Module 17 Practice CPC Exam - PDF - Artificial Cardiac Pacemaker - Surgery PDF

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Save Embed Share Print CPC Sample Exam Practice Exam- 2014 CPC Final Medica
1 10000 Series Practice Exam /… CPC Pr
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Practice CPC Exam

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Note: All answers have options of A-D answers. Please be sure to check the following page if all options
are not printed on one page due to a page break. Unless otherwise stated, assume that all information
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provided was documented by a physician. No outside materials may be used on this exam other than
the CPT, ICD-9-CM and HCPCS Level II manuals.
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Integumentary – 9 Questions  Useful  Not useful
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1. Patient presents with a stage III pressure ulcer of the sacrum and a stage III pressure ulcer of the
upper back. Physician performs an 18 sq.cm. debridement of the sacrum down to and including
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the muscle. During the
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same session the physician also performed
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debridement of the
back down to and including the muscle. How should these services be reported?
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b. 11043, 97597-59
c. 11043, 11046
d. 11043,
CPC Sample Exam Practice Exam- 11043-59
2014 CPC Final Medical Coding Certified Coding 20 q cpc Practice Exam-
1 10000 Series Practice Exam /… CPC Practice… Specialist CCS… 60000 Series
“c” Per CPT Coding Guidelines for debridement you may combine sums of wounds that are the
same depth.
2. Patient presents with ulcers of the ischium, left heel and upper back. The physician performs a 12
sq. cm. full thickness debridement of the ischium down to and including the muscle fascia. During
the same operative session the physician also performs a 10 sq. cm. debridement of the upper
back down to the muscle. The 4 sq cm heel ulcer was debrided down to the bone. How should
these services be reported?
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a. 11043, 11043-59, 11044-59
b. 11043, 11046, 11044-59
 Home c. 11043, 11044-59
d. 11043, 11046
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“b” Per CPT Coding Guidelines for debridement in multiple wounds, sum the surface area of those
wounds that are the same depth, but do not combine the sums for different depths.
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Copyright 2000-2012 HCPro, Inc. All rights reserved. These materials may not be document
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CPC Sample Exam Practice Exam- 2014 CPC Final Medical Coding Certified Coding 20 q cpc Practice Exam-
1 3. The physician excised a 5mm excised diameter benign blue nevus from the patient’s
10000 Series Practice Exam /… CPC Practice… Specialist CCS… 60000
armSeries
and
performed a simple closure for a patient for which the physician reported CPT 11400. A month
later (outside the postoperative period), the same patient as in the above question returned to
her surgeon’s office with a 2 cm malignant lesion on her arm. In order to ensure that the entire
malignancy was removed, the surgeon excised the 2 cm lesion and 2 cm skin margin (1 cm above
the lesion and 1 cm below the lesion). This was the narrowest clinical margin required to
adequately excise the lesion. How should this be reported?
a. 11404
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c. 11604
d. 11604-58
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“c” Based on CPT guidelines, the reporting of the excision of a lesion is based on the greatest
clinical diameter of the lesion plus the narrowest margins required for complete excision. See
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guidelines preceding the Excision of Benign Lesions (11400-11471) and Excision of Malignant
Lesions (11600-11646) codes. Answer “d’ is incorrect because the question stated that the service
was provided outside the postoperative period.
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4. A surgeon excised a benign 5 cm lesion from a patient’s back. An adjacent tissue transfer was
 Books performed to repair the defect resulting from the lesion excision. The defect repaired
encompassed 11 sq. cm (including both the primary and secondary defects). What are the correct
code(s) for these services?
 Audiobooks
a. 14001

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“a” The excision of the lesion is bundled into the adjacent tissue transfer codes per the Guidelines
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The procedure  based on the total size of the defect,
is reported  Upload ofENthe
not the size  lesion. 
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4 ofBased
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on the operative report, document
the cyst non-
was involving the
muscle fascia. After excising the cyst the physician had to close the non-muscle fascia as well as
the skin and subcutaneous tissues. What are the correct codes to be reported?
1 a. 11423, 12002-51
10000 Series Practice Exam /… CPC Practice… Specialist CCS… 60000 Series
b. 11403, 12032-59
c. 11404, 12042-51
d. 11403, 12032-51
“d” A sebaceous cyst is a cyst on the epidermis or in a hair follicle. The guidelines for excision of
benign
in lesions
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excision, of benign
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Copyright 2000-2012 HCPro, Inc. All rights reserved. These materials may not be duplicated without the express
written permission of HCPro, Inc. (804-608-0385). No claim asserted to CPT or any materials copyrighted by the
 Home
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

