PATH & LAB (MULTIPLE CHOICE)

CPC® STUDY GROUP WITH LEGACY EDUCATION

1. A patient presents with right upper quadrant pain, nausea and other symptoms of liver disease as well as complaints of decreased
urination. Her physician orders an albumin; bilirubin, both total and direct; alkaline phosphatase; total protein; alanine amino
transferase; aspartate amino transferase, and creatinine. What CPT® code(s) is/are reported?
a. 82040, 82247, 82248, 84075, 84155, 84460, 84450, 82565
b. 80076, 82565
c. 80076
d. 80076-22

2. A patient has a cytopathology study performed by a fine needle aspiration. The results are quite unusual and are considered
moderately complex. The slides as well as a copy of pertinent information from the patient’s record are sent to another
cytopathologist for consultation. The consulting pathologist reviews the slides and reviews the patient’s chart material. A report is
sent back to the original pathologist with the findings. The medical decision making is considered moderate. What CPT® code is
reported?
a. 80504 c. 80503
b. 99245 d. 88173

3. A pregnant patient is tested for serologic blood type and Rh factor. What CPT® code(s) are reported?
a. 86920, 86906 c. 86900
b. 86900, 86901 d. 85060

4. A 35-year-old type II diabetic is feeling weak. The physician performs a stat glucose test in which a finger stick is done placing the drop
of blood on a reagent strip. The test indicates the patient is hypoglycemic. The physician gives the patient some glucose supplements
and performs another stat glucose test using the same lab test as before 30 minutes later. The second test shows the glucose levels
returned to normal. How are the lab tests reported?
a. 82947, 82947-91 c. 82948, 82948-91
b. 82947, 82947-76 d. 82948, 82948-76

5. A patient arrives at to the ED. It appears the patient has been suffering from periods of disorientation, persistent stomachache, fatigue,
over the past several months but the persistent patch of dark skin that appeared on the patient’s chest has prompted his visit. The
treating ED physician orders a stimulation panel for adrenocorticotropic hormone (ACTH) consisting of two cortisol injections, 60
minutes apart. Blood tests reveal ACTH levels are at 300 nmol/L and diagnoses the patient with adrenal insufficiency. What CPT®
codes are reported for the lab services?
a. 82533 x 2 c. 80408
b. 80400 d. 82533 x 2, 83498 x 2

6. A patient will be undergoing a transplant and needs HLA tissue typing with DR/DQ multiple antigen and lymphocyte mixed culture.
How will these services be coded?
a. 86805-26, 86817 c. 86816-26, 86821
b. 86817, 86821 d. 86806-26, 86817

7. A patient has partial removal of his lung which is sent in for gross and microscopic examination. The pathologist also did gross and
microscopic exam on biopsies for several lymph nodes in the patient’s chest which are placed in one container. A consultation is
performed on a tissue block of a single specimen intraoperatively by frozen section. The pathologist also performs a trichrome stain.
What CPT® codes are reported for the lab tests performed?
 a. 88309 x 2, 88313, 88329
b. 88309, 88305, 88313, 88331
c. 88307, 88305 x 2, 88332
d. 88309 x 2, 88307 x 2, 88313, 88331, 88332

8. In a legal hearing to determine child support there is a dispute about the child’s paternity. The court orders a paternity test, and a
nasal smear is taken from the plaintiff and the child. The plaintiff is confirmed as the father of the child. Choose the CPT®, ICD-10-CM
codes and modifier for the paternity testing of the plaintiff.
a. 89190-32, Z31.448 c. 86900, Z02.81
b. 86910-32, Z02.81 d. 86910 x 2, Z31.448

9. A left breast biopsy is performed on a mass and the surgeon requests a frozen section examination of the specimen to determine
whether more extensive resection is appropriate. The frozen section reveals no indications of malignancy. No other specimen is
obtained but the remainder of the biopsy specimen is sent for further testing and examination, including decalcification. The results
indicate breast fibrosclerosis only. What CPT® and ICD-10-CM codes are reported?
a. 88331, 88313, N63.20
b. 88305, 88331, 88311, N60.32
c. 88307, 88331, R92.0
d. 88307, 88305, 88331, 88313, N60.32

