TransCode Solutions www.transcodeglobal.

com

TRANSCODE SOLUTIONS
90,000 series Medicine Section Questions: 3X2=60mints

1. A patient is coming in to have osteopathic manipulative treatment (OMT)

performed on two regions one in cervical region and one in thoracic region.
Which code is reported by the physician for the OMT?

a. 98927
b. 98940
c. 98925
d. 98942

c – OMT performed on two regions one in cervical region and one in thoracic
region (98925).

2. The patient is admitted to the hospital for a radio16 channel EEG to

determine the focus of her cerebral seizures. The test also consists of video
recording and interpretation with nurse attendance. The EEG is performed in 12
hours. Select the appropriate coding.

a. 95950-26
b. 95953-26-52
c. 95951-26
d. 95956-26-52

d - (95956-26-52 )The key to this encounter is time and the cerebral seizures
monitoring using a radio 16 channel EEG. A nurse is in attendance during the test.
CPT® guidelines state: Codes 95950-95953 and 95956 are used per 24 hours of
recording. For recording of 12 hours or less, use modifier 52.

3. A patient presents to her oncologist’s office for schedule chemotherapy.

The patient is severely dehydrated. The physician decides to schedule the
chemotherapy for another day and orders hydration therapy to be performed
today instead of the chemotherapy. The therapy is ordered and administered for
one hour and 10 minutes. Select the code(s).

9985277066 9959602447
TransCode Solutions www.transcodeglobal.com

a. 96413-53, 96360
b. 96360
c. 96360, 96361
d. 96413, 96361

b - Although the patient is scheduled for chemotherapy, only hydration therapy is

performed. Hydration therapy codes are selected based on time. The total time
for this procedure is one hour and 10 minutes. There is a parenthetical note
following code 96361 which states: Report 96361 for infusion intervals greater
than 30 minutes beyond one hour increments. There are only 10 additional
minutes beyond the first hour, so only 96360 is reported

4. Left heart catheterization retrograde from the femoral artery with injection
procedures for selective coronary angiography and selective left ventriculography,
including imaging supervision and interpretation with report, are performed. The
cardiologist performed all of the services at the hospital. The CPT® codes are:
a. 93458-26
b. 93459-26
c. 93452-26
d. 93460-26

a - Because a left retrograde heart catheterization is performed for a coronary

angiography and left ventriculography, multiple choices C and D are eliminated.
There is no mention of catheterization in bypass graft(s), which eliminates
multiple choices B. The procedure is performed in the hospital. There is a
professional and technical component for the cardiac catheterization codes in
which modifier 26 is appended.

5.A patient is coming in to have osteopathic manipulative treatment (OMT)

performed on two root lesions in his cervical region and three root lesions in the
thoracic region. Which code is reported by the physician for the OMT?

a. 98927
b. 98940
c. 98925
d. 98925

9985277066 9959602447
TransCode Solutions www.transcodeglobal.com

Omit code - OMT was only performed on two body regions (cervical and thoracic).
The OMT codes are only reported for the number of body regions involved, not
the number of lesions in a particular body region.
6. 69-year-old female has been having chest tightness. Cardiologist orders
percutaneous transluminal coronary angioplasty (PCTA) of the right coronary
artery and left anterior descending coronary artery. The procedure revealed
atherosclerosis in the native vessel of the left anterior descending coronary artery
and right coronary artery. Stents were inserted in both arteries to keep the
arteries opened. Patient was placed under moderate conscious sedation during
the procedure for a total of 30 minutes. What CPT® codes should be reported for
this procedure?

a. 92920-LT, 92921-RT
b. 92980-LD, 92981-RC, 99144
c. 92920-LD, 92921-RC
d. 92920-LT, 92921-RT, 99144

c - (92920, 92921) Stents were placed in the left anterior descending coronary
artery (LD) and right coronary artery (RC) (additional vessel). There is a bull’s-eye
symbol in front of code 92920 indicates moderate sedation is included in the code
and is not reported separately

7. A two-month-old returns for a well check up and several shots (Rota, DTaP-Hib,
PCV) with her pediatrician. He offers suggestions to the mom, completes the
exam, and counsels her on the vaccinations. How should this be coded?

a. 99391-25, 90460,, 90461 x 2, 90680, 90721, 90669

b. 99381-25, 90471, 90472 x 2, 90474, 90680, 90700, 90648, 90669
c. 99381-25, 90471, 90472 x3, 90680, 90700, 90645, 90669
d. 99391-25, 90460 x 3, 90461 x 3, 90680, 90721, 90669

d - We know this patient is established because she is “returning to her

pediatrician.” The well check up is coded as a preventive service. The patient is
two-months-old. The proper code is 99391. According to NCCI, modifier 25 is
appended when a significant and separately identifiable E/M service is performed
with other services at the same encounter. In this case vaccinations are
performed. A vaccine administration for each is coded as well as the vaccine itself.

