AAPC CPC FINAL EXAM PRACTICE QUESTIONS |231 REAL QUESTIONS WITH 100% CORRECT ANSWERS | LAT, Exams of Nursing

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AAPC CPC FINAL EXAM PRACTICE QUESTIONS | 231

REAL QUESTIONS WITH 100% CORRECT ANSWERS |

LATEST UPDATED 2024/2025 |

A 46 - year-old female had a previous biopsy that indicated positive malignant margins anteriorly on the right side of her neck. A 0.5 cm margin was drawn out and a 15 blade scalpel was used for full excision of an 8 cm lesion. Layered closure was performed after the removal. The specimen was sent for permanent histopathologic examination. What are the CPT® code(s) for this procedure? A. 11626 B. 11626, 12004 - 51 C. 11626, 12044 - 51 D. 11626, 13132 - 51, 13133 Correct Answer: C. 11626, 12044 - 51 A 30 - year-old female is having 15 sq cm debridement performed on an infected ulcer with eschar on the right foot. Using sharp dissection, the ulcer was debrided all the way to down to the bone of the foot. The bone had to be minimally trimmed because of a sharp point at the end of the metatarsal. After debriding the area, there was minimal bleeding because of very poor circulation of the foot. It seems that the toes next to the ulcer may have some involvement and cultures were taken. The area was dressed with sterile saline and dressings and then wrapped. What CPT® code should be reported? A. 11043 B. 11012 C. 11044 D. 11042 Correct Answer: C. 11044 A 64 - year-old female who has multiple sclerosis fell from her walker and landed on a glass table. She lacerated her forehead, cheek and chin and the total length of these lacerations was 6 cm. Her right arm and left leg had deep cuts measuring 5 cm on each extremity. Her right hand and right foot had a total of 3 cm lacerations. The ED physician repaired the lacerations as follows: The forehead, cheek, and chin had debridement and cleaning of glass debris with the lacerations being closed with one layer closure, 6-0 Prolene sutures. The arm and leg were repaired by layered closure, 6- 0 Vicryl subcutaneous sutures and Prolene sutures on the skin. The hand and foot were closed with adhesive strips. Select the appropriate procedure codes for this visit. A. 99283 - 25, 12014, 12034 - 59, 12002 - 5 9, 11042 - 51 B. 99283 - 25, 12053, 12034-59, 12002- 59 C. 99283 - 25, 12014, 12034 - 59, 11042 - 51 D. 99283 - 25, 12053, 12034 - 59 Correct Answer: D. 99283 - 25, 12053, 12034 - 59 A 52 - year-old female has a mass growing on her right flank for several years. It has finally gotten significantly larger and is beginning to bother her. She is brought to the Operating Room for definitive excision. An incision was made directly overlying the mass. The mass was down into the subcutaneous tissue and the surgeon encountered a well encapsulated lipoma approximately 4 centimeters. This was excised primarily bluntly with a few attachments divided with electrocautery. What CPT® and ICD- 10 - CM codes are reported? A. 21932, D17.

B. 21935, D17.

C. 21931, D17.

D. 21925, D17.

Correct Answer: C. 21931, D17. Question 5 PREOPERATIVE DIAGNOSIS: Right scaphoid fracture. TYPE OF PROCEDURE: Open reduction and internal fixation of right scaphoid fracture. DESCRIPTION OF PROCEDURE: The patient was brought to the operating room; anesthesia having been administered. The right upper extremity was prepped and draped in a sterile manner. The limb was elevated, exsanguinated, and a pneumatic arm tourniquet was elevated. An incision was made over the dorsal radial aspect of the right wrist. Skin flaps were elevated. Cutaneous nerve branches were identified and very gently retracted. The interval between the second and third dorsal compartment tendons was identified and entered. The respective tendons were retracted. A dorsal capsulotomy incision was made, and the fracture was visualized. There did not appear to be any type of significant defect at the fracture site. A 0.045 Kirschner wire was then used as a guidewire, extending from the proximal pole of the scaphoid distal ward. The guidewire was positioned appropriately and then measured. A 25 - mm Acutrak® drill bit was drilled to 25 mm. A 22.5-mm screw was selected and inserted and rigid internal fixation was accomplished in this fashion. This was visualized under the OEC imaging device in multiple projections. The wound was irrigated and closed in layers. Sterile dressings were then applied. The patient tolerated the procedure well and left the operating room in stable condition. What CPT® code is reported for this procedure? A. 25628 - RT B. 25624 - RT C. 25645 - RT D. 25651 - RT Correct Answer: A. 25628 - RT An infant with genu valgum is brought to the operating room to have a bilateral medial distal femur hemiepiphysiodesis done. On each knee, the C-arm was used to localize the growth plate. With the growth plate localized, an incision was made medially on both sides. This was taken down to the fascia, which was opened. The periosteum was not opened. The Orthofix® figure- of-eight plate was placed and checked with X-ray. We then irrigated and closed the medial fascia with 0 Vicryl suture. The skin was closed with 2-0 Vicryl and 3-0 Monocryl®. What procedure code is reported? A. 27470 - 50 B. 27475 - 50 C. 27477 - 50 D. 27485 - 50 Correct Answer: D. 27485 - 50 The patient is a 67-year-old gentleman with metastatic colon cancer recently operated on for a brain metastasis, now for placement of an Infuse-A-Port for continued chemotherapy. The left subclavian vein was located with a needle and a guide wire placed. This was confirmed to be in the proper position fluoroscopically. A transverse incision was made just inferior to this and a subcutaneous pocket created just inferior to this. After tunneling, the introducer was placed over the guide wire and the power port line was placed with the introducer and the introducer was peeled away. The tip was placed in the appropriate position under fluoroscopic guidance and the

catheter trimmed to the appropriate length and secured to the power port device. The locking mechanism was fully engaged. The port was placed in the subcutaneous pocket and everything sat very nicely fluoroscopically. It was secured to the underlying soft tissue with 2 - 0 silk stitch. What CPT® code(s) is (are) reported for this procedure? A. 36556, 77001- 26 B. 36558 C. 36561, 77001- 26 D. 36571 Correct Answer: C. 36561, 77001 - 26 Question 8 A CT scan identified moderate-sized right pleural effusion in a 50 year-old male. This was estimated to be 800 cc in size and had an appearance of fluid on the CT Scan. A needle is used to puncture through the chest tissues and enter the pleural cavity to insert a guidewire under ultrasound guidance. A pigtail catheter is then inserted at the length of the guidewire and secured by stitches. The catheter will remain in the chest and is connected to drainage system to drain the accumulated fluid. The CPT® code is: A. 32557 B. 32555 C. 32556 D. 32550 Correct Answer: A. 32557 The patient is a 59-year-old white male who underwent carotid endarterectomy for symptomatic left carotid stenosis a year ago. A carotid CT angiogram showed a recurrent 90% left internal carotid artery stenosis extending into the common carotid artery. He is taken to the operating room for re-do left carotid endarterectomy. The left neck was prepped and the previous incision was carefully reopened. Using sharp dissection, the common carotid artery and its branches were dissected free. The patient was systematically heparinized and after a few minutes, clamps were applied to the common carotid artery and its branches. A longitudinal arteriotomy was carried out with findings of extensive layering of intimal hyperplasia with no evidence of recurrent atherosclerosis. A silastic balloon-tip shunt was inserted first proximally and then distally, with restoration of flow. Several layers of intima were removed and the endarterectomized surfaces irrigated with heparinized saline. An oval Dacron patch was then sewn into place with running 6 - 0 Prolene. Which CPT® code(s) is/are reported? A. 35301 B. 35301, 35390 C. 35302 D. 35311, 35390 Correct Answer: B. 35301, 35390 A 52 - year-old patient is admitted to the hospital for chronic cholecystitis for which a laparoscopic cholecystectomy will be performed. A transverse infraumbilical incision was made sharply dissecting to the subcutaneous tissue down to the fascia using access under direct vision with a Vesi-Port and a scope was placed into the abdomen. Three other ports were inserted under direct vision. The fundus of the gallbladder was grasped through the lateral port, where multiple adhesions to the gallbladder were taken down sharply and bluntly: The gallbladder appeared chronically inflamed. Dissection was carried out to the right of this identifying a small cystic duct and artery, was clipped twice proximally, once distally and transected. The gallbladder was

