CCS Procedure Coding Outpatient Practice Questions & Answers

Only 2 (HTN and DM). For a problem to be addressed, the physician must evaluate or treat the condition at that encounter. Simply noting a condition in the history or problem list without management or assessment does not count toward MDM complexity. **CCS Tip:** AHIMA often tests the distinction between history and addressed. If the physician writes COPD-stable, continue meds from Pulmonologist, it is addressed. If it's just in the PMH list, it's not.

92950 (CPR) and 99291 (Critical Care). Rationale: CPR (92950) is a separate, non-bundled procedure. The time spent performing CPR does NOT count toward critical care time. Since the physician spent 40 minutes on critical care *after* the procedure, 99291 is supported. Exam Tip: Watch for ROSC (Return of Spontaneous Circulation). Time spent *before* ROSC is often procedural (CPR); time *after* is often critical care (stabilizing organ systems). Do not double-count the time.

33214 Rationale: CPT 33214 is a specific code for the upgrade of a single-chamber pacemaker system to a dual-chamber system. This single code includes the insertion of the new transvenous lead and the removal/replacement of the pulse generator. Clinical Pearl: This is a combo code. Do not unbundle it into lead insertion (33210) and generator replacement (33228). Exam Tip: AHIMA prioritizes Upgrade scenarios. If the patient is moving from single to dual, 33214 is the gold standard. If moving from a dual-chamber pacemaker to a biventricular (CRT) system, you would use 33225 as an add-on code.

This is a Concurrent Infusion. For therapeutic/prophylactic/diagnostic infusions (non-chemo), use add-on code 96368. Note: 96368 is reported only once per encounter, regardless of how many additional drugs are infused concurrently. This code cannot be used with chemotherapy or hydration. Strategy: AHIMA often tests the once per day rule for concurrent codes.

Report J2350 with 300 units and append modifier JZ. Rationale: 300 mg administered / 1 mg unit = 300 units. Since the vial was a 300 mg single-dose vial and the full 300 mg was given, there is zero waste, necessitating the JZ modifier. Exam Strategy: AHIMA often combines unit calculation with modifier application. For Ocrevus, the initial dose is often two 300 mg infusions 2 weeks apart, then 600 mg every 6 months. Pay attention to the date of service and the dose provided in the case study to ensure the units match the specific encounter.