9985277066 9959602447
TransCode Solutions www.transcodeglobal.com

In this case three vaccines are performed; rotavirus (90680), combination vaccine
DTaP-Hib (90721) and Pneumococcal (90669). The physician counsels the
patient’s mother regarding the vaccinations. This eliminates multiple choices B
and C. Add-on-code 90461 is reported when a combination vaccine is given. DTaP-
HIB is a combination vaccine that has a total of four components. Code 90460 is
reported three times for the administration of the rotavirus, diphtheria (first
component of the combination vaccine), and pneumococcal. Add-on-code 90461
is reported three times for the remaining three components (tetanus toxoids,
acellular pertussis and Hemophilus influenza B) in the combination vaccine.

8. Mary, who has food allergies, came to her physician for her weekly allergen
immune therapy that consists of two injections prepared and provided by the
physician. The correct code is:

a. 95125
b. 95117
c. 95144
d. 95146

a – (95125) In this case the patient presents for allergen immune therapy for food
allergies. The injections are prepared and provided by the physician, which is
reported with 95125 for two injections. Code 95144 is reported when the antigen
extract is prepared and supplied in a vial. The therapy is not for an insect which
makes 95146 incorrect answers. 95117 does not include the provision of the
extract so it is also incorrect.

9. An 8 years old female had one face to face visit with her physician and received
3 daily dialysis services during a once a month period to her kidney transplant.
How these services should be reported.

a. 90945
b. 90968*3
c. 90964*3
d. 90956

9985277066 9959602447
TransCode Solutions www.transcodeglobal.com

b - (90968*3) received 3 daily dialysis services during a once a month period to

her kidney transplant.

10. Dinah a 18 years old patient underwent 4 daily ESRD services in the outpatient
clinic to being hospitalized. A complex assessment was not provided before
Dinah’s hospitalization. How should you report the daily services?

a. 90957, 90969
b. 90965
c. 90957
d. 90969*4

d - (90969*4) 18 years old patient underwent 4 daily ESRD services in the

outpatient.

11. Mother brings her 1-year-old in for the influenza split virus vaccine. Physician
discuses merits of the vaccine with the mother

a. 90658; 90472
b. 90657; 90460
c. 90703
d. 90657

b - 90657 (influenza split virus vaccine); 90460 (via any route through 18 years
which means from birth to 18).

12. A 29-year-old patient is given an intramuscular Hepatitis A and Hepatitis B

vaccine. Select the appropriate codes to report this service.

a. 90471, 90646, 90747

b. 90467, 90632, 90646

c. 90473, 90636

d. 90471, 90636

9985277066 9959602447
TransCode Solutions www.transcodeglobal.com

d - 90471 (intramuscular single or combination use), 90636 (Hepatitis A and

Hepatitis B vaccine/ adult dosage).

13. DIALYSIS INPATIENT NOTE: This 24-year-old male patient is on continuous

peritoneal dialysis (CAPD) using 1.5%. He drains more than 600cc. He is tolerating
dialysis well. He continues to have some abdominal pain, but his abdomen is not
distended. He has some diarrhea. His abdomen does not look like acute abdomen.
His vitals, other than the pressure in the 190s over 100s, are fine. He is afebrile.
At this time, I will continue with 1.5% dialysate. I gave him labetalol IV for blood
pressure. Because of diarrhea, I am going to check stool for white cells, culture.
Next we will see what the primary physician says today. His HIDA scan was
normal. The patient suffers from ESRD.

a. 90947, 90921, 585.6, 787.91

b. 90945, 585.6, 787.91
c. 90921, 585.6
d. 90945, 585.6

b - 90945 (peritoneal dialysis), 585.6 (ESRD), 787.91 (Diarrhea). Cholescintigraphy

scan, also known as: Hepatobiliary Iminodiacetic Acid HIDA. (HIDA Scan) is a
procedure used to diagnose gallstones or tumors in the gallbladder.

