CCA Exam Reviewed and Verified
Code 87900, infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics, is used in the management of patients with what disease?
Identify the CPT procedure code(s) and correct modifier for a thyroid stimulating hormone...
Code 87900, infectious agent drug susceptibility phenotype prediction using regularly
updated genotypic bioinformatics, is used in the management of patients with what
disease?
a. Cancer patients on toxic chemotherapy agents
b. HIV patients on antiretroviral therapy
c. Tuberculosis patients on rifampin therapy
d. Organ transplant patients on immunosuppressive therapy Answer - Correct Answer:
B.
CPT code 87900 for infectious agent drug susceptibility phenotype prediction using
regularly updated genotypic bioinformatics is used in the management of HIV patients
on antiretroviral therapy (AMA 2012b, 442).
Identify the CPT procedure code(s) and correct modifier for a thyroid stimulating
hormone (TSH) when medical necessity is not met and the patient signs a required
waiver of liability signifying the patient will be responsible for payment if the test is not
covered by Medicare. Another name for waiver of liability is Advance Beneficiary Notice
(ABN).
a. 84443-GA
b. 80418-GA
c. 84443-GY
d. 80418-GY Answer - Correct Answer: A.
Index Thyroid simulating hormone, 80418, 80438-80440, 84443. Code 84443 is the
correct code for a TSH while the rest of the codes are panels including several tests.
Modifier -GA is listed in the front cover of the CPT Professional Edition and signifies the
patient was given a notice of non-coverage also known as waiver of liability or ABN
(AMA 2012b, 427; CMS 2010d; CMS 2010e).
GA- Waiver of Liability Statement Issued as Required by Payer Policy, Individual Case-
Use this modifier to report when you issue a mandatory ABN for a service as required
and it is on file. You do not need to submit a copy of the ABN, but you must have it
available on request.
GX- Notice of Liability Issued, Voluntary Under Payer Policy- Use this modifier to report
when you issue a voluntary ABN for a service Medicare never covers because it is
statutorily excluded or is not a Medicare benefit. You may use this modifier in
combination with modifier GY.
GY- Item or Service Statutorily Excluded, Does Not Meet the Definition of Any Medicare
Benefit- Use this modifier to report that Medicare statutorily excludes the item or service
or the item or service does not meet the definition of any Medicare benefit. You may use
this modifier in combination with modifier GX.
,GZ- Item or Service Expected to Be Denied as Not Reasonable and Necessary- Use
this modifier to report when you expect Medicare to deny payment of the item or service
due to a lack of medical necessity and no ABN was issued.
An infusion that lasts less than 15 minutes would be reported with a(n):
a. Intravenous infusion code
b. Intravenous piggyback code
c. Intravenous or intra-arterial push code
d. Intravenous hydration code Answer - Correct Answer: C.
An infusion that lasts less than 15 minutes should be reported with an IV push code per
the CPT coding guidelines of the CPT Professional Edition based on the instructional
notes preceding the hydration notes (AMA 2012b, 518; AHIMA 2012a, 630).
Identify the appropriate CPT code(s) for 23 minutes of therapeutic exercise.
a. 97110
b. 97110, 97110
c. 97110, 97110, 97110
d. 97110-50 Answer - Correct Answer: B.
Index Physical Medicine/Therapy/Occupational Therapy, procedures, therapeutic
exercises, resulting in code 97110. Review of the code indicates that it is reported in 15-
minute increments. Thus, a 23-minutes session would be reported with code 97110
twice because a unit of time must be at least 8 minutes at a minimum, which the second
unit meets the 8-minute minimum (AHIMA 2012a, 633).
Which of the following statements about Category III CPT codes is false?
a. They are temporary codes.
b. They are updated more frequently than the rest of the CPT codes.
c. They are intended to allow for the coding of new technologies, services, and
procedures.
d. They are tracking codes that can be used for performance measurement. Answer -
Correct Answer: D.
Category II CPT codes are used for performance measurement (AMA 2012b, 535).
How frequently are Category III CPT codes updated?
a. Annually
b. Semiannually
c. Every two years
d. Every four months Answer - Correct Answer: B.
An instructional note has been added to the introductory language under Category III
codes in the CPT Professional Edition. "New codes in this section are released semi-
annually via the AMA/CPT internet site, to expedite dissemination for reporting. The full
, set of temporary codes for emerging technology, services, and procedures are
published annually in the CPT codebook." (AMA 2012b, 553).
A 45-year-old man underwent colon resection for carcinoma of the transverse colon.
The physician progress note on postoperative day two states anemia. Hemoglobin and
hematocrit levels dropped significantly after surgery, and a blood transfusion was
ordered. How is the anemia coded?
a. 285.1
b. 998.11
c. 998.11, 285.1
d. Unable to code; the physician must be queried. Answer - Correct Answer: D.
The anemia may be acute blood loss or a complication due to surgery, but it is not
stated by the physician. Due to incomplete physician documentation, query the
physician (AHA 2004, 4; AHA 2000, 6; AHA 1992, 15-16; AHIMA 2012a, 645).
An 8-year-old male hemophiliac is admitted with acute blood loss anemia due to
uncontrolled bleeding. He is given clotting factor and six units of whole blood. Which of
the following diagnosis and procedure ICD-9-CM codes would be correct?
a. 286.0, 99.06, 99.03
b. 285.1, 286.0, 99.06, 99.03
c. 286.0, 285.1, 99.06, 99.03
d. 285.1, 99.06, 99.03 Answer - Correct Answer: B.
The anemia code 285.1 would be coded as the principal diagnosis. In accordance with
the UHDDS definition for principal diagnosis, the anemia (not the hemophilia), is the
reason for admission and sequenced as the principal diagnosis (CMS 2010c, Section II,
96; AHIMA 2012a, 646).
The patient was admitted with increasing shortness of breath, weakness, and
nonproductive cough. Treatment included oxygen therapy. Final diagnoses listed as
acute respiratory insufficiency and acute exacerbation of chronic obstructive pulmonary
disease (COPD). Which of the following is the correct ICD-9-CM diagnostic code
assignment?
a. 491.21
b. 491.21, 518.82
c. 518.81, 491.21
d. 518.82, 491.21 Answer - Correct Answer: A.
Acute respiratory insufficiency is an integral part of COPD and is therefore not coded
separately. The patient had acute respiratory insufficiency and not acute respiratory
failure (AHIMA 2012a, 682).
What term is used for retrospective cash payments paid by the patient for services
rendered by a provider?
a. Fee-for-service
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller smartchoices. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $11.79. You're not tied to anything after your purchase.