then taken down from the bed using electrocautery, delivering it into an endo-bag and removing it from the abdominal cavity with the umbilical port. What CPT® and ICD- 10 - CM codes are reported? A. 47564, K81. B. 47562, K81. C. 47610, K81. D. 47600, K81.1 Correct Answer: B. 47562, K81. A 70 - year-old female who has a history of symptomatic ventral hernia was advised to undergo laparoscopic evaluation and repair. An incision was made in the epigastrium and dissection was carried down through the subcutaneous tissue. Two 5-mm trocars were placed, one in the left upper quadrant and one in the left lower quadrant and the laparoscope was inserted. Dissection was carried down to the area of the hernia where a small defect was clearly visualized. There was some omentum, which was adhered to the hernia and this was delivered back into the peritoneal cavity. The mesh was tacked on to cover the defect. What procedure code(s) is (are) reported? A. 49560, 49568 B. 49652 C. 49653 D. 49652, 49568 Correct Answer: B. 49652 The patient is a 50-year-old gentleman who presented to the emergency room with signs and symptoms of acute appendicitis with possible rupture. He has been brought to the operating room. An infraumbilical incision was made which a 5 - mm VersaStep™ trocar was inserted. A 5 - mm 0 - degree laparoscope was introduced. A second 5 - mm trocar was placed suprapubically and a 12-mm trocar in the left lower quadrant. A window was made in the mesoappendix using blunt dissection with no rupture noted. The base of the appendix was then divided and placed into an Endo-catch bag and the 12-mm defect was brought out. Select the appropriate code for this procedure: A. 44970 B. 44950 C. 44960 D. 44979 Correct Answer: A. 44970 A 45 - year-old male is going to donate his kidney to his son. Operating ports where placed in standard position and the scope was inserted. Dissection of the renal artery and vein was performed isolating the kidney. The kidney was suspended only by the renal artery and vein as well as the ureter. A stapler was used to divide the vein just above the aorta and three clips across the ureter, extracting the kidney. This was placed on ice and sent to the recipient room. The correct CPT® code is: A. 50543 B. 50547 C. 50300 D. 50320 Correct Answer: B. 50547 A 67 - year-old female having urinary incontinence with intrinsic sphincter deficiency is having a cystoscopy performed with a placement of a sling. An incision was made over the mid urethra

dissected laterally to urethropelvic ligament. Cystoscopy revealed no penetration of the bladder. The edges of the sling were weaved around the junction of the urethra and brought up to the suprapubic incision. A hemostat was then placed between the sling and the urethra, ensuring no tension. What CPT® code(s) is (are) reported? A. 57288 B. 57287 C. 57288, 52000- 51 D. 51992, 52000 - 51 Correct Answer: A. 57288 A 16 - day-old male baby is in the OR for a repeat circumcision due to redundant foreskin that caused circumferential scarring from the original circumcision. Anesthetic was injected and an incision was made at base of the foreskin. Foreskin was pulled back and the excess foreskin was taken off and the two raw skin surfaces were sutured together to create a circumferential anastomosis. Select the appropriate code for this surgery: A. 54150 B. 54160 C. 54163 D. 54164 Correct Answer: C. 54163 5 year-old female has a history of post void dribbling. She was found to have extensive labial adhesions, which have been unresponsive to topical medical management. She is brought to the operating suite in a supine position. Under general anesthesia the labia majora is retracted and the granulating chronic adhesions were incised midline both anteriorly and posteriorly. The adherent granulation tissue was excised on either side. What code should be used for this procedure? A. 58660 B. 58740 C. 57061 D. 56441 Correct Answer: D. 56441 The patient is a 64 year-old female who is undergoing a removal of a previously implanted Medtronic pain pump and catheter due to a possible infection. The back was incised; dissection was carried down to the previously placed catheter. There was evidence of infection with some fat necrosis in which cultures were taken. The intrathecal portion of the catheter was removed. Next the pump pocket was incised and the pump was dissected from the anterior fascia. A 7 - mm Blake drain was placed in the pump pocket through a stab incision and secured to the skin with interrupted Prolene. The pump pocket was copiously irrigated with saline and closed in two layers. What are the CPT® and ICD- 10 - CM codes for this procedure? A. 62365, 62350 - 51, T85.898A, Z46. B. 62360, 62355-51, T85.79XA C. 62365, 62355-51, T85.79XA D. 36590, I97.42, T85.898A Correct Answer: C. 62365, 62355 - 51, T85.79XA The patient is a 73 year-old gentleman who was noted to have progressive gait instability over the past several months. Magnetic resonance imaging demonstrated a ventriculomegaly. It was

recommended that the patient proceed forward with right frontal ventriculoperitoneal shunt placement with Codman® programmable valve. What is the correct code for this surgery? A. 62220 B. 62223 C. 62190 D. 62192 Correct Answer: B. 62223 What is the CPT® code for the decompression of the median nerve found in the space in the wrist on the palmar side? A. 64704 B. 64713 C. 64721 D. 64719 Correct Answer: C. 64721 A 2 - year-old male has a chalazion on both upper and lower lid of the right eye. He was placed under general anesthesia. With a #11 blade the chalazion was incised and a small curette was then used to retrieve any granulomatous material on both lids. What CPT® code should be used for this procedure? A. 67801 B. 67805 C. 67800 D. 67808 Correct Answer: D. 67808 An 80-year-old patient is returning to the gynecologist's office for pessary cleaning. Patient offers no complaints. The nurse removes and cleans the pessary, vagina is swabbed with betadine, and pessary replaced. For F/U in 4 months. What CPT® and ICD- 10 - CM codes are reported for this service? A. 99201, Z46. B. 99211, Z46. C. 99202, Z46. D. 99212, Z46.9 Correct Answer: B. 99211, Z46. Patient was in the ER complaining of constipation with nausea and vomiting when taking Zovirax for his herpes zoster and Percocet for pain. His primary care physician came to the ER and admitted him to the hospital for intravenous therapy and management of this problem. His physician documented a detailed history, comprehensive examination and a medical decision making of moderate complexity. Which E/M service is reported? A. 99285 B. 99284 C. 99221 D. 99222 Correct Answer: C. 99221 A 20 - day-old infant was seen in the ER by the neonatologist admitting the baby to NICU for cyanosis and rapid breathing. The neonatologist performed intubation, ventilation management and a complete echocardiogram in the NICU and provided a report for the echocardiography which did indicate congenital heart disease. Select the correct codes for the physician service.