10. A couple has been trying to conceive for nine months without success. Preliminary studies show the woman ovulates and the
husband’s sperm count is good. A sperm sample is submitted for both a post coital Huhner test and a hamster penetration test.
Report the codes.
a. 89300, 89320 c. 89300, 89329
b. 89310, 89330 d. 89325, 89260
 PATH & LAB (SCRATCH)
CPC® STUDY GROUP WITH LEGACY EDUCATION
1. A patient presents with right upper quadrant pain, nausea and other symptoms of liver disease as well as complaints of decreased
urination. Her physician orders an albumin; bilirubin, both total and direct; alkaline phosphatase; total protein; alanine amino
transferase; aspartate amino transferase, and creatinine. What CPT® code(s) is/are reported?

CPT®: __________, __________

2. A patient has a cytopathology study performed by a fine needle aspiration. The results are quite unusual and are considered
moderately complex. The slides as well as a copy of pertinent information from the patient’s record are sent to another
cytopathologist for consultation. The consulting pathologist reviews the slides and reviews the patient’s chart material. A report is
sent back to the original pathologist with the findings. The medical decision making is considered moderate. What CPT® code is
reported?

CPT®: __________

3. A pregnant patient is tested for serologic blood type and Rh factor. What CPT® code(s) are reported?

CPT®: __________, __________

4. A 35-year-old type II diabetic is feeling weak. The physician performs a stat glucose test in which a finger stick is done placing the drop
of blood on a reagent strip. The test indicates the patient is hypoglycemic. The physician gives the patient some glucose supplements
and performs another stat glucose test using the same lab test as before 30 minutes later. The second test shows the glucose levels
returned to normal. How are the lab tests reported?

CPT®: __________, __________

5. A patient arrives at to the ED. It appears the patient has been suffering from periods of disorientation, persistent stomachache, fatigue,
over the past several months but the persistent patch of dark skin that appeared on the patient’s chest has prompted his visit. The
treating ED physician orders a stimulation panel for adrenocorticotropic hormone (ACTH) consisting of two cortisol injections, 60
minutes apart. Blood tests reveal ACTH levels are at 300 nmol/L and diagnoses the patient with adrenal insufficiency. What CPT®
codes are reported for the lab services?

CPT®: __________

6. A patient will be undergoing a transplant and needs HLA tissue typing with DR/DQ multiple antigen and lymphocyte mixed culture.
How will these services be coded?

CPT®: __________, __________

7. A patient has partial removal of his lung which is sent in for gross and microscopic examination. The pathologist also did gross and
microscopic exam on biopsies for several lymph nodes in the patient’s chest which are placed in one container. A consultation is
performed on a tissue block of a single specimen intraoperatively by frozen section. The pathologist also performs a trichrome
stain. What CPT® codes are reported for the lab tests performed?

CPT®: __________, __________

8. In a legal hearing to determine child support there is a dispute about the child’s paternity. The court orders a paternity test, and a
nasal smear is taken from the plaintiff and the child. The plaintiff is confirmed as the father of the child. Choose the CPT®, ICD-10-CM
codes and modifier for the paternity testing of the plaintiff
CPT®: __________
 ICD-10-CM: __________

9. A left breast biopsy is performed on a mass and the surgeon requests a frozen section examination of the specimen to determine
whether more extensive resection is appropriate. The frozen section reveals no indications of malignancy. No other specimen is
obtained but the remainder of the biopsy specimen is sent for further testing and examination, including decalcification. The results
indicate breast fibrosclerosis only. What CPT® and ICD-10-CM codes are reported?

CPT®: __________, __________, __________

ICD-10-CM: __________

10. A couple has been trying to conceive for nine months without success. Preliminary studies show the woman ovulates and the
husband’s sperm count is good. A sperm sample is submitted for both a post coital Huhner test and a hamster penetration test.
Report the codes.