14. INDICATION: Hypertension with acute myocardial infarction.

PROCEDURE PERFORMED: Insertion of Swan-Ganz catheter.

DESCRIPTION OF PROCEDURE: The right internal jugular and subclavian area was
prepped with antiseptic solution. Sterile drapes were applied. Under usual sterile
precautions, the right internal jugular vein was cannulated. A 9 French introducer
was inserted, and a 7 French Swan Ganz catheter was inserted without difficulty.
Right atrial pressures were 2 to 3, right ventricular pressures 24/0, and pulmonary
artery 26/9 with a wedge pressure of 5. This is a Trendelenburg position. The
patient tolerated the procedure well.

a. 93501, 93503-51, 401.9

b. 93508, 401.9

9985277066 9959602447
TransCode Solutions www.transcodeglobal.com

c. 93503, 93539, 401.9, 410.91

d. 93503, 401.9, 410.91

d - 93503 (Insertion and placement of Swan-Ganz catheter); 401.9 (Hypertension),

410.91 (acute myocardial infarction).

15. DIAGNOSIS: Atrial flutter.

PROCEDURE PERFORMED: Electrical cardioversion.

DESCRIPTION OF PROCEDURE: The patient was sedated with Versed and

morphine. She was given a total of 5 mg of Versed. She was cardioverted with 50
joules into sinus tachycardia. The patient was given a 20-mg Cardizem IV push.
Her heart rate went down to the 110s, and she was definitely in sinus tachycardia.

CONCLUSION: Successful electrical cardio version of atrial flutter into sinus

tachycardia.

a. 92961, 427.61
b. 92960, 427.32
c. 92960, 92973, 427.32
d. 92960, 427.89

b – 92960 (electrical cardio version), 427.32 (atrial flutter)

16. The Correct way for reporting the 60 minutes of face-to-face insight oriented,
behavior modifying psychotherapy services for 60 minutes

a. 90832-22
b. 90834
c. 90836
d. 90837-22
d - 60 minutes of face-to-face (90837-22).

17. Physician performs 16 percutaneous tests (scratch, puncture, or prick) with

allergenic extract, Code the procedure

a. 95052, Specify 16 in Units Block

9985277066 9959602447
TransCode Solutions www.transcodeglobal.com

b. 95044, Specify 16 in Units Block

c. 95004, Specify 16 in Units Block
d. 95017, Specify 16 in Units Block

c -95004 (percutaneous tests (scratch, puncture, or prick) with allergenic extract,),

Specify 16 in Units Block.

18. 17. A patient presents for a pleural cavity chemotherapy session that required
a thoracentesis to be performed:

a. 96445
b. 96440, 32000
c. 96440
d. 96445, 32000

c - 96440 (Pleural cavity chemotherapy session that required a thoracentesis to be

performed).

19. Select the correct statement

I. Code 90951 is reported once per month

II. 90945 is assigned for peritoneal dialysis

III. Code 90970 for ESRD services outside of inpatient hospitalization

IV. Code 90963 is assigned for home dialysis patients

a. I, I
b. III, IV
c. I, IV
d. I, II, III, IV

d - I, II, III, IV

20. A patient presents to her oncologist’s office for schedule chemotherapy. The
patient is severely dehydrated. The physician decides to schedule the

9985277066 9959602447
TransCode Solutions www.transcodeglobal.com

chemotherapy for another day and orders hydration therapy to be performed

today instead of the chemotherapy. The therapy is ordered and administered for
one hour and 10 minutes. Select the code(s).

a. 96413-53, 96360
b. 96360
c. 96360, 96361
d. 96413, 96361

b - orders hydration therapy to be performed today instead of the chemotherapy.

96360 (hydration therapy is ordered and administered for one hour and 10
minutes).

21. The correct code for OMT performed on the cervical, thoracic and sacral
regions would be:

a. 97110
b. 98941
c. 98926
d. 97124

c - 98926 (OMT performed on the cervical, thoracic and sacral regions. 3 regions)

22. The patient is admitted to the hospital for an eight channel EEG to determine
the focus of her cerebral seizures. The EEG is performed for 24 hours. Select the
appropriate code

a. 95813
b. 95824
c. 95827
d. 95950

d - eight channel EEG to determine the focus of her cerebral seizures. The EEG is
performed for 24 hours (95950).