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 Audiobooks it required an intermediate repair (see guidelines for lesion excision). The modifier –51 is used
because multiple procedures are being reported.
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6.
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A patient presents for destruction of premalignant lesions. The patient had five lesions. What are
the correct code(s) for these services?  Useful  Not useful
a. 17000, 17003 x 4
 Documents b. 17000, 17003
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c. 11200
d. 17000 x 5
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“a” The destruction of these premalignant lesions is reported based on the number of lesions
destroyed. Code 17000 describes the destruction of the first lesion and 17003 x 4 describes the
destruction of the remaining four lesions.
7. A patient presents for destruction of three lesions. The pathologist confirmed that the lesions
were dermatofibrosarcomas. Cryosurgery was used to destroy a 1.2 cm back lesion, a 2.1 cm nec
lesion, and a 1.2 cm foot lesion. What are the correct code(s) for these services?
a. 216.5, 216.4, 216.7, 17000, 17003

b. 173.59, 173.49, 173.79, 17273, 17272-59, 17262-59,
c. 173.59, 173.49, 173.79, 11602, 11602-59, 11623-59
d. 173.89, 17262 x 3
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 “b” Dermatofibrosarcomas are defined in the ICD-9 manual as malignant neoplasms of the skin.
Malignant lesion destruction is reported based on the site and size of the lesions. Code 17273 is
reported for the destruction of the 2.1 cm malignant neck lesion. 17272-59 is reported for the
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destruction of the 1.2 cm malignant back lesion. 17262-59 is reported for the destruction of the
1.2 cm malignant foot lesion.
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History: 21 year old cook at a local Waffle House was admitted to the burn center after suffering
Learn more about 8. third degree burns from scalding grease involving the left shoulder and chest. The total body
surface area with a third degree burn is 10%. Procedure: The patient was brought to the operating
room and placed in a supine position. After the induction of general anesthesia, the subcutaneous
 Home tissue beneath the full-thickness burn is infiltrated with crystalloid solution containing epinephrine
to minimize blood loss during the procedure. The eschar involving the left shoulder and anterior
chest area is excised down to clean bloody bed of viable subcutaneous tissue. A total area of 100
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sq cm (40 sq cm on the arm and 60 sq cm on the chest) is excised and readied for a staged graft
procedure to be performed at a later date. Hemostasis is obtained with electrocautery,
epinephrine soaked pads and topical thrombin. The patient tolerated the procedure well and was
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discharged to recovery in good condition. Estimated blood loss was 100ccs. Report the physician
services.
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a. 942.32, 943.35, 948.11, E924.0, E849.6, E015.2, E000.0, 15002
b. 946.3, 948.11, E924.0, E849.6, E015.2, E000.0, 15002, 15220-51, 15221, 15200-51, 15201 x2
 Audiobooks
c. 948.11, E924.2, E849.6, E015.2, E000.0, 15002, 15200-51, 15200 X 5
d. 942.32, 943.35, 948.10, E924.0, E849.6, E015.2, E000.0, 15002
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“a” This is a surgical preparation of a burn site. Per the Op note, Useful isNot
sq cm usefuland readied
excised
 Magazines Related titles for a staged graft procedure “. 15002 is reported for preparation of specific sites involving the
trunk, arms, legs 1st 100sq cm. Answer “B “ is incorrect because per the Official Guidelines for
burns code 946 should only be used if the location of the burns is not documented. Also, the graft
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procedure during this encounter per the Op Upload
note. Answer “C” ENis incorrect because
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per the Official Guidelines category 948 may only be used as the first listed diagnosis when the
 Sheet Music burn sites are not specified. Answer “D “ is incorrect because the fifth digit of “0” for category 948
is reported when the TBSA contains less than 10% of third degree burns. Per the Op note, the
TBSA was listed as 10%.
9. Practice
CPC Sample Exam Exam- presented
A patient 2014 CPC Final
for Medical Coding
a percutaneous Certified
needle core Coding
biopsy 20 q cpc
of a lesion PracticeThe
in her left breast. Exam-
1 10000 Series Practice Exam /… CPC Practice… Specialist CCS…
procedure was performed without imaging guidance. What is the correct code for the biopsy 60000 Series
procedure?
a. 19102
b.
c. 11100
19100
d. 19101
“c” Code 19102 would not be reported unless the procedure was performed under imaging
Learn more about guidance. Code 11100 is not reported for breast biopsies. Code 19101 is not reported unless the
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biopsy was performed using an open (i.e., non-percutaneous) technique.
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Musculoskeletal – 10 Questions
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Download A 25 year-old construction worker
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presents  Search document
to the emergency department and
with a penetrating
traumatic open wound to his left arm. He has fallen from a ladder and a small piece of wood has
become lodged in his arm. The physician performs an exploration and enlargement of the
CPC Sample Exam penetrating
Practice Exam- wound and
2014 CPC removes
Final the foreign
Medical Coding body. HowCoding
Certified should these services be reported?
20 q cpc Practice Exam-
a. 959.2, 20102
b. 884.1, 20103, 24200-51
c. 884.1, 20103
d. 959.2, 10120
“c” The wound is reported as “complicated” due to the foreign body. See Note in the ICD-9
guidelines preceding the Open Wound codes (870-897). The removal of the foreign body is
bundled into the exploration of the wound.
Learn more about
Scribd Membership  11. A driver suffered a closed LeFort fracture in a motor vehicle accident from striking a guardrail (on
a highway). The patient now presents for a midface reconstruction. The physician uses a LeFort I
technique involving a complete separation of the midfacial bones. The procedure requires bone
 Home
grafts, but is performed without LeFort I. How should these services be reported?
 Saved a. 802.4, E815.0, E849.5, 21155