A. 99468 - 25, 93303- 26

B. 99471 - 25, 31500, 94002, 93303- 26

C. 99460 - 25, 31500, 94002, 93303- 26

D. 99291 - 25, 93303 - 26 Correct Answer: A. 99468 - 25, 93303 - 26 A 42 - year-old with renal pelvis cancer receives general anesthesia for a laparoscopic radical nephrectomy. The patient has controlled type 2 diabetes otherwise no other co-morbidities. What is the correct CPT® and ICD- 10 - CM code for the anesthesia services? A. 00860 - P1, C64.9, E11. B. 00840 - P3, C65.9, E11. C. 00862 - P2, C65.9, E11. D. 00868 - P2, C79.02, E11.9 Correct Answer: C. 00862 - P2, C65.9, E11. A healthy 32 - year-old with a closed distal radius fracture received monitored anesthesia care for an ORIF of the distal radius. What is the code for the anesthesia service? A. 01830 - P B. 01860 - QS-P C. 01830 - QS-P D. 01860 - QS-G9-P1 Correct Answer: C. 01830 - QS-P A 10 - month-old child is taken to the operating room for removal of a laryngeal mass. What is (are) the appropriate anesthesia code(s) to report? A. 00320 B. 00326 C. 00320, 99100 D. 00326, 99100 Correct Answer: B. 00326 A catheter is placed in the left common femoral artery which was directed into the right the external iliac (antegrade). Dye was injected and a right lower extremity angiogram was performed which revealed patency of the common femoral and profunda femoris. The catheter was then manipulated into the superficial femoral artery (retrograde) in which a lower extremity angiogram was performed which revealed occlusion from the popliteal to the tibioperoneal artery. What are the procedure codes that describe this procedure? A. 36217, 75736- 26 B. 36247, 75716- 26 C. 36217, 75756- 26 D. 36247, 75710 - 26 Correct Answer: D. 36247, 75710 - 26 56 - year-old female is having a bilateral mammogram with computer aid detection conducted as a screening because the patient has a family history of breast cancer. She does not presently have signs or symptoms of breast disease. What radiological services are reported? A. 77065 x 2 B. 77065, 77066 C. 77067 D. 77066 Correct Answer: C. 77067

A 63 - year-old patient with bilateral ureteral obstruction presents to an outpatient facility for placement of a right and left ureteral stent along with an interpretation of a retrograde pyelogram. What codes should be reported? A. 52332, 74425 B. 52332 - 50, 74420- 26 C. 52005, 74420 D. 52005 - 50, 74425 - 26 Correct Answer: B. 52332 - 50, 74420 - 26 Patient is coming in for a pathological examination for ischemia in the left leg. The first specimen is 1.5 cm of a single portion of arterial plaque taken from the left common femoral artery. The second specimen is 8.5 x 2.7 cm across x 1.5 cm in thickness of a cutaneous ulceration with fibropurulent material on the left leg. What surgical pathology codes should be reported for the pathologist? A. 88304 - 26, 88302- 26 B. 88305 - 26, 88304- 26 C. 88307 - 26, 88305- 26 D. 88309 - 26, 88307 - 26 Correct Answer: B. 88305 - 26, 88304 - 26 During a craniectomy the surgeon asked for a consult and sent a frozen section of a large piece of tumor and sent it to pathology. The pathologist received a rubbery pinkish tan tissue measuring in aggregate 3 x 0.8 x 0.8 cm. The entire specimen is submitted in one block and also a gross and microscopic examination was performed on the tissue. The frozen section and the pathology report are sent back to the surgeon indicating that the tumor was a medulloblastoma. What CPT® code(s) will the pathologist report? A. 80500 B. 88331 - 26, 88307- 26 C. 80502 D. 88331 - 26, 88332 - 26, 88304 - 26 Correct Answer: B. 88331 - 26, 88307 - 26 Physician orders a basic (80047) and comprehensive metabolic (80053) panels. Select the code(s) on how this is reported. A. 80053, 80047 B. 80053 C. 80047, 82040, 82247, 82310, 84075, 84155, 84460, 84450 D. 80053, 82330 Correct Answer: D. 80053, 82330 A 4 - year-old is getting over his cold and will be getting three immunizations in the pediatrician's office by the nurse. The first vaccination administered is the Polio vaccine intramuscularly. The next vaccination is the live influenza (LAIV3) administered in the nose. The last vaccination is the Varicella (live) by subcutaneous route. What CPT® codes are reported for the administration and vaccines? A. 90713, 90658, 90716, 90460, 90461 x 2 B. 90713, 90660, 90716, 90460, 90461 x 1 C. 90713, 90660, 90716, 90471, 90472, 90474 D. 90713, 90658, 90716, 90471, 90472, 90473 Correct Answer: C. 90713, 90660, 90716, 90471, 90472, 90474

A patient with chronic renal failure is in the hospital being evaluated by his nephrologist after just placing a catheter into the peritoneal cavity for dialysis. The physician is evaluating the dwell time and running fluid out of the cavity to make sure the volume of dialysate and the concentration of electrolytes and glucose are correctly prescribed for this patient. What code should be reported for this service? A. 90935 B. 90937 C. 90947 D. 90945 Correct Answer: D. 90945 An established patient had a comprehensive exam in which she has been diagnosed with dry eye syndrome in both eyes. The ophthalmologist measures the cornea for placement of the soft contact lens for treatment of this syndrome. What codes are reported by the ophthalmologist? A. 92014 - 25, 92071- 50 B. 99214 - 25, 92072- 50 C. 92014 - 25, 92325- 50 D. 92014 - 25, 92310 - 50 Correct Answer: A. 92014 - 25, 92071 - 50 A patient who is a singer has been hoarse for a few months following an upper respiratory infection. She is in a voice laboratory to have a laryngeal function study performed by an otolaryngologist. She starts off with the acoustic testing first. Before she moves on to the aerodynamic testing she complains of throat pain and is rescheduled to come back to have the other test performed. What CPT® code is reported? A. 92520 B. 92700 C. 92520 - 52 D. 92614 - 52 Correct Answer: C. 92520 - 52 What is the difference between entropion and ectropion? A. Entropion is the inward turning of the eyelid and ectropion is the outward turning of the eyelid. B. Entropion is facial droop and ectropion is a facial spasm. C. Entropion is the outward turning of the hands and ectropion is the inward turning of the hands. D. Entropion inward turning of the feet and ectropion is the outward turning of the feet due to muscle disorder. Correct Answer: A. Entropion is the inward turning of the eyelid and ectropion is the outward turning of the eyelid. What is the full CPT® code description for 00846? A. Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy B. Radical hysterectomy C. Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified radical hysterectomy

D. Radical hysterectomy not otherwise specified Correct Answer: A. Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy Ventral, umbilical, spigelian and incisional are types of: A. Surgical approaches B. Hernias C. Organs found in the digestive system D. Cardiac catheterizations Correct Answer: B. Hernias Fracturing the acetabulum involves what area? A. Skull B. Shoulder C. Pelvis D. Leg Correct Answer: C. Pelvis When a patient is having a tenotomy performed on the abductor hallucis muscle, where is this muscle located? A. Foot B. Upper Arm C. Upper Leg D. Hand Correct Answer: A. Foot A 44 - year-old had a history of adenocarcinoma of the cervix on a conization in March 20XX who has been followed with twice-yearly endocervical curettages and Pap smears that were all negative for two years, per the recommendation of a GYN oncologist. Her Pap smear results from the last visit noted atypical glandular cells. In light of this, she underwent a colposcopy and the biopsy of the normal-appearing cervix on colposcopy was benign. The endocervical curettage was benign endocervical glands, and the endometrial sampling was benign endometrium. In light of the fact that she had had previous atypical glandular cells that led to diagnosis of adenocarcinoma and the concerns that this may have recurred, she had been recommended for a cone biopsy and fractional dilatation and curettage, which she is undergoing today. What ICD- 10 - CM code(s) should be reported? A. R87.619, C53. B. C C. R87.619, Z85. D. Z12.4, Z85.41 Correct Answer: C. R87.619, Z85. Patient comes into see her primary care physician for a productive cough and shortness of breath. The physician takes a chest X-ray which indicates the patient has double pneumonia. Select the ICD- 10 - CM code(s) for this visit. A. J18.9, R05, R06. B. R05, R06.2, J18. C. J18. D. J15.9 Correct Answer: C. J18.

