AAPC CPC FINAL EXAM AND PRACTICE EXAM 2024, Exams of Nursing

Download AAPC CPC FINAL EXAM AND PRACTICE EXAM 2024 and more Exams Nursing in PDF only on Docsity! 1 | P a g e AAPC CPC FINAL EXAM AND PRACTICE EXAM 2024 WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|NEWEST|GUARANTEED PASS|LATEST UPDATE Local Coverage Determinations are administered by whom? a. State Law b. NCDs c. Each regional MAC d. LMRPs c. Each regional MAC ABN stands for _____. a. Advanced Benefits Notification b. Advisory Beneficial Notice c. Admitting Beneficiary Notice d. Advance Beneficiary Notice d. Advance Beneficiary Notice What type of health insurance provides coverage for low-income families? a. Commercial HMO b. Medicaid c. Medicare d. Commercial PPO 2 | P a g e b. Medicaid Which type of information is NOT maintained in a medical record? a. Treatment outcomes b. Financial records c. Medical or surgical interventions d. Observations b. Financial records According to the OIG, internal monitoring and auditing should be performed by what means? a. Focused audits on problems brought to the attention of the compliance officer. b. Baseline audits. c. Periodic audits. d. Audits on all denied claims. c. Periodic audits. Urine is transported from the kidneys to the urinary bladder by which structure? a. Ureter b. Urethra c. Kidney pelvis d. Urinary vein a. Ureter Which of the following does NOT circulate fluids throughout the body? a. Venous system b. Endocrine system c. Arterial system d. Lymphatic system b. Endocrine system What is a function of the alveoli in the lungs? a. Oxygen exchange b. Nicotine is destroyed c. Fluid in the lungs absorbed d. Providing an airway to breathe a. Oxygen exchange Cytopathology is the study of: 5 | P a g e c. N08, E85.3 d. N08, E85.4 b. E85.4, N08 A 45 year-old-male patient has developed an ulcer on his upper back. He has had diabetes for several years and is on insulin. The provider determines that the ulcer is due to his diabetes. What ICD-10-CM codes are reported? a. E11.622, Z79.4 b. E11.9, L98.429, Z79.4 c. E11.622, L98.429, Z79.4 d. E11.622, L98.429 c. E11.622, L98.429, Z79.4 In which circumstances would an external cause code be reported? a. Delivery of a newborn. b. Causes of injury or health condition. c. Chemotherapy treatment of neoplasms. d. Only for the cause of motor vehicle accidents. b. Causes of injury or health condition. Patient presents with no menses and positive pregnancy test but an ultrasound reveals no uterine contents. An embryo has implanted on the left ovary and this is treated with laparoscopic oophorectomy. What ICD-10-CM code is reported for this procedure? a. O00.102 b. O00.202 c. O00.802 d. O00.09 b. O00.202 A patient has an open displaced fracture of the second cervical vertebra. This is her fifth visit and the fracture is healing normally. What ICD-10-CM code is reported? a. S12.9XXS b. S12.190D c. S12.9XXD d. S12.190A b. S12.190D 6 | P a g e A 43 year-old female presents to the provider for a diabetic ulcer of the right ankle. What ICD-10-CM codes are reported? a. L97.319 b. L97.319, E11.9 c. L97.319, E11.622 d. E11.622, L97.319 d. E11.622, L97.319 A patient is prescribed anticonvulsant medication for her seizures. She returns to her doctor three days later with nausea and rash due to taking the anticonvulsant medication. The provider notes that this is a drug reaction to an anticonvulsant and changes the medication. What ICD-10-CM codes are reported? a. L27.0, R11.2, T42.71XA b. R21, R11.2, T42.71XA c. R21, R11.0, T42.75XA d. L27.0, R11.0, T42.75XA d. L27.0, R11.0, T42.75XA What surgical status indicator represents the Global Surgical Package for endoscopic procedures (without an incision) where there is no postoperative period after the day of the surgery?? a. XXX b. 000 c. 010 d. 090 b. 000 What code represents a secondary rhinoplasty where a small amount of work is performed on the tip of the nose? a. 30430 b. 30420 c. 30435 d. 30400 a. 30430 What is the appropriate modifier to use when two surgeons perform separate distinct portions of the same procedure? a. 59 b. 66 c. 62 d. 80 7 | P a g e a. 59 What is the correct CPT® coding for a cystourethroscopy with brush biopsy of the renal pelvis? a. 52005, 52007 b. 52007 c. 52000, 52007 d. 52005 b. 52007 What codes are voluntarily reported to payers, provide evidence-based performance-measure data? a. CPT® Category I codes b. CPT® Category II codes c. CPT® Category III codes d. HCPCS Level II codes b. CPT Category II codes Which statement is true regarding coding of carbuncles and furuncles in ICD-10-CM? a. There are separate codes for carbuncles and furuncles. b. The differentiation between a carbuncle and a furuncle is specified by a 7th character extender. c. Code L02.43 is a complete code. d. Carbuncles and furuncles are reported with the same code. a. There are separate codes for carbuncles and furuncles. Patient presents to the physician for removal of a squamous cell carcinoma of the right cheek. After the area is prepped and draped in a sterile fashion the surgeon measured the lesion, and documented the size of the lesion as 2.3 cm at its largest diameter. Additionally, the physician took margins of 2 mm on each side of the lesion. Single layer closure was performed. The patient tolerated the procedure well. What CPT® code(s) is/are reported? a. 11643, 12013 b. 11642, 12013 c. 11643 d. 11442 c. 11643 Joe has a terrible problem with ingrown toenails. He goes to the podiatrist to have a nail permanently removed along with the nail matrix. What CPT® code is reported? a. 11720 b. 11765 10 | P a g e c. 23030-RT d. 23076-RT A 16 year-old female was hit by a car while crossing a two-lane highway. She was taken to the hospital by ambulance. She was found to have an open wound of the left lower thigh, just above the knee and a displaced fracture of the left femoral neck. She was taken to the operating room within four hours of her injury. She was given general endotracheal anesthesia and was prepped and draped in sterile fashion. Debridement including excision of devitalized skin and muscle was performed on the lateral thigh. The area was approximately 15 sq cm. After debridement and thorough copious irrigation, the wound was closed with layer sutures and a dressing was applied and then covered with adhesive plastic. The patient was then prepped and draped for the fracture and turned on her right side. We all rescrubbed. An 8 inch incision was made over the left hip and the head of the femur was exposed. Multiple fragments from the neck and the greater tuberosity were removed. The decision was made to replace the femoral head. The femur was removed from the acetabulum and the femoral head was removed. The femoral canal was reamed and a prosthesis was placed. It was then replaced in the acetabulum with a good fit, and the capsule was closed. The wound was closed. The patient was sent to recovery in good condition. a. 27125-LT, 11010-59-LT b. 27236-LT, 11043-59-LT c. 27130-LT, 11010-59-LT d. 27244-LT, 11043-59-LT A 74 year-old male presented with ankle avascular necrosis of the talus with collapse of the body. After general anesthesia and sterile prep, the patient was placed prone. A lateral incision was made. The fibula was dissected and approximately 6 cm of the fibula was removed for the autograft. There were a lot of free fragments of bone around the subtalar joint and the talus itself. The bone fragments were removed and a large defect consistent with avascular necrosis of the body of the talus was noted. An egg-shaped burr was introduced and the articulating cartilage of the ankle joint was excised and debrided. The subtalar joint was approached and resection of the articulating surface of the subtalar joint was completed. Bone graft from the fibula was prepared on the back table. We made two large blocks to fill the defect in the talus and then additional small fragments of cortical cancellous bone to fill in smaller defects around the talus and ankle. Fixation was performed in the calcaneocuboid. The talar screw was inserted, followed by fixation of the talonavicular, tibiotalar and additional compression. The ankle screws were inserted proximally and the wound was irrigated and closed in layers. What CPT® codes are reported? a. 28730, 20900-51 b. 28725, 20924-51 c. 28705, 20902-51 d. 28715, 20910-51 What is the largest single mass of lymphatic tissue? 