Download Medical Coding and Terminology and more Exams Law in PDF only on Docsity! AAPC Final Exam Questions and Answers 2024 Local Coverage Determinations are administered by whom? a. State Law b. NCDs c. Each regional MAC d. LMRPs Correct ans - c. Each regional MAC ABN stands for __ _. a. Advanced Benefits Notification b. Advisory Beneficial Notice c. Admitting Beneficiary Notice d. Advance Beneficiary Notice Correct ans - d. Advance Beneficiary Notice What type of health insurance provides coverage for low-income families? a. Commercial HMO b. Medicaid c. Medicare d. Commercial PPO Correct ans - b. Medicaid Which type of information is NOT maintained in a medical record? a. Treatment outcomes b. Financial records c. Medical or surgical interventions d. Observations Correct ans - b. Financial records According to the OIG, internal monitoring and auditing should be performed by what means? a. Focused audits on problems brought to the attention of the compliance officer. b. Baseline audits. c. Periodic audits. d. Audits on all denied claims. Correct ans - c. Periodic audits. Urine is transported from the kidneys to the urinary bladder by which structure? a. Ureter b. Urethra c. Kidney pelvis d. Urinary vein Correct ans - a. Ureter c. H57.8, H57.8 d. H53.10 Correct ans - d. H53.10 What diagnosis codes should be reported for spastic cerebral palsy due to previous illness of meningitis? a. G03.9, G80.1 b. G80.1, G43.909, G03.9 c. G09, G80.1 d. G80.1, G09 Correct ans - d. G80.1, G09 The patient is a 12 month-old with a history of muscle weakness. Unfortunately, his etiology is unknown and to help delineate the diagnosis, Neurology has consulted us to obtain a right bicep muscle biopsy. What diagnosis code is reported? a. R29.898 b. M62.81 c. R53.1 d. G58.9 Correct ans - b. M62.81 A 50 year-old patient has been diagnosed with elevated blood pressure. The patient does not have a history of hypertension. What is the correct ICD-10- CM code to report? a. I15.0 b. I13.0 c. R03.0 d. I10 Correct ans - c. R03.0 A 32 year-old male was seen in the ASC for removal of two lipomas. One was located on his back and the other was located on the right forearm. Both involved subcutaneous tissue. What ICD-10-CM code(s) is/are reported? a. D17.1, D17.23 b. D17.21, D17.1 c. D17.30 d. D17.39 Correct ans - b. D17.21, D17.1 What is the time frame defining when pain becomes chronic? a. After the global period b. One year c. The 30th day d. No time frame Correct ans - d. No time frame A patient with amyloidosis being treated for glomerulonephritis. What ICD- 10-CM codes are reported? a. E85.3, N08 b. E85.4, N08 c. N08, E85.3 d. N08, E85.4 Correct ans - b. E85.4, N08 A 45 year-old-male patient has developed an ulcer on his upper back. He has had diabetes for several years and is on insulin. The provider determines that the ulcer is due to his diabetes. What ICD-10-CM codes are reported? a. E11.622, Z79.4 b. E11.9, L98.429, Z79.4 c. E11.622, L98.429, Z79.4 d. E11.622, L98.429 Correct ans - c. E11.622, L98.429, Z79.4 In which circumstances would an external cause code be reported? a. Delivery of a newborn. b. Causes of injury or health condition. c. Chemotherapy treatment of neoplasms. d. Only for the cause of motor vehicle accidents. Correct ans - b. Causes of injury or health condition. Patient presents with no menses and positive pregnancy test but an ultrasound reveals no uterine contents. An embryo has implanted on the left ovary and this is treated with laparoscopic oophorectomy. What ICD-10- CM code is reported for this procedure? a. O00.102 b. O00.202 c. O00.802 d. O00.09 Correct ans - b. O00.202 A patient has an open displaced fracture of the second cervical vertebra. This is her fifth visit and the fracture is healing normally. What ICD-10-CM code is reported? a. S12.9XXS b. S12.190D c. S12.9XXD d. S12.190A Correct ans - b. S12.190D A 43 year-old female presents to the provider for a diabetic ulcer of the right ankle. What ICD-10-CM codes are reported? a. L97.319 b. L97.319, E11.9 c. L97.319, E11.622 d. E11.622, L97.319 Correct ans - d. E11.622, L97.319 A patient is prescribed anticonvulsant medication for her seizures. She returns to her doctor three days later with nausea and rash due to taking the anticonvulsant medication. The provider notes that this is a drug reaction to an anticonvulsant and changes the medication. What ICD-10-CM codes are reported? a. L27.0, R11.2, T42.71XA b. R21, R11.2, T42.71XA c. R21, R11.0, T42.75XA d. L27.0, R11.0, T42.75XA Correct ans - d. L27.0, R11.0, T42.75XA What surgical status indicator represents the Global Surgical Package for endoscopic procedures (without an incision) where there is no postoperative period after the day of the surgery?? a. XXX b. 000 c. 010 d. 090 Correct ans - 000 What code represents a secondary rhinoplasty where a small amount of work is performed on the tip of the nose? a. 30430 b. 30420 c. 30435 d. 30400 Correct ans - 30430 What is the appropriate modifier to use when two surgeons perform separate distinct portions of the same procedure? a. 59 b. 66 c. 62 d. 80 Correct