CPT®: __________, __________

 ANSWER KEY
1. A patient presents with right upper quadrant pain, nausea and other symptoms of liver disease as well as complaints of decreased
urination. Her physician orders an albumin; bilirubin, both total and direct; alkaline phosphatase; total protein; alanine amino
transferase; aspartate amino transferase, and creatinine. What CPT® code(s) is/are reported?
a. 82040, 82247, 82248, 84075, 84155, 84460, 84450, 82565
b. 80076, 82565
c. 80076
d. 80076-22

ANS: B
Rationale: The patient was being tested for symptoms of liver disease, hepatic. Look in the CPT® Index for Blood Tests/Panels/Hepatic
Function referring you to 80076. Also, see Creatinine/Blood referring you to 82565. Code the laboratory panel anytime all of the tests
listed in the panel are completed. If additional tests are also performed, they are coded separately.

2. A patient has a cytopathology study performed by a fine needle aspiration. The results are quite unusual and are considered
moderately complex. The slides as well as a copy of pertinent information from the patient’s record are sent to another
cytopathologist for consultation. The consulting pathologist reviews the slides and reviews the patient’s chart material. A report is
sent back to the original pathologist with the findings. The medical decision making is considered moderate. What CPT® code is
reported?
a. 80504 c. 80503
b. 99245 d. 88173

ANS: A
Rationale: In the CPT® Index, look for Consultation/Clinical Pathology. This will lead to codes 80503-80506. The clinical problem is of
moderate complexity, there is review of patient’s history and medical record, and level of medical decision making is moderate, leading
to code 80504. The E/M consultation codes require a face-to-face encounter with the patient.

3. A pregnant patient is tested for serologic blood type and Rh factor. What CPT® code(s) are reported?
a. 86920, 86906 c. 86900
b. 86900, 86901 d. 85060

ANS: B
Rationale: Patient is getting two different lab tests. The first lab test is to determine if the patient has O, A, B or AB blood type. In the
CPT® Index, look for Blood Typing, Serologic/ABO Only which directs you to code 86900. The second lab test is to determine if the
patient is negative or positive for the Rh antigen. For the Rh factor, look in the CPT® Index for Blood Typing, Serologic/Rh (D), which
directs you to 86901.

4. A 35-year-old type II diabetic is feeling weak. The physician performs a stat glucose test in which a finger stick is done placing the drop
of blood on a reagent strip. The test indicates the patient is hypoglycemic. The physician gives the patient some glucose supplements
and performs another stat glucose test using the same lab test as before 30 minutes later. The second test shows the glucose levels
returned to normal. How are the lab tests reported?
a. 82947, 82947-91 c. 82948, 82948-91
b. 82947, 82947-76 d. 82948, 82948-76

ANS: C
Rationale: Look in the CPT® Index for Glucose/Blood Test referring you to codes 82947, 82948, 82950. The lab test used a reagent strip
for the glucose test reporting code 82948. Modifier 91 is the correct modifier to use when the same laboratory test is repeated on the
same day for a subsequent result.
5. A patient arrives at to the ED. It appears the patient has been suffering from periods of disorientation, persistent stomachache, fatigue,
over the past several months but the persistent patch of dark skin that appeared on the patient’s chest has prompted his visit. The
treating ED physician orders a stimulation panel for adrenocorticotropic hormone (ACTH) consisting of two cortisol injections, 60
minutes apart. Blood tests reveal ACTH levels are at 300 nmol/L and diagnoses the patient with adrenal insufficiency. What CPT®
codes are reported for the lab services?
a. 82533 x 2 c. 80408
 b. 80400 d. 82533 x 2, 83498 x 2

ANS: B
Rationale: Each cortisol injection is included in the ACTH Stimulation Panel. Looking in the CPT® Index for Panel/Stimulation
Panel/ACTH or look for Evocative/Suppression Test/Analytes/Stimulation Panel/ACTH referring you to 80400, 80402, and 80406 .
Reviewing the codes, confirms the only code that applies to ACTH Stimulation Panel is 80400.

6. A patient will be undergoing a transplant and needs HLA tissue typing with DR/DQ multiple antigen and lymphocyte mixed culture.
How will these services be coded?
a. 86805-26, 86817 c. 86816-26, 86821
b. 86817, 86821 d. 86806-26, 86817

ANS: B
Rationale: In the CPT® Index look for Tissue/Typing/Human Leukocyte Antigen (HLA)/Antibodies. Code 86817 is the correct code to
report for HLA tissue typing with DR/DQ. Then, look in the CPT® Index for Tissue/Typing/Lymphocyte Culture referring you to code
86821. Codes 86805 and 86806 are for lymphocytotoxicity, not lymphocyte mixed culture.

