HCPCS NEW EXAM REVIEW SOLUTION FOR 2022 NEW UPDATE
CPT, HCPCS Level II and HCPCS Level III codes are all HIPAA-approved National
Codes Sets.
a.) True
b.) False - b: False.
HCPCS Level III codes are not included in the HIPAA-approved National Code Sets.
They will be eliminated on Dec. 31, 2003.
In most cases, which modifier is needed for an emergency room case when reporting
both a CPT surgery code and evaluation and management (E/M) code?
a.) 52
b.) 59
c.) 25 - c: Modifier -25 is appended to the ED E/M code. Modifier -25 identifies
significant, separately identifiable E/M services on the same day of the procedure or
other services. In most instances, patients that come to the ED do not present to have a
procedure performed. The patient first needs to be evaluated by a physician.
HCPCS Level II "A" codes represent:
a.)Transportation services, including ambulance
b.)Durable medical equipment
c.)Temporary medical and surgical supplies - a: HCPCS Level II A codes are used to
report transportation services, including ambulance.
CPT codes and HCPCS Level II codes are updated by CMS annually.
a.) True
b.) False - b: False. HCPCS Level II codes are updated by CMS. CPT codes are not.
CPT codes are updated by AMA.
A flexible diagnostic colonoscopy is performed. During the procedure, a polyp is
removed from one area and a lesion is removed from another. Both the polyp and the
lesion are removed by snare technique. Which of the following would be the appropriate
code selection?
a) 45378-59, 45385, 45385-59
b) 45385, 45385-59
c) 45385
d) 45378-59, 45385 - c: Only code 45385 is reported.
The diagnostic colonoscopy is not coded separately. Notice the separate procedure
designation. The diagnostic colonoscopy is included in the code for any definitive
procedure performed.
, 45385 is not reported twice because the description of the code indicates "with removal
of tumor(s), polyp(s), or other lesion(s) by snare technique." Therefore, all tumors,
polyps or lesions removed using this technique are reported only once.
The same CCI edits are used by CMS for editing both physician and hospital outpatient
services.
a) True
b) Fals - b: False.
The CCI edits used by CMS to edit physician and hospital outpatient services are not
the same. CMS uses the most current version of CCI edits to edit physician services.
The CCI edits used by CMS to edit hospital outpatient services are included in the
Outpatient Code Editor (OCE) and is one release behind. Also, the CCI edits included in
the OCE do not include the entire CCI table.
On April 15, 2003, it was appropriate to bill services provided on March 15, 2003, using
either 2002 or 2003 HCPCS codes because of the grace period.
a) True
b) False - b: False.
On April 15, 2003, it is not appropriate to bill services provided on March 15, 2003,
using either 2002 or 2003 HCPCS codes. The three-month grace period is intended to
allow providers time to implement the new codes. After April 1st, all claims for services
after January 1st must include the new codes.
The patient presents to the ED with multiple lacerations. Simple repairs of a 2 cm
laceration of the leg and a 3 cm laceration of the back are performed. Another 3 cm
laceration of the back was repaired but first required extensive cleaning to remove
gravel before the single layer closure was performed. Which of the following would be
the appropriate code selection for the laceration repairs?
a) 12004
b) 12001, 12002-59, 12002-59
c) 12002, 12032
d) 12001, 12002-59, 12032 - c: Codes 12002 and 12032 are assigned.
The length of the leg and back wounds are added together because they are both
simple repairs from anatomical sites that are grouped together. Code 12002 is
assigned. Even though the second 3 cm laceration of the back was a single layer
closure, extensive cleansing and removal of gravel were required before the wound
could be sutured. Code 12032 is assigned. Please refer to the note in the beginning of
the Integumentary/Repair section for instructions.
Modifier -52 is used to report the elective cancellation of a procedure that does not
require anesthesia because the physician is unavailable.
a) True
CPT, HCPCS Level II and HCPCS Level III codes are all HIPAA-approved National
Codes Sets.
a.) True
b.) False - b: False.
HCPCS Level III codes are not included in the HIPAA-approved National Code Sets.
They will be eliminated on Dec. 31, 2003.
In most cases, which modifier is needed for an emergency room case when reporting
both a CPT surgery code and evaluation and management (E/M) code?
a.) 52
b.) 59
c.) 25 - c: Modifier -25 is appended to the ED E/M code. Modifier -25 identifies
significant, separately identifiable E/M services on the same day of the procedure or
other services. In most instances, patients that come to the ED do not present to have a
procedure performed. The patient first needs to be evaluated by a physician.
HCPCS Level II "A" codes represent:
a.)Transportation services, including ambulance
b.)Durable medical equipment
c.)Temporary medical and surgical supplies - a: HCPCS Level II A codes are used to
report transportation services, including ambulance.
CPT codes and HCPCS Level II codes are updated by CMS annually.
a.) True
b.) False - b: False. HCPCS Level II codes are updated by CMS. CPT codes are not.
CPT codes are updated by AMA.
A flexible diagnostic colonoscopy is performed. During the procedure, a polyp is
removed from one area and a lesion is removed from another. Both the polyp and the
lesion are removed by snare technique. Which of the following would be the appropriate
code selection?
a) 45378-59, 45385, 45385-59
b) 45385, 45385-59
c) 45385
d) 45378-59, 45385 - c: Only code 45385 is reported.
The diagnostic colonoscopy is not coded separately. Notice the separate procedure
designation. The diagnostic colonoscopy is included in the code for any definitive
procedure performed.
, 45385 is not reported twice because the description of the code indicates "with removal
of tumor(s), polyp(s), or other lesion(s) by snare technique." Therefore, all tumors,
polyps or lesions removed using this technique are reported only once.
The same CCI edits are used by CMS for editing both physician and hospital outpatient
services.
a) True
b) Fals - b: False.
The CCI edits used by CMS to edit physician and hospital outpatient services are not
the same. CMS uses the most current version of CCI edits to edit physician services.
The CCI edits used by CMS to edit hospital outpatient services are included in the
Outpatient Code Editor (OCE) and is one release behind. Also, the CCI edits included in
the OCE do not include the entire CCI table.
On April 15, 2003, it was appropriate to bill services provided on March 15, 2003, using
either 2002 or 2003 HCPCS codes because of the grace period.
a) True
b) False - b: False.
On April 15, 2003, it is not appropriate to bill services provided on March 15, 2003,
using either 2002 or 2003 HCPCS codes. The three-month grace period is intended to
allow providers time to implement the new codes. After April 1st, all claims for services
after January 1st must include the new codes.
The patient presents to the ED with multiple lacerations. Simple repairs of a 2 cm
laceration of the leg and a 3 cm laceration of the back are performed. Another 3 cm
laceration of the back was repaired but first required extensive cleaning to remove
gravel before the single layer closure was performed. Which of the following would be
the appropriate code selection for the laceration repairs?
a) 12004
b) 12001, 12002-59, 12002-59
c) 12002, 12032
d) 12001, 12002-59, 12032 - c: Codes 12002 and 12032 are assigned.
The length of the leg and back wounds are added together because they are both
simple repairs from anatomical sites that are grouped together. Code 12002 is
assigned. Even though the second 3 cm laceration of the back was a single layer
closure, extensive cleansing and removal of gravel were required before the wound
could be sutured. Code 12032 is assigned. Please refer to the note in the beginning of
the Integumentary/Repair section for instructions.
Modifier -52 is used to report the elective cancellation of a procedure that does not
require anesthesia because the physician is unavailable.
a) True
