Question 1

A 6-year-old boy needs to have his influenza vaccine for the 2016 flu season. What is the correct CPT code(s) for nasal administration of the quadrivalent influenza vaccine, where the physician counsels the parents about the administration route?

Accepted Answer

90460, 90672 is the correct code sequence for this vaccine. Code 90460 is the correct code for immunization administration through 18 years of age by any route, with counseling from the physician. Code 90672 is the correct code for quadrivalent live, intranasal influenza vaccine.
Code 90660 is incorrect because this code is for the live trivalent intranasal influenza vaccine. Code 90471 is incorrect because this code is for immunization administration of greater than 19 years old via percutaneous, intradermal, subcutaneous, or intramuscular injection. Code 90473 is incorrect because this code is for immunization administration by intranasal or oral route, but is not specific to pediatrics.

Question 2

A psychiatrist is evaluating a patient in his office for an initial visit. The physician billed for a psychiatric diagnostic evaluation and he is using medical records and family reports to evaluate this patient, including ordering diagnostic studies. What is the CPT code for this visit?

Accepted Answer

90791 is the correct code for a psychiatric diagnostic evaluation.
Code 90785 is incorrect because this code is an add-on code, indicating interactive complexity. Code 90792 is incorrect because this is psychiatric diagnostic evaluation with medical services. Code 90832 is incorrect because this code is for psychotherapy.

Question 3

A patient is being admitted to a psychiatric facility for suicidal ideation. The patient undergoes psychotherapy for crisis and the doctor spends 70 minutes with this patient. What is the correct code(s) for this visit?

Accepted Answer

90839, 90840 is the correct code for psychotherapy for crisis. Code 90839 is the correct code for the first 60 minutes, and 90840 is the correct code for each additional 30 minutes.
This patient was seen for 70 minutes. Had the patient been seen for 90 minutes, the add-on code would have been multiplied based on each additional 30 minutes.

Question 4

A patient is undergoing hypnotherapy at the psychiatry office. What is the correct CPT code for this procedure?

Accepted Answer

90880 is the correct code for hypnotherapy.
Code 90870 is incorrect because this code is for electroconvulsive therapy. Code 90875 is incorrect because this code is for individual psychophysiology therapy with biofeedback. Code 90885 is incorrect because this code is for psychiatric evaluation of hospital records and other psychiatric reports.

Question 5

A patient undergoes biofeedback to help with chronic pain. What is the correct CPT code for this procedure?

Accepted Answer

90901 is the correct code for biofeedback training by any modality.
Codes 90875 and 90876 are incorrect because these codes are for psychophysiological therapy. Code 90911 is incorrect because this code is specific for EMG and/or manometry of the perineal muscles, anorectal or urethral sphincter.

Question 6

A patient with bowel incontinence undergoes anorectal biofeedback training. What is the correct CPT code for this procedure?

Accepted Answer

90911 is the correct code for anorectal biofeedback training.
Codes 90875 and 90876 are incorrect because these codes are for psychophysiological therapy. Code 90901 is incorrect because this is the code for biofeedback training by any modality.

Question 7

A patient is undergoing heart variability biofeedback. What is the correct code for this type of biofeedback therapy?

Accepted Answer

90901 is the correct code for biofeedback training by any modality.
Code 90911 is incorrect because this is the code for EMG and/or manometry biofeedback training for perineal muscles, anorectal or urethral sphincter. Codes 90875 and 90876 are incorrect because these codes are for psychophysiological therapy incorporating biofeedback.

Question 8

A patient who has dialysis three times a week as an outpatient goes in for a routine hemodialysis appointment. What is the correct code for this procedure where he only requires a single evaluation by a physician?

Accepted Answer

90935 is the correct code for hemodialysis procedure with single evaluation by a physician or other qualified healthcare professional.
Code 90937 is incorrect because this is the code for hemodialysis requiring repeated evaluations. Code 90940 is incorrect because this is the code for a hemodialysis access flow study and 90945 is incorrect because this code refers to dialysis procedure other than hemodialysis.

Question 9

A patient needs to have a gastric manometric (motility) study performed. What is the correct CPT code for this procedure?

Accepted Answer

91020 is the correct code for a gastric motility (manometric) study.
Code 91010 is an incorrect code because this is the code for an esophageal motility study. Code 91013 is an add-on code for the esophageal motility study with stimulation or perfusion. Code 91022 is incorrect because this code is for duodenal manometric (motility) study.

Question 10

A patient who has been having chronic reflux is scheduled to have an acid perfusion test performed on the esophagus. This test is also known as the Bernstein test. What is the correct CPT code for this procedure?

Accepted Answer

91030 is the correct code for the Esophagus acid perfusion (Bernstein) test for esophagitis.
Code 91022 is incorrect because this code is for a duodenal motility study. Codes 91034 and 91035 are incorrect codes because these are used to test for gastroesophageal reflux testing.

Question 11

A patient needs to have a capsule endoscopy of the esophagus through the ileum. What is the correct CPT code for this test?

