Medical coding sample Question and Answers Part 6 2026

Question 1
Which of the following statements is correct regarding the reporting of a telemedicine service that occurs on the same day as an in-person E/M service?
A. The telemedicine service should always be reported separately with its own E/M code.
B. The telemedicine service must be combined with the in-person E/M service, and the total time or MDM-related activities should be aggregated under the in-person E/M code.
C. The provider should bill both services separately without adjusting the documentation.
D. The telemedicine service should only be reported if it was the longer of the two encounters.
Rationale:
When a telemedicine service occurs on the same day as an in-person evaluation and management (E/M) visit, American Medical Association guidelines state that the time and elements from both encounters should be aggregated and reported under the in-person E/M code to prevent duplicate billing and ensure accurate reporting. Reporting them separately is not permitted unless payer-specific exceptions exist.

Question 2
A surgeon performs an excision of a malignant skin lesion on the left arm and also takes a biopsy from a separate benign lesion on the right arm during the same surgical session. Which modifier(s) should be appended to the biopsy code to indicate it was a distinct procedure from the excision?
A. 25
B. 59 or XU
C. LT or RT
D. 51
Rationale:
Modifier 59 (or its subset modifier XU) indicates that the biopsy of the separate lesion on the right arm is a distinct procedure, separate from the excision of the malignant lesion on the left arm. This ensures proper reimbursement for both services, as they are not part of the same anatomical site or procedure.

Question 3
What is the ICD-10-CM code for Peyronie’s disease?
A. N48.6
B. Q55.61
C. Z87.438
D. N48.4

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Question 4
Which of the following biopsy types involves obtaining a cylindrical full-thickness sample of tissue?
A. Brush biopsy
B. Fine-needle aspiration biopsy
C. Punch biopsy
D. Shave biopsy
Rationale:
A punch biopsy is performed using a circular punch tool, which removes a cylindrical section of tissue, often including deeper layers of the skin.

Question 5
According to AMA guidelines, how should a provider report a telemedicine service if an audio-video connection is lost and only audio communication remains available?
A. The service should be coded as an in-person visit since video was originally intended.
B. The provider should report the service that accounted for the majority of the interactive portion of the visit.
C. The visit should not be billed since it no longer meets the telemedicine criteria.
D. The provider should automatically bill for an audio-only visit regardless of how much time was spent on video.
Rationale:
American Medical Association (AMA) guidelines clarify that if an audio-video connection is lost, the provider should report the service based on the mode of communication used for the majority of the visit.

Question 6
When a physician performs a biopsy and excision on the same lesion during the same procedure, how should these services be billed?
A. Bill both procedures separately with modifier 59.
B. Bill only for the biopsy procedure.
C. Bill only for the excision procedure.
D. Bill both procedures with modifier XU.
Rationale:
When a biopsy is performed as part of an excision, the biopsy is considered inherent to the excision procedure and is not separately reportable.