1. The provider
trims non-dystrophic nails on the right hand (five fingers) and the left hand
(two fingers), with debridement of the same fingers. Proper coding is:
a)
11719, 11721
b)
11719, 11721-59
c)
11719,
11721-51
d)
11719
2. A
patient present with right upper quadrant pain, nausea, and other symptoms of
liver disease as well as complaints of decreased urination. Her physician
orders an albumin, bilirubin, both total and direct, alkaline phosphatase,
total protein, alanine amino transferase, aspartate amino tranferase and
creatinine.How should this be coded?
a)
82040, 82247, 82248, 84075, 84155, 84460, 84450, 82565
b)
80076, 82565
c)
80076
d)
80076-22
3.Patient is 40-year-old male who was involved in a motor vehicle
crash. He is having some pulmonary insufficiency. Procedure: Bronchoscope was
inserted through the accessory point on the end of the ET tube and was then
advanced through the ET tube. The ET tube came pretty close down to the carina.
We selectively intubated the right, main stem bronchus with the bronchoscope.
There were some secretions here, and these were aspirated. We then advances
this selectively into first the lower and then the middle and upper lobes.
Secretions were present, more so in the middle and lower lobes. No mucous plug
was identified. We then went into the left main stem and looked at the upper
and lowerlobes.There was really not much in the way of secretions present. We
did inject some saline and aspirated this out. We then removed the bronchoscope
and put the patient back on the supplemental O2, we waited a few minutes. The
oxygen level actually stayed pretty good during this time. We then reinserted
the bronchoscope and went down to the right side again. We aspirated out all
secretions and made sure everything was clear. We then removed the bronchoscope
and pulled back on the ET tube about 1.5 cm. We then again placed the patient
on supplemental oxygenation. Findings: No mucous plug was identified.
Secretions were found mainly in the right lung and were aspirated. The left
side looked pretty clear.
a)
31645, J98, V87.7XXA
b) 32654,
J98.4, V87.7XXA
c)
31645, J98.4, V89.2XXA
d) 31646,
J98, V89.2XXA
4.Incision
was made into the frontal, ethmoid and sphenoid sinus in the same session, this
should be coded as,
a)
31020, 31070, 31050
b) 31090
c) 31020,
31075, 31050
d)
31030, 31075, 31050
5. Dr. Alexis completed Mohs surgery on Ralph’s left arm. She
reported routine stains on all slides, mapping, and color coding of specimens.
The procedure was accomplished in three stages with a total of seven blocks in
the second stage. How would you report Dr. Alexis’ services?
a. 17313,
17314-58, 17315-59, 88314-59
b. 17311, 17312 x
7
c. 17313, 17314 x
2, 17315 x 2
d. 17311, 88302,
17314 x 3, 17312 x 7
6.
The frozen section pathology after 1.5 cm malignant melanoma lesion showed
positive margins, so an additional excision for 2.5 cm was done in the post
operative period of the initial procedure. How will you code the second
re-excision procedure?
a) 11602-58
b) 11603
c) 11603-58
d) 11606
7. A 43 year-old female is seen in the
emergency room with severe epistaxis. She said this is a common occurrence for
her during the cold dry months of winter and this is why she is here for the
third time this week. Extensive bilateral posterior cautery and packing is
again required to control the hemorrhage. What CPT® code is reported for
the procedure? (Note: Do not code the E/M)
a)
30906-50
b) 30905-50
c)
30905-22
d) 30903-50
8. An 18 month-old patient is seen in the ED
unable to breathe due to a toy he swallowed
which had lodged in his throat. Soon brain death will occur if an airway
is not established immediately. The ED provider performs an emergency
transtracheal tracheostomy. What CPT® and ICD-10-CM codes are reported?
a)
31601, J34.9, T17.298A
b) 31603, T17.290A
c)
31601, 31603, T17.228A
d) 31603, T17.220A
9. A patient’s nose was hit with a
baseball during a high school baseball game. At that time reconstruction was
performed with local grafts. Patient returns now as an adult, discontent with
the bony prominence along the bony pyramid and flat look of the tip of the
nose. He underwent major repair with osteotomies and nasal tip work. What CPT®
code is reported?
