Chapter 18: Path and Lab – Set B

1. A 35-year-old type II diabetic is feeling weak. The physician performs a stat glucose test
in which a finger stick is done placing the drop of blood on a reagent strip. The test
indicates the patient is hypoglycemic. The physician gives the patient some glucose
supplements and performs another stat glucose test using the same lab test as before 30
minutes later. The second test shows the glucose levels returned to normal. How are the
lab tests reported?
a. 82947, 82947-91 c. 82948, 82948-91
b. 82947, 82947-76 d. 82948, 82948-76
2. A young man is bitten by a dog found to have rabies. Although he shows no symptoms of
rabies, testing is done to see if he has the infection. The tests come back negative. What
diagnosis code is used to establish the medical necessity for the service?
a. A82.9 c. Z20.3
b. Z23 d. None of the code choices
3. A 17-year-old female has a bone marrow biopsy for examination as a potential volunteer
stem cell donor for her mother who has acute monocytic leukemia (AML). What
diagnosis code(s) is/are used for the typing of the stem cell specimens?
a. C93.00 c. Z52.3, C93.00
b. Z00.5 d. C93.00, Z52.3
4. A patient has a fine needle aspiration with the specimen sent to cytopathology for
examination. Once the specimen is reviewed, it is found to be inadequate to perform the
test. A new specimen must be obtained which is then examined and a diagnosis is
confirmed. What modifier is appropriate to indicate that two specimens were examined?
a. 76 c. 91
b. 77 d. no modifier
5. A physician orders a General Health Panel, all tests except a creatinine, including CBC
with automated differential. What CPT® code(s) is/are reported?
a. 80050
b. 80050-52
c. 85025, 84443, 82040, 82247, 82310, 82374, 82435, 82947, 84075, 84132, 84155,
84295, 84460, 84450, 84520
d. 80050-22
6. A patient has a history of chronic atrophic gastritis which has been identified as due to
Helicobacter pylori. Although previously eradicated with almost complete resolution of
gastritis symptoms, the patient has recently begun experiencing pain and other symptoms
indicating the infection may have recurred. A biopsy of the stomach was obtained with a
gross and microscopic examination performed with an order to verify the presence of H.
pylori and, if present, perform sensitivity studies for possible resistant strains. Testing of
the biopsy specimen with acid-fast stains confirms chronic gastritis due to H. pylori. Agar
dilution studies for susceptibility to five antibiotics are performed. The susceptibility
studies indicate resistance to clarithromycin (a macrolide antimicrobial). What codes are
reported for the diagnosis and procedure to identify the infectious agent, and test for
susceptibility?
a. 87299, 87181, B96.81
 b. 87140, 87181 x 5, B96.81, Z16.29
c. 88312, 87181, K29.40, B96.81, Z16.29
d. 88305, 88312, 87181 x 5, K29.40, B96.81, Z16.29
7. A patient arrives at to the ED. It appears the patient has been suffering from periods of
disorientation, persistent stomachache, fatigue, over the past several months but the
persistent patch of dark skin that appeared on the patient's chest has prompted his visit.
The treating ED physician orders a stimulation panel for adrenocorticotropic hormone
(ACTH) consisting of two cortisol injections, 60 minutes apart. Blood tests reveal ACTH
levels are at 300 nmol/L, and diagnoses the patient with adrenal insufficiency. What
CPT® codes are reported for the lab services?
a. 82533 x 2 c. 80408
b. 80400 d. 82533 x 2, 83498 x 2
8. Referring to the CPT® codebook in the Evocative/Suppression subsection, if a patient
has congenital adrenal hypoplasia (CAH) and testing is performed to identify if the
insufficiency is due to 21 hydroxylase deficiency (insufficient stimulating hormones or
inability to react to those hormones), what substances are tested for and how many times
must the tests be performed?
a. Cortisol x 2, 17 Hydroxyprogesterone x 2
b. Aldosterone x 2, Renin x 2
c. Adrenocorticotropic hormone (ACTH) x 6
d. Estradiol x 2
9. What is/are the code(s) for thawing 4 units of fresh frozen plasma?
a. 86927 c. 86931
b. 86927 x 4 d. 86931 x 4
10. The code for sweat collection by iontophoresis can be found in what section of the
Pathology Chapter of CPT®?
a. Cytopathology c. Hematology
b. Chemistry d. Other Procedures
11. A patient will be undergoing a transplant and needs HLA tissue typing with DR/DQ
multiple antigen and lymphocyte mixed culture. How will these services be coded?
a. 86805-26, 86817 c. 86816-26, 86821
b. 86817, 86821 d. 86806-26, 86817
12. A physician orders a quantitative FDP. What CPT® code is reported?
a. 85362 c. 85379
b. 85366 d. 85378
13. A patient's mother and sister have been treated for breast cancer. She has blood drawn for
cancer gene analysis with molecular pathology testing. She has previously received
genetic counseling. Blood will be tested for full sequence analysis and common
duplication or deletion variants (mutations) in BRCA1, BRCA2 (breast cancer 1 and 2).
