AAPC CPC FINAL EXAM WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED RATIONALES ANSW, Exams of Nursing

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AAPC CPC FINAL EXAM WITH

ACTUAL CORRECT QUESTIONS AND

VERIFIED DETAILED RATIONALES

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QUESTIONS AND SOLUTIONS

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A patient with a long history of endometriosis has an open surgical approach to perform an exploratory laparotomy for an enlarged right ovary seen on ultrasound with other possible masses on the uterus and in the peritoneum. Exploration reveals these masses to be endometriosis including a chocolate cyst (endometrioma) of the right ovary, right fallopian tube and peritoneum. The endometriomas are all small, less than 5 cm, and laser is used to ablate them, except the ovarian cyst, which is excised. During the procedure the patient also has a tubal ligation. What are the CPT® and ICD-10-CM codes reported for this service?

a. 49203, 58611, N80.1, N80.2, N80.3, Z30. b. 58662, 58600-51, N80.1, N80.2, N80.3, Z30. c. 49203, 58671-51, N80. d. 49000, 58662-51, 58925-51, 58671-51, N80.1, N80.2, N80.3, Z30.

a. 49203, 58611, N80.1, N80.2, N80.3, Z30.

Preoperative Diagnosis: Left orbital cyst, hemangioma versus lymphangioma Postoperative Diagnosis: Left orbital cyst, hemangioma versus lymphangioma Procedures Performed: Aspiration of left orbital cyst with injection of Kenalog Anesthesia: General Complications: None Estimated Blood Loss: Minimal Indications for Procedure: The patient presents with a small cyst of the superior medial left orbit felt to be suggestive for hemangioma versus lymphangioma. Risks, benefits, and alternatives of steroid injection to inactivate the cyst were reviewed. These risks included failure to work and significant visual loss. After discussion, they elected to proceed. Description of Procedure: After informed operative consent was obtained, the patient was brought to the operating room and laid in the supine position. General anesthetic was administered per the

anesthesiologist. A 25-gauge needle on a 5-cc syringe was placed within the mass and aspirated. Approximately 0.5 cc of blood was recovered, but the blood was of normal bright red color. Kenalog 40 mg (1 cc) was then injected where the mass was aspirated without difficulty. Operative area was clean and dry. The patient was then awakened and taken to the recovery room. Pupil reactions were brisk and equal with 2 mm pupils noted in the recovery room. There were no operative complications. What CPT® and ICD-10-CM codes are reported?

a. 67405-LT, D18. b. 67500-LT, D18. c. 67515-LT. H05. d. 67415-LT, H05.

d. 67415-LT, H05.

Rationale: The provider aspirated a cyst that was in the left orbit. In the CPT index look for Aspiration/Orbital Contents referring you to code 67415. Code 67500 is reported when there is an injection of a therapeutic or local anesthetic behind the eyeball(retrobulbar). Diagnoses documented as versus are not definitive diagnosis codes and are not coded. The postoperative header indicates and orbital cyst. In the ICD-10-CM alphabetical index look for Cyst/orbit referring you to code H05.81. Verify code in the Tabular List. A 6th character is required to indicate which eye; 2 is reported for the left eye.

PROCEDURES PERFORMED:

1. Bilateral facet joint injections, L4-L
2. Bilateral facet joint injections, L5-S1.
3. Fluoroscopy. TECHNIQUE: The AP view was aligned with the proper tilt so that the end plates for the desired levels were perpendicular. The AP image showed the sacrum and the L5 spinous process. Manual palpation located the sacral hiatus. The 6-inch, 20-gauge needle with a slight volar bend was inserted using fluoroscopy into each facet joint under AP image. The bilateral L4-L5, and L5-S1 facet joints were injected in a systematic fashion from caudal to cranial. A sterile dressing was applied. The patient tolerated the procedure well with no complications and was transferred to recovery in good condition. What CPT® codes are reported?

a. 64493-50 x 2 b. 64493-50, 64494-50-51, 77002- c. 64493-50, 64494 x 2, 77002- d. 64493-50, 64494 x 2

d. 64493-50, 64494 x 2

A 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
3. Worsening ARF due to cardio-renal syndrome PLAN:
4. Increase BUMEX to 2 mg IV Q6.
5. Give 500 mg IV DIURIL times one.
6. Re-check usual labs in a.m. Total time: 20 minutes. What E/M category is used for this visit?

a. Inpatient Consultation (99251-99255) b. Initial Hospital Visit (99221-99223) c. Established Patient Office/Outpatient Visit (99211-99215) d. Subsequent Hospital Visit (99231-99233)

d. Subsequent Hospital Visit (99231-99233)

Operative Report: Pre-Operative Diagnoses: Basal Cell Carcinoma, forehead Basal Cell Carcinoma, right cheek Suspicious lesion, left nose Suspicious lesion, left forehead Post-Operative Diagnoses: Basal Cell Carcinoma, forehead with clear margins Basal Cell Carcinoma, right cheek with clear margins Compound nevus, left nose with clear margins Epidermal nevus, left forehead with clear margins INDICATIONS FOR SURGERY: The patient is a 47-year-old white man with a biopsy proven basal cell carcinoma of his forehead and a biopsy proven basal cell carcinoma of his right cheek. We were not quite sure of the patient's location of the basal cell carcinoma of the forehead whether it was a midline lesion or lesion to the left. We felt stronger about the midline lesion, so we marked the area for elliptical excision in relaxed skin tension lines of his forehead with gross normal margins of 1-2 mm and I marked

the lesion of the left forehead for biopsy. He also had a lesion of his left alar crease we marked for biopsy and a large basal cell carcinoma of his right cheek, which was more obvious. This was marked for elliptical excision with gross normal margins of 2-3 mm in the relaxed skin tension lines of his face. I also drew a possible rhomboid flap that we would use if the wound became larger. He observed all these margins in the mirror, so he could understand the surgery and agree on the locations, and we proceeded. DESCRIPTION OF PROCEDURE: All four areas were infiltrated with local anesthetic. The face was prepped and draped in sterile fashion. I excised the lesion of the forehead measuring 6 mm and right cheek measuring 1.3 cm as I had drawn them and sent in for frozen section. The biopsies were taken of the left forehead and left nose using a 2-mm punch, and these wounds were closed with 6-0 Prolene. Meticulous hemostasis was achieved of those wounds using Bovie cautery. I closed the cheek wound first. Defects were created at each end of the wound to facilitate primary closure and because of this I considered a complex repair and the wound was closed in layers using 4-0 Monocryl, 5-0 Monocryl and 6-0 Prolene, with total measurement of 2.1 cm. The forehead wound was closed in layers using 5- Monocryl and 6-0 Prolene, with total measurement of 1.0 cm. Loupe magnification was used and the patient tolerated the procedure well. What ICD-10-CM codes are reported?

a. C44.202, C44.40, D22.23, D22. b. C44.319, D04.39, D48.5, D22. c. C44.319, D22. d. C44.202, C44.309, D48.5, D49.

c. C44.319, D22.

