Answers to questions for 2008 CPC Practice Examination

Section 1
Number of questions from each code range:
Surgery, integumentary system (nine questions)
Musculoskeletal system (10 questions)
Respiratory/Cardiovascular system (10 questions)
Digestive system (10 questions)
Urinary system, male and female genital system
(11 questions)
Nervous system, eye and ocular adnexa, and auditory system (10 questions)

1. “d” The code 15852 includes “under anesthesia (other than local).” You can find this code
in the index of the CPT Professional Edition under Dressing, Change, and Anesthesia.
Modifier -LT provides additional information regarding which side of the body was involved
in the procedure.
2. “a” You would report this excision to a benign lesion. In the CPT Professional Edition under
the heading Excision – Benign Lesions, cystic lesion is given as an example, (layered)
intermediate closure should be reported in addition to the excision. The local anesthesia is
included per the CPT Surgery section guidelines.

3. “d” This is an Autograft (coming from one part of a patient’s body to another). In the CPT
Professional Edition under the Skin Replacement Surgery and Skin Substitutes subsection in
the Surgery/Integumentary System (15002–15431), the guidelines state, “Procedures are
coded by recipient site,” [which is the nose in this question], further, the guidelines read, “…
includes simple debridement of granulation tissue.” There is no documentation of an
additional office visit on the day of the procedure.

4. “b” One way to find this procedure is in the index of the CPT Professional Edition under
Excision, Chest wall, Tumor. The parenthetical note under this code indicates code 19272
should not be used in conjunction with 32503.

5. “c” Mohs surgery is reported by anatomic site. The code description includes mapping,
color coding of specimens, and routine stains. The first stage is reported with code 17313,
the two additional stages are reported with 17314 x 2, and the additional blocks in stage two
are reported with code 17315 x 2

6. “b” The CPT Professional Edition subcategory guidelines for Adjacent Tissue Transfer or
Rearrangement procedures under the Surgery/Integumentary System, state, “excision
(including lesion).”

7. “c” In the CPT Professional Edition under the heading for Repair (Closure), the guidelines
define simple, intermediate, and complex. The repair to the arm and foot are classified to
simple repairs and reported by the sum of lengths of repairs for each group of anatomic site,
12006. The repair to the hand is classified as intermediate (refer to the definitions) 12044.
These guidelines also state, under number two, multiple wounds, “When more than one
classification of wounds is repaired, list the more complicated as the primary procedure and
the less complicated as the secondary procedure, using modifier -51.”

8. “c” In the CPT Processional Edition guidelines under Excision – Malignant Lesions, the last
sentence of the guidelines state, “Append modifier -58 if the re-excision procedure is
performed during the postoperative period of the primary excision procedure.”

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9. “b” This question asks how to report the biopsy procedure, not the excision. Biopsies of
different lesions or different sites on the same date as another procedure are reported
separately. Append Modifier -59 to identify that there were two separate lesions.

10. “a” The primary procedure is a partial corpectomy (you can find this in the CPT
Professional Edition index under corpectomy). An arthrodesis was done in addition to the
definitive procedure; therefore modifier -51 is necessary (you can find this in the subcategory
guidelines under Arthrodesis). Do not attach modifier -51 to add-on codes (see Appendix A
for this definition). You would report the code for a structural allograft.

11. “a” One way to find this answer is in the index of the CPT Professional Edition under
Fracture, Femur, Neck, Open Treatment. There is an illustration under the code 27236 for a
prosthetic replacement.

12. “a” You can find this answer in the CPT Professional Edition in the main section guidelines
for the Musculoskeletal System.

13. “d” One way to find this answer is in the index of the CPT Professional Edition under
Wound, Exploration, Back.

14. “b” Refer to the index of the CPT Professional Edition under Dislocation, Patella closed
treatment for a code range. It is necessary to look up the code range and read the
descriptions to select the correct code. You can find the ICD-9-CM codes under Dislocation,
patella, open. The E code Alphabetic listing is in Volume 2, Section 3. Look up, Fall, (from off),
tree; the second code, look up Accident, (occurring at in), house.

