96415x3, 96417x2
D. 94613, 96415x2, 96417x2

Answer: C

Explanation:
Unless a separate IV site is established for a secondary or tertiary administration, CPT
96413 should be reported only once to represent the initial drug infusion. In this case, it is the cyclophosphamide. The remaining 94 minutes are reported with Ovo units of add-on CPT 96415, which may be reported ifthe time spent beyond the first hour is between 31 and 60 minutes. CPT
96417 is reported only once per subsequent infusion of a different drug up to the first hour.
Consequently, the 72 minutes of irinotecan is reported with a single unit of CPT 96417, and the 15 minutes of panitumumab is also reported with one unit ofthat same CPT code.

NEW QUESTION # 82
......

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