11 | P a g e a. Spleen b. Peyer's Patches c. Tonsils d. Thymus a. Spleen An 18 month-old patient is seen in the ED unable to breathe due to a toy he swallowed which had lodged in his throat. Soon brain death will occur if an airway is not established immediately. The ED provider performs an emergency transtracheal tracheostomy. What CPT® and ICD-10-CM codes are reported? a. 31601, 31603, T17.228A b. 31601, J34.9, T17.298A c. 31603, T17.220A d. 31603, T17.290A What ICD-10-CM codes are reported for postoperative pulmonary edema due to fluid overload from an infusion? a. T80.89XA, J81.1, Y63.0 b. J95.89, E87.70, Y63.1 c. J81.0, E87.70, Y63.1 d. T81.9XXA, J81.1, Y63.0 a. T80.89XA, J81.1, Y63.0 A 27 year-old girl has been on the lung transplant list for months and today she will be receiving a LT and RT lung from an individual involved in an MVA. This person was DOA at the hospital and is an organ donor. The donor pneumonectomy was performed by physician A, the backbench work by physician B and the transplant of both lungs into the prepped and waiting patient by physician C. What is the correct coding for the removal (physician A), preparation (physician B) and insertion (physician C) of the lungs? a. 32850, 32855, 32851 b. 32850, 32856, 32851 x 2 c. 32850, 32856, 32853 d. 32850, 32855 x 2, 32850-50 A 45 year-old presents with acute pericarditis. The surgeon makes a small incision between two ribs and enters the thoracic cavity. An endoscope is introduced and the pericardial sac is examined by direct visualization. Using an instrument introduced through the endoscope, the surgeon creates an opening in the pericardial sac for drainage purposes. What CPT® code is reported? a. 32659 b. 32662 12 | P a g e c. 32658 d. 32661 Patient presents to her physician 10 weeks following a true posterior wall myocardial infarction. The patient is still symptomatic and is diagnosed with ischemic heart disease. What is (are) the correct ICD- 10-CM code(s) for this condition? a. I21.29 b. I22.8 c. I25.2 d. Z51.89, I25.9 Due to infections from hemodialysis, the physician replaces a dual chamber implantable defibrillator system with a multi-lead system with an epicardial lead and transvenous dual chamber lead defibrillator system. The original dual leads are extracted transvenously. The generator pocket is relocated. What CPT® codes are reported? a. 33244, 33220-51, 33264-51, 33223-59 b. 33243, 33202-51, 33263-51, 33223-59 c. 33241, 32330-51, 33263-51, 33223-59 d. 33244, 33202-51, 33264-51, 33223-59 A patient presents to the hospital for a cardiovascular SPECT study. A single study is performed under stress, but without quantification, with a wall motion study, and ejection fraction. Select the CPT® code(s) for this procedure. a. 78451, 78472 b. 78451 c. 78453 d. 78453, 78472 In the hospital setting a patient undergoes transcatheter placement of an extracranial vertebral artery stent in the right vertebral artery. Which CPT® code is reported by the physician providing only the radiologic supervision and interpretation? a. 0075T b. 0075T-26 c. 35301 d. 35005 A patient is brought to the operating suite when she experiences a large output of blood in her chest tubes post CABG. The physician performing the original CABG yesterday is concerned about the post- operative bleeding. He explores the chest and finds a leaking anastomosis site and he resutured. 15 | P a g e The patient is a pleasant 51 year-old male with morbid obesity, weighing approximately 560 pounds and BMI being 85.1. He has uncontrolled diabetes and was evaluated due to testicular pain. He was found to have erythema, edema and possible areas of eschar on the scrotum. He was transferred to the hospital, evaluated and found to be stable with cellulitis and suspect early Fournier's gangrene. What are the appropriate ICD-10-CM codes reported? a. N49.2, E11.9, E66.01, Z68.45 b. N50.1, E11.9, N49.2, E66.01, Z68.45 c. N50.1, N49.2, E66.01, Z68.52 d. E66.01, E11.9, N50.1, E66.01, Z68.52 A 40 year-old presents with vaginal bleeding for several weeks unrelated to her menstrual cycle. The gynecologist orders an ultrasound to obtain more information for a diagnosis. What diagnosis code is appropriate for this encounter? a. N92.1 b. N92.4 c. N92.6 d. N93.9 An ED physician treats a 30 year-old patient who was a victim of a rape. She has bruises and other trauma as well as a laceration of the vaginal wall, which is repaired with sutures (colporrhaphy) by the ED physician. What are the CPT® and ICD-10-CM codes reported for this procedure? a. 59300, S31.41XA, T74.21XA b. 57260, N89.8 c. 57200, S31.41XA, T74.21XA d. 57289, N89.8 What does the abbreviation IVF mean? a. In vitro fertilization b. Infundibulum via Fallopian tube c. Intravaginal foreign body d. Intravenous fluids a. In vitro fertilization A patient has ovarian cancer of both ovaries. She has removal of her ovaries with peritoneal washings and assessment of the abdomen for any metastases, including inspection of omentum, diaphragm and multiple biopsies. Lymph nodes in the pelvic and peri-aortic areas were also biopsied. She has previously had a hysterectomy. What are the CPT® and ICD-10-CM codes reported for this service? 16 | P a g e a. 58943, C56.1, C56.2 b. 58950, 49255, C79.61, C79.62 c. 58720, 38770, C56.1, C79.62 d. 58940, C56.1, C56.2 Mrs. Smith is visiting her mother and is 150 miles away from home. She is in the 26th week of pregnancy. In the late afternoon she suddenly feels a gush of fluids followed by strong uterine contractions. She is rushed to the hospital but the baby is born before they arrive. In the ED she and the baby are examined and the retained placenta is delivered. The baby is in the neonatal nursery doing okay. Mrs. Smith has a 2nd degree perineal laceration secondary to precipitous delivery which was repaired by the ED physician. She will return home for her postpartum care. What ICD-10-CM and CPT® codes are reported by the ED physician? a. 59409, 59414-51, 59300-51, O62.3, O70.1, Z3A.26, Z37.0 b. 59414, 59300-51, O73.0, O70.1, Z3A.26, Z37.0 c. 59414, 59300-51, O62.3, O70.9, Z3A.26, Z37.0 d. 59409, O80, Z3A.26, Z37.0 What does contralateral mean? a. Affecting or originating in the opposite side. b. Contractions occurring on opposite sides of the body. c. Pertaining to the same side of the body. d. Lateral contractions. b. Contractions occurring on opposite sides of the body. A patient with MEN1 (Multiple Endocrine Neoplasia 1) has surgery to remove three of her parathyroid glands and part of the fourth parathyroid gland. What CPT® and ICD-10-CM codes are reported? a. 60505, E31.22 b. 60505, E31.21 c. 60500, E31.21 d. 60502, E31.22 How is Streptococcal A Meningitis reported in ICD-10-CM? a. Only Streptococcal, group A, as the cause of diseases classified elsewhere is reported. b. Only one code is reported for streptococcal meningitis. c. Streptococcal, group A, as the cause of diseases classified elsewhere is reported first; Streptococcal meningitis is reported second. 