Procedural Terminology and HCPCS Coding Systems
2022 Edition, 9th Edition Mary Jo Bowie
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, Solution and Answer Guide: Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2022 edition, ISBN
9780357621837; Chapter 1: Introduction to Current Procedural Terminology
Solution and Answer Guide
Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2022 edition,
ISBN 9780357621837; Chapter 1: Introduction to Current Procedural Terminology
Table of Contents
Exercises.............................................................................................................................................................................. 1
Exercise 1.1: Check Your Understanding ................................................................................................... 1
Chapter Review ................................................................................................................................................................ 2
True/False.................................................................................................................................................. 2
Fill in the Blank .......................................................................................................................................... 2
Coding Assignments ...................................................................................................................................................... 2
Short Answer..................................................................................................................................................................... 2
Exercises
Exercise 1.1: Check Your Understanding
Code Section/Subsection
1. 70300 Radiology/Diagnostic Radiology (Diagnostic Imaging)
2. 60220 Surgery/Endocrine System
3. 26034 Surgery/Musculoskeletal System
4. 88036 Pathology & Laboratory—Anatomic Pathology
5. 43651 Surgery/Digestive System
6. 38115 Surgery/Hemic and Lymphatic Systems
7. 99304 Evaluation and Management/Nursing Facility Services
8. 97010 Medicine/Physical Medicine and Rehabilitation
9. 77021 Radiology/Radiologic Guidance
10. 65112 Surgery/Eye and Ocular Adnexa
11. 90371 Medicine/Immune Globulins, Serum, or Recombinant Products
12. 99203 Evaluation and Management/Office or Other Outpatient Services
13. 10160 Surgery/Integumentary System
14. 33120 Surgery/Cardiovascular System
15. 50100 Surgery/Urinary System
16. 21811 Surgery/Musculoskeletal System
17. 66184 Surgery/Eye and Ocular Adnexa
18. 52441 Surgery/Urinary System
19. 61000 Surgery/Nervous System
20. 59074 Surgery/Maternity Care and Delivery
© 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 1
website, in whole or in part.
, Solution and Answer Guide: Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2022 edition, ISBN
9780357621837; Chapter 1: Introduction to Current Procedural Terminology
Chapter Review
True/False
1. False
2. True
3. False
4. False
5. True
Fill in the Blank
6. American Medical Association (AMA)
7. Appendix A
8. Six
9. Semicolon
10. Index
Coding Assignments
1. Anesthesia
2. Surgery
3. Pathology and Laboratory
4. Surgery
5. Surgery
6. Medicine
7. Evaluation and Management
8. Radiology
9. Surgery
10. Medicine
11. Surgery
12. Radiology
13. Surgery
14. Pathology and Laboratory
15. Medicine
16. Medicine
17. Pathology and Laboratory
18. Radiology
19. Surgery
20. Medicine
Short Answer
1. Unlisted procedure or service: A service may be provided that is not specifically listed in the CPT
manual. When this occurs, an unlisted procedure code is used from within a specific subsection of
the CPT manual.
2. Add-on codes are codes that are listed as secondary to a main procedure code and are used in
conjunction with the main code. Add-on codes are not to be reported alone.
3. Modifiers are two-digit codes that are appended to a CPT code to enhance or further describe a
service provided.
© 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 2
website, in whole or in part.
, Solution and Answer Guide: Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2022 edition, ISBN
9780357621837; Chapter 1: Introduction to Current Procedural Terminology
4. A special report may be required by some third-party payers when an unusual, variable, or new
service is provided. Information contained in the special report includes a description of the
nature, extent, and need for the procedure and the time, effort, and equipment necessary to
provide the service.
5. The Alphabetical Reference Index is an expanded alphabetical index that includes listings by the
name of the procedure and anatomic site. Eponyms and other designations are also included in
the index.
6. The section numbers and their sequences are as follows:
Evaluation and Management 9920299499
Anesthesia 00100–01999, 99100–99140
Surgery 1000469990
Radiology (including Nuclear Medicine and Diagnostic Ultrasound)
70010–79999
Pathology and Laboratory 80047–89398, 0001U–0284U
Medicine (except Anesthesia) 90281–99199, 99500–99607
7. Code Answer
11047 yes
60540 no
36100 no
63082 yes
81416 yes
8. Code Answer
99202 no
20975 yes
97535 no
93618 yes
36620 no
9. Level I codes are CPT codes. Level II codes are HCPCS codes and are commonly referred to as
National Codes.
10. Vaccine Code Vaccine Administration Code(s)
91302 0021A (first dose)
0022A (second dose)
91304 0041A (first dose)
0042A (second dose)
91303 0031A (single dose)
© 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 3
website, in whole or in part.
, Solution and Answer Guide: Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2022 edition, ISBN
9780357621837; Chapter 2: Modifiers
Solution and Answer Guide
Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2022 edition,
ISBN 9780357621837; Chapter 2: Modifiers
Table of Contents
Exercises.............................................................................................................................................................................. 1
Exercise 2.1: Check Your Understanding ................................................................................................... 1
Exercise 2.2: Pricing and Statistical/Informational Modifiers .................................................................... 1
Exercise 2.3: Modifiers Used for Ambulatory Surgery Center Hospital Outpatient Claims ....................... 1
Chapter Review ................................................................................................................................................................ 2
Fill-in-the-Blank ......................................................................................................................................... 2
Identify the Modifier ................................................................................................................................. 2
Case Studies ...................................................................................................................................................................... 3
Exercises
Exercise 2.1: Check Your Understanding
1. ND
2. US, GW
3. 56, T2
4. AA, 47
5. 51, 59
Exercise 2.2: Pricing and Statistical/Informational Modifiers
1. Pricing
2. Statistical/informational
3. Pricing
4. Pricing
5. Statistical/informational
6. Statistical/informational
7. Statistical/informational
8. Pricing
9. Statistical/informational
10. Statistical/informational
Exercise 2.3: Modifiers Used for Ambulatory Surgery Center Hospital Outpatient Claims
1. No
2. Yes
3. No
4. Yes
5. No
6. No
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website, in whole or in part.