ans - 62 What is the correct CPT® coding for a cystourethroscopy with brush biopsy of the renal pelvis? a. 52005, 52007 b. 52007 c. 52000, 52007 d. 52005 Correct ans - d. Gustilo classification for open fracturesCorrect ans - A 49 year-old female presented with chronic deQuervain's disease and has been unresponsive to physical therapy, bracing or cortisone injection. She has opted for more definitive treatment. After induction of anesthesia, the patient's left arm was prepared and draped in the normal sterile fashion. Local anesthetic was injected using a combination 2% lidocaine and 0.25% Marcaine. A transverse incision was made over the central area of the first dorsal compartment. The subcutaneous tissues were gently spread to protect the neural and venous structures. The retractors were placed. The fascial sheath of the first dorsal compartment was then incised and opened carefully. The underlying thumb abductor and extensor tendons were identified. The tissues were dissected and the extensor retinaculum of the first extensor compartment was incised. The fibrotic tissue was incised and the tendons gently released. The tendons were freely moving. Subcutaneous tissues were closed with a 3-0 Vicryl and the skin with 3-0 Prolene subcuticular closure. Steri-strips, Xeroform and dry sterile dressings were applied. What CPT® code is reported? a. 25001-LT b. 25118-LT c. 25085-LT d. 25000-LT Correct ans - 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 Correct ans - A 16 year-old female was hit by a car while crossing a two-lane highway. She was taken to the hospital by ambulance. She was found to have an open wound of the left lower thigh, just above the knee and a displaced fracture of the left femoral neck. She was taken to the operating room within four hours of her injury. She was given general endotracheal anesthesia and was prepped and draped in sterile fashion. Debridement including excision of devitalized skin and muscle was performed on the lateral thigh. The area was approximately 15 sq cm. After debridement and thorough copious irrigation, the wound was closed with layer sutures and a dressing was applied and then covered with adhesive plastic. The patient was then prepped and draped for the fracture and turned on her right side. We all rescrubbed. An 8 inch incision was made over the left hip and the head of the femur was exposed. Multiple fragments from the neck and the greater tuberosity were removed. The decision was made to replace the femoral head. The femur was removed from the acetabulum and the femoral head was removed. The femoral canal was reamed and a prosthesis was placed. It was then replaced in the acetabulum with a good fit, and the chamber lead defibrillator system. The original dual leads are extracted transvenously. The generator pocket is relocated. What CPT® codes are reported? a. 33244, 33220-51, 33264-51, 33223-59 b. 33243, 33202-51, 33263-51, 33223-59 c. 33241, 32330-51, 33263-51, 33223-59 d. 33244, 33202-51, 33264-51, 33223-59 Correct ans - A patient presents to the hospital for a cardiovascular SPECT study. A single study is performed under stress, but without quantification, with a wall motion study, and ejection fraction. Select the CPT® code(s) for this procedure. a. 78451, 78472 b. 78451 c. 78453 d. 78453, 78472 Correct ans - In the hospital setting a patient undergoes transcatheter placement of an extracranial vertebral artery stent in the right vertebral artery. Which CPT® code is reported by the physician providing only the radiologic supervision and interpretation? a. 0075T b. 0075T-26 c. 35301 d. 35005 Correct ans - A patient is brought to the operating suite when she experiences a large output of blood in her chest tubes post CABG. The physician performing the original CABG yesterday is concerned about the post-operative bleeding. He explores the chest and finds a leaking anastomosis site and he resutured. a. 35761-78 b. 35241 c. 35761 d. 35820-78 Correct ans - A patient is seen in the ED for nausea and vomiting that has persisted for 4 days. The ED physician treats the patient for dehydration which is documented in the patient's record as the final diagnosis. What ICD-10-CM code(s) is/are reported for this encounter? a. R11.2, E86.0 b. E86.0 c. R11.14 d. R11.10, R11.0, E86.0 Correct ans - What CPT® and ICD-10-CM codes represent the creation of an opening into the stomach to insert a temporary feeding tube for nutritional support in an adult patient with proximal esophageal carcinoma due to alcohol dependence? A gastric tube was not created. a. 43870, C15.8, F10.99 b. 43831, D49.0, F10.10 c. 43830, C15.3, F10.20 d. 43653, C15.9, F10.20 Correct ans - What is the correct ICD-10-CM coding for diverticulosis of the small intestine which has been present since birth? a. K57.90, Q43.8 b. Q43.8 c. K57.90 d. K57.10 Correct ans - A 57 year-old patient with chronic pancreatitis presents to the operating room for a pancreatic duct-jejunum anastomosis by the Puestow-type operation. What are the correct CPT® and ICD-10-CM codes for the encounter? a. 48548, K85.90 b. 48548, K86.1 c. 48520, K86.1 d. 48520, K85.80 Correct ans - Margaret has a cholecystoenterostomy with a Roux-en-Y. Five hours later, she has an enormous amount of pain, abdominal swelling and a spike in her temperature. She is returned to the OR for an exploratory laparotomy and subsequent removal of a sponge that remained behind from surgery earlier that day. The area had become inflamed and was demonstrating early signs of peritonitis. What is the correct coding for the subsequent services on this date of service? The same surgeon took her back to the OR as the one who performed the original operation. What CPT® code is reported? a. 49000-58 b. 49402-77 c. 49000-77 d. 49402-78 Correct ans - What is the correct CPT® code for a percutaneous pyelostolithotomy with dilation and basket extraction measuring 1 cm? a. 50080 b. 50130 c. 50040 d. 50081 Correct ans - 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. 53446 b. 53448 c. 53447 d. 53445 Correct ans - A fracture of the corpus cavernosum penis is repaired. What is the correct code? a. 54440 b. 54420 c. 54430 d. 54435 Correct ans - Patient comes in today to the provider's office for routine monthly Foley catheter change. A two way Foley catheter is replaced in the usual sterile fashion. An abdominal urinary drainage bag and bedside bag are given to the patient. What is/are the correct code(s)? a. 51702, A4338, A4357, A4358 b. 51100 c. 51102 d. 51701, A4338, A4357, A4358 Correct ans - The patient is a pleasant 51 year-old male with morbid obesity, weighing approximately 560 pounds and BMI being 85.1. He has uncontrolled diabetes and was evaluated due to testicular pain. He was found to have erythema, edema and possible areas of eschar on the scrotum. He was transferred to the hospital, evaluated and found to be stable with cellulitis and suspect early Fournier's gangrene. What are the appropriate ICD-10-CM codes reported? a. N49.2, E11.9, E66.01, Z68.45 b. N50.1, E11.9, N49.2, E66.01, Z68.45 c. N50.1, N49.2, E66.01, Z68.52 d. E66.01, E11.9, N50.1, E66.01, Z68.52 Correct ans - A 40 year-old presents with vaginal bleeding for several weeks unrelated to her menstrual cycle. The gynecologist orders an ultrasound to obtain more information for a diagnosis. What diagnosis code is appropriate for this encounter? b. 62270, 76942-26, G95.0 c. 62270, G12.9 d. 62269, 76942-26, G95.0 Correct ans - What does IOL stand for? a. Interdimensional ocular lengths b. Iridescence over lamina c. Intraocular lens d. Interoptic laser Correct ans - c. Intraocular lens Patient had an abscess in the external auditory canal which was incised and drained in the office. What CPT® code is reported? a. 69000 b. 69020 c. 69540 d. 69105 Correct ans - What CPT® code is reported for a tympanoplasty with mastoidotomy and with ossicular chain reconstruction in the right ear? a. 69636-RT b. 69632-RT c. 69644-RT d. 69646-RT Correct ans - A 70 year-old female has a drooping left eyelid obstructing her vision and has consented to having the blepharoptosis repaired. A skin marking pencil was used to outline the external proposed skin incision on the left upper eyelid. The lower edge of the incision was placed in the prominent eyelid crease. The skin was excised to the levator aponeurosis. An attenuated area of levator aponeurosis was dehisced from the lower strip. Three 6-0 silk sutures were then placed in mattress fashion, attaching this attenuated tissue superiorly to the intact tissue inferiorly. This provided moderate elevation of the eyelid. What CPT® code is reported? a. 67911-E1 b. 67901-E1 c. 67903-E1 d. 67904-E1 Correct ans - A 53 year-old woman with scarring of the right cornea has significant corneal thinning with a high risk of perforation and underwent reconstruction of the ocular surface. The eye is incised and an operating microscope is used with sponges and forceps to debride necrotic corneal epithelium. Preserved human amniotic membrane is first removed from the storage medium and transplanted by trimming the membrane to fit the thinning area of the cornea then sutured. This process was repeated three times until the area of thinning is flush with surrounding normal thickness cornea. All of the knots are buried and a bandage contact lens is placed with topical antibiotic steroid ointment. What CPT® code is reported? a. 65435 b. 65780 c. 65781 d. 65710 Correct ans - What are the three classifications of anesthesia? a. General, Regional and Moderate Sedation b. General, Regional and Epidural c. General, Regional and Monitored Anesthesia Care d. General, MAC and Conscious Sedation Correct ans - c. General, Regional and Monitored Anesthesia Care What time is used to report the start of anesthesia time? a. Surgery start time b. Entering the operating room c. When the anesthesiologist begins to prepare the patient for anesthesia d. During the pre-anesthesia assessment Correct ans - c. When the anesthesiologist begins to prepare the patient for anesthesia A 42 year-old patient was undergoing anesthesia in an ASC and began having complications prior to the administration of anesthesia. The surgeon immediately discontinued the planned surgery. If the insurance company requires a reported modifier, what modifier best describes the extenuating circumstances? a. 53 b. 23 c. 73 d. 74 Correct ans - What ICD-10-CM code is reported for a reaction to anesthesia, initial encounter? a. T88.59XA b. T88.2XXA c. T88.52XA d. T88.4XXA Correct ans - A 43 year-old patient with a severe systemic disease is having surgery to remove an integumentary mass from his neck. What CPT® code and modifier are reported for the anesthesia service? a. 00300-P2 b. 00300-P3 c. 00322-P3 d. 00350-P3 Correct ans - A non-Medicare patient reports for a bilateral screening mammography with CAD. What CPT® code(s) is/are reported? a. 77066 b. 77067 c. 77059 d. 77062 Correct ans - A 1 year post-thyroidectomy patient who had thyroid cancer is coming in for area imaging of the neck and chest to evaluate for metastases. What CPT® code(s) is/are reported for the nuclear medicine exam? a. 78013 b. 78015, 78020 c. 78014 d. 78015 Correct ans - A patient needing scoliosis measurements is coming in to have standing anteroposterior and lateral views of his entire thoracic and lumbar spine. What CPT® code(s) is/are reported for radiology? a. 72084 b. 72082 c. 72083 d. 72040, 72070, 72100Correct ans - The patient is a 63 year-old gentleman diagnosed with rectal cancer, who had a resection of the cancer performed. He now presents to have a Port-A- Cath (a central venous access device) inserted for postoperative adjuvant therapy. An 18-gauge introducer needle was inserted into the left subclavian vein through which a soft tipped guide wire was inserted into the superior vena cava under fluoroscopy. A subcutaneous pouch in the anterior part of the chest was created for the port. The catheter was then tunneled and measured to length. The dilator and introducer sheath were passed over the wire into the superior vena cava under fluoroscopic guidance. The catheter was passed through the sheath and the port was applied with good venous return. What CPT® codes are reported? a. 36571, 77001-26 b. 36560, 77002-26 c. 36561, 77001-26 d. 36563, 77003-26 Correct ans - a. 99471-25, 94610, 36510 b. 99291 c. 99471 d. 99291-25, 31500, 36510, 94610Correct ans - 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: 1. Increase BUMEX to 2 mg IV Q6. 2. Give 500 mg IV DIURIL times one. 3. Re-check usual labs in a.m. What E/M Category is used for this visit? a. Inpatient Consultation (99251-99255) b. Established Patient Office/Outpatient Visit (99211-99215) c. Subsequent Hospital Visit (99231-99233) d. Initial Hospital Visit (99221-99223) Correct ans - A new patient with cystic fibrosis underwent evaluation of lung function, including percussion, vibration and cupping to the chest wall to facilitate his lung function. What CPT® code(s) is/are reported for this service? a. 94664 b. 99201-25, 94668 c. 94667 d. 94662 Correct ans - A patient with hypertensive cardiovascular disease is admitted by his primary care provider. What is/are the correct ICD-10-CM code(s) for this encounter? a. I11.0 b. I11.9 c. I10, I25.10 d. I11.9, I25.10 Correct ans - What ICD-10-CM code is reported when a flu vaccine is administered? a. J11.1 b. Z28.3 c. Z28.04 d. Z23 Correct ans - d. Z23 A 5 year-old is brought in to see an allergist for generalized urticaria. The family just recently visited a family member that had a cat and dog. The mother wants to know if her son is allergic to cats and dogs. The child's skin was scratched with two different allergens. The provider waited 15 minutes to check the results. There was a flare up reaction to the cat allergen, but there was no flare up to the dog allergen. The provider included the test interpretation and report in the record. a. 95004 x 2 b. 95027 x 2 c. 95024 x 2 d. 95018 x 2 Correct ans - A 32 year-old ETOH dependent female is in a partial hospitalization program and has been seeing an addictive disease specialist (psychotherapist) in a chemical dependency program. Her employer is aware of her problem. She was referred to the group through their Employee Assistance Program. As long as she is in compliance they will support her efforts. Recently, she has arrived late at the meetings. The provider met with the patient and discussed the importance of her treatment, compliance with the program and avoidance of situations in which she may use alcohol. She denies contact with her previous associates and assures the provider she has had no alcohol intake since beginning the substance abuse treatment program. They will continue to reinforce her progress and successful 0 d. I10, N18.9 Correct ans - I12.0 N18.6 Patient with coronary arteriosclerosis disease (CAD) sees his cardiologist to discuss a coronary artery bypass graft (CABG). This will be the patient's first CABG. What ICD-10-CM code is reported? a. I25.1 0 b. I25.81 0 c. I25.75 9 d. I25.720 Correct ans - I25.10 A 45 year-old-male patient developed an ulcer on his upper back. He has had diabetes for several years and is on insulin. The provider determines that the ulcer is due to his diabetes. What ICD-10-CM codes are reported? a. E11.622, L98.429, Z79.4 b. E11.9, L98.429, Z79.4 c. E11.622, Z79.4 d. E11.622, L98.429 Correct ans - . E11.622, L98.429, Z79.4 Friends brought a young male with type 1 diabetes to the emergency department, in a comatose state. He was admitted with ketoacidosis and was resuscitated with saline hydration via insulin drip. After regaining consciousness, the patient reported that the morning of admission he was experiencing nausea and vomiting and decided not to take his insulin because he had not eaten. He was treated with intravenous hydration and insulin drip. By the following morning, his laboratory work was within normal range and he was experiencing no symptoms. What ICD-10-CM code(s) are reported? a. E10.1 1 b. E11.01, R06.4 c. E11.01, Z79.4 d. E10.10, R06.4, Z79.4Correct ans - E10.11 According to the ICD-10-CM Official Guidelines for Coding and Reporting, Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A), codes in this range have sequencing priority over what codes? a.Chapter 15 codes do not have sequencing priority over other codes.b.Codes from Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99).c.Codes from all other chapters.d.All codes including Z33.1 Correct ans - CODES FROM ALL OTHER CHAPTERS A patient was admitted three weeks following a normal vaginal delivery with a postpartum breast abscess. What ICD-10-CM code is reported? a.O91.13b.O91.22c.O91.12d.N61.1 Correct ans - 091.12 An X-ray is performed for pain in the left little finger. This is the initial encounter for this visit. The X-ray report shows a fractured distal phalanx that is dislocated. What ICD-10-CM code(s) is/are reported? a.S62.635Ab.S62.637B, S63.257Bc.S62.637A, S63.257Ad.S62.637A Correct ans - S62.637A A baby boy is born by cesarean section in the hospital. ABO incompatibility was documented, but the Coomb's test was negative, ruling out the ABO incompatibility, so no treatment was given. What ICD-10-CM codes are reported for the newborn's record? a. O36.1190, Z38.01, Z03.79 b. Z38.01, Z05.8 c. P01.8, Z38.01 d. Z38.01, P55.1 Correct ans - Z38.01, Z05.8 A patient is prescribed anticonvulsant medication for her seizures. She returns to her doctor three days later with nausea and rash from taking the anticonvulsant medication. The provider notes that this is a drug reaction to an anticonvulsant and changes the medication. What ICD-10-CM codes are reported? a. R21, R11.2, T42.71XA b. R21, R11.0, T42.75XA c. L27.0, R11.2, T42.71XA d. L27.0, R11.0, T42.75XACorrect ans - L27.0, R11.0, T42.75XA What is the CPT® code used to report a right heart cardiac catheterization for congenital anomalies? a. 9353 a. H codes b. Q codes c. C codes d. G codes Correct ans - C CODES Which statement is TRUE regarding the Table of Neoplasms in ICD-10-CM? a. There is not a Table of Neoplasms in ICD-10-CM. b. The Table of Neoplasms is found in the Tabular List. c. There are six columns in the Table of Neoplasms that show the types of neoplasm: Malignant Primary, Malignant Secondary, Ca in situ, Benign, Uncertain Behavior and Unspecified Behavior. d. The Table of Neoplasms is found by looking for Neoplasm in the ICD-10- CM Alphabetic Index. Correct ans - C 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. 1711 0 b. 1711 1 c. 17110, 17003 d. 17110, 17111-52 Correct ans - 17111 A 14-year-old boy was thrown against the window of the car on impact. The resulting injury was a star-shaped pattern cut to the top of his head. In the ED, the MD on call for plastic surgery was asked to evaluate the injury and repair it. The total length of the intermediate repair was 5+4+4+5 cm (18 cm total). The star-like shape allowed the surgeon to pull the wound edges together nicely in a natural Y-plasty in two spots. What CPT® code is reported for the repair? a. 1312 1 b. 1404 1 c. 1404 0 d. 12035 Correct ans - 12035 COPD with bronchitis is reported for COPD with asthma. Correct ans - B A 20-year-old female who returned from spring break in Mexico six days ago, presents to the ED with a high fever for three days, a sore throat, general aches and a miserable cough. The ED provider suspects flu and orders a rapid flu test. What ICD-10-CM code(s) is reported? a. J11.1, R50.9, J02.9, R05 b. J11. 1 c. J09.X 9 d. R50.9, J02.9, R52, R05Correct ans - D The pulmonologist in a multispecialty group refers a patient to the otolaryngologist because he thinks that the shortness of breath that the patient is experiencing may be due to sinusitis and laryngopharyngeal reflux (LPR). The otolaryngologist decides to perform a rigid bilateral nasal endoscopy to get a better look at what is going on in the sinuses and a flexible laryngoscopy to determine if (LPR) is contributing to the problems because he could not get adequate visualization on manual exam. First the bilateral nasal endoscopy is performed and the otolaryngologist diagnosis chronic pansinusitis. Next a flexible fiberoptic laryngoscope is introduced nasally and the larynx and trachea are inspected. The diagnosis is chronic laryngitis/tracheitis and LPR. He prescribes Singulair and Nexium and proposes endoscopic surgery will be considered in the future if the current treatment does not fully take care of the problems experienced by the patient. What CPT® and ICD-10-CM codes are reported for the procedure? a. 31575, 31231-59, J32.4, J37.1 b. 31575, 31231-50-59, J32.4, J37.1 c. 31576, 31231-51, J32.4, J02.9, J41.8 d. 31576, 31237-50-59, J32.4, J37.0, J41.8 Correct ans - ITS NOT B - I GOT THIS ONE WRONG __ is a term standing for enlargement of the heart. a.Cardiorenalb.Valvuloplastyc.Angiomegalyd.Cardiomegaly Correct ans - D Due to infections from hemodialysis, the physician replaces a dual chamber implantable defibrillator system with a multi-lead system with an epicardial lead and transvenous dual chamber lead defibrillator system. The original dual leads are extracted transvenously. The generator pocket is relocated. What CPT® codes are reported? a. 33243, 33202-51, 33263-51, 33223-59 b. 33241, 32330-51, 33263-51, 33223-59 c. 33244, 33220-51, 33264-51, 33223-59 d. 33244, 33202-51, 33264-51, 33223-59 Correct ans - D A patient presents to the outpatient surgery department for revision to his autogenous radiocephalic fistula so he can continue his hemodialysis. What is the correct CPT® code? a.36831b.36904c.36825d.36832 Correct ans - D A patient is brought to the operating suite when she experiences a large output of blood in her chest tubes post CABG. The physician performing the original CABG yesterday is concerned about the post-operative bleeding. He explores the chest and finds a leaking anastomosis site and he resutured. What CPT® code is reported? a. 3521 1 b. 3582 0 c. 3524 1 d. 35820-78 Correct ans - D What ICD-10-CM code(s) is reported for ulcerative colitis with rectal bleeding? a.K51.90b.K51.911c.K51.511d.K52.9, K62.5 Correct ans - B What ICD-10-CM code is reported for acute gastritis with bleeding? a. K29.70 b. K29.0 0 c. K29.7 1 d. K29.01 Correct ans - D What ICD-10-CM code is reported for non-erosive duodenitis? a.K29.81b.K29.90c.K29.91d.K29.80 Correct ans - D A 66-year-old female is admitted to the hospital with a diagnosis of stomach Correct ans - C Patient wishes permanent sterilization and elects laparoscopic tubal ligation with Falope ring. What is the CPT® code reported for this service? a.58671b.58600c.58615d.58670 Correct ans - A A patient with previous tubal ligation decides that she would like to have another child and requests reversal of the previous procedure. Re- anastomosis of the ligated tubes is performed successfully by low transverse incision. It is found that the fimbriated end of the right tube has adhesions to the ovary and fimbrioplasty is also performed. What is/are the CPT® code(s) reported for this procedure? a. 58673-50, 58672-51-RT b. 58750-50 c. 58750-50, 58760-51-RT d. None of these Correct ans - C A 32-year-old woman with a previous vertical incision for cesarean delivery presents in spontaneous labor with the baby in cephalic presentation. She has had an uneventful pregnancy and after laboring for 10 hours she delivers a single female child with brief use of a vacuum extractor over an episiotomy that is repaired by the delivering physician. There are no complications. What are the diagnosis codes for this delivery? a. O75.9, O70.9, O82, Z3A.00, Z37.0 b. O80, Z3A.00, Z37.0 c. O66.5, O34.212, Z3A.00, Z37.0 d. O80, O70.9, O66.5, Z3A.00 Correct ans - C What ICD-10-CM code is reported for Addisonian crisis? a. E27.0 b. E27.4 0 c. E27. 2 d. E27.1 Correct ans - C The provider removes the thymus gland in a 27-year-old female with myasthenia gravis. Using a transcervical approach the blood supply to the thymus is divided and the thymus is dissected free from the pericardium and the thymus is removed. What CPT® code is reported for this procedure? a. 6052 2 b. 6052 0 12:37 pm. The surgery finished at 15:12 pm and the patient was turned over to PACU at 15:26 pm, which was reported as the ending anesthesia time. What is the anesthesia time reported? a. 12:37 pm to 15:26 pm (169 minutes) b. 12:26 pm to 15:12 pm (166 minutes) c. 12:26 pm to 15:26 pm (180 minutes) d. 10:21 am to 15:12 pm (291 minutes) Correct ans - C Which plane divides the body into anterior and posterior halves? a. Axia l b. Coron al c. Transver se d. Sagittal Correct ans - B A 25-year-old female in her last trimester of her pregnancy comes into her obstetrician's office for a fetal biophysical profile (BPP). An ultrasound is used to first monitor the fetus' movements showing three movements of the legs and arms (normal). There are two breathing movements lasting 30 seconds (normal). Non-stress test (NST) of 30 minutes showed the heartbeat at 120 beats per minute that increased with movement (normal or reactive). Arms and legs were flexed with fetus' head on its chest, opening and closing of a hand. Two pockets of amniotic fluid at 3cm were seen in the uterine cavity (normal). Biophysical profile scored 9 out of 10 points (normal or reassuring). What CPT® code is reported by the obstetrician? a. 59025, 76818 b. 7681 9 c. 7681 5 d. 76818 Correct ans - D A patient is seen in the clinic with sharp abdominal pain, vomiting and nausea and a history of cholelithiasis. An ultrasound of the gallbladder is performed revealing she has stones in the gallbladder. What CPT® code is reported? a. 7401 8 b. 7670 5 c. 7697 5 d. 76700 Correct ans - ITS NOT A - I GOT THIS ONE WRONG 85379 Correct ans - D What category of codes should be used to report an evaluation and management service provided to a patient in a psychiatric residential treatment center? a.Hospital inpatient servicesb.Nursing facility servicesc.Domiciliary, rest home or custodial cared.Observation services Correct ans - B A 75-year-old established patient sees his regular primary care provider for a physical screening prior to joining a group home. He has no new complaints. The patient has an established diagnosis of cerebral palsy and type 2 diabetes and is currently on his meds. A comprehensive history and examination is performed. The provider counsels the patient on the importance of taking his medication and gives him a prescription for refills. Blood work was ordered. PPD was done and flu vaccine given. Patient already had a vision exam. No abnormal historical facts or finding are noted. What CPT® code is reported? a. 9921 5 b. 9938 7 c. 9921 4 d. 99397 Correct ans - D Dr. Howitzer sees Mrs. Jones in Clinic Eight for sudden loss of consciousness while watching the Olympic Torch go by. He is a new provider to the neurology department. Dr. Drake Rinaldi, a prominent member of the neurology faculty at the university saw Mrs. Jones last month. Dr. Howitzer performs a medically appropriate history and exam. Medical decision making of high complexity. The final diagnosis given is transient loss of consciousness. The patient makes a follow-up appointment to see Dr. Rinaldi in one week. What is the appropriate diagnosis and E/M code for this visit? a. 99214, R40.1 b. 99203, R55 c. 99202, R40.1 d. 99215, R55 Correct ans - ITS NOT A - I GOT THIS ONE WRONG A 37-year-old female is seen in the clinic for follow-up of lower extremity swelling.HPI: Patient is here today for follow-up of bilateral lower extremity swelling. The swelling responded to hydrochlorothiazide.DATA REVIEW: I reviewed her lab and echocardiogram. The patient does have moderate pulmonary hypertension.Exam: Patient is in no acute distress.ASSESSMENT: 1. Bilateral lower extremity swelling. This has resolved with diuretics; it may be secondary to problem #2.2. Pulmonary hypertension: Etiology is not clear at this time, will work up and possibly refer to a pulmonologist.PLAN: Will evaluate the pulmonary hypertension. Patient will be scheduled for a sleep study. a. 9921 5 b. 9921 2 c. 9921 4 d. 99213 Correct ans - ITS NOT B - I GOT THIS ONE WRONG A 5-year-old fell on broken glass and required suturing of a laceration. Due to the age and combative behavior of the patient, the provider utilized moderate sedation while repairing the laceration. The provider gave the child 50 mg of Ketamine IM. A nurse monitored the patient during the procedure which took 30 minutes. What CPT® code is reported for moderate sedation? a. 9915 6 b. 99152, 99153 c. 99156, 99157 d. 99152 Correct ans - B A patient with atrial fibrillation had a dual lead pacemaker implanted 1 year ago. Today she returns to the provider's office for evaluation of function of the device by analyzing and reviewing the parameters stored comparing it to current readings. It was determined minor adjustments and reprogramming were needed. What CPT® code is reported? a. 9328 8 b. 9328 0 c. 9328 9 d. 93283 Correct ans - B What ICD-10-CM code is reported when a flu vaccine is administered? a. Retroperitoneal dissection was started in the pelvis and continued along the left paracolic gutter. The ligamentous and peritoneal attachments were taken down with Bovie cautery in a stepwise fashion around the splenic flexure of the colon until the entire left colon was mobilized medially. Similar steps were then carried on the right side as the right colon and hepatic flexure were mobilized. The peritoneal and ligamentous attachments were taken down with Bovie cautery. Vascular attachments were clamped, cut, and suture ligated with 2-0 silk until the right colon was mobilized satisfactorily. The GIA stapler was introduced and fired at both ends to dissect the tumorous bowel free. The bowel was delivered off the operative field.Attention was then directed towards re-anastomosis of the colon. Linen- shod clamps were used to gently clamp the proximal and distal segments of the large bowel. The staple line was removed with Metzenbaum scissors and the colon lumen was irrigated. The silk sutures were used to divide the circumference of the bowel into equal thirds, and the proximal and distal edges of the bowel were reapproximated with silk sutures. The posterior segment of the bowel was then retracted and secured with a TA stapler, ensuring a full thickness bowel wall insertion into the staple line. The additional two-thirds were also isolated and, with the TA stapler, clamped, ensuring that all layers of the bowel wall were incorporated into the anastomosis. A third staple