SAMPLE CPC MODEL TEST - 005

1.      An MRI is taken to confirm the diagnosis of a subperiosteal abscess (SPA) between the orbital bones and left periorbital caused by a staphylococcus infection. The MRI is performed first without contrast material and then followed by contrast materials and further sections. An independent radiologist reads the MRI confirming the diagnosis. What are the CPT and ICD 10 CM codes reported for the radiologist’s services?

A.     70542-26, M90.88, B95.4

B.      70540-26, 70481-26, M90.89, B95.7

C.      70543-26, H05.022, B95.7

D.     70546-26, 70545-26, H05.022, B95.62

2.      A patient with recurrent bladder infection presents today for a voiding urethrocystogram. The urologist performs the injection procedure and four views under radiological supervision and interpretation in his office. What codes are reported by the urologist?

A.     51600, 74430

B.      51605, 74430

C.      51605, 74455

D.     51600, 74455

3.      A surgeon performs a cholecystectomy for a patient with cholecystitis. The removed organ is sent to the pathologist for gross and microscopic examination. What CPT code is reported for the surgical pathologists examining and reporting on the specimen?

A.     88307

B.      88302

C.      88304

D.     88300

4.      A patient presents to the ER with crushing chest pain radiating down the left arm and up under the chin. There are elevated S-T segments on EKG. The cardiologist orders three serial CPK enzyme levels with instructions that the tests are also to be performed with isoenzymes if the initial tests are elevated on that date of service. The CPK enzyme levels were elevated; therefore, the lab codes would be :

a)      82550, 82552, 82550-76 x 2 units, 82552-76 x 2 units

b)     82550, 82552, 82552-91*2 units

c)      82550, 82550-91 x 2 units, 82552, 82552-91 x 2 units

d)     82550 x 3 units, 82554 x 3 unit

5.      The MRI shows full- thickness tear of the right rotator cuff consistent with Mr. John’s acute symptoms. The symptoms began when he slipped and fell on the ice Thursday?

a)      S46.001A, W00.0XXA

b)     M66.20, W00.0XXA

c)      M75.121, W00.0XXA

d)     S46.011A, W00.0XXA

6.      The patient’s dense breast tissue made the mammogram unreadable and she is here today for a breast ultrasound. Her mother and sister both have a history of breast cancer. What codes are reported for the diagnosis?

A.     N60.89, Z80.3

B.      N12.39, N64.59, Z80.3

C.      Z12.39, R92.2, Z80.3

D.     Z12.31, R92.2, Z83.3

7.      What is the code to report 1 mcg of Aranesp for a patient on dialysis with ESRD?

A.     J0881

B.      J0882

C.      J0885

D.     J0887

8.      Patient has a torn medial meniscus. An arthroscope was placed through the anterolateral portal for the diagnostic procedure. The patellofemoral joint showed some grade 2 chondromalacia on the patella side of joint only, & this was debrided with 4.0 mm shaver. The medial compartment was also entered & a complex posterior horn tear of the medial meniscus was noted. It was probed to define its border. A meniscectomy was carried out back to a stable rim. The procedure is coded as

a)      29880, 29879-59

b)     29881, 29877-59

c)      29880

d)     29881

9.      A 3 yr old is bought into ER. He cannot bend his left arm after his older brother pulled it while they were playing. X ray obtained and provider diagnosed dislocated Nursemaid elbow. He reduced the elbow. Now the patient is able to move his arm. Provider referred to an orthopedist for F/U. The procedure is coded as

a)      24640-54, S53.032A, Y93.83

b)     24565-54, S53.032A, Y93.83A

c)      24640-54, S51.009A, Y93.83

d)     24600-54, S53.006A, Y93.83A

10. A 2 yrs old presents to ED with Rt upper arm pain. Rt humerus anterior/posterior and lateral views are obtained and found as no fracture, dislocation or other abnormality. What CPT & ICD codes to be reported for Physician Service?

a)      73060-26, M79.621

b)     73060-26, R93.8

c)      73090-26, M79.601

d)     73092-26, M86.9

11. A Provider performs a surgical removal of two skin lesions; one being a pigmented nodule measuring 2 cm X 2.5 cm on the left upper back; second lesion an inclusion cyst measuring 2.5 cm X 3 cm in the middle of the back. Both specimen are placed in individual containers & sent to surgical pathology for gross and microscopic examination. Select the correct CPT code(s) for this service.

a)      88304 X 2

b)     88305 X 2

c)      88304, 88305

d)     88304 X 2, 88329

12. An adult patient had the following immunizations with administration: Yellow fever vaccine, subcutaneous injection; Hepatitis B (adult dose) vaccine, intramuscular injection; Plague vaccine, intramuscular injection. How would you report these services?

a)      90460, 90461 x 2, 90717-51, 90746-51, 90749-51

b)     90471, 90472 x 2, 90717, 90746, 90749

c)      90473, 90474 x 2, 90746, 90717, 90749

d)     90471, 90472 x 2, 90746-51, 90717-51, 90749-51

13. 4-year-old is getting over his cold and will be getting three immunizations in the pediatrician’s office by the nurse. The first vaccination administered is the Polio vaccine intramuscularly. The next one is the influenza (live) administered in the nose. The last vaccination is the Varicella (live) by subcutaneous route. What CPTR codes are reported for the administration and vaccines?

a)      90713, 90658, 90716, 90460, 90461 x 2

b)     90713, 90656, 90716, 90460, 90461 x 1

c)      90713, 90660, 90716, 90471, 90472, 90474

d)     90713, 90658, 90716, 90471, 90472, 90473

14. Mae’s physician asked her to wear a glucose monitoring device to obtain more accurate information about her blood sugars. She had sensors placed and was then hooked up to a calibrated wearable device. Once this was complete, the technician provided Mae with training for the noninvasive ambulatory continuous glucose monitoring device. After wearing the device for 72 hours, Mae’s physician’s office removed the device, printed recordings, and downloaded analyses reports to its computer system. Which code captures this service?

a. 99090

b. 99091

c. 95250

d. 95251

15. A 19-year-old patient received immunizations at her health clinic. The immunizations were administered by a medical assistant at the same clinic. The patient was seen two weeks ago but was unable to complete the immunizations due to a stomach virus. Today, she is symptom free and receives an intramuscular H1N1 influenza pandemic formulation, preservative-free vaccine and an intramuscular hepatitis A immunization. Which codes capture these services?

a)      99211-25, 90633, 90667, 90473-51, 90474-51

b)     99213-25, 90632-51, 90666-51, 90471-51, 90472-51

c)      90460, 90749, 90632-51

d)     90632, 90749, 90471, 90472

16. A 35 yrs old was diagnosed with Stage I ductal carcinoma insitu in her Rt breast. She underwent a localized biopsy of sentinel lymph and axillary nodes in her Rt breast. An incision made with scalpel, once glandular tissue of the breast was intercepted, dissection was carried down through the skin & subcutaneous tissue. 1-2 cm of breast tissue was dissected free to the lymph node. The incision was carried deep to the Rt axilla & two sentinel & non sentinel lymph nodes were identified and excised. The procedure is coded as

a)      38525

b)     38570

c)      38500

d)     38505

17. A 45 yrs old male with stage III non Hodgkin’s lymphoma showed pathologic cervical nodes on the PET scan. A biopsy was recommended. A supraclavicular incision was made, deepened down through the platysmal muscle. Ligation of external jugular vein was performed and deep to this structure, numerous large nodes appx. 3-3.5 cm in greater dimension, were seen. Once elevated the hilar aspect of one of the node was serially clipped with hemoclips to remove it. The procedure is coded as

a)      38720

b)     38520

c)      21550

d)     38510

18. 69 yrs old white female with 10 yr status post dual chamber pacemaker where the generator is at its end of life. The pacemaker generator is explanted and the leads are then attached to a new generator. The procedure is coded as

a)      33213

b)     33208

c)      33213, 33233

d)     33228

19. A 38 yrs old’s blood pressure was progressively trending downward and it was determined that as emergent central venous access was needed for fluid resuscitation. A non tunneled catheter was used to access the subclavian vein and secured into place to infuse medication. Due to the patient’s low BP & anticipated need for vasopressor agents, a radial arterial line was also desired. The left radial artery pulse was easily palpable and the skin was punctured by a needle & the angiocatheter was placed in the left wrist. What CPT code to be reported for this encounter?

a)      36555, 36625-51

b)     36556, 36620

c)      36558, 36640-51

d)     36569, 36620

20. A patient underwent single transplant with cardiopulmonary bypass employed during the procedure.

a) 32852

b) 32854

c) 32853

d) 32851

21. A 62-year old female with three-vessel disease and supraventricular tachycardia, which has been refractory to other management. She previously had pacemaker placement and stenting of the coronary artery stenosis, which has failed to solve the problem. She will undergo CABG with autologous saphenous vein and a modified MAZE procedure to treat the tachycardia. The risks and benefits have been discussed and the patient wishes to proceed. She is brought to the cardiac OR and placed supine on the OR table. She is prepped and draped and adequate endotracheal anesthesia is assured. A median sternotomy incision is made and cardio- pulmonary bypass is initiated. The endoscope is used to harvest an adequate length of saphenous vein from her left leg. This is uneventful and bleeding is easily controlled. The vein graft is prepared and cut to the appropriate lengths for anatomosis. Three bypasses are performed, one to the LAD, one to the circumflex and another distally on the circumflex. A modified maze procedure was then performed and the patient was weaned from bypass. Once the heart was once again beating on its own again, we attempted to induce an arrhythmia and this could not be done. At this point, the sternum was closed with wires and the skin reapproximated with staples. The patient tolerated the procedure without difficulty and was taken to the PACU. Choose the procedure code(s) for this service.

a)      33519, 33508, 33254-51

b)     33512, 33508, 33999-51

c)      33512, 33508, 33254-51

d)     33512, 33508-51, 33254-51

22. A 30 year old is brought into the burn unit with burns covering 30 % of his total body. He has third degree burns to his chest wall (10%). Second degree burns on his arm and both legs (15%), and first degree burns on his face (5%) What ICD 10 CM codes are reported for the burn?

a)      T21.30XA, T22.239A, T24.231A, T24.232A, T20.10XA

b)     T30.0, T21.60XA, T30.4

c)      T21.31XA, T22.20XA, T24.201A, T24.202A, T20.10XA, T31.31

d)     T20.10XA, T22.20XA, T21.31XA, T24.201A, T23.202A, T31.31

23. Two malignant lesions on the scalp measuring 1.1 cm and one malignant lesion on the neck measuring 2.2 cm were destroyed. Electrocautery was used for the first two lesions and laser was used for the third lesion. What procedure code(s) is/ are reported?

a)      17276

b)     17273, 17272-51

c)      17273, 17272-51, 17272-51

d)     17274, 17273-51

24. At the patient’s bedside using Xylocaine local anesthesia, aseptic technique, and ultrasound guidance, a 21- gauge needle was used to aspirate the right cephalic vein of a 72 year old patient. Ultrasound demonstrated vascular needle entry and vessel patency of the cephalic and subclavian veins. When blood was obtained, a 0.018 inch platinum tip guide wire was advanced to the central venous circulation. A 6 French dual lumen PICC was introduced through a 6 French peel away sheath to the SVA RA junction. After removal of the sheath , the catheter was attached to the skin with a STAT-LOCk device and flushed with 500 units of Heparin in each lumen. Permanent ultrasound recordings were placed in the record. A sterile dressing was applied and the patient was discharged in improved condition. What CPT codes are reported for the physician?

a)      36569, 76937-26

b)     36568, 76942-26

c)      36569, 76942-26

d)     36556, 76942-26

25. A patient presents to the Emergency Department suffering from an acute exacerbation of his asthma. The ED physician performs an expanded problem focused history. The physician documents a detailed six organ exam. Medical decision making of moderate complexity is performed and includes ordering a chest X-Ray and providing a prescription for an inhaler to be used every two hours. What Emergency Department E/M level is reported?

a)      99282

b)     99283

c)      99284

d)     99285

26. A primary care provider admitted a 96 year old patient to the nursing facility last week. He returns to the nursing home for follow up. The physician performs  an expanded problem focused interval history, a detailed examination, and documents the findings of the patients lungs, hearts, skin, cranial nerves/sensations, ears, nose, throat, and eyes, and bowel sounds throughout the abdomen. Medical decision making is of low complexity. What E/M level is reported?

a)      99304

b)     99305      

c)      99307

d)     99308

27. The physician inserted a ventriculo-peritoneal shunt for the purpose of draining cerebrospinal fluid shunt in a 10 year old male patient with secondary hydrocephaluas resulting from bacterial meningitis. Anesthesia was started at 11 AM and ended at 11.50 AM. The procedure was performed from 11.05 AM to 11.45 AM. What CPT code is reported for the anesthesia and what anesthesia time is reported?

a)      00211; 40 Minutes

b)     00210; 45 Minutes

c)      00220; 50 Minutes

d)     00215; 50 Minute

28. A patient has six wounds repaired. Three wounds 2 cm of the scalp, 3.5 cm on the leg and 1.5 cm on the face require simple repairs. Two more wounds 1 cm on the foot and 3 cm on the hand require layered closures. The final procedure is a complex repair 5 cm on the ear. Code these repairs and list them according to complexity.

a) 13152, 12042-51, 12002-51, 12011-51

b) 12052, 12041-51, 12042-51, 12001-51, 12011-51, 12002-51

c) 12052, 12002-51, 12041-51, 12011-51, 12002-51, 12001-51

d) 12042, 12002-51, 12011-51, 13152-51

29. 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

30. What is the CPT code(s) for a segmentectomy of the right lung and a wedge resection of the left lung due to bacterial infection?

a) 32484-50

b) 32505-LT, 32484-RT

c) 32440-RT, 32484-LT

d) 32486-RT, 32505-LT

31. When a wedge resection of the RUL is done along with a lobectomy of the RLL, this should be coded as,

a) 32505

b) 32666

c) 32480, 32505-59

d)32505, 32480-59

32. Postoperative Diagnosis: Calculi of the gallbladder Procedure: Removal of gallbladder Indications: The patient is a 40-year-old woman who has a six month history of RUQ pain, which ultrasound revealed to be multiple gallstones. She presents for removal of her gallbladder. Procedure: The patient was brought to the OR and prepped and draped in a normal sterile fashion. After adequate general endotracheal anesthesia

was obtained, a trocar was placed and CO2 was insufflated into the abdomen until an adequate pneumoperitoneum was achieved. A camera was placed at the umbilicus and the gallbladder and liver bed were visualized. The gallbladder was enlarged and thickened, and there was evidence of chronic inflammatory changes. Two additional ports were placed and graspers were used to free the gallbladder from the liver bed with a combination of sharp dissection and electrocautery. Several attempts were made

before it was decided that additional exposure was needed and I converted to an open approach. The trocars were removed and a midline incision was made. At this time, it was clear that there were multiple adhesions in the area, and once these were carefully taken down, we were able to grasp the gallbladder. The cystic duct was carefully ligated and the gallbladder carefully removed from the field. The area was copiously irrigated, and a needle biopsy of the liver was taken. Then the skin was reapproximated in layers. Sponges and needle counts were correct, and the patient was taken to the recovery room in good condition.

a. 47600-22

b. 47600-22, 47001

c. 47562, 47600-22, 47001

d. 47562-22, 47000

33. A patient with right lower quadrant pain underwent emergent diagnostic laparoscopy. The surgeon found severe appendicitis on laparoscopic examination and did laparoscopic appendectomy. What codes the surgeon should bill for:

a) 44970

b) 44950, 44955

c) 44970, 44320

d) 44950, 49320

34. In a patient suffering from parotid gland tumor, the doctor needed to removal the whole parotid along with unilateral radical neck dissection. During the surgery the facial nerve was sacrificed and had to be sutured back extracranially. What CPT(s) will the doctor bill for?

a) 42426, 64864

b) 42426, 64864-51

c) 42426, 69990-26

d) 42425

35. DIAGNOSIS: 1. Primary adenocarcinoma descending colon 2. Hydronephrosis, bilateral

OPERATION: 1. Cystoscopy 2. Bilateral insertion of Double J stents

FINDINGS AT OPERATION: Endoscopic examination of the urinary bladder showed no significant abnormalities. Double-J stent insertion as accomplished bilaterally with minimal difficulty in the patient’s left side.

PROCEDURE: With the patient in the lithotomy position and under satisfactory general anesthesia, the genitalia were prepped and draped in a routine sterile manner. The McCarthy panendoscope was inserted, and 24-cm, 6-French, silastic, Double J stents inserted bilaterally with ease. The patient was then sent to the recovery room in satisfactory condition.

a) 52332

b) 52332, 50575

c) 52000, 52332-51

d) 52332, 52332-51, 50575

36. A 30-year-old disabled Medicare patient is scheduled for surgery due to the finding of what looks like an ovarian mass on the right ovary. On entering the abdomen, the surgeon finds an enlarged ovarian cyst on the right, but the ovary is otherwise normal. The left ovary is necrotic looking. The decision is made, based on the patient’s age, to remove the cyst from the right ovary, but performs a left salpingooophorectomy. Code this encounter.

A. 58720-RT, 58925-LT

B. 58925-RT, 58720-51-LT

C. 58925, 58720-50

D. 58720, 58925-51

37. A 37-year-old female has menorrhagia and wants permanent sterilization. The patient was placed in Allen stirrups in the operating room. Under anesthesia the cervix was dilated and the hysteroscope was advanced to the endometrium into the uterine cavity. No polyps or fibroids were seen. The Novasure was used for endometrial ablation. A knife was then used to make an incision in the right lower quadrant and

left lower quadrant with 5-mm trocars inserted under direct visualization with no injury to any abdominal contents. Laparoscopic findings revealed the uterus, ovaries and fallopian tubes to be normal. The appendix was normal as were the upper quadrants. Because of the patient’s history of breast cancer and desire for no further children, it was decided to take out both the tubes and ovaries. This had been discussed with the patient prior to surgery. What are the codes for these procedures?

A. 58660, 58353

B. 58661, 58563-51

C. 58661, 58558

D. 58662, 58563-51

38. A 42-year-old patient returns to the hospital neurology clinic for follow-up. He was checked three days prior to this visit where a lumbar puncture was done to find the etiology of the patient’s headaches. The headaches have increased in intensity over the past three days. The neurologist examines the patient and finds a CSF leak from the lumbar puncture. A blood patch by epidural injection is performed to repair the leak. Code the services for today’s visit.

A. 62272

B. 62273

C. 62270, 62273

D. 62270, 62287

39. A 63-year-old woman presented to the eye clinic as a new patient with symptoms of flashing lights and floaters in the right eye for two days duration. The ophthalmologist does a general evaluation of the complete visual system, including dilating her eyes and checking her with the indirect ophthalmoscope, revealing peripheral retinal tear. The physician explains to the patient that if left untreated, there is a high likelihood of retinal detachment. The patient agrees to the procedure. The physician lasers the retinal tear and tells the patient to come back in 24 hours for follow-up. Code this visit.

A. 67210, 92004-25

B. 67145, 92004-25

C. 66821

D. 67145

40. The patient is a 64-year-old female who is undergoing a removal of a previously implanted Medtronic pain pump and catheter due to a possible infection. The back was incised; dissection was carried down to the previously placed catheter. There was evidence of infection with some fat necrosis in which cultures were taken. The intrathecal portion of the catheter was removed. Next the pump pocket was opened with evidence of seroma. The pump was dissected from the anterior fascia. A 7-mm Blake drain was placed in the pump pocket through a stab incision and secured to the skin with interrupted Prolene. The pump pocket was copiously irrigated with saline and closed in two layers. What are the CPT and ICD-9-CM codes for this procedure?