15. “c” This question asks for you to report the procedure. There is not enough information
to report the evaluation and management code. You can find the procedure in the index of
the CPT Professional Edition under Sequestrectomy, Olecranon Process. The modifier -RT
provides additional information.

16. “b” The code 20206 reports a needle biopsy of soft tissue. Use code 27324 to report a
deep biopsy of soft tissue of the thigh or knee area.

17. “a” Modifier -50 indicates a bilateral procedure. You can find this procedure in the index
of the CPT Professional Edition under Incision and Drainage, Hematoma, Knee.

18. “a” One way to find this answer is in the index of the CPT Professional Edition under
Annuloplasty.” This procedure was done to more than one level, which requires use of the
add-on code 22527.

19. “d” You can find codes exempt from modifier -51 in Appendix E of the CPT Professional
Edition. You could also look up each code and locate the symbol that indicates modifier -51
exempt.

20. “a” You can find the code 35476 in the index of the CPT Professional Edition under
Angioplasty, Venous, Percutaneous. See the parenthetical note under code 34576 regarding
the correct radiology code. This procedure includes moderate conscious sedation. The
modifier -26 represents the professional services for the radiology code.

21. “b” Code 39000 is a cervical approach, code 39010 reports a transthoracic approach.

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22. “a” This is a secondary rhinoplasty with major revision. The closure is bundled with the
surgical procedure. Modifier -78 isn’t required because the second service was not
performed within the postoperative period. Generally, the maximum postoperative period is
no more than 90 days.

23. “d” A surgical thorascopy always includes a diagnostic thorascopy. You can find this note
in the CPT Professional Edition under the Endoscopy heading.

24. “c” The code 33530 and 35572 are add-on codes and should not have modifier -51
appended. Review modifier -51 in Appendix A of the CPT Professional Edition for this note.

25. “a” You can find this statement under the heading of Endovascular Repair of Descending
Thoracic Aorta in the CPT Professional Edition. Read the guidelines carefully and you will see
the primary codes listed with this statement.

26. “a” The code 33210 reports a temporary transvenous single chamber pacemaker. There is
not enough information in the question to code for the placement of the permanent system.
27. “d” When coding for this procedure, it is necessary to code for the removal (33235) and
then replacement of the leads (33217). Modifier -51 indicates multiple procedures in the
same anatomic site.

28. “b” The code 36592 describes this procedure. You can find this answer in the index of the
CPT Professional Edition under Collection and Processing, Specimen, Venous Catheter.

29. “b” The code 37186 is an add-on code and would be reported in addition to the primary
procedure. The guidelines preceding this procedure clearly state, do not report 37184–37185
with code 37186.

30. “b” This answer must have the diagnosis codes and procedure code. The diagnoses codes
report special screening for the colonoscopy, family history of colon cancer, and benign
polyps of the colon. The procedure code 45384 reports a therapeutic procedure with
removal of the polyps.

31. “d” You can find this answer in the index of the CPT Professional Edition under Suture,
Abdomen.

32. “d” You can find this answer in the index of the CPT Professional Edition under
Vestibuloplasty. You can find the definition of the vestibule of the mouth at the beginning of
the digestive system above code 40800. Modifier -50 isn’t necessary because the code
description states “bilateral.”

33. “a” You should append modifier -26 to the radiology code to indicate the professional
portion of this procedure. You can find this procedure in the index of the CPT Professional
Edition under Placement, Needle, Interstitial Radioelement Application, Head.

34. “c” This is a replacement procedure via the same access site. The same provider who
does the procedure reports the moderate sedation codes. You can find the rules for
moderate sedation in Appendix G of the CPT Professional Edition.

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35. “a” Use add-on code 49568 to report the implantation of the mesh in addition to
debridement and hernioplasty. Modifier -51 is not attached to add-on codes (see Appendix
A).

36. “c” The code 45320 includes moderate sedation.

37. “a” The parenthetical notes under code 43268 direct the use of code 43262 for the
sphincterotomy.

38. “a” Report modifier -52. This statement is printed in the CPT Professional Edition under
the code 44950. You can find this answer by looking up appendectomy in the index and cross
referencing the codes.

