Certified Professional Coder (CPC) Quiz: Apply Radiology Supervision Rules
20 questions · exam conditions
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Apply Radiology Supervision RulesQuestion 1 of 20

A radiologist performs fluoroscopic guidance for a nephrostomy catheter placement. In this scenario, who reports the fluoroscopic guidance code?

The urologist who placed the catheter
Either provider may report it, based on who did more work
The facility reports it as part of the global service
The radiologist who provided fluoroscopic supervision
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Certified Professional Coder (CPC) Quiz

Certified Professional Coder (CPC) Quiz: Apply Radiology Supervision Rules

Practice Apply Radiology Supervision Rules in Certified Professional Coder (CPC) with focused quiz questions that help you check what you know, review explanations, and build confidence with test-style prompts.

What this quiz covers

This quiz focuses on Apply Radiology Supervision Rules, giving you a quick way to practice the rules, question types, and explanations that matter most for Certified Professional Coder (CPC).

How to use this quiz

Try each quiz question before looking at the correct answer. Use the explanations to review missed ideas, then come back to similar questions until the pattern feels familiar.

All questions

Question 1

A radiologist performs fluoroscopic guidance for a nephrostomy catheter placement. In this scenario, who reports the fluoroscopic guidance code?

  1. The urologist who placed the catheter
  2. Either provider may report it, based on who did more work
  3. The facility reports it as part of the global service
  4. The radiologist who provided fluoroscopic supervision (correct answer)
Explanation: The radiologist who provides fluoroscopic guidance and documents the supervision and interpretation reports the S&I code. CPT® 74425 covers urinary tract, introduction of contrast material for retrograde ureteropyelography; for nephrostomy tube placement guidance, 74485 (or 77002 for fluoroscopic guidance) is used. The procedural code (nephrostomy placement) is reported by the interventionalist. S&I codes belong to the supervising/interpreting radiologist.

Question 2

A physician performs image-guided tumor ablation of a renal mass using CT guidance. How is the CT guidance reported relative to the ablation procedure?

  1. CT guidance is always bundled into ablation procedure codes
  2. The ablation code automatically includes all imaging guidance
  3. CT guidance is only reported when the ablation is unsuccessful
  4. CT guidance (77013) is reported separately from the ablation procedure code (correct answer)
Explanation: CPT® 77013 covers CT guidance for parenchymal tissue ablation and is reported in addition to the ablation procedure code. Unlike fluoroscopic guidance for vascular interventions (which is often bundled), CT guidance for ablation procedures is separately reportable. Both the ablation code and 77013 are reported to fully capture the service provided.

Question 3

A radiologist supervises and interprets a fluoroscopic guidance procedure for a central venous catheter placement performed by a surgeon. The radiologist provides only the supervision and interpretation. Which modifier does the radiologist append to the imaging guidance code?

  1. -26 (correct answer)
  2. -TC
  3. -52
  4. -59
Explanation: Modifier -26 (Professional Component) is appended by the radiologist when providing only the supervision and interpretation of an imaging guidance procedure. The technical component (equipment operation, staffing) is performed by the facility or another entity. When a radiologist interprets imaging without owning the equipment, -26 is required to identify the professional component only.

Question 4

A physician uses ultrasound guidance for a central venous catheter placement and documents the imaging in the medical record, including a permanent record of the image. Which CPT® code covers ultrasound guidance for vascular access procedures?

  1. 76937 (correct answer)
  2. 76942
  3. 77002
  4. 77021
Explanation: CPT® 76937 covers ultrasound guidance for vascular access, including documentation of final catheter position using permanent recording of the image. This is the correct code for ultrasound-guided vascular access procedures (e.g., CVC placement). Code 76942 covers ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection); 77002 is fluoroscopic guidance for needle placement.

Question 5

A radiologist interprets a fluoroscopic upper GI series performed by a radiologic technologist. The radiologist provides the interpretation and written report but did not operate the fluoroscope. How is the radiologist's service reported?

  1. With modifier -TC since the radiologist supervised technically
  2. As the global code since the radiologist directed the study
  3. With modifier -26 for the professional (interpretation) component only (correct answer)
  4. With modifier -52 for reduced service
Explanation: The radiologist who interprets and reports a study without performing the technical component reports the code with modifier -26 (professional component). The facility reports the technical component (-TC). This applies to all radiological procedures where the professional and technical components are split between providers or entities. The radiologist's modifier -26 reflects the interpretation and report only.

Question 6

A vascular surgeon performs a percutaneous transluminal angioplasty of the right iliac artery under fluoroscopic guidance. In addition to the interventional procedure code, how is the fluoroscopic guidance component reported?

  1. It is always separately reportable with 77001
  2. It is reported with modifier -59 to identify it as separate
  3. It is bundled into the angioplasty code per CPT® guidelines for interventional vascular procedures (correct answer)
  4. It is reported only when the procedure exceeds 30 minutes
Explanation: For interventional vascular procedures such as angioplasty, fluoroscopic guidance (including road-mapping and image documentation) is considered integral to the procedure and is bundled into the primary intervention code. The CPT® code for peripheral transluminal angioplasty (e.g., 35473) includes the imaging guidance as a component. Reporting fluoroscopic guidance separately constitutes unbundling for these specific procedures.

