CPC Certified Professional Coder MCQ 3 — Questions and Answers
Question 1: Which of the following is the correct way to report a bilateral procedure when the CPT code descriptor does not specify bilateral?
- Report the code once with modifier -50
- Report the code twice on separate lines with modifier -RT and -LT
- Either A or B depending on payer requirements (Correct answer)
- Report with modifier -51
Correct answer: Either A or B depending on payer requirements
Bilateral procedures can be reported with modifier -50 or with separate line items using -RT and -LT modifiers; the approach depends on specific payer requirements.
Question 2: What is the purpose of the National Correct Coding Initiative (NCCI) edits?
- To establish fee schedules for Medicare services
- To prevent improper payment of procedures that should not be billed together (Correct answer)
- To define coverage policies for Medicare Part D
- To regulate coding for workers' compensation claims
Correct answer: To prevent improper payment of procedures that should not be billed together
NCCI edits, developed by CMS, prevent improper payment when two or more procedure codes are submitted together that are mutually exclusive or represent components of a more comprehensive code.
Question 3: A surgeon performs an open reduction and internal fixation (ORIF) of a closed distal radius fracture. The correct ICD-10-CM fracture code should indicate:
- Type of fracture, laterality, and encounter type (Correct answer)
- Only the fracture location
- The mechanism of injury and body part
- The type of fixation device used
Correct answer: Type of fracture, laterality, and encounter type
ICD-10-CM fracture codes capture specificity including fracture type (displaced/nondisplaced), laterality, and the appropriate 7th character for encounter type.
Question 4: When a physician provides care to a patient in a skilled nursing facility (SNF), which code set is used for subsequent care visits?
- 99307-99310 (Correct answer)
- 99281-99285
- 99221-99223
- 99241-99245
Correct answer: 99307-99310
CPT codes 99307-99310 are used for subsequent nursing facility care visits based on the level of medical decision making or time.
Question 5: Which of the following conditions would be coded as an 'uncertain diagnosis' in the outpatient setting?
- 'Probable pneumonia' listed as the final diagnosis
- Chest pain listed as the chief complaint (Correct answer)
- Confirmed appendicitis
- Hypertension managed during the visit
Correct answer: Chest pain listed as the chief complaint
In the outpatient setting, uncertain diagnoses (probable, suspected, possible) are not coded; instead, the presenting sign or symptom — such as chest pain — is coded.
Question 6: A coder sees a note that a patient received 'moderate sedation' administered by the performing physician during a colonoscopy. How should the moderate sedation be coded?
- Separately with codes 99151-99153
- It is bundled into the colonoscopy code and not coded separately (Correct answer)
- With modifier -47
- As an anesthesia service using 00810
Correct answer: It is bundled into the colonoscopy code and not coded separately
For procedures where moderate sedation is included in the procedure's work (as indicated by a bull's-eye symbol in CPT), it is bundled and not reported separately.
Question 7: Which section of the CPT codebook contains codes for non-face-to-face physician services, such as online medical evaluations?
- Surgery
- Medicine
- Evaluation and Management (Correct answer)
- Radiology
Correct answer: Evaluation and Management
Non-face-to-face E/M services including online digital evaluation and management services are found within the Evaluation and Management section of CPT.
CPC Certified Professional Coder MCQ 3
Which of the following is the correct way to report a bilateral procedure when the CPT code descriptor does not specify bilateral?