39.“c” Always review how the procedure is being performed – laparoscopy, excision, etc. This
is a key to finding and reporting the correct code.

40. “c” The code 50380 reports the auto-transplantation and re-implantation of a kidney. The
parenthetical note under this code directs the use of the code for nephrectomy with
modifier -51.

41. “b” The code 55875 represents the procedure and the code 77778 is the clinical
brachytherapy. Code 77778 includes admission to the hospital and daily visits. You can find
this rule in the subcategory guidelines for Clinical Brachytherapy in the CPT Professional
Edition.

42. “a” This is a lithotripsy, extracorporeal shock wave treatment. You can find this procedure
in the index of the CPT Professional Edition under Lithotripsy.

43. “d” You can find this answer in the CPT Professional Edition index under Excision, Lesion,
Epididymis. Be careful with the index in this section and follow it to lesion or you may use
the incorrect code.

44. “a” You can find this procedure in the index of the CPT Professional Edition under Repair,
Penis, Injury. You would report modifier -79 for the unrelated procedure during a post-
operative period by the same physician.

45. “b” The code 58671 reports this procedure via a laparoscopic approach. Modifier -50 is
not necessary to report a bilateral procedure due to the code description of oviducts (which
is bilateral).
46. “c” The code 50385 includes the conscious sedation, radiological supervision, and
interpretation. The code defines a removal and replacement so there is one code to describe
the entire procedure.
47. “d” The code 51785 describes this procedure. The guidelines under urodynamics
indicate…“When the physician only interprets the results and/or operates the equipment, a
professional component, modifier -26, should be used to identify physicians’ services.”
48. “b” You can find this code in the index of the CPT Professional Edition under Prostate,
Enucleation. The vasectomy procedure is bundled with code 52649.
49. “d” You can find this information in the CPT Professional Edition under the Delivery After
Previous Cesarean Delivery subsection.
50. “d” The code 50300 describes a donor nephrectomy (including cold preservation); from a
cadaver donor, unilateral or bilateral. Because the procedure is described as a unilateral or
bilateral procedure, you would not report modifier -50.

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51. “a” The note under Prophylaxis indicate that these services are repetitive, performed in
multiple sessions, and are intended to include all services in a defined treatment period. The
parenthetical note under code 67229 states to use modifier -50 for a bilateral procedure. The
operating microscope is bundled into this procedure. Refer to code 69990 for a list of
bundled codes.
52. “d” One way to answer this question is to look in the index of the CPT Professional
Edition under the main heading of Tumor.
53. “b” The professional services for the CT should have a modifier -26. The professional
service is the procedure; therefore, there would be no modifier -26 on code 60300.
54. “a” This question represents a subsequent tap. The code 61000 is reported for an initial
procedure. Modifier -50 is not necessary because it is inherently included in the code
description.
55. “b” One way to find this answer is in the index of the CPT Professional Edition under
Fenestration Procedure, Revision. You would attach modifier -50 to indicate a bilateral
procedure.
56. “c” Each surgeon should report the work he or she completed. Because Dr. Martin
completed the definitive procedure, use code 61606, which includes the repair and graft.
57. “d” The code 63050 reports two or more vertebral segments, therefore, there is no need
to change the units. You could find this answer by looking in the index of the CPT
Professional Edition under Laminoplasty.
58. “a” You can find this answer by looking up Neuroplasty in the index of the CPT
Professional Edition and reading the definition under the sub-heading.
59. “c” Code 64857 describes suturing of a major peripheral nerve in the leg without
transposition. The add-on code 64859 is used for the second major peripheral nerve. The
add-on code 64876 reports the shortening of the bone.
Add-on codes should not have modifier -51 attached (see Appendix A).
60. “a” The code 65273 is reported for hospitalization. The code 65272 is for without
hospitalization.