17 | P a g e d. Streptococcal meningitis is reported first; Streptococcal, group A, as the cause of diseases classified elsewhere is reported second. d. Streptococcal meningitis is reported first; Streptococcal, group A, as the cause of diseases classified elsewhere is reported second. A 47 year-old female presents to the OR for a partial corpectomy to three thoracic vertebrae. One surgeon performs the transthoracic approach while another surgeon performs the three vertebral nerve root decompressions necessary. How should each provider involved code their portion of the surgery? a. 63087-52, 63088-52 x 2 b. 63087-80, 63088-80 x 2 c. 63085-62, 63086-62 x 2 d. 63085, 63086-82 x 2 A patient recently experienced muscle atrophy and noticed she did not have pain when she cut herself on a piece of glass. The provider decides to obtain a needle biopsy of the spinal cord under ultrasound guidance in the outpatient setting. The biopsy results come back as syringomyelia. What CPT® and ICD- 10-CM codes are reported for the biopsy procedure? a. 62269, G12.9 b. 62270, 76942-26, G95.0 c. 62270, G12.9 d. 62269, 76942-26, G95.0 What does IOL stand for? a. Interdimensional ocular lengths b. Iridescence over lamina c. Intraocular lens d. Interoptic laser c. Intraocular lens Patient had an abscess in the external auditory canal which was incised and drained in the office. What CPT® code is reported? a. 69000 b. 69020 c. 69540 d. 69105 What CPT® code is reported for a tympanoplasty with mastoidotomy and with ossicular chain reconstruction in the right ear? 20 | P a g e c. 78014 d. 78015 A patient needing scoliosis measurements is coming in to have standing anteroposterior and lateral views of his entire thoracic and lumbar spine. What CPT® code(s) is/are reported for radiology? a. 72084 b. 72082 c. 72083 d. 72040, 72070, 72100 The patient is a 63 year-old gentleman diagnosed with rectal cancer, who had a resection of the cancer performed. He now presents to have a Port-A-Cath (a central venous access device) inserted for postoperative adjuvant therapy. An 18-gauge introducer needle was inserted into the left subclavian vein through which a soft tipped guide wire was inserted into the superior vena cava under fluoroscopy. A subcutaneous pouch in the anterior part of the chest was created for the port. The catheter was then tunneled and measured to length. The dilator and introducer sheath were passed over the wire into the superior vena cava under fluoroscopic guidance. The catheter was passed through the sheath and the port was applied with good venous return. What CPT® codes are reported? a. 36571, 77001-26 b. 36560, 77002-26 c. 36561, 77001-26 d. 36563, 77003-26 A CT study of the lumbar spine (L2-L4) was performed with IV contrast in the hospital outpatient radiology department and the interpretation of the images is performed by the radiologist. What CPT® code(s) should be reported by the radiologist who is not an employee of the hospital? a. 72132 b. 72132-26 c. 72132-26, 72132-TC d. 72132-TC What modifier must always be applied to Medicare claims for tests performed in a site with a CLIA Waived certificate? a. 91 b. 26 c. 90 d. QW If the findings on examination of a Pap smear are normal and described as "negative for intraepithelial lesion or malignancy" this is an example of what type of results reporting? a. Surgical pathology b. Cytogenetics 21 | P a g e c. Bethesda d. Non-Bethesda A patient has a traumatic head injury and some cerebrospinal fluid (CSF) is removed to limit potential damage from swelling of the brain. The CSF is sent to pathology for examination and the results show unusual cytological counts, although no specific findings. The patient has had no previous symptoms known to his family members. What is the ICD-10-CM code for this examination of CSF? a. A39.0 b. Z00.01 c. S06.1X0A d. R83.6 A urine pregnancy test is performed by the office staff using the Hybritech ICON (qualitative visual color comparison test). What CPT® code is reported? a. 84702 b. 81025 c. 81025, 36415 d. 84703 A left breast biopsy is performed on a mass and the surgeon requests a frozen section examination of the specimen to determine whether more extensive resection is appropriate. The frozen section reveals no indications of malignancy. No other specimen is obtained but the remainder of the biopsy specimen is sent for further testing and examination, including decalcification. The results indicate breast fibrosclerosis only. What CPT® and ICD-10-CM codes are reported? a. 88331, 88313, N63.20 b. 88305, 88331, 88311, N60.32 c. 88307, 88305, 88331, 88313, N60.32 d. 88307, 88331, R92.0 A patient is seen by Dr. B who is covering on call services for Dr. A. The patient is an established patient with Dr. A. but she has not been seen by Dr. B. before. Which E/M subcategory is appropriate to report the services provided by Dr. B? a. Established patient office visit b. Preventive medicine visit c. Office consultation d. New patient office visit A patient is diagnosed as having both acute and chronic tonsillitis. How is this reported in ICD-10-CM? a. The chronic tonsillitis is reported first; the acute tonsillitis is reported second. b. The acute tonsillitis is reported first; the chronic tonsillitis is reported second. c. Only the chronic tonsillitis is reported. d. Only the acute tonsillitis is reported. 22 | P a g e A provider visits Mr. Smith's home monthly. Today, the provider performs a problem focused history, an expanded problem focused examination and a medical decision making of low complexity. What CPT® code is reported? a. Home visits are no longer reportable. b. 99348 c. 99349 d. 99347 An infant is born six weeks premature in rural Arizona and the pediatrician in attendance intubates the child and administers surfactant in the ET tube while waiting in the ER for the air ambulance. During the 45-minute wait, he continues to bag the critically ill patient on 100 percent oxygen while monitoring VS, ECG, pulse oximetry and temperature. The infant is in a warming unit and an umbilical vein line was placed for fluids and in case of emergent need for medications. How is this coded? a. 99471-25, 94610, 36510 b. 99291 c. 99471 d. 99291-25, 31500, 36510, 94610 65 year-old was admitted in the hospital two days ago and is being examined today by his primary care physician, who has been seeing him since he has been admitted. Primary care physician is checking for any improvements or if the condition is worsening. CHIEF COMPLAINT: CHF INTERVAL HISTORY: CHF symptoms worsened since yesterday. Now has some resting dyspnea. HTN remains poorly controlled with systolic pressure running in the 160s. Also, I'm concerned about his CKD, which has worsened, most likely due to cardio-renal syndrome. REVIEW OF SYSTEMS: Positive for orthopnea and one episode of PND. Negative for flank pain, obstructive symptoms or documented exposure to nephrotoxins. PHYSICAL EXAMINATION: GENERAL: Mild respiratory distress at rest VITAL SIGNS: BP 168/84, HR 58, temperature 98.1. LUNGS: Worsening bibasilar crackles CARDIOVASCULAR: RRR, no MRGs. EXTREMITIES: Show worsening lower extremity edema. LABS: BUN 56, creatinine 2.1, K 5.2, HGB 12. IMPRESSION: 1. Severe exacerbation of CHF 2. Poorly controlled HTN 25 | P a g e Neuromuscular junction The term "episiotomy" Best describes a procedure of what type? An incision made into the perineum to enlarge the passage for the fetus during delivery A patient is diagnosed with inflammation of the testes and epididymis. The medical term for this condition is: Orchiepididymitis A condition where the thyroid is overactive is called: Thyrotoxicosis What does ICD 10 CM stand for? International classification of diseases - 10th revised - clinical modification What is the sequencing order when coding a sequela (late effect)? The residual condition is coded first, in the code(s) for the cause of the late effect are coded as secondary What is the ICD 10 CM code for hives? L50.9 20-year-old comes into the ED with symptoms of a severe headache, vomiting, stiff neck, and fever. The ED physician suspects that the meningitis is bacterial and performs a lumber puncture. The