Pathology question 1

1. In the Pathology and Laboratory section, what additional items may be included with
special reports?
a. Complexity of symptoms, final diagnosis, pertinent physical findings, diagnostic and
therapeutic procedures, concurrent problems, follow-up care
b. Signs and symptoms, final diagnosis, follow-up care, concurrent problems, drug testing,
pathology findings
c. Complexity of symptoms, final diagnosis, pathology findings, pertinent physical findings,
diagnostic and therapeutic procedures, concurrent problems, follow-up care
d. Complexity of symptoms, final diagnosis, testing time, consultations notes, follow-up car

2. Brent had the following lab tests:

 Calcium, ionized
 Carbon dioxide
 Chloride
 Creatinine
 Glucose
 Potassium
 Sodium
 Urea Nitrogen (BUN)
How should you report Brent’s lab work?
a. 80048
b. 80047-52
c. 82310, 82374, 82435, 82565, 82947, 84132, 84295, 84520
d. 80047

3. Dr. Lee performed an intra-operative consultation on a bile duct tumor requiring frozen
section and cytological evaluation to a bladder tumor. How would you report his professional
services?
a. 88329
b. 88331-26, 88334-26
c. 88331, 88332 x 2
d. 88331-26, 88333-26

4. Which modifier would you use to report with code 88239 if the test was looking for hereditary
breast cancer?
a. OB
b. 59
c. 91
d. OA
5. Marvin had a breath alcohol test completed at the hospital after the police arrested him for
racing his four-wheeler past a McDonald’s drive through window. Marvin’s breath alcohol test
was mathematically calculated. How would you report the calculation on this test?
a. 82075
b. 82075 x 2
c. 82075, 82355
d. 82355

6. Dr. Monday provided a comprehensive clinical pathology consultation at the request of Dr.
Adams. This request was regarding a patient with various infections, drug allergies, skin rash,
and Down’s syndrome. The patient is in the hospital intensive care unit being treated with
intravenous antibiotics. Dr. Monday did not see the patient but he reviewed the patient’s history,
complex medical records, and provided a written report back to Dr. Adams regarding his
findings and recommendations for further treatment. How would Dr. Monday report his
services?
a. 80502
b. 99244
c. 99244-25, 80502
d. 99255-25, 80500

7. A patient had a semi-quantitative urinalysis for infectious agent detection. How should you
report this test?
a. 81050
b. 81005
c. 81099
d. 81005, 83518

8. Code 3011F describes which diagnostic or screening process?

a. Lipid panel results including total cholesterol, HDL-C, triglycerides, calculated LDL-C
b. Lipid panel results including total cholesterol
c. Lipid panel results including cholesterol, triglycerides, lipoprotein
d. Lipid panel results including cholesterol, triglycerides, carbon dioxide, glucose, potassium

9. A 58-year-old male patient with abdominal pain and episodes of bright red blood in his stool
reports to his physician’s office for a check-up. His physician performs a digital rectal exam and
tests for occult blood. Dr. Smith documents this blood occult test was done for purposes other
than colorectal cancer screening. How would you report the occult blood test?
a. 82270
b. 82274
c. 82271
d. 82272

10. Kathy has had intermittent abdominal pain, occasional diarrhea, stool frequency, and
bloating. Her symptoms have worsened over the past two months. Her physician orders a fecal
Calprotectin test to check for Crohn’s disease. How should you report the lab test?
a. 82270
b. 82272, 83993
c. 83993
d. 82271, 82272
11. Patient is coming in for a pathological examination for ischemia in the left leg. The first
specimen is 1.5 cm of a single portion of arterial plaque taken from the left common femoral
artery. The second specimen is 8.5 x 2.7 cm across x 1.5 cm in thickness of a cutaneous
ulceration with fibropurulent material on the left leg. What surgical pathology codes should be
reported for the pathologist?

A. 88302, 88304 B. 88304-26, 88305-26

C. 88305-26, 88307-26 D. 88307, 88309

12. During a craniectomy the surgeon performed a frozen section of a large piece of tumor and
sent it to pathology. The pathologist received a rubbery pinkish tan tissue measuring in aggregate
3 x 0.8 x 0.8 cm. The entire specimen is submitted in one block and a microscope was used to
examine the tissue. The frozen section and the pathology report are sent back to the surgeon
indicating that the tumor was a medulloblastoma. What CPT® code(s) will the pathologist
report?

A. 80500 B. 88331-26 C. 80502 D. 88331-26, 88304-26

13. Physician orders a comprehensive metabolic panel but also wants blood work on calcium
ions and also orders a basic metabolic panel. Select the code(s) on how this is reported.

