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Medical Tests American Academy of Professional Coders: Certified Professional Coder Sample Questions (Q17-Q22):

NEW QUESTION # 17
A patient is seen with complaints of recurring infections in the foreskin. The physician recommends circumcision to help improve penile hygiene. The patient agrees, a local anesthetic is injected into the penis, and the procedure is completed by clamping the foreskin and trimming the excess skin. How should the physician report the encounter?

A. 54150, 64450, Z41.2, Z87.2
B. 54150-52, 64450, N48.89
C. 54150, N48.29
D. 54150-52, Z41.2, Z87.2

Answer: C

Explanation:
A circumcision procedure includes a local anesthetic, also known as a ring block. Therefore, an additional anesthesia code (CPT 64450) should not be reported as a secondary code, nor should modifier 52 be appended on the primary procedure. The code notes for ICD-IO-CM code Z41.2 specifically state that this diagnosis should be used only when the procedure is elective and not related to a specific diagnosis. In this case, because the procedure is related to a recurring condition the patient is experiencing. the infection should be the primary diagnosis. The diagnosis crosswalk would be "infection" followed by "penis," which directs the coder to N48.29.

NEW QUESTION # 18
When seen next to a diagnosis code, the term "Excludes 20 indicates that the condition excluded is not part of the condition represented by the code and that the patient may have both conditions simultaneously.

A. True
B. b False

Answer: A

Explanation:
The statement is true. The term "Excludes 2" shows that two seemingly related conditions can be billed in the same encounter. See Section I of the Coding Guidelines in the ICD-IO-CM 2020 edition for reference.

NEW QUESTION # 19
A gastroenterologist performs a gastric bypass surgery on an obese patient with a body mass index of 52. During the procedure, the size of the stomach is reduced by 77%; the intestine is bypassed from the duodenum and then attached to the ileum. The pylorus is preserved and left intact. Which CPT code best describes the surgery performed?

A. 0
B. 1
C. 2
D. 3

Answer: D

Explanation:
In this scenario, the gastroenterologist performed a procedure known as a biliopancreatic diversion with duodenal switch (BPD/DS). A BPD/DS removes a portion of the stomach and transfers parts of the duodenum and small intestine to the lower end of the large intestine in an effort to limit intestinal absorption for weight loss. CPT codes 43842-43843 describe gastric restrictive procedures without gastric bypass. However, gastric bypass was done in rearranging the small intestine to connect to the ileum.

NEW QUESTION # 20
A physician provides a GIPO 39-weeks twin gestational patient with antepartum care, delivery, and postpartum care. Baby A was delivered vaginally without complications, and Baby B was delivered by Cesarean due to fetal tachycardi a. Assign the correct ICD-IO-CM and CPT codes.

A. 59510, 076, Z3A39, Z37.o and 59409-51, Z3A39, Z37.o
B. 59409, Z3A.39, Z37.o and 59510-51, 076, Z3A39, Z37.o
C. 59400, Z37.o and 59510-51, 036.8332, Z37.o
D. 59410, Z37.2 and 59510-51, 076, Z37.2

Answer: A

Explanation:
The Cesarean delivery (59510) would be sequenced first because this code has the highest RVU and would include the antepartum and postpartum care. The vaginal delivery by itself (59409), without antepartum and postpartum care, would be reported secondary because the charges for the antepartum and postpartum care of the mother have already been included in the Cesarean delivery code.

NEW QUESTION # 21
A patient relocates after receiving treatment for an arm fracture. The patient schedules an appointment with a new orthopedist to remove the cast. The orthopedic office should report the fracture diagnosis code with the seventh character A to indicate active treatment.

A. False
B. True

Answer: A

Explanation:
The statement is false. When a patient is in the healing and/or recovery phase of an injury, the seventh character would be D to indicate that the care is subsequent-whether the provider has treated the patient in the past or not.

NEW QUESTION # 22
......

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