MOCK-13

Anatomy:

1. How does Hodgkin’s lymphoma differ from non-Hodgkin’s lymphoma?

a. The type of treatment the patient had in the past six weeks for an infarction.
b. Hodgkin’s is a respiratory disorder that is only non-cancerous.
c. It is staged as low-grade or high-grade bladder system disorder detected only in males.
d. It is distinguished by the presence of Reed-Sternberg cells.

2. What does the hard palate of the mouth form?

a. A separation between the interior and exterior portion of the nose

b. A barrier between the tonsils and the adenoids
c. The floor of the nasal cavity separating the nasal and oral cavities
d. The separation of the nasal septum

3. The nervous system can be grouped into what two major categories?

a. Parasympathetic and sympathetic nervous systems

b. Somatic and norepinephrine nervous systems
c. Efferent and peripheral nervous systems
d. Central and peripheral nervous systems

4. What are the main functions of the integumentary system?

a. Sensation, protection, thermoregulation, and secretion

b. Sensation, protection, secretion, and exchange of gases
c. Sensation, secretion, fluid exchange, and thermoregulation
d. Sensation, elimination of solid waste, and protection

Medical terminology

5. Mobilization of an organ by freeing adhesions is referred to as?

a. irrigation b. Fusion c. extraction d. Lysis

6. Bleeding from the bladder is best described by which term?

a. Cystoptosis b. Cystorrhagi a c. Cystorrhaphy d. Cystorrhexis

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 7. Which term means the tissue death of an artery or arteries?

a. Atherostenosis
b. Arterioscleros is
c. Atherosclerosis
d. Arterionecrosis

8. Which term describes a surgical puncture of the eardrum?

a. Thoracentesis c. Tympanocentesis
b. Arthrocentesis d. plurodesis

ICD 10 cm

9. While at church, Fred was standing on a chair when he fell. He suffered a closed Colles’
fracture and contusions to his right cheek, right elbow, right hand, and left leg. What codes
would you report for this injury?

a. S00.83XA, S52.531XA, S52.539A, S80.11XA, W07.XXXA , Y92.29

b. S52.539A, S00.83XA, S50.01XA, S60.221A, S80.12XA, W07.XXXA,Y92.22
c. S52.531A, S00.83XA, S50.01XA, S60.221A, S80.12XA, W07.XXXA,Y92.22
d. S00.83XA, S50.01XA, S52.539A, S80.11XA, W07.XXXA , Y92.29

10. Dr. Lloyd, Bill’s family physician, preformed a physical on Bill in December. Dr. Lloyd noted Bill
had swollen glands, changes in blood tests and on chest x-ray, as well as the patient’s report of
general fatigue and weight loss. Bill was scheduled to see a specialist the following week.
Dr.Schapiro, the specialist, examined Bill, performed tests, and told him he had metastatic
malignant melanoma from the left lateral chest wall to the cervical lymph nodes. Today, Bill
started treatment with Dr. Schapiro directed to his lymph nodes. What are the correct
diagnoses codes For Dr. Schapiro’s treatment?

a. C79.89, C79.10  b. C79.00, C49.3  C. C79.19, D03.52  d. C77.0, D03.59 

 
11. Roger, a firefighter, was burned while fighting a forest fire. He is being treated in a burn unit, with
burns to 30% of his total body surface area. The burns are reported as third degree to 25% of his
body. The remaining 5% are first- and second-degree burns of the upper limb. How should you
report the diagnoses codes?

a.T31.32, T22.20XA, T22.10XA, X01.8XXA

b. T22.20XA. T31.31, X01.0XXA
c. T31.32, T22.20XA, X01.8XXA
d. T31.31, T22.20XA, T22.10XA, X01.8XXA

12. Rosemary, a 52-year-old female, returned to her physician for treatment of glaucoma and
prob- lems with peripheral angiopathy of her feet due to diabetes. She has had problems
controlling her diabetes and is insulin dependent. Which diagnosis codes best describe this
patient’s condition?

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 a. E10.39, E10.51, H40.9, Z79.4
b. E08.39, E08.51, H42, Z79.4
c. E11.51, E11.39, H42, Z79.4
d. E10.39, E08.51, H40.9, Z79.4

13. Karen, a 26-year-old healthy female, suffered a cardiac arrest with administration of anesthetic
during delivery. What are the correct diagnoses codes?

a. O74.2, I46.9 b. I46.9, O74.2

c. O74.4, I46.9 d. O74.9, I46.9

HCPCS

14. Amy receives her new prosthetic wrist disarticulation, molded socket with expandable interface,
flexible elbow hinges, triceps pad with an upper extremity addition, disconnected locking wrist
unit. How would the facility report the HCPCS Level II codes?

a. L6055, L6615 b. L6055, L6616

c. L6050, L6615 d. L6050, L6616

15. Bryce was burned on his left upper arm and requires a graft of nine sq. cm of tissue. He is being
treated with dermal and epidermal tissue substance of human origin, Apligraft. What HCPCS
Level II code should you report?

a.Q4101x 9 c. Q4106 x7
b. J7330 d. Q4101x4

16. A75-year old patient with a history of malignant neoplasm of the lower gastrointestinal trace
presents for his follow-up colorectal cancer screening. Today, he has a colonoscopy. What HCPCS
Level II code describes this procedure?

a. G0104 c.G0120
b. G0105 d.G0121

CODING GUIDLINES

17. Stand-alone CPT codes have a full description; indented codes are listed under related stand-
alone codes. An indented code includes the portion of the stand-alone code description, which
precedes the semicolon. The semicolon is used in the CPT book to save space. Words following
the semicolon can specify which of the following?

a. Extent of the service, modifiers, specific anatomic site

b. Extent of the service, specific anatomic site, unlisted services
c. Extent of the service, specific anatomic site, alternative procedure