7. A patient has partial removal of his lung which is sent in for gross and microscopic examination. The pathologist also did gross and
microscopic exam on biopsies for several lymph nodes in the patient’s chest which are placed in one container. A consultation is
performed on a tissue block of a single specimen intraoperatively by frozen section. The pathologist also performs a trichrome stain.
What CPT® codes are reported for the lab tests performed?
a. 88309 x 2, 88313, 88329
b. 88309, 88305, 88313, 88331
c. 88307, 88305 x 2, 88332
d. 88309 x 2, 88307 x 2, 88313, 88331, 88332

ANS: B
Rationale: Look in the CPT® Index for Surgical Pathology/Gross and Microscopic Exams. The lung examination is found under Level VI,
Lung – total/lobe/segment resection reporting code 88309. The lymph node biopsies are found under Level IV. Code 88305 is only
reported once because all the specimens from the one area is placed in one container. Next, look in the CPT® Index for Trichrome
Stain referring you to 88313 . Then, look in the CPT® Index Consultation/Surgical Pathology/Intraoperative. The frozen section
pathology consultation on one tissue block and single specimen is reported with 88331.

8. In a legal hearing to determine child support there is a dispute about the child’s paternity. The court orders a paternity test, and a
nasal smear is taken from the plaintiff and the child. The plaintiff is confirmed as the father of the child. Choose the CPT®, ICD-10-CM
codes and modifier for the paternity testing of the plaintiff.
a. 89190-32, Z31.448 c. 86900, Z02.81
b. 86910-32, Z02.81 d. 86910 x 2, Z31.448

ANS: B
Rationale: Always choose codes identifying the service and reason for the service as specifically as possible. Look in the CPT® Index for
Paternity Testing. Code 86910 represents testing for one person. Parenthetic comments in CPT® can sometimes assist in finding a
challenging code. Modifier 32 is appropriate when services are mandated by courts or insurers.
In the ICD-10-CM Alphabetic Index, look for Encounter (with health service) (for)/administrative purpose only/examination
for/paternity testing directing you to Z02.81.

9. A left breast biopsy is performed on a mass and the surgeon requests a frozen section examination of the specimen to determine
whether more extensive resection is appropriate. The frozen section reveals no indications of malignancy. No other specimen is
obtained but the remainder of the biopsy specimen is sent for further testing and examination, including decalcification. The results
indicate breast fibrosclerosis only. What CPT® and ICD-10-CM codes are reported?
a. 88331, 88313, N63.20
b. 88305, 88331, 88311, N60.32
c. 88307, 88331, R92.0
d. 88307, 88305, 88331, 88313, N60.32
 ANS: B
Rationale: In the CPT® Index, look for Surgical Pathology/Gross and Microscopic Exams. The breast biopsy did not include margins.
Breast biopsy not including surgical margins is found under Level IV, 88305. Next, look in the CPT® Index for Consultation/Surgical
Pathology/Intraoperative. Code 88331 is the correct code to report. Also code the decalcification procedure and frozen section. Look
in the CPT® Index for Surgical Pathology/Decalcification Procedure directing you to 88311.

For the ICD-10-CM code, look in ICD-10-CM Alphabetic Index for Fibrosclerosis/breast directing you to N60.3-. Verification in the
Tabular List shows that a 5th character is needed to indicate laterality, report 2 for the left breast.

10. A couple has been trying to conceive for nine months without success. Preliminary studies show the woman ovulates and the
husband’s sperm count is good. A sperm sample is submitted for both a post coital Huhner test and a hamster penetration test.
Report the codes.
a. 89300, 89320 c. 89300, 89329
b. 89310, 89330 d. 89325, 89260

ANS: C
Rationale: Look in the CPT® Index for Huhner Test/Semen Analysis. The post coital test is described by code 89300. The second test
ordered and performed on the sperm sample is a hamster penetration test. Look in the CPT® Index for Hamster Penetration
1.
Test/Sperm Evaluation referring you to code 89329.