Accepted Answer

91110 is the correct code for gastrointestinal tract imaging, intraluminal (capsule endoscopy) of the esophagus through the ileum with interpretation and report.
Code 91040 is incorrect because this code is for esophageal balloon distension provocation study. Code 91111 is incorrect because this is the code for capsule endoscopy of just the esophagus. Code 91112 is incorrect because this is for gastrointestinal transit and pressure measurement of the stomach through the colon.

Question 12

A patient has been having difficulties swallowing. He is set up for a flexible fiberoptic endoscopy evaluation of swallowing by video recording. What is the correct CPT code for this procedure?

Accepted Answer

92612 is the correct code for flexible fiberoptic endoscopic evaluation of swallowing by cine or video recording.
Code 92610 is incorrect because this is the code for the evaluation of oral and pharyngeal swallowing function. Code 92611 is incorrect because this is the code for motion fluoroscopic evaluation of swallowing function by cine or video recording. Code 92614 is incorrect because this is the code for flexible fiberoptic endoscopic evaluation of laryngeal sensory testing by cine or video recording.

Question 13

A patient who undergoes hemodialysis three times a week needs to have his access scanned to make sure the blood flow is patent. What is the correct code for a duplex scan of hemodialysis access?

Accepted Answer

93990 is the correct code for a duplex scan of hemodialysis access including arterial inflow, body of access and venous outflow.
Code 93970 is incorrect because this code is for duplex scan of extremity veins. Code 93975 is incorrect because this is for a duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs. Code 93998 is incorrect because this code is for unlisted noninvasive vascular diagnostic study.

Question 14

A patient needs a duplex scan of extracranial arteries. The vascular surgeon orders a complete bilateral study instead of a unilateral or limited study. What is the correct CPT code for this procedure?

Accepted Answer

93880 is the correct code for a complete bilateral duplex scan of the extracranial arteries.
Code 93882 is incorrect because this code is for a unilateral or limited study. Codes 93886 and 93888 refer to transcranial Doppler studies.

Question 15

A patient with history of a small aortic aneurysm needs to have a complete duplex scan of the aorta, inferior vena cava, and iliac vasculature. What is the correct CPT code for this procedure?

Accepted Answer

93978 is the correct code for a complete duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts.
Code 93975 is incorrect because this code is for a duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs. 93979 is the incorrect code for this procedure because this code is for a unilateral or limited study instead of a complete study. Code 93980 is incorrect because this code is for a duplex scan of arterial inflow and venous outflow of penile vessels.

Question 16

A patient who has been having shortness of breath on exertion is scheduled for a simple pulmonary stress test. What is the correct CPT code for this procedure?

Accepted Answer

94620 is the correct code for a simple pulmonary stress test.
Code 94610 is incorrect because this code is for intrapulmonary surfactant administration through endotracheal tube. Code 94621 is incorrect because this is for a complex pulmonary stress test. Code 94640 is incorrect because this is for a pressurized or nonpressurized inhalation treatment for acute airway obstruction.

Question 17

A patient is being set up with a continuous positive airway pressure (CPAP) machine upon arriving to the unit from the emergency department. What is the correct code for CPAP ventilation initiation and management?

Accepted Answer

94660 is the correct code for initiation and management of CPAP ventilation.
Codes 94644 and 94645 are incorrect because these codes refer to continuous inhalation treatment with aerosol medication. Code 94662 is incorrect because this code is for continuous negative pressure ventilation initiation and management.

Question 18

A pediatric patient with suspected food allergies is sent for allergy testing that involves scratch tests over his back. He is tested for eight different foods and there are two control tests performed. What is the correct code for percutaneous (scratch) tests with allergenic extracts?

Accepted Answer

95004 is the correct code for percutaneous tests with allergenic extracts.
Code 95017 is incorrect because this code is for combination testing, including percutaneous and intracutaneous tests with venoms. Code 92018 is incorrect because this is a combination test of percutaneous and intracutaneous testing with drugs or biological. Code 95024 is incorrect because this test is specific for intracutaneous tests with allergenic extracts.

Question 19

A three year old is going to have a peanut challenge performed in the allergist's office under direct supervision. The child is scheduled for three hours of testing, what is the correct code(s) for this testing?

Accepted Answer

95076, 95079 is the correct code for three hours of ingestion challenge testing.
Code 95076 is the correct code for ingestion challenge test for the first 120 minutes of testing. Code 95079 is correct as well because this is an add-on code for each additional 60 minutes of testing. This patient had three hours of testing performed, so the add-on code only has to be used once for a total of 180 minutes.

Question 20

A patient is undergoing de-sensitivity for bee stings, which involves allergen immunotherapy with a single stinging insect venom. What is the correct code for this procedure?

Accepted Answer

95130 is the correct code for allergen immunotherapy for single stinging insect venom.
Code 95120 is incorrect because this code is for allergen immunotherapy in the office including provision of allergenic extract for a single injection. Code 95125 is incorrect because this code is for 2 or more injections of allergenic extracts and 95131 is incorrect because this code is for two stinging insect venoms and not just one, as specified above

Quiz 11: Medicine