, Solution and Answer Guide: Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2022 edition, ISBN
9780357621837; Chapter 2: Modifiers
7. Yes
8. Yes
9. Yes
10. Yes
11. Yes
12. No
13. Yes
14. Yes
15. Yes
Chapter Review
Fill-in-the-Blank
1. Two
2. Appendix A
3. 24d
4. Informational
5. Multiple
6. Preoperative
7. 32
8. 54
9. 80
10. Outside
Identify the Modifier
1. 62
2. 23
3. 22
4. 52
5. 55
6. To report the professional component of a code
7. Modifier 47 is used only by physicians or surgeons when regional or general anesthesia is
provided by the same physician or surgeon who is completing a procedure or service.
8. 50
9. 56
10. 76
11. 53
12. 57
13. 66
14. 80
15. 26
16. G2
17. F8
18. GM
19. 81
20. 91
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website, in whole or in part.
, Solution and Answer Guide: Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2022 edition, ISBN
9780357621837; Chapter 2: Modifiers
Case Studies
Case 1: Modifier 25
An Evaluation and Management (E/M) code (99213) and a procedure code (OMT-98925) for the same
day require a modifier to identify that two separate and distinct services were performed. Modifier 25
is reported with the E/M code.
Case 2: Modifier 53
Because of the extenuating circumstances of the drop in blood pressure, the doctor felt that it was in
the patient’s best interest to stop the procedure.
Case 3: Modifier 55
Modifier 55 is appended to the code to report that the provider is completing postoperative
management only.
Case 4: Modifier 63
When a procedure is completed and the patient is a newborn and weighs less than 4 kg, modifier 63
is appended to the procedure code.
Case 5: 33475-80
Modifier 80 is appended to the procedure code to report that the provider is the assistant surgeon for
the case.
Case 6: Modifier 57
Modifier 57 denotes that the decision for surgery was made.
Case 7: Modifier 32
When a service occurs because the service is mandated, modifier 32 is appended to the basic
procedure code.
Case 8: Modifier 26
Modifier 26 is appended to the code to report that the provider completed the professional
component of the procedure.
Case 9: No, both should report 32854-66
Because the providers worked as a team, modifier 66 would be reported by both providers.
Case 10: 32960-76
Modifier 76 would be appended to the procedure code to denote that the procedure was repeated.
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website, in whole or in part.
, Solution and Answer Guide: Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2022 edition, ISBN
9780357621837; Chapter 3: Evaluation and Management
Solution and Answer Guide
Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2022 edition,
ISBN 9780357621837; Chapter 3: Evaluation and Management
Table of Contents
Exercises.............................................................................................................................................................................. 1
Exercise 3.1: Subsection and Subcategories of the CPT Evaluation and Management Section ................. 1
Exercise 3.2: POS and Evaluation and Management Codes ...................................................................... 1
Exercise 3.3: Documentation of Patient History ........................................................................................ 2
Exercise 3.4: Evaluation and Management Coding ................................................................................... 2
Exercise 3.5: Hospital Service Codes ......................................................................................................... 2
Exercise 3.6: Observation Coding .............................................................................................................. 2
Exercise 3.7: Critical Care Services ............................................................................................................ 2
Exercise 3.8: Critical Care Services ............................................................................................................ 3
Exercise 3.9: Nursing Facility Services ....................................................................................................... 3
Chapter Review ................................................................................................................................................................ 3
True/False.................................................................................................................................................. 3
Fill-in-the-Blank ......................................................................................................................................... 3
Case Studies ...................................................................................................................................................................... 4
Exercises
Exercise 3.1: Subsection and Subcategories of the CPT Evaluation and Management Section
1. Office and other outpatient services; established patiente
2. Emergency department services; new or established patient
3. Home services; new patient
4. Hospital inpatient services; hospital discharge services
5. Consultations; inpatient consultation services
6. Hospital observation services; observation care discharge services
7. Hospital inpatient services; subsequent hospital care
8. Consultations; office or other outpatient consults
9. Advance Care Planning
10. Standby Services
Exercise 3.2: POS and Evaluation and Management Codes
1. 11
2. 21
3. 12
4. 31
5. 21
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website, in whole or in part.
, Solution and Answer Guide: Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2022 edition, ISBN
9780357621837; Chapter 3: Evaluation and Management
6. 31
7. 21
8. 11
9. 11
10. 23
Exercise 3.3: Documentation of Patient History
1. 2—Chief complaint
2. 4—Severity
3. 6—Quality
4. 8—Associated signs and symptoms
5. 5—Family history
6. 3—Past history
7. 7—Review of systems
8. 1—Social history
Exercise 3.4: Evaluation and Management Coding
1. 99233
2. 99221
3. 99232
4. 99221
5. 99223
Exercise 3.5: Hospital Service Codes
1. 99222
2. 99232
3. 99223
4. 99238
5. 99232
Exercise 3.6: Observation Coding
1. True
2. False; use 99219 only
3. True
4. True
5. True
6. False
7. False
8. False
9. False
10. True
Exercise 3.7: Critical Care Services
1. True
2. False
3. True
4. True
5. True
6. True
7. False
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website, in whole or in part.