AAPC Certified Professional Coder (CPC) — All Questions
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When may an organ- or disease-oriented laboratory panel (for example, a basic metabolic panel) be reported with its panel code?
- a.When at least one component test in the panel is performed
- b.Only when every component test listed in that panel is performed✓
- c.Whenever the physician orders it by name, regardless of which tests are run
- d.When any two of the component tests are performed
Panels are all-or-nothing: the panel code may be reported only if ALL of its defined component tests are performed. If only some components are done, you report the individual test codes instead. Reporting a panel when a component was not performed is unbundling in reverse and is inaccurate coding.
A pathologist performs the microscopic examination of a surgical specimen and renders the diagnosis in a written report. This physician work represents which component of the service?
- a.The technical component
- b.The professional component✓
- c.The global service, which cannot be split
- d.A service that is never separately reportable
Surgical pathology, like radiology, can split into technical (specimen accessioning, tissue processing, slide preparation) and professional (the pathologist's microscopic interpretation and diagnostic report) components. The pathologist's interpretive work is the professional component, reported with modifier -26 when the lab bills the technical portion separately.
A clinician orders serial potassium levels drawn several hours apart on the same date to monitor a patient. Which modifier is appended to the repeat laboratory tests?
- a.Modifier -91 (repeat clinical diagnostic laboratory test)✓
- b.Modifier -76 (repeat procedure by the same physician)
- c.Modifier -59 (distinct procedural service)
- d.Modifier -26 (professional component)
Modifier -91 is specific to laboratory tests intentionally repeated on the same day to obtain successive (serial) results — a medically necessary trend, not a re-run of a bad specimen. -76 applies to repeated procedures/services (e.g., imaging), not to clinical lab. Using -91 correctly distinguishes legitimate serial testing from duplicate billing.