b. 802.4, E815.0, E849.5, 21154
c. 802.4, E816.0, E849.5, 21141
 Bestsellers d. 802.5, E829.8, E849.5, 21150
“b” A LeFort fracture is of the maxilla. The description for 21154 indicates that the bone grafts
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are bundled.
 Audiobooks 12. A physician performs an anterior interbody arthrodesis on C5-C7 including discectomy and
decompression of the spinal cord. How should the physician’s services be reported?

a. 22551, 22552, 63075-51, 63076
b. 22551, 22552, 63075-59, 63076
 Magazines Related titles c. 22551, 22552
d. 22554, 22585, 63075-51, 63076
“c” Per CPT Coding Guidelines, codes 22551 and 22552 include discectomy and decompression.
Based off the parenthetical notes under CPT codes 22554, 22585 the instruction is to assign 22551
 Sheet Music
Download Now(and 22552, if applicable) when4 both
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discectomy and fusion are performed 
at the same level.
Codes 63075-63076 cannot be reported separately even if performed by separate providers.
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13. History: A 30 year old
This document is...
o ld female fell while rollerblading (leisure). She suffered a closed fracture of the
distal radius of her right arm as documented on plain films in the  emergency
Useful  Not useful
room. Procedure: She
 Magazines Related titles is brought to the operating room in stable condition. She is placed in a supine position on the
operating table. After induction of general anesthesia,
anesthesia, site is cleaned and prepped. The distal
 Documents radius is manipulated and the fracture fragments are visualized
Search   using fluoroscopic
Upload  EN  imaging. It was

determined with fluoroscopic imaging that the fracture did not require reduction prior to placing
the wires. The optimal site for wire placement is determined and a small incision was made. Tissue
 Sheet Music
passed through 
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 Search document the
incision. The wire is drilled into position at the fracture site. After insuring correct placement, the
wire is then drilled into the second site completing the fixation process. Two more wires are
placed in similar fashion for stabilization. The patient was moved to recovery in excellent
e xcellent
1 condition.
10000 Series Report theExam
Practice physician
/… CPCservices for this procedure.
Practice… Specialist CCS… 60000 Series
a. 813.52, E885.1; E006.0, E000.8, 25606, fluoroscopy included