What CPT® code is reported for this molecular pathology procedure?
a. 81200 c. 81211
b. 81206 d. 81213
14. A patient with AIDS presents for follow up care. An NK (natural killer cell) total count is
ordered. What CPT® code(s) is/are reported?
a. 86359 c. 86361, 86359
b. 86703 d. 86357
15. A patient has partial removal of his lung which is sent in for gross and microscopic
examination. The pathologist also did gross and microscopic exam on biopsies for several
lymph nodes in the patient’s chest which are placed in one container. A consultation is
performed on a tissue block of a single specimen intraoperatively by frozen section. The
pathologist also performs a trichrome stain. What CPT® codes are reported for the lab
tests performed?
a. 88309 x 2, 88313, 88329
b. 88309, 88305, 88313, 88331
c. 88307, 88305 x 2, 88332
d. 88309 x 2, 88307 x 2, 88313, 88331, 88332
16. A couple with inability to conceive has fertility testing. The semen specimen is tested for
volume, count, motility and a differential is calculated. The findings indicate infertility
due to oligospermia. What CPT® and ICD-10-CM codes are reported?
a. 89310, 89320, Z31.41 c. 89320, N46.11
b. 89257, Z31.41 d. 89264, N46.11
17. In a legal hearing to determine child support there is a dispute about the child's paternity.
The court orders a paternity test, and a nasal smear is taken from the plaintiff and the
child. The plaintiff is confirmed as the father of the child. Choose the CPT®, ICD-10-
CM codes and modifier for the paternity testing.
a. 89190-32, Z31.448 c. 86900, Z02.81
b. 86910 x 2-32, Z02.81 d. 86910 x 2, Z31.448
18. A virus is identified by observing growth patterns on cultured media. What is this type of
identification is called?
a. Definitive c. Quantitative
b. Qualitative d. Presumptive
19. A left breast biopsy is performed on a mass and the surgeon requests a frozen section
examination of the specimen to determine whether more extensive resection is
appropriate. The frozen section reveals no indications of malignancy. No other specimen
is obtained but the remainder of the biopsy specimen is sent for further testing and
examination, including decalcification. The results indicate breast fibrosclerosis only.
What CPT® and ICD-10-CM codes are reported?
a. 88331, 88313, N63.20 c. 88307, 88331, R92.0
b. 88305, 88331, 88311, N60.32 d. 88307, 88305, 88331, 88313, N60.32
20. A major university medical center has an International Clinic specializing in treating
individuals who move to the USA bringing with them diseases and conditions native to
their home countries. A Brazilian woman presents to this clinic with complaints of
hematuria and fatigue. Urine analysis with microscopy identifies eggs in the urine and
further testing from a stool sample identifies Schistosomiasis through direct smear to
concentrate and evaluate ova. What CPT® and ICD-10-CM codes are reported?
 a. 87177, 81000, B65.0 c. 87207, 81007, B65.0
b. 87045, 81007, R31.9, R53.83 d. 87209, 81000, R31.9, R53.83
21. Flow cytometry is performed for DNA analysis. What CPT® code is reported?
a. 88182 c. 88187
b. 88184 d. 88189
22. A urine pregnancy test is performed by the office staff using the Hybritech ICON
(qualitative visual color comparison test). What CPT® code is reported?
a. 84703 c. 81025
b. 84702 d. 81025, 36415
23. Mr. Bowen is having a pre-employment physical (screening). His doctor ordered the
following serum blood tests: CBC, automated, automated differential WBC,
comprehensive metabolic panel and a thyroid stimulating hormone (TSH) assay. Code
the services for these labs.
a. 80050 c. 80050-26
b. 80048 d. 80053, 84443
24. A couple has been trying to conceive for nine months without success. Preliminary
studies show the woman ovulates and the husband's sperm count is good. A sperm
sample is submitted for both a post coital Huhner test and a hamster penetration test.
Report the codes.
a. 89300, 89320 c. 89300, 89329
b. 89310, 89330 d. 89325, 89260
25. Esther Glass has a primary cancer located in the intra-hepatic biliary tract and had a
cholecystectomy and biopsy of the duodenum done. Two separate specimens (gall
bladder, biopsy of duodenum) were sent to the pathologist working at a hospital
laboratory. The technician prepared the slides and the pathologist (self-employed) read
them. Select the best code or codes for the pathologist's services.
a. 88305-26 x2 c. 88304-26 x2
b. 88304-26, 88305-26 d. 88304, 88305