Section 2
Number of questions from each code range:
Evaluation and management (12 questions)
Anesthesia (six questions)
Radiology (nine questions)
Laboratory and pathology (10 questions)
Medicine (10 questions)

61. “b” A new patient is described as not receiving any professional serves in the past three
years. You can find this answer in the Evaluation and Management Services Guidelines and
on the Decision Tree for New vs. Established Patients (same guidelines) in the CPT
Professional Edition.
62. “d” Counseling and/or risk factor reduction intervention services are provided to patients
with symptoms or established illness.

63. “a” The guidelines for critical care have a list of services that are included with critical
care when performed by the physician providing the critical care and these services should
not be reported separately.

64. “c” This is an established patient visit and meets two of the three key components for a
99214 level visit.

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65. “b” The subcategory guidelines for Initial Hospital Care state, “When the patient is
admitted to the hospital as an inpatient in the course of an encounter in another site of
service (e.g., hospital, emergency department, observation status in a hospital, physician’s
office, nursing facility) all evaluation and management services provided by that physician in
conjunction with that admission are considered part of the initial hospital care when
performed on the same date as the admission. Therefore, the services are reported with the
initial hospital care code only. The office visit is a bundled service.

66. “b” These codes are included (bundled) and you can’t report them in addition to the
Continuing Intensive Care Services. In the subcategory guidelines for these services it is
noted, “…These codes include the same procedures that are outlined in the Pediatric Critical
care services section and these services should not be separately reported.”

67. “a” This question deals with outpatient anticoagulant management. The code 99363
gives specific parameters for reporting.

68. “d” Day one admission or initial hospital care is 99223. Days two and three are
subsequent hospital care services at 99232 and you should report them separately. Day four
is subsequent hospital care at level 99231. Day five is the discharge service, which is based
on time and code 99239 is reported for services of more than 30 minutes, regardless of the
actual time. Report this code only once.

69. “a” Refer the page 21 in CPT manual.

70. “b” This is a new patient visit not a consultation. “A “consultation” initiated by a patient
and/or family, and not requested by a physician or other appropriate source, …is not
reported using the consultation codes but may be reporting using the office visit, home
service, or domiciliary/rest home care codes.” Report a consultation code only when a
request (written or verbal) is made by another physician or appropriate source, an opinion is
rendered, and a written report is sent back to the “requestor.” In this case the patient
initiated the visit.

71. “a” You can find this definition in the CPT Professional Edition under the subcategory
guidelines for Emergency Department Services.

72. “d” Preventive medicine services are based on new vs. established patient and age.
73. “b” You should report the anesthesia services with modifier -P2 for mild systemic disease
and qualifying circumstances due to the patient’s age.

74. “c” Refer to Appendix G in the CPT Professional Edition. This appendix lists the codes that
include moderate conscious sedation along with guidelines to assist with reporting these
services. Additionally, code 93315 has a “bulls-eye” symbol that indicates moderate
conscious sedation is included with the service.

75. “d” According to the Anesthesia Guidelines in the CPT Professional Edition, the
preoperative visit is “bundled” or included in the anesthesia services.

76. “b” According to the Anesthesia Guidelines in the CPT Professional Edition, “To report
regional or general anesthesia provided by a physician also performing the services for which
the anesthesia is being provided, see modifier -47 in Appendix A.” Appendix A describes the
use of modifier -47 for a basic service when the anesthesia is provided by the surgeon.

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77. “a” According to the Anesthesia Guidelines in the CPT Professional Edition, Swan-Ganz
monitoring is not included.

78. “c” You can find the definition for Modifier -23 – Unusual Anesthesia in Appendix A of the
CPT Professional Edition.

79. “a” Report a screening mammography with 77057 and the computer-aided detection
with 77052. The code 77052 is an add-on code and should not have a modifier -51 attached
(see Appendix A in the CPT Professional Edition for a definition of modifier -51).

80. “c” The code 76942 is the correct code to report this procedure According to the CPT
Assistant, Apr 05:15-16, “From a CPT coding perspective, code 76942 should be reported per
distinct lesion that requires separate needle placement. Therefore, if passes are made into
two separate lesions in the same organ (i.e., two lesions in same breast), then code 76942
would be reported twice.”

81. “b” You can find this study in the index of the CPT Professional Edition under DXA (with a
cross reference).This study was completed on the axial skeleton.

