Last Attempt CPC Questions

The Office of Inspector General (OIG) operates under the Department of Health and Human Services (HHS) and is specifically responsible for detecting, investigating, and preventing fraud, waste, and abuse in federal healthcare programs such as Medicare and Medicaid.

This is a key compliance and regulatory topic on the CPC exam.

For the procedure involving access to the subclavian vein and advancing a catheter to the inferior vena cava for injection and imaging, the following codes are used:

36010 for the catheter placement.

75825-26 for the supervision and interpretation of the imaging.

Modifier -26 indicates the professional component of the radiological supervision and interpretation.

The CPT® codes for skin biopsies depend on the method used and the location of each lesion. Here, the scenario includes:

1. Two punch biopsies on the trunk: CPT® code 11104 is used for a full-thickness punch biopsy of the skin, and 11104 x 2 is appropriate since two lesions on the trunk were sampled.

2. One partial-thickness shave biopsy on the forehead: CPT® code 11102 is used for a tangential (shave) biopsy, which captures a partial-thickness sample, appropriate for the forehead lesion.

Explanation of other options:

B. 11104, 11105, 11103: Incorrect, as 11105 is an add-on for additional punch biopsies at separate sites but not used here.

C. 11104, 11103 x 2: 11103 is an add-on code for additional shave biopsies, which does not apply to the punch biopsies on the trunk.

D. 11104, 11102 x 2: Incorrect, as 11102 is only used for the shave biopsy, not for the punch biopsies.

When a patient experiences an underdose of insulin due to an insulin pump malfunction, the primary reason for the encounter would be the malfunction itself, which is coded first. The resulting hyperglycemia or hypoglycemia due to the pump failure is a secondary condition. According to ICD-10-CM guidelines, the code for the mechanical complication of the pump (T85.633-) is sequenced first, followed by a code for the diabetes with complication (E11.65 for type 2 diabetes with hyperglycemia).

ICD-10-CM (current year), Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88), ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.4.