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 d. Unlisted services, alternative procedures, specific anatomic site

18. Physical status modifiers are appended to codes listed in which major section of the CPT book?

a. Evaluation and Management

b. Anesthesia
c. surgery
d. Medicine

19. What are the two sections don’t report in addition to lesion excision

a. local anesthesia and simple closure

b. Local anesthesia and intermediate repair
c. Local anesthesia, simple closure and intermediate repair
d. Local anesthesia

20. True or false: The following is an example of a correct code combination: The placement of a
nasogastric tube is reported with Evaluation and Management (E/M) critical care code.

a. True b. false

21. The term “intra-service time” has been measured in studies and is predictive of the work associ-
ated to E/M services. Intra-service times are defined as face-to- face time for office and other
outpatient visits and as unit/floor time for hospital and other inpatient visits. What is included in
the intra-service time for an office and other outpatient visits?

a. Time in which the physician obtains a history, performs an examination, provides patient
counseling
b. Time in which the physician establishes/reviews the patient’s chart and communicates with
other professionals regarding the patient’s family
c. Postoperative discussions, working with physical therapy departments, and counseling
d. Counseling/coordinating care that dominates more than 50% of the time with a patient

22. Panel tests in the Pathology and Laboratory section of the CPT book include all the codes listed
with the panel description. When a panel is performed, and additional Pathology/laboratory tests
are completed how should those additional tests be reported?

a. All tests are bundled when performed with a panel

b. Reporting additional tests is up-coding and could flag an audit that always leads to
financial penalties
c. Both a and b
d. The additional test should be reported separately in addition to the panel code

23. True or False: unlisted procedures are the services or procedures provided by physicians or
other qualified health care professionals that are not found in the CPT code set

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 a. True b. false

HIPAA

24. A critical ill patients transfer to the super specialty hospital from emergency department of the
rural hospital and the ambulatory assistance provided for the patient which HIPPA plan cover this
entity

a. Part A c. Part C
b. Part B d. Part D

25. One of the examples of ABN is- If the doctor or supplier does give you an ABN that you sign
before you get the service and Medicare does not pay for it then you will have to pay your doctor
or supplier for it.
a. True. b. False

26. What is the eligibility for Medicare system?

a. People who are older than 65 age and ESRD patients

b. Low-income people
c. Newborn
d. Pregnant ladies

INTEGUMENTARY

27. A patient presents for an incision and drainage of a pilonidal cyst. What is the correct code for
these services?

a.10060 c.10080
b.10061 d.10081

28. Heather presents for removal of three benign sebaceous cysts. The first lesion excised from her
leg is three cm (which requires a four cm incision). The second lesion excised from her abdomen
is five cm (which required a 5.5 cm incision). The third lesion excised from her scalp is 0.5 cm
(which required a one cm incision). The physician performed intermediate layered closure to the
wound on her abdomen. The other wounds were repaired by simple closure. What are the cor-
rect code(s) for these services?

a. 12032, 11406-59, 11403-59, 11420-59

b. 12032, 11406-51, 11403-51,11420-51
c. 12032, 11406 x 2, 11402
d. 12032, 11406-51, 11403-59, 11420-59

29. A splinter is removed from the subcutaneous tissue of a patient’s index finger through an incision
made by the physician. The medical record states that this was a complicated procedure. How

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 should the physician code this procedure?

a.10121 b.10120
c.11010 d.11011

30. On January 31st, Barbara had a two cm malignant lesion excised from her left foot. During a
postoperative check-up on February 2nd, a residual tumor was noted at the margin of the origi-
nal excision and the margins were re-excised. The re-excision included a three cm excised
diameter. How would the same physician code there- excision?

a. 11622, 11623-59
b. 11626
c.11623- 59
d.11623- 58

31. Dr. Smith completed an extensive debridement due to infected skin. The patient was an 18-year-
old who was fully cooperative. The debridement included 13% of the total body surface including
portions of his abdominal wall. How would you code Dr. Smith’s services?

a. 11005,11001-59 b. 11000,11001-52
c. 11000,11001 d. 11005
32. Dr. Faye, a dermatologist specializing in Moh’s completed surgery on Howard’s right thigh for an
ill-defined skin cancer. Dr. Faye is acting as both the surgeon and pathologist for this surgery.
The surgery consisted of nine excised specimens prepared and examined during stage one.
Additionally, a total of seven excised specimens were prepared and examined during stage two.
How would you code Dr. Faye’s services?

a. 17311, 17312 x 6
b. 17313,17314,17315x6
c. 17313, 17314 x 6
d. 17311, 17312, 17315

MUSCULOSKELETAL SYSTEM

33. A surgeon performed a radical resection of both a malignant tumor from the soft tissue of the
scalp and a malignant tumor of the mandible. A bone graft was completed during the same
surgical session to the mandible. How would the surgeon code this procedure?

a. 21015, 21215-51, 21045-51

b. 21015, 21045-59,21215-51
c. 61501, 21045, 21215
d. 61501, 21045-59, 21215-51

34. During a postpartum check-up, Kayla told Dr. Terry, her OBGYN, about a recurrent lump on her
right wrist. Kayla has a history of ganglion cysts on both wrists. Dr. Terry refers Kayla to Dr.
Eagan, a general surgeon, who excises the cyst. How would you code Dr. Eagan’s services?