A. 62365, 62350-51, T85.890A, Z45.49

B. 62360, 62355, T81.4xxA

C. 62365, 62355-51, T85.738 A

D. 36590, T85.890A, G97.63

41. A plastic surgeon is called to the ED at the request of the emergency department physician to evaluate a patient that arrived with multiple facial fractures after being in an automobile accident for her opinion on the need for reconstructive surgery. The plastic surgeon arrives at the ED, obtains a history of present illness including an extended history of present illness; a system review, including constitutional, musculoskeletal, integumentary, neurologic, and EENMT; and the patient’s social history and past medical history. The plastic surgeon then performs a physical exam including respiratory, cardiovascular, and an extended examination of the skin and bony structures of the patient’s face. The plastic surgeon performs moderate medical decision making, including deciding the patient needs major surgery to repair the injuries. The plastic surgeon schedules the patient for surgery the next day and documents her full note with findings in the ED chart.

A. 99284-57

B. 99244

C. 99243-57

D. 99221

42. A patient presents for epicardial lead placement via median sternotomy to the right atrium and right ventricle. A dual pacemaker generator is then inserted subcutaneously. The patient has bundle branch block and sinoatrial node dysfunction. What CPT® and ICD-10-CM codes are reported?

a.      33203, 33213-51, I45.10, I49.5

b.      33202, 33213-51, I45.4, I49.5

c.       33208, 33213-51, I45.4, I49.5

d.      33214, I45.2, I49.8

43. Preoperative Diagnosis: Aortic valve stenosis with coronary artery disease associated with congestive heart failure

Postoperative Diagnosis: Same

Anesthesia: General endotracheal

Incision: Median sternotomy

Description of Procedure: The patient was brought to the operating room and placed in supine position. After the patient was prepared, median sternotomy incision was carried out and conduits were taken from the left arm as well as the right thigh. She was cannulated after the aorta and atrium were exposed and after full heparinization. She went on cardiopulmonary bypass, and the aortic cross-clamp was applied. Cardioplegia was delivered through the coronary sinuses in a retrograde manner. The patient was cooled to 32 degrees. Iced slush was applied to the heart. The aortic valve was then exposed through the aortic root by transverse incision. The valve leaflets were removed, and the 23 St. Jude mechanical valve was secured into position by circumferential pledgeted sutures. At this point, aortotomy was closed.

Attention was turned to the coronary arteries. The first obtuse marginal artery was a very large target and the vein graft to this target indeed produced an excellent amount of flow. Proximal anastomosis was then carried out to the foot of the aorta. The radial artery was anastomosed to the left anterior descending artery target in an end-to-side manner. The proximal anastomosis was then carried out to the root of the aorta.

The patient came off cardiopulmonary bypass after aortic cross-clamp was released. She was adequately warmed. Protamine was given without adverse effect. Sternal closure was then done using wires. The subcutaneous layers were closed using Vicryl suture. The skin was approximated using staples. What are the CPT® codes?

a.      33405, 33533-51, 33510, 35500

b.      33390, 33533-51, 33510

c.       33405, 33533-51, 33517, 35600

d.      33411, 33533-51, 33517, 35600

44. Preoperative Diagnosis: Coronary artery disease associated with congestive heart failure. In addition, the patient has diabetes and massive obesity.

Postoperative Diagnosis: Same

Anesthesia: General endotracheal

Incision: Median sternotomy

Indications: The patient had presented with severe congestive heart failure associated with her severe diabetes. She had significant coronary artery disease, consisting of a chronically occluded right coronary artery but a very important large obtuse marginal artery coming off as the main circumflex system.  She also has a left anterior descending artery which has moderate disease and this supplies quite a bit of collateral to her right system. The decision was therefore made to perform a coronary artery bypass grafting procedure particularly because she is so symptomatic. The patient was brought to the operating room.

Description of Procedure: The patient was brought to the operating room and placed in supine position. Myself, the operating surgeon was scrubbed throughout the entire operation. After the patient was prepared, median sternotomy incision was carried out and conduits were taken from the left arm as well as the right thigh. The patient weighs almost three hundred pounds and with her obesity there was some concern as to taking down the left internal mammary artery. Because the radial artery appeared to be a good conduit, she should have an arterial graft to the left anterior descending artery territory. She was cannulated after the aorta and atrium were exposed and after full heparinization. Attention was turned to the coronary arteries. The first obtuse marginal artery was a very large target and the vein graft to this target indeed produced an excellent amount of flow. Proximal anastomosis was then carried out to the foot of the aorta. The left anterior descending artery does not have severe disease but is also a very good target, and the radial artery was anastomosed to this target, and the proximal anastomosis was then carried out to the root of the aorta. Sternal closure was then done using wires. The subcutaneous layers were closed using Vicryl suture. The skin was approximated using staples.

a.      33511

b.      33533, 33517

c.       33533, 33510

d.      33533, 33517, 35600

45. A patient had a temporary transvenous pacemaker system inserted with electrodes placed in the right atrial and ventricular chambers. How should you report this service?

a.       33211

b.      33208

c.       33213, 33208-51

d.       33211, 33208-51

46. A catheter is placed in the left common femoral artery in retrograde fashion which was directed into the right iliac system advancing it to the external iliac. Dye was injected and a select right lower extremity angiogram was performed which revealed patency of the common femoral and profunda femoris. The catheter was then manipulated into the femoral artery in which a select lower extremity angiogram was performed which revealed occlusion from the popliteal to the peroneal artery. What are the procedure codes that describe this procedure?

a.      36217, 75736-26, 75774-26

b.      36247, 75716-26

c.       36217, 75658-26

d.      36247, 75710-26

47. A patient suffering from an abdominal aortic aneurysm involving a renal artery undergoes endovascular repair deploying a fenestrated visceral autograft using two visceral artery endoprostheses. Radiological supervision and interpretation was performed. Select the CPT® code for this procedure.

a.      34703

b.      34841

c.       34842

d.      34702

48. A 82 year-old female with a right leg medial malleolar non-healing ulcer elected to proceed with peripheral angiography. Using a RIM catheter, from a left femoral artery access, the contralateral right iliac artery was accessed and the catheter was gradually advanced to the right common femoral artery. The right lower extremity angiography was performed with both C02 injection and subsequently localized pictures of femoral distal bypass grafts were performed using contrast injections. This revealed the right superficial femoral artery is 100% occluded at its origin. Decision for angioplasty was made and intervention was performed through this area with a 7 mm x 20 mm balloon inflated up to 7 atmospheres. The gradual inflation resulted in enlarging the artery to a more normal flow of blood. What CPT codes is/are reported?

a.      36902, 36246

b.      37220, 75710-26-59

c.       37224, 75716-26-59

d.      37224, 75710-26-59

49. After being called to the emergency room to treat one of his patients suffering from multiple injuries, a provider is asked to examine another one of his patients already registered in the ER, presenting with acute respiratory distress symptoms including a productive cough. The ER is very busy, therefore the ER provider has the patient’s provider see and treat this patient. The provider ordered a CBC and chest x-ray. An expanded history of the present illness was taken, an expanded problem focused examination performed and medical decision making was of moderate complexity. Overall level of medical decision making was moderate. The patient was given a prescription and written instructions for continued home care and told to make an appointment in the office if the symptoms persist. Code the provider’s service for the second patient.

a) 99212

b) 99283

c) 99284

d) 99243

50. Andrea, a 52-year-old patient, had a hysterectomy on Monday morning. That afternoon, after returning to her hospital room, she suffered a cardiac arrest. A cardiologist responded to the call and delivered one hour and 35 minutes of critical care. During this time the cardiologist ordered a single view chest x-ray and provided ventilation management. How should you report the cardiologist’s services?

a. 99291, 99292

b. 99291, 99292, 71010, 94002

c. 71010, 94002, 99231

d. 99291, 99292, 99292-52