a)
30450
b) 30410
c)
30462
d) 30435
10.A 55 year-old female smoker presents with
cough, hemoptysis, slurred speech and weight loss. Chest X-ray done today
demonstrates a large, unresectable right upper lobe mass, and brain scan is
suspicious for metastasis. Under fluoroscopic guidance in an outpatient
facility, a percutaneous needle biopsy of the right lung lesion is performed
for histopathology and tumor markers. A diagnosis of small cell carcinoma is
made and chemoradiotherapy is planned. What CPT® and ICD-10-CM codes are
reported?
a)
32400-RT, 77002-26, C34.90
b) 32405-RT, 77002-26, C34.11
c)
32607-RT, 77002-26, R22.2
d) 32098-RT, 77002-26, C34.10, R07.9, R04.89,
R47.81, R63.4
11.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)
31576, 31231-51, J32.4, J02.9, J41.8
b) 31576, 31237-50-59, J32.4, J37.0, J41.8
c)
31575, 31231-59, J32.4, J37.1
d) 31575, 31231-50-59, J32.4, J37.1
12.A 55 year-old patient has history of lung
cancer of the right lower lobe. He is complaining of difficulty breathing and
mild chest pain. Patient is scheduled for a diagnostic VATS (Video-assisted
thoracoscopic surgery). Under general anesthesia he was placed in left lateral
decubitus position and a thoracoscope was inserted through a port site. The
VATS exploration immediately revealed a mass of the left upper lobe. A biopsy
was performed and sent to pathology. Results from pathology revealed small cell
carcinoma. Decision was made to remove the upper lobe of his left lung by
performing an open procedure. The thoracoscope is withdrawn and the surgeon
opens the chest cavity and rib spreaders are inserted to separate the ribs to
gain access to the lung. The upper lobe of the left lung is identified,
isolated and removed. The instruments are removed and the chest incision is
closed in layers. What CPT® codes are reported?
a)
32663, 32601-51
b) 32663
c)
32480-58, 32608-51
d) 32440
13.A 78 year-old patient with bilateral, lower
lobe lung cancer has been in the hospital for seven days with a tunneled chest
tube in place to drain fluid from the pleural space. The chest tube currently
is inserted between the 4th and 5th intercostal
space on the left side. There is a very bad infection at the insertion site.
The provider removes this chest tube and inserts another chest tube between the
5th and 6th intercostal space on the left side
to continue fluid drainage. The tube placed today is just the same as the one
removed, only sterile. What CPT® and ICD-10-CM codes are reported?
a)
32561, 32552-51, T81.89XA, C34.90
b) 32560, 32552-51, T81.89XA, C34.80
c)
32551, 32552-51, T85.79XA, C78.01,
C78.02
d) 32550, 32552-51, T85.79XA, C34.31, C34.32
14. Dr. Lee performed an intra-operative consultation on a bile
duct tumor requiring frozen section and cytological evaluation to a bladder
tumor. How would you report his professional services?
a) 88329
b) 88331-26, 88334-26
c) 88331, 88332 x 2
d) 88331-26, 88333-26
15. A patient came to the hospital with severe abdominal pain and
was diagnosed with common bile duct stone. The physician did ERCP with
sphincterotomy and retrograde stone removal and provided interpretation and
written report. Select the CPT codes for the procedure.
a)
43260
b)
74330-52
c)
43264, 43262-51, 74330-26
d)
43264, 74330-26
16. Preoperative Diagnosis: Lower left inguinal pain Postoperative
Diagnosis: Inguinal hernia Procedure: This 30-year-old patient presented with
lower left inguinal pain and on examination was found to have a left inguinal
hernia. The decision to perform a left inguinal hernia repair was made. The
procedure was performed in the outpatient hospital surgery center. Risks and
benefits of the surgery were discussed with the patient and the patient decided
to proceed with the surgery. A skin incision was placed at the umbilicus where
the left rectus fascia was incised anteriorly. The rectus muscle was retracted
laterally. Balloon dissector was passed below the muscle and above the
peritoneum. Insufflation and deinsufflation were done with the balloon removed.
The structural balloon was placed in the preperitoneal space and insufflated to
10 mm Hg carbon dioxide. The other trocars were placed in the lower midline
times two. The hernia sac was easily identified and was well-defined. It was
dissected off the cord anteromedially. It was an indirect sac. It was taken
back down and reduced into the peritoneal cavity. Mesh was then tailored and
placed overlying the defect, covering the femoral, indirect, and direct spaces,
tacked into place. After this was completed, there was good hemostasis. The
cord, structures, and vas were left intact. The trocars were removed. The
wounds were closed with 0 Vicryl for the fascia, 4-0 for the skin. Steri-Strips
were applied. The patient was awakened and carried to the recovery room in good
condition, having tolerated the procedure well. What are the correct procedure
and diagnostic codes?
a) 49505-LT, K40.90
b) 49505-LT, 49568, K40.91
c) 49507-LT, K40.11
d) 49501-LT, 49568, K40.90
17. A patient with a third-degree burn of 54% of his body is being
treated under anesthesia for excision, debridement, and extensive skin
grafting. The patient’s condition is listed as severe, and he is not expected
to survive without the operation. The operation is further complicated by the
emergency condition of the patient, and delaying this procedure could lead to
loss of body parts. How should the anesthesiologist report her services with
this procedure?
a)
01952-P5, 01953-P5 x 4, 99140
b)
01952-P5, 01953-P5
c)
01951, 01952, 01953 x 4
d)
01951, 01952, 01953 x 5, 99140-51
18. PRE OP DIAGNOSIS: Left Breast Abnormal MMX or Palpable Mass;
Other Disorders Of Breast PROCEDURE: Automated Stereotactic Biopsy Left Breast
FINDINGS: Lesion is located in the lateral region, just at or below the level
of the nipple on the 90 degree lateral view. There is a subglandular implant in
place. I discussed the procedure with the patient today including risks,
benefits and alternatives. Specifically discussed was the fact that the implant
would be displaced out of the way during this biopsy procedure. Possibility of
injury to the implant was discussed with the patient. Patient has signed the
consent form and wishes to proceed with the biopsy. The patient was placed
prone on the stereotactic table; the left breast was then imaged from the inferior
approach. The lesion of interest is in the anterior portion of the breast away
from the implant which was displaced back toward the chest wall. After imaging
was obtained and stereotactic guidance used to target coordinates for the
biopsy, the left breast was prepped with Betadine. 1% lidocaine was injected
subcutaneously for local anesthetic. Additional lidocaine with epinephrine was
then injected through the indwelling needle. The SenoRx needle was then placed
into the area of interest. Under stereotactic guidance we obtained 9 core
biopsy samples using vacuum and cutting technique. The specimen radiograph
confirmed representative sample of calcification was removed. The tissue
marking clip was deployed into the biopsy cavity successfully. This was confirmed
by final stereotactic digital image and confirmed by post core biopsy mammogram
left breast. The clip is visualized projecting over the lateral anterior left
breast in satisfactory position. No obvious calcium is visible on the final
post core biopsy image in the area of interest. The patient tolerated the
procedure well. There were no apparent complications. The biopsy site was
dressed with Steri-Strips, bandage and ice pack in the usual manner. The
patient did receive written and verbal post-biopsy instructions. The patient
left our department in good condition. IMPRESSION: 1. SUCCESSFUL STEREOTACTIC
CORE BIOPSY OF LEFT BREAST CALCIFICATIONS. 2. SUCCESSFUL DEPLOYMENT OF THE
TISSUE MARKING CLIP INTO THE BIOPSY CAVITY 3. PATIENT LEFT OUR DEPARTMENT IN
GOOD CONDITION TODAY WITH POST-BIOPSY INSTRUCTIONS. 4. PATHOLOGY REPORT IS
PENDING; AN ADDENDUM WILL BE ISSUED AFTER WE RECEIVE THE PATHOLOGY REPORT. What
are the codes for the procedures?
a) 19081
b) 19283
c) 19101, 19283
d) 19100, 19283
19. Patient is seen in the hospital’s outpatient surgical area
with a diagnosis of a displaced comminuted fracture of the lateral condyle,
right elbow. An ORIF procedure was performed, which included the following
techniques: An incision was made in the area of the lateral epicondyle. This
was carried through subcutaneous tissue, and the fracture site was easily
exposed. Inspection revealed the fragment to be rotated in two places about 90
degrees. It was possible to manually reduce this quite easily, and the manipulation
resulted in an almost anatomic reduction. This was fixed with two pins driven
across the humerus. The pins were cut off below skin level. The wound was
closed with plain catgut subcutaneously and 5-0 nylon for the skin. Dressings
and a long arm cast were applied. Which are the correct ICD-10-CM and CPT®
codes assignment?
a) 24579, 29065-51, S42.451B
b) 24577, S42.451B
c) 24579, S42.451A
d) 24575, S42.451A
20. PREOPERATIVE DIAGNOSIS: Medial meniscus tear, right knee
POSTOPERATIVE DIAGNOSIS: Medial meniscus tear, extensive synovitis with an
impingement medial synovial plica, right knee TITLE OF PROCE-DURE: Diagnostic
operative arthroscopy, partial medial meniscectomy and synovectomy, right knee
The patent was brought to the operating room, placed in the supine position
after which he underwent general anesthesia. The right knee was then prepped
and draped in the usual sterile fashion. The arthroscope was introduced through
an anterolateral portal, interim portal created anteromedially. The
suprapatellar pouch was inspected. The findings on the patella and the femoral
groove were as noted above. An intra-articular shaver was introduced to debride
the loose fibrillated articular cartilage from the medial patellar facet. The hypertrophic
synovial scarring between the patella and the femoral groove was debrided. The
hypertrophic impinging medial synovial plica was resected. The hypertrophic
synovial scar-ring overlying the intercondylar notch and lateral compartment
was debrided. The medial compartment was inspected. An upbiting basket was
introduced to transect the base of the degenerative posterior horn flap tear.
This was removed with a grasper. The meniscus was then further contoured and
balanced with an intra-articular shaver, reprobed and found to be stable. The
cruciate ligaments were probed, palpated and found to be intact. The lateral
compartment was then inspected. The lateral meniscus was probed and found to be
intact. The loose fibrillated articular cartilage along the lateral tibial
plateau was debrided with the intra-articular shaver. The knee joint was then
thoroughly irrigated with the arthroscope. The arthroscope was then removed.
Skin portals were closed with 3-0 nylon sutures. A sterile dressing was
applied. The patient was then awakened and sent to the recovery room in stable
condition. What CPT and should be reported?
a) 29880-RT
b) 29881-RT
c) 29881-RT, 29822-59-RT
d) 29880-RT, 29822-59-RT
21. The patient is 15 weeks pregnant with twins coming back to her
obstetrician to have a trans-abdominal ultrasound performed to reassess
anatomic abnormalities of both fetuses that were previously demonstrated in the
last ultrasound. What code(s) should be used for this procedure?
a) 76815
b) 76816, 76816-59
c) 76801, 76802
d) 76805, 76810
22. A patient is admitted to the hospital for insertion of 15
interstitial radiation ribbons. How would the facility report the radiology
services?
a.
77778
b.
99222, 77763
c.
77799-TC
d.
77762 x 15
23. Mary tells her physician that she has been having pain in
her left wrist for several weeks. The physician examines the area and palpates
a ganglion cyst of the tendon sheath. He marks the injection sites, sterilizes
the area, and injects corticosteroid into two areas.
a) 20550-LT x 2, M67.432
b) 20551-LT, M67.40
c) 20551-LT x 2, M67.432
d) 20612-LT, 20612-59-LT, M67.432
24. Maryann received a blow to her right tibial shaft while
moving a large stuffed chair up a flight of stairs when the person in front of
the chair slipped and released his hold on the chair.
The full weight of the chair was pushed against her; when she
was unable to hold the chair in place, both she and the chair fell to the
landing a dozen steps below. The chair tipped on its side and landed on her
tibia. On x-ray, the right tibia shaft was fractured in 3 places. Percutaneous
screws and pins were placed to secure the fracture sites.
a) 27750-RT, S82.201B
b) 27756-RT, S82.201B
c) 27756-RT, S82.201A
d) 27750-RT, S82.201A
25. While playing at home, Riley dislocated his patella, when
he fell from a tree. The surgeon documented an open dislocation. Riley
underwent a closed treatment under anesthesia. How would you report the
treatment and diagnoses?
a. 27420, S83.006A
b. 27562, S83.013A
c. 27840, 27562-51, S83.006A
d. 27562, S83.006A
26. An 88-year-old male patient
suffering from dementia accidentally pulled out his gastrostomy tube during the
night. Dr. Keys, an interventional radiologist, takes him into an angiography
suite, administers moderate sedation (an independent observer was present
during the procedure), probes the site with a catheter and injects contrast
medium for assessment and tube placement. Dr. Keys finds that the entry site
remains open and replaced the tube into the proper position. The intra-service
time for the procedure took 45 minutes. How would Dr. Keys report his services?
a. 49440, 99156, 99157
b. 49440, 49450-59
c. 49450, 99152, 99153*2
d. 49450
27. A patient diagnosed with GERD
presents to the same day surgery department for an upper GI endoscopy. The
procedure is done in order to treat the GERD by delivering thermal energy to
the muscle of the gastric cardia and lower esophageal sphincter. Anesthesia was
administered and as the physician begins the procedure, the patient’s blood
pressure drops to a dangerously low level. The physician decides not to finish
the procedure due to the risk it may cause the patient. What are the codes for
this procedure and diagnosis?
A. 43257-73, K21.9, Z53.09
B. 43499, K21.8, I95.0
C. 43257-74, K21.0, I95.9
D. 43257-53, K21.9, I95.89, Z53.09
28. An anesthesiologist provided
general anesthesia for open repair of a fractured pelvis column involving the
acetabulum for a 74-year-old patient. Further documentation for this patient
includes severe hypertension and uncontrolled diabetes. How should the
anesthesiologist report her services?
a. 01173-P3, 99100
b. 27226, 01160-P3, 99100
c. 01190-P4, 99100-51
d. 01170-P4
29. After intravenous administration of
5.1 millicuries Tc-99m DTPA, flow imaging of the kidneys was performed for
approximately 30 minutes. Flow imaging demonstrated markedly reduced flow to
both kidneys bilaterally. What CPT® code is reported?
a) 78710
b) 78708
c) 78701
d) 78725
30. An oncology patient is having weekly
radiation treatments with a total of seven conventional fractionated
treatments. Two fractionated treatments daily for Monday, Tuesday and Wednesday
and one treatment on Thursday. What radiology code(s) is/are appropriate for
the clinical management of the radiation treatment?
a) 77427
b) 77427 x 2
c) 77427 x 7
d) 77427-22
31. Magnetic resonance imaging of the
chest is first done without contrast medium enhancement and then is performed
with an injection of contrast. What CPT® code(s) is/are reported for the
radiological services?
a) 71550, 71551
b) 71555
c) 71552
d) 71275
32. A 78-year-old with lower back pain and leg pain is scheduled for
an MRI of lumbar spine without contrast. Following the MRI, the patient is
diagnosed with spinal stenosis of the lumbar region. What are the procedure and
diagnosis codes?
a)
72020, M54.5, M79.609, M48.00
b)
72149, M54.9
c)
72148, M48.06
d)
72158, M54.5, M79.609
33. The physician orders a heart CT without contrast. The tests will
evaluate the amount of coronary calcium. What is the correct code?
a)
75571
b)
75572
c)
75574
d)
75557
34. A patient is having knee replacement
surgery. The surgeon requests that in addition to the general anesthesia for
the procedure that the anesthesiologist also insert a lumbar epidural for
postoperative pain management. The anesthesiologist performs postoperative
management for two postoperative days.
A. 01400-AA, 62326
B. 01402-AA, 01996 x 2
C. 01402-AA, 62326, 01996 x 2
D. 01402-AA, 01996 x 2
35. A pathologist performs a test for the following elements:
Calcium, carbon dioxide, chloride, creatinine, glucose, potassium, sodium, urea
nitrogen, and blood typing (both ABO and D). Give the CPT for these procedures.
a) 82310, 82374, 82435, 82565, 82947,
84132, 84295, 86850, 86900
b)80048, 86850, 86906
c) 80048, 86900, 86901
d) 82310, 82374, 82435, 82565, 82947,
84132, 84295, 86910, 86901
36. After obtaining capillary blood, a
glucose screening by Dextrostix method (reagent strip)was performed. Select the
CPT code for the service.
a) 82962
b) 82962, 36415
c) 82948, 36416
d) 82948, 36410
37. An established patient comes in
the outpatient hospital clinic for a follow-up visist for chronic hepatitis.
After being examined, the physician ordered the patient to have a hepatic
function panel drawn. The panel includes the following elements: bilirubin,
total and direct; SGPT; and SGOT. Code for the procedures and diagnosis.
a) 80076, K73.9
b) 80074, K73.0
c) 86709, 86705, 87340, 86803, K73.0
d) 84460, 84450, 82247, 82248, K73.9
d) 84460, 84450, 82247, 82248, K73.9
38. A patient has a severe traumatic fracture of the
humerus. During the open reduction procedure, the surgeon removes several
small pieces of bone embedded in the nearby tissue. They are sent to
Pathology for examination without microscopic sections. The pathologist
finds no evidence of disease. How should the pathologist code for his
services?
a)
88309, 88311
b)
This service cannot be billed
c)
88300
d)
88304
39. A 27 year-old male dies of a gunshot wound. An autopsy
is performed to gain evidence for the police investigation and any subsequent
trial. What CPT® code is reported?
a.
88040
b.
88025
c.
88045
d.
88005
40. A patient’s mother and sister have been treated for breast
cancer. She has blood drawn for cancer gene analysis with molecular pathology
testing. She has previously received genetic counseling. Blood will be tested
for full sequence analysis and common duplication or deletion variants
(mutations) in BRCA1, BRCA2 (breast cancer 1 and 2). What CPT® code is reported
for this molecular pathology procedure?
a)
81213
b)
81206
c)
81211
d)
81200
41. A patient has a history of chronic atrophic gastritis which has been identified as due to Helicobacter pylori. Although previously eradicated with almost complete resolution of gastritis symptoms, the patient has recently begun experiencing pain and other symptoms indicating the infection may have recurred. A biopsy of the stomach was obtained with a gross and microscopic examination performed with an order to verify the presence of H. pylori and, if present, perform sensitivity studies for possible resistant strains. Testing of the biopsy specimen with acid-fast stains confirms chronic gastritis due to H. pylori. Agar dilution studies for susceptibility to five antibiotics are performed. The susceptibility studies indicate resistance to clarithromycin (a macrolide antimicrobial). What codes are reported for the diagnosis and procedure to identify the infectious agent, and test for susceptibility?
A)
88312, 87181, K29.40, B96.81, Z16.29
B)
87299, 87181, B96.81
C)
88305, 88312, 87181 x 5, K29.40, B96.81, Z16.29
D)
87140, 87181x 5, B96.81, Z16.29
42. A
major university medical center has an International Clinic specializing in treating
individuals who move to the USA bringing with them diseases and conditions
native to their home countries. A Brazilian woman presents to this clinic
with complaints of hematuria and fatigue. Urine analysis with microscopy
identifies eggs in the urine and further testing from a stool sample identifies
Schistosomiasis through direct smear to concentrate and evaluate ova.
What CPT® and ICD-10-CM codes are reported?
A. 87045,
81007, R31.9, R53.83
B.
87207, 81007, B65.0
C.
87177, 81000, B65.0
D. 87209,
81000, R31.9, R53.83
43. A patient arrives at the urgent care facility with a swollen
ankle. Anteroposterior and lateral view X-rays of the ankle are taken to
determine whether the patient has a fractured ankle. What CPT® code(s)
is/are reported?
a)
73610
b) 73600
x 2
c)
73600
d) 73600,
73610
44. A 52 year-old female is sent to radiology for a
lymphangiography of both arms. The patient has swelling in both arms which is
suspected to be lymphangitis. She also has a history of breast cancer having
had a double mastectomy 5 years ago. What CPT® and ICD-10-CM codes are
reported?
a)
75801, L03.123, L03.124, Z80.3, Z90.13
b) 75801,
M79.89, Z80.3, Z90.13
c)
75803, M79.89, Z85.3, Z90.13
d) 75803,
L03.123, L03.124, Z85.3, Z90.13
45.Procedure: Body PET-CT Skull Base to Mid-thigh
History: A 65 year-old male Medicare patient with a history of rectal carcinoma presenting for restaging examination. Description: Following the IV administration of 15.51 mCi of F-18 deoxyglucose (FDG), multiplanar image acquisitions of the neck, chest, abdomen and pelvis to the level of mid-thigh were obtained at one hour post radiopharmaceutical administration. What CPT® code(s) is/are reported?
History: A 65 year-old male Medicare patient with a history of rectal carcinoma presenting for restaging examination. Description: Following the IV administration of 15.51 mCi of F-18 deoxyglucose (FDG), multiplanar image acquisitions of the neck, chest, abdomen and pelvis to the level of mid-thigh were obtained at one hour post radiopharmaceutical administration. What CPT® code(s) is/are reported?
A. 70542,
71555, 74182
B.
78815
C.
78816
D. 70491,
71551, 74176
46. A parent brings her child to the ED. She thinks she swallowed
a small toy figure. A radiology exam from the nose to the rectum is performed.
The foreign body is not located. What CPT® code(s) is/are reported for the
radiology services?
a)
70160, 70370, 71045, 74245
b) 76010
c)
70160, 70370, 71045, 43235, 44363
d) 43235,
44363
47. A patient in her 2nd trimester with a triplet
pregnancy is seen in the obstetrician’s office for an obstetrical ultrasound
only for obtaining fetal heartbeats and position of the fetuses. What CPT®
code(s) is/are reported for the ultrasound?
A. 76811,
76812, 76812
B.
76815
C.
76805, 76810, 76810
D. 76815
x 3
48. 21. A woman is referred to a plastic surgeon when excessive
skin weighs down her eyelids to the point that her sight is impaired. The
surgeon performs bilateral blepharoplasty 2 weeks later. Which of the following
would be correct for the surgical procedure?
a.
67917-50
b.
15822
c.
15823
d. 15823-50
49. 32. DIAGNOSIS: Conductive deafness, left ear.
NAME
OF OPERATION: Tympanoplasty with ossicular chain reconstruction.
PROCEDURE:
Under general endotracheal plus 2% Xylocaine endaural block anesthesia, the ear
was inspected. The patient had several surgical procedures performed on this
ear over the years, the last one being approximately three months ago, at which
time the tympanic membrane was totally reconstructed, and the ossicular chain
reconstructed using a hydroxyapatite prosthesis from the stapes head to the
underside of the cartilage-reinforced drumhead. At the time of this present
operation, the drum head was intact and slightly lateralized. The middle ear
was entered through a posterior tympanomeatal incision, and it was found that
the hydroxyapatite prosthesis was lying free in the inferior part of the middle
ear with the shaft still touching the stapes head, but the head attached to the
medial wall of the middle ear. This prosthesis was carefully dissected away.
The medial aspect of the cartilage cap was scraped with a sharp right angle,
and the reverse elevator, and then inspected with a Buckingham mirror to make
certain that it was denuded of mucosa. Next, the middle ear was partly filled
with moist Gelfoam. Another offset hydroxyapatite partial prosthesis was
sculptured with diamond burs with approximately 0.5 mm extra length from the
old prosthesis, with a groove cut for the stapedius tendon. This was placed in
position with the chorda tympani touching this shaft at the medial aspect of
the prosthesis. Using glue, the attachment with the stapedius tendon and the
stapes head was glued in place. Then, the middle ear was completely filled with
moist Gelfoam to stabilize the prosthesis. The chorda tympani was also glued to
the superior portion of the shaft of the prosthesis. Next, the head of the
prosthesis was covered with glue and the drumhead with the cartilage cap was
replaced in position. The tympanomeatal flap was secured in place with
compressed, moist Gelfoam. External auditory canal was filled with Polysporin
ointment. It was anticipated this ossicular reconstruction will stay in the
proper position, and the patient will have a significant improvement in the
hearing. The patient tolerated the procedure well and returned to the recovery
room in good condition.
a. 69632-LT
b. 69633-LT
c. 69635-LT
d.
