Chapter 19 — Quiz
26 questions. Answers and explanations are in the instructor guide.
1. The professional component of a diagnostic service consists of:
- A. The equipment and supplies
- B. The physician's supervision where required, and the interpretation and written report
- C. The technologist's work
- D. The order for the test
2. A physician reviews an image and discusses it verbally with a colleague. No report is written. The professional component:
- A. May be reported with modifier 26
- B. May be reported with modifier 52
- C. Does not exist; there is no professional component without a written report
- D. Is included in the E/M service
3. Who bills the technical component?
- A. Whoever is physically closest to the equipment
- B. Whoever owns the equipment
- C. The facility where the patient was seen
- D. The ordering physician
4. Which file column tells you whether a code may be split into professional and technical components?
- A. The global period indicator
- B. The multiple procedure indicator
- C. The PC/TC indicator
- D. The bilateral surgery indicator
5. A CT of the abdomen is performed after the patient drank oral contrast. Nothing was administered intravenously. The study is coded:
- A. With contrast
- B. Without contrast
- C. Without followed by with contrast
- D. With contrast, using modifier 52
6. "With contrast" requires contrast administered:
- A. By any route
- B. Orally or rectally
- C. Intravascularly, intra-articularly, or intrathecally
- D. Only intravenously
7. A study performed without contrast and then with contrast in one session is reported as:
- A. Two codes
- B. One code — "without contrast followed by with contrast"
- C. One code with two units
- D. The with-contrast code only
8. An ultrasound report documents six of the eight elements required for a complete study. You report:
- A. The complete study
- B. The complete study with modifier 52
- C. The limited study
- D. Nothing; query the physician
9. In radiation oncology, treatment management is reported:
- A. Per visit
- B. Per week
- C. Per a defined number of fractions
- D. Once per course
10. Imaging guidance named in a procedure's descriptor is:
- A. Separately reportable
- B. Included; reporting it separately is unbundling
- C. Reportable with modifier 59
- D. Reportable only if documented
11. A panel contains fourteen analytes. Thirteen were performed. You report:
- A. The panel
- B. The panel with modifier 52
- C. The thirteen individual tests
- D. The panel minus one unit
12. All fourteen components of a panel were performed and the coder reports them individually. This is:
- A. Correct and preferred
- B. Unbundling, and easily detected without any chart
- C. Correct if the payer does not recognize the panel
- D. A units error
13. The unit of service in surgical pathology is:
- A. The lesion
- B. The block
- C. The separately identified and separately submitted specimen
- D. The pathologist's time
14. Definitive drug testing differs from presumptive testing in that it:
- A. Is performed on a different specimen type
- B. Identifies specific drugs and quantities
- C. Requires a physician's presence
- D. Is always waived under CLIA
15. A practice collects a specimen and sends it to a reference laboratory. The practice bills:
- A. The tests
- B. The tests and the collection
- C. The specimen collection only
- D. Nothing
16. The ordering physician's role on a claim for a test performed elsewhere is:
- A. Rendering provider
- B. Referring or ordering provider
- C. Supervising provider
- D. They do not appear on the claim
17. Which referring-provider denial cause CANNOT be fixed by the billing office?
- A. The field is blank
- B. The identifier belongs to the practice rather than the physician
- C. The ordering physician is not enrolled with the payer
- D. The name has a spelling difference
18. Provider-performed microscopy requires that the procedure be performed:
- A. By any laboratory technician on site
- B. Personally by the provider, during the patient encounter, on a specimen not easily transportable
- C. In a certified reference laboratory
- D. Under a Certificate of Compliance
19. Modifier QW identifies:
- A. A repeat laboratory test
- B. A CLIA-waived test performed by a waiver site
- C. A test performed by an outside laboratory
- D. A test requiring physician interpretation
20. A Certificate of Waiver site bills a moderate-complexity test and it denies for CLIA. The correct response is:
- A. Resubmit with modifier QW
- B. Resubmit with the certificate number corrected
- C. Escalate; the site performed a test its certificate does not cover
- D. Appeal with the test result attached
21. Modifier 91 is appropriate for:
- A. A repeat because of equipment failure
- B. A repeat because the specimen was inadequate
- C. A medically necessary repeat performed to obtain subsequent results
- D. Confirming an abnormal result
22. Cardiovascular studies — electrocardiograms, echocardiography, stress testing — appear in which CPT section?
- A. Surgery
- B. Medicine
- C. Radiology
- D. Pathology and Laboratory
23. The eye codes (general ophthalmological services) are:
- A. Reported in addition to an E/M office visit
- B. An alternative to the E/M office visit codes
- C. Used only for surgical consultations
- D. Reported only by optometrists
24. A patient receives hydration first, then an antiemetic push, then chemotherapy. The initial service is:
- A. The hydration, because it was first
- B. The push, because it was in the middle
- C. The chemotherapy, because hierarchy overrides chronology
- D. Whichever took longest
25. An immunization is reported with:
- A. The vaccine product code only
- B. The administration code only
- C. Both the vaccine product code and the administration code
- D. One combined code
26. A therapist provides 8 minutes of one timed service and 8 minutes of another on the same date. Under the substantial-portion methodology, the units are:
- A. 2
- B. 1
- C. 0
- D. 3