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Basic Procedural Coding

Chapter 4 Exam

1. Operative Report

Procedure: Excision of back lesion

Indications for Surgery: The patient has an enlarging lesion on the upper midback.
Findings at Surgery: There was a 5-cm, upper midback lesion.
Operative Procedure: With the patient prone, the back was prepped and draped in the
usual sterile fashion. The skin and underlying tissues were anesthetized with 30ml of
1%
lidocaine with epinephrine. Through a 5-cm transverse skin incision, the lesion was excised.
Hemostasis was ensured. The incision was closed using 3-0 Vicryl for the deep layers and
running 3-0 Prolene subcuticular stitch with Steri-Strips for the skin. The patient was
returned to the same-day surgery center in stable postoperative condition. All sponges,
needle, and instrument counts were correct. Estimated blood loss is Oml.
Pathology Report Indicates: Dermatofibroma, skin of back .

Assign codes(s) for the physician service only:

a. 11406, 12002
b. 11424
c. 11406, 12032
d. 11606

2. What CPT code would be used to code the destruction of a malignant lesion
on the skin of the female genitalia measuring 1.6 em using cryosurgery?

a. 17272
b. 11602
c. 11420
d. 11622

3. Libby was thrown from a horse while riding along the side of the road; a truck that honked
the hom as it passed her startled her horse . The horse reared up, and Libby was thrown to
the ground. The condyle of her left tibia was fractured and required insertion of multiple
pins to stabilize the defect area. A Monticelli multiplane external fixation system was then
attached to the pins. Code the placement of the fixation device only.

a. 20661-LT
b. 20692-LT
c. 20692-RT
d. 20690-LT
Basic Procedural Coding
Chapter 4 Exam

4. The patient is in for a bone marrow biopsy. The patient was sterilized by standard
procedure . Bone marrow core biopsies were obtained from the left posterior iliac crest with
minimal discomfort. At the end of the procedure, the patient denied discomfort, without
evidence of complications . The patient has diffuse, malignant lymphoma.

Assign codes for the physician service only.

a. 20225
b. 38221
c. 38230
d. 38220

5. Connie was brought to the operating room for repair of an acute, traumatic
diaphragmatic Hernia.

a. 39540
b. 39503
c. 39541
d. 39540

6. What CPT code would you use if the physician performs a pyloroplasty and vagotomy in the
same surgical session?

a. 43865
b. 50400
c. 43635
d. 43640

7. This 43-year-old female come in with peritonsillar abscess. The patient is brought to the
same-day surgery and given general anesthesia. On examination of the peritonsillar
abscess, an incision was made and fluid was drained. The area was examined again, saline
was applied, and then the area was packed with gauze. The patient tolerated the procedure
well .

a. 42825
b. 42700
Basic Procedural Coding
Chapter 4 Exam

8. This 70-year-old male is brought to the operating room for a biopsy of the pancreas. A
wedge biopsy is taken and sent to pathology. The report comes back immediately indicating
that primary malignant cells were present in the specimen. The decision was made to
perform a total pancreatectomy.

Code the operative procedure(s) only for physician services.

a. 48100
b. 48155
c. 48155,48100-51
d. 48155,48100-51,88309

9. The pediatric physician takes this newborn male to the nursery to perform a
clamp circumcision.

a. 54160
b. 54150

10. This 32-year-old female presents with an ectopic pregnancy. The physician elects to
remove the entire fallopian tube with the products of conception laparoscopically.

a. 59120
b. 59151
c. 58943

11. This 66-year-old male has been diagnosed with senile cataract of the posterior subcapsular
and is scheduled for a cataract extraction by phacoemulsification of the right eye. The
physician has taken the patient to the operating room to perform a posterior subcapsular
cataract extraction with IOL placement, diffuse of the right eye.

a. 66982-RT
b. 66984-RT
c. 66983-RT
d. 66830-RT
Basic Procedural Coding
Chapter 4 Exam

12. What CPT code would you assign to report the removal of30% of the left
thyroid lobe, with isthmusectomy?

a. 60210
b. 60220
c. 60212
d. 60225

13. The patient was taken to the operating room for a repair of a strangulated inguinal hernia.
This hernia was previously repaired 4 months ago.

a. 49521
b. 49520
c. 49492
d. 49521-78

14. A patient is seen with difficulty breathing due to deviated nasal septum. The
surgeon performs a submucous resection of the septum.

a. 30520
b. 30620
c. 30630
d. 30140

15. Nephrolithotomy for removal of kidney stones.

a. 50045
b. 50060
c. 50040
d. 50075
Basic Procedural Coding
Chapter 4 Exam

True or False

_ 16. Treatment of a medial malleolus fracture would be found in the knee section of the
musculoskeletal system in CPT.
 17. A surgeon would perform strabismus surgery on a patient who is diagnosed with
crossed eyes.

18. A surgeon removes a 2.0 seborrheic keratosis of the neck. This lesion is defined
as a malignant lesion.

_ 19. To control a nasal hemorrhage a physician could perform cautery and

packing either simple or complex.

__ ;20. There is only one code for a colonoscopy with removal oftumor(s), polyp(s),
or other lesion(s).

21. The CPT code for blood transfusion(s) are found in the Cardiovascular
System subsection of the surgery section.

22. Nerve blocks are often performed to provide post surgical pain relief.

23. Tympanostomy (requiring insertion of ventilating tube) has a different CPT

code depending if the procedure is done using local or topical anesthesia or
done under general anesthesia.

24. It would be appropriate to add modifier 50 to CPT code 52290.

; 25. A fetal non-stress test codes to CPT code 59025 and is found under the
Female Genital System in the CPT book.
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