ED physician reviews the results in the patient is admitted in the hospital for meningitis. The ED physician suspects that the meningitis is bacterial. Which ICD 10 CM code is reported by the ED physician? G03.9 45 year old female with malignant Mullerian duct cancer is receiving her first treatment of chemotherapy. What diagnosis codes are reported? Z51.11, C57.7 The patient is a 12 month old with a history of muscle weakness. Unfortunately his etiology is unknown and to help delineate the diagnosis neurology has consulted us to obtain a right biceps muscle biopsy. What diagnosis code is reported? M62.81 The provider orders the following serum blood tests as part of a pre-employment physical exam. The patient goes to the local hospital for the following tests: CBC automated and automated differential WBC count (85025), comprehensive metabolic panel (80053), and a thyroid stimulating hormone assay (84443), all part of the general health panel. A drug screen for multiple drug classes was also collected (80100). What diagnosis code is reported? Z02.1 26 | P a g e What ICD 10 CM code is reported for a patient who is a habitual abuser of cannabis? F12.10 What codes, according to ICD 10 CM sequencing guidelines, describe a patient that has heart disease due to malignant hypertension with left heart failure? I11.0, 150.1 A 45-year-old male patient has developed in ulcer on his upper back. He has had diabetes for many years and is on insulin. The physician determines that the ulcer is due to his diabetes. What ICD 10 CM code are reported? E11.622, L98.429, Z79.4 What does the root word cool/o stand for? Vagina What does the abbreviation CKD stand for? Chronic kidney disease The patient is in for in initial replacement of a leaking dialysis catheter. What ICD 10 CM code is reported? T82.43XA What is/are the external cause code(s) for a passenger involved in a MVA that lost control on the highway and hit a guardrail? Y92.411 A patient was admitted three weeks following a normal vaginal delivery with a postpartum breast abscess. What ICD 10 code should be reported? O91.12 A 28-year-old male was rushed to the ED after being found unconscious. Information from family members indicated that the patient had left a suicide note and taking a large amount of LSD (a hallucinogenic). What ICD 10 CM codes are reported? T40.8X2A, R40.20 A 63-year-old fractured her scaphoid bone in her right wrist three months ago in an accident. She now presents with a non-union of the scaphoid bone. What ICD 10 CM code is reported? S62.001K 27 | P a g e What three components are considered when relative value units are established? Physician work, practice expense, malpractice insurance What is the correct HCPCS Level II code for a removable metatarsal foot arch support which is pre- molded? L3050 What is another term for hives? Urticaria The patient has a suspicious lesion of the left Jolle line. Clinical diagnosis of this lesion is unknown but due to the appearance malignancy is a realistic concern. The lesion was excised into the suspicious that measuring .8 cm and margins of .1 cm on each side. Hemostasis was achieved using light pressure. The wound was closed in layers using 5.0 Monocryl and 6.0 Prolene. Pathology revealed a benign nevus with clear margins. What CPT and ICD 10 CM codes are reported? 12051, 11441-51, D23.39 44-year-old male with biplanar deformity acquired limb length discrepancies in tibial nonunion has undergone deformity correction. He now requires exchange of an external fixation strut 45 days postoperatively. The intraoperative mounting parameter deformity parameters and initial strut settings are inserted into the computer prior to Jim's discharge and a daily schedule is generated for him to perform the gradual deformity correction necessary. What CPT code should reported? 20697 A young female patient was taken to the operative suite, and was placed under appropriate anesthesia. She has been suffering from pain and a potential rotator cuff tear of the right shoulder. The right arm was sterilely draped and prepped. Arthroscopic portals were created anteriorly- posteriorly. The joint line was carefully examined. The biceps insertion was noted to be normal. The middle and inferior glenohumeral ligaments were visualized in noted to be normal. The undersurface of the rotator cuff was clearly visualized and also noted to be normal. There was a large anterior spur formation. The blur was introduced through a lateral portal and the anterior lip of the acromion was resected. The undersurface of the clavicle was noted to be quite prominent and part of the impinging process. There was intense bursitis and a bursectomy was performed, allowing for acromial decompression and release. Spurs were removed from the distal clavicle. All instruments were removed skin incisions were closed and a dress was applied. The patient was placed in a sling and returned to the recovery room. What CPT code is reported? 23415-RT What modifier must always be applied to medicare claims for test performed in a site with CLIA Waived certificate? QW 30 | P a g e Which of the following represents three of the six elements that a special report must contain? nature, extent, need Which punctuation mark between codes in the index of the CPT manual indicates a range of codes is available? hypen Which punctuation mark between codes in the index of the CPT manual indicates two codes are available? comma The words that follow a code number in the CPT manual are called: procedure/ service descriptor A code that has all the words that describe the code following it is called what type of code? stand alone According to surgery guidelines, is surgical destruction part of a surgical procedure? yes First division in the CPT SECTION Second division in the CPT SUBSECTION Third division in the CPT SUBHEADING Fourth division in the CPT CATEGORY What is the largest single mass of lymphatic tissue? Spleen Which main coronary artery bifurcates into two smaller ones? Left What is the term for the divider between the heart chamber walls? Septum ______ is a term standing for enlargement of the heart 31 | P a g e Cardiomegaly cardio= heart megaly= enlargement repair of coronary vessel is called: Angioplasty angio= vessel plasty= repair Where is the hypertension table located in ICD-10-CM? there is no hypertension table in ICD-10-CM Which statement is true regarding codes for hypertension and heart disease in ICD-10-CM? Hypertension and heart disease without a stated casual relationship must be coded separately. What information is needed in order to accurately code hypertension retinopathy in ICD-10-CM? The affected eye(s) What is the default code for coronary artery atherosclerosis? 1125.10 How many layers of tissue does an artery have? 3 The conduction system contains pacemaker cells, nodes, the ____, and the _____. Purkinje fibers and Bundle of His What part of the cardiovascular system is responsible for the one-way flow of blood through the chambers of the heart? Heart valves What information is required to accurately code PVD due to diabetes in ICD-10-CM? Whether the patient has gangrene Bile empties into the duodenum through what structure? Common bile duct Which of the following is not a function on the skin? Acts as a gland by synthesizing vitamin A. What ICD-10-CM code is reported for spontaneous pneumothorax? J93.83 32 | P a g e When a patient has a blood test for HIV that is inconclusive, what ICD-10-CM code is assigned? R75 What does MRSA stand for? Methicillin resistant Staphylococcus Aureus When do you code acute respiratory failure as a secondary diagnosis? When it occurs after admission When the type of diabetes mellitus is not documented in the medical note, what is used as the default type? Type 2 If a patient uses insulin, what type of diabetic does it mean the patient is? The use of insulin doesn't specify the patient is a certain type of diabetic According to ICD-10-CM Guidelines, when a patient is seen for management of anemia due to malignancy, how is it reported? The malignancy is reported first, followed by the code for the anemia. First episode of an acute myocardial infraction I21.3 secondary neoplasm of the descending colon C78.5 In which circumstances would an external cause code be reported? causes of injury or health condition adverse effect rash developing when taking oenicillin colp/o vagina CKD stand for: Chronic Kidney Disease Which statement is TRUE for reporting burn codes? 