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Free CIRCC Practice Questions

10 free, exam-style IR Cardiovascular Coder (CIRCC) practice questions with answers and explanations. No signup required. Work through them below, then take the full free CIRCC practice test to study every exam domain.

Question 1

From a right common femoral artery puncture, the catheter is advanced into the abdominal aorta, then selectively into the celiac trunk, then into the common hepatic artery, and finally into the proper hepatic artery, where hepatic arteriography is performed. All vessels are in one vascular family. For the catheter placement, the coder should report:

  1. Three separate selective placement codes, one each for the celiac trunk, the common hepatic, and the proper hepatic artery
  2. A non-selective aortic placement plus a first-order selective placement for the celiac trunk that was entered first
  3. A single selective placement coded to the highest order reached within that family
  4. A first-order selective placement, because the celiac trunk was the initial branch entered off the aorta
Show answer & explanation

Correct answer: C - A single selective placement coded to the highest order reached within that family

Question 2

A patient with a fully documented, recently imaged renal artery stenosis returns for a planned angioplasty. At the start of the case, the physician performs imaging that simply confirms the known lesion before treating it. How should this same-session imaging be handled?

  1. Report a separate diagnostic angiogram and append modifier 26 to show the professional component
  2. Report a separate diagnostic angiogram and append modifier 59 to show a distinct procedural service
  3. Report a new first-order selective catheter placement to account for the confirmatory imaging
  4. Do not separately report it, because it is bundled into the planned intervention as roadmap imaging
Show answer & explanation

Correct answer: D - Do not separately report it, because it is bundled into the planned intervention as roadmap imaging

Question 3

A diagnostic peripheral angiogram is performed at a hospital that owns the imaging equipment. The interventional radiologist personally performs and interprets the study but does not own the equipment. Which modifier is appended to the radiological supervision and interpretation (S&I) code?

  1. Modifier 26, to report the physician's professional interpretation when the facility owns the equipment
  2. Modifier TC, because the technical resources and equipment used to perform the imaging belong to the hospital facility
  3. Modifier 52, because the supervision and interpretation service provided was partial and reduced
  4. Modifier 59, to identify the supervision and interpretation as a distinct and separate service
Show answer & explanation

Correct answer: A - Modifier 26, to report the physician's professional interpretation when the facility owns the equipment

Question 4

In a single femoropopliteal vessel territory, the physician performs balloon angioplasty and then deploys a stent across the same lesion. Using the lower-extremity endovascular revascularization codes, how many revascularization codes are reported for this territory?

  1. Two codes - one for the balloon angioplasty and a second for the stent placement in that territory
  2. One code - the stent placement code, which already includes the angioplasty performed in that territory
  3. One angioplasty code, with the stent placement reported as a separate procedure under modifier 59 as distinct
  4. Three codes - the angioplasty, the stent, and the selective catheterization needed to reach the lesion
Show answer & explanation

Correct answer: B - One code - the stent placement code, which already includes the angioplasty performed in that territory

Question 5

Four interventions are documented. Which one is reported using the embolization code group intended for hemorrhage, lymphatic, vascular malformation, and active bleeding?

  1. Embolization of esophageal varices
  2. Embolization of a hepatic tumor to induce ischemia
  3. Embolization of an arteriovenous malformation
  4. Embolization of a splenic artery for hypersplenism
Show answer & explanation

Correct answer: C - Embolization of an arteriovenous malformation

Question 6

A percutaneous vertebral augmentation is performed at L1 and L2. The physician injects bone cement into each vertebral body without using a balloon or other cavity-creation device. How is this most appropriately reported?

  1. A single kyphoplasty base code reported once to cover the augmentation at both L1 and L2
  2. Two separate vertebroplasty base codes, reporting one full base code for each individual level
  3. One vertebroplasty base code for L1, plus the appropriate add-on code for the additional level L2
  4. One vertebroplasty base code with modifier 50 appended to account for the treatment of the second level
Show answer & explanation

Correct answer: C - One vertebroplasty base code for L1, plus the appropriate add-on code for the additional level L2

Question 7

A combined right and left heart catheterization with coronary angiography is performed and fully documented. A coder trained on older interventional radiology rules wants to add a separate radiological supervision and interpretation (S&I) code for the imaging. Under the current cardiac catheterization code structure, this is:

  1. Correct, because under component coding the catheter placement and the imaging S&I are always reported as two separate codes
  2. Correct, but only when modifier 26 is appended to the separate S&I code to show the professional interpretation component
  3. Correct, but only when the hospital rather than the physician owns and operates the cardiac imaging equipment used
  4. Incorrect, because the current combined cardiac catheterization codes already include the catheter, imaging, and report
Show answer & explanation

Correct answer: D - Incorrect, because the current combined cardiac catheterization codes already include the catheter, imaging, and report

Question 8

During a percutaneous coronary intervention, a stent is placed in the left anterior descending (LAD) artery, and balloon angioplasty is performed in a diagonal branch of the LAD. How is this reported?

  1. Two separate PCI base codes, reporting one base code for the LAD and one for the diagonal branch
  2. A single PCI stent base code only, treating the diagonal branch work as not separately reportable
  3. A PCI stent base code for the LAD, plus a PCI add-on code for the branch intervention performed
  4. Two PCI add-on codes, on the basis that both target sites lie within the same coronary arterial system
Show answer & explanation

Correct answer: C - A PCI stent base code for the LAD, plus a PCI add-on code for the branch intervention performed

Question 9

A coder is selecting a central venous access device code for a non-tunneled catheter inserted directly into the internal jugular vein of a 45-year-old patient. Which set of factors must the coder confirm to choose the correct code?

  1. Whether the catheter is tunneled or non-tunneled, whether it is centrally or peripherally inserted, and the patient's age
  2. The volume of contrast injected, the angle of venous access used, and the manufacturer of the catheter device
  3. The patient's primary diagnosis as it would be assigned and reported in the ICD-10-CM code set for the entire encounter
  4. The number of physicians present during insertion and the documented start and stop time of the procedure
Show answer & explanation

Correct answer: A - Whether the catheter is tunneled or non-tunneled, whether it is centrally or peripherally inserted, and the patient's age

Question 10

During a selective catheterization, the operative note states the catheter was advanced from the abdominal aorta into the celiac trunk and then into the splenic artery, where imaging was performed. For order-of-selectivity coding, the splenic artery is classified as a:

  1. First-order vessel, because it supplies a major abdominal organ
  2. Non-selective placement, because the catheter began in the aorta
  3. Third-order vessel, because three vessels were named in the path
  4. Second-order vessel, because it branches off the celiac trunk
Show answer & explanation

Correct answer: D - Second-order vessel, because it branches off the celiac trunk

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