CPC Practice 3 — Questions and Answers
Question 1: A physician performs a laparoscopic appendectomy and also performs an incidental laparoscopic cholecystectomy at the same session. How should this be reported?
- Report only the appendectomy
- Report both procedures with modifier -51 on the secondary procedure (Correct answer)
- Report both procedures without any modifier
- Report only the cholecystectomy as it has a higher RVU
Correct answer: Report both procedures with modifier -51 on the secondary procedure
Both procedures should be reported, with modifier -51 appended to the secondary (lower-valued) procedure to indicate multiple procedures.
Question 2: Which of the following best describes an 'unbundling' error in medical coding?
- Reporting a combination code when individual codes are appropriate
- Reporting component codes separately when a comprehensive code should be used (Correct answer)
- Using an incorrect diagnosis code
- Adding modifier -25 to every E/M service
Correct answer: Reporting component codes separately when a comprehensive code should be used
Unbundling occurs when services covered by a single comprehensive CPT code are billed as separate codes, inflating reimbursement.
Question 3: A patient has Type 2 diabetes mellitus with diabetic chronic kidney disease, stage 3. Which ICD-10-CM combination code captures both conditions?
- E11.65
- E11.649
- E11.22 (Correct answer)
- E13.22
Correct answer: E11.22
E11.22 represents Type 2 diabetes mellitus with diabetic chronic kidney disease, stage 3 as a combination code.
Question 4: Which of the following describes the correct sequencing when a patient is admitted for chemotherapy and also has the underlying malignancy?
- Sequence the malignancy first, then the chemotherapy code
- Sequence the chemotherapy encounter code (Z51.11) first, followed by the malignancy code (Correct answer)
- Sequence an adverse effect code first
- Sequence a complication code first
Correct answer: Sequence the chemotherapy encounter code (Z51.11) first, followed by the malignancy code
When the admission is solely for chemotherapy, Z51.11 is the principal diagnosis; the malignancy is coded as a secondary diagnosis.
Question 5: What is the global surgical period for most major surgeries in the Medicare fee schedule?
- 10 days
- 30 days
- 60 days
- 90 days (Correct answer)
Correct answer: 90 days
Medicare assigns a 90-day global period to most major surgical procedures, encompassing pre- and post-operative care.
Question 6: A coder is reviewing a chart where the physician documented 'UTI' without further specification. Which ICD-10-CM code should be assigned?
- N39.0 (Correct answer)
- N30.00
- N30.90
- N39.3
Correct answer: N39.0
N39.0 (Urinary tract infection, site not specified) is used when the physician documents UTI without identifying a specific site.
Question 7: Which HCPCS Level II code range is used to report durable medical equipment (DME)?
- A0000–A9999
- E0100–E9999 (Correct answer)
- K0000–K9999
- L0000–L9999
Correct answer: E0100–E9999
HCPCS Level II E-codes (E0100–E9999) are designated for durable medical equipment such as wheelchairs, walkers, and hospital beds.
CPC Practice 3
A physician performs a laparoscopic appendectomy and also performs an incidental laparoscopic cholecystectomy at the same session.
How should this be reported?