35 | P a g e b. An X-ray procedure allowing the visualization of internal organs in motion c. Technique using magnetism, radio waves and a computer to produce images d. A scan using an X-ray beam rotating around the patient b. An X-ray procedure allowing the visualization of internal organs in motion Which of the following characterizes the disorder dystonia? a. Difficulty swallowing b. Slowness of motion c. Abnormal muscle tone causing abnormal postures and muscle spasm d. Impairment of speech c. Abnormal muscle tone causing abnormal postures and muscle spasm In the ICD-10-CM Alphabetic Index what is the code next to the main term called? a. Category Code b. Default Code c. Unspecified Code d. Subcategory Code b. Default Code What is the ICD-10-CM code for eyestrain? a. H53.10 b. H53.10, H53.10 c. H57.811, H57.812 d. H57.813 a. H53.10 What is the ICD-10-CM code for fatigue? a. R29.898 b. F45.8 c. F48.8 d. R53.83 d. R53.83 A patient sees his primary care provider for chest pain and regurgitation. The provider's diagnosis for the patient is gastroesophageal reflux. What diagnosis code(s) should be reported? a. K21.9 b. K21.9, R07.9, K21.9 c. R07.9, R11.10 d. R07.9, R11.10, K21.9 a. K21.9 A 45 year-old female with malignant Mullerian duct cancer is receiving her first treatment of chemotherapy. What diagnosis codes are reported? a. C79.82, Z51.11 36 | P a g e b. C57.7, Z51.11 c. Z51.11, D28.7 d. Z51.11, C57.7 d. Z51.11, C57.7 According to ICD-10-CM guidelines, when a patient is seen for management of anemia due to malignancy, how is it reported? a. Anemia is the only condition reported. b. The malignancy is the only condition reported. c. Anemia is reported first, followed by the code for the malignancy. d. The malignancy is reported first, followed by the code for the anemia. d. The malignancy is reported first, followed by the code for the anemia. What ICD-10-CM code is reported for a patient who is a habitual abuser of cannabis? a. F12.159 b. F12.129 c. F12.121 d. F12.10 d. F12.10 A patient presents to the ED with weakness on the left side and aphasia. Tests are ordered and the patient is admitted with a cerebrovascular accident (CVA). What ICD-10-CM code(s) is/are reported? a. I67.89 b. R53.1, R47.01 c. I63.50 d. I63.9 d. A patient is admitted after being found unresponsive at home. The patient had right-sided hemiplegia and aphasia from a previous CVA. The provider documents a current cerebral infarction due to occlusion of the right middle cerebral artery as the final diagnosis and the patient is transferred for rehabilitation. What ICD-10-CM code(s) is/are reported? a. I67.89, I69.959, I69.920 b. I65.319 c. I67.89, I69.954, R47.01 d. I63.511, I69.351, I69.320 d. I63.511, I69.351, I69.320 Response Feedback: Rationale: Refer to ICD-10-CM guideline I.C.9.d.2. Look in the ICD-10-CM Alphabetic Index for Infarct, infarction/cerebral/due to/occlusion NEC/cerebral arteries directing you to code I63.5-. Report I63.511 Cerebral infarct due to unspecified occlusion or stenosis of right middle cerebral artery. This patient has a history of CVA with right-sided hemiplegia and aphasia. Look in the Alphabetic Index for Sequelae (of)/infarction/cerebral/hemiplegia which directs the coder to I69.35-. Also look for 37 | P a g e Sequelae/infarction/cerebral/aphasia I69.320. Verify in the Tabular List I69.351 Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side.Per ICD-10-CM guideline I.C.9.d.1 because the right side was affected and we do not know the dominant side, the default for dominance is right Four years post hepatic transplant, the patient is diagnosed with combined hepatocellular carcinoma and cholangiocarcinoma of the liver. What ICD-10-CM codes are reported? a. T86.49, C80.2, C22.0, C22.1, Z94.4 b. C80.2, C22.0 c. C80.2, C22.0, C22.1, Z94.4 d. T86.49, C80.2, C22.0 d. T86.49, C80.2, C22.0 What is NOT an example of active treatment for pathological fractures? a. Surgical treatment b. Emergency department encounter c. Evaluation and treatment by a new provider d. Cast change d. Cast change A patient was admitted three weeks following a normal vaginal delivery with a postpartum breast abscess. What ICD-10-CM code is reported? a. O91.12 b. O91.22 c. N61.1 d. O91.13 a. O91.12 What is/are the external cause code(s) for a passenger involved in an MVA that lost control on the highway and hit a guardrail? a. Y92.411 b. V47.6XXA c. V47.5XXA d. V47.6XXA, Y92.411 a. Y92.411 A 7 year-old female patient was seen in the emergency department after being bitten by a dog. The child received treatment for the puncture wounds to her left leg. She also received a rabies vaccine because the dog was known to have rabies. What ICD-10-CM codes are reported? a. S81.852A, Z20.3, Z23, W54.0XXA b. S81.812A, Z20.3, Z23, W54.0XXA 40 | P a g e A patient presents with a recurrent seborrheic keratosis of the left cheek. The area was marked for a shave removal. The area was infiltrated with local anesthetic, prepped and draped in a sterile fashion. The lesion measuring 1.8 cm was shaved using an 11-blade. Meticulous hemostasis was achieved using light pressure. The specimen was sent for permanent pathology. The patient tolerated the procedure well. What CPT® code is reported? a. 11642 b. 11200 c. 11312 d. 11442 c. 11312 INDICATIONS FOR SURGERY: The patient is an 82 year-old male with biopsy-proven basal cell carcinoma of his right lower eyelid extending to the upper part of the cheek. I marked the area for rhomboidal excision and I drew my planned rhomboid flap. The patient observed these markings in a mirror, he understood the surgery and agreed on the location and we proceeded. DESCRIPTION OF PROCEDURE: The area was infiltrated with local anesthetic. The face was prepped and draped in sterile fashion. I excised the lesion as drawn into the subcutaneous fat. Hemostasis was achieved using Bovie cautery. Modified Mohs analysis showed the margin to be clear. I incised the rhomboid flap as drawn and elevated the flap with a full-thickness of subcutaneous fat. Hemostasis was achieved in the donor site, the Bovie cautery was not used, hand held cautery was used. The flap was rotated into the defect. The donor site was closed and flap inset in layers using 5-0 Monocryl and 6-0 Prolene. The patient tolerated the procedure well. The total site measured 1.3 cm x 2.7 cm. What CPT® code(s) should be reported? a. 14040, 14060 b. 14060, 11643 c. 14060 d. 11643 c. 14060 Operative Report PREOPERATIVE DIAGNOSIS: Congenital left breast deformity. POSTOPERATIVE DIAGNOSIS: Congenital left breast deformity. PROCEDURE PERFORMED: Placement of left breast implant using mentor catalog #, lot #, serial #, 425 cc smooth round moderate profile implant filled with 475 cc of normal saline for breast reconstruction. INDICATIONS FOR SURGERY: The patient is a 34 year-old female who approximately 15 to 16 years ago had a left breast implant placed for breast reconstruction for her congenital deformity of the left breast. This implant ruptured and in late September 20XX, I performed a capsulectomy and exchanged her ruptured implant for a new implant. About a week after surgery the patient developed an infection. Due to the infection, her implant had to be