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 a. 25112- RT
b.26160
c.25111
d. All services are included in postpartum care and should not be reported separately

35. A patient has been diagnosed with Treacher-Collins Syndrome. A surgeon performs LeFortII to
reconstruct the midface by anterior intrusion. How would you code for the surgeon’s services?

a. 21150-22 b. 21141
c. 21150 d. 21151

36. Judy noticed swelling in both her hips. She is referred to Dr. Roy, an orthopedic surgeon, who
performs a fasciotomy on both hips. Prior to surgery, Dr. Roy obtains the patient’s permission to
have a resident observe the surgery. What is the correct code for Dr. Roy’s services?

a. 27025x2 b.27025- 50
c. 27025 d. 27025-80

37. Zachery injured his back while playing tennis; his injury required surgery. He was taken to the
operating room where an orthopedic surgeon preformed an anterior osteotomy, including
discectomy to three thoracic vertebral segments. Additionally, Zachery required a structural bone
graft obtained from a cadaver. How would you code this procedure?

a. 22222, 22226 x 2,20931 b. 22226, 22222,20931-51

c. 22216, 22212, 20938 d. 22212, 22216 x 2, 20938-51
38. A patient noticed a mass on his neck. He was referred to a general surgeon who determined that
the mass was a five cm soft tissue lipoma. The surgeon took the patient to the operating room
and removed the lipoma. The surgeon dictated in the operative report that the procedure was
deep. How would you code the surgeon’s services?

a.21554 b.21555
c. 21554,15819-51 d. 21555,15819-59

CARDIOVASCULAR AND RESPIRATORY

39. Riley suffers from recurrent sinus infections. He underwent the following procedure to remove
pus from the right sphenoid sinus. His physician entered the sphenoid sinus through the spheno-
ethmoidal recess in the superior nasal cavity. A flexible cannula was inserted into the opening
and the right sinus was irrigated with saline solution. What is the correct code for this procedure?

a. 31002- RT b.31000-RT
c. 31299 d. 31002-50

40. How is an endoscopic diagnostic bronchoscopy coded if it is performed by the same physician
during the same session as a surgical bronchoscopy?

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 a.3162 2 b.3162 4 c.3162 5
d. Surgical bronchoscopy includes a diagnostic bronchoscopy when performed by the
same physician in the same session.

41. Mr. Garrett was seen by his cardiologist, Dr. Kelly. During the examination, Dr. Kelly talked with
Mr. Garret and his family about the need for a pacemaker and its benefits for Mr. Garret’s condi-
tion. Mr. Garrett was scheduled for the procedure the following day. Dr. Kelly inserted a perma-
nent pacemaker, pulse generator, and placed a transvenous electrode in the ventricle. What
code indicates this service?

a.33207 b.33208 c.33210 d.33220

42. Polly had the battery changed for her single chamber permanent pulse generator, which was
inserted one year ago. This procedure was completed in the same session by the same provider.
How should the provider’s services be coded?

a. 33233,33212-59 b. 33233,33212-51
c. 33234, 33213-59 d. 33227

43. A physician performs a lymphangiography bilaterally to the extremities. She also provides the
radiological supervision and interpretation for this procedure, which was completed in a hospital
setting. How would you code the physician services?

a. 38790,75801
b. 38792,78195
c. 38790-50,75803-26
d. 38790-50,75801-26
44. A physician performs a transluminal balloon angioplasty of the left iliac by inserting a catheter
through the skin. The balloon is inflated several times during this procedure. The physician did
not provide the radiological supervision and interpretation with this procedure. Which code indi-
cates this service?

a.36902
b.37224
c. 36901,37220
d. 37220

DIGESTIVE SYSTEM

45. Dr. Barns excised a four cm esophageal lesion with primary repair. To excise the lesion Dr. Barns
made an upper midline abdominal incision to access the esophagus. The surgical site was closed
with two layers of sutures. What code(s) indicate this service?

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 a. 43116, 21720
b. 43101, 11424-59, 12042-51
c. 43116, 69990
d. 43101

46. A patient presents with gastroesophageal reflux disease. To treat this disorder, the surgeon
performs a laparoscopic Nissen procedure. A diagnostic laparoscopy was completed during the
same session. What code(s) indicate this service?

a.43280 b.43289
c. 43325 d. 43280, 43325-52

47. Sam, a healthy 32-year-old male, is scheduled for surgery. He has no systemic diseases, doesn’t
smoke, and regularly exercises. He is prepped and taken into the operating room. The surgeon
performs an endoscopic retrograde cholangiopancreatography with endoscopic retrograde in-
sertion of naso-biliary drainage tube. Within the same operative session, the surgeon also per-
forms a sphincterotomy. How would you code this service?

a. 43276-P1 b. 43260, 43276-51, 43262-51

c. 43274, 43262-51 d. 43274

48. Jim presents to Dr. Martin’s office with severe abdominal pain. Dr. Martin has not made a defini-
tive diagnosis. He schedules Jim for diagnostic laparoscopy that same afternoon. Dr. Martin
begins the operation with a diagnostic laparoscopy. He notices Jim has a vermiform appendix.
Dr. Martin removes the appendix laparoscopically. The final diagnosis is appendicitis. What code(s)
capture these services?

a. 44950, 49320-51 b. 49320

c. 44970 d. 44970, 49320-51

49. Dr. Mist performed the following procedures on a patient: a flexible diagnostic colonoscopy with
collection of eight specimens by brushing in the morning. Later the same day, the patient had a
diagnostic upper gastrointestinal endoscopy (EGD), including the esophagus, stomach, and the
jejunum with transmural drainage of a pseudocyst. These procedures were not staged or related
and occurred during different sessions. What codes capture these procedures?
a. 45380 x 8,43240-58
b. 43239 x 8,44388-59
c. 45378,43240-59
d. 45388,43235-59

50. Dean lost his teeth in an auto accident one year ago. He has had several facial surgeries to
restore his nasal function and rebuild the orbit of his eye and cheek. Currently, he is scheduled
for a posterior complex vestibuloplasty with muscle repositioning. What code(s) capture the
current procedure?

