1.
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
2.
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
3.
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
4.
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
5.
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
6.
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
7.
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
8.
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
9.
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
10.
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
11.
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
12.
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
13.
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
14.
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
15.
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
16.
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
17.
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
18.
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
19.
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
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