b. 813.42, E885.1; E006.0, E000.8, 25606, 77002-26
c. 813.42, E885.1; E006.0, E000.8, 25600, 77002-26
d. 813.43, E885.1; E006.0, E000.8, 25574
“b” 813.42, 25606 and 77002; Per the Musculoskeletal guidelines, percutaneous skeletal fixation
is where the fracture fragments are not visualized but fixation is placed via radiologic guidance.
Learn more about You're
Since fluoroscopy is not inclusive Reading
of 25606, a Preview
it is appropriate to report an additional code for
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
fluoroscopic imaging when performed. Per the Op note, closed reduction was not performed
therefore “c” is incorrect. There
Uploadis no
yourmention of thetoulna
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incorrect. The fracture is described as a closed fracture therefore “a” is incorrect.
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OR
14. In the morning, Dr. Jones attempted
attempted to treat a humeral shaft fracture with manipulation. The
Become a Scribd memberlater
for full access. Your
 Saved procedure appeared to be successful. However, that evening, the patient developed
developed
additional problems first 30 days
problems relating to the fracture. Dr. are free. re-manipulated the fracture.
Williams fracture. The repea
procedure was a success. What modifier should be be appended to the code for thethe procedure
performed by Dr. Williams?
 Bestsellers Continue for Free
a. -77
 Books
b. -76
c. -62
 Audiobooks d. -22
“a” This was a repeat procedure by a different physician.

physician. 
 Sheet Music

CPC Sample Exam Practice2000-2012

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HCPro, FinalAll rights
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reserved. materialsCoding
may not20
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1 10000 Series Practice Exam /… CPC Practice… Specialist CCS… 60000
written permission of HCPro, Inc. (804-608-0385). No claim asserted to CPT or any materials copyrighted by theSeries
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
15. A patient with scoliosis was scheduled for major surgery to repair the shape of his spine.
spine. The
 Home physician determined that 10 vertebral segments
segments required surgical repair. She performs posterio
arthrodesis followed by posterior
posterior segmental instrumentation. How should these services be
reported?
 Saved
a. 737.30, 22802, 22843

b. 754.2, 22802, segmental
segmental instrumentation is bundled
 Bestsellers
c. 737.30, 22802, 22843-51
d. 754.2, 22812, 22847
 Books
“a” The scoliosis without
without further description is reported as “acquired” rather than congenital.
“Acquired” is a non-essential modifier.
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16. A patient presents for an excision

exc ision of a benign bone tumor of the right clavicle with autograft.
 How
 Snapshots should these services be reported? This document is...
 Magazines Related titles a. 23145-RT
b. 23140-RT; 20936-51
c. 23150-RT
 Documents
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23155-RT   Upload  EN  
You're Reading a Preview

 Sheet Music “a” Code 23145 includes the autograft and therefore
therefore it would be inappropriate to report
report 23140
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for the download.
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humerus.
humerus. 
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A general
17. Practice
CPC Sample Exam Exam- surgeon
shoulder. The 2014 performed
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CCS… Your
surgeon also excised a small 1 cm benign mass from the patient’s right hand. How should these 60000 Series
services be reported? first 30 days are free.
a. 23066, 11401-59
Continue for Free
b. 23066, 11421-59
c. 23076, 11421-59
d. 23076, 11401-59
“b” Code 23066 is reported rather than 23076 because

because this case involved a soft tissue biopsy of
Learn more about the shoulder area rather than the excision of soft tissue lesion in the shoulder area. The -59 is
appended to 11421 because this case
c ase involved separate sites.
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18. A patient injured his elbow in a motorcycle accident. The physician had to excise the radial head
and replace it with an implant.
implant. How should these services be
be reported?
1 10000
a. Series
24130 Practice Exam /… CPC Practice… Specialist CCS… 60000 Series
b. 24999
c. 24365
d. 24366
“d” According to the parenthetical note

note following 24130, when the radial head is replaced with a
implant, 24366 is reported.
19. Dr. Jackson and Dr. Barber, two orthopedic

or thopedic surgeons, performed an anterior interbody arthrodesi
Learn more about of L2-L3. Dr. Barber then proceeded to insert a morselized
morselized allograft and apply
apply anterior
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 instrumentation across L2-L3. How should each physician
physician report their services?
Dr. Jackson Dr. Barber

 Home
a. 22558-62, 20930-62, 22845-62 22558-62, 20930-62, 22845-62
b. 22558-62, 22585-62 22554-62, 22585-62, 20930, 22845
 Saved c. 22558-62 22558-62, 20930, 22845
d. 22558-62, 22585-62 20930, 22845-51
You're Reading a Preview
 Bestsellers “c” Dr Jackson was not considered a co-surgeon for the
Upload-62
your documents
the bone grafting and
to download.
and instrumentation. In the
guidelines, it states that modifier should not be appended to the bone grafting and
instrumentation codes. L2-L3 involves only one interspace therefore 22585 would not be
 Books
appropriate. Modifier-51 cannot be appended ORto 22845 because it is an add-on code.
 Audiobooks Become a Scribd