9
 a. 40845
b. 40843-52
c. 40842, 40845
d. 40899

URINARY SYSTEM

51. Mary underwent a bilateral vulvectomy with removal of 92% of the vulvar area. She also had an
inguinofemoral lymphadenectomy during the same operative session. What code(s) capture
these services?

a. 56637-50
b. 56637
c. 56632
d. 56625, 38760

52. A physician performs laser vaporization of the prostate with a vasectomy. The patient had some
postoperative bleeding that was controlled at the time of the procedure. What code(s) capture
this service?

a. 52648
b. 52601, 52648-51
c. 52647-22
d. 52601, 52648-51, 54162-59

53. Cheryl is a 36-year-old established patient with Dr. Winn, an OBGYN. During Cheryl’s annual
physical examination, Dr. Winn noticed lesions on the perineum. After completing the annual
exam, Dr. Winn biopsies five lesions on the perineum. How should his office code the service for
the biopsy?

a. 56605, 56606 x 4
b. 99395, 56605, 56606 x4
c. 56606, 56606-51
d. 99395, 56606, 56606-59

54. Mr. Bill has urinary incontinence. The urologist performs an anterior vesico urethropexy to
correct the incontinence. The physician documented that this was a complicated repair. What
code captures this service?

a.51840 b.51841
c.53440 d.53899
55. How would Dr. Jay report her services for an injection procedure for retrograde urethrocystography
with radiological supervision and interpretation? She completed this procedure in a hospital sur-
gical suite.

10
 a. 51610
b. 51610, 74430-26
c. 51605,74450-26
d. 51610,74450-26

56. Mrs. Jones is pregnant with twins. She has been with the same obstetrician, Dr. Green, for her
entire pregnancy. Now, Mrs. Jones is ready to deliver. Dr. Green helps Mrs. Jones deliver her
twins vaginally. What are the correct codes for these services?

a. 59400, 59409-51
b. 59400-22
c. 59610-22
d. Both b and c

NERVOUS SYSTEM

57. Todd was in a motorcycle accident. He suffered multiple fractures and lacerations. During one
surgical session, a surgeon elevated a depressed skull fracture. This procedure required repair
of the dura. What code(s) capture these services?

a.62010 b.62000
c. 62005 d. 62005, 62010

58. A physician obtains corneal tissue from an eye bank and sizes the tissue for transplant. The
physician then performs a lamellar keratoplasty. He removes the anterior layer of the diseased
cornea and replaces it with the prepared donor tissue. What are the correct codes for these
services?

a.65710 b.65755
c. 65426, d. 65710, 68371

59. Mr. Keller had a six cm neoplastic lesion at the base of the anterior cranial fossa excised. The
lesion was not connected to the dura matter. Dr. Roberts, a neurosurgeon, excised the lesion.
Dr. Reed preformed an extradural craniofacial approach to the anterior cranial fossa without
orbital exenteration. What is the correct code for the excision procedure?

a. 61580,61600-51
b. 61600,61580-58
c.61580
d.61600

60. Today, Terri had a re-exploration procedure of the thoracic region of her spine. This procedure is
rarely performed but has FDA approval. Terri has signed extensive consent forms and under-
stands the risks involved. She and her surgeon believe this procedure might offer her pain relief.
What is the correct code for this service?

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 a. 64999 b. 63003-52
c. 63046 d. 63271

61. Two-year-old Bobby was running through the house with a Popsicle when he fell, suffering a
three cm partial thickness laceration to his left upper eyelid. This injury involved the lid
marginand tarsus. Bobby was taken to an emergency room by his parents and the physician did
a directlayered closure. How would you code the physician’s service?

a. 2-E1 b.12002- LT
c.67935- E1 d.67930- E1

62. A physician excised multiple chalazions on bilateral eyelids. The procedure required general
anesthesia. At the same session, the physician excised another non-chalazion lesion on the
right eyelid, which required simple closure. What codes correctly capture the surgeon’s ser-
vices?

a. 67808, 67805-51, 67840-51

b. 67808-50, 67840-59
c. 67805-50, 67808-50, 67840-59
d. 67808, 67850-51, 67840-51, 11310-51

63. Mr. Fisher was referred by his internist to a surgeon’s office for a consultation regarding
hemorrhoids. The surgeon noted the request tofor consult in his medical record and sent a
letter back to the referring physician. The decision making was of low decision-making. The
surgeon recommended medical treatment and prescribed two different ointments and an oral
medication. He suggested re-evaluation if the hemorrhoids caused Mr.Fisher problems in the
future or if he continued to have active symptoms. What code correctly captures the surgeon’s
services?

a. 99243  b.99242  c.99203  d.99214 

 
64. Dr. Lyon was called to the critical care burn unit to see a 50-year-old patient who suffered third-
degree burns to 30% of her body. Dr. Lyon spent two hours and 40 minutes with this patient, her
family, and coordinating care with other specialists. He made several phone calls from the unit
on her behalf and consulted with the nursing staff. During this time, Dr. Lyon provided ventilator
management and gastric intubation. What codes correctly capture Dr. Lyon’s services?

a. 43752,  99291 x 1, 99292x 3  b. 99291 x 1, 99292 x 3 

c. 99291 x 2, 99292 x 2  d. 43753, 99291 x 1, 99292 x3 
 
65. Edna,  an  80‐year‐old  patient,  had  a  stroke  with  late  effect  hemiplegia  to  her  dominant  side.  She  was 
transferred from the hospital to a nursing facility. Dr. George, an internist, documents the high risk of 
complications due to extensive medications and management of multiple systemic diseases. Dr. George 
talks  with  the  multidisciplinary  rehabilitation  team  regarding  Edna’s  physical  activities,  including  a 
planfor physical therapy. What are the correct codes for Dr. George’s visit? 
 

