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TRANSCODE SOLUTIONS
90,000 series Medicine Section Questions:

1. A patient is coming in to have osteopathic manipulative treatment (OMT)

performed on two regions one in cervical region and one in thoracic region.

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Which code is reported by the physician for the OMT?

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A.98927
B.98940

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C.98925
D.98942

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C– OMT performed on two regions one in cervical region and one in thoracic

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region (98925).

2. The patient is admitted to the hospital for a radio16 channel EEG to determine
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the focus of her cerebral seizures. The test also consists of video recording and
interpretation with nurse attendance. The EEG is performed in 12 hours. Select
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the appropriate coding.
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A.95950-26
B.95953-26-52
C.95951-26
C

D.95956-26-52
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D- (95956-26-52 )The key to this encounter is time and the cerebral seizures
monitoring using a radio 16 channel EEG. A nurse is in attendance during the
test. CPT® guidelines state: Codes 95950-95953 and 95956 are used per 24 hours
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of recording. For recording of 12 hours or less, use modifier 52.

3. A patient presents to her oncologist’s office for schedule chemotherapy. The

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patient is severely dehydrated. The physician decides to schedule the

chemotherapy for another day and orders hydration therapy to be performed
today instead of the chemotherapy. The therapy is ordered and administered for
one hour and 10 minutes. Select the code(s).

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A.96413-53, 96360
B.96360
C.96360, 96361
D.96413, 96361

B- Although the patient is scheduled for chemotherapy, only hydration therapy

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is performed. Hydration therapy codes are selected based on time. The total
time for this procedure is one hour and 10 minutes. There is a parenthetical

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note following code 96361 which states: Report 96361 for infusion intervals
greater than 30 minutes beyond one hour increments. There are only 10
additional minutes beyond the first hour, so only 96360 is reported

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4. Left heart catheterization retrograde from the femoral artery with injection

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procedures for selective coronary angiography and selective left ventriculography,
including imaging supervision and interpretation with report, are performed. The

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cardiologist performed all of the services at the hospital. The CPT® codes are:
A.93458-26
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B.93459-26
C.93452-26
D.93460-26
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A- Because a left retrograde heart catheterization is performed for a coronary

angiography and left ventriculography, multiple choices C and D are eliminated.
There is no mention of catheterization in bypass graft(s), which eliminates
multiple choices B. The procedure is performed in the hospital. There is a
C

professional and technical component for the cardiac catheterization codes in

which modifier 26 is appended.
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5. Serial tonometry withmultiple measurements of intraocular pressure over an

extended time period with interpretation and report is performed on the same
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day.
A. 92132
B. 92082
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C. 92100
D. 92083

C- 92100

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6. 69-year-old female has been having chest tightness. Cardiologist orders

percutaneous transluminal coronary angioplasty (PCTA) of the right coronary
artery and left anterior descending coronary artery. The procedure revealed
atherosclerosis in the native vessel of the left anterior descending coronary artery
and right coronary artery. Stents were inserted in both arteries to keep the
arteries opened. Patient was placed under moderate conscious sedation during

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the procedure for a total of 30 minutes. What CPT® codes should be reported for
this procedure?

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A.92920-LT, 92921-RT
B.92980-LD, 92981-RC, 99144

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C.92920-LD, 92921-RC
D.92920-LT, 92921-RT, 99144

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C- (92920, 92921) Stents were placed in the left anterior descending coronary

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artery (LD) and right coronary artery (RC) (additional vessel). There is a bull’s-
eye symbol in front of code 92920 indicates moderate sedation is included in
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the code and is not reported separately

7. A two-month-old returns for a well check up and several shots (Rota, DTaP-Hib,
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PCV) with her pediatrician. He offers suggestions to the mom, completes the
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exam, and counsels her on the vaccinations. How should this be coded?

