WITH CORRECT ANSWERS 2025
Which one of the following is an example of fraud?
A. Reporting the code for ultrasound guidance when used to perform a liver biopsy
B. Reporting a biopsy and excision performed on the same skin lesion during the same encounter
C. Failing to append modifier 26 on an X-
ray that is performed and interpreted in the physician's office
D. Reporting a lab panel with an additional lab test that is not included in the lab panel -
CORRECT ANSWER -
B. Reporting a biopsy and excision performed on the same skin lesion during the same encounter
Answer B is the only example of unbundling of CPT® which would result in a fraudulent claim. Acc
ording to National Correct Coding Initiative (NCCI) and CPT® coding guidelines, a biopsy performed
on the same lesion as an excision during the same encounter is an incidental service and is not r
eported separately. If ultrasound guidance is performed for a liver biopsy, it is billable. X-
rays performed in a physician's office do not require modifier 26, because the physician owns the
equipment and performs the interpretation, he bills the global service. Lab panels can be reported
with additional lab tests that are not listed in a lab panel.
Which place of service code is reported for fracture care performed by an orthopedic physician in
the ED?
A. 11
B. 20
C. 22
D. 23 - CORRECT ANSWER -D. 23
Place of service codes are reported on the claim form to identify the site of the service provided.
In this case, the services are rendered in the ED which is reported with place of service (POS) 23.
The place of service codes can be found in the CPT® codebook.
, What A is A the A full A CPT® A code A description A for A 61535?
A. A Craniotomy A with A elevation A of A bone A flap; A for A subdural A implantation A of A an A electrode
A array, A for A lon Ag-
term A seizure A monitoring; A for A removal A of A epidural A or A subdural A electrode A array, A without
A excision A of A c Aerebral A tissue A (separate A procedure)
B. A Craniotomy A with A elevation A of A bone A flap; A for A removal A of A epidural A or A subdural A electrode
A array, A wit Ahout A excision A of A cerebral A tissue A (separate A procedure)
C. A For A removal A of A epidural A or A subdural A electrode A array, A without A excision A of A cerebral A tissue
A (separate Aprocedure)
D. A For A excision A of A epileptogenic A focus A without A electrocorticography A during A surgery; A for
A removal A of A e Apidural A or A subdural A electrode A array, A without A excision A of A cerebral A tissue
A (separate A procedure) A - ACORRECT A ANSWER A -
B. A Craniotomy A with A elevation A of A bone A flap; A for A removal A of A epidural A or A subdural A electrode
A array, A wit Ahout A excision A of A cerebral A tissue A (separate A procedure)
In A the A CPT® A codebook A the A description A for A code A 61535 A is A indented A which A means A the
A description A fro Am A 61533 A up A to A the A semicolon A is A the A beginning A of A the A full A description
A for A 61535.
Which A Z A code A category A can A ONLY A be A reported A as A a A first A listed A diagnosis A code?
A. A Z67
B. A Z69
C. A Z58
D. A Z03 A - A CORRECT A ANSWER A -D. A Z03
The A Official A ICD-10-
CM A Coding A Guidelines A provides A a A list A of A Z A code A categories A and A Z A codes A that A can A only
A be A reported Aas A a A first A listed A diagnosis A code. A The A list A can A be A found A in A the A ICD-10-
CM A codebook A referring A to A guideline A I.C.21.c.16.
The A patient A has A a A history A of A symptomatic A HIV A and A has A been A treated A for A an A HIV A related
A illness. A Whi Ach A ICD-10-CM A code A is A reported?