12
 
 
a. 99306, I69.351  b. 99306, I69.359 
c. 99305, I69.353  d. 99306, I69.352 
 
66. Alex moved back to the area after being out‐of‐state for six years. He returns as a patient to Dr.Ben, his 
previous internist. Dr. Ben sees Alex in the office for an evaluation of his asthma. Dr.Ben documents a 
decision‐making  of  low  complexity.  Several  hours  after  Alex  left  the  office  he  returns  because  he  is 
having difficulty breathing and has hives after using his new inhaler. Dr. Ben admits Alex to the hospital. 
He dictates a high decision making in the admission report. Additionally, Dr. Ben instructs his staff to fax 
a copy of his office note to include in the hospital record for admission. What code(s) correctly capture 
Dr. Ben’s service? 
 
  a. 99203      b. 99222    c. 99203‐25,99223  d. 99205  
 
67. A  healthy  22‐year‐old  female  is  seen  for  her  annual  examination.  She  is  new  to  this  clinic  and  this 
physician. She is taking no medication, has no family history of systemic disease, and states that she is 
smoking but trying to stop. During her annual exam she asks the physician to look at a mole on her upper 
right  arm  that  has  changed  in  appearance.  The  physician  documented  straight  forward  decision‐ 
making. The physician instructs her to watch the mole carefully and report any further changes. What 
code(s) correctly capture this encounter? 
 
a. 99285              b. 99395,99203                    c. 99385, 99202‐25  d. 99203 
 
 
68. Lilly, a 36-year-old female, made an appointment to talk with her physician about prevention of
sexually transmitted diseases including HIV. She saw the same physician three months ago for
a complete physical. She is asymptomatic at this time but has engaged in some high-risk behav-
ior. During this visit, Lilly discussed diagnostic and laboratory test results, family issues, sub-
stance abuse, and sexual practices. The visit lasted 30 minutes. What code correctly captures
this encounter?

a. This service is bundled with the next office visit

b. 99078
c.99395
d.99402

Anesthesia

69. When does anesthesia time begin and end?

a. Time begins when the anesthesiologist begins to prepare the patient for the induction of
anesthesia in the operating room or in an equivalent area. Time ends when the anesthesiolo
gist is no longer in personal attendance and when the patient may be safely placed under
postoperative supervision.
b. Time begins when the anesthesiologist begins to prepare the patient for induction of anesthe

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 sia in the operating room or chair side in a waiting area. Time ends when the patient can
respond to simple questions.
c. Time begins when the anesthesiologist starts to prepare the patient for induction of anesthesia
in the operating room or in an equivalent area. Time ends when the anesthesiologist leaves
the operating room.
d. Time begins when the patient is considered “under” anesthesia and ends when the surgery
site is closed.

70. An anesthesiologist administers general anesthesia to a one-year-old healthy patient undergo-

ing a mediastinoscopy. What code(s) capture the anesthesia services?

a. 00528-P1,99100 b. 00528,99100- P1 c. 00528 d. 00528-P1

71. A five‐year‐old patient lacerated his forehead. He presents to the emergency room with his parents. 
It  is  determined  that  the  patient  will  need  multiple  sutures  to  repair  the  wound.  The  patient  has 
Down’s syndrome and is unable to cooperate with the medial staff. His parents’ consent to general 
anesthesia  for  the  wound  repair.  After  general  anesthesia  intermediate  sutures  are  completed  to 
repair the six cm wound. What code(s) correctly capture this service? 
 
a. 00210‐ 23         b. 12053‐ 23      c. 12053, 00190  d. 00210‐P1, 99100 
 
72 A patient presents to the hospital with an embedded piece of wood in his left shoulder. The
patient stated that he was cutting down a tree when a limb fell and punctured his shoulder. Dr.
Weber, a surgeon, administered general anesthesia for removal of a foreign body to a patient
shoulder. What code captures the surgeon’s services?

a.23330- 22 b.00450- P1
c.23330- 47 d.00450- 47

RADIOLOGY

73. Dr. Jones owns the x-ray equipment in his office and serves as the employer to the technologist.
He ordered a three- view film of Paula’s zygomatic bone. He reviewed the films and dictated a
report while she was in the office. What code captures Dr. Jones ‘services?

a. 70150-26 b. 70150
c. 70150-TC d. 70150-52

74. Dr. White ordered an MRI of Jerry’s pelvis without contract. Jerry went to the local outpatient
imaging center for this study. The MRI was completed and read by Cardiologist at the imagining
center. A complete report was sent back to Dr. White. What code captures the radiology service?

a.72196 b.7219 5
c.72195-26 d. 72198

75. Becky reported to her physician’s office after feeling a lump in her right breast. Dr. Sarah had the
results of Becky’s last screening mammography, which did not show any changes. Dr. Sarah

14
 completed an exam and detected a lump in the right breast and abnormal changes in the left
breast. After a complete work-up Dr. Sarah ordered a bilateral diagnostic mammography with
computer aided detection. What code(s) correctly capture the mammography?

a. 77047,77062 b. 77066
c. 77047, 77062 d. 77047

76. A 45-year-old female patient had abdominal pain for several days. She had a hysterectomy one
year ago with no complications. During her office visit she had a complete pelvic ultrasound.
What code correctly captures this ultrasound?
a.76801 b.76816 c.76857 d.76856

77. Mr. Fredrick is in his second phase of radiation treatment for stomach cancer. Today, he reports
to the cancer treatment facility for his regularly scheduled treatment. He is given seven MeV to a
single area that requires a single port and a simple block. How should the facility report this
service?