removed. The patient's infection has completely resolved and she is now ready to have her implant replaced. In the preoperative holding area, I marked her for the ideal position of this implant and performed a breast exam not showing a mass in either breast and no mass in axillae and we proceeded. We discussed with the patient that even though her original implant was 41 | P a g e placed in subglandular position I felt it would be beneficial to place the implant behind her pectoralis major muscle in submuscular position today. The patient agreed and we proceeded. DESCRIPTION OF PROCEDURE: The patient was given 1 g of IV Vancomycin. The patient was taken to the operating room; general anesthesia was induced and bilateral pneumatic compression stockings were worn throughout the procedure. A lower body Bair Hugger was placed. Both arms were secured to padded arm boards using Kerlix rolls. The neck, chest, axillae, and upper abdomen were prepped and draped in sterile fashion. I began by incising the central portion of her previous scar. I dissected down to the pectoralis major muscle. A submuscular plane was developed through a lateral approach and the inferior and medial origin of the muscle was partially divided using the Bovie cautery. Meticulous hemostasis was achieved using Bovie cautery. There were no signs of infection nor were there any pockets of seroma fluid or hematoma. The wound was carefully inspected. Meticulous hemostasis was achieved. Gloves were changed. The implant was opened and air was evacuated. It was placed in the submuscular pocket and the wound was temporarily closed using a skin stapler. The implant was filled to its maximum volume of 475 cc of normal saline. The patient was sat up. I adjusted the volume and ultimately felt she needed a 475 cc implant for breast symmetry with her contralateral breast. Once I was satisfied with the position of the implant, the patient was placed supine. Gloves were changed again. The fill tube was removed and I then secured the filled valves digitally and the deepest layer of breast tissue was closed using 3-0 Vicryl in running suture and the skin was closed in three layers using 4-0 Monocryl, 5-0 Monocryl, and 5-0 Prolene. The wound was dressed with Xeroform and gauze. The patient tolerated the procedure well. She was taken to recovery in good condition. What CPT® and ICD-10-CM codes are reported? a. 19325-LT, N64.89 b. 19342-LT, Q83.9 c. 19316-LT, N64.89 d. 19340-LT, Q83.9 b. 19342-LT, Q83.9 In ICD-10-CM, what classification system is used to report open fracture classifications? a. Muller AO classification of fractures b. Danis-Weber classification c. Gustilo classification for open fractures d. PHF classification of fractures c. Gustilo classification for open fractures A patient is given Xylocaine, a local anesthetic, by injection in the thigh above the site to be biopsied. A small bore needle is then introduced into the muscle, about 3 inches deep, and a muscle biopsy is taken. What CPT® code is reported for this service? a. 20206 b. 27324 c. 20225 d. 20205 a. 20206 42 | P a g e This 45 year-old male presents to the operating room with a painful mass of the right upper arm. Upon deep dissection a large mass in the soft tissue of the patient's shoulder was noted. The mass appeared to be benign in nature. With deep blunt dissection and electrocautery, the mass was removed and sent to pathology. What CPT® code is reported? a. 23030-RT b. 23075-RT c. 23076-RT d. 23066-RT d. 23066-RT A 22 year-old female sustained a dislocation of the right elbow with a medial epicondyle fracture while on vacation. The patient was given general anesthesia and the elbow was reduced and was stable. The medial epicondyle was held in the appropriate position and was reduced in acceptable position and elevated. A long arm splint was applied. The patient is referred to an orthopedist when she returns to her home state in a few days. What CPT® code(s) are reported? a. 24576-54-RT, 24620-54-51-RT b. 24565-54-RT, 24605-54-51-RT c. 24577-54-RT, 24600-54-51-RT d. 24575-54-RT, 24615-54-51-RT b. 24565-54-RT, 24605-54-51-RT A patient is seen in the hospital's outpatient surgical area with a diagnosis of a displaced fracture of the lateral condyle, right elbow. An ORIF (open reduction) procedure was performed and included the following techniques: An incision was made in the area of the lateral epicondyle. This was carried through subcutaneous tissue, and the fracture site was easily exposed. Inspection revealed the fragment to be rotated in two places about 90 degrees. It was possible to manually reduce this quite easily, and the manipulation resulted in an almost anatomic reduction. This was fixed with two pins driven across the humerus. The pins were cut off below skin level. The wound was closed with plain catgut subcutaneously and 5-0 nylon for the skin. Dressings and a long arm cast were applied. What CPT® and ICD-10-CM codes are reported? a. 24577-RT, S42.451A b. 24579-RT, S42.451A c. 24579-RT, 29065-51-RT, S42.434B d. 24575-RT, S42.434B c. 24579-RT, 29065-51-RT, S42.434B What CPT® code is reported for open decortication and parietal pleurectomy? a. 32652 b. 32225 c. 32320 d. 32220 45 | P a g e primarily stented with a 4.5 x 16 mm Express stent. It was expanded to 12 atmospheres. There was no residual stenosis. IMPRESSION: Successful Angio-Jet and stenting of the distal right coronary artery with no residual stenosis. Angio-Seal to the right femoral vein post procedure. PROCEDURE: Through the femoral artery sheath, the EBU was advanced to the right coronary. Following this a PT graphic intermediate wire was used to cross the lesion. Following this angioplasty of the lesion was performed, utilizing a 2.5 x 20 millimeter CrossSail balloon at multiple sites to ten atmospheres. Following this there was a fair result; however, there was a significant stenosis and significant calcification at the area, and the decision was made to pursue trying to stent the lesion. Multiple stents were attempted, including a 2.5 x 9 millimeter zipper MX and a 2.5 x 13 millimeter Guidant stent. This was abandoned, and in switching out to a balloon for further ballooning, the patient became hypertensive and with difficulty in terms of her respiratory status. Angiography revealed an occlusion of the mid left anterior descending and thrombus throughout the proximal left anterior descending extending into the left main. Recheck of ACT showed the ACT to be at eight seconds. This likely represented subtherapeutic range for her anticoagulation. A check of her medications revealed that instead of Angiomax, the patient had been given ReoPro without antithrombotic agent. She was therefore given IV heparin up to 12,000 units, and her ReoPro was continued. The lesion was then rewired, and an AngioJet was used to try to suction out this area of thrombus. Unfortunately, the AngioJet was unable to cross the mid left anterior descending lesion and therefore was somewhat limited in its use for a more distal thrombus, although it did suction out the proximal left anterior descending thrombus. At this point, the patient was emergently intubated, and multiple pressors were started, including dopamine, Levophed, vasopressin, and epinephrine. Following this, a laser was attempted to cross the lesion an excimer laser X80 Spectranetics 0.9 Vitesse; however, this laser was unable to cross the lesion. Therefore, a long balloon, a 2.0 x 40 millimeter CrossSail balloon, was used to cross the lesion and inflate multiple segments of the mid left anterior descending up to a maximum inflation pressure of ten atmospheres. This improved flow though by no means restored it back to normal. Therefore, following this, longer balloon inflations were performed utilizing a 2.0 x 20 millimeter CrossSail balloon up to fourteen atmospheres for one and a half