A. 80053, 80047 B. 80053

C. 80047, 82040, 82247, 82310, 84075, 84155, 84460, 84450 D. 80053, 82330

15. therapeutic drug testing performed to assess serum plasma levels of Topiramate medication.
What lab code is reported for this testing?
A. 80101
B. 80102
C. 80201
D. 80201, 80102

16. Patient that is a borderline diabetic has been sent to the laboratory to have an oral glucose
tolerance test. Patient drank the glucose and five blood specimens were taken every 30 to 60
minutes up to three hours to determine how quickly the glucose is cleared from the blood. What
code(s) should be reported for this test?
A. 82947 x 5
B. 82946
C. 80422
D. 82951, 82952 x 2

17.A patient with severe asthma exacerbation has been admitted. The admitting physician orders
a blood glass for oxygen saturation only. The admitting physician performs the arterial puncture
drawing blood for a blood gas reading on oxygen saturation only. The physician draws it again in
 an hour to measure how much oxygen the blood is carrying. Select the codes for reporting this
service.
A. 82805, 82805-51
B. 82810, 82810-91
C. 82803, 82803-51
D. 82805, 82805-90

18. Cells were taken from amniotic fluid for analyzation of the chromosomes for possible Down’s
syndrome. The geneticist performs the analysis with two G-banded karyotypes analyzing 30 cells.
Select the lab codes for reporting this service.
A. 88248
B. 88267, 88280, 88285
C. 88273, 88280, 88291
D. 88262, 88285

19. Sperm is being prepared through a washing method to get it ready for the insemination of five
oocytes for fertilization by directly injecting the sperm into each oocyte. Choose the CPT® codes
to report this service.
A. 89257, 89280
B. 89260, 89280
C. 89261, 89280
D. 89260, 89268

20. A pathologist performs a comprehensive consultation and report after reviewing a patient’s
records and specimens from another facility. The correct CPT® code to report this service is:
A. 88325
B. 99244
C. 80502
D. 88329

21. A surgical specimen was removed from the proximal jejunum during a resection for
adenocarcinoma and was submitted to surgical pathology for gross and microscopic examination.
The correct code for this service is:
A. 88300 B. 88309
C. 88304 D. 88305

22. The physician performs the following tests on her automated equipment: HDL, total serum
cholesterol, triglycerides and a quantitative glucose. The correct codes for these procedures are:
A. 83718, 82465, 84478, 82947 B. 83721, 82465, 82951
C. 80061, 82947 D. 80061, 82950

23. A patient with rheumatoid arthritis is being treated with gold. The physician orders a
therapeutic drug test to measure the level of gold. What is the correct code?
A. 80172 B. 80100
C. 80102 D. 80299
24. A patient presents to the ED with crushing chest pain radiating down the left arm and up
under the chin. There are elevated S-T segments on EKG. The cardiologist sees and admits the
patient to CCU. He orders three serial CPK enzymes levels with instructions that the tests are also
to be done with isoenzymes if the initial tests are elevated for that date of service. The CPK
enzyme levels were elevated, the lab codes would be:
A. 82550, 82552, 82550-76 x 2, 82552-76 x 2 B. 82550, 82552, 82552-91 x 2
C. 82550, 82550-91 x 2, 82552, 82552-91 x 2 D. 82550 x 3, 82554 x 3

25. Which of the following panels does NOT include chloride?

A. 80061 B. 80050
C. 80053 D. 80047

26. The patient presents with burning urination and frequency. The physician performs a UA
dipstick, which shows elevated WBC. He orders a urine culture with identification for each isolate
to determine which antibiotic to give to the patient for the infection. What are the appropriate lab
codes?
A. 81000, 81007 B. 81002, 87088
C. 81001, 87086 D. 87086, 87088

27. Which of the following coding combinations is an example of unbundling?

A. 80048, 80061 B. 80076, 80100
C. 80061, 83718, 84478 D. 82310, 82355, 82374

28. Patient is undergoing in vitro fertilization to get pregnant. Following the retrieval of follicular
fluid from the patient, the physician uses a microscope to examine the fluid to identify the
ooctyes. What is the code for the laboratory service?
A. 89250 B. 89254
C. 89255 D. 89258

29. A patient has an iliac crest bone marrow biopsy. The physician suspects the patient has
myelofibrosis. The bone marrow specimen is sent to pathology for gross and microscopic exam.
What is the appropriate code for the pathologist’s service?
A. 88304 B. 88305
C. 88309 D. 88307

30. A pathologist performs a comprehensive consultation and report after reviewing a patient’s
records, specimens and official findings from other sources. What is the correct code?
A. 88325 B. 99244
C. 80502 D. 88329

31. Which code(s) should be reported for the following case?

Clinical history: Mass in the body of stomach
Gross description: Cavity effusion – two Diff-Quick four smears prepared with simple filter and
interpretation Specimen received using Saccomanno technique: Stomach mass touch prep
Adequacy: Specimen satisfactory for cytological evaluation
Diagnosis: Primary malignant neoplasm – body of the stomach
Notes: Cytology completed on specimen. The malignant cells show subjective features suggestive
of small-cell carcinoma; however, cell size is more attuned with non-small-cell carcinoma.
a. 88108
b. 88104
c. 88107
d. 88106

32. Dr. Ross, a pathologist, completed both gross and microscopic surgical pathology after a lung
wedge biopsy. Dr. Miles, the surgeon, sent a single specimen to the laboratory after the
completion of a limited biopsy by thoracotomy. How would Dr. Ross report her services?
a. 88300, 88307
b. 32151, 88305-26
c. 88307
d. 32095, 88307-26

34. Jane underwent a combined rapid anterior pituitary evaluation panel with multiple exposures
and suppressions and had a hepatic function panel. How should these tests be reported?
a. 82024 x 4, 83002 x 4, 83001 x 4, 84146 x 4, 83003 x 4, 82533 x 4, 84443 x 4
b. 80418, 80076
c. 80418, 82024, 83002, 83001, 84146, 83003, 82533, 84443
d. 80076

35. Dr. Thomas received a request for consultation that included records and specimens. Dr.
Thomas did not see the patient but documented the patient as inpatient status with a
comprehensive family history of colon cancer. The patient takes multiple medications and is at
high risk of complications due to weight loss, chronic diarrhea, and a continued fever. His
confirmative opinion, based on the review of specimens and records, indicates positive small-cell
cancer. Dr. Thomas sent his written report back to the requesting physician. How should Dr.
Thomas report his services?
a. 99254
b. 88325
c. 99254-25, 88325-26
d. 88323

37. Larry had a venipuncture during his annual physical examination. The blood sample was used
for the following antibody tests: West Nile IgM, Shigella, mumps, and total hepatitis B. How
should you report these tests?
a. 36415
b. 86486
c. 86788, 86771, 86735, 86704
d. 36415-32, 86788, 86771, 86735, 86704

38. Today, an extended culture of five-day embryos was completed. The transfer tests will be
completed when the culture test results are confirmed. The culture testing results are scheduled
for return within 48 hours. How should the culture service be reported?
a. 89272
b. 89250
c. 89258
d. 89255, 89272

39. A patient had the following blood tests completed as part of her primary care physician’s
described metabolic panel: albumin, bilirubin total, calcium total, carbon dioxide, chloride,
creatinine, glucose, phosphatase alkaline, potassium, protein total, sodium, transferase (ALT
SGPT), transferase aspartate (AST SGOT), urea nitrogen (BUN), bilirubin direct, and a hepatitis
A IgM. How should these services be reported?
a. 80053, 82248, 86709
b. 80053-22
c. 80076-52, 80074-52, 80053-52
d. 80047, 80053, 80076

40. A patient had glucose tolerance testing completed on five specimens. How should these
laboratory services be reported?
a. 82947, 82951, 82952-51
b. 82951, 82952 x 2
c. 82947, 82952 x 5
d. 82951 x 5

Pathology questions 2

1. A physician ordered an “electrolyte panel” from a local laboratory company. The order form
supplied by this company indicates the following tests are always included whenever an
electrolyte panel is ordered: carbon dioxide, chloride, glucose, potassium and sodium. The lab
company performed all of these tests. How should the lab company report these services?
a. 82374, 82435, 84132, 84295, 82947
b. 80051, 82374, 82435, 84132, 84295, 82947
c. 80051
d. 80051, 82947

2. A patient has partial removal of his lung. The surgeon also biopsies several lymph nodes in the
patient’s chest which are examined intraoperatively by frozen section and sent with the lung
tissue for Pathologic examination. The pathologist also performs a trichrome stain. What CPT®
codes are reported for the lab tests performed?
a.88309 x 2, 88313
b 88307, 88305×2, 88332
c 88309, 88305, 88313, 88331
d 88309, 88305, 88313

3. A lab performed a calcitonin stimulation panel consisting of three separate calcitonin tests.
How should these lab services be reported?
a. 80410, 82308 x 3
b. 82308 x 3
c. 80410
d. 82308, 82308-91 x 3

4. A pathologist was asked to consult on the results of a quantitative urine alkaloid test taken in a
primary care physician’s office. The pathologist reviewed the test results but did not review the
patient’s records or personally examine the patient. A written report was produced by the
pathologist rendering his opinion and sent back to the primary care physician’s office. How
should the pathologist’s services be reported?
a. The pathologist’s professional services should not be separately reported – they are a part of
the lab’s overhead.
b. 80500
c. 82101, 80500
d. 82101

5. A six-year old child was taken to the hospital emergency department after swallowing a lead
toy soldier. A lead toxicity test was performed immediately and the patient was started on IV
infusion of a detoxification agent. Three hours later, a lead test was run again to determine
whether the IV infusion was reducing the level of lead in the patient’s blood. How should these
lab services performed in connection with this encounter be reported?
a. 83655
b. 83655 x 2
c. 83655-91
d. 83655, 83655-91

6. A physician aspirated a sample of bone marrow and then interpreted a smear from the sample.
How should the physician’s professional services be reported?
a. 38220, 85097-26
b. 38220, 88305-26
c. 38221, 85097-26
d. 85097

7. A quantitative colony count bacterial culture of the urine was performed with isolation and
presumptive identification of isolates. How should these lab services be reported?
a. 87040
b. 87070
c. 87075
d. 87088
8. Cytopathology slides prepared from a vaginal specimen were manually screened with
computer-assisted rescreening using cell selection with the Bethesda system of reporting. This
service was performed by lab personnel under physician supervision. The initial results were
positive. The pathologist then reviewed the initial test results and rendered an interpretation.
How should these lab services (including the physician interpretation) be reported?
a. 88154
b. 88167, 88141
c. 88154, 88141
d. 88142, 88141

9. A patient who had developed a tumor on his tonsils underwent surgery for resection of the
tonsils. After the tonsils had been removed and the patient was sent to the recovery room, the
tonsils were sent (as a single specimen) to the pathologist for gross and microscopic evaluation.
How should the pathologist’s services be reported?
a. 88305-26
b. 88304-26
c. 88309-26
d. 88399-26

10. A patient presented for a colonoscopy. The gastroenterologist biopsied three polyps from the
colon and sent each polyp as a separately identified specimen to pathology requesting a
pathology consult while the patient was still on the table. Tissue blocks and frozen sections were
then prepared and examined as follows:
Specimen 1: First Tissue Block – Three Frozen Sections
Second Tissue Block – One Frozen Section
Specimen 2: First Tissue Block – Two Frozen Sections
Second Tissue Block – Four Frozen Sections
Specimen 3: Single Tissue Block – Three Frozen Sections
How should the pathologist’s services be reported?
a. 88331-26, 88332-26 x 5
b. 88331-26 x 3, 88332-26 x 10
c. 88331-26 x 8, 88332-26 x 5
d. 88331-26 x 3, 88332-26 x 2

11. A surgical specimen was removed from the proximal jejunum during a resection for
adenocarcinoma and was submitted to surgical pathology for gross and microscopic examination.
The correct code for this service is:
A. 88307
B. 88309
C. 88304
D. 88305

12. The physician performs the following tests on her automated equipment: HDL, total serum
cholesterol, triglycerides, and a quantitative glucose. The correct codes for these procedures are:
A. 83718, 82465, 84478, 82947
B. 83721, 82465, 82951
C. 80061, 82947
D. 80061, 82950

13. A patient with a manic-depressive disorder is being treated with lithium. The physician
orders a therapeutic drug test to measure the level of lithium. What is the correct code?
A. 80178
B. 80375
C. 80302
D. 80299

14. A patient presents to the ED with crushing chest pain radiating down the left arm and up
under the chin. There are elevated S-T segments on EKG. The cardiologist sees and admits the
patient to CCU. He orders three serial CPK enzymes levels with instructions that the tests are
also to be done with isoenzymes if the initial tests are elevated for that date of service. The CPK
enzyme levels were elevated, the lab codes would be:
A.82550, 82552, 82550-76 ,82552-76 x 2
B. 82550, 82552, 82552-91 x 2
C. 82550, 82550-91 x 2, 82552, 82552-91 x 2
D. 82550 x 3, 82554 x 3

15. 22-year-old has had no prenatal care. Fundal height indicates a term fetus and by dates it is
determined she is 38 weeks pregnant. Few hours prior to admission to Labor and Delivery her
membranes ruptured spontaneously. She does not have fever, but the physician performs a rapid
antigen test for group B strep. An enzyme immunoassay method is performed. Physician obtains
a lower vaginal swab, then S shows the patient is negative for the antigen. If clinical risk factors
appear, intrapartum antibiotics will be initiated. Which lab test is reported?
A. 87802
B. 87653
C. 86317
D. 87450

16. The patient presents with burning urination and frequency. The physician performs a UA
dipstick, which shows elevated WBC. He orders a urine culture with identification for each
isolate to determine which antibiotic to give to the patient for the infection. What are the
appropriate lab codes?
A. 81000, 81007
B. 81002, 87088
C. 81001, 87086
D. 87086, 87088

17. Which of the following coding combinations is an example of unbundling?

A. 80048, 80061
B. 80076, 80300
C. 80061, 83718, 84478
D. 82310, 82355, 82374
18. Patient is undergoing in vitro fertilization to get pregnant. Following the retrieval of
follicular fluid from the patient, the physician uses a microscope to examine the fluid to identify
the oocytes. What is the code for the laboratory service?
A. 89250
B. 89254
C. 89255
D. 89258

19. A pathologist performs a comprehensive consultation and report after reviewing a patient’s
records, specimens, and official findings from other sources. What is the correct code?
A. 88325
B. 99244
C. 80502
D. 88329

20. A rare infection is suspected in the blood stream of an immigrant from Southeast Asia. Flow
cytometry is used to isolate and quantitate this mononuclear cell antigen. There is not a specified
immunological study for this antigen. How should the test be coded?
A. 88182
B. 86356
C. 88187
D. 88185

21. Thomas has end stage renal failure and comes to the clinic lab today for his monthly
urinalysis (qualitative, microscopic only).
a. 81015, N19 b. 81001, N17.9
c. 81015, N18.6 d. 81003, N18.6

22. This 34-year-old female had been suffering from chronic fatigue. Her physician has ordered a
TSH test.
a. 80418, R53.81
b. 80438, R53.82
c. 84146, R53.81
d. 84443, R53.82

23. The 62-year-old female who suffers from treatment-resistant schizophrenia comes into the
lab today to have a quantitative drug assay performed for the anti-psychotic medication
clozapine, a regular white blood cell and absolute neutrophil count due to concern with
agranulocytosis.
a. 80159
b. 80159, 85048
c. 80159, 85048, 85004
d. 80159, 85025
24. The 67-year-old female suffers from Chronic liver disease and needs a hepatic function panel
performed every six months. Tests include total bilirubin (82274), direct bilirubin (82248), total
protein (84155), alanin aminotransferases (ALT and SGPT) (84460), aspartate aminotransferases
(AST and SGOT) (84450) and what other lab tests?
a. 82040, 84075
b. 80061, 83718
c. 82040, 82247
d. 84295, 84450

25. The patient presented to the laboratory at the clinic for the following blood tests ordered by
her physician: albumin (serum), bilirubin (total), and Urea nitrogen (BUN) (quantitative)
a. 82044, 82248, 84520
b. 82040, 82252, 84525
c. 82040, 82247, 84520
d. 82044, 82247, 84540

26. This male is status post kidney transplant and comes into the clinic for a follow up creatinine
clearance.
a. 82540, Z94.0
b. 82575, Z94.0
c. 82565, N19
d. 82570, N18.6
27. A 24 year old runner presents to the emergency room with dizziness, malaise and fatigue.
The ER physician performs a history, a physical examination and orders carbon dioxide,
chloride, potassium, sodium and glucose tests from the hospital laboratory to check for
dehydration and/or hypoglycemia. The blood draw is performed by the hospital lab technician
and the glucose test is performed by reagent strip. Select the appropriate codes for this ER visit.
a. 80048, 36410
b. 80051, 36416
c. 82374, 82435, 84132, 84295, 82947, 36415
d. 80051, 82948

28. A urine pregnancy test is performed by the office staff using a qualitative visual color
comparison test. What is the proper code selection for this service?
a. 84703
b. 84702
c. 81025
d. 81025, 36415

29. The physician assistant performs a glucose screening by Dextrostix method (reagent strip)
using capillary blood. Code for all the components.
a. 82947, 36415
b. 82948
c. 82948, 36416
d. 99211
30. The Pathologist, who works in the hospital’s blood bank, is requested to review, evaluate
and provide a written report on data that indicates detection of a possible irregular blood
grouping antibody. Which code reports the Pathology service?
a. 86077
b. 80500
c. 88300
d. 86870