What is the correct way to code a patient having bradycardia due to Demerol that was correctly prescribed and properly administered? A. T40.2X1A, R00. B. T40.2X3A, R00. C. R00.1, T40.2X5A D. R00.1, T40.2X2A Correct Answer: C. R00.1, T40.2X5A Which statement is TRUE when reporting pregnancy codes (O00-O9A): A. These codes can be used on the maternal and baby records. B. These codes have sequencing priority over codes from other chapters. C. Code Z33.1 should always be reported with these codes. D. The seventh character assigned to these codes only indicate a complication during the pregnancy. Correct Answer: B. These codes have sequencing priority over codes from other chapters. A 66 - year-old Medicare patient, who has a history of ulcerative colitis, presents for a colorectal cancer screening. The screening is performed via barium enema. What HCPCS Level II code is reported for this procedure? A. G B. G C. G D. G0121 Correct Answer: C. G What is PHI? A. Physician-health care interchange B. Private health insurance C. Protected health information D. Provider identified incident-to Correct Answer: C. Protected health information What is NOT included in CPT® surgical package? A. Typical postoperative follow-up care B. One related Evaluation and Management service on the same date of the procedure C. Returning to the operating room the next day for a complication resulting from the initial procedure D. Evaluating the patient in the post-anesthesia recovery area Correct Answer: C. Returning to the operating room the next day for a complication resulting from the initial procedure Which statement is TRUE about reporting codes for diabetes mellitus? A. If the type of diabetes mellitus is not documented in the medical record the default type is E11.- Type 2 diabetes mellitus. B. When a patient uses insulin, Type 1 is always reported. C. The age of the patient is a sole determining factor to report Type 1. D. When assigning codes for diabetes and its associated condition(s), the code(s) from category E08-E13 are not reported as a primary code. Correct Answer: A. If the type of diabetes mellitus is not documented in the medical record the default type is E11.- Type 2 diabetes mellitus.

Which statement is TRUE for reporting external cause codes of morbidity (V00-Y99)? A. All external cause codes do not require a seventh character. B. Only report one external cause code to fully explain each cause. C. Report code Y92.9 if the place of occurrence is not stated. D. External cause codes should never be sequenced as a first-listed or primary code Correct Answer: D. External cause codes should never be sequenced as a first-listed or primary code PRE OP DIAGNOSIS: Left Breast Abnormal MMG or Palpable Mass; Other Disorders of Breast PROCEDURE: Automated Stereotactic Biopsy Left Breast FINDINGS: Lesion is located in the lateral region, just at or below the level of the nipple on the 90 degree lateral view. There is a subglandular implant in place. I discussed the procedure with the patient today including risks, benefits and alternatives. Specifically discussed was the fact that the implant would be displaced out of the way during this biopsy procedure. Possibility of injury to the implant was discussed with the patient. Patient has signed the consent form and wishes to proceed with the biopsy. The patient was placed prone on the stereotactic table; the left breast was then imaged from the inferior approach. The lesion of interest is in the anterior portion of the breast away from the implant which was displaced back toward the chest wall. After imaging was obtained and stereotactic guidance used to target coordinates for the biopsy, the left breast was prepped with Betadine. 1% lidocaine was injected subcutaneously for local anesthetic. Additional lidocaine with epinephrine was then injected through the indwelling needle. The SenoRx needle was then placed into the area of interest. Under stereotactic guidance we obtained 9 core biopsy samples using vacuum and cutting technique. The specimen radiograph confirmed representative sample of calcification was removed. The tissue marking clip was deployed into the biopsy cavity successfully. This was confirmed by final stereotactic digital image and confirmed by post core biopsy mammogram left breast. The clip is visualized projecting over the lateral anterior left breast in satisfactory position. No obvious calcium is visible on the final post core biopsy image in the area of interest. The patient tolerated the procedure well. There were no apparent complications. The biopsy site was dressed with Steri-Strips, bandage and ice pack in the usual manner. The patient did receive written and verbal post-biopsy instructions. The patient left our department in good condition. IMPRESSION: 1. SUCCESSFUL STEREOTACTIC CORE BIOPSY OF LEFT BREAST CALCIFICATIONS. 2. SUCCESSFUL DEPLOYMENT OF THE TISSUE MARKING CLIP INTO THE BIOPSY CAVITY 3. PATIENT LEFT OUR DEPARTMENT IN GOOD CONDITION TODAY WITH POST-BIOPSY INSTRUCTIONS. 4. PATHOLOGY REPORT IS PENDING; AN ADDENDUM WILL BE ISSUED AFTER WE RECEIVE THE PATHOLOGY REPORT. What is (are) the CPT® code(s)? A. 19081 B. 19283 C. 19081, 19283 D. 19100, 19283 Correct Answer: A. 19081 A 53 - year-old male is in the dermatologist's office for removal of 2 lesions located on his lower lip and nose. Lesions were identified and marked. The lower lip lesion of 4 mm in size was shaved to the level of the superficial dermis. Utilizing a 3 - mm punch, a biopsy was taken of the left supratip nasal area. What are the CPT® codes for these procedures? A. 40490, 11104 - 59

B. 11310, 11104 - 59

C. 17000, 17003

D. 11440, 11105 - 59 Correct Answer: B. 11310, 11104 - 59 A 76 - year-old has dermatochalasis on bilateral upper eyelids. A blepharoplasty will be performed on the eyelids. A lower incision line was marked at approximately 5 mm above the lid margin along the crease. Then using a pinch test with forceps the amount of skin to be resected was determined and marked. An elliptical incision was performed on the left eyelid and the skin was excised. In a similar fashion the same procedure was performed on the right eye. The wounds were closed with sutures. The correct CPT® code(s) is/are? A. 15822, 15823- 51 B. 15823 - 50 C. 15822 - 50 D. 15820 - LT, 15820 - RT Correct Answer: C. 15822 - 50 A 42 - year-old male has a frozen left shoulder. An arthroscope was inserted in the posterior portal in the glenohumeral joint. The articular cartilage was normal except for some minimal grade III- IV changes, about 5% of the humerus just adjacent to the rotator cuff insertion of the supraspinatus. The biceps was inflamed, not torn at all. The superior labrum was not torn at all, the labrum was completely intact. The rotator cuff was completely intact. An anterior portal was established high in the rotator interval. The rotator interval was very thick and contracted. Adhesions were destroyed with electrocautery and the Bovie. The superior glenohumeral ligament, the middle glenohumeral ligament and the tendinous portion of the subscapularis were released. The arthroscope was placed anteriorly, adhesions were destroyed and the shaver was used to debride some of the posterior capsule and the posterior capsule was released in its posterosuperior and then posteroinferior aspect. What CPT® code(s) is (are) reported? A. 23450 - LT B. 23466 - LT C. 29805 - LT, 29806 - 51 - LT D. 29825 - LT Correct Answer: D. 29825 - LT After adequate anesthesia was obtained the patient was turned prone in a kneeling position on the spinal table. A lower midline lumbar incision was made and the soft tissues divided down to the spinous processes. The soft tissues were stripped away from the lamina down to the facets and discectomies and laminectomies were then carried out at L3-4, L4-5 and L5-S1. Interbody fusions were set up for the lower three levels using the Danek allografts and augmented with structural autogenous bone from the iliac crest. The posterior instrumentation of a 5.5 mm diameter titanium rod was then cut to the appropriate length and bent to confirm to the normal lordotic curve. It was then slid immediately onto the bone screws and at each level compression was carried out as each of the two bolts were tightened so that the interbody fusions would be snug and as tight as possible. Select the appropriate CPT® codes for this visit? A. 22612, 22614 x 2, 22842, 20938, 20930 B. 22533, 22534 x 2, 22842 C. 22630, 22632 x 2, 22842, 20938, 20930 D. 22554, 22632 x 2, 22842 Correct Answer: C. 22630, 22632 x 2, 22842, 20938, 20930