Question 7

A radiologist performs a limited abdominal ultrasound because the patient could not tolerate a full examination, evaluating only the gallbladder and common bile duct. Which CPT® code is appropriate?

  1. 76700
  2. 76770
  3. 76775
  4. 76705 (correct answer)
Explanation: CPT® 76705 covers a limited abdominal ultrasound — a single organ or quadrant, or follow-up study, when not all elements of a complete study are performed or documented. When clinical circumstances or patient tolerance prevent a complete evaluation, the limited code (76705) must be reported. Reporting the complete code (76700) when not all required elements were evaluated would constitute overcoding.

Question 8

A radiologist reads a portable chest X-ray performed in the ICU by a technologist employed by the hospital. The radiologist bills for the interpretation only. Which modifier is required?

  1. -TC
  2. -26 (correct answer)
  3. -32
  4. -52
Explanation: When a radiologist provides only the interpretation and report of an imaging study and does not own the equipment or perform the technical component, modifier -26 (professional component) is appended to the X-ray code. The hospital bills -TC for the equipment and technologist component. For portable studies performed in the ICU, the technical component belongs to the facility and the professional component to the interpreting radiologist.

Question 9

A catheter is placed into the right common carotid artery. The radiologist then performs angiography of the right carotid artery and right vertebral artery from the same catheter position. How are the S&I codes reported?

  1. One S&I code for the entire study since the catheter was not repositioned
  2. Two separate S&I codes — one for the carotid and one for the vertebral — as each vessel studied is separately coded (correct answer)
  3. Three codes — one for catheter placement, one for carotid, and one for vertebral S&I
  4. One S&I code with modifier -22 for the additional vessel studied
Explanation: Radiology S&I codes for angiography are reported per vessel studied, not per catheter position. Each distinct vessel that is selectively catheterized or studied is separately reported with its own S&I code. The carotid angiography and vertebral angiography are different vessels requiring separate S&I codes, even if the catheter was not repositioned between studies. This reflects the separate radiological interpretation required for each vessel.

Question 10

A CT scan of the chest is performed with contrast material. The radiologist notes that the study was done "with and without contrast" in the impression. However, the order only specified "with contrast." Which code is reported?

  1. Report the "with and without" code because the radiologist documented both
  2. Report the "with contrast only" code based on what was ordered and performed (correct answer)
  3. Report both the "without" and "with contrast" codes to reflect full documentation
  4. Report the "without contrast" code as the default
Explanation: The procedure code must reflect what was actually performed and documented, based on the order and the imaging protocol used. If the study was ordered and performed with contrast only, the "with contrast" code is reported — not the "with and without" code. The radiologist's impression should be verified against the imaging protocol. Reporting a higher-level code without clinical support constitutes upcoding.

Question 11

A radiologist performs a diagnostic lower extremity venous duplex ultrasound of both legs to evaluate for deep vein thrombosis. Which CPT® code covers bilateral lower extremity venous duplex ultrasound?

  1. 93970 (correct answer)
  2. 93971
  3. 93971-50
  4. 93925
Explanation: CPT® 93970 covers duplex scan of extremity veins, bilateral. Code 93971 covers unilateral extremity venous duplex scan. When both legs are studied, 93970 (bilateral) is the correct code — not 93971-50. The bilateral code already includes both sides, so modifier -50 would not be applied. Reporting 93971-50 instead of 93970 would be incorrect use of the bilateral modifier when a specific bilateral code exists.

Question 12

A MRI of the brain is ordered with and without contrast. The technologist performs the MRI; the radiologist interprets it. Which CPT® code represents the MRI brain with and without contrast (global study)?

  1. 70551
  2. 70552
  3. 70553 (correct answer)
  4. 70554
Explanation: CPT® 70553 covers MRI of the brain with and without contrast material. Code 70551 is MRI brain without contrast; 70552 is with contrast only; 70553 is with and without contrast. When both pre- and post-contrast sequences are performed, the "with and without" code (70553) is reported — not 70551 and 70552 together. Reporting both pre- and post-contrast studies as separate codes constitutes unbundling when a combination code exists.

Question 13

A radiologist reviews and interprets a series of outside imaging studies (from another facility) at the request of a treating physician, without performing any new imaging. Which CPT® code covers the radiology consultation (interpretation of outside imaging)?

  1. 70553-26
  2. 76140 (correct answer)
  3. 77067-26
  4. 99242
Explanation: CPT® 76140 covers consultation on X-ray examination made elsewhere — the interpretation by a physician of radiological images originally performed at another facility. The radiologist reviews the outside studies and provides a written consultation report. This is distinct from repeating the imaging or from a clinical consultation. Code 76140 specifically captures the review and interpretation of outside imaging without new image acquisition.

Question 14

A radiologist interprets a complete abdominal ultrasound and documents evaluation of the liver, gallbladder, common bile duct, pancreas, spleen, kidneys, and aorta. Which CPT® code covers a complete abdominal ultrasound?