minutes. This did not improve significantly the flow distally, and therefore the decision was made to try to stent the mid segment with a 2.5 x 9 millimeter zipper MX stent to a maximum inflation pressure of fourteen atmospheres. This resolved the issue in terms of the mid left anterior descending lesion; however, beyond the stent there continued to be residual stenosis, and multiple balloons were used to balloon this up to a 2.5 x 20 millimeter balloon up to fourteen atmospheres. The final result in the left anterior descending revealed a lesion in the mid-left anterior descending that was approximately 40 percent, there was TIMI III flow throughout the proximal and mid left anterior descending. However, at the level of the apex, there was TIMI 0 flow. Throughout the angioplasty, the patient had episodes of bradycardia, and a temporary pacemaker was placed, and this was removed at the end of the procedure. IMPRESSION: Successful stent to the mid left anterior descending, complicated by thrombotic event in the left anterior descending system. Final result was a successful stent to the mid left anterior descending with residual TIMI 0 flow in the distal left anterior descending. We returned to the right coronary artery and successfully employed a 4.5 x 16 mm Express sent. At the end of the case, an intra- aortic balloon pump was placed in the left femoral artery sheath, and the patient was sent to the Coronary Care Unit on multiple pressors including epinephrine, vasopressin, Levophed and dopamine. 46 | P a g e a. 92928-RC, 92929-LD, 92973 b. 92928-RC, 92928-LD, 33967, 92973 c. 92928-RC, 92929-LD d. 92928-RC, 92929-LD, 33967, 92973-RC d. 92928-RC, 92929-LD, 33967, 92973-RC ??? CLINICAL SUMMARY: The patient is a 41 year-old female with known coronary disease and recent recurrent chest pain, cardiac catheterization demonstrated subtotal occlusion of the diagonal artery at its takeoff from the left anterior descending artery. PROCEDURE: With informed consent obtained, the patient was prepped and draped in the usual sterile fashion. With the right groin area infiltrated with 2% Xylocaine, the patient was given 2 mg of Versed and 50 mcg Fentanyl intravenously for conscious sedation and pain control. The right femoral artery was cannulated with a modified Seldinger technique and a 6 French catheter sheath placed. A 6 French JL3.5 catheter with no side holes was utilized as a guiding catheter. After the initial guiding picture had been obtained, the patient was given Angiomax per protocol, and a short Cross-it 100 wire was advanced to the LAD and then into the diagonal vessel. A 2.0. 15-mm-long Maverick balloon was used for dilatation of the diagonal artery ostium with inflation pressure up to 8 atmospheres applied. Final angiographic documentation was carried out after the patient received 200 mcg of intracoronary nitroglycerine. The guiding catheter was then pulled, the sheath secured in place. The patient is now being transferred to telemetry for post coronary intervention observation and care. RESULTS: The initial guiding picture of the left coronary system demonstrates the high-grade ostial stenosis of the diagonal artery taking off within the LAD. Following the coronary intervention with balloon angioplasty there is complete resolution of the stenosis with less than 10 percent residual narrowing observed, no evidence for intimal disruption, no intraluminal filling defect, and good antegrade TIMI III flow preserved. CONCLUSION: Successful coronary intervention with balloon angioplasty to the ostial/proximal segment of the second diagonal vessel. a. 92937-LD b. 92924-LD c. 92920-LD d. 92921-LD c. 92920-LD ??? What ICD-10-CM code(s) is reported for ulcerative colitis with rectal bleeding? a. K51.90 b. K52.9, K62.5 c. K51.911 d. K51.511 C 47 | P a g e Bile empties into the duodenum through what structure? a. Common hepatic duct b. Common bile duct c. Biliary artery d. Pyloric sphincter B A patient is seen in the gastroenterologist's clinic for a diagnostic colonoscopy. When performing the service, the physician notes suspicious looking polyps and removes three using a snare technique to send to pathology for further testing. What is/are the correct CPT® code(s) to report? a. 45378, 45385-51 b. 45385 c. 45380 d. 45378, 45380-51 c. 45380 A patient with hypertension is scheduled for same day surgery for removal of her gallbladder due to chronic gallstones. She is examined preoperatively by her cardiologist to be cleared for surgery. What ICD-10-CM codes are reported by the cardiologist? a. K80.21, Z01.89, I10 b. K80.20, I10, Z01.810 c. Z01.810, K80.20, I10 d. I10, Z01.818, K80.20 c. Z01.810, K80.20, I10 A 56 year-old patient complains of occasional rectal bleeding. His physician decides to perform a rigid proctosigmoidoscopy. During the procedure, two polyps are found in the rectum. The polyps are removed by a snare. What CPT® and ICD-10-CM codes are reported? a. 45320, K62.1 b. 45309, 45309, K63.5 c. 45385, K63.5 d. 45315, K62.1 d. 45315, K62.1 What ICD-10 -CM code is reported for carcinoma of the bladder dome? a. C67.9 b. C67.5 c. C67.3 d. C67.1 d. C67.1 Vasectomy reversal is performed, bilaterally, using the operating microscope. Choose the procedure code(s). a. 55400-50, 69990 50 | P a g e A patient is having a decompression of the nerve root involving two segments of the lumbar spine via transpedicular approach. What CPT® code(s) is/are reported? a. 63056, 63057 b. 63030, 63035 c. 63030 d. 63056 a. 63056, 63057 A patient with MEN1 (Multiple Endocrine Neoplasia 1) has surgery to remove three of her parathyroid glands and part of the fourth parathyroid gland. What CPT® and ICD-10-CM codes are reported? a. 60502, E31.22 b. 60500, E31.21 c. 60505, E31.22 d. 60505, E31.21 b. 60500, E31.21 A patient with a malignant neoplasm of the spinal meninges is receiving a programmable pump implantation for chemotherapy. The patient is placed in the prone position where the provider made a midline incision overlying the area of the spinal cord. The reservoir was placed in the subcutaneous tissues and attached to the previously placed catheter. Layered sutures were used to close the incision. The patient tolerated the procedure well and was released in good condition. What CPT® and ICD-10- CM codes are reported for this procedure? a. 62360, C70.0 b. 62367, C70.1 c. 62350, C70.0 d. 62362, C70.1 d. 62362, C70.1 A 47 year-old female presents to the OR for a partial corpectomy to three thoracic vertebrae. One surgeon performs the transthoracic approach while another surgeon performs the three vertebral nerve root decompressions necessary. How should each provider involved code their portion of the surgery? a. 63085, 63086-82 x 2 b. 63087-80, 63088-80 x 2 c. 63085-62, 63086-62 x 2 d. 63087-52, 63088-52 x 2 c. 63085-62, 63086-62 x 2 Which option best describes what is being done during strabismus surgery? a. Corrects the condition in which the refractive surfaces of the eye are unequal. b. Is a repair of the cornea. 