PREOPERATIVE DIAGNOSIS: Displaced impacted Colles fracture, left distal radius and ulna. POSTOPERATIVE DIAGNOSIS: Displaced impacted Colles fracture, left distal radius and ulna. OPERATIVE PROCEDURE: Reduction with application of an external fixation system, left wrist fracture FINDINGS: The patient is a 46 year-old right-hand-dominant female who fell off stairs 4 to 5 days ago sustaining an impacted distal radius fracture with possible intraarticular component and an associated ulnar styloid fracture. Today in surgery, fracture was reduced anatomically and an external fixation system was applied. PROCEDURE: Under satisfactory general anesthesia, the fracture was manipulated and C-arm images were checked. The left upper extremity was prepped and draped in the usual sterile orthopedic fashion. Two small incisions were made over the second metacarpal and after removing soft tissues including tendinous structures out of the way, drawing was carried out and blunt-tipped pins were placed for the EBI external fixator. The frame was next placed and the site for the proximal pins was chosen. Small incision was made. Subcutaneous tissues were carried out of the way. The pin guide was placed and 2 holes were drilled and blunt-tipped pins placed. Fixator was assembled. C-arm images were checked. Fracture reduction appeared to be anatomic. Suturing was carried out where needed with 4-0 Vicryl interrupted subcutaneous and 4-0 nylon interrupted sutures. Sterile dressings were applied. Vascular supply was noted to be satisfactory. Final frame tightening was carried out. What CPT® code(s) is/are reported? A. 25600 - LT, 20692 - 51 B. 25605 - LT, 20690 - 51 C. 25606 - LT D. 25607 - LT Correct Answer: B. 25605 - LT, 20690 - 51 A 79 - year-old male with symptomatic bradycardia and syncope is taken to the Operating Suite where an insertion of a DDD pacemaker will be performed. After the anesthesiologist provided moderate sedation, the cardiologist performed a left subclavian venipuncture was carried out. A guide wire was passed through the needle, and the needle was withdrawn. A second subclavian venipuncture was performed, a second guide wire was passed and the second needle was withdrawn. An oblique incision in the deltopectoral area incorporating the wire exit sites. A subcutaneous pocket was created with the cautery on the pectoralis fascia. An introducer dilator was passed over the first wire and the wire and dilator were withdrawn. A ventricular lead was passed through the introducer, and the introducer was broken away in the routine fashion. A second introducer dilator was passed over the second guide wire and the wire and dilator were withdrawn. An atrial lead was passed through the introducer and the introducer was broken away in the routine fashion. Each of the leads were sutured down to the chest wall with two 2-0 silk sutures each, connected the leads to the generator, curled the leads, and the generator was placed in the pocket. We assured hemostasis. We assured good position with the fluoroscopy. What CPT® code(s) is (are) reported by the cardiologist? A. 33208 B. 33212 C. 33226 D. 33235, 71090 - 26 Correct Answer: A. 33208 Patient has lung cancer in his upper right and middle lobes. Patient is in the operating suite to have a video-assisted thorascopy surgery (VATS). A 10 - mm-zero-degree thoracoscope is inserted in the right pleural cavity through a port site placed in the ninth and seventh intercostal spaces.

Lung was deflated. The tumor is in the right pleural. Both lobes were removed thorascopically. Port site closed. A chest tube was placed to suction and patient was sent to recovery in stable condition. Which CPT® code is reported for this procedure? A. 32482 B. 32484 C. 32670 D. 32671 Correct Answer: C. 32670 The patient is a 58 - year-old white male, one month status post pneumonectomy. He had a post pneumonectomy empyema treated with a tunneled cuffed pleural catheter which has been draining the cavity for one month with clear drainage. He has had no evidence of a block or pleural fistula. Therefore a planned return to surgery results in the removal of the catheter. The correct CPT® code is: A. 32440 - 78 B. 32035 - 58 C. 32036 - 79 D. 32552 - 58 Correct Answer: D. 32552 - 58 This 67-year-old man presented with a history of progressive shortness of breath. He has had a diagnosis of a secundum atrioseptal defect for several years, and has had atrial fibrillation intermittently over this period of time. He was in atrial fibrillation when he came to the operating room, and with the patient cannulated and on bypass, The right atrium was then opened. A large 3 x 5 cm defect was noted at fossa ovalis, and this also included a second hole in the same general area. Both of these holes were closed with a single pericardial patch. What CPT® and ICD- 10 - CM codes are reported? A. 33675, Q21. B. 33647, Q21.1, R06. C. 33645, Q21.2, R06. D. 33641, Q21.1 Correct Answer: D. 33641, Q21. An 82-year-old female had a CAT scan which revealed evidence of a proximal small bowel obstruction. She was taken to the Operating Room where an elliptical abdominal incision was made, excising the skin and subcutaneous tissue. There were extensive adhesions along the entire length of the small bowel. The omentum and bowel were stuck up to the anterior abdominal wall. Time consuming, tedious and spending an extra hour to lysis the adhesions to free up the entire length of the gastrointestinal tract from the ligament to Treitz to the ileocolic anastomosis. The correct CPT® code is: A. 44005 B. 44180 - 22 C. 44005 - 22 D. 44180 - 59 Correct Answer: C. 44005 - 22 55 year-old patient was admitted with massive gastric dilation. The endoscope was inserted with a catheter placement. The endoscope is passed through the cricopharyngeal muscle area without

difficulty. Esophagus is normal, some chronic reflux changes at the esophagogastric junction noted. Stomach significant distention with what appears to be multiple encapsulated tablets in the stomach at least 20 to 30 of these are noted. Some of these are partially dissolved. Endoscope could not be engaged due to high grade narrowing in the pyloric channel, the duodenum was not examined. It seems to be a high grade outlet obstruction with a superimposed volvulus. A repeat examination is not planned at this time. What code should be used for this procedure? A. 43246 - 52 B. 43241 - 52 C. 43235 D. 43191 Correct Answer: B. 43241 - 52 The patient is a 78-year-old white female with morbid obesity that presented with small bowel obstruction. She had surgery approximately one week ago and underwent exploration, which required a small bowel resection of the terminal ileum and anastomosis leaving her with a large inferior ventral hernia. Two days ago she started having drainage from her wound which has become more serious. She is now being taken back to the operating room. Reopening the original incision with a scalpel, the intestine was examined and the anastomosis was reopened , excised at both ends, and further excision of intestine. The fresh ends were created to perform another end- to-end anastomosis. The correct procedure code is: A. 44120 - 78 B. 44126 - 79 C. 44120 - 76 D. 44202 - 58 Correct Answer: A. 44120 - 78 PREOPERATIVE DIAGNOSIS: Diverticulitis, perforated diverticula POST OPERATIVE DIAGNOSIS: Diverticulitis, perforated diverticula PROCEDURE: Hartmann procedure, which is a sigmoid resection with Hartmann pouch and colostomy. DESCRIPTION OF THE PROCEDURE: Patient was prepped and draped in the supine position under general anesthesia. Prior to surgery patient was given 4.5 grams of Zosyn and Rocephin IV piggyback. A lower midline incision was made, abdomen was entered. Upon entry into the abdomen, there was an inflammatory mass in the pelvis and there was a large abscessed cavity, but no feces. The abscess cavity was drained and irrigated out. The left colon was immobilized, taken down the lateral perineal attachments. The sigmoid colon was mobilized. There was an inflammatory mass right at the area of the sigmoid colon consistent with a divertiliculitis or perforation with infection. Proximal to this in the distal left colon, the colon was divided using a GIA stapler with 3.5 mm staples. The sigmoid colon was then mobilized using blunt dissection. The proximal rectum just distal to the inflammatory mass was divided using a GIA stapler with 3.5 mm staples. The mesentary of the sigmoid colon was then taken down and tied using two 0 Vicryl ties. Irrigation was again performed and the sigmoid colon was removed with inflammatory mass. The wall of the abscessed cavity that was next to the sigmoid colon where the inflammatory mass was, showed no leakage of stool, no gross perforation, most likely there is a small perforation in one of the diverticula in this region. Irrigation was again performed throughout the abdomen until totally clear. All excess fluid was removed. The distal descending colon was then brought out through a separate incision in the lower left quadrant area and a large 10 mm 10 French JP drain was placed into the abscessed cavity. The sigmoid colon or the colostomy site was sutured on the inside using interrupted 3- 0 Vicryl to the peritoneum and then two sheets of film were placed

into the intra- abdominal cavity. The fascia was closed using a running #1 double loop PDS suture and intermittently a #2 nylon retention suture was placed. The colostomy was matured using interrupted 3 - 0 chromic sutures. I palpated the colostomy; it was completely patent with no obstructions. Dressings were applied. Colostomy bag was applied. Which CPT® code should be used? A. 44140 B. 44143 C. 44160 D. 44208 Correct Answer: B. 44143 A 5 - year-old male with a history of prematurity was found to have a chordee due to congenital hypospadias. He presents for surgical management for a plastic repair in straightening the abnormal curvature. Under general anesthesia, bands were placed around the base of the penis and incisions were made degloving the penis circumferentially. The foreskin was divided in Byers flaps and the penile skin was reapproximated at the 12 o'clock position. Two Byers flaps were reapproximated, recreating a mucosal collar which was then criss- crossed and trimmed in the midline in order to accommodate median raphe reconstruction. This was reconstructed with use of a horizontal mattress suture. The shaft skin was then approximated to the mucosal collar with sutures correcting the defect. Which CPT® code should be used? A. 54304 B. 54340 C. 54400 D. 54440 Correct Answer: A. 54304 A 22 - year-old is 14 weeks pregnant and wants to terminate the pregnancy. She has consented for a D&E. She was brought to the operating room where MAC anesthesia was given. She was then placed in the dorsal lithotomy position and a weighted speculum was placed into her posterior vaginal vault. Cervix was identified and dilated. A 6.5-cm suction catheter hooked up to a suction evacuator was placed and products of conception were evacuated. A medium size curette was then used to curette her endometrium. There was noted to be a small amount of remaining products of conception in her left cornua. Once again the suction evacuator was placed and the remaining products of conception were evacuated. At this point she had a good endometrial curetting with no further products of conception noted. Which CPT® code should be used? A. 59840 B. 59841 C. 59812 D. 59851 Correct Answer: B. 59841 A 37 - year-old female has menorrhagia and wants permanent sterilization. The patient was placed in Allen stirrups in the operating room. Under anesthesia the cervix was dilated and the hysteroscope was advanced to the endometrium into the uterine cavity. No polyps or fibroids were seen. The Novasure was used for endometrial ablation. A knife was then used to make an incision in the right lower quadrant and left lower quadrant with 5-mm trocars inserted under direct visualization with no injury to any abdominal contents. Laparoscopic findings revealed the uterus, ovaries and fallopian tubes to be normal. The appendix was normal as were the upper quadrants. Because of the patient's history of breast cancer and desire for no further children, it

was decided to take out both the tubes and ovaries. This had been discussed with the patient prior to surgery. What are the codes for these procedures? A. 58660, 58353- 51 B. 58661, 58563- 51 C. 58661, 58558- 51 D. 58662, 58563 - 51 Correct Answer: B. 58661, 58563 - 51 MRI reveals patient has cervical stenosis. It was determined he should undergo bilateral cervical laminectomy at C3 through C6 and fusion. The edges of the laminectomy were then cleaned up with a Kerrison and foraminotomies were done at C4, C5, and,C6. The stenosis is central; a facetectomy is performed by using a burr. Nerve root canals were freed by additional resection of the facet, and compression of the spinal cord was relieved by removal of a tissue overgrowth around the foramen. Which CPT® code(s) is (are) used for this procedure? A. 63045 - 50, 63048- 50 B. 63020 - 50, 63035-50, 63035- 50 C. 63015 - 50 D. 63045, 63048 x 2 Correct Answer: D. 63045, 63048 x 2 An extracapsular cataract removal is performed on the right eye by manually using an iris expansion device to expand the pupil. A phacomulsicfication unit was used to remove the nucleus and irrigation and aspiration was used to remove the residual cortex allowing the insertion of the intraocular lens. What CPT® code is reported? A. 66985 B. 66984 C. 66982 D. 66983 Correct Answer: C. 66982 An infant who has chronic otitis media in the right and left ears was placed under general anesthesia and a radial incision was made in the posterior quadrant of the left and right tympanic membranes. A large amount of mucoid effusion was suctioned and then a ventilating tube was placed in both ears. What CPT® and ICD- 10 - CM codes are reported? A. 69436 - 50, H65. B. 69436 - 50, H66. C. 69433 - 50, H65. D. 69421 - 50, H65.33 Correct Answer: A. 69436 - 50, H65. A 50 - year-old patient is coming to see her primary care physician for hypertension. The patient also discusses with her physician that the OBGYN office had just told her that her Pap smear came back with an abnormal reading and is worried because her aunt had passed away with cervical cancer. The physician documents she spent 40 minutes face-to-face time with the patient, and 25 minutes of that time is giving counseling on the awareness, other screening procedures and treatment if it turns out to be cervical cancer. What E/M code(s) is (are) reported for this visit? A. 99215 B. 99213, 99358 C. 99214, 99354

D. 99213 Correct Answer: A. 99215 A patient was admitted yesterday to the hospital for possible gallstones. The following day the physician who admitted the patient performed a detailed history, a detailed exam and a medical decision making of low complexity. The physician tells her the test results have come back positive for gallstones and is recommending having a cholecystectomy. What code is reported for this evaluation and management service for the following day? A. 99253 B. 99221 C. 99233 D. 99234 Correct Answer: C. 99233 A patient came in to the ER with wheezing and a rapid heart rate. The ER physician documents a comprehensive history, comprehensive exam and medical decision of moderate complexity. The patient has been given three nebulizer treatments. The ER physician has decided to place him in observation care for the acute asthma exacerbation. The ER physician will continue examining the patient and will order additional treatments until the wheezing subsides. Select the appropriate code(s) for this visit. A. 99284, 99219 B. 99219 C. 99284 D. 99235 Correct Answer: B. 99219 A 6 - month-old patient is administered general anesthesia to repair a cleft palate. What anesthesia code(s) is (are) reported for this procedure? A. 00170, 99100 B. 00172 C. 00172, 99100 D. 00176 Correct Answer: C. 00172, 99100 A 50 - year-old female had a left subcutaneous mastectomy for cancer. She now returns for reconstruction which is done with a single TRAM flap. Right mastopexy is done for asymmetry. Select the anesthesia code for this procedure. A. 00404 B. 00402 C. 00406 D. 00400 Correct Answer: B. 00402 A patient is having knee replacement surgery. The surgeon requests that in addition to the general anesthesia for the procedure that the anesthesiologist also insert a continuous lumbar epidural infusion for postoperative pain management. The anesthesiologist performs postoperative management for two postoperative days. A. 01400 - AA, 62326, 01996 x 2 B. 01402 - AA, 62327, 01966 x 2 C. 01402 - AA, 62326, 01996 x 2 D. 01404 - AA, 62327 Correct Answer: C. 01402 - AA, 623 26, 01996 x 2

A 35 - year-old male sees his primary care physician complaining of fever with chills, cough and congestion. The physician performs a chest X-ray taking lateral and AP views in his office. The physician interprets the X-ray views and the patient is diagnosed with walking pneumonia. Which CPT® code is reported for the chest X-rays performed in the office and interpreted by the physician? A. 71046 - 26 B. 71047 - 26 C. 71046 D. 71045 - 26 - TC Correct Answer: C. 71046 This gentleman has localized prostate cancer and has chosen to have complete transrectal ultrasonography performed for dosimetry purposes. Following calculation of the planned transrectal ultrasound, guidance was provided for percutaneous placement of 1 - 125 seeds. Select the appropriate codes for this procedure. A. 55920, 76965- 26 B. 55876, 76942- 26 C. 55860, 76873- 26 D. 55875, 76965 - 26 Correct Answer: D. 55875, 76965 - 26 A 76 - year-old female had a ground level fall when she tripped over her dog earlier this evening in her apartment. The Emergency Department took X-rays of the left wrist in oblique and lateral views which revealed a displaced distal radius fracture, type I open left wrist. What radiological service and ICD- 10 - CM codes are reported? A. 73100 - 26, S52.502B, W18.31XA, Y92. B. 73110 - 26, S52.602A, W18.31XA, Y92. C. 73115 - 26, S52.502A, W18.31XA, Y92. D. 73100 - 26, S52.602B, W18.31XA, Y92.039 Correct Answer: A. 73100 - 26, S52.502B, W18.31XA, Y92. An 18-year-old female with a history of depression comes into the ER in a coma. The ER physician orders a drug screen on antidepressants, phenothiazines, and benzodiazepines. The lab performs a screening for single drug class using an immunoassay in a random access chemistry analyzer. Presence of antidepressants is found and a drug confirmation is performed to identify the particular antidepressant. What correct CPT® codes are reported? A. 80307, 80338 B. 80305, 80338 C. 80306 x 3, 80332 D. 80307 x 3, 80333 Correct Answer: A. 80307, 80338 A patient uses Topiramate to control his seizures. He comes in every two months to have a therapeutic drug testing performed to assess serum plasma levels of this medication. What lab code(s) is (are) reported for this testing? A. 80305 B. 80375 C. 80201

D. 80306, 80375 Correct Answer: C. 80201 Patient that is a borderline diabetic has been sent to the laboratory to have an oral glucose tolerance test. Patient drank the glucose and five blood specimens were taken every 30 to 60 minutes up to three hours to determine how quickly the glucose is cleared from the blood. What code(s) is (are) reported for this test? A. 82947 x 5 B. 82946 C. 80422 D. 82951, 82952 x 2 Correct Answer: D. 82951, 82952 x 2 A patient with severe asthma exacerbation has been admitted. The admitting physician orders a blood gas for oxygen saturation only. The admitting physician performs the arterial puncture drawing blood for a blood gas reading on oxygen saturation only. The physician draws it again in an hour to measure how much oxygen the blood is carrying. Select the codes for reporting this service. A. 82805, 82805 - 51 B. 82810, 82810- 91 C. 82803, 82803- 51 D. 82805, 82805 - 90 Correct Answer: B. 82810, 82810 - 91 A new patient is having a cardiovascular stress test done in his cardiologist's office. Before the test is started the physician documents a comprehensive history and exam and moderate complexity medical decision making. The physician will be supervising and interpreting the stress on the patient's heart during the test. What procedure codes are reported for this encounter? A. 93015 - 26, 99204- 25 B. 93016, 93018, 99204- 25 C. 93015, 99204- 25 D. 93018 - 26, 99204 - 25 Correct Answer: C. 93015, 99204 - 25 A cancer patient is coming in to have a chemotherapy infusion. The physician notes the patient is dehydrated and will first administer a hydration infusion. The infusion time was 1 hour and 30 minutes. Select the code(s) that is (are) reported for this encounter? A. 96360 B. 96360, 96361 C. 96365, 96366 D. 96422 Correct Answer: A. 96360 A patient that has multiple sclerosis has been seeing a therapist for four visits. Today's visit the therapist will be performing a comprehensive reevaluation to determine the extent of progress. There was a revised plan assessing the changes in the patient's functional status. Initial profile was updated to reflect changes that affect future goals along with a revised plan of care. A total care of 30 minutes were spent in this re-evaluation. What CPT® and ICD- 10 - CM codes should be reported? A. 97168, Z51.89, G35 B. 97164, Z56.89, G35

C. 97167, G35

D. 97163, Z56.9, G35 Correct Answer: A. 97168, Z51.89, G35 What is the term used for inflammation of the bone and bone marrow? A. Chondromatosis B. Osteochondritis C. Costochondritis D. Osteomyelitis Correct Answer: D. Osteomyelitis The root word trich/o means: A. Hair B. Sebum C. Eyelid D. Trachea Correct Answer: A. Hair Complete this series: Frontal lobe, Parietal lobe, Temporal lobe,. A. Medulla lobe B. Occipital lobe C. Middle lobe D. Inferior lobe Correct Answer: B. Occipital lobe A patient is having pyeloplasty performed to treat an uretero-pelvic junction obstruction. What is being performed? A. Surgical repair of the bladder B. Removal of the kidney C. Cutting into the ureter D. Surgical reconstruction of the renal pelvis Correct Answer: D. Surgical reconstruction of the renal pelvis A 27 - year-old was frying chicken when an explosion of the oil had occurred and she sustained second-degree burns on her face (5%), third degree burns on both hands (5%). There was a total of 10 percent of the body surface that was burned. Select which ICD- 10 - CM codes are reported. A. T20.20XA, T23.301A, T23.302A, T31.10, X10.2XXA, Y93.G3 B. T23.301A, T23.302A, T20.20XA, T31.11, X10.2XXA, Y93.G3 C. T23.301A, T23.302A, T20.20XA, T31.10, X10.2XXA, Y93.G3 D. T23.601A, T23.602A, T20.60XA, T31.10, X10.2XXA, Y93.G3 Correct Answer: C. T23.301A, T23.302A, T20.20XA, T31.10, X10.2XXA, Y93.G3 A patient that has cirrhosis of the liver just had an endoscopy performed showing hemorrhagic esophageal varices. The ICD- 10 - CM codes are reported: A. I85.01, K74.69 B. I85.11, K74.60 C. K74.60, I85.11 D. I85.00, K74.69 Correct Answer: C. K74.60, I85.11