69636-LT
50.
Code the CPT procedure(s):
Diagnosis:
Proliferative vitreal retinopathy, retinal detachment right eye. Status post
trauma. Aphakia.
Operative
Procedures: Scleral buckle revision, pars plana vitrectomy, membrane peeling,
removal of silicone oil, PFO, fluid gas exchange, endolaser and reinjection of
silicone oil right eye.
Indications:
The patient is a 11-year-old boy who suffered a screwdriver injury to the right
eye previously. He had undergone intersegment surgery by Dr. Smith for anterior
segment reconstruction. Following this, he was noted to have a retinal detachment
with a cataract approximately four months ago. At that time, he underwent pars
plana lensectomy, vitrectomy, membrane peeling, endolaser, fluid gas exchange
and injection of silicone oil with a scleral buckle to the right eye. he
developed recurrent proliferation superiorly with a superior detachment. He is
taken to the operating room now for repair of the superior detachment.
Procedure:
He underwent general anesthesia and intubation without difficulty. He was
prepped and draped in a sterile fashion. A lid speculum was inserted straight
in the right eye lid 2.5 mm inferotemporally a 5-0 Mersilene suture was passed
in a mattress fashion and a 20 gauge sclerotomy created into the suture. A 4mm
infusion cannula space sclerotomy verified pin position inserted into place.
Then the infusion was then turned on. The nasal sclerotomies were similarly
created, a 2.5 mm posterior to the limbus. The superior detachment was noted to
be anterior to the equator, between the equator and ora serrata superiorly.
There were extensive preretinal fibrotic bands as well as subretinal fibrotic
bands noted. The silicone oil was then removed form the eye. Following this, a
Michel’s pick was used to take off the preretinal proliferative membrane. The
Dean forceps examination with the Michel’s pick and vitrector were used.
Specimens were sent to pathology. Attention was also turned to the retrocorneal
fibrotic band, which was present nasally from 12 o’clock towards 3 o’clock with
a dense fibrovascular white band. Using a Michel’s pick and vertical scissors
the band was cut away from the corneal endothelium. Dewar pick forceps were
used to peel off the fibrotic tissue. It was noted that there was a fibrotic
band extending from the cornea onto the ciliary body and onto the retinal surface
itself, which was responsible for tenting of the retina nasally. These
specimens were also sent to pathology. Following this, the view improved
through the now more clear cornea in that location. There were still in the
area of the corneal wound, fibrotic tissue which could not be removed.
Following this, it was elected to pull up the scleral buckle. Plugs were placed
into the eye, the Wtazke sleeve and the ends of the 287 were identified
superonasally. The ends of the 287 were trimmed an additional 3 mm. The Watzke
sleeve was placed and the 240-band was tightened and trimmed. There was now a
nice high buckling effect at 60 degrees. The plugs were removed from the
eye.The retinal tear was seen at 12 o’clock, which was felt to be the causative
break. The previous break superotemporally still was attached and an additional
laser reinforcement was placed to it. PFO was injected into the eye and all the
subretinall fluid was drained out through the superior causative tear.Extensive
endolaser was placed just around the tear superiorly as well as 360 degrees on
the buckle.Following this the PRO was washed out with a fluid air exchange.
Saline was injected into the eye to rinse out any residual PFO which may be
remaining. The sclerotomy superonasally was closed. Silicone oil was injected
into the eye for a good fill. Already present was an inferior peripheral
iridotomy. The other sclerotomy was closed with 7-0 Vicryl suture. The infusion
cannula was cut and removed from that eye and that sclerotomy closed with 7-0
Vicryl suture. Five milliliters of 0.75% Marcaine was then injected using a
blunt cannula into the retrobulbar space for postoperative analgesia. The
conjunctiva was then closed with 6-0 plain sutures. Ancef 150 mg and 4 mg of
Decadron were given in a subconjunctival fashion. Erythromycin ointment and
atropine drops were instilled into the right eye. The lid speculum was removed
from the right eye and a patch and shield was placed. The patient underwent
general anesthesia extubation without difficulty.
a.
67107, 67015-51
b.
67110, 67015-51
c.
67108, 67015-51
d.
67113, 67015-51
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