82. “b” You can find this answer in the index of the CPT Professional Edition under Proton
Treatment Delivery.

83. “d”
84. “a” The fastest way to find these codes is to refer to the list in Radiology Guidelines of the
CPT Professional Edition. Or, refer to the index under Unlisted Services and Procedures for a
complete listing.

85. “a” You can find this answer by referring to the index of the CPT Professional Edition
under Magnetic Resonance Imaging (MRI), Heart. When you cross reference the code set,
the subcategory guidelines preceding these codes define the difference in testing.

86. “c” You can find his answer in the index of the CPT Professional Edition under
Brachytherapy, High Code Electronic. There is also a parenthetical note preceding CPT Code
77750.

87. “c” The common part of the code 78130 (the part before the semicolon) is considered
part of the code 78135.

88. “a” You can find this answer at the beginning of the Pathology and Laboratory Guidelines
of the CPT Professional Edition.

89. “d” The tests reported are listed under the basic metabolic panel code 80047. When
reporting a panel, all the tests listed in the panel must be completed. If one test is missing,
then you should not report a panel. If a panel is completed and there are additional test(s),
then you would report the panel and the code(s) for the additional test(s). Do not add
modifier -52 to panel codes to indicate that not all the tests in the panel were completed.

90. “b” The first parenthetical note following codes 88331 and 88334 give reporting
instructions (us both codes).There are two tumor sites in this question.

91. “a” Genetic Testing Modifiers are listed in Appendix I of the CPT Professional Edition. The
note under the subcategory Cytogenetic Studies refers to Appendix I.

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92. “a” The math calculations are included (bundled) with chemistry tests. You can find this
note in the last paragraph under the Chemistry subsection of the CPT Professional Edition.

93. “a” The code 80502 reports a comprehensive clinical pathology consultation. The patient
was not present; therefore you would not report an evaluation and management
consultation code.

94. “B”

95. “a” You can find this code in Category II codes..50

96. “d” The code 82272 states, “…performed for other than colorectal neoplasm screening.”

97. “c” You can find this test in the CPT Professional Edition under Calprotectin, fecal.

98. “a” The description under code 92557 lists the codes that are combined and should not
be reported separately. In addition, the subcategory guidelines for the Audiologic Function
Tests with Medical Diagnostic Evaluation state to add modifier -52 if studies are completed
on one ear.

99. “b” Administration of vaccines are reported according to the route and the age of the
patient. These vaccines, all injections, were given to an adult patient; therefore, you would
report the codes 90471 and 90472 x 2. The vaccines are reported for each type given or
injected. According to the guidelines under the Vaccines, Toxoids subsection, do not report
modifier -51 for the vaccines when performed with the administration procedures.

100. “c” Use code 96360 to report hydration of 31 inutes to one hour.

101. d” You can find this answer by looking in the index of the CPT Professional under
Endoscopy, Bronchi, Stenosis.

102. “a” Use the new 2008 codes for Medication Therapy Management Services. The
guidelines for these codes indicate the documentation elements and times necessary to
select a code.

103. “c” Code 98969 is reportable for non-physician healthcare professionals.

104. “c” You can find this answer in Appendix J under the code 95904.

105. “a” The notes above the code 96904 indicate this service is typically consultative and
the consultation evaluation and management code may be appropriate in addition to the
special dermatological procedures. The other answers are incorrect due to the reporting of
the evaluation and management code.

106. “b” See the subsection Ophthalmology in the CPT Professional Edition under for the
definition of special ophthalmological services, “…these services may be reported in
addition….”

107. “c” Code 92980 describes intracoronary stent(s) and describes one or more stents
placed, therefore the units are not changed for the three stents in this question. The add-on
code 92996 describes the arthrectomy, which is not bundled into the stent placement

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because there are different arteries involved in this procedure. The PTCA procedure is
bundled into the athrectomy code. Add-on codes do not have modifier -51 attached.

Section 3
Number of questions from each topic:
Medical terminology (13 questions)
Anatomy (nine questions)
ICD-9-CM (11 questions)
HCPCS Level II (five questions)
Coding guidelines (five questions)
108. “a” You can find this answer by studying or knowing medical terminology.

