Laboratory

Question 1

Disease oriented panel requirements

Answer 1

All tests must be ordered, performed, and medically necessary, or each individual test must be coded/billed

Question 2

Automated vs manual

Answer 2

Automated least significant for physician coding

Question 3

Specimen surgery pathology guidelines

Answer 3

Each specimen submitted as separately identifiable is coded a unit of service

Question 4

Laboratory services

Answer 4

Automated or manual

Question 5

Automated vs manual not specified

Answer 5

Assign code for automated

Question 6

Modifier 51

Answer 6

Not necessary for labs

Question 7

Modifier 90

Answer 7

Reference lab, used when specimen was sent to a reference lab

Question 8

Modifier 91

Answer 8

Repeat procedure, used when an identical pathology service is repeated

Question 9

Modifier 92

Answer 9

Alternative lab platform testing, used when the testing is performed using an alternative lab platform

Question 10

Organ or disease-oriented panels

Answer 10

All tests must be ordered and medically necessary

Question 11

CMP

Answer 11

Comprehensive metabolic profile

Question 12

BMP

Answer 12

Basic metabolic profile

Question 13

Drug assays

Answer 13

For monitoring therapeutic levels of prescribed drugs

Question 14

Presumptive drug testing

Answer 14

Performed to determine if a specific drug is present, also referred to as a drug screen

Question 15

Definitive drug testing

Answer 15

Performed to identify specific drugs in the system, also referred to as drug confirmation

Question 16

Presumptive drug class screening codes

Answer 16

Assign only one code per encounter per day

Question 17

Definitive drug test codes

Answer 17

One is performed per category per day

Question 18

Pathology consultations

Answer 18

Pathologist may use E/M codes when services are performed face to face with a patient or clinical pathology consult codes when expert opinion only is requested

Question 19

Clinical pathology consultation test results

Answer 19

Reporting test results alone is not considered a consult

Question 20

Urinalysis methods

Answer 20

Dip stick, automated, manual

Question 21

Urinalysis methodology

Answer 21

Least significant is dip stick, then automated, then manual

Question 22

Urinalysis method not documented

Answer 22

Use dip stick

Question 23

Molecular pathology

Answer 23

Analysis of nucleic acid (DNA, RNA) to detect gene variants

Question 24

Included in molecular pathology codes

Answer 24

All analytical services performed in the test

Question 25

Molecular pathology interpretation and report only

Answer 25

Use modifier 26

Question 26

Tier II codes

Answer 26

Defined as "codes not included in tier 1"

Question 27

Chemistry specimens

Answer 27

May be from any source

Question 28

Multiple specimens from multiple sources

Answer 28

Assign each source individually

Question 29

Hct

Answer 29

Hematocrit

Question 30

Hgb

Answer 30

Hemoglobin

Question 31

CBC

Answer 31

Complete blood count, can be performed with platelet counts, automated or manual

Question 32

Antigen testing/screening

Answer 32

Reported by number of antigen tests or per units screened

Question 33

Injection of platelet rich plasma

Answer 33

0232T (includes harvesting and preparation)

Question 34

Injection of autologous white blood cells

Answer 34

0418T (includes harvesting/preparation)

Question 35

Microbiology section codes

Answer 35

Includes testing for bacteriology, mycology, parasitology, and virology

Question 36

Multiple specimens/sites using same cpt code

Answer 36

Append modifier 59 to subsequent procedures

Question 37

Gross examination

Answer 37

Use when only "eyes on" exam (observation only without any microscopic eval)

Question 38

Limited codes

Answer 38

Use when only a single region or organ is examined

Question 39

Conventional pap smears performed via non Bethesda reporting methods

Answer 39

Codes 88150, 88152, and 88153

Question 40

Conventional pap smears performed via Bethesda reporting methods

Answer 40

Codes 88164-88167

Question 41

Liquid based specimens with thin layer preparation (thin prep pap smear)

Answer 41

Codes 88142, 88143

Question 42

Surgical pathology codes

Answer 42

Used for specimens submitted as a result of a surgical procedure during which a specimen is removed and sent to pathology

Question 43

Level of specimen

Answer 43

Determined by the extent of examination

Question 44

Surgical pathology specimens from the same anatomical area

Answer 44

May be located in multiple levels

Question 45

Each specimen identified separately

Answer 45

May be assigned surgical pathology code, whether specimens are in one container or multiple

Question 46

ADLTs

Answer 46

Advanced diagnostic laboratory tests

Question 47

CDLTs

Answer 47

Clinical diagnostic lab tests

Question 48

Multiple procedures codes for proprietory lab analyses

Answer 48

May be coded, modifier 51 not necessary

Question 49

Proprietory lab analysis codes

Answer 49

4 numeric digits, followed by 1 alpha character