A.99391-25, 90460,, 90461 x 2, 90680, 90721, 90669

B.99381-25, 90471, 90472 x 2, 90474, 90680, 90700, 90648, 90669
C

C.99381-25, 90471, 90472 x3, 90680, 90700, 90645, 90669

D.99391-25, 90460 x 3, 90461 x 3, 90680, 90721, 90669
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D - We know this patient is established because she is “returning to her

pediatrician.” The well check up is coded as a preventive service. The patient is
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two-months-old. The proper code is 99391. According to NCCI, modifier 25 is

appended when a significant and separately identifiable E/M service is
performed with other services at the same encounter. In this case vaccinations
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are performed. A vaccine administration for each is coded as well as the vaccine
itself. In this case three vaccines are performed; rotavirus (90680), combination
vaccine DTaP-Hib (90721) and Pneumococcal (90669). The physician counsels
the patient’s mother regarding the vaccinations. This eliminates multiple

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choices B and C. Add-on-code 90461 is reported when a combination vaccine is

given. DTaP-HIB is a combination vaccine that has a total of four components.
Code 90460 is reported three times for the administration of the rotavirus,
diphtheria (first component of the combination vaccine), and pneumococcal.
Add-on-code 90461 is reported three times for the remaining three components
(tetanus toxoids, acellular pertussis and Hemophilus influenza B) in the

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combination vaccine.

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8. Mary, who has food allergies, came to her physician for her weekly allergen
immune therapy that consists of two injections prepared and provided by the
physician. The correct code is:

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A.95125

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B.95117

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C.95144
D.95146 S
A– (95125) In this case the patient presents for allergen immune therapy for
food allergies. The injections are prepared and provided by the physician, which
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is reported with 95125 for two injections. Code 95144 is reported when the
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antigen extract is prepared and supplied in a vial. The therapy is not for an
insect which makes 95146 incorrect answers. 95117 does not include the
provision of the extract so it is also incorrect.
C

9. An 8 years old female had one face to face visit with her physician and received
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3 daily dialysis services during less than a month period to her kidney transplant.
How these services should be reported.

A.90945
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B.90968X3
C.90964X3
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D.90956

B - (90968X3) received 3 daily dialysis services during a once a month period to

her kidney transplant.

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10. Dinah an 18 years old patient underwent 4 daily ESRD services in the
outpatient clinic to being hospitalized. A complex assessment was not provided
before Dinah’s hospitalization. How should you report the daily services?

A.90957, 90969
B.90965

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C.90957

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D.90969X4

D- (90969X4) 18 years old patient underwent 4 daily ESRD services in the

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outpatient.

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11. Mother brings her 1-year-old in for the influenza split virus vaccine. Physician
discuses merits of the vaccine with the mother and provided counseling to

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mother. S
A.90658; 90472
B.90657; 90460
C.90703
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D.90657
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B- 90657 (influenza split virus vaccine); 90460 (via any route through 18 years
which means from birth to 18).
C

12. A 29-year-old patient is given an intramuscular Hepatitis A and Hepatitis B

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vaccine. Select the appropriate codes to report this service.

A. 90471, 90646, 90747

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B. 90467, 90632, 90646

C.90473, 90636
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D. 90471, 90636

D- 90471 (intramuscular single or combination use), 90636 (Hepatitis A and

Hepatitis B vaccine/ adult dosage).

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13. DIALYSIS INPATIENT NOTE: This 24-year-old male patient is on continuous

peritoneal dialysis (CAPD) using 1.5%. He drains more than 600cc. He is tolerating
dialysis well. He continues to have some abdominal pain, but his abdomen is not
distended. He has some diarrhea. His abdomen does not look like acute abdomen.
His vitals, other than the pressure in the 190s over 100s, are fine. He is afebrile.
At this time, I will continue with 1.5% dialysate. I gave him labetalol IV for blood

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pressure. Because of diarrhea, I am going to check stool for white cells, culture.

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Next we will see what the primary physician says today. His HIDA scan was
normal. The patient suffers from ESRD.

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A.90947, 90921, N18.6
B.90945, N18.6, R19.7

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C.90921, N18.6

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D.90945, N18.6
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B- 90945 (peritoneal dialysis), N18.6 (ESRD), R19.7 (Diarrhea). Cholescintigraphy
scan, also known as: Hepatobiliary Iminodiacetic Acid HIDA. (HIDA Scan) is a
procedure used to diagnose gallstones or tumors in the gallbladder.
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14. INDICATION: Hypertension with acute myocardial infarction.

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PROCEDURE PERFORMED: Insertion of Swan-Ganz catheter.