109. “a” You can find this answer in the index of the CPT Professional Edition. Once you
locate the term, cross reference the code(s) to determine the type of procedure.

110. “d” You can find this answer in the ICD-9-CM index under Thyroiditis, Hashimoto’s and
cross reference it to determine the type of disease.

111.“c” This question is an example of an answer that you could not find in the source
materials allowed for the CPC exam. This type of question is based on general knowledge of
medical specialties.

112. “c” The degree of a burn is determined by the layers of skin involved. A third degree
burn, also known as a full thickness burn, involves damage to all three layers of skin and
possibly the muscle. You could find this by looking up burn in the ICD-9-CM book and cross
referencing to that section for further definition.

113.“b” You can find this answer in the CPT Professional Edition in the illustrations of
anatomical and procedural review at the front of the book. You could also find this answer by
looking in the in the CPT index under Choroid and then cross referencing the procedures.

114. “a” This question is best answered by studying or knowing medical terminology.
However you could also discover the correct answer by using the CPT Professional Edition
index and looking up procedures that beginwith enter/o.

115.“a” You can find the answer in the index of the CPT Professional Edition by looking up
ERG.

116. “b” This answer comes from studying medical terminology. You can break down the
term anorectal (an/o – anus, rect – rectum, and –al pertaining to).

117. “d” Sciatica is an inflammation of the sciatic nerve that results in pain, burning, and
tingling along the course of the nerve through the thigh and leg. You could find the answer
by looking up each term in the ICD-9-CM index, if necessary.

118. “c” You can find this answer by looking up the term in the ICD-9-CM index of diseases
and then cross referencing the code.

119. “b” You can find the answer by breaking down the medical term cystopexy (cyst/o –
urinary bladder, pexy – surgical fixation). The CPT Professional Edition lists a few surgical
procedure suffixes in the front of the book, which are helpful for learning medical
terminology.

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120. “b” You can find this answer in the index of the CPT Professional Edition under the
procedure Episiotomy, then cross referencing the code. You could also reference the list in
the front of the book that describes surgical procedures (suffix otomy– cutting into or
incision).

121. “b” This is an example of an answer that you may not be able to find in the resource
material available for the CPC exam. Studying or knowing anatomy and medical terminology
is the best way to answer this type of question.

122. “b” The aorta is an artery not a vein. There are four types of valves that regulate blood
flow through the heart.
1. The tricuspid valve regulates blood flow between the right atrium and right ventricle.
2. The pulmonary valve controls blood flow from the right ventricle into the pulmonary
arteries, which carry oxygen-poor blood to the lungs to pick up oxygen.
3. The mitral valve lets oxygen-rich blood from the lungs pass from the left atrium into the
left ventricle.
4. The aortic valve opens to allow oxygen-rich blood to pass from the left ventricle into the
aorta, the largest artery, where this blood is delivered to the rest of the body.

123. “d” You can find this answer in the ICD-9-CM index under Syndrome, Zollinger-Ellison.
Once you locate the code, cross reference to review the definition provided.

124. “a” This is an example of an answer that you may not be able to find in the resource
material available for the CPC exam. Studying and knowing anatomy and medical
terminology is the best way to answer this question. The lower respiratory tract consists of
the trachea, bronchi, bronchioles, alveoli, and capillaries of the lungs.

125. “c” You can find this answer by looking up uvula in the CPT Professional Edition and
cross referencing the codes listed. This will provide information about where the uvula is
located in the body.

126. “a” This is an example of an answer that you may not able to find using the resource
material available for the CPC exam. Studying and learning anatomy and medical terminology
is the best way to answer this question.

127. “d” This is an example of an answer that you may not be able to find in the resource
material available for the CPC exam. Studying and knowing anatomy and medical
terminology is the best way to answer this question. Break down the word (leuk/o – white
and cytes – cell).

