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2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

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Tag Archives: Question

Auditor question about 4×4 method for PE

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Pennsylvania Medicare auditors score a physical exam as Detailed when there are 4 or more exam items noted in the medical record for 4 or more body areas or organ systems. They use the 1995 E/M examination guidelines utilizing this 4×4 tool. Do you think the following is sufficient documentation for Detailed PE (4×4 method) or should there be more details?:
"She is awake, alert and oriented. Lungs are clear. Heart exam reveals regular rate and rhythm. Abdomen is soft and protuberant with hypoactive bowel sounds, significant tenderness in the upper abdomen without rebound."

Thank you!

Medical Billing and Coding Forum

ICD-10-PCS question

Posted on by
Hi all,

I just finished my CPC Coding/Billing course, and am currently studying for the big exam.

I had an assignment that I got an A on (A for effort), but my instructor never got back to me (I emailed her twice) of what the correct code was for the following:

Right ureteroscopy, retrograde pyelogram, and right ureteral biopsy
Dx: Hematuria

I was told there should only be one code, so I coded the first procedure. However, after reading the guidelines, I put that I would also code the biopsy. I also stated that because there can only be one code, I chose 0TJ98ZZ.

My instructor wrote that she understood my logic (I won’t paste my whole reasoning here). But: what is the correct procedue to code, and why? Thank you!

Medical Billing and Coding Forum

Debridement question

Posted on by
Hello,

I have the following codes for this case:

11042 – Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less
11045 – Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof
11045 – Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof

The operative report states “A total of 60 sq. cm. of skin and subcutaneous necrotic fat was debrided and excised.” Why wasn’t a code(s) for excisional debridement of the skin (dermis) assigned?

What are the appropriate modifiers to append?

Thanks

Medical Billing and Coding Forum

MDM risk table question

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On the MDM risk table on the far right column where it talks about minor/major surgery w/identified risk factors…..does the provider actually have to SCHEDULE them for the surgery and it be the definite plan of care for the patient OR can he just talk about the ‘options’ of the surgery and go over benefits and risk factors but let the patient think about it and not schedule it that day? Does he get credit in that section for going over all of it in the absence of actually scheduling/planning it?

Medical Billing and Coding Forum

ROS negative except as documented in HPI question

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I would appreciate any thoughts on this as there isn’t agreement in my office. Would this be acceptable documentation for a 10pt ROS?

Thank you?

Review of Systems Constitutional: Negative except as documented in history of present illness.
Eye: Negative.
Ear/Nose/Mouth/Throat: Negative.
Respiratory: Negative except as documented in history of present illness.
Cardiovascular: Negative except as documented in history of present illness.
Gastrointestinal: Negative.
Genitourinary: Negative.
Musculoskeletal: Negative.
Neurologic: Negative.
Psychiatric: Negative.

Medical Billing and Coding Forum