What type of insurance is Medicare Part D?

a. Hospital coverage available to all Medicare beneficiaries. b. A Medicare Advantage program managed by private insurers. c. Provider coverage requiring monthly premiums. d. Prescription drug coverage available to all Medicare beneficiaries

d. Prescription drug coverage available to all Medicare beneficiaries

HITECH provides a ______ day window during which any violation not due to willful neglect may be corrected without penalty. a. 45 b. 60 c. 30 d. 40

c. 30

The Medicare program is made up of several parts. Which part covers provider fees without the use of a private insurer?

a. Part D

b. Part C c. Part A d. Part B

b. Part C

Which CMS product describes whether specific medical items, services, treatment procedures or technologies are considered medically necessary under Medicare?

a. Medicare Physician Fee Schedule Final Rule b. Medicare Claims Processing Manual c. National Coverage Determinations Manual d. Relative Value Files

c. National Coverage Determinations Manual

If an NCD does not exist for a particular service/procedure performed on a Medicare patient, who determines coverage?

a. Centers for Medicare & Medicaid Services (CMS) b. Current Procedural Terminology (CPT®) guidelines c. Medicare Administrative Contractor (MAC) d. The physician providing the service

c. Medicare Administrative Contractor (MAC)

Which does NOT contribute to refraction in the eye?

a. Cornea b. Aqueous c. Macula d. Lens

c. Macula

Which part of the brain controls blood pressure, heart rate and respiration? a. Cerebellum b. Medulla c. Cerebrum d. Cortex

b. Medulla

Upon leaving the stomach, nutrients move through the small intestine in what order?

a. Duodenum, jejunum, ileum. b. Jejunum, ileum, duodenum c. Jejunum, duodenum, ileum d. Duodenum, ileum, jejunum

a. Duodenum, jejunum, ileum.

Bone marrow harvesting is a procedure to obtain bone marrow from a donor. Bone marrow collected from a close relative is: a. Autoinfusion b. Allogenic c. Alloplasty d. Autologous

b. Allogenic

A respiratory disease characterized by overexpansion and destruction of the alveoli is identified as: a. Respiratory distress syndrome b. Emphysema c. Pneumoconiosis d. Cystic fibrosis

b. Emphysema

The terms malignant, benign, in situ and uncertain behavior are all terms used when coding what? a. Seeds b. Lumps c. Skin rashes d. Neoplasms

d. Neoplasms

What do brackets [ ] indicate in the ICD-10-CM Alphabetic Index? a. Use the code(s) in brackets first. b. Use the code(s) in brackets in addition to the disease or condition to identity an associated manifestation. c. Use the code(s) in brackets as the only code. d. Do not assign the code in brackets.

b. Use the code(s) in brackets in addition to the disease or condition to identity an associated manifestation.

What is the ICD-10-CM code for nausea? a. R11. b. R11. c. T75.3XXA d. R11.

a. R11.

A 45-year-old female with malignant Müllerian duct cancer is receiving her first treatment of chemotherapy. What diagnosis codes are reported? a. C79.82, Z51. b. C57.7, Z51.

c. Z51.11, C57. d. Z51.11, D28.

c. Z51.11, C57.

A 30-year-old female patient was seen in the ED with complaints of diarrhea for the past four days. She was also complaining of lower abdominal pain. After examination, the patient was diagnosed with viral gastroenteritis. She was instructed to drink plenty of fluids and to begin eating solids only after the diarrhea has subsided. What diagnosis code(s) would be reported for this encounter? a. R10.31, R19. b. K52. c. A08.4, R10.84, R19. d. A08.

d. A08.

What is the ICD-10-CM code for a patient with postoperative anemia due to acute blood loss during the surgery who needs a blood transfusion? a. D53. b. D50. c. D d. D64.

c. D

A patient is having surgery to repair a recurrent left inguinal hernia without obstruction. What ICD-10- CM code is reported? a. K40. b. K40. c. K40. d. K40.

b. K40.

A 45-year-old patient is scheduled to have an INFUSAID pump installed. He has primary liver cancer and the pump is being inserted for continuous administration of 5-FU. A pocket is created just under the skin and the pump is placed in the pocket. A catheter is attached to the pump and to the subclavian vein. The pump is filled with a chemotherapy agent provided by the hospital and the patient is given his first treatment and observed for adverse reaction and discharged to home. What ICD-10-CM codes are reported? a. Z51.11, C22. b. Z51.11, C22. c. C22.9, Z51. d. C22.8, Z51.

a. Z51.11, C22.

Rationale: ICD-10-CM Guideline I.C.2.e.2 indicates an encounter for chemotherapy code is to be

reported as the primary code with a code for the cancer as secondary when the reason for the visit is solely for chemotherapy. Look in the ICD-10-CM Alphabetic Index for Chemotherapy (session) (for)/cancer Z51.11. For the malignancy, look in the ICD-10-CM Table of Neoplasms for liver/primary and use the code from the Malignant Primary column which directs the coder to C22.8. Verify code selection in the Tabular List.

A patient with hypertension presents to the outpatient hospital radiology department for an ultrasound due to a suspected suspicious mass. The patient's provider performed an ACTH and a 24-hour urinary free cortisol and short suppression test confirming the diagnosis of Cushing's disease. The radiology report indicated a 5.5 cm right adrenal mass that appeared well circumscribed and rounded. The final diagnosis indicated Cushing's disease secondary to a right adrenal tumor. The hypertension is due to the Cushing's syndrome. What ICD-10-CM codes are reported? a. D49.7, I15. b. D49.7, E24.9, I15. c. C74.91, E24.9, I d. C74.91, E24.9, I15.

b. D49.7, E24.9, I15.