128. “b” This is an example of an answer that you may not be able to find in the resource
material available for the CPC exam. Studying and knowing anatomy and medical
terminology is the best way to answer this question. Read the answers carefully. Both the
use of vaccination and immunoglobulins harvested are “artificial” not “natural” means of
immunity.

129. “a” You can find this answer in the CPT Professional Edition in the index under
Olecranon Process. If you cross reference the codes, you will discover the answer is the
elbow.

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130. “a” You can find this answer in the ICD-9-CM book by looking up cellulites, foot (except
toes) for the first listed diagnosis and diabetes Type I without mention of complications and
not stated as uncontrolled. Per the Coding Clinic, you may not code conditions as diabetic
complications without the physician making the link between the two conditions.

131. “d” You can find this answer in the ICD-9-CM coding guidelines under Chapter 3, a. 20
Type of diabetes mellitus not documented. The section states, “If the type of diabetes
mellitus is not documented in the medical record the default is type II.”

132. “c” You can find this answer in the ICD-9-CM coding guidelines under Chapter 11, a, 1,
Codes from Chapter 11 and sequencing priority, which states, “. . . Chapter 11 codes have
sequencing priority over codes from other chapters. Additional codes from other chapters
may be used in conjunction with Chapter 11 codes to further specify conditions.”

133. “c” One way to approach this question is to look up the codes for each condition and
then check those off against the answers. Be careful when selecting multiple codes.

134. “b” Coding for poisonings have an absolute sequence order. First, poisoning followed by
codes for manifestations, and finally the E code to describe the external cause.

135. “d” The fifth-digit sub-classification of eight (8) indicates the correct weight range for
this question. You can find this answer in the ICD-9-CM index under Light-for-dates.

136. “a” According to ICD-9-CM guidelines in Chapter 17, c, 3, “Non-healing burns are coded
as acute burns.”

137. “d” Section II of the ICD-9 Official Guidelines for coding and reporting, Chapter 19, a.1.,
“An E code may be used with any code in the range of 001-V848. 8, which indicates an injury,
poisoning, or adverse effect due to an external cause.”

138. “a” When radiation therapy is the reason for the encounter, this is the primary
diagnosis, followed by the site being treated. The code 199.1 is reported to indicate the
unknown primary site of the cancer.

139. “b” You can find this answer in the Table of Drugs and Chemicals in the ICD-9-CM
manual.

140. “b” You can find this answer in the index of the ICD-9-CM manual under Crohn’s
disease. Review of the code 555.1 includes Crohn’s disease of the colon and large bowel. All
of the sign and symptoms are part of this disease process and would not be reported.

141. “c”
142. “a” You can find this answer by referring to the Table of Drugs in the HCPCS Level II
manual.

143. “a” You can find this answer in the index of the HCPCS Level II manual under Helmet,
head.

144. “b” You can find this answer in the index of the HCPCS Level II manual under Prosthetic
additions, lower extremity. Once you find this code range, review the codes to determine the
correct code.

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145. “d” You can find this answer in the index HCPCS Level II manual under Transportation, x-
ray (portable). Review of code R0075, indicates “. . . more than one patient seen.”

146. “c” Modifier -E3 describes upper right eyelid. You can find this modifier in the HCPCS
Level II manual or the front inside cover of the CPT Professional Edition.

147. “a” You can find the four primary classes of main entries listed at the beginning of the
index section in the CPT Professional Edition.

148. “d” The coding concepts for modifiers are complicated. In this question none of the
codes and modifier combinations are correct. All of the codes listed in this question are add-
on codes. Modifier descriptors are also incorrect with the codes listed: -25 could be attached
only to an evaluation and management code, -21 could only be appended to the highest
level evaluation and management code within a given category, and modifier -51 should not
be attached to add-on codes. See the definitions of these modifiers in Appendix A of the CPT
Professional Edition.

149. “b” According to the ICD-9-CM Coding Guidelines, (Chapter 17, b. 5) Multiple fractures
sequencing …”Multiple fractures are sequenced in accordance with the severity of the
fracture. The provider should be asked to list the fracture diagnoses in the order of severity.”

150. “b” You can find this answer in the CPT Professional Edition under Liver Transplantation
subcategory guidelines.

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