SHEET 2026 PREMIUM QUESTION
COLLECTION
◉ ID ICD-10-CM definition "the expulsion of some, but not all, of the
POC from the uterus":
Answer: Incomplete abortion
◉ ICD-10-CM code(s) for threatened abortion with hemorrhage at
15 wks; home undelivered:
Answer: O20.0 - Abortion, threatened (hemorrhage is included in
this code per Include notes)
Z3A = Weeks of gestation (additional code for all pg/childbirth)
◉ ICD-10-CM and ICD-10-PCS code(s) for 40 wk gestation, term
pregnancy with poor cervical dilatation; lower uterine segment
cesarean delivery, open approach, with single liveborn female:
Answer: O62.0 - Delivery, complicated, by, dilation, cervix
incomplete, poor, or slow
Z37.0 - Outcome of delivery, single, liveborn
Z3A.40 - Weeks of gestation
10D00Z1 - Cesarean section (see Extraction, POC), open, no device,
low cervical
,◉ ID infected ingrown toenail with paronychia of first toe of right
foot
Answer: L60.0 - Ingrowing, nail (excludes paronychia)
L03.031 - Paronychia, see Cellulitis, digit, toe, see Cellulitis, toe, see
tabular for right toe
◉ ICD-10-CM for 6 mo-old child scheduled for clinic visit for routine
well-child exam, and physician documents "well child, born
premature":
Answer: Z00.129 - Examination, child (over 28 days old)
P07.30 - Premature, infant
◉ ICD-10-PCS code(s) for cystoscopy with diagnostic biopsy of
bladder:
Answer: 0TBB8ZX - Excision, bladder, via natural or artificial
opening/endoscopic, no device, diagnostic qualifier
◉ Payment system introduced on 1992 and replace Medicare's
customary, prevailing, and reasonable CPR payment system:
Answer: Resource-based relative value scale system (RBRVS) is the
Fed's pymt system for physicians; classifies health services based on
cost of furnishing physicians' services in different settings, the skill
and training level req to perform services, and the time and risk
involved
, ◉ Best reference tool to determine how CPT codes should be
assigned:
Answer: AMA's CPT Assistant newsletter
◉ Electrolyte panel (80051) in the lab section of CPT includes test
for carbon dioxide (82374), chloride (82435), and sodium (84295).
If each component code is reported, billed individually on a claim,
this would be considered:
Answer: Unbundling
◉ In the lab section of CPT, if a group of tests overlap tow or more
panels, report the panel that incorporates greatest number of tests
to fulfill code definition, but what would a coder do with the
remaining test codes that are not part of the panel?
Answer: Report remaining test codes using individual test codes,
according to CPT
◉ What is clustering?
Answer: Coding or charging one or two middle levels of service
exclusively
◉ CMS developed this to promote national correct coding
methodologies and to control improper coding leading to
inappropriate pymts in Part B claims: