After you submit, every question opens like this — correct answer, why it's right, and the Navigator note that shows where it lives in the book.
Question 27 — Worked in fullEvaluation & Management
For office or other outpatient E/M services (codes 99202-99215), the level of service may be selected based on either the total time on the date of the encounter or which other element?
A)The number of body systems examined only
B)The patient's age
C)The level of medical decision making (MDM) ✓
D)The number of prescriptions written only
Why it's correct: Since the 2021 revisions, office/outpatient E/M level selection is based on either the level of medical decision making (problems addressed, data reviewed, and risk) or total time on the date of the encounter. History and exam are still performed and documented as medically appropriate but no longer drive the level. This framework is heavily tested.
Navigator — how to find it in the book: CPT: Evaluation and Management Guidelines, the office/outpatient subsection and the MDM table (Number/Complexity of Problems, Amount/Complexity of Data, Risk) used to assign 99202-99215.
Question 37 — Worked in fullRadiology
A radiologic procedure description includes a 'professional component' and a 'technical component.' When a radiologist interprets a film owned and operated by a hospital, the radiologist typically reports the service with which modifier?
A)Modifier 26 for the professional component ✓
B)Modifier TC for the technical component
C)Modifier 50 for bilateral
D)Modifier 76 for a repeat procedure
Why it's correct: Modifier 26 identifies the professional component (the physician's interpretation and report) when the technical component (equipment, supplies, technologist) is provided and billed by the facility. Modifier TC reports the technical component alone. When one entity performs both, a global service is reported with no split modifier.
Navigator — how to find it in the book: CPT: Appendix A (Modifiers) for modifier 26 and modifier TC (HCPCS); the Radiology Guidelines explain the professional/technical split and 'separate procedure' conventions.
Question 91 — Worked in fullCase Coding
A 58-year-old established patient presents to dermatology for a 1.2 cm pigmented lesion on the left forearm that has changed in appearance. The physician performs an excision; the lesion plus a 0.3 cm margin on each side is removed, and the wound is closed with a simple single-layer suture. Pathology later returns the lesion as malignant melanoma. How should the coder approach final code assignment?
A)Code from the benign-lesion excision range because the lesion looked benign at the time of surgery
B)Bundle the closure and code only a biopsy
C)Code the excision from the malignant-lesion excision range using the excised diameter (lesion + margins = 1.8 cm) for the forearm; the simple closure is included in the excision and is not reported separately; and assign the malignant melanoma ICD-10-CM code once pathology confirms it ✓
D)Wait and code nothing because the diagnosis was uncertain at the time of service
Why it's correct: Lesion excision is coded by behavior (use the malignant range once pathology confirms melanoma), and the excised diameter is the lesion plus the narrowest margins (1.2 + 0.3 + 0.3 = 1.8 cm). A simple closure is included in the excision code and is not reported separately; only intermediate or complex repairs would be reported in addition. The diagnosis follows the confirmed pathology.
Navigator — how to find it in the book: CPT: Integumentary 'Excision—Malignant Lesions' (11600 series) + 'Repair (Closure)' simple-repair rules; ICD-10-CM Index: [Melanoma] → confirm site (skin of forearm) in the Tabular and the Table of Neoplasms (Malignant Primary).