a.77412 b.77402
c. 77417 d. 77402-TC

78. Tiffany is pregnant with twins after a successful IVF treatment. She is in her first trimester of
pregnancy. Her physician completed a transabdominal follow-up ultrasound to evaluate the fetal
size of both babies and review a suspected abnormality from a previous ultrasound. What code(s)
correctly capture this service?

a. 76816, 76816-59
b. 76816 x 2
c. 76801, 76802 x 2
d. 76811, 76812

PATHOLOGY

79. Dr. Bob verbally requested Dr. Heinz, a clinical pathologist, to provide a consultation for one of
his patients. Dr. Heinz provided a limited review of the patient’s history, medical records, and
sent a written report back to Dr. Bob. Which code correctly captures Dr. Heinz’s services?

a.80503 b.88321
c.80505 d.99255

80. Dr. Shaw performed an electrolyte panel on automated equipment in her office. The tests she
includes in this panel are sodium, potassium, chloride, carbon dioxide, and glucagon tolerance
test. How should she report these services?

a. 82374, 82435, 84132, 84295, 82946

b. 80051, 82946
c. 80051 d. 80053-52

15
81. A patient has been taking Digoxin, per his prescription, for several weeks. Two days ago he ran
out of his medicine and stopped. He knew he had an appointment with his physician and decided
to wait until his next checkup to get a new prescription. His physician ordered a quantitative drug
assay to check the therapeutic level of Digoxin total still present in the patient’s blood. What code
correctly captures this service?

a.80170 b.80162
c.80157 d.80163

82. Which CPT code describes a lab test for Prostate specific antigen (PSA);total?

a. 86316 b.84154 c.8415 3 d.8415 2

83. A 22-year-old female presents in the emergency department in a coma. Her friends tell the
attending physician they were drinking and saw her take a couple of pills before she passed out.
She has a history of depression and anxiety and is being treated with prescription medication.
The physician orders a drug screen for alcohol, tricyclic antidepressants, opiates, and barbitu-
rates. The lab completes a single drug class screening for each analyte with direct optical obser-
vation by means of immunoassay methods. What code(s) correctly capture the lab services?

a. 80306 x4 b. 80305 c. 80305x4 d. 80307x2

84. A breast biopsy was submitted for surgical pathology gross and microscopic evaluation of the
surgical margins. A consultation, comprehensive examination and report was completed on the
specimen. What codes correctly capture the laboratory services?

a. 88307 b. 88307, 88325-26

c. 88305 d. 88305, 88323-26

MEDICINE

85. Mr. North presented for his weekly therapeutic visit with his physician. During this visit Mr. North
had a comprehensive computer-based motion analysis study with videotaping and 3-D kinemat-
ics, with dynamic plantar pressure measurements during walking. This study was completed to
assist with major therapeutic decision- making for continued gait training and rehabilitation after
a stroke. What code(s) should correctly capture this procedure?

a. 96001
b. 99214,96000
c. 97116
d. 97116, 96001-59

86. Dr. Edit preformed a percutaneous left heart catheterization with injection procedures for coro-
nary angiography and left ventriculography. Dr. Edit also completed the imaging supervision
interpretation and report. This procedure was completed in a hospital setting. How should Dr.
Edit code his services?

16
 a. 93458 b. 93452, 93454-26 c. 93458-26 d. 93452

87. Which services are included with hydration, therapeutic, prophylactic, and diagnostic injections
and infusions (excluding chemotherapy)?

a. Use of local anesthesia, IV start, access to indwelling IV, subcutaneous catheter or port
b. Flush at conclusion of infusion
c. Standard tubing, syringes, and supplies
d. All of the above

88. A physician performed a spirometry graphic record, timed vital capacity, and expiratory flow rate
measurements with maximal voluntary ventilation. What code captures this service?

a.94010 b.94014 c.9401 6 d.9401 5

89. Madison was attending a soccer camp when she complained of fatigue, dizziness, and a head-
ache. Her mother took her to Dr. Boyle’s office for a checkup that afternoon. Dr. Boyle completed
an expanded problem-focused history and examination, and then determined that Madison was
dehydrated. Madison received five hours of IV infusion. What codes capture these services?

a. 96360, 96361 x5 b. 96360, 96361

c. 96360, 96361 x 4 d. 99203, 96360 x 2, 96361 x 4

90. A patient with known hearing loss in the left ear presents for an audiometry threshold function
test with speech recognition. Calibrated electronic equipment is used for this testing procedure.
What code(s) capture this procedure?

a. 92557-22,69990 b. 92552-50,69990
c.92555-47 d.92556-52

CASE STUDY

91. Two weeks ago Mrs. Randy, a 62‐year‐old insulin dependent diabetic, trimmed her toenails and cut the 
skin  around  her  right  great  toe.  She  tried  to  keep  the  wound  clean  and  applied  over‐the  countar 
antibiotic cream for several days before the pain and inflammation was too severe wear shoes. Today, 
Dr.  French  admitted  Mrs.  Randy  to  the  hospital.  Dr.  French  requested  a  consult  from  Dr.  Wells,  a 
surgeon, regarding possible amputation of the toe. Dr. Wells saw Mrs.Randy and provided a moderate 
decision‐making. Her documentation included the request for consult and a written statement back to 
Dr.  French.  After  the  toe  was  amputated  Mrs.  Randy  healed  without  further  complications  and  was 
discharged  by  Dr.  French.  It  took  Dr.  French  more  than  an  hour  to  complete  the  discharge  visit. 
Whatcode(s) correctly capture the discharge? 
 
a. 99254‐25, 28820  b. 99239  c. 99239 x 2  d. 99223 
 
 
 