line was fired and the integrity of the anastomosis was checked. First, complete hemostasis was noted. There was well beyond a finger width lumen within the large bowel. The linen-shod clamps were released and gas and bowel fluid were moved through the anastomosis aggressively with intact staple line; no leakage of gas or fluid. The abdomen was then irrigated and water was left over the anastomosis. The anastomosis was manipulated with no extravasation of air. The abdomen and pelvis were then irrigated aggressively. The Mesenteric trap was then re- approximated with interrupted 3-0 silk suture ligatures. All sites were inspected and noted to be hemostatic. Attention was directed towards closing.Pathology report showed intra- abdominal cancer. Transverse colon and hepatic flexure cancer were also indicated. The origin of the cancer could not be determined from the specimen given.What is the correct CPT® and ICD-10-CM coding for this report? a. 44140, 44139, C76.2, C18.8 b. 44147, 44139, C76.2, C18.8 c. 44140, C79.89, C78.5 d. 44160, C18.8 Correct ans - A A 54-year-old female with uncontrolled type 1 insulin dependent diabetes and related peripheral vascular disease presents with a deep diabetic ulceration on the bottom of her right foot. The wound reaches into the fascia and appears to be draining. She acknowledges going barefoot frequently and is not certain how or when the wound occurred. After the provider discusses the seriousness of her condition he debrides the wound, using a water jet and surgical scissors. Size of wound is 70 sq. cm. He applied topical ointment and a sterile dressing. He counseled the patient about the need to wear shoes at all times and inspect her feet daily. He advised the patient to wear a water protective covering on her lower leg when taking a shower and to change the dressing daily, using ointment provided. A surgical shoe was provided. Patient is to return weekly until the wound heals and procedure. She is about 1 1/2 years status post lumbar decompression for stenosis. Two weeks ago she underwent an interarticular left L4-L5 paravertebral facet joint injection. She had no relief of symptoms from that injection.TECHNIQUE: The patient was positioned prone and the skin was prepped and draped in the usual sterile fashion. The skin and underlying soft tissues were anesthetized with 3 cc of 1% lidocaine. Due to the advanced degenerative changes, the left L3-L4 paravertebral facet joint could not be distinctly visualized fluoroscopically, despite trying numerous angles. This was explained to the patient who wished to proceed with the injection. A 22-gauge 6-inch spinal needle was advanced toward the region of the left L3-L4 paravertebral facet joint under fluoroscopic guidance. Injection of 0.5 cc of Isovue 200 contrast showed the needle was not in an intravascular location.Intra-articular placement could not be confirmed and the injection was presumed to be peri-articular. 2 cc containing equal parts preservative free 2% Lidocaine plus Depo-Medrol (80 mg per ml) was injected. The patient reported injection of medication produced discomfort in the region of her usual left low back pain. Immediately following the procedure, upon standing up from the procedure table, she reported her pain was a little bit better.What CPT® code(s) is/are reported for this procedure? a. 64493-26 b. 6449 3 c. 64493-50-26 d. 64493-50, 77003 Correct ans - B Operative ReportDiagnosis: Basal Cell CarcinomaProcedure: Mohs micrographic excision of skin cancer.Site: Face left lateral upper canthus eyelidPre-operative size: 0.8 cmIndications for surgery: Area of high recurrence, area of functional and/or cosmetic importance. Discussed procedure including alternative therapy, expectations, complications, and the possibility of a larger or deeper defect than expected requiring significant reconstruction. Patient's questions were answered.Local anesthesia 1:1 Marcaine and 1% Lidocaine with Epinephrine. Sterile prep and drape.Stage 1: The clinically apparent lesion was marked out with a small rim of normal appearing tissue and excised down to subcutaneous fat level with a defect size of 1.2 cm. Hemostasis was obtained and a pressure bandage placed. The tissue was sent for slide preparation. Review of the slides show clear margins for the site.Repair: Complex repair.Repair of Mohs micrographic surgical defect. Wound margins were extensively undermined in order to mobilize tissue for closure. Hemostasis was achieved. Repair length 3.4 cm. A layered closure was performed. Multiple buried absorbable sutures were placed to re-oppose deep fat. The epidermis and dermis were re- opposed using monofilament sutures. There were no complications; the patient tolerated the procedure well. Post-procedure expectations (including discomfort management), wound care and activity restrictions were reviewed. Written Instructions with urgent contact numbers given, follow-up visit and suture removal in 3-5 daysWhat CPT® and ICD- 10-CM codes are reported? a. 17313, 13152-51, C44.1191 b. 13152, 11442-51, C44.311 c. 17311, 13152-51, C44.1191