Chapter 18 — Quiz
26 questions. Answers and explanations are in the instructor guide.
1. Under the endoscopic base-code rule, additional endoscopic procedures from the same family are reduced by:
- A. 50% of their allowed amount
- B. The value of the diagnostic base procedure of that family
- C. 25% of the primary procedure
- D. Nothing; endoscopies are not reduced
2. A diagnostic endoscopy performed immediately before a surgical endoscopy of the same family is:
- A. Separately reportable with modifier 59
- B. Not separately reported
- C. Reported with modifier 51
- D. Reported only if abnormal findings prompted the surgery
3. Four polyps are removed by snare during one colonoscopy. You report:
- A. Four snare codes
- B. One snare code
- C. One snare code with four units
- D. One snare code plus three add-on codes
4. Two polyps are removed by snare and two by hot biopsy forceps in the same colonoscopy:
- A. One code, because it is one colonoscopy
- B. Four codes
- C. Generally two codes — one per technique — subject to the edits
- D. Two codes with modifier 51 on the second
5. A screening colonoscopy in an average-risk patient finds and removes a polyp. The first-listed diagnosis is:
- A. The polyp
- B. Z12.11, screening for malignant neoplasm of colon
- C. The pathology result
- D. Whichever produces coverage
6. In that same encounter, the procedure reported is:
- A. The screening colonoscopy code, because that was the indication
- B. The therapeutic code, because that is what was done
- C. Both
- D. The diagnostic colonoscopy code
7. Which is NOT one of the five questions the hernia family asks?
- A. Initial or recurrent
- B. Reducible or incarcerated
- C. Patient age
- D. Duration of symptoms
8. A laparoscopic procedure is converted to an open procedure. You report:
- A. Both the laparoscopic and the open procedure
- B. The laparoscopic procedure with modifier 22
- C. The open procedure only
- D. The open procedure with modifier 53
9. Cardiac catheterization codes:
- A. Require separate reporting of catheter placement, injections, and supervision and interpretation
- B. Bundle the catheter placement, injection procedures, and imaging supervision and interpretation
- C. Are reported per vessel only
- D. Have no bundling rules
10. For a pacemaker or defibrillator, the code depends primarily on:
- A. The manufacturer
- B. Which components were involved — generator, leads, or both
- C. The patient's diagnosis
- D. The length of the procedure
11. A urinary code whose descriptor is already bilateral, reported with modifier 50, produces:
- A. A 150% payment
- B. A duplicate
- C. A denial for missing laterality
- D. The correct payment
12. A prostate biopsy with transrectal ultrasound guidance and specimen interpretation involves how many CPT sections?
- A. One
- B. Two
- C. Three
- D. Four
13. Spine surgery is structured by approach, level, what was done, and:
- A. Surgeon specialty
- B. Instrumentation and bone graft
- C. Anesthesia type
- D. Facility type
14. The global obstetric package includes:
- A. Antepartum care, delivery, and postpartum care
- B. Delivery only
- C. All care during pregnancy including complications
- D. All care including ultrasounds and laboratory
15. Which IS included in the global obstetric package?
- A. Amniocentesis
- B. Routine urinalysis
- C. Fetal non-stress tests
- D. Treatment of a pregnancy complication
16. A patient receives antepartum care from one practice and delivers with another:
- A. The delivering practice reports the global package
- B. The antepartum practice reports the global package
- C. Each reports the components it actually provided
- D. Neither may bill
17. Under the multiple-procedure payment reduction, the highest-valued procedure is paid:
- A. At 50%
- B. In full
- C. At 100% minus the base procedure
- D. At the payer's discretion
18. Claim lines for multiple surgical procedures should be sequenced:
- A. In the order performed
- B. Alphabetically by code
- C. By descending value, highest first
- D. By ascending value, lowest first
19. Mis-sequenced claim lines can produce:
- A. A denial
- B. A rejection at the clearinghouse
- C. An underpayment that pays, with nothing appearing in a work queue
- D. An automatic reprocessing
20. The bilateral surgery indicator tells you:
- A. Which side was operated on
- B. How the bilateral payment rules apply to that code
- C. Whether the patient has bilateral coverage
- D. Which modifier the payer prefers
21. Modifier 55 identifies a physician who provided:
- A. Preoperative management only
- B. Surgical care only
- C. Postoperative management only
- D. Assistant-at-surgery services
22. When a global package is split between two physicians:
- A. Each reports a different code
- B. Each reports the same procedure code with the applicable modifier
- C. The second physician reports E/M services
- D. Only the surgeon may bill
23. Modifier 62 requires:
- A. Two surgeons in the room
- B. Two surgeons each performing a distinct part, each documenting an operative report
- C. Two surgeons of different specialties
- D. A single note signed by both surgeons
24. Anesthesia charges are computed as:
- A. Time × conversion factor
- B. (Base units + time units + modifying units) × conversion factor
- C. Base units × time
- D. A percentage of the surgical fee
25. Anesthesia time begins:
- A. When the patient enters the operating room
- B. When the anesthesiologist begins preparing the patient for induction
- C. At incision
- D. When the patient loses consciousness
26. Intraservice time for moderate sedation begins:
- A. When the patient arrives
- B. With administration of the sedating agent
- C. At the start of the procedure
- D. When the independent trained observer arrives