17
 
92. CHIEF COMPLAINT: Right inguinal hernia. 
This 44‐year‐old athletic man has been aware of a bulge And a pain in his right groin for over a year. He 
is  very  active,  both  aerobically  and  anaerobically.  He  has  a  weight  routine  which  he  has  modified 
because of this bulge in his right groin. Usually, he can complete his entire workout. He can swim and 
work without problems. Several weeks ago, in the shower he noticed there was a bulge in the groin, 
and he was able to push on it and make it go away. He has never had a groin operation on either side. 
The pain is minimal, but it is uncomfortable, and it limits his ability to participate in his physical activity 
routine. In addition, he Likes to do a lot of exercise in the back country and his personal provider.Dr. X 
told him it would be dangerous to have this become incarcerated in the back country . Dr x discussed 
observation and repair and documented mdm of low complexity. He is motivated toward repair and I 
described the operation in detail. I gave him the scheduling number, and he will call and arrange the 
operation.What CPT® and ICD‐10‐CM codes are reported? 
 
a.99202, K46.9  b.99203, K40.90  c.99204, K 40 .90  d.99205,  K46.9 
 
93. A patient presents to the hospital for a scheduled procedure to remove suspicious lesions from
the right side of her neck. The surgeon excised one lesion near the anterior portion of the man-
dible, the second near the clavicle bone. A pathologist received two separately labeled contain-
ers, container A-mandible, and container B-clavicle. The surgeon requests a consult during sur-
gery for immediate diagnosis. The pathologist examines each specimen, taking two blocks from
specimen A and three blocks from specimen B. Specimen A is further processed into two frozen
sections and B into five frozen sections. The blocks are examined microscopically. What codes
correctly capture the pathologist’s services?

a. 88331, 88332-26 x 2
b. 88331-26 x 2, 88332-26 x 3
c. 88331, 88332 x 7
d. 88329, 88331-47, 88332-26 x 2

94. Jeffery, a six-year-old established patient, was given a measles, mumps, rubella, and varicella
(MMRV) vaccination. This vaccination was completed the same day as his regularly scheduled
annual pediatric checkup. The physician completed all necessary paperwork and examination
for Jeffery. The physician provided face-to- face counseling with Jeffery’s mother, while she was
in the exam room with Jeffrey. The physician stayed in the exam room during the vaccine admin-
istration to continue to answer questions. What codes correctly capture the physician’s ser-
vices?

a. 99393, 90710, 90460, 90461x3

b. 90707, 90460
c. 99393, 90710, 90460
d. 90710, 90461

18
 95. A 25‐year‐old female presented to a physician’s office complaining of persistent abdominal pain This 
patient is new to this practice and this physician. The physician took a medical decision‐ making was of 
moderate complexity. The physician spent approximately 50 minutes with the patient. The physician 
spent 15 of those minutes counseling the patient on dietary changes. What code correctly capture is 
encounter? 
 
a.99205    b.99214  c.99204    d.99215 
 
96. Patient encounter reason: esophagoscopy Patient condition: esophageal inflammation Proce-
dure performed: esophagoscopy, flexible, trans oral for diagnosis of inflammation of esophagus
and also the physician perform collection of specimen from esophagus Description: Dr. Nicholas
performed a diagnostic flexible esophagoscopy to a 72-year-old patient with mild hypertension.
This service was completed in Dr. Nicholas’s office. He administered moderate conscious seda-
tion. The intra-service time was 60 minutes. What code(s) capture the physician’s services?

a. 43200, 99152, 99153 x 3 b. 43200-P2, 99100

c. 43200-23 d. 43191

97. Bart’s jaw needs to be set back. He consults with Dr. Todd, an orthopedic surgeon, and is sched-
uled for the recommended procedure. Dr. Todd reconstructs the mandibular rami by sagittal split
with internal rigid fixation. She uses a saw to cut the mandible bone along the inside, top, and
outside surfaces. Then, she uses osteotomes to pry the mandible bone apart along cuts in the
sagittal plane. Once separated, she moves the mandible into the desired position and stabilized
the bone with screws. She repairs a one cm incision site of the skin and mucosa membranes
with sutures. How would you code for Dr. Todd’s services?

a. 21196, 13131-51 b. 21195

c. 21196 d. 21196, 12001

98. Operative Report

PREOPERATIVE DIAGNOSIS: Squamous cell carcinoma, scalp. POSTOPERATIVE DIAGNO-

SIS: Squamous carcinoma, scalp.
PROCEDURE PERFORMED: Excision of Squamous cell carcinoma, scalp with Yin- Yang flap
repair ANESTHESIA: Local, using 4 cc of 1% lidocaine with epinephrine. COMPLICATIONS:
None.

ESTIMATED BLOOD LOSS: Less than 5 cc.

SPECIMENS: Squamous cell carcinoma, scalp sutured at 12 o’clock, anterior tip INDICATIONS
FOR SURGERY: The patient is a 43-year-oldwhite man with a biopsy- proven basosquamous
cell carcinoma of his scalp measuring 2.1 cm. I marked the area for excision with gross normal
margins of 4 mm and I drew my planned Yin-Yang flap closure. The patient observed these
markings in two mirrors, so he can understand the surgery and agreed on the location and we
proceeded.

19
 DESCRIPTION OF PROCEDURE: The area was infiltrated with local anesthetic. The patient
was placed prone, his scalp and face were prepped and draped in sterile fashion. I excised the
lesion as drawn to include the galea. Hemostasis was achieved with the Bovie cautery. Patho-
logic analysis showed the margins to be clear. I incised the Yin-Yang flaps and elevated them
with the underlying galea. Hemostasis was achieved in the donor site using Bovie cautery. The
flap rotated into the defect with total measurements of 2.9 cm x 3.2 cm. The donor sites were
closed, and the flaps inset in layers using 4-0 Monocryl and the skin stapler. Loupe magnification
was used. The patient tolerated the procedure well. What CPT® and ICD-10-CM codes are
reported?

a.14060, C43.31 b. 14040, C43.39

c. 14041, C44.42 d.14020, C44.42

99. PREOPERATIVE& POSTOPERATIVE DIAGNOSES: Macromastia, Back pain, Neck pain, Shoul-
der pain, Shoulder grooving, Intertrigo.

