Chapter 35 — Quiz

30 questions: multiple choice and short answer. The answer key is in the collapsed block at the bottom. All dollar figures, base units, conversion factors, and criteria are this book's constructed teaching figures, and every code set changes on a schedule — verify before use.

1. "Specialty coding" is best described as:

• A. A separate code set maintained for each medical specialty
• B. The same code sets applied under a specialty's own volume slice, payment convention, source document, policy landscape, and documentation vocabulary
• C. A credential required before coding for a specialist
• D. Coding performed only by physicians in that specialty

2. Of the five things that genuinely differ by specialty, the one that produces a wrong shape on every claim rather than a wrong code on one claim is:

• A. The volume slice
• B. The source document
• C. The payment convention
• D. The documented words

3. 93010 reports:

• A. The complete electrocardiogram service
• B. The tracing only, without interpretation
• C. The interpretation and report only
• D. An electrocardiogram performed during a stress test

4. Short answer: name the two facts that decide which of the three electrocardiogram codes a practice reports — and state what they are facts about.

5. 93458 — left heart catheterization with coronary angiography — already includes:

• A. Any subsequent intervention performed in the same session
• B. The catheter placement, the injection procedures, and the imaging supervision and interpretation
• C. The facility's technical resources
• D. The pre-procedure evaluation and management service

6. In 93306, the word that carries a documentation requirement is:

• A. Transthoracic
• B. Doppler
• C. Complete
• D. Color flow

7. The choice between global fracture care and an evaluation and management service plus casting is decided by:

• A. Whether the fracture was displaced
• B. Whether the physician is providing definitive care through healing, as documented in the plan
• C. Which produces the higher payment
• D. The setting in which the patient was first seen

8. A global fracture care code carries a global period of:

• A. 000 days
• B. 010 days
• C. 090 days
• D. XXX — no global period

9. During a 090-day global period, the modifier that identifies a planned or staged return to the operating room — and that restarts the global period — is:

• A. 24
• B. 58
• C. 78
• D. 79

10. During the same global period, modifier 78 identifies an unplanned return for a related complication and:

• A. Restarts the global period
• B. Does not restart the global period
• C. Converts the original global period to XXX
• D. Extends the global period by 90 days

11. A physician reports global fracture care and applies the initial cast. On the claim:

• A. Both the application and the supply are separately reportable
• B. Neither the application nor the supply is separately reportable
• C. The application is included; the casting supply is separately reportable
• D. The supply is included; the application is separately reportable

12. 59400 and 59510 differ in:

• A. The number of antepartum visits included
• B. The delivery route — vaginal versus cesarean
• C. Whether postpartum care is included
• D. Whether the patient is new or established

13. Which of the following falls outside the obstetric global package?

• A. The routine urinalysis at a prenatal visit
• B. Management of uncomplicated labor
• C. A fetal non-stress test
• D. The admission history and examination for the delivery

14. Short answer: on the obstetric episode log, which field must be recorded contemporaneously rather than reconstructed later, and who should record it?

15. Preventive medicine service codes are selected by:

• A. Medical decision making
• B. Total time on the date of the encounter
• C. The patient's age and new-versus-established status
• D. The number of screenings performed

16. For a Medicare beneficiary, a routine annual physical examination is:

• A. Covered as a preventive medicine service
• B. Not covered; the program instead covers an annual wellness visit reported with HCPCS Level II G-codes
• C. Covered once every three years
• D. Covered only when a chronic condition is addressed

17. Three vaccines are administered at one encounter. The administration is reported as:

• A. 90471 × 3
• B. 90471 × 1 and 90472 × 1
• C. 90471 × 1 and 90472 × 2
• D. 90472 × 3

18. A claim carries a vaccine administration code and no vaccine product code. This is:

• A. Always an error; the product must be added
• B. Correct when the dose came from a public supply program the practice did not purchase
• C. Correct only for patients under 18
• D. A rejection rather than a denial

19. Transitional care management requires interactive contact with the patient or caregiver within:

• A. 24 hours of discharge
• B. Two business days of discharge
• C. Seven calendar days of discharge
• D. Fourteen calendar days of discharge

20. 99496 requires the face-to-face visit within:

• A. Two business days of discharge
• B. Seven calendar days of discharge
• C. Fourteen calendar days of discharge
• D. Thirty calendar days of discharge

21. The emergency department E/M family, 99281–99285, is unlike every other E/M family because it has:

• A. No new-versus-established distinction and no time-based selection option
• B. Six levels rather than five
• C. No medical decision making requirement
• D. A single national facility leveling standard

22. Criteria for assigning an emergency department facility visit level are published by:

• A. CPT
• B. CMS, nationally
• C. The individual facility
• D. The Medicare Administrative Contractor

23. Short answer: a hospital's facility ED levels match its physicians' levels on essentially every claim. What does that suggest, and why?

24. Anesthesia time begins when:

• A. The patient enters the operating room
• B. The anesthesia professional begins preparing the patient for induction
• C. The surgeon makes the incision
• D. The induction agent is administered

25. Two procedures are performed under a single anesthetic. The anesthesia service is reported as:

• A. Two anesthesia codes, the second with modifier 51
• B. Two anesthesia codes, with the time split between them
• C. One anesthesia code — the one with the highest base unit value
• D. One anesthesia code — the one matching the surgeon's primary CPT code

26. The physical status modifier (P1–P6) is assigned by:

• A. The coder, from the patient's problem list
• B. The anesthesia professional, and documented on the anesthesia record
• C. The surgeon, in the operative report
• D. The payer, during adjudication

27. Under the Medicare methodology for timed therapy codes, 8 minutes of one timed service plus 8 minutes of another on the same date is:

• A. 0 units
• B. 1 unit
• C. 2 units
• D. 3 units

28. Modifier 95 asserts:

• A. That the service was medically necessary
• B. That the service was rendered by synchronous real-time interactive audio and video
• C. That the patient was at home
• D. That the payer has approved telehealth for this service

29. Place of service 10 reports:

• A. Telehealth provided other than in the patient's home
• B. Telehealth provided in the patient's home
• C. The patient's home for a house call
• D. An off-campus outpatient hospital department

30. Short answer: in the two-week method, what is the day-9 task, and in one sentence, why is it described as the highest-yield hour of the two weeks?