DESCRIPTION OF PROCEDURE: The right internal jugular and subclavian area was
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prepped with antiseptic solution. Sterile drapes were applied. Under usual sterile
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precautions, the right internal jugular vein was cannulated. A 9 French introducer
was inserted, and a 7 French Swan Ganz catheter was inserted without difficulty.
Right atrial pressures were 2 to 3, right ventricular pressures 24/0, and pulmonary
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artery 26/9 with a wedge pressure of 5. This is a Trendelenburg position. The

patient tolerated the procedure well.
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A.93501, 93503-51, I10

B.93508, I10
C.93503, 93539, I10, I21.3
D.93503, I10, I21.3

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 9959602447 www.transcode.in 9985277066

D- 93503 (Insertion and placement of Swan-Ganz catheter); I10 (Hypertension),

I21.3 (acute myocardial infarction).

15. DIAGNOSIS: Atrial flutter.

PROCEDURE PERFORMED: Electrical cardioversion.

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DESCRIPTION OF PROCEDURE: The patient was sedated with Versed and

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morphine. She was given a total of 5 mg of Versed. She was cardioverted with 50
joules into sinus tachycardia. The patient was given a 20-mg Cardizem IV push.
Her heart rate went down to the 110s, and she was definitely in sinus tachycardia.

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CONCLUSION: Successful electrical cardio version of atrial flutter into sinus

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tachycardia.

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A.92961, I48.21
B.92960, I48.92
C.92960, 92973, I48.92
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D.92960, I48.21
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B– 92960 (electrical cardio version), I48.92 (atrial flutter)

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16. The Correct way for reporting the 60 minutes of face-to-face insight oriented,
behavior modifying psychotherapy services for 60 minutes
C

A.90832-22
B.90834
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C.90836
D.90837-22
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D- 60 minutes of face-to-face (90837-22).

17. Physician performs 16 percutaneous tests (scratch, puncture, or prick) with

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allergenic extract, Code the procedure

A.95052, Specify 16 in Units Block

B.95044, Specify 16 in Units Block
C.95004, Specify 16 in Units Block

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D.95017, Specify 16 in Units Block

C-95004 (percutaneous tests (scratch, puncture, or prick) with allergenic

extract,), Specify 16 in Units Block.

18. A patient presents for a pleural cavity chemotherapy session that required a

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thoracentesis to be performed:

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A.96445
B.96440, 32000
C.96440

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D.96445, 32000

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C- 96440 (Pleural cavity chemotherapy session that required a thoracentesis to

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be performed). S
19. Select the correct statement

I. Code 90951 is reported once per month

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II. 90945 is assigned for peritoneal dialysis

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III. Code 90970 for ESRD services outside of inpatient hospitalization

IV. Code 90963 is assigned for home dialysis patients

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A.I, I
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B.III, IV
C.I, IV
D.I, II, III, IV
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D - I, II, III, IV
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20. A patient presents to her oncologist’s office for schedule chemotherapy. The
patient is severely dehydrated. The physician decides to schedule the
chemotherapy for another day and orders hydration therapy to be performed

202, A-Block, Ameer Estate, Beside ICICI Bank,SR Nagar, Hyderabad-500038

 9959602447 www.transcode.in 9985277066

today instead of the chemotherapy. The therapy is ordered and administered for
one hour and 10 minutes. Select the code(s).

A.96413-53, 96360
B.96360
C.96360, 96361

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D.96413, 96361

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B- orders hydration therapy to be performed today instead of the
chemotherapy. 96360 (hydration therapy is ordered and administered for one

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hour and 10 minutes).

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21. The correct code for OMT performed on the cervical, thoracic and sacral
regions would be:

A.97110
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B.98941
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C.98926
D.97124
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C- 98926 (OMT performed on the cervical, thoracic and sacral regions. 3 regions)

22. The patient is admitted to the hospital for an eight channel EEG to
determine the focus of her cerebral seizures. The EEG is performed for 24 hours.
C

Select the appropriate code

ns

A.95813
B.95824
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C.95827
D.95950
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D- eight channel EEG to determine the focus of her cerebral seizures. The EEG is
performed for 24 hours (95950).

23. A patient who had been thrown across the freeway in a motorcycle accident
goes to the physical therapy department for non-selective debridement of

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 9959602447 www.transcode.in 9985277066

devitalized tissues on massive deep abrasions incurred on both lower extremities.

The abrasions go to the level of the dermis. What is the most appropriate code for
this service?

A.97606
B.11042

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C.11043

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D.97602

D-97602 (non-selective debridement of devitalized tissues).