51 | P a g e c. Removes the opaque covering on or in the lens. d. Corrects the muscle misalignment. d. Corrects the muscle misalignment. A 65 year-old patient presents with an ectropion of the right lower eyelid. Repair with tarsal wedge excision is performed for correction. Attention was then directed to the left eye. The patient also has an ectropion of the left lower eyelid which is repaired by suture repair. What CPT® code(s) is/are reported? a. 67914-50 b. 67916-E4, 67914-E2 c. 67916-50 d. 67923-E4, 67921-E2 b. 67916-E4, 67914-E2 A patient with right and left prominent ears presents for an otoplasty. What CPT® and ICD-10-CM codes are reported? a. 69320, H61.113 b. 69300-50, Q17.5 c. 69310, H61.113 d. 69300, Q17.5 d. 69300, Q17.5 A 65 year-old male with a history of chronic glaucoma has progressive optic nerve damage and elevated intraocular pressure. A clear corneal incision is made and viscoelastic material is injected into the anterior chamber over the lens to increase and maintain anterior chamber depth. The endoscope is inserted through the temporal incision to view the nasal ciliary processes, which is coagulated with the endpoint of shrinkage and whitening. The endoscope is moved in an arc, allowing treatment of the processes over an arc of 180° and a second corneal incision is made 90° away and 180° of ciliary processes are destroyed with laser therapy. The surgeon has completed coagulation of 270° of angle. The eye is reformed with balanced salt solution. Wounds are checked for leakage and sutures are placed to seal the wound. What CPT® code is reported? a. 66710 b. 66711 c. 66680 d. 66700 b. 66711 A patient presents to the emergency room with a severely damaged eye. The injury was sustained when the patient was a passenger in a multi-car accident on the public highway. The patient sustained a large open lacerated wound to the left eye. The posterior chamber was ruptured and significant vitreous and some intraocular tissue was lost. The eyeball was not repairable and was removed, en masse. A permanent implant was inserted but not attached to the extraocular muscles. The patient was released with an occlusive eye patch. What CPT® and ICD-10-CM codes are reported? a. 65103-LT, S05.22XA, V49.59XA, Y92.411 b. 65101-LT, S05.22XD, V89.2XXD, Y92.488 52 | P a g e c. 65093-LT, S05.22XA, V43.92XA, Y92.411 d. 65091-LT, S05.22XS, V49.59XS, Y92.411 a. 65103-LT, S05.22XA, V49.59XA, Y92.411 Report the appropriate anesthesia code for an obstetric patient who had a planned general anesthesia for cesarean hysterectomy. a. 01962 b. 01969 c. 01963 d. 01967 c. 01963 What is the anesthesia code for an insertion of a penile prosthesis performed via a perineal approach? a. 00934 b. 00938 c. 00932 d. 00936 b. 00938 What ICD-10-CM code is reported for left knee primary osteoarthrosis? a. M17.0 b. M17.5 c. M17.12 d. M17.2 c. M17.12 Code 00940 Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); not otherwise specified has a base value of three (3) units. The patient was admitted under emergency circumstances, qualifying circumstance code 99140, which allows two (2) extra base units. A preanesthesia assessment was performed and signed at 2:00 a.m. Anesthesia start time is reported as 2:21 am, and the surgery began at 2:28 am. The surgery finished at 3:25 am and the patient was turned over to PACU at 3:36 am, which was reported as the ending anesthesia time. Using fifteen- minute time increments and a conversion factor of $100, what is the correct anesthesia charge? a. $800.00 b. $1,200.00 c. $900.00 d. $1,000.00 a. $800.00 A 40 year-old female in good physical health is having a laparoscopic tubal ligation. The anesthesiologist begins to prepare the patient for surgery at 08:30 am. Surgery begins at 09:00 am and ends at 10:00 am. The anesthesiologist releases the patient to recovery nurse at 1015. What is the total anesthesia time and anesthesia code? a. 1 hr. 15 minutes, 00851 55 | P a g e A couple with inability to conceive has fertility testing. The semen specimen is tested for volume, count, motility and a differential is calculated. The findings indicate infertility due to oligospermia. What CPT® and ICD-10-CM codes are reported? a. 89264, N46.11 b. 89320, N46.11 c. 89257, Z31.41 d. 89310, 89320, Z31.41 b A patient is seen by Dr. B who is covering on call services for Dr. A. The patient is an established patient with Dr. A. but she has not been seen by Dr. B. before. Which E/M subcategory is appropriate to report the services provided by Dr. B? a. Office consultation b. Preventive medicine visit c. New patient office visit d. Established patient office visit d A patient is diagnosed as having both acute and chronic tonsillitis. How is this reported in ICD-10-CM? a. The chronic tonsillitis is reported first; the acute tonsillitis is reported second. b. The acute tonsillitis is reported first; the chronic tonsillitis is reported second. c. Only the chronic tonsillitis is reported. d. Only the acute tonsillitis is reported. b A 3 year-old critically ill child is admitted to the PICU from the ER with respiratory failure due to an exacerbation of asthma not manageable in the ER. The provider starts continuous bronchodilator therapy and pharmacologic support along with cardiovascular monitoring and possible mechanical ventilation support. The provider documents a comprehensive history and exam and orders are written after treatment is initiated. What is the CPT ® code for this encounter? a. 99476 b. 99475 c. 99291 d. 99284 b Subjective: 6 year-old girl twisted her arm on the playground. She is seen in the ED complaining of pain in her wrist. Objective: Vital Signs: stable. Wrist: Significant tenderness laterally. X-ray is normal Assessment: Wrist sprain Plan: Over the counter Anaprox. Give twice daily with hot packs. Recheck if no improvement. 56 | P a g e What is the E/M code for this visit? a. 99281 b. 99241 c. 99221 d. 99284 a an established patient presents to the clinic today for a follow-up of his pneumonia. He was hospitalized for 6 days on IV antibiotics. He was placed back on Singulair and has been doing well with his breathing since then. An expanded problem focused exam was performed. Records were obtained from the hospital and the provider reviewed the labs and X-rays. The patient was told to continue antibiotics for another two weeks to 20 days, and the prescription Keteck was replaced with Zithromax. Patient is to return to the clinic in two weeks for recheck of his breathing and follow up X-ray. What CPT® code is reported? a. 99213 b. 99242 c. 99335 d. 99214 a A patient who has had two recent seizures underwent a 3-hour EEG study. What CPT® code is reported? a. 95953-52 b. 95812 c. 95813 d. 95950-52 c A provider has ordered de-ironing by therapeutic phlebotomy to be performed weekly. The patient is diagnosed with hemochromatosis and therapeutic phlebotomy is used to avoid irreversible tissue damage. One unit of blood is removed weekly. What CPT® and ICD-10-CM codes are reported for each weekly visit treatment? a. 99195, E80.0 b. 36415, E83.110 c. 99195, E83.119 d. 36430, 99195, E83.119 c A patient with atrial fibrillation had a dual lead pacemaker implanted 1 year ago. Today she returns to the provider's office for evaluation of function of the device by analyzing and reviewing the parameters stored comparing it to current readings. It was determined minor adjustments and reprogramming were needed. What CPT® code is reported? a. 93288 b. 93280 57 | P a g e c. 93289 d. 93283 a A patient with carcinoma of the descending colon presents for chemotherapy administration at the infusion center. The infusion was started with 1000 cc of normal saline. Heparin, 1000 units was added and then Fluorouracil, 800 mg was added and infused over 2 hours. Dexamethasone, 20 mg was administered, IV push. At the end of the 2 hours, the IV was disconnected and the patient was discharged. What codes are reported? a. 96415, 96375, J9190, J1100, J1644, Z51.0, C18.9 b. 96413, J9190, J1100, J1642, Z51.11, C18.6 c. 96413, 96415, 96375, J9190 x 2, J1100 x 20, J1644, Z51.11, C18.6 d. 96413, 96375, J9190 x 2, J1100 x 20, Z51.12, C18.8 a A 5 year-old is brought in to see an allergist for generalized urticaria. The family just recently visited a family member that had a cat and dog. The mother wants to know if her son is allergic to cats and dogs. The child's skin was scratched with two different allergens. The provider waited 15 minutes to check the results. There was a flare up reaction to the cat allergen, but there was no flare up to the dog allergen. The provider included the test interpretation and report in the record. a. 95004 x 2 b. 95027 x 2 c. 95018 x 2 d. 95024 x 2 a