Respiratory member for full
and Cardiovascular access.
– 10 Your
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first 30 days are free.
her nose. A total of 3 polyps were 
20. A patient has nasal polyps removed from both sides of her
 Snapshots
removed. How should the physician’s services be reported?
This document is...
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 Magazines Related titles a. 30110 x 3
b. 30115-50
 Documents c. 30110 x 2
d. 30110-50
 Sheet Music
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4 of 54that this was an extensive the coder must
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procedure,
assume it was “simple.” Per the note following 30110, the bilateral excision of simple nasal polyps
is reported using 30110-50. The number of nasal polyps excised does notnot affect reporting because
the code description refers to “polyp(s).”
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

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21. Mrs. Johnson underwent outpatient surgery for repair of a fractured left turbinate. The surgeon
ended up having to completely remove the left inferior turbinate using a surgical drill to sever it
 Books
from the lateral nasal wall. The procedure involved only mucousal nasal tissue
tissue and did not extend
into the submucousal tissue.
tissue. How should the physician’s
physician’s services be reported?
 Audiobooks
a. 30130-LT
b. 30140-LT 
 Snapshots c. 30130-22-LT This document is...
d. 30140-52-LT
 Magazines Related titles “a” This was excision
excision of a turbinate. Code 30130 is reported
reported for the excision of a turbinate,
regardless of whether the procedure was partial or complete. It would not be appropriate
appropriate to
 Documents report -22 based on the information provided because doing so would require
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the coderENto
 
conclude that the use of the surgical drill made the procedure unusually complicated.
complicated. In fact, it
may be that a surgical drill would always be used for this
this procedure. As a general rule, do not
 Sheet Music report the -22 unless the
t he documentation clearly indicates that there was something about this
Download Now 4 of 54
particular case that made the procedure unusually
 Search document
unusually complicated. Also, the fact that the physician
physician 
started out to do a repair and ended up doing an excision does not necessarily mean that the
excision in this case was “unusually complicated” as compared to other turbinate excision
procedures.
22. A patient presented to the emergency room with an acute pneumothorax. The ER physician
performed a thoracentesis with insertion of a tube under CT guidance. The hospital owned the CT
machine. How should the physicianYou're
report forReading a Preview
these surgical
surgical services?
a. 512.0, 32551, 77012-26 Upload your documents to download.

b. 512.8, 32422, 77012-26
c. 512.0, 32422, 75989-26 OR
d. 512.8, 32551, 75989-26
Become a Scribd member for full access. Your
Learn more about “b” Although this procedure is labeled
labeled a “separate procedure” it should be reported since it was
 first 30 days are free.
Scribd Membership not performed as a component of a more comprehensive service. CPT code 32551 is for a tube
tube
thoracostomy. An “ostomy” is a surgically created opening. In this question the patient
underwent thoracentesis which is a punctureContinue for
of a cavity to Free
remove fluid.
 Home
23. Clara has had trouble breathing for two days. Her primary care physician referred her to an ENT.
The ENT performed a diagnostic maxillary sinusoscopy.
sinusoscopy. How should the sinusoscopy be reported?
 Saved
a. 31237
b. 31231-50
c. 31233
 Bestsellers
d. 31256-RT
 Books “c” This was a diagnostic procedure that involved the insertion of an endoscope
endoscope into a maxillary
sinus. In the absence of further documentation, the coder must assume that this was a unilateral
procedure.
 Audiobooks


 Snapshots Copyright 2000-2012 HCPro, Inc. All rights reserved. These materials may not be duplicated without the express
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American Medical Association.  Useful  Not useful
 Sheet Music

24. Beverly had been hoarse for two weeks.

weeks. Her surgeon scheduled a direct
direct laryngoscopy with
injection of her vocal cords. During the surgery it became necessary for
for the surgeon to use an
operating microscope. How should the physician’s
physician’s services be reported?
Learn more about a. 31571

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 b. 31570, 69990
c. 31513-50
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