9985277066 9959602447
TransCode Solutions www.transcodeglobal.com

23. A patient who had been thrown across the freeway in a motorcycle accident
goes to the physical therapy department for non-selective debridement of
devitalized tissues on massive deep abrasions incurred on both lower extremities.
The abrasions go to the level of the dermis. What is the most appropriate code for
this service?

a. 97606
b. 11042
c. 11043
d. 97602

d -97602 (non-selective debridement of devitalized tissues).

24. During the month of July, a 7 year old patient with end stage renal disease is
followed by his nephrologist. The care provided by the nephrologist includes:
monitoring the dialysis cycle, monitoring the patient’s nutrition, assessment of
growth and development, and counseling of the patient’s parents. During the
month of July, the patient was seen by his nephrologist at his office 3 times. What
is the correct CPT code for this encounter?

a. 90955
b. 90968 x 3
c. 90993 x 3
d. 90945

a - 90955 (End stage renal disease, per month (July), age 2-11 (7yrs), monitoring
the patient’s nutrition, assessment of growth and development, and counseling of
the patient’s parents, month of July, the patient was seen by his nephrologist at
his office 3 times).

25. A patient who has had the stomach flu for one week presents to the
physician's office. The physician evaluates the patient and determines he needs IV
hydration. The physician orders and administers IV fluids which take two hours to
complete. What are the correct CPT® codes for the service?

9985277066 9959602447
TransCode Solutions www.transcodeglobal.com

a. 96360 x 4
b. 96360, 96361
c. 96360 x 2
d. 96360, 96361 x 2

b -96360 (IV hydration code upto 1 hr), 96361 (additional 1 hr).

26. Mrs. Emma has severe atrial fibrillation. She presents today for an EPS study.
Dr. H. Prince performs the professional component of a comprehensive EPS study,
which includes right atrial and ventricular pacing/recording, bundle of His
recording and induction of atrial fibrillation. How should this service be coded?

a. 93620 – 26
b. 93619, 93620
c. 93619-26, 93620 –26
d. 93600-26, 93602 – 26, 93603 –26, 93610, 93612, 93618

a - 93620 (comprehensive EPS study, which includes right atrial and ventricular
pacing/recording, bundle of His recording and induction).

Below code 93620 the parenthetical note says do not report 93620 with codes
93600, 93602, 93610, 93612, 93618 or 93619

27. A patient with atrial fibrillation had a dual lead pacemaker implanted 1 year
ago. Today she returns to the physician’s office for evaluation of the function of
the device and reprogramming if needed. What is the appropriate CPT® code for
this encounter?

a. 93288
b. 93280
c. 93283
d. 93289

b - 93280 (evaluation of the function of the implanted device dual lead

pacemaker).

9985277066 9959602447
TransCode Solutions www.transcodeglobal.com

28. A patient has a 60-minute session of psychoanalysis with a Freudian specialist.

What is the most appropriate code for these services?

a. 90826
b. 90837
c. 90812
d. 90845

d - 90845 (psychoanalysis).

29. Mr. Warner comes in once a week for his chemotherapy into the pleural
cavity. He has a thoracentesis tube placed first and then the chemo is
administered. What is the most appropriate way to code for administration of
intrapleural chemotherapy?

a. 96440, 32421
b. 32422
c. 96440
d. 96445

c - 96440 (chemotherapy into the pleural cavity including thoracentesis).

30. A cardiologist pediatrician sends a four-week-old baby to an outpatient facility

to have an echocardiogram. The baby has been having rapid breathing. He is
sedated and a probe is placed on the chest wall and images are taken through the
chest wall. A report is generated and sent to the pediatrician. The interpretation
of the report by the pediatrician reveals the baby has an atrial septal defect.
Choose the CPT® code the cardiologist pediatrician should report.

a. 93303
b. 93315-26
c. 93303-26
d. 93315

9985277066 9959602447
TransCode Solutions www.transcodeglobal.com

c - Infant is having the echocardiogram performed through the chest

(transthoracic) not through the a device in the esophagus (transesophageal),
eliminating multiple choices B and D. The subsection guidelines for
Echocardiography in the CPT® codebook states: When interpretation is performed
separately, use modifier 26. Modifier 26 needs to be appended since only the
interpretation of the echocardiogram was performed by the pediatrician.

9985277066 9959602447