Practice Flashcards

Under ICD-10-CM guidelines, when should you code signs and symptoms as the principal diagnosis?

Answer: When no definitive diagnosis has been established

Signs and symptoms are coded when a definitive diagnosis has not been confirmed by the provider.

A patient is seen for a new patient office visit. The physician spends 45 minutes total time on date of encounter. Which E/M code applies under the 2021 guidelines?

Answer: 99204

Under 2021 AMA guidelines, 99204 corresponds to 45–59 minutes of total time on the date of service for a new patient.

Which modifier is appended to indicate a service was reduced or eliminated at the physician's discretion?

Answer: -52

Modifier -52 indicates that a service or procedure was partially reduced at the physician's discretion.

A patient is admitted with acute respiratory failure due to pneumonia. Which condition should be sequenced as the principal diagnosis?

Answer: Either can be principal diagnosis per ICD-10-CM guidelines

ICD-10-CM guidelines allow either the acute respiratory failure or the underlying cause (pneumonia) to be the principal diagnosis when both are present on admission.

Which CPT code range covers Surgery of the Musculoskeletal System?

Answer: 20000–29999

CPT codes 20000–29999 cover musculoskeletal system surgeries including bones, joints, and soft tissues.

A patient with Medicare is seen for an annual wellness visit. Which code is used?

Answer: G0438

G0438 is used for the Initial Preventive Physical Examination (IPPE), also called the 'Welcome to Medicare' visit for first-time beneficiaries.

When a fracture is treated with closed reduction and casting, which type of fracture care code is typically reported?

Answer: Closed treatment with manipulation

Closed reduction involves manipulating the fracture back into alignment, so a 'closed treatment with manipulation' code is appropriate.