NAME OF PROCEDURE:
Right breast reduction of 1950 g. Right free-nipple graft. Left breast reduction of
1915 g. Left free-nipple graft.

INDICATIONS FOR SURGERY: The patient is a 43-year-old female with macromastia and as-
sociated back pain, neck pain, shoulder pain, shoulder grooving and Intertrigo. She desired a
breast reduction. Because of the extreme ptotic nature of her breasts, we felt she would need a
free- nipple graft technique. In the preoperative holding area, we marked her for this free-nipple
graft technique of breast reduction. The patient observed these markings so she could under-
stand the surgery and agree on the location, and we proceeded. The patient also was morbidly
obese with a body mass index of 54. Because of this, we felt she met the criteria for DVT
prophylaxis, which included Lovenox injection. The patient understood this would increase her
risk of bleeding. She also made it known she is a Jehovah’s Witness and refused blood prod-
ucts, but she did understand her risk of bleeding would significantly increase and we proceeded.

DESCRIPTION OF PROCEDURE: The patient was given 40 mg of subcutaneous Lovenox in

the Preoperative holding area. She was then taken to the operating room. Bilateral thigh- high
TED hose, in addition to bilateral pneumatic compression stockings were used throughout the
procedure. IV Ancef 1g was given. Anesthesia was induced. Both arms were secured on padded
arm boards using Kerlix rolls. A similar body bear hugger was placed. The chest and abdomen
were prepped and draped in sterile fashion. I began by circumscribing around each nipple-
areolar complex using a 42- mm areolar marker. On each side the free-nipple grafts were har-
vested. They were marked to be side specific and were stored on the back table in moistened lap
sponges. Meticulous hemostasis was achieved using Bovie cautery. The tail of the apex of each
breast was deepithelialized using the scalpel. I amputated the inferior portion of the breast from
the right side. Again, meticulous hemostasis was achieved using the Bovie cautery. There were
also large feeder vessels divided and ligated using either a medium Ligaclip or 3-0 silk tie su-
tures. I then moved to the left and again amputated the inferior portion of the breast. Meticulous
hemostasis was achieved using the Bovie cautery. Each of these wounds was temporarily closed
using the skin stapler. The patient was then sat up. I felt we had achieved every symmetrical
result. The new positions for the nipple-areolar complexes were marked with a 42-mm areolar

20
 marker and methylene blue. The patient was then placed in the supine position and the new
positions for the nipple-areolar complexes were deepithelialized using the scalpel. Meticulous
hemostasis was then achieved again using the Bovie cautery. The free- nipple grafts were then
retrieved from the back table. They were each defatted using scissors and were placed in an
only fashion on the appropriate side, and each was inset using 5-0 plain sutures. Vents were
made in the skin graft to allow for the egress of fluid on each side. A vertical mattress suture was
used, tied over a piece of Xeroform in critical areas of each of the nipple-areolar complexes. A
Xeroform nipple-areolar complexes using 5-0 nylon suture. The vertical and transverse incisions
were closed using 3- 0 Monocryl, both interrupted and running suture, and 5-0 Prolene. The
patient tolerated the procedure well. Again, meticulous hemostasis was achieved using the Bovie
cautery. She was given another 1 g of Ancef at the 2-hour mark by our anesthesiologist and was
taken to the recovery room in good condition. What CPT® codes are reported?

a.19316-50, 19355-59-50 b.19318-50, 19350-59-50

c.19318-50, 19355-59-50 d.19340-50, 19350-59-50

100. The patient was taken to the operating room and placed in the dorsal lithotomy position, prepped
and draped in the usual sterile fashion. A vertical paramedian incision was made along the left
side of the umbilicus from the symphysis and taken up to above the umbilicus. This incision was
carried down to the rectus muscles, which were separated in the midline. The peritoneal cavity
was entered with findings as described. The ascitic fluid was removed and hand-held retractors
were used to assist in surgical exposure. The tumor was resected from the hepatic flexure into
the mid transverse colon. The resection was extended into the left upper quadrant and the
attachments were also clamped, cut and suture ligated with 2-0 silk sutures in a stepwise fashion
until mobilization of the tumor mass could be brought medial and hemostasis was obtained.
Attempts to find a dissection plane between the tumor mass and the transverse colon were
unsuccessful as it appeared that the tumor mass was invading into the wall of the bowel with
extrinsic compression and distortion of the bowel lumen. Given the mass could not be resected
without removal of bowel, attention was directed to mobilization of the splenic flexure. Retroperi-
toneal dissection was started in the pelvis and continued along the left paracolic gutter. The
ligamentous and peritoneal attachments were taken down with Bovie cautery in a stepwise fash-
ion around the splenic flexure of the colon until the entire left colon was mobilized medially.
Similar steps were then carried on the right side as the right colon and hepatic flexures were
mobilized. The peritoneal and ligamentous attachments were taken down with Bovie cautery.
Vascular attachments were clamped, cut, and suture ligated with 2-0 silk until the right colon was
mobilized satisfactorily. The GIA stapler was introduced and fired at both ends to dissect the
tumorous bowel free. The bowel was delivered off the operative field. Attention was then directed
towards re-anastomosis of the colon. Linen-shod clamps were used to gently clamp the proximal
and distal segments of the large bowel. The staple line was removed with Metzenbaum scissors,
and the colon lumen was irrigated. The silk sutures were used to divide the circumference of the
bowel into equal thirds, and the proximal and distal edges of the bowel were reapproximated with
silk sutures. The posterior segