1.
The
patient is a 73-year-old gentleman who was noted to have progressive gait
instability over the past several months. Magnetic resonance imaging
demonstrated a ventriculomegaly. It was recommended that the patient proceed
forward with right frontal ventriculoperitoneal shunt placement with Codman
programmable valve. What is the correct code for this surgery?
a.
62220
b.
62223
c.
62190
d.
62192
2.
What
is the CPT code for the decompression of the median nerve found in the space in
the wrist on the palmar side?
a.
64704
b.
64713
c.
64721
d.
64719
3.
2-year-old
Hispanic male has a chalazion on both upper and lower lid of the right eye. He
was placed under general anesthesia. With an #11 blade the chalazion was
incised and a small curette was then used to retrieve any granulomatous
material on both lids. What code should be used for this procedure?
a.
67801
b.
67805
c.
67800
d.
67808
4.
92.
MRI reveals patient has cervical stenosis. It was determined he should undergo
bilateral cervical laminectomy at C3 through C6 and fusion. The edges of the
laminectomy were then cleaned up with a Kerrison and foraminotomies were done
at C4, C5, and,,C6. The stenosis is central: a facetectomy is performed by
using a burr. Nerve root canals were freed by additional resection of the
facet, and compression of the spinal cord was relieved by removal of a tissue
overgrowth around the foramen. Which CPT codes should be used for this
procedure?
a.
63045-50,
63048-50
b.
63020-50,
63035-50, 63035-50
c.
63015-50
d.
63045,
63048 x 3
5.
An extracapsular cataract removal is performed
on the right eye by manually using an iris expansion device to expand the
pupil. A phacomulsicfication unit was used to remove the nucleus and irrigation
and aspiration was used to remove the residual cortex allowing the insertion of
the intraocular lens. What code should be used for this procedure?
a.
66985
b.
66984
c.
66982
d.
66983
6.
An infant who has chronic otitis media was
placed under general anesthesia and a radial incision was made in the posterior
quadrant of the left tympanic membrane. A large amount of mucoid effusion was
suctioned and then a ventilating tube was placed in both ears. What CPT and
ICD-10-CM codes should be reported:
a.
69436-50,
H65.32
b.
69436-50,
H65.90
c.
69433-50,
H67.9
d.
69421-50,
H65.32
7.
A craniectomy is being performed on a patient
who has Chiari malformation. Once the posterior inferior scalp was removed a
C-1 and a partial C-2 laminectomy was then performed. The right cerebellar
tonsil was dissected free of the dorsal medulla and a gush of cerebrospinal
fluid gave good decompression of the posterior fossa content. Which CPT code
should be used?
a.
61322
b.
61345
c.
61343
d.
61458
8.
Under
fluoroscopic guidance an injection of a combination of steroid and analgesic
agent is performed on T2-T3, T4-T5, T6-T7 and T8-T9 on the left side into the
paravertebral facet joints. The procedure was performed for pain due to
thoracic root lesions. What are the procedure codes?
a.
64479,
64480×3, 77003
b.
64490,
64491, 64492×2, 77003
c.
64520×4,
77003
d.
64490,
64491, 64492
9.
An
entropian repair is performed on the left lower eyelid in which undermining was
performed with scissors of the inferior lid and inferior temporal region. Deep
sutures were used to separate the eyelid margin outwardly along with stripping
the lateral tarsus to provide firm approximation of the lower lid to the globe.
The correct CPT code is:
a.
67914-E4
b.
67924-E2
c.
67921-E2
d.
67917-E1
10.
A
65-year-old patient presented with ectropion of the right lower eyelid. Repair
with tarsal wedge excision is performed for correction. Attention was then
directed to the left eye. The patient also had an ectropion of the left lower
lid which was repaired by suture repair. Code this procedure.
a.
67916-50
b.
67916-E4,
67914-E2
c.
67914-50
d.
67923-E4,
67921-E2
11.
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 etology 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
12.