Rationale: The patient has Cushing's disease secondary to an adrenal tumor. First code the adrenal tumor. We are told that there is a right adrenal tumor; however, we are not given more information as to a specific type of adrenal tumor and whether it is benign or malignant. In the ICD-10-CM Alphabetic Index look for Tumor (see also Neoplasm, unspecified behavior, by site). Look in the ICD-10-CM Table of Neoplasms for Neoplasm, neoplastic/adrenal and use the code from the Unspecified Behavior column directing you to D49.7. Next, in the ICD-10-CM Alphabetic Index find Cushing's/syndrome or disease which directs the coder to E24.9. The unspecified code for Cushing's syndrome is used because we are not given the specific type of Cushing's the patient has. The Cushing's syndrome is associated to the hypertension. Look for Hypertension/due to/endocrine disorder referring you to code I15.2. Verify all codes in the Tabular List.

A 58-year-old patient sees the provider for confusion and loss of memory. The provider diagnoses the patient with early onset stages of Alzheimer's disease with dementia. What ICD-10-CM codes are reported?

a. G30.0, F02. b. F02.80, G30.0, F29, R41. c. F02.80, G30. d. G30.0, F02.80, F29, R41.

a. G30.0, F02.

What type of fracture is considered traumatic? a. Comminuted fracture b. Pathological fracture c. Stress fracture d. Spontaneous fracture

a. Comminuted fracture

A pregnant woman in her 40th week has gestational diabetes which is controlled by diet. What ICD-10- CM code(s) is/are reported? a. O24.113, O24.410, Z3A. b. O24.410, Z3A. c. O24.410, O24. d. O24.

b. O24.410, Z3A.

A patient was referred to the radiology department for chronic low back pain. The radiology report indicated there was no marrow abnormality identified and the conus medullaris was unremarkable. Additional findings include: L4-L5: There is a minor diffusely bulging annulus at L4-L5. A small focal disc bulge is seen in far lateral position on the left at L4-L5 within the neural foramen. No definite encroachment on the exiting nerve root at this site is seen. No significant spinal stenosis is identified. L5- S1: There is a diffusely bulging annulus at L5-S1, with a small focal disc bulge centrally at this level. There is minor disc desiccation and disc space narrowing at L5-S1. No significant spinal stenosis is seen at L5- S1. The final diagnosis is minor degenerative disc disease at L4-L5 and L5-S1, as described. What ICD-10- CM code(s) is/are reported? a. M51.36, M51. b. M51. c. M51.37, M54. d. M51.36, M54.

b. M51.36, M51.

Response Feedback: Rationale: Look in the ICD-10-CM Alphabetic Index for Degeneration, degenerative/intervertebral disc NOS/lumbar region directing you to code M51.36. Look in the ICD-10-CM Alphabetic Index for Degeneration, degenerative/intervertebral disc NOS/lumbosacral region directing you to code M51.37. Verify code selection in the Tabular List. The low back pain is a symptom of the degenerative disc disease and is not reported separately.

A 16-year-old male is brought to the ED by his mother. He was riding his bicycle in the park when he fell off the bike. The patient's right arm is painful to touch, discolored, and swollen. The X-ray shows a closed fracture of the ulna. What ICD-10-CM codes are reported? a. S52.201A, V18.0XXA, Y92. b. S52.201A, V18.4XXA, Y92. c. S52.209A, V18.4XXA, Y92. d. S52.201A, V19.9XXA, Y92.

a. S52.201A, V18.0XXA, Y92.

A child is seen in a hospital based pediatric clinic for active treatment of 10% first and second degree burns to the left calf area and 5% third degree burns on her right hand. What ICD-10-CM codes are

reported? a. T23.301A, T24.232A, T24.132A b. T23.291A, T24.202A c. T23.301A, T24.232A d. T24.202A, T23.301A, T24.132A

c. T23.301A, T24.232A

Response Feedback:Rationale: Burns are classified as burns or corrosions in ICD-10-CM. In this scenario, there is no specification as to what caused the burns, but they are stated as burns. ICD-10-CM guideline I.C.19.d.1 indicates to sequence first the code that reflects the highest degree of burn when more than one is present. In this case, the third degree burn on the right hand is listed first. In the ICD-10-CM Alphabetic Index, look for Burn/hand(s)/right/third degree directing you to T23.301-. In the Tabular List, a 7 th character A is reported for the initial encounter (active treatment). ICD-10-CM guideline I.C.19.d. indicates to code burns of the same site, but of different degrees to the subcategory identifying the highest degree recorded. Therefore, report second degree burns to the left calf. Look in the Alphabetic Index for Burn/calf/left/second degree T24.232. In the Tabular List a 7th character A is reported for the initial encounter. ICD-10-CM guideline I.C.19.d.6 indicates a code from category T31 is reported when there is mention of a third-degree burn involving 20% or more of the body surface. This does not apply in this case, so a code from T31 is not required (unless reporting for a burn unit or other facility requiring the additional data). The codes in the burn section have a note to use additional external cause codes to identify the source, place and intent of the burn. This information is not known in this case so it cannot be reported. Verify code selection in the Tabular List.

What type of CPT® code is "modifier 51 exempt" even though there is no modifier 51 exempt symbol next to it? a. Surgery codes b. Mandated services c. Bilateral procedures d. Add-on codes

d. Add-on codes

What publications does the AMA copyright and maintain?

a. CPT® code book, HCPCS Level II codebook, ICD-10-CM codebook

b. CPT® codenbook and CPT® Assistant

c. CPT® codenbook and HCPCS Level II codebook

d. AHA Coding Clinic and CPT® Assistant

b. CPT® codenbook and CPT® Assistant

What modifier is used to report the termination of a surgery following induction of anesthesia due to extenuating circumstances or those that threaten the well-being of the patient? a. Modifier 53 b. Modifier 22 c. Modifier 52 d. Modifier 54

a. Modifier 53

Response Feedback: Rationale: Modifier 53 is used to indicate the physician has elected to terminate a surgical or diagnostic procedure due to extenuating circumstances or those that threaten the well-being of the patient. CPT® modifiers are found on the inside front cover and in Appendix A of the CPT® code book.