  1. 76700 (correct answer)
  2. 76705
  3. 76770
  4. 76775
Explanation: CPT® 76700 covers ultrasound, abdominal, real time with image documentation, complete — which includes evaluation of the liver, gallbladder, common bile duct, pancreas, spleen, kidneys, upper abdominal aorta, and inferior vena cava. Code 76705 is a limited abdominal ultrasound. Code 76770 is a complete retroperitoneal ultrasound; 76775 is a limited retroperitoneal. Documenting all required elements is necessary to report the complete study code.

Question 15

A radiologist performs a diagnostic aortogram and bilateral iliofemoral runoff angiogram during the same session. The study includes a complete evaluation of the abdominal aorta and bilateral lower extremity vessels. Which CPT® code covers the supervision and interpretation of this complete abdominal aortogram?

  1. 75600
  2. 75625
  3. 75630 (correct answer)
  4. 75710
Explanation: CPT® 75630 covers aortography, abdominal plus bilateral iliofemoral lower extremity, with serialography — the comprehensive code for an aortogram that includes bilateral runoff. Code 75625 covers abdominal aortography alone, without the bilateral lower extremity component. Code 75600 covers thoracic aortography; 75710 covers angiography of an extremity vessel. When the study includes both the abdominal aorta and bilateral iliofemoral runoff, 75630 is the correct and only code needed.

Question 16

A radiologist performs a diagnostic arthrogram of the left shoulder by injecting contrast under fluoroscopic guidance and then interprets the fluoroscopic images. How many CPT® codes are reported for this service?

  1. One code captures the entire arthrogram service
  2. Three codes — injection, fluoroscopic guidance, and interpretation
  3. Two codes — one for the injection procedure and one for the radiological supervision and interpretation (correct answer)
  4. The arthrogram is captured by the MRI arthrogram code when contrast is used
Explanation: A shoulder arthrogram requires two codes: the injection procedure code (e.g., 23350 for the shoulder joint injection with arthrographic contrast) and the radiological S&I code (e.g., 73040 for radiological examination, shoulder, arthrography, radiological supervision and interpretation). The injection and the imaging interpretation are separately coded components of the arthrogram service.

Question 17

A radiologist performs the radiological supervision and interpretation for a percutaneous transluminal coronary angioplasty (PTCA). The interventional cardiologist performs the catheterization and the angioplasty. Which statement correctly describes the S&I coding in this scenario?

  1. The cardiologist reports the S&I codes since they performed the procedure
  2. The radiologist reports the S&I codes separately; the cardiologist reports the interventional procedure codes
  3. Both providers report the S&I codes with different modifiers
  4. No S&I code is reported for PTCA — imaging is bundled into the cardiac intervention codes (correct answer)
Explanation: Coronary intervention codes (e.g., 92920–92944 for PTCA, stenting) are cardiac catheterization-based codes that include the imaging and guidance components. Unlike peripheral vascular interventions that use separate S&I codes from the 75000 series, coronary intervention codes include the angiographic guidance as an integral component. Separate S&I codes are not reported for coronary interventions.

Question 18

A radiologist performs radiological supervision and interpretation for a diagnostic carotid artery angiogram following catheter placement by a surgeon. The surgeon reports the catheter placement code. Which CPT® code range covers carotid angiography supervision and interpretation?

  1. 75600–75630
  2. 75716–75774
  3. 75650–75680 (correct answer)
  4. 75801–75807
Explanation: CPT® codes 75650–75680 cover extracranial cerebrovascular angiography supervision and interpretation, including carotid and vertebral arteries. Code 75650 covers cervicocerebral (carotid/vertebral) angiography S&I, including any follow-up angiography; 75671 covers bilateral carotid angiography. These S&I codes are reported by the radiologist separately from the catheter placement codes reported by the interventionalist.

Question 19

A physician performs a breast needle localization under stereotactic guidance before surgical excision of a breast lesion. Which CPT® code covers stereotactic guidance for needle placement in the breast?

  1. 19281
  2. 19283 (correct answer)
  3. 19285
  4. 77031
Explanation: CPT® 19283 covers placement of breast localization device(s), stereotactic guidance, first lesion. This current localization code includes both the procedure and the imaging guidance — a separate stereotactic guidance code is not additionally reported when 19283 is used. Code 19281 uses mammographic guidance; 19285 uses ultrasound guidance. Code 77031 is a standalone stereotactic localization code that predates the current localization device code family and is not separately reported alongside 19281–19285.

Question 20

A radiologist provides fluoroscopic supervision and interpretation for needle placement during a percutaneous bone biopsy. Which CPT® code covers fluoroscopic guidance for needle placement?

  1. 77001
  2. 77002 (correct answer)
  3. 77003
  4. 77012
Explanation: CPT® 77002 covers fluoroscopic guidance for needle placement procedures, including biopsy, aspiration, injection, and localization device placement. When a radiologist provides real-time fluoroscopic supervision specifically for guiding a needle to a target site, 77002 is the appropriate code. Code 77001 is specific to fluoroscopic guidance for central venous access device placement; 77003 is for spine or paraspinous procedures; 77012 covers CT guidance, not fluoroscopy.