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24. During the month of July, a 7 year old patient with end stage renal disease is

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followed by his nephrologist. The care provided by the nephrologist includes:
monitoring the dialysis cycle, monitoring the patient’s nutrition, assessment of

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growth and development, and counseling of the patient’s parents. During the
month of July, the patient was seen by his nephrologist at his office 3 times. What
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is the correct CPT code for this encounter?

A.90955
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B.90968 x 3
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C.90993 x 3
D.90945
C

A- 90955 (End stage renal disease, per month (July), age 2-11 (7yrs), monitoring
the patient’s nutrition, assessment of growth and development, and counseling
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of the patient’s parents, month of July, the patient was seen by his nephrologist
at his office 3 times).
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25. A patient who has had the stomach flu for one week presents to the
physician's office. The physician evaluates the patient and determines he needs IV
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hydration. The physician orders and administers IV fluids which take two hours
and 20 minutes to complete. What are the correct CPT® codes for the service?

A.96360 x 4
B.96360, 96361

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 9959602447 www.transcode.in 9985277066

C.96360 x 2
D.96360, 96361 x 2

B-96360 (IV hydration code upto 1 hr), 96361 (additional 1 hr). don’t give extra
code if it is less than 30 min.

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26. Cardiologist performed 12-lead ECG and he interpreted it on a patient with 60

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years of age.

A. 93000

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B. 93005

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C. 93010

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D. 93040

A- 93000 includes tracing and interpretation of ECG with at least 12 leads.

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27. A patient with atrial fibrillation had a dual lead pacemaker implanted 1 year
ago. Today she returns to the physician’s office for evaluation of the function of
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the device and reprogramming if needed. What is the appropriate CPT® code for
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this encounter?

A.93288
C

B.93280
C.93283
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D.93289

B- 93280 (evaluation of the function of the implanted device dual lead

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pacemaker).

28. A patient has a 60-minute session of psychoanalysis with a Freudian specialist.

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What is the most appropriate code for these services?

A.90826
B.90837
C.90812

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D.90845

D- 90845 (psychoanalysis).

29. Mr. Warner comes in once a week for his chemotherapy into the pleural
cavity. He has a thoracentesis tube placed first and then the chemo is

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administered. What is the most appropriate way to code for administration of

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intrapleural chemotherapy?

A.96440, 32421
B.32422

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C.96440

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D.96445

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C- 96440 (chemotherapy into the pleural cavity including thoracentesis).
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30. A cardiologist pediatrician sends a four-week-old baby to an outpatient facility
to have an echocardiogram. The baby has been having rapid breathing. He is
sedated and a probe is placed on the chest wall and images are taken through the
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chest wall. A report is generated and sent to the pediatrician. The interpretation
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of the report by the pediatrician reveals the baby has an atrial septal defect.
Choose the CPT® code the cardiologist pediatrician should report.

A.93303
C

B.93315-26
ns

C.93303-26
D.93315
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C- Infant is having the echocardiogram performed through the chest

(transthoracic) not through the a device in the esophagus (transesophageal),
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eliminating multiple choices B and D. The subsection guidelines for

Echocardiography in the CPT® codebook states: When interpretation is
performed separately, use modifier 26. Modifier 26 needs to be appended since
only the interpretation of the echocardiogram was performed by the
pediatrician.

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31. This 3-year-old is brought to the ED as he fell from stairs and met with
shoulder dislocation. ED physician provided moderate conscious sedation and
orthopedic reduced the joint into the normal position. It took 1 hour and 15
minutes to complete the procedure. Assign code for MCS?

A. 99143, 99145X3

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B. 99144, 99145X2

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C. 99148, 99150X3

D. 99149, 99150X3

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D. 99149, 99150X3

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32. This 12-year-old is brought to the ED as he fell down in a football court and

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met with knee dislocation. ED physician provided moderate conscious sedation
and reduced the joint to the normal location during a time period of one hour.
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A. 99143, 99145X3
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B. 99144, 99145X2
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C. 99148, 99150X3

D. 99149, 99150X2
C

D. 99149, 99150X2
ns

33. This 86-year-old presents today for chemotherapy. Intralesional

administration for 16 lesions were administered.
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A. 96405

B. 96406X16
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C. 96406

D. 96409X16

C. 96406

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