A 55 - year-old-patient had a fracture of his left knee cap six months ago. The fracture has healed but he still has staggering gait in which he will be going to physical therapy. What ICD- 10 - CM codes are reported? A. S82.002A, R26.81 B. R26.0, S82.002A C. S82.092S, R26.0 D. R26.0, S82.002S Correct Answer: D. R26.0, S82.002S Which statement is TRUE about Z codes: A. Z codes are never reported as a primary code. B. Z codes are only reported with injury codes. C. Z codes may be used either as a primary code or a secondary code. D. Z codes are always reported as a secondary code. Correct Answer: C. Z codes may be used either as a primary code or a secondary code. Patient with corneal degeneration is having a cornea transplant. The donor cornea had been previously prepared by punching a central corneal button with a guillotine punch. This had been stored in Optisol GS. It was gently rinsed with BSS Plus solution and was then transferred to the patient's eye on a Paton spatula and sutured with 12 interrupted 10-0 nylon sutures. Select the HCPCS Level II code for the corneal tissue. A. V2790 B. V2785 C. V2628 D. V2799 Correct Answer: B. V2785 The patient presents to the office for an injection. Joint prepped using sterile technique. Muscle group location: gluteus maximus. Sterilely injected with 40 mg of Kenalog-10, 2 cc Marcaine and 2 cc lidocaine 2%. Sterile bandage applied. Choose the HCPCS Level II code for this treatment. A. J3301 x 4 B. J3301 C. J3300 x 40 D. J3300 Correct Answer: A. J3301 x 4 Which of the following is an example of electronic data? A. A digital X-ray B. An explanation of benefits C. An advance beneficiary notice D. A written prescription Correct Answer: A. A digital X-ray Which health plan does NOT fall under HIPAA? A. Medicaid B. Medicare C. Workers' compensation D. Private plans Correct Answer: C. Workers' compensation

Guidelines from which of the following code sets are included as part of the code set requirements under HIPAA? A. CPT® Category III codes B. ICD- 10 - CM C. HCPCS Level II D. ADA Dental Codes Correct Answer: B. ICD- 10 - CM Which statement is an example in which a diabetes-related problem exists and the code for diabetes is NEVER sequenced first? A. If the patient has an underdose of insulin due to an insulin pump malfunction. B. If the patient is being treated for secondary diabetes. C. If the patient is being treated for Type 2 diabetes and uses insulin. D. If the patient is diabetic with an associated condition. Correct Answer: A. If the patient has an underdose of insulin due to an insulin pump malfunction. Patient has basal cell carcinoma on his upper back. A map was prepared to correspond to the area of skin where the excisions of the tumor will be performed using Mohs micrographic surgery technique. There were three tissue blocks that were prepared for cryostat, sectioned, and removed in the first stage. Then a second stage had six tissue blocks which were also cut and stained for microscopic examination. The entire base and margins of the excised pieces of tissue were examined by the surgeon. No tumor was identified after the final stage of the microscopically controlled surgery. What procedure codes are reported? A. 17313, 17314, 17314 B. 17313, 17315 C. 17260, 17313, 17314 D. 17313,17314, 17315 Correct Answer: D. 17313,17314, 17315 A 45 - year-old male is in outpatient surgery to excise a basal cell carcinoma of the right nose and have reconstruction with an advancement flap. The 1.2 cm lesion with an excised diameter of 1.5 cm was excised with a 15-blade scalpel down to the level of the subcutaneous tissue, totaling a primary defect of 1.8 cm. Electrocautery was used for hemostasis. An adjacent tissue transfer of 3 sq cm was taken from the nasolabial fold and was advanced into the primary defect. Which CPT® code(s) is (are) reported? A. 14060 B. 11642, 14060 C. 11642, 15115 D. 15574 Correct Answer: A. 14060 A 24 - year-old patient had an abscess by her vulva which burst. She has developed a soft tissue infection caused by gas gangrene. The area was debrided of necrotic infected tissue. All of the pus was removed and irrigation was performed with a liter of saline until clear and clean. The infected area was completely drained and the wound was packed gently with sterile saline moistened gauze and pads were placed on top of this. The correct CPT® code is: A. 56405 B. 10061 C. 11004

D. 11042 Correct Answer: C. 11004 A 76 - year-old female had a recent mammographic and ultrasound abnormality in the 6 o'clock position of the left breast. She underwent core biopsies which showed the presence of a papilloma. The plan now is for needle localization with excisional biopsy to rule out occult malignancy. After undergoing preoperative needle localization with hookwire needle injection with methylene blue, the patient was brought to the operating room and was placed on the operating room table in the supine position where she underwent laryngeal mask airway (LMA) anesthesia. The left breast was prepped and draped in a sterile fashion. A radial incision was then made in the 6 o'clock position of the left breast corresponding to the tip of the needle localizing wire. Using blunt and sharp dissection, we performed a generous excisional biopsy around the needle localizing wire including all of the methylene blue-stained tissues. The specimen was then submitted for radiologic confirmation followed by permanent section pathology. Once hemostasis was assured, digital palpation of the depths of the wound field failed to reveal any other palpable abnormalities. At this point, the wound was closed in 2 layers with 3- 0 Vicryl and 5 - 0 Monocryl. Steri-Strips were applied. Local anesthetic was infiltrated for postoperative analgesia. What CPT® and ICD- 10 - CM codes describe this procedure? A. 19100, N63.20 B. 19285, C50.912 C. 19120, R92.8 D. 19125, D24.2 Correct Answer: D. 19125, D24.2 The patient is a 66 - year-old female who presents with Dupuytren's disease in the right palm and ring finger. This results in a contracture of the ring digit MP joint. She is having a subtotal palmar fasciectomy for Dupuytren's disease right ring digit and palm. An extensile Brunner incision was then made beginning in the proximal palm and extending to the ring finger PIP crease. This exposed a large pretendinous cord arising from the palmar fascia extending distally over the flexor tendons of the ring finger. The fascial attachments to the flexor tendon sheath were released. At the level of the metacarpophalangeal crease, one band arose from the central pretendinous cord-one coursing toward the middle finger. The digital nerve was identified, and this diseased fascia was also excised. What procedure code(s) is (are) used? A. 26123 - RT, 26125 - F7 B. 26121 - RT C. 26035 - RT D. 26040 - RT Correct Answer: A. 26123 - RT, 26125 - F7 This is a 32 - year-old female who presents today with sacroilitis. On the physical exam there was pain on palpation of the left and right sacroiliac joint and fluoroscopic guidance was done for the needle positioning. Then 80 mg of Depo-Medrol and 1 mL of bupivacaine at 0.5% was injected into the left and right sacroiliac joint with a 22 gauge needle. The patient was able to walk from the exam room without difficulty. Follow up will be as needed. The correct CPT® code(s) is (are): A. 20611 B. 27096 - 50, 77012 C. 27096 - 50 D. 27096, 27096 - 51, 77012 Correct Answer: C. 27096 - 50