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CPC June 3

CERTIFICATION
EXAM
2017
Question 1
Indication: Patient has a hypertrophic scar on the posterior side of the left leg, at the level of the knee.
This has begun to restrict his mobility. His physical therapy trial was unsuccessful. Procedure: After the
proper induction of anesthesia, the subcutaneous tissue of the patient’s left leg beneath the scar was
infiltrated with crystalloid solution containing epinephrine to minimize blood loss. The scar was then
excised down to viable dermis. Hemostasis was obtained with epinephrine soaked pads. Skin was
harvested from the patient’s thigh in a split thickness fashion and was used to cover the 90 sq cm defect
created by the surgery. The graft was secured with skin staples, and then dressed with fine mesh gauze
followed by medication-soaked gauze. The donor site was dressed with mesh followed by Adaptic™,
followed by a dry dressing and an Ace wrap. What are the CPT® codes?

A. 15110-52, 15002
B. 15100, 11406
C. 15100, 15002
D. 15110, 15002

Question 2
The physician is called in to perform repairs for a 17 year-old girl involved in a motor vehicle accident.
She sustained an 8.6 cm laceration to her forehead, a 5.5 cm laceration to her right cheek, a 4 cm
laceration to her left cheek, a 4 cm laceration across her chin, and a 12.5 cm laceration to her chest. The
wound on her chin required a layered closure. All other wounds required complex closure. The CPT®
codes to report are:

A. 13132, 13133 x 4, 13101, 12052


B. 13132, 13133 x 3, 13133-52, 13101, 13102, 12052
C. 13132, 13133 x 3, 13101, 13102, 12052
D. 13131, 13132, 13133 x 3, 13101, 13102, 12052

Question 3
A 36 year-old male presents to have multiple lesions destroyed. Three benign lesions on his face are
destroyed and five actinic keratoses on his left arm are destroyed. The CPT® code(s) to report is (are):

A. 17000, 17003
B. 17000, 17003 x 4, 17110
C. 17110
D. 17260 x 5, 17110 x 3

Question 4
Patient is having ongoing back and hip pain. The physician elects to perform a sacroiliac injection at an
ambulatory surgery center. After sterile prep, the patient is placed prone position. A needle is placed
under fluoroscopic guidance into the SI joint and a mixture of 20 mg of Celestone and Marcaine is
injected for pain relief. Report the CPT® code(s).

A. 27096, 77003-26
B. 20611
C. 20552
D. 27096
Question 5
Patient is seen in the hospital’s outpatient surgical area with a diagnosis of a displaced comminuted
closed 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 is the
correct ICD-10-CM and CPT® code assignment?

A. 24579-RT, 29065-51-RT, S42.451B


B. 24577-RT, S42.451A
C. 24579-RT, S42.451A
D. 24575-RT, S42.451B

Question 6
A 35 year-old female patient presents with acute onset of severe pain since October. Her workup has
revealed evidence of disk herniation with loss of lordosis at the C5-C6. Intraoperative findings were
consistent with two large fragments of free disk fragments in the foramen at C5-C6 on the right side.
After general anesthesia, the patient was placed on the operative table in the supine position. All
pressure points were cushioned and a transverse skin incision was fashioned under fluoroscopic
guidance over the C5-C6 disc space. Dissection through the platysma eventually allowed for exposure of
the anterior entrance to the vertebral body of C5 and C6 and retractors were inserted to maintain
adequate exposure. The operating microscope was brought into the field. Caspar posts were placed and
slight distraction allowed exposure. A complete discectomy was performed at C5-C6 by using endplate
curets pituitary rongeurs and Kerrison rongeurs. The posterior longitudinal ligament was resected and
beneath the posterior longitudinal ligament, two significant sized disc fragments were noted in the
foramen at C5-C6. These were removed using pituitary and Decker instruments. The endplates were
then decorticated so that they were parallel to each other and a midline keel was performed on AP and
lateral fluoroscopy. A size #1 by 5 mm interbody Kineflex-C device was placed under fluoroscopic
guidance. Satisfied with the positioning of the device, the decision was made to close. What is the
correct CPT® code for this procedure?

A. 63075
B. 63081
C. 22856
D. 22554

Question 7
OPERATION: Dual chamber transvenous implantable pacing cardioverter-defibrillator system
implantation with leads. INDICATIONS: A 67 year-old, white gentleman has significant underlying
ischemic cardiomyopathy with EF of 25 percent, prior infarcts, remote history of syncope, and at a high
risk for malignant ventricular arrhythmias. He has had a recent T wave alternans test which was clearly
abnormal. He has had episodes of resting bradycardia, also noted. He meets Madit II criteria for
insertion of a transvenous implantable pacing cardioverter-defibrillator (ICD). PROCEDURE: After
informed consent had been obtained, the patient was brought to the outpatient hospital lab in the
fasting state. The left anterior chest was prepped and draped in a sterile fashion. Intravenous sedation
and local anesthetic were given. After local anesthetic, a 5 cm incision was made at the left
deltopectoral groove. With blunt dissection and cautery, this was carried down through the
prepectoralis fascia. The cephalic vein was identified and ligated distally. Through the venotomy, a
subclavian venogram was performed to provide a roadmap. The atrial and ventricular leads were then
advanced into the vessel to the level of the right atrium under fluoroscopic guidance. The ventricular
lead was maneuvered to the right ventricular outflow tract, and then through the RV apex where it was
actively fixed. Good sensing and pacing thresholds were demonstrated. The lead was anchored to the
pre-pectoralis fascia with interrupted 2-0 Tycron sutures. 10-volt pacing did not result in diaphragmatic
capture. The atrial lead was maneuvered to the anterolateral right atrial wall where it was actively fixed.
Good sensing and pacing thresholds were demonstrated. The lead was anchored to the pre-pectoralis
fascia with interrupted 2-0 Tycron sutures. 10-volt pacing did not result in diaphragmatic capture. A
subcutaneous pocket was created with good hemostasis achieved. The pocket was subsequently
irrigated with solution of Bacitracin. The generator was connected to the lead, and then placed in the
pocket with no tension on the lead. The deep fascial layer was closed with interrupted 2-0 Vicryl suture.
The subcutaneous closure was made with running 3-0 Vicryl suture. Subcuticular closure was made with
running 4-0 Vicryl suture. Steri-strips were applied. Ventricular fibrillation was induced with a T wave
shock. This was successfully sensed and terminated with a 15 joule shock to sinus rhythm. High voltage
impedance was 39 ohms. Dry dressing was placed over the wound. The patient returned to the floor in
stable condition without apparent complications. Which of the following CPT® code(s) accurately
describes the basic procedure summarized in this report?

A. 33208
B. 33249, 76000-26
C. 33241, 33243, 33249
D. 33249

Question 8
The patient comes in today to have an arteriovenous fistula created to facilitate dialysis. The surgeon
performs an upper arm basilic vein transposition based on the patient’s previous arterial duplex scan.
Which is the appropriate CPT® code for this procedure?

A. 36825
B. 36830
C. 36818
D. 36819

Question 9
56 year-old with lung cancer developed an effusion that is suspicious for malignancy. Needle aspiration
is performed to obtain a sample of the fluid for pathological examination. A needle is inserted between
the ribs and into the pleural space, and the fluid is withdrawn. The specimen is sent to pathology.
Choose the CPT® code that reports the procedure described.

A. 32554
B. 32555
C. 32551
D. 32400
Question 10
A 67 year-old male patient is referred for a flex sigmoidoscopy exam to remove polyps. The physician
found three polyps in the rectosigmoid junction. They were removed by hot biopsy forceps. The path
report indicated the polyps were benign. What is the CPT® code to report for this encounter?

A. 45333
B. 45315
C. 45384
D. 45346

Question 11
Name of Procedure: Endoscopic retrograde cholangiopancreatogram with stent placement and antral
biopsy. Indications: 50 year-old male who underwent liver transplantation for end-stage liver disease
secondary to chronic hepatitis C and hepatocellular carcinoma in 01/2007. The patient has cholestatic
liver enzymes, requiring ERCP before placement of a 7-French 12 cm stent and to evaluate the biliary
system. Description of Procedure: The patient was taken to the fluoroscopy suite in the GI lab where he
was found to be alert and oriented x 3. After discussing risks and benefits of the procedure, informed
consent was obtained. Patient was kept in the semi prone position. After adequate conscious sedation,
an Olympus side-viewing therapeutic scope was inserted through the mouth all the way to the second
portion of the duodenum. Then, the common bile duct was cannulated and the cholangiogram was
obtained. After the fluoroscopy evaluation of the cholangiogram a 12 cm stent was deployed for biliary
drainage. A biopsy from the antrum was obtained. The patient tolerated the procedure well. There were
no immediate complications. Which CPT® codes should be reported?

A. 43276, 43261-51
B. 43274, 43261-51
C. 43266, 43239-51
D. 43212, 43202-51

Question 12
A patient with rectal bleeding underwent a proctosigmoidoscopy that showed she had two internal
hemorrhoids. The anus was prepped and draped. A field block with Marcaine 0.25% was then placed.
There was an internal prolapsing hemorrhoid in the anterior midline. This was rubber band ligated by
applying two bands. In the posterior midline, there was another internal hemorrhoid that was banded in
the same manner. Code the procedure.

A. 0249T
B. 46221
C. 46945
D. 46930
Question 13
A neonatal male had an elective circumcision before being discharged home from the newborn nursery.
The physician uses a ring block for the local anesthetic and the foreskin is placed over the glans. A clamp
is selected for the size of the glans and a constricting circular ring is placed over the foreskin to compress
and devascularize the foreskin. The devascularized foreskin is excised with a scalpel and the clamp is left
in place. Which CPT® code should be used?

A. 54150
B. 54160
C. 54161
D. 54150-52

Question 14
A 30 year-old disabled Medicare patient is scheduled for surgery due to the discovery 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 and to remove the entire left
ovary and fallopian tube. Code this encounter.

A. 58920, 58940-51
B. 58925, 58720-59
C. 58925-50, 58720-50-59
D. 58920-50, 58700-50-59

Question 15
The patient is a 25 year-old G2P1 female at 13-weeks with a molar pregnancy. She has had irregular
bleeding for one week. Ultrasound was performed yesterday and the physician confirms a 16-week size
uterus with hydatidiform molar pregnancy. She is admitted today for an evacuation and curettage. What
are the CPT® and ICD-10-CM codes?

A. 59870, O01.9
B. 59812, O02.89
C. 57505, O02.0
D. 59160, O01.9

Question 16
A 55 year-old man with complaints of an elevated PSA of 6.5 presents to the outpatient surgical facility
for prostate biopsies. The patient is placed in the lateral position. Some calcifications were found in the
right lobe, with no obvious hypoechogenic abnormality. The base of the prostate was infiltrated and
random needle biopsies were performed under ultrasonic guidance by the physician. His interpretation
was reported in the record. What is (are) the CPT® code(s)?

A. 10022
B. 55706
C. 55700, 76942-26
D. 55705, 76942-26
Question 17
An injection is performed to anesthetize a nerve located between two ribs to block chest wall pain.
Which CPT® nerve injection code is reported?

A. 64415
B. 64421
C. 64413
D. 64420

Question 18
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. Which CPT® code(s) is (are) reported?

A. 67916-50
B. 67916-E4, 67914-E2
C. 67914-50
D. 67923-E4, 67921-E2

Question 19
A 42 year-old patient was in the hospital three days ago in which a lumbar puncture was performed to
find the etiology of the patient’s headaches. Today he is in the neurology clinic because after having the
lumbar puncture 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 is performed by
epidural injection to repair the leak. Code the CPT® code(s) for today’s visit.

A. 62272
B. 62273
C. 62270, 62273
D. 62270, 62282

Question 20
A 63 year-old woman presented to the eye clinic as with symptoms of flashing lights and floaters in the
right eye for two days. The ophthalmologist dilates her eyes and checking her with an indirect
ophthalmoscope, revealing peripheral retinal break. The physician explains to the patient that there is a
high likelihood of retinal detachment. The patient agrees to have the procedure done. The physician
lasers the retinal tear and tells the patient to come back in 24 hours for follow-up. The appropriate CPT®
code for this visit is:

A. 67210
B. 67145
C. 67220
D. 67141
Question 21
The patient is a 35 year-old male who presents to the emergency department (ED) after several hours of
low back pain, nausea, and chills. The ED physician takes a detailed history and performs a
comprehensive examination. A urinalysis lab and CT of the abdomen is ordered. The results of the CT
show two small kidney stones. The ED physician discusses the results with the patient and tells him the
stones are small and will pass on their own. Medical decision making (MDM) of moderate complexity is
made with the patient being discharged, with a prescription of pain medication, and with a diagnosis of
kidney stones. Select the E/M code and diagnosis code(s).

A. 99285, N20.0, M54.5, R11.2, R68.83


B. 99284, M54.5, R11.2, R68.83, N20.0
C. 99283, N20.0
D. 99284, N20.0

Question 22
A 63 year-old man wants a second opinion for his sleep apnea. He decides to go to another physician.
The physician documents a detailed history. He has had it for the past five months. Sleep is disrupted by
frequent awakenings and getting worse due to anxiety and snoring. Current medication that he is on
now is not helping him. Physician also performs a comprehensive exam and moderate MDM. Which E/M
code is reported?

A. 99204
B. 99203
C. 99243
D. 99214

Question 23
A 55 year-old established patient is coming in for a pre-op visit; he is getting a liver transplant due to
cirrhosis. The physician performs an expanded problem-focused history, detailed examination, and
moderate MDM. Patient agrees with his physician’s recommendations and the transplantation will take
place as scheduled. After the evaluation, the patient expresses a number of concerns and questions for
the prospective liver transplant. Physician spends an additional 45 minutes, excluding the time spent
performing the E/M service, in answering questions and addressing his concerns regarding the surgery
and discussing possible outcomes. What CPT® codes should be reported?

A. 99213, 99403
B. 99214, 99358
C. 99213, 99356
D. 99214, 99354
Question 24
A 56 year-old receives general anesthesia for an open pleura biopsy. An anesthesiologist medically
directs two other cases, and medically directs a CRNA on this case. What are the anesthesia codes and
modifiers reported for the anesthesiologist and CRNA?

A. 00540-AA, 00540-QZ
B. 00540-QK, 00540-QX
C. 00541-AA, 00540-QZ
D. 00541-QK, 00541-QX

Question 25
A patient is given general anesthesia by the anesthesiologist for a carpal tunnel nerve release. After the
surgery the anesthesiologist is called to perform an axillary block for postoperative pain management on
the same patient. What are the appropriate CPT® codes?

A. 01829-AA, 64417-59
B. 01840-AA, 64417-59
C. 01810-AA, 64417-59
D. 01830-AA, 64417-59

Question 26
A healthy 45 year-old is having a needle thyroid biopsy. The anesthesiologist begins to prepare the
patient for surgery at 09:00 am. The surgery begins at 09:15 am and ends at 09:45 am. The
anesthesiologist turns over the patient’s care to the recovery room nurse at 10:00 am. Which is the
appropriate anesthesia code and what is the anesthesia time?

A. 00320, One hour


B. 00320, 45 minutes
C. 00322, 45 minutes
D. 00322, One hour

Question 27
A 32 year-old pregnant female has gestational diabetes at 34 weeks gestation. Her doctor is concerned
about decreased fetal movement. The patient is sent to the radiology department of the hospital for a
biophysical profile (BPP). The radiologist performs and interprets four elements scored by the
ultrasound and it was reassuring, 8/8. A non-stress test will be performed by the obstetrician at the
patient's next office visit, not the radiologist. What is the correct CPT® code for the fetal profile
performed by the radiologist?

A. 76818
B. 76815
C. 76819
D. 76820
Question 28
The physician performs a selective catheterization of the right renal artery and renal angiography. The
puncture site was the right femoral artery. Which CPT® code(s) is (are) reported?

A. 36251-RT, 36200-51, 75625-26


B. 36245-RT
C. 36215-RT, 36200-51, 75625-26
D. 36251-RT

Question 29
A patient with colon cancer receives five sessions of radiation treatments. During the course of
treatments, the physician views the port films, reviews the treatment parameters, and assesses the
patient’s response to the treatment. The patient receives two more treatment sessions when ending the
course of treatment. Code the CPT® code (s) for the radiation treatment management.

A. 77427
B. 77431 x 7
C. 77427 x 7
D. 77427, 77431

Question 30
A surgical specimen was removed from the proximal jejunum during a resection for adenocarcinoma
and was submitted to surgical pathology for gross and microscopic examination. The correct CPT® code
for this service is:

A. 88307
B. 88309
C. 88304
D. 88305

Question 31
The physician performs the following tests on her automated equipment: HDL, total serum cholesterol,
triglycerides, and a quantitative glucose. The correct CPT® codes for these lab tests are:

A. 83718, 82465, 84478, 82947


B. 83721, 82465, 82951
C. 80061, 82947
D. 80061, 82950

Question 32
A patient with a manic depressive disorder is being treated with lithium. The physician orders a
therapeutic drug test to measure the level of lithium. What is the correct CPT® code?

A. 80178
B. 80375
C. 80306
D. 80299
Question 33
A patient presents to her oncologist’s office for schedule chemotherapy. The patient is severely
dehydrated. The physician decides to schedule the chemotherapy for another day and orders hydration
therapy to be performed today instead of the chemotherapy. The therapy is ordered and administered
for one hour and 10 minutes. Select the appropriate CPT® code(s).

A. 96413-53, 96360
B. 96360
C. 96360, 96361
D. 96413, 96361

Question 34
Left heart catheterization retrograde from the femoral artery with injection procedures for selective
coronary angiography and selective left ventriculography, including imaging supervision and
interpretation with report, are performed. The cardiologist performed all of the services at the hospital.
The CPT® code is:

A. 93458-26
B. 93459-26
C. 93452-26
D. 93460-26

Question 35
A patient is coming in to have osteopathic manipulative treatment (OMT) performed on two root lesions
in his cervical region and three root lesions in the thoracic region. Which CPT® code is reported by the
physician for the OMT?
A. 98927
B. 98940
C. 98925
D. 98942

Question 36
The patient is admitted to the hospital for a radio16 channel EEG to determine the focus of her cerebral
seizures. The test also consists of EEG recording and interpretation with nurse attendance. The EEG is
performed in 12 hours. Select the appropriate coding.

A. 95950-26
B. 95953-26-52
C. 95951-26
D. 95956-26-52

Question 37
What is orchitis?
A. Inner ear imbalance
B. Lacrimal infection
C. Inflammation of testis
D. Inflammation of an ilioinguinal hernia
Question 38
The patient is a 16 year-old female with pelvic pain. Her ultrasound is normal. A laparoscopy found
several small cysts in the area of the fallopian tubes. These cysts are called:

A. Pilonidal cysts
B. Myomas
C. Paratubal cysts
D. Synovial cysts

Question 39
Which of the following patients might be documented as having meconium staining?

A. Woman with renal failure


B. Teenage boy with sickle cell anemia
C. Newborn with pneumonia
D. Man with alcoholic cirrhosis of liver

Question 40
Which of the following anatomical sites have septums?

A. Nose, heart
B. Kidney, lung
C. Sternum, coccyx
D. Orbit, ovary

Question 41
Lordosis is a disorder of which anatomical site?

A. Spine
B. Hand
C. Male genitalia
D. Nasal sinus

Question 42
A 35 year-old female returns to her primary care provider for follow up of an upper respiratory infection
diagnosed the previous week. Her condition has not improved and her cough has increased. She has a
long history of smoking and currently smokes one pack a day. She uses a bronchodilator for her chronic
bronchitis which is caused by her smoking history. The physician changes her antibiotics to treat both
her chronic and acute bronchitis. Provide the diagnosis codes for this visit.

A. J44.9, Z72.0
B. J20.9, J41.0, Z72.0
C. J20.9, Z72.0
D. J41.0, J20.9, Z72.0
Question 43
Following the MUGA scan, the physician documents that the patient has developed congestive heart
failure as an adverse effect of the Trastuzumab she received as a treatment for her breast cancer. The
trastuzumab antineoplastic antibiotic therapy is being discontinued while the heart failure management
is attempted pharmaceutically. What ICD-10-CM codes are reported?

A. I50.9, T45.1X4A, Z85.3


B. I50.9, T45.1X1A, C50.919
C. I50.9, T45.1X5A, C50.919
D. I50.9, T45.1X3A, C50.919

Question 44
The patient has a history of symptomatic HIV and has been treated for an HIV related illness. Which ICD-
10-CM code is reported?

A. Z21
B. B20
C. Z20.6
D. R75

Question 45
The mother, at 38-weeks gestation, advances to severe pre-eclampsia during labor. Fetal heart rate
deceleration during contractions are not improved with the administration of oxygen, so a low
transverse cesarean section is performed in the hospital. There is evidence of intrauterine growth
retardation. The male infant weighs 1587 gm and has Apgars of 3 and 5. Select the ICD-10-CM codes for
the newborn's chart.

A. Z37.0, P00.0, P03.811, P05.9


B. Z38.01, P00.0, P03.810, P05.9
C. Z38.01, P00.0, P03.811, P05.9
D. Z37.0, P00.0, P03.810, P05.9

Question 46
A 67 year-old newly diagnosed with DM type 2 is being seen in the office today for dietetic training with
the office’s dietitian. The training was for an hour and covered special diet instructions, blood glucose
monitoring, and instruction on how to administer daily insulin injections. Which HCPCS Level II code(s)
will be reported for this session?

A. G0108 x 2
B. G0109 x 2
C. A9275, A4211
D. S9214
Question 47
Which Z code category can only be reported as a first listed diagnosis code?

A. Z67
B. Z69
C. Z58
D. Z03
Question 48
What is the full CPT® code description for 61535?

A. Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term
seizure monitoring; for removal of epidural or subdural electrode array, without excision of cerebral
tissue (separate procedure)
B. Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without
excision of cerebral tissue (separate procedure)
C. For removal of epidural or subdural electrode array, without excision of cerebral tissue (separate
procedure)
D. For excision of epileptogenic focus without electrocorticography during surgery; for removal of
epidural or subdural electrode array, without excision of cerebral tissue (separate procedure)

Question 49
Which of the following place of service code is reported for fracture care performed by an orthopedic
physician in the ED?

A. 11
B. 20
C. 22
D. 23

Question 50
Which of the following is an example of fraud?

A. Reporting the code for ultrasound guidance when used to perform a liver biopsy
B. Reporting a biopsy and excision performed on the same skin lesion during the same encounter
C. Failing to append modifier 26 on an X-ray that is performed and interpreted in the physician’s office
D. Reporting a lab panel with an additional lab test that is not included in the lab panel

Question 51
Indications: 15 year-old boy was burned in a fire and assessed to have received burns to 75 percent of
his total body surface area. He was transferred to a burn center for definitive treatment. Once stable, he
was brought to the OR. Procedure: Due to extent of the patient’s burns and lack of sufficient donor sites,
his full-thickness burns will be excised and covered with xenograft (skin substitute graft), and a split-
thickness skin biopsy will be harvested for preparation of autologous grafts to be applied in the coming
weeks, when available. After induction of anesthesia, extensive debridement of the full-thickness burns
was undertaken. Attention was first directed to the patient’s face, neck, and scalp. A total of 500 sq cm
in this area received full-thickness burns. The eschar involving this area was excised down to viable
tissue. Hemostasis was achieved using electrocautery. Attention was then turned to the trunk. A total of
950 sq cm in this area received full-thickness burns. The eschar involving this area was excised down to
viable tissue. Hemostasis was achieved. Attention was then turned to the arms and legs. A total of 725
sq cm received full-thickness burns. The eschar involving this area was excised down to viable tissue.
Hemostasis was achieved. Attention was then turned to the hands and feet. A total of 300 sq cm in this
area received full-thickness burns. The eschar involving this area was excised down to viable tissue. All
involved areas were then covered with xenograft. Finally a split thickness skin graft of 0.015 inches in
depth was harvested using a dermatome from a separate donor site. A total of 85 sq cm was recovered.
What procedures codes would be reported?

A. 15200, 15201 x 123, 15004, 15005, 15002, 15003


B. 15275, 15276 x 31, 15271, 15272 x 66, 15004, 15005 x 16, 15002, 15003 x 7
C. 15277, 15278 x 7, 15273, 15274 x 16, 15004, 15005 x 7, 15002, 15003 x 16, 15040
D. 15130, 15131 x 7, 15135, 15136 x 16, 15004, 15005 x 7, 15002, 15003 x 16

Question 52
The left breast was prepped and draped in a sterile fashion. An incision from the 3 around to the 9
o’clock position on the areolar border on its inferior aspect was made in the skin and extended to the
subcutaneous tissue. The breast mass was excised by sharp dissection. The mass was found to be
approximately 1.5 - 2 cm in maximum dimension. Hemostasis was made adequate using electrocautery
and the Argon beam coagulator. After this was accomplished, the skin margins were reapproximated
with running inverted 3-0 Vicryl subcuticular suture. Select the procedure and diagnosis codes.

A. 19120, N63
B. 19301, D49.3
C. 19125, N60.82
D. 19101, N64.51

Question 53
Indications: 55 year-old female had a sizeable 1.5 cm basal cell carcinoma on the right upper lip. She had
a 2 cm defect. After excision, it was reconstructed in a first stage with a nasolabial cheek flap. The
margins were clear and she is planned for the second stage. Operative Procedure: Under intravenous
sedation, patient is supine, the face was prepped and draped. Division performed to the bridge between
the base of the flap of the upper lip. Unfurled the base of the flap that was excised until it was soft and
pliable. It is defatted and laid back onto the cheek with interrupted 5-0 Monocryl and running 6-0 plain
catgut. Similar procedure was performed on the redundant portion of the flap and permanently set into
the upper lip. Steri-strips applied. Which CPT® code and modifier are used?

A. 15758-79
B. 15630-58
C. 15758-76
D. 15630-78
Question 54
25 year-old male has a ruptured distal biceps tendon at the proximal end of the radius. An incision is
made overlying the antecubital fossa. The biceps tendon was tagged using #1 Vicryl-suture. The second
incision made on the superior border of the ulna. The supinator was incised deep to expose the radial
tuberosity. Drill holes are made at the radial tuberosity in which sutures and the distal biceps tendon
are placed in the hole of the radial tuberosity. Two sutures are placed in the biceps tendon in horizontal
mattress type fashion pulled tight and secured. The distal biceps tendon is reattached to the radius to
restore elbow function. Closure was then accomplished with sutures and staples. What is the correct
code for this procedure?

A. 24342
B. 24340
C. 23430
D. 23440

Question 55
Patient complains of chronic/acute arm and shoulder pain following bilateral carpal tunnel surgery.
Patient is followed by pain management for over a year. Physician finally diagnoses patient with reflex
dystrophy syndrome (RSD). Physician performs six trigger point injections into four muscle groups. How
is this encounter reported?

A. 20552
B. 20553 x 6
C. 20551 x 6
D. 20553

Question 56
A Grade I, high velocity type 1 open right femur shaft fracture was incurred when a 15 year-old female
pedestrian was hit by a car. She was taken to the operating room within four hours of her injury for
thorough irrigation and debridement, including excision of devitalized bone. The patient was then
reprepped, redraped, and repositioned. Intramedullary rodding was then carried out with proximal and
distal locking screws. What are the correct codes for this diagnosis and procedure?

A. 27506, 11044-51, S72.301B, V03.90XXA, Y93.01


B. 27506, 11012-51, S72.301B, V03.90XXA, Y93.01
C. 27507, 11012-51, S72.301A, V03.90XXA, Y93.01
D. 27507, 11044-51, S72.91XA, V03.90XXA, Y93.01
Question 57
This 25 year-old male presents with deviated nasal septum. After intubation, a left hemitransfixion
incision was made with elevation of the mucoperichondrium. Cartilage from the bony septum was
detached and the nasoseptum was realigned and removed in a piecemeal fashion from the obstructed
perpendicular plate of the ethmoid. Thereafter, 4-0 chronic was used to approximate mucous
membranes. A small amount of silver nitrate cautery was used to achieve hemostasis. A dressing
consisted of a fold of Telfa with a ventilating tube for nasal airway on each side achieved good
hemostasis, patient went to recovery in good condition. What is the correct CPT® code for this
procedure?

A. 30520
B. 30420
C. 30620
D. 30450

Question 8
A 67 year-old female has CAD, atrial fibrillation, claudication and several chronic conditions that have
been marginally controlled with medication. The doctor decided that the benefits outweigh the risks for
her having a single vessel cardiopulmonary bypass using an arterial graft. Her medication Heparin has
been stopped for several days. She was admitted in the hospital a day before the surgery. In the
operating room, general anesthesia was administered. After the chest is opened the patient begins to
hemorrhage and drops in blood pressure. The decision is made to stop the procedure and close the
chest. How is this service coded?

A. Service is not coded due to not completing the procedure


B. 33533-52
C. 33533-74
D. 33533-53

Question 59
Mr. Y presents to outpatient surgery for placement of a dual chamber pacemaker after multiple
attempts to manage his bradycardia medically. Atrial and ventricular leads were placed under
fluoroscopic guidance via the subclavian vein. Testing confirmed appropriate placement and conduction.
The left chest was then infiltrated with Epinephrine and a pocket was opened for placement of the
generator. The leads were attached to the generator and the generator was programmed. Appropriate
pacing was confirmed. The skin pocket was closed in layers and dressing placed. Select the appropriate
CPT® code(s).

A. 33208
B. 33213, 33217
C. 33235, 33208
D. 33214
Question 60
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 cardiopulmonary 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 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 codes for
this service.

A. 33512, 33254-51, 33508


B. 33535, 33254-51, 33508
C. 33512, 33257, 33508
D. 33512, 33257-51, 33508-51

Question 61
A patient comes in for surgery today to address complications from his previous partial enterectomy
performed 5 months ago. Upon reopening the patient’s previous incision the surgeon resected the
ileum and a portion of the colon. An ileocolostomy was performed to complete the procedure with no
complications. The appropriate CPT® code to report is:

A. 44144
B. 44160
C. 44150
D. 44205

Question 62
PREOPERATIVE DIAGNOSIS: History of prior colon polyps POSTOPERATIVE DIAGNOSIS: Colon polyps,
diverticulosis, hemorrhoids PROCEDURE: After sedation was provided by the anesthesiologist, a rectal
exam was performed by the gastroenterologist and revealed small external hemorrhoids. The video
colonoscope was passed without difficulty from anus to cecum. The colon was well prepped. The
instrument was slowly withdrawn with good views obtained throughout. There was a 3 mm polyp in the
proximal ascending colon. This polyp was removed with hot biopsy forceps and retrieved. There was a 4
mm rectal polyp located 10 cm from the anus in the proximal rectum. The polyp was removed by hot
biopsy forceps. There was also moderate diverticulosis extending from the hepatic flexure to the distal
sigmoid colon. What CPT® codes(s) is (are) reported?

A. 45384
B. 45385
C. 45388
D. 45384 x 2, 45378-59
Question 63
A patient with esophageal cancer is brought to the OR for subtotal esophagectomy. A thoracotomy
incision is made and the esophagus is identified. The tumor is carefully dissected free of the surrounding
structures. No invasion of the aorta or IVC is identified. The cervical esophagus is controlled with
pursestring sutures and then transected above the sternal notch. The esophagus is then dissected free
of the stomach and the entire specimen is removed from the chest cavity and sent to pathology. The
stomach is then pulled into the chest cavity and anastomosed to the remaining cervical esophageal
stump. The anastomosis is tested for patency and no leaks are found. Hemostasis is assured. The chest is
examined for any signs of additional disease but is grossly free of cancer. The chest is closed in layers
and a chest tube is place through a separate stab incision. The patient tolerated the procedure well and
was taken to the PACU in stable condition. What CPT® code is reported?

A. 43101
B. 43117
C. 43107
D. 43112

Question 64
Patient with RUQ pain and nausea suspected of having a stone or other obstruction in the biliary tract is
brought in for ERCP under radiologic guidance. Procedure: The patient was brought to the outpatient
endoscopy suite and placed supine on the table. The mouth and throat were anesthetized. Under
radiologic guidance, the scope was inserted through the oropharynx, esophagus, stomach, and into the
small intestine. The ampulla of vater was cannulated and filled with contrast. It was clear that there was
an obstruction in the common bile duct. The endoscope was advanced retrograde to the point of the
obstruction, which was found to be a stone that was removed with a stone basket. The rest of the biliary
tract was visualized and no other obstructions or anomalies were found. The scope was removed
without difficulty. The patient tolerated the procedure well.

A. 47554, 74363-26
B. 43264, 74328-26
C. 43265, 74328-26
D. 43275, 74329-26

Question 65
Newborn male is scheduled for a circumcision. He is sterilely prepped and draped; a penile nerve block
is performed. The circumcision is performed by a ring device. Hemostasis is achieved. Vaseline Gauze
dressing applied. Patient tolerated the procedure well. How is this encounter coded?

A. 54160
B. 54150
C. 54161, 64450
D. 54150, 64450
Question 66
A laparoscopic assisted total hysterectomy is planned for a patient who has severe intramural fibroids.
After inserting the laparoscope, extensive adhesions are noted to the extent that the ligaments
supporting the uterus cannot be visualized. The physician decides to convert the procedure to an open
abdominal hysterectomy in which the uterus and cervix are removed. What CPT® code(s) should be
reported?

A. 58262, 58570-53
B. 58150
C. 58260, 58550-22
D. 58570

Question 67
Patient has consented for further testing to determine the extent of her cervical dysplasia. A cervical
cone biopsy of endocervical tissue was cut using a laser. It was tagged with a single stitch. Dilation and
curettage was performed. Small amount of tissue was obtained and sent to pathology. Which
procedure code(s) is (are) reported?

A. 57520, 58120
B. 57461
C. 57520
D. 57500, 57505

Question 68
58 year-old female has lumbar degenerative spondylolisthesis with severe stenosis and instability. The
spinous process of L4 and L5 are decompressed bilaterally by performing a laminectomies, right-sided
forminotomies and then left-sided facetectomy completely decompressing the nerve roots as well as
the dura. How is this procedure reported?

A. 63047, 63048
B. 63030-50, 63035-50
C. 63017
D. 63047-50, 63048-50
Question 69
Operation: Replacement of shunt valve with medium pressure ventriculo-peritoneal shunt assembly
with in-line 0-25 Aesculap Shunt Assistant Implant ICP Monitor.
Procedure: After obtaining general anesthesia, patient prepped and draped. Right parietal scalp incision
was reopened and shunt catheter identified. The shunt reservoir was delivered from the wound and the
distal catheter freed from it. Abdominal incision reopened, shunt passer was used to bring the distal
catheter from the head wound to the abdominal wound. The old ventricular catheter was removed. A
new ventricular-catheter was inserted into the tract of the old catheter and fed, good flow seen. It was
then attached to the shunt reservoir that was then seated after attaching a 0-25 shunt assistant valve to
it. The distal catheter was then fed into the peritoneal cavity. Subcutaneous tissues were closed in multi-
layer fashion and skin with staples. Patient tolerated the procedure well and taken to PICU in stable
condition. Code this procedure.
A. 62223, 62225-51
B. 62258, 62160
C. 62230, 62225-51
D. 62256, 62225-51

Question 70
Physician is performing an intracapsular cataract extraction. The anterior chamber of the eye is entered
performing an anterior capsulotomy using forceps. The lens nucleus was hydrodissected and loosened.
Using phacoemulsification unit, the lens nucleus was divided and emulsified. Cortical and capsular
fragments were removed. The anterior chamber and capsule bag inflated. Using lens inserter an
intraocular lens prosthesis, Cystalens, was inserted and rotated to the horizontal position. Topical
solution applied, conjunctiva repositioned over the wound with wet field cautery and patch applied.
Which CPT® code(s) is (are) reported?

A. 66984, 66985
B. 66983, 66985
C. 66985
D. 66983

Question 71
Physician performs a medical review and documentation on an 83 year-old patient who has been in the
hospital for the last two days with confusion. Problem focused exam where she is alert and oriented x 3
today. Low medical decision making by ordering an echocardiogram and to continue IV fluids. Patient is
not safe to return home. What E/M code is reported for this visit?

A. 99231
B. 99221
C. 99224
D. 99234
Question 72
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 that may need surgery. Patient was in an automobile
accident and an opinion is needed for reconstructive surgery. The plastic surgeon arrives at the ED,
obtains detailed history and performs a detailed exam. The plastic surgeon performs a moderate
medical decision making, in deciding that 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. The E/M service reported by the plastic surgeon is:

A. 99284-57
B. 99243-32
C. 99243-57
D. 99284-32

Question 73
At the request of the mother’s obstetrician, a neonatologist is called to attend the birth of an infant
being delivered at 29 weeks gestation. During delivery, the neonate was pale and bradycardic needing
resuscitation. Neonatologist performs the suctioning and bag ventilation on this 1000 gram neonate was
performed with 100 percent oxygen. Brachycardia worsened, requiring endotracheal intubation and
insertion of an umbilical line for fluid resuscitation. Later this critically ill neonate was moved from the
delivery room and admitted to the NICU with severe respiratory distress and continued hypotension.
What are the appropriate procedure codes reported by the neonatologist?

A. 99465, 99468
B. 99465, 99464, 99468-25, 31500-59, 36510-59
C. 99468, 99464
D. 99465, 99468-25, 31500-59, 36510-59

Question 74
Patient is admitted in labor for delivery. She received a labor neuraxial epidural for a vaginal delivery.
The baby goes into fetal distress and a cesarean section is performed. Following delivery the patient
starts to hemorrhage. The physician decides, with family approval, to perform a hysterectomy. Code the
anesthesia services.

A. 01967, 00840
B. 01962
C. 01968
D. 01967, 01969

Question 75
Angiograms reveal three artery blockages. The patient has COPD, which is a severe systemic disease. The
patient undergoes a CABG X 3 venous grafts on cardiopulmonary bypass and cell saver. Code the
anesthesia service.
A. 00562-P3
B. 00560-P4
C. 00567-P3
D. 00566-P4
Question 76
A healthy 11 month-old patient with bilateral cleft lip and palate undergoes surgery. The surgeon
performs a bilateral cleft lip repair, single stage. Code the anesthesia service.

A. 00170-P1, 99100
B. 00102-P1
C. 00102-P1, 99100
D. 00170-P1

Question 77
A 78 year-old with lower back pain and leg pain is scheduled for a 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. 72020-26, M54.5, M79.606, M48.06


B. 72149-26, M48.06
C. 72148-26, M48.06
D. 72158-26, M48.07, M54.5, M79.606

Question 78
22 year-old driver lost control of her car and crashed into a light pole on the highway. She arrived to the
hospital. She had CT scans without contrast of the brain and chest. She had X-rays of AP and PA views of
her left ribs and AP and PA views of her right ribs with a posterioanterior view of the chest. The CT scan
of the brain showed a fracture of the skull base with no hemorrhage of the brain. The CT of the lung
showed no puncture of the lungs. The X-ray showed fractures in the right and left second, third, and
fifth ribs. What CPT® and ICD-10-CM codes should be reported.

A. 70450-26, 71250-26, 71101-26, S02.109A, S22.43XA, V47.32XA, Y92.411


B. 70460-26, 71260-26, 71110-26, S02.01XA, S22.49XB V47.0XXA, Y92.411
C. 70450-26, 71250-26, 71111-26, 71010-26, S01.109A, S22.49XA, V47.32XA, Y92.411
D. 70450-26, 71250-26, 71111-26, S02.109A, S22.43XA, V47.52XA, Y92.411

Question 79
The physician orders an ultrasound on a patient 25 weeks pregnant with twins to access fetal heart rate
and fetal position. Select the code(s).

A. 76805, 76810
B. 76811, 76812
C. 76816 x 2
D. 76815
Question 80
A patient presents to the ED with crushing chest pain radiating down the left arm and up under the chin.
There are elevated S-T segments on EKG. The cardiologist sees and admits the patient to CCU. He orders
three serial CPK enzymes levels with instructions that the tests are also to be done with isoenzymes if
the initial tests are elevated for that date of service. The CPK enzyme levels were elevated, the lab codes
would be:

A. 82550, 82552, 82550-76 x 2, 82552-76 x 2


B. 82550, 82552, 82552-91 x 2
C. 82550, 82550-91 x 2, 82552, 82552-91 x 2
D. 82550 x 3, 82554 x 3

Question 81
22 year-old has had no prenatal care. Fundal height indicates a term fetus and by dates it is determined
she is 38 weeks pregnant. Few hours prior to admission to Labor and Delivery her membranes ruptured
spontaneously. She does not have fever, but the physician performs a rapid antigen test for group B
strep. An enzyme immunoassay method is performed. Physician obtains a lower vaginal swab, then
observes that it visually shows the patient is negative for the antigen. If clinical risk factors appear,
intrapartum antibiotics will be initiated. Which lab test is reported?

A. 87802
B. 87653
C. 86317
D. 87450

Question 82
The patient presents with burning urination and frequency. The physician performs a UA dipstick, which
shows elevated WBC. He orders a urine culture with identification for each isolate to determine which
antibiotic to give to the patient for the infection. What are the appropriate lab codes?

A. 81000, 81007
B. 81002, 87088
C. 81001, 87086
D. 87086, 87088

Question 83
Which of the following coding combinations is an example of unbundling?

A. 80048, 80061
B. 80076, 80305
C. 80061, 83718, 84478
D. 82310, 82355, 82374
Question 84
69 year-old female has been having chest tightness. Cardiologist performs a percutaneous transluminal
coronary angioplasty (PCTA) of the right coronary artery and left anterior descending coronary artery.
The procedure revealed atherosclerosis in the native vessel of the left anterior descending coronary
artery and right coronary artery. Stents were inserted in both arteries to keep the arteries opened.
Patient was placed under moderate conscious sedation by the anesthesiologist during the procedure for
a total of 30 minutes. What CPT® codes are reported for the cardiologist?

A. 92928-LT, 92929-RT
B. 92928-LD, 92929-RC, 99152, 99153
C. 92928-LD, 92928-RC
D. 92928-LD, 92928-RC, 99152, 99153

Question 85
A two month-old returns for a well check up and several shots (Rota, DTaP-HepB-IPV, Pneumococcal
PCV13) with her pediatrician. He offers suggestions to the mom, completes the exam, and counsels her
on the vaccinations. How should this be coded?

A. 99391-25, 90460, 90461 x 2, 90680, 90723, 90670


B. 99381-25, 90471, 90472 x 2, 90474, 90680, 90700, 90648, 90670
C. 99381-25, 90471, 90472 x 3, 90680, 90723, 90670
D. 99391-25, 90460 x 3, 90461 x 4, 90680, 90723, 90670

Question 86
Mary, who has food allergies, came to her physician for her weekly allergen immune therapy that
consists of two injections prepared and provided by the physician. The correct code is:

A. 95125
B. 95117
C. 95144
D. 95146

Question 87
While playing softball a 12 year-old boy sustains a blowout fracture. What is the anatomical location of a
blowout fracture?

A. Orbit
B. Clavicle
C. Patella
D. Femur

Question 88
A pediatrician examines an adolescent that has a thoracic curvature of the spine which is called:

A. Sclerosis
B. Osteochondrosis
C. Kyphosis
D. Neurofibromatosis
Question 89
The root metr/o means:

A. Menstruation
B. Breast
C. Mammary gland
D. Uterus

Question 90
According to the CPT® Appendix L, when performing a selective vascular catheterization, which vessels
would you pass through to place the catheter into the right middle cerebral artery?

A. Innominate, right common carotid, right exteranl carotid


B. Innominate, right subclavian & axillary
C. Left common carotid, left internal carotid
D. Innominate, the right common, and internal carotid

Question 91
42 year-old male was previously treated with external fixation of an ankle trimalleolar fracture. He is
now presenting with a nonunion fracture of the trimalleolar. What is the ICD-10-CM code to report?

A. S82.853D
B. S82.853S
C. S82.853K
D. S82.53XA

Question 92
Mr. Jones is here today to receive an intercostal nerve block to mitigate the debilitating pain of his
malignancy. His treatment is for the cancer that has metastasized to his right lung. Select the
appropriate ICD-10-CM codes.

A. G89.3, C78.01
B. C34.91, G89.3
C. G89.3, C34.91
D. C78.01, G89.3

Question 93
55 year-old female presents to the office with ongoing history of diabetes which has been controlled
with insulin. During the exam the physician notes that gangrene has set in due to the diabetes on her
left great toe. Patient is recommended to see a general surgeon for treatment of the gangrene on her
left great toe. Select the diagnosis codes to report.

A. E10.610, Z79.4
B. E11.52, Z79.4
C. E10.52, Z79.2
D. E11.610, Z79.2
Question 94
32 year-old delivered a baby girl one week ago via cesarean section. She is in the obstetrician’s office
with complaint of her cesarean wound bleeding. The wound is cleaned and a small hematoma removed.
The edges are pulled with steri-strips, and a clean dressing is applied. What ICD-10-CM code should be
reported?

A. L76.02
B. O90.1
C. O90.2
D. O82

Question 95
70 year-old had fallen breaking her jaw. She has had difficulty eating after having her jaw wired. Her
doctor ordered a stationary parenteral nutrition infusion pump for her TPN. A seven day supply of a
parenteral home mix nutrition supply kit was also given. What HCPCS Level II codes are reported?

A. B9002, B4220 x 7
B. B9004, B4222
C. B9006, B4222 x 7
D. B9006, B4172

Question 96
A patient has an insulin pump of 100 units. The pump is filled. Which code reports the supply?
A. J1817
B. J1815 x 20
C. J1817 x 2
D. J1835

Question 97
When coding for a patient who has had a primary malignancy of the thyroid cartilage that was
completely excised a year ago, which of the following statements is TRUE?

A. When the cancer is surgically removed with no further treatment provided and there is no evidence
of any existing primary malignancy, code Z85.850.
B. When further treatment is provided and there is evidence of an existing metastasis, code first Z85.850
and then C32.9.
C. Any mention of extension, invasion, or metastasis to another site is coded as a D49.1, Z85.850.
D. When the cancer is surgically removed but the patient is receiving chemotherapy treatment report
Z85.850.
Question 98
In order to use the critical care codes, which statement is TRUE?

A. Critical care services can be provided in an internist’s office


B. Critical care services provided for more than 15 minutes but less than 30 minutes should be billed
with 99291 and modifier 52.
C. Time spent reviewing laboratory test results or discussing the critically ill patient’s care with other
medical staff in the unit or at the nursing station on the floor cannot be included in the determination of
critical care time.
D. Critical care services are never reported with endotracheal intubation (31500)
E. Physician can provide services to another patient during the same time providing critical care services
to a critically ill patient

Question 99
Which of the following statements regarding advanced beneficiary notices (ABN) is TRUE?

A. ABN must specify only the CPT® code that Medicare is expected to deny.
B. Generic ABN which states that a Medicare denial of payment is possible, or the internist is unaware
whether Medicare will deny payment or not is acceptable.
C. An ABN must be completed before delivery of items or services are provided.
D. An ABN must be obtained from a patient even in a medical emergency when the services to be
provided are not covered.

Question 100
Which of the following services are covered by Medicare Part B?

A. Inpatient chemotherapy
B. Minor surgery performed in a physician’s office
C. Routine dental care
D. Assisted living facility

Question 101
7 year-old riding his bike struck a tree stump throwing him off his bike. He received multiple lacerations.
He had a 3 cm dermis laceration on his scalp with two 0.5 cm lacerations on his face. His right arm had a
5 cm laceration and right leg has a 5 cm laceration. The physician stapled the laceration for the scalp.
Physician used steri-strips (adhesive strips) to close the wounds on the face. The legs and arms were
cleaned by heavily irrigating them with normal saline and removal of embedded debris performed on
both wounds, followed with a single-layer closure. Select the repair codes to report.

A. 12032, 12032-59, 12011-59, 12002-59


B. 12002, 12002-59, 12011-59, 12002-59
C. 12005, 11042-59
D. 12034, 12002-59
Question 102
A 55 year-old male presents in the office with an ingrown toenail on the right and left foot. The
procedure was discussed in detail and the patient elected to have it performed. The right foot was
prepped and draped in sterile fashion. The right great toe was anesthetized with 50/50 solution of 2
percent lidocaine and .05 percent Marcaine. A mini-tourniquet was placed around the toe for
hemostasis in which part of the nail plate and matrixectomy were performed. Phenol was then applied,
the toe was then flushed. Tourniquet was released and dressing applied. At this time the patient elected
to only have one performed and will return in two weeks for the left foot. Code the procedure.

A. 11765-T5
B. 11750-T5
C. 11730-T5
D. 11740-T5

Question 3
Procedure Diagnosis: Basal cell carcinoma, left chin. Procedure: Wide local excision of 3.0 cm with 0.3
cm margin basal cell carcinoma of the left chin with a 4 cm closure. Procedure: The patient’s left chin
was examined. The site of intended excision was marked out. The site was then prepped. The patient
was then prepped and draped in the usual fashion. A 15 blade scalpel was then used to make an incision
in the previously marked site. It was carried down to the subcuticular fat. The lesion was then sharply
dissected off underlying tissue bed using a 15-blade scalpel. It was tagged for pathologic orientation. The
hyfrecator was used for hemostasis. The wound was then closed by advancing the tissue surrounding
the lesion and closing in layers with 3-0 Vicryl for the deep layer, followed by 5-0 Prolene for the skin.
The skin closure was in a running subcuticular fashion. Steri-Strips were then applied. What are the
procedure and diagnosis codes?

A. 11644, 12052-51, C44.319


B. 11643, 12013-51, C44.319
C. 11444, 12052-51, D49.2
D. 11443, 12013-51, D49.2

Question 104
The physician removes a tumor from the patient’s neck using the Mohs micrographic surgery technique.
During the first stage, the physician takes four tissue blocks and reviews them under a microscope. The
exam of the tissue blocks reveals a second stage is necessary to remove areas where the tumor is still
present. The physician examines two additional tissue blocks. What are the appropriate CPT® codes for
reporting the procedure?

A. 17311, 17312, 17315


B. 17313, 17315
C. 17313, 17314, 17315
D. 17311, 17312
Question 105
This 45 year-old male presents to the operating room with a painful mass of the right upper arm.
General anesthesia was induced. Soft tissue dissection was carried down thru the proximal aspect of the
teres minor muscle. Upon further dissection a large mass was noted just distal of the IGHL(inferior
glenohumeral ligament), which appeared to be benign in nature. With blunt dissection and
electrocautery, the 4.5 cm mass was removed en bloc and sent to pathology. The wound was irrigated,
and repair of the teres minor with subcutaneous tissue was then closed with triple-0 Vicryl. Skin was
closed with double-0 Prolene in a subcuticular fashion. What is the correct CPT® code for this service?

A. 23076
B. 23066
C. 23075
D. 23077

Question 106
Postoperative Diagnosis: 1. Impingement syndrome left shoulder. 2. AC synovitis left shoulder
Procedure: Arthroscopy with subacromial decompression and AC resection left shoulder. The patient
was placed supine on the operating table and prepped and draped in usual sterile fashion. The scope
was introduced from a posterior portal and the joint was inspected. The rotator cuff looked in good
condition. The articular surfaces looked good. The bicep also was in good condition. We went
subacromially and there was a fair amount of bursal inflammation encountered. We did a thorough
bursectomy. A ligament chisel was used to take down the coracoacromial ligament. A high-speed bur
was used to do a subacromial decompression going from lateral to medial. We took off about 2 cm of
bone anteriorly. Part of the acromion is surgically corrected. Next we opened the AC joint through an
anterosuperior portal. High-speed bur was used to grind off about 10 mm of distal clavicle because
there was a large subchondral cyst and we wanted to get this totally ground out, which we did. Then the
wounds were irrigated out, Nylon suture was placed in our portals. The patient was placed in a bulky
dressing and an arm sling and sent to the recovery room in stable condition. Code the procedure.

A. 29824-LT, 29826-LT
B. 29825-LT, 29827-LT
C. 23120-LT, 23130-LT
D. 29827-LT, 29826-LT

Question 7
The patient presented for medial meniscal bucket-handle tear left knee. Arthroscopy with partial medial
meniscectomy left knee and arthroscopic picking (drilling pick holes) of the lateral femoral condyle left
knee was performed. Code the procedure and diagnosis codes.

A. 29880-LT, 29879-51-LT, S83.212A


B. 29881-LT, 29879-51-LT, S83.212A
C. 29882-LT, 29885-51-LT, S83.282A
D. 29881-RT, 29885-51-LT, S83.242A
Question 108
A 47 year-old patient was previously treated with external fixation for a type IIIA open left tibia fracture.
There is now nonunion of the left proximal tibia and he is admitted for open reduction of tibia with bone
grafting. Approximately 30 grams of cancellous bone was harvested from the iliac crest. The fracture site
was exposed and the area of nonunion was osteotomized, cleaned, and repositioned. Interfragmentary
compression was applied and three screws and the harvested bone graft were packed into the fracture
site. What are the correct codes for this diagnosis and procedure?

A. 27724, S82.102N
B. 27758, S82.202S
C. 27722, S82.202P
D. 27759, S82.102N

Question 109
Patient had a dual chamber pacemaker put in two days ago. He is having problems with the battery and
the cardiologist found that it is malfunctioning. He is taken to the operating suite to replace the
pacemaker battery. What CPT® and ICD-10-CM codes are reported?
A. 33226-76, T82.111A
B. 33235-52, T82.110A
C. 33228-78, T82.111A
D. 33213-58, T82.119A

Question 110
2 year-old male requires a central venous catheter. Using xylocaine local anesthesia a percutaneous
approach is used in the neck and venous access is achieved. A subcutaneous tunnel is created from the
anterior chest wall to the venotomy site and the catheter passed through the tunnel. The CV catheter is
then placed at the superior vena cava and sutured in position. Which procedure code is used?

A. 36568
B. 36555
C. 36557
D. 36560

Question 111
Pre-Operative Diagnosis: Right lung mass Indications: Patient with a mass in the right lung identified on
routine X-ray presents for bronchoscopy and biopsy. Procedure: The patient was brought to the
endoscopy suite and the mouth and throat were anesthetized. The bronchoscope was inserted and
advanced through the larynx to the bronchus. The bronchoscope was introduced into the right
bronchus. Using fluoroscopic guidance, the tip of the bronchoscope was maneuvered into the area of
the mass. A closed biopsy forceps was passed through the channel in the bronchoscope and then
through the bronchial wall. A tissue sample was obtained. There were no other abnormalities
appreciated in the right side and the bronchoscope was removed. The specimen was labeled and sent to
pathology for testing. The patient tolerated the procedure well. Pathology indicates that the lung mass
is cancer. What are the procedure and diagnosis codes?
A. 31628, R22.2
B. 31628, C34.91
C. 31628, 31622-51, C34.91
D. 31625, R22.2
Question 112
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. 49650-LT, K40.90
B. 49651-LT, 49568, K40.90
C. 49650-LT, K40.20
D. 49652-LT, K40.20

Question 113
Preoperative Diagnosis: Chronic tonsillitis. Chronic adenoiditis. Postoperative Diagnosis: Same.
Procedure: Tonsillectomy and adenoidectomy. Patient is a 24 year-old male who was taken to the
operating room and put under IV sedation by the anesthesia department. An initial curettage of
adenoids was done and packing was placed. The left tonsil was then identified and dissected out
extracapsular and removed with scissors. Hemostasis was maintained by packing the left tonsil. Next,
the right tonsil was identified and incision was made. Dissection was done extracapsular and the right
tonsil was then removed. Both the right and left tonsil were sent as specimens as well as adenoid tissue.
What are the procedure and diagnosis codes?

A. 42826, 42831-59, J35.02


B. 42820, J35.03
C. 42821, 42836-59, J35.01, J35.02
D. 42821, J35.03

Question 114
Diagnostic esophagogastroduodenoscopy of the esophagus, stomach, and duodenum was performed
after esophageal balloon dilation (less than 30 mm diameter) was done at the same operative session.
Code the procedure(s).
A. 43249, 43235-51
B. 43249
C. 43220, 43200-51
D. 43220
Question 115
A 46 year-old female with history of cervical carcinoma underwent placement of an ileal conduit, with
subsequent development of left hydronephrosis. A retrograde ureteral catheter was recently placed.
She returns today for catheter exchange. Patient was placed in the supine on the operating table. The
ileal conduit was accessed. The existing catheter was removed over a guidewire and replaced with a
similar 10 French 50 cm long locking pigtail catheter. Contrast was injected for monitoring, confirming
good position of the catheter placement. Interpretation and report is in the record. IMPRESSION: Left
retrograde ureteral catheter exchange via the ileal conduit. How is this reported?

A. 50435
B. 50693
C. 50385
D. 50688, 75984-26

Question 116
70 year-old with significant pelvic prolapse and grade IV cystocele who has failed previous primary
repair and is status post hysterectomy. She presents for anterior repair and colpopexy. Procedure:
Patient placed in the dorsal lithotomy position and general anesthetic was induced without problems. A
midline incision is made from just above the bladder neck to the vaginal cuff. She is noted to have a
grade IV cystocele. Vaginal flaps were dissected to the level of the pubocervical fascia. Her vaginal
mucosa was in good condition but near the urethra and bladder neck it was a little thinner. There is
significant scarring on the left side from previous procedures. Ishcial spine is identified and swept fiber
fatty tissue off of the sacrospinous ligament bilaterally. No scarring or adhesions in this area. Anterior
needles were passed into place on the elevate mesh and these were fixed in a manner similar to the
MiniArc. They were passed along just below the bladder neck toward the obturator foramen and fixed in
place. An anterior support was created without tension at the vesicourethral junction. Apical needles
were then used to pass the apical arms into place. There were gently fixed into place along the
sacrospinous ligament approximately 2cm away from the ischial spine. This was done bilaterally. They
passed in a single pass and were fixed in place confirmed by gentle tugging on both arms. Three Vicryl
sutures had been placed and the vaginal apex were then passed over into the mesh and tied down. The
apical arms were placed through the eyelets of the mesh and passed down toward the sacrospinous
ligament bilaterally to create good apical support. Eyelet fasteners placed bilaterally and mesh arms
trimmed providing excellent apical and anterior support. Vaginal mucosa was closed and vaginal packed
placed. No complications. What CPT® code(s) describe(s) this procedure?

A. 57250, 57280
B. 57240, 57282
C. 57240, 57283
D. 57250, 57283
Question 117
Preoperative Diagnosis: Right hydronephrosis Postoperative Diagnosis: Right hydronephrosis
Operation: Cystoscopy and right retrograde pyelogram Procedure: Patient prepped and draped in the
dorsolithotomy position. Placed under general anesthesia a 23 French cystoscope was passed into the
bladder. No tumors were visualized. Urine from the bladder was sent for urine cytology. Then a 6 French
access catheter was passed into the right ureteral orifice. Contrast was injected and there were no filling
defects noted. There was no fixed tumor and no stone. There was mild hydroureteral nephrosis against
the bladder. There was a narrowing at the UVJ no abnormalities. Renal pelvis barbotaged with saline
and renal pelvis urine sent to pathology for urine cytology. After the retrograde pyelogram was
performed the access catheter was removed. Interpretation and report are in the medical record. What
CPT® codes are reported?

A. 52000-RT, 74420-26
B. 52281-RT, 74425-26
C. 52007-RT, 74400-26
D. 52005-RT, 74420-26

Question 118
5 year-old male has diminished hearing in the left ear due to chronic otitis media. He has had hearing aid
prosthetic devices in the ear which have resulted in additional infections. Parents have decided on an
osseointegrated implant to restore hearing. The mastoid cortex is exposed. Spiral drilling is performed
to create a pilot hole. The stem of the titanium pedestal is placed in the tunnel adjacent to the cochlea
and abutment subsequently secured to the fixture. Which CPT® code should be used?
A. 69717-LT
B. 69718-LT
C. 69714-LT
D. 69715-LT

Question 119
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 sternocleidomastoid 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
Question 120
PROCEDURE: Bilateral lumbar medial branch block under ultrasound guidance for the L3, L4, L5 medial
branches injecting the L4-L5, L5-S1 facets for diagnostic and therapeutic purposes. PROCEDURE: The
patient was placed in the prone position 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 an ultrasound 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
ultrasound guidance for the L4-L5 and L5-S1 facet joints. At each joint 1 mL consisting of 0.5%
bupivacaine and Depo-Medrol was injected. A total of 80 mg of Depo-Medrol was given in both sides.
Which CPT® codes should be used?

A. 0216T-50, 0217T-50, 0218T-50, 76942-26


B. 64493-50, 64494-50, 64495-50
C. 64493-50, 64494-50, 76942-26
D. 0216T-50, 0217T-50

Question 121
15 year-old male is seen by the pediatrician in his office for having excessive thirst and frequent
urination. A urine dip is performed showing +3 sugar and with some ketones. Glucometer reading is
done showing a blood sugar range of 500-600. Physician sends the patient with his father to the hospital
for emergency admission and insulin drip. The pediatrician meets the patient at the hospital and
performs a detailed history, comprehensive exam and a high complexity medical decision making. How
should the pediatrician code the E/M service for this visit?

A. 99214
B. 99221
C. 99223
D. 99285

Question 122
A 62 year-old female returns to a family practice having shortness of breath, nausea and diaphoresis. It
has been two years since her last visit to the practice. An comprehensive history is documented. A
comprehensive general multisystem examination of eight organ systems is performed. An EKG, chest X-
ray and labs are ordered. The physician also orders to have her records sent from her cardiologist. The
medical decision making is high. The patient is diagnosed with exacerbation of congestive heart failure.
What is the correct evaluation and management service for this encounter?

A. 99205
B. 99215
C. 99204
D. 99214
Question 123
This morning a 48 year-old is placed in observation status from the emergency room with severe
diarrhea and extreme thirst. The physician performs a comprehensive history, comprehensive
examination and determines the patient is suffering from dehydration. The physician places the patient
on IV saline 500 ml and conducts normal saline hydration for a couple hours. The medical making
decision making is of moderate complexity. Patient is discharged home in the late evening on the same
day and is told to return if symptoms occur again. The E/M service(s) for this encounter is:

A. 99285
B. 99219, 99217
C. 99235
D. 99217

Question 124
Physician was called to the floor to evaluate a 94 year-old that had sudden weakness, hypotension, and
diaphoresis. Physician found the patient in mild distress and dyspneic. Her BP 101/60, pulse 85. Labs
were still pending. Arterial blood gas was drawn and interpreted by the physician. She was admitted to
CCU for Acute Antero-lateral MI and hypotension. Physician spent total critical care time of 65 minutes.
Select the appropriate CPT® code(s) for this visit:

A. 99291, 99292
B. 99233, 82803-26
C. 99291
D. 99291, 82803-26

Question 125
The anesthesiologist performed MAC (monitored anesthesia care) for a patient undergoing an
arthroscopy of the right knee. Code the anesthesia service.

A. 01382-AA
B. 01382-AA-QS
C. 01400-AA
D. 01400-AA-QS

Question 126
General anesthesia is administered to a 9 month-old undergoing a tracheostomy. Code the anesthesia
service.

A. 00320, 99100
B. 00320
C. 00326
D. 00326, 99100
Question 127
65 year-old woman is one year post with B-cell non-Hodgkin’s lymphoma. She is having recurrent fever
and pain. Tumor recurrence was confirmed by CT studies and chest X-ray. She has failed prior
chemotherapy and radiation treatments. A new treatment is being contemplated and she is referred for
a radiopharmaceutical distribution imaging as a requirement before starting this new treatment. The
provider injects small amounts of gamma-emitting radioactive material paying particular attention for
potential reaction. A gamma camera is used to take planar images of the whole body for three days.
Three sets of image data are interpreted. Qualitative assessment of distribution and determination of
treatment with monoclonal antibody are provided. A report is dictated and placed in the medical record.
Which CPT® code is reported?

A. 78806-26
B. 78802-26
C. 78804-26
D. 78801-26

Question 128
Due to an elevated CEA level two years following a colon resection, the patient’s oncologist ordered a
diagnostic liver ultrasound. Which radiology code is reported for this encounter.

A. 76700
B. 78206
C. 76705
D. 76970

Question 129
52 year-old male has a 3.2 cm metastasized lung cancer in his left upper lobe. The tumor cannot be
removed by surgery due to the patient having severe respiratory conditions. He will be receiving
stereotactic body radiation therapy management under image guidance. There is a delivery of 25 Gy for
four fractions under direct supervision of the radiation oncologist. The patient’s treatment set up is
assessed to manage the execution of the treatment to make any adjustments needed for accuracy and
safety. The oncologist reviews and approves all the images used to locate the tumor and images of fields
arranged to deliver the dose. What CPT® and ICD-10-CM codes should be reported?

A. 77373, Z51.0, C34.92


B. 77435, Z51.0, C78.02
C. 77435, C78.02, Z51.0
D. 77402, C34.92, Z51.0

Question 130
A 42 year-old has a lesion on his pancreas. The physician passes the biopsy needle through the skin and
removes tissue to be sent to pathology. Fluoroscopic guidance is used to obtain the biopsy. Physician's
report and interpretation is placed in the record. Code this encounter.

A. 48100, 77002-26
B. 48102, 77002-26
C. 48120, 76942-26
D. 48102, 76942-26
Question 131
Patient is undergoing in vitro fertilization to get pregnant. Following the retrieval of follicular fluid from
the patient, the physician uses a microscope to examine the fluid to identify the oocytes. What is the
code for the laboratory service?

A. 89250
B. 89254
C. 89255
D. 89258

Question 132
22 year-old comes into the Emergency Department with convulsions. The ED physician orders a drug
screening without identifying any specific drug class to be tested. The lab runs two drug classes
screening using an immunoassay multipex strip (dipstick) and the results are visually read. The lab report
comes back positive for alcohol and benzodiazepines. The ED physician then orders a confirmatory test
to be performed by the lab to confirm both positive results. What CPT® codes are reported?

A. 80307, 80320, 80346


B. 80305, 80320, 80346
C. 80305 x 2, 80320, 80346
D. 80306 x 2, 80320 x 2, 80346 x 2

Question 133
A pathologist performs a comprehensive consultation and report on referred material after reviewing a
patient’s records, specimens and official findings from other sources. What is the correct code?

A. 88325
B. 99244
C. 80502
D. 88329

Question 134
Photodynamic therapy involving application of light externally to destroy premalignant lesions on the
lower lip was provided to a 63 year-old patient. Code the encounter.

A. 96570
B. 96999
C. 96567
D. 96913
Question 135
A four year-old patient presents with pain in the left forearm following a fall from a chair. The injury
occurred one hour ago. Her mom applied ice to the injury but it does not appear to help. The ED
physician performs a detailed history, expanded problem focused examination and medical decision
making of moderate complexity. An X-ray is ordered, which shows a fracture of the distal end of the
radius as read by the radiologist. The ED physician consults with an orthopedic surgeon. The ED
physician performs moderate conscious sedation with Ketamine for 30 minutes. The fracture is reduced
and cast applied by an orthopedic surgeon. The child was monitored with pulse oximetry, cardiac
monitor and blood pressure by the ED physician frequently. The patient was discharged with a sling and
requested to follow up with the orthopedic surgeon. Code the services performed by the ED physician.

A. 99284-25, 99151, 99153


B. 99283-25, 99155, 99157
C. 99283-25, 99152, 99157
D. 99284-25, 99151, 99157-51

Question 136
In the inpatient setting, the psychiatrist provides psychotherapy for 30 minutes to affect a change in the
patient’s maladaptive behavior. What is the procedure code?

A. 90845
B. 90832
C. 90847
D. 90853

Question 137
CKD is a disease of which system?

A. Circulatory
B. Genitourinary
C. Digestive
D. Musculoskeletal

Question 138
A person who has nephritis has inflammation in what location?

A. Gallbladder
B. Nerve
C. Uterus
D. Kidney

Question 139

What is ascites?
A. Fluid in the abdomen
B. Enlarged liver and spleen
C. Abdominal malignancy
D. Abdominal tenderness
Question 140
Which of the following is a disorder in causing paralysis of the facial nerve?

A. Exotropia
B. Tarsal tunnel syndrome
C. Brachial plexus lesions
D. Bell’s palsy

Question 141
Complete this series: Pulmonary, Aortic, Mitral, and ________are valves of the heart.
A. Tricuspid
B. Superior Vena Cava
C. Carotid
D. Atrium

Question 142
Which of the following terms is one who has an overload of sodium?
A. Hyperkalemia
B. Hyperpotassemia
C. Hypernatremia
D. Hypercalcemia

Question 143
The term paracentesis found in CPT® code 49082 means:
A. A procedure performed to drain fluid that has accumulated in the abdominal cavity
B. Biopsy of an abdominal mass
C. Removal of tissue samples from the abdominal cavity by an open approach
D. Removal of a cyst located in the abdominal cavity

Question 144
A 25 year-old is brought to the burn unit being rescued from a burning house. She sustained 25% second
degree burns on her anterior trunk and back and 20% third degree burns on her legs and arms. Total
body surface area burned is 45%. What ICD-10-CM code is reported for the burns classified according to
the extent of body surface involved?

A. T31.22
B. T32.42
C. T31.24
D. T31.42
Question 145
The patient is a 75 year-old woman who is here for follow-up after an incident last week in which she
had an FB lodged in her throat. An emergency esophagoscopy was performed and the piece of
hamburger meat removed and biopsy performed. She is positive for Barrett’s esophagus. She has GERD
which is currently being treated by medication and is here today to be evaluated for photodynamic
therapy.
What diagnosis codes should be reported for today’s visit?

A. K22.2, K22.70
B. T18.12XA, K22.70
C. T18.12XA, K22.70, K21.9
D. K22.70, K21.9

Question 146
A 78 year-old patient, with known arrhythmia, presented to an outpatient clinic for the insertion of a
cardiac event recorder. What is the proper HCPCS Level II code for this device?

A. C1767
B. C1764
C. C1777
D. E0616

Question 147
The physician performed manipulation of a closed fracture of the distal radius on a 12 year-old male. He
placed a short arm fiberglass cast. What is the HCPCS Level II code for the supply?

A. Q4012
B. Q4011
C. Q4010
D. Q4009

Question 148
Which of the following statements regarding the ICD-10-CM coding conventions is TRUE?

A. If the same condition is described as both acute and chronic and separate subentries exist in the
Alphabetic Index at the same indentation level, code only the acute condition.
B. Sequela (Late effect) codes are reported for a current acute phase of the injury or illness
C. An ICD-10-CM code is still valid even if it has not been coded to the full number of characters required
for that code.
D. Signs and symptoms that are integral to the disease process should not be assigned as additional
codes, unless otherwise instructed.
Question 149
Which modifier should be append to a CPT®, for which the provider had a patient sign an Advance
Beneficiary Notice (ABN) form because there is a possibility the service may be denied because the
patient’s diagnosis might not meet medical necessity for the covered service?

A. GJ
B. GA
C. GB
D. GY

Question 150
What is the patient’s right when it involves making changes in the personal medical record?

A. Patient must work through an attorney to revise any portion of the personal medical information.
B. They should be able to obtain copies of the medical record and request corrections of errors and
mistakes.
C. It is a violation of federal health care law to revise a patient medical record.
D. Revision of the patient medical record depends solely on the facility’s compliance program policy.

-END-