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
13.
Postoperative Diagnosis: Carpal tunnel
syndrome right wrist The patient was brought to the operating room and sedated
by anesthesia. After sterile prepping and draping of the right hand, wrist and
arm the patient’s area of incision was infiltrated with Xylocaine/Marcaine
infiltration. After satisfactory anesthesia an Esmarch bandage was used to
exsanguinate the right hand and wrist and used about the distal forearm asa
tourniquet. A curvilinear incision was made on the palmar aspect of the right
wrist. Dissection was carried out through the skin and subcutaneous tissue.
Bleeding was controlled. The median nerve and it branches were identified,
retracted, and protected at all times. The ligament was incised from proximal
to distal. A thorough decompression was carried out. A neurolysis was carried
out. The nerve was found to be flattened and ischemic underneath the transverse
carpal ligament. The fascia was closed, the tourniquet was released. A dressing
was applied and patient was transferred to recovery room. Code this procedure.
a.
64721-RT
b.
64450-RT
c.
64642-RT
d.
29848-RT
14.
A 35-year-old man presents to the urgent care
center with severe neck pain. The physician examines the patient and makes the
diagnosis of cervical nerve impingement and injects an anesthetic agent into
the cervical plexus using three injections. Select the procedure and diagnosis
codes.
a.
64400
x 3
b.
64405
c.
64413
d.
64413
x 3
15.
A four-year-old with chronic otitis media and
fluid buildup in both ears was admitted by her otolaryngologist for a bilateral
tympanostomy. The procedure was performed with placement of ventilating tubes.
The procedure required general anesthetic due to the patient’s age. Select the
procedure code for this procedure.
a.
69420-50
b.
69421-50
c.
69433-50
d.
69436-50
16.
A patient presents to the emergency department
with complaint of painful eye. The patient states that her right eye is
constantly tearing and is sensitive to light. The physician performs an exam
and identifies a corneal foreign body in the right eye. Utilizing a slit lamp,
the foreign body is removed. Code the encounter.
a.
65205-RT
b.
65220-RT
c.
65222-RT
d.
65435-RT
17.
The physician performs a right thyroid
lobectomy. The patient was prepped and draped. After adequate general
anesthesia, the neck was incised on the right side and sharp dissection was
then used to cut down onto the strap muscles and sternodcleidomastoid muscles.
The strap muscles were separated and transected on the right side. A small
thyroid lobe was visualized and dissected free. There was no evidence of a
tumor. The wound was closed with 3-0 interrupted Vicryl for the platysma, 4-0
Vicryl for the deep tissues and 6-0 fast absorbing gut for the skin. Code the
encounter.
a.
60252-RT
b.
60210-RT
c.
60220-RT
d.
60260-RT
18.
PROCEDURE:
Bilateral lumbar medial branch block under fluoroscopy for the L3, L4, L5
medial branches for the L4-L5, L5-S/1 facets for diagnostic and therapeutic
purposes. PROCEDURE: The patient was placed in the prone position on the
fluoroscopy table and automated blood pressure cuff and pulse oximeter applied.
The skin entry points for approaching the anatomic target points of the
bilateral segmental medial branches or dorsal ramus of L3, L4, L5 were
identified with a 22.5 degree from perpendicular lateral oblique fluoroscopy
view and marked. Following thorough Chloraprep preparation of the skin and
draping and 1% lidocaine infiltration of the skin entry points and subcutaneous
tissues, a 22 gauge 6″ spinal needle was placed under fluoroscopic guidance
down on the target point for each respective segmental medial branch or dorsal
ramus. At each point 1 mL consisting of 0.5% bupivacaine and Depo-Medrol was
injected. A total of 80 mg of Depo-Medrol was divided between all six spots.
Code the procedure(s).
a.
64483,
64484, 77003-26
b.
64493-50,
64494-50, 64495-50
c.
64493,
64494, 77003-26
d.
64493-50,
64494-50
19.
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-10-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
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