Certified Professional Coder (CPC) Practice Test

What CPT and ICD-9-CM codes would be assigned for a patient with dementia requiring a skilled nursing facility admission?

1. 99305, 290.0

2. 99255

3. 99396

4. 69436-50

The correct answer is: 99305, 290.0

The assignment of CPT and ICD-9-CM codes for a patient with dementia requiring admission to a skilled nursing facility is vital for accurately representing the patient's condition and the level of care needed. The correct choice is justified by the specific codes provided. The CPT code 99305 is designated for the initial comprehensive assessment of a patient admitted to a skilled nursing facility, fitting perfectly for a scenario involving a patient with dementia who requires skilled nursing. This code reflects the services medically necessary for evaluating and managing the patient's cognitive impairment and associated healthcare needs. The ICD-9-CM code 290.0 corresponds to "Senile dementia, uncomplicated," which is the appropriate diagnostic code to describe dementia in this context. Accurate coding of the patient's diagnosis is crucial for proper documentation and reimbursement, as it signifies the medical condition being treated. Together, these codes embody both the clinical scenario of skilled nursing facility admission due to dementia and serve to indicate the complexity of care required by the patient. The other options provided do not fit this specific patient scenario regarding either the care level needed (as in the case of the evaluation codes or other unrelated procedures) or the diagnostic context related to dementia.