Test Your HCPCS Codes Knowledge

Multiple Choice


What route is Blenoxane administered?

a. IM, IV, SC

b. IM, SC

c. IV, IM

d. INH, IM, SC


Physician prescribes a wheelchair accesory (E2373) for a patient.  Patient orders this accessory from a DME supplier that is not approved by Medicare.  How will this be paid?

a. DME supplier will bill Medicare and paid because the patient has a prescription written by the provider and Medicare cannot deny services due to prescription and DME supplier will be paid but at a lower rate than a participating DME provider.

b. Patient will be responsible for payment because the DME supplier is not approved by Medicare

c. DME will bill Medicare because the patient has a prescription written by provider. Medicare will pay the patient and not the DME supplier because they are non-participating.

d. There are no Medicare or DME guidelines for wheelchair accessories because of Medical Necessity for these types of products.


What is the correct HCPCS code for an external urinary pouch collection device for a 68 year-old female?

a. A4326

b. A4349

c. A4327

d. None of the above


Which answer is TRUE for the difference between HCPCS code G0402 and G0438?

a. G0402 is a annual wellness examination and a benefit to a new Medicare beneficiary within the first 6 months of enrollment. G0438 is used thereafter for Medicare beneficiary annual wellness physical examination.

b. G0402 is a preventive physical examination and benefit to a new Medicare beneficiary within the first 12 months of Medicare enrollment. G0438 can only be used with those Medicare patients enrolled in Medicare Part C.

c. G0402 is a preventive physical examination and benefit to a new Medicare beneficiary within the first 12 months of Medicare enrollment. G0438 is a annual wellness visit only and does not include a physical examination.

d. G0402, G0438 are both annual physician examinations. G0402 is used for the Medicare beneficiary during the first 12 months of Medicare enrollment. G0438 is an annual physical and examination used yearly after the Initial Preventive Exam of G0402.


This Medicare patient needs a foot arch support for his flat foot. Is this covered by Medicare?

a. No flat foot is not covered unless it is documented that it is a routine procedure by a podiatrist

b. No, flat foot is not covered for correction of any condition

c. Yes if medical record indicates the patient has diabetes

d. Yes if performed by a podiatrist or other qualified heathcare individual


Doctor documents a CTLSO is needed for this patient. What does this acronym stand for?

a. Completed treatment for long-term skilled nursing patient

b. Computed tomography for lumbar sacral orthopedics procedure

c. Cervical-thoracic-lumbar-sacral orthosis

d. Chronic thoracic-lumbar-spinal correction


What is required by Medicare for a supplier to enroll in the Medicare program for reimbursement as a DMEPOS supplier?

a. Obtain DMEPOS accreditation from a CMS-approved organization

b. Enroll in Medicare program as DME supplier, post a surety bond to the National Supplier Clearinghouse

c. Enroll as a Medicare Provider under PECOS, obtain NPI number and apply for EHR incentive program if eligible

d. Answers b and c


Which answer is TRUE for use of HCPCS Modifier PC?

a. Append this modifier to a code for services related to an emergency or disaster related condition

b. Append this modifier so the insurer including Medicare knows not to reimburse provider due to an event of wrong surgery or other invasive procedure performed on a patient.

c. Append this modifier for recording and storage of the voice data by digital recorder in solid state memory.

d. Append this modifier when the supplier delivers the same DMEPOS item in multiple competitive bidding product categories for standard product category


Patient is renting a portable oxygen concentrator. The DME supplier is submitting the claim for the second month of rental. Which answer is the correct code(s) for billing of this DMEPOS item?

a. E1392-KH

b. E1392-KI

c. E1392-RR

d. This is not a billable DME item


What is the BETOS system developed for HCPCS codes?

a. This systems was developed by OIG for analyzing fraud for DME products

b. This system was developed for analyzing the growth in Medicare expenditures

c. This system was developed for analyzing Medicaid patients using DME products

d. This system was developed by Social Security Act 1834 (a) (17) for tracking unsolicited telephone calls to beneficiaries or non-covered DME supplies


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