CPT® Category III codes reimburse at what level? a. 100 percent b. 85 percent c. 10 percent d. Reimbursement, if any, is determined by the payer

d. Reimbursement, if any, is determined by the payer

Response Feedback:Rationale: Per AMA, there are no relative value units (RVUs) assigned to these codes. Payment for these services or procedures is based on the policies of payers.

What is the correct code for the application of a short arm cast? a. 29075 b. 29280 c. 29065 d. 29125

a. 29075

Rationale: In the CPT® Index, look for Cast/Type/Ambulatory/Short Arm. The code you are directed to use is 29075.

A patient presents to the office with a suspicious lesion of the nose. The physician takes a biopsy of the lesion and pathology determines the lesion to be uncertain. What is the correct diagnosis code to report? a. D22. b. C44. c. D48. d. D49.

c. D48.

The patient is diagnosed with a superficial basal cell carcinoma of the neck and cheek. After discussion with the physician about different treatment options the patient decides to have these lesions destroyed using cryosurgery. Consent is obtained and the areas are prepped in a sterile fashion. With the use of cryosurgery, the physician destroys the lesion on the neck measuring 2.3 cm and the lesion on the cheek measuring 0.8 cm. What CPT® codes are reported? a. 17000, 17003 b. 17273, 17281- c. 17272, 17281- d. 11623, 11641-

b. 17273, 17281-

Response Feedback: Rationale: Basal cell carcinoma is a malignant lesion. In the CPT® Index, look for Destruction/Lesion/Skin/Malignant, you are directed to code range 17260-17286, 96567. 96567 is for photodynamic therapy. 17260-17286 is used for cryosurgery. Code selection is based on location and size. For the neck, a code from range 17270-17276 is selected. The neck lesion is 2.3 cm making 17273 the correct code. For the cheek, a code from range 17280-17286 is selected. The cheek lesion is 0.8 cm making 17281 the correct code choice. Modifier 51 is appended to 17281 to indicate multiple surgeries.

What CPT® code(s) would best describe treatment of 9 plantar warts removed and 6 flat warts all destroyed with cryosurgery during the same office visit? a. 17110, 17111- b. 17110, 17003 c. 17110 d. 17111

d. 17111

Rationale: Cryosurgery is a method of destruction using extreme cold to destroy the lesion. In the CPT® Index look for Destruction/Warts/Flat referring you to CPT® codes 17110 and 17111. In the numeric section guidelines under the Integumentary section, subheading Destruction, flat warts and plantar warts are both included in the definition of lesions. Warts are considered benign lesions; they are coded from code range 17110-17111. A total of 15 lesions were destroyed by cryosurgery. Code 17111 represents the destruction of 15 or more lesions.

Patient presents with a suspicious lesion on her left arm. With the patient's permission the physician marked the area for excision. The margins and lesion measured a total of 0.9 cm. The wound measuring 1.2 cm was closed in layers using 4-0 Monocryl and 5-0 Prolene. Pathology later reported the lesion to be a sebaceous cyst. What codes are reported? a. 11402, L72. b. 11401, D22. c. 12031, 11401-51, L72. d. 13121, 11401-51, D22.

c. 12031, 11401-51, L72.

Response Feedback: Rationale: Understanding a sebaceous cyst is benign, look in the CPT® Index for Skin/Excision/Lesion/Benign referring you to code ragen 11400-11446. The lesion is coded based on size and location. Report 11401 for excision of the 0.9 cm arm lesion. The note also indicates the wound was closed in layers allowing for intermediate closure and is also coded based on location and size. Report 12031 for intermediate closure of 1.2 cm. Modifier 51 is appended to 11401 to show additional procedures in the same session. In the ICD-10-CM Alphabetic Index look for Cyst/sebaceous directing you to L72.3. Verify code selection in the Tabular List.

Operative ReportPre-Operative and Post-Operative Diagnosis: Squamous cell carcinoma, left legOpen wound, right legPersonal history of squamous cell carcinoma, right legINDICATIONS FOR SURGERY: The patient is an 81-year-old white man with biopsy proven squamous cell carcinoma of his left leg. I marked the areas for excision with gross normal margins of 5 mm, and I drew my planned skin graft donor site from his left lateral thigh. He also had an open wound of his right leg from a squamous cell carcinoma excised four months ago; the skin graft had not taken. We plan on re-skin grafting the area. The patient is aware of all of these markings, and understands the surgery and location.DESCRIPTION OF PROCEDURE: The patient was taken to the operating room. IV Ancef was given. I used plain lidocaine for his local anesthetic throughout the procedure until the skin grafts were inset. The anterior of his leg and the thigh were infiltrated with local anesthetic. Both lower extremities were prepped and draped circumferentially, which included the left thigh on the left side. I excised the lesion on his left leg as drawn into the subcutaneous fat. Hemostasis achieved with the Bovie cautery. I then excised the wound on his right leg to lower the bacterial counts. I took a 1-2 mm margin around the wound and excised the granulation tissue as well. Hemostasis was achieved using the Bovie cautery. I then changed gloves. A split-thickness skin graft was harvested from the left thigh using the Zimmer dermatome. This was meshed 1:5:1. By this time, the pathology returned showing the margins were clear.Skin grafts were inset on each leg wound using the skin stapler. Xeroform and gauze bolster was placed over the skin graft using 4-0 nylon. The skin graft donor site was dressed with OpSite. The legs were further dressed with heavy cast padding and the double Ace wrap. The patient tolerated the procedure well.PROCEDURES: Excision squamous cell carcinoma, left leg with excised diameter of 2.5 cm, repaired with a split-thickness skin graft measuring 5.1 cm 2. Excisional preparation of right leg wound repaired with a split-thickness skin graft measuring 3.2 cm2.What CPT® codes are reported? a. 15100, 15100-51-LT, 11603-51-LT, 15002-51-RT b. 15100, 11603-51-LT c. 15100, 11603-51-LT, 15002-51-RT d. 15100, 11403-51-LT, 15100-51-RT

c. 15100, 11603-51-LT, 15002-51-RT

Response Feedback:

Rationale: The first excision is for a malignant neoplasm of the left leg measuring 2.5 cm and repaired with a split thickness skin graft measuring 5.1 cm 2. In the CPT® Index look for Skin/Excision/Lesion/Malignant referring you to code range 11600-11646. The site is the leg, which narrows down the code range to 11600-11606. The size of the lesion is 2.5 cm making code 11603 correct. The second excision is a surgical wound preparation of an open wound of the right leg. Look in the CPT® Index for Skin Graft and Flap/Recipient Site Preparation directing you to code range 15002-

15005. Report 15002 for the leg wound, which was repaired with a split thickness autograft measuring 3.2 cm2. Split thickness autografts are added together (5.1 cm2 + 3.2 cm2) for a total graft size of 8. cm2. In the CPT® Index look for Skin Graft and Flap/Split Graft referring you to codes 15100, 15101, 15120, 15121. Report 15100 for the split-thickness graft. Because the original surgery on the right leg was four months ago, this surgery is outside of any global period, so no additional modifier is needed. Modifier 51 is appended to indicate multiple procedures in the same session.

The acronym BKA means:

a. bilateral knee amputation b. below knee amputation c. bursitis knee & arthritis d. bilateral knee arthritis

b. below knee amputation

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. 23075-RT b. 23066-RT c. 23030-RT d. 23076-RT

a. 23075-RT

Rationale: Look in the CPT® Index for Excision/Tumor/Shoulder and you are referred to 23071-23078. Code 23075 reports the excision of a soft tissue mass (tumor), subcutaneous. The mass was removed with deep, blunt dissection; however, there is no mention of the depth and you cannot assume that the mass was subfascial because of the word deep. The measurement of the mass is not documented resulting in the default to the smallest measurement of less than 3 cm for code 23075. It is a rule of thumb that if a coder cannot ask the physician to document the size of a mass, lesion or repair in order to give the physician credit, the smallest measurement is reported. Modifier RT is appended to indicate the procedure is performed on the right side.

A 49-year-old presents with an abscess of the right thumb. The physician incises the abscess and purulent sanguineous fluid is drained. The wound is packed with iodoform packing. What CPT® code is reported? a. 26011-F b. 10060-F

c. 26010-F d. 10061-F

c. 26010-F

Rationale: There are specific Incision and Drainage (I&D) procedure codes when performed on a specific anatomical area. In the CPT® Index, look for Finger/Abscess/Incision and Drainage. You are referred to 26010-26011. Review the codes to choose the appropriate service. 26010 is the correct code. Code 26011 includes extensive debridement, multiple incisions or extensive dissection. Insertion of a drain or gauze strip packing to allow continuous drainage does not constitute complicated incision and drainage.

Under general anesthesia, a 45-year-old patient was sterilely prepped. The wrist joint was injected with Marcaine and epinephrine. Three arthroscopic portals were created. The articulating surface between the scaphoid and the lunate clearly showed disruption of the ligamentous structures. We could see soft tissue pouching out into the joint; this was debrided. There was abnormal motion noted within the scapholunate articulation. At this point the C-arm was brought in. Arthroscopic instruments were placed in the joint and confirmed the location of the shaver as a probe in the scapholunate ligament. There was a significant gap between the capitate and lunate. K-wire was utilized from the dorsal surface into the lunate, restoring the space. Further examination revealed gross instability between the capitate and lunate. With the wrist in neutral position, a K-wire was passed through the scaphoid, through the capitate and into the hamate. This provided stabilization of the wrist joint. Stitches were placed, and a thumb spica cast was applied. What CPT® code(s) is/are reported? a. 29847 b. 29847, 29840- c. 29846 d. 29840

a. 29847

Rationale: The wrist arthroscopy and stabilization was surgically performed to provide stabilization. Look in the CPT® Index for Arthroscopy/Surgical/Wrist directing you to 29843-29847. Check the tabular listing and 29847 reports arthroscopy of the wrist with internal fixation for fracture or instability. Although several K-wires were passed, 29847 is reported only once. The diagnostic arthroscopy is included in the procedure code, 29847 and is not coded separately.

This 36-year-old female presents with an avulsed anterior cruciate ligament off the femoral condyle with a complete white on white horizontal cleavage tear of the posterior horn of the medial meniscus, causing instability. A general endotracheal anesthesia was performed, and the patient was placed supine on the operating table. The right lower extremity was prepped with Betadine and draped free. Standard arthroscopic portals were created, and the knee was systematically examined and probed. The posterior horn of the medial meniscus was noted to be buckled and frayed. This area was carefully probed and found to be irreparable. It was decided that our best option was to proceed with a limited partial meniscectomy, with the goal being to leave as much viable meniscal tissue as possible. Therefore, a medial infrapatellar portal was developed with a longitudinal stab wound. A series of straight-angled and curved basket punches was used to perform a saucerization of the damaged portion of the meniscus, leaving the intact portion of the medial meniscus in place. Debris was meticulously removed

with the 4.0 meniscal cutter. Approximately 50% of the medial meniscus remained. Next, our attention was turned to the ACL repair. Through a 5 cm longitudinal anterior incision, a central one-third tendon bone was harvested. A 10 mm graft was taken and bone plug sculpted. Anterolateral notchplasty was done with a curette and polished with the burr. All debris was removed and instruments were used to ensure proper isometry. The graft was tightened in extension about 2.5 mm and actually lengthened in flexion, and this was considered acceptable. Endoscopic guides were used to create the tibial and femoral tunnels, and the edges were rasped smooth. Using a percutaneous guide pin, the graft was placed retrograde to the knee and secured proximally with an 8 x 25 mm interference screw. The knee was put through range of motion, and with the leg in 30 degrees of flexion with the posterior drawer applied to the proximal tibia; an 8 x 20 mm interference screw was used to secure the bone plug distally. The graft was tight, isometric and without adverse features. The wound was copiously irrigated with Kantrex1. Cancellous bone fragments from bone plugs were used to graft the donor site defect in the patella. The paratenon was closed over this to house the graft with a running #1 Vicryl. The edge of the distal bone plug was beveled with the rongeur. The subcutaneous tissue was closed with triple-0 Vicryl. Skin was closed with double-0 Prolene in a subcuticular fashion. Steri-Strips, sterile dressing, cryo cuff and hinged knee brace were applied. The patient was awakened and taken to the recovery room in satisfactory condition. What CPT® codes are reported? a. 29888-RT, 29880-51-RT b. 29889-RT, 29880-51-RT c. 29888-RT, 29881-51-RT d. 29888 -RT, 29882-51-RT

c. 29888-RT, 29881-51-RT

Response Feedback: Rationale: The anterior cruciate ligament repair can be found in the CPT® Index by looking for Cruciate Ligament/Repair/Arthroscopic Repair 29888, 29889. This was the anterior cruciate ligament; 29888 is the correct code. A medial meniscectomy was also performed which is reported with 29881. In the CPT® Index look for Arthroscopy/Surgical/Knee referring you to 29866-29868, 29871-29889. This is a medial meniscectomy 29881. Modifier -51 is required to report multiple procedures performed during the same session. The patellar tendon bone graft is included in 29888. The notchplasty (29999) is also bundled as only one procedure can be reported per compartment (patellofemoral). Modifier RT is appended to indicate the right side.

A final diagnosis for a patient in the ER is COPD with acute bronchitis due to echovirus. How is this diagnosis coded? a. J44.9, J20. b. J40, J20. c. J44.9, J d. J44.0, J20.

d. J44.0, J20.

Response Feedback: Rationale: Look in the ICD-10-CM Alphabetic Index for Disease, diseased/pulmonary/chronic obstructive/with/acute bronchitis directing you to J44.0. In the Tabular List an instructional note is given

for code J44.0 to use additional code to identify the infection. Look for Bronchitis/acute or subacute/due to/virus/echovirus directing you to code J20.7.

What CPT® codes are reported for an extrapleural pneumonectomy as well as empyemectomy performed during the same surgical session? a. 32440, 32036- b. 32445, 32540- c. 32445, 32036- d. 32440, 32540-

b. 32445, 32540-

Response Feedback: Rationale: In the CPT® Index, look for Pneumonectomy. By looking at codes 32440-32445 we see that code 32445 represents the extrapleural pneumonectomy. Next in the CPT® Index look for Empyemectomy which directs us to code 32540. There is also a parenthetical statement under code 32540 instructing us to report the correct lung removal code with 32540 if performed.

Which option is TRUE regarding reporting codes for cytomegaloviral pneumonitis in ICD-10-CM? a. Only the pneumonia is reported, it is not necessary to report the underlying diseases. b. Pneumonia is reported first; the underlying disease is reported second. c. One code is used to report both the pneumonia and the cytomegaloviral disease. d. The underlying disease is reported first; pneumonia is reported second.

c. One code is used to report both the pneumonia and the cytomegaloviral disease.

Rationale: ICD-10-CM Tabular List does not have the instructional note to code first underlying disease that is seen for codes listed in ICD-10-CM for category code B25. Both conditions are reported with one code in ICD-10-CM.

Repair of coronary vessel is called: a. Endarterectomy b. Angioplasty c. Aortic d. Endovascular

b. Angioplasty

In the cath lab, from a right femoral artery access, the following procedures are performed: Catheter placed in the left renal, accessory renal superior to the left renal and one main right renal artery. Radiologic supervision and imaging are performed in all locations. What CPT® code(s) is/are reported? a. 36245, 36245-59, 36245-59, 36252- b. 36252 c. 36252, 36251 d. 36245-LT, 36245-59-LT, 36245-59-RT, 75774-

b. 36252

Response Feedback: Rationale: Look in the CPT® Index for Angiography/Renal Artery referring you to code range 36251-

36254. This is a bilateral procedure, with an accessory left renal artery. Code 36252 includes bilateral and accessory renal angiography, and radiologic supervision and imaging.

Aortography and bilateral extremity angiography were performed. The physician placed the catheter in the aorta at the level of the renal arteries and injected contrast for the aortography and repositioned the catheter just above the bifurcation for angiography of the lower extremities. Which CPT® codes are reported? a. 36200, 75716- b. 36200, 75630- c. 36200, 75625-26, 75716- d. 36200, 75625-26, 75710-50-

c. 36200, 75625-26, 75716-

Response Feedback: Rationale: Because the catheter was repositioned, and separate studies were performed, both the aortography and the extremity angiography are reported. Look in the CPT® Index for Catheterization/Aorta referring you to 36160-36200. In the CPT® Index see Aorta/Aortography referring you to 75600-75630. To locate angiography of the lower extremities, look for Angiography/Leg Artery referring you to 73706, 75635, 75710-75716. Modifier 26 reports the professional service.

In the cardiac suite, an electrophysiologist performs an EP study. With programmed electrical stimulation, the heart is stimulated to induce arrhythmia. Observed is right atrial and ventricular pacing, recording of the bundle of His, right atrial and ventricular recording and left atrial and ventricular pacing and recording from the left atrium. What CPT® coding is reported? a. 93620, 93618, 93621 b. 93619, 93621 c. 93620, 93621, 93622 d. 93600, 93602, 93603, 93610, 93612, 93618, 93621, 93622

c. 93620, 93621, 93622

Response Feedback: Rationale: The studies performed make up a comprehensive study (93620) which includes: evaluation with right atrial pacing and recording, right ventricular pacing and recording, and His bundle recording with induction of or attempted induction of arrhythmia. Left atrial pacing and recording (+93621) and left ventricular pacing and recording (+93622) are add-on codes. Look in the CPT® Index for Electrophysiology Procedure which directs you to 93600-93660.

What is the CPT® code for removal of a foreign body from the esophagus via the thoracic area? a. 43045 b. 43215 c. 43500 d. 43020

a. 43045

Rationale: In the CPT® Index, look for Esophagus/Removal/Foreign Bodies referring you to 43020, 43045, 43194, 43215, 74235. There are two open approaches and two endoscopic approaches in the CPT® code book for the removal of a FB from the esophagus. 43020 is via a cervical approach and 43045 is via a thoracic approach, making code 43045 the correct choice.

What ICD-10-CM code is reported for acute gastritis with bleeding? a. K29. b. K29. c. K29. d. K29.

d. K29.

Rationale: In ICD-10-CM, Gastritis is identified by specific four character codes to indicate with or without bleeding. Look in the ICD-10-CM Alphabetic Index for Gastritis (simple)/acute (erosive)/with bleeding K29.01.

What is the correct ICD-10-CM coding for diverticulosis of the small intestine which has been present since birth? a. K57. b. Q43. c. K57. d. K57.90, Q43.

b. Q43.

Rationale: If a condition has been present since birth, it is considered congenital. Look in the ICD-10-CM Alphabetic Index for Diverticulosis/small intestine which refers you to K57.10. Verification in the Tabular list has an Excludes1 note under category code K57 for a congenital diverticulum of intestine and directs you to code Q43.8. Congenital diverticulum is in the list of congenital malformations beneath code Q43.8.

A 4-year-old patient, who accidentally ingests valium found in his mother's purse, is found unconscious and rushed to the ED. The child is treated by the ED physician, who inserted a tube orally into the stomach and performed a gastric lavage, removing the stomach contents. What CPT® and ICD-10-CM codes are reported? a. 43754, R40.20, T42.71XA b. 43753, T42.4X1A, R40. c. 43755, T43.501A d. 43756, T42.71XA

b. 43753, T42.4X1A, R40.

Rationale: Code 43753 is the correct CPT® code for gastric lavage performed for the treatment of ingested poison. Look in the CPT® Index for Gastric Lavage, Therapeutic/Intubation. The ICD-10-CM code

for the poisoning is found in the Table of Drugs and Chemicals by looking for Valium/Poisoning, Accidental (unintentional) column, referring you to code T42.4X1-. In the Tabular List a 7 th character is needed to complete the code. A is reported as the 7 th character because this was the patient's initial encounter.The next code is the manifestation of ingesting the Valium, unconsciousness. Unconsciousness is found in the ICD-10-CM Alphabetic Index and directs you to see Coma R40.20. The Tabular List confirms this code is reported for unconsciousness.

Patient is a 40-year-old female presenting for repeat urethral dilation for urethral stricture using the instillation of a saline solution. What CPT® code is reported for this service? a. 53665 b. 53661 c. 53605 d. 53660

b. 53661

Rationale: In the CPT® Index look for Urethra/Dilation/Suppository and/or Instillation. CPT® code 53660 is for the initial dilation. CPT® codes 53605 and 53665 are reported when general or spinal anesthesia is provided. No type of anesthesia is indicated in the note. This is a repeat procedure and the subsequent CPT® code 53661 is reported.

Patient presents to the emergency room with complaints of an erection lasting longer than two hours. Saline solution is used to irrigate the corpora cavernosa. What CPT® code is reported for this service? a. 54230 b. 54231 c. 54220 d. 54235

c. 54220

Rationale: Priapism is a condition marked by a prolonged erection. This condition must be treated, or permanent damage may result. Usually the penis is irrigated to reduce the erection; however, in some cases, surgical intervention may be necessary. In the CPT® Index look for Irrigation/Penis/for Priapism or Repair/Penis/Priapism.

A 63-year-old male presents for the insertion of an artificial inflatable urinary sphincter for urinary incontinence. A 4.5 cm cuff, 22 ml balloon, 61-70 mmHg artificial inflatable urinary sphincter was inserted. What CPT® code is reported for this service? a. 53447 b. 53446 c. 53448 d. 53445

d. 53445

Rationale: In the CPT® Index look for Insertion/Prosthesis/Urethral Sphincter. You're directed to 53444-

53445. Codes 53446-53448 are for the removal or removal/replacement of the inflatable sphincter.

CPT® 53445 describes the insertion of an inflatable urethra/bladder neck sphincter, including placement of pump, reservoir and cuff.

Patient is status post left extracorporeal shock wave therapy (ESWL) performed three weeks ago; there is no global time for this procedure. He returns today for scheduled left ureteroscopy with basket extraction of ureteral calculi. What CPT® code is reported for this service? a. 52352 b. 52352-58 c. 52352-76 d. 52352-78

a. 52352

Response Feedback: Rationale: Many times, after an ESWL, the provider will schedule the patient for follow up extraction of the remaining stone fragments. In the CPT® Index, look for Calculus/Removal/Ureter directing you to several codes. Code 52352 is the appropriate code. Modifiers 58 and 78 are used for additional procedures performed during a global period and modifier 76 is used for a repeat of the same procedure. These modifiers are not appropriate in this case because there is no global period

What is a root word for vagina? a. Metri/o b. Ureter/o c. Hyster/o d. Colp/o

d. Colp/o

How is a visit for supervision of normal pregnancy coded in ICD-10-CM? a. A code from category O80 is reported with a code from category Z37. b. A code from category Z34 is reported with a code from category Z3A. c. A code from category Z34 is reported without a code from category Z3A. d. A code from category O80 is reported with a code from category Z3A.

c. A code from category Z34 is reported without a code from category Z3A

A woman with a long history of rectocele and perineal scarring from multiple episiotomies develops a rectovaginal fistula with perineal body relaxation. She has transperineal repair with perineal body reconstruction and plication of the levator muscles. What are the CPT® and ICD-10-CM codes reported for this procedure? a. 57300, 56810-51, N82.3, N81.89 b. 57308, N82.3, N81.89 c. 57250, N81.6 d. 57330, N82.3

b. 57308, N82.3, N81.89

In ICD-10-CM which statement is TRUE regarding type 1 diabetes with peripheral angiopathy with gangrene? a. One code is used to report diabetes with peripheral angiopathy; the gangrene is not reported separately. b. Three codes are reported; one for the diabetes, one for the peripheral angiopathy, and a third for the gangrene. c. Two codes are reported; one to report diabetes with peripheral angiopathy and a second to report the gangrene. d. One code is used to report secondary diabetes with peripheral angiopathy; the gangrene is not reported.

a. One code is used to report diabetes with peripheral angiopathy; the gangrene is not reported separately.

A patient has a right thyroid lobectomy for a thyroid follicular lesion. An incision is made 2 cm above the sternal notch and carried through the platysma. The right thyroid was dissected free from the surrounding tissues. The isthmus was divided from the left thyroid lobe. The left thyroid lobe was explored revealing a single nodule. The right thyroid lobe was completely removed from the trachea and surrounding tissues. It was marked and sent off the table as a specimen. What CPT® code is reported? a. 60220 b. 60240 c. 60200 d. 60210

a. 60220

Rationale: The patient had a unilateral thyroidectomy. Because only the right side is removed, it is a total unilateral (partial) thyroidectomy. In the CPT® Index look for Thyroidectomy/Partial directing you to code range 60210-60225. 60220 reports a unilateral total thyroid lobectomy with or without isthmusectomy.

What ICD-10-CM code is reported for Ataxia telangiectasia? a. G11.0 b. G11.3 c. G31.89 d. R27.0

b. G11.3

A 59-year-old is suffering from foraminal spinal stenosis. Patient is to have a L4-L5 laminectomy on the right side. Under general anesthesia a knife dissection was made on the back and was taken down to the fascia. The fascia on the right side of the spine was stripped. The deep Taylor retractor was placed. Using an intraoperative X-ray, the physician traced out the foramen of L4-L5. There appeared to be some compression at this lamina into the foramen and significant stenosis. The provider removed the spinous process and lamina. Nerve roots canals are freed by removal of the facet. Compression is relieved by removing bony overgrowth around the foramen. What CPT® code is reported for this procedure? a. 63017

b. 63005 c. 63047 d. 63030

c. 63047 Response Feedback: Rationale: In the CPT® Index look for Laminectomy/with Facetectomy directing you to 63045-63048, 0202T, 0274T, 0275T. A laminectomy with knife dissection is being performed for spinal stenosis eliminating codes 0202T, 0274T, and 0275T. Codes 63045-63048 are reported based on location. This was performed on the lumbar, making the correct code 63047. 63030 is a code specific to the interspaces and codes 63001 and 63017 specifically state without facetectomy making them incorrect choices.

What ICD-10-CM code is used to report acute actinic otitis externa of the left ear? a. H60.512 b. H60.62 c. H60.542 d. H66.90

a. H60.512

Response Feedback: Rationale: In the ICD-10-CM Alphabetic Index look for Otitis/externa/acute/actinic and you are directed to H60.51-. Verification in the Tabular List indicates a 5 th character is reported for laterality. 5th character of 2 is for left ear.

An 89-year-old patient who has significant partial opacities in the lens of the left eye presents for phacoemulsification and lens implantation. What ICD-10-CM code is reported? a. H25.9 b. H26.40 c. H26.9 d. H26.112

c. H26.9

Response Feedback: Rationale: In the ICD-10-CM Alphabetical Index look for Opacity, opacities/lens which states see Cataract. Look in the Alphabetic Index for Cataract and the user is directed to the default code H26.9. Confirmation in the Tabular List confirms code selection.

What CPT® code(s) is/are reported for the placement of two adjustable sutures during strabismus surgery involving the horizontal muscles? a. 67334, 67335-51 b. 67318 c. 67312, 67335 d. 67316, 67335-51

c. 67312, 67335

Response Feedback: Rationale: Code 67312 represents strabismus surgery on two (2) horizontal muscles. In the CPT® Index look for Strabismus/Repair/Two Horizontal Muscles. In the numeric section below code 67316, there is a parenthetical note with instructions to use code 67335 in addition to codes 67311-67334 when adjustable sutures are used for primary procedure reflecting number of muscles operated on. Code 67335 is an add-on code and exempt from multiple procedures modifier 51. This is located in the CPT® Index by looking for Strabismus/Repair/Adjustable Sutures.

A patient with mixed conductive and sensorineural hearing loss in the right ear has tried multiple medical therapies without recovery of her hearing. Patient has consented to have an electromagnetic bone conduction hearing device implanted in the temporal bone. What CPT® and ICD-10-CM codes are reported? a. 69710-RT, H90.11 b. 69714-RT, H90.8 c. 69710-RT, H90.71 d. 69930-RT, H90.0

c. 69710-RT, H90.71

Response Feedback: Rationale: In the CPT® Index look for Hearing Aid/Implants/Bone Conduction/Implantation. You are referred to 69710. Review the code to verify accuracy. In the ICD-10-CM Alphabetical Index look for Loss (of)/hearing which states see also Deafness. Look for Deafness/mixed conductive and sensorineural/unilateral. You are referred to H90.7-. Review the code in the Tabular List to verify accuracy and 5 th character 1 is for right ear

Report the appropriate anesthesia code for an obstetric patient who had a planned general anesthesia for cesarean hysterectomy. a. 01962 b. 01963 c. 01967 d. 01969

b. 01963

Response Feedback: Rationale: Use the CPT® Index look for Anesthesia/Hysterectomy/Cesarean which directs you to 01963,

1969. Review the codes in the numeric section to determine that code 01963 is the appropriate code. Note: Code +01969 is an add-on code and cannot be coded without a primary procedure code.

What time is used to report the start of anesthesia time? a. When the anesthesiologist begins to prepare the patient for anesthesia b. During the pre-anesthesia assessment c. Surgery start time d. Entering the operating room

a. When the anesthesiologist begins to prepare the patient for anesthesia

Response Feedback: Rationale: Per Anesthesia Guidelines in the CPT® code book under the subheading Time Reporting: Anesthesia time begins when the anesthesiologist begins to prepare the patient for anesthesia in the operating room (or an equivalent area). Pre-anesthesia assessment time is not part of reportable anesthesia time, as it is considered in the base values assigned.

A 77-year-old patient was scheduled for a left total hip replacement due to degenerative joint disease (DJD) and the anesthesiologist documented the DJD as primary. The pre-anesthesia assessment indicates the patient had surgery in 2015 for gastroesophageal reflux disease (GERD). What ICD-10-CM coding is reported? a. M16.7 b. M16.12 c. K21.9 d. M16.9, K21.9

b. M16.12

Mr. Johnson, age 82, having been in poor health with diabetes and associated peripheral neuropathy, is having a fem-pop bypass. The anesthesiologist documents he has severe systemic disease. What coding is correct for anesthesia? a. 01272-AA-P3 b. 01272-AA-P2, 99100 c. 01260-AA-P2, 99100 d. 01270-AA-P3, 99100

d. 01270-P3, 99100

Rationale: Fem-pop bypass is an abbreviation for femoral-popliteal bypass of arteries in the upper leg. Look in the CPT® Index for Anesthesia/Bypass Graft/Leg, Upper which directs you to code 01270. Review the code in numeric section to determine the correct code is 01270. The qualifying circumstance code 99100 is added to indicate the extreme age of the patient. Physical status modifier P3 indicates the patient has severe systemic disease.

A 59-year-old patient is having surgery on the pericardial sac, without use of a pump oxygenator. The perfusionist placed an arterial line. What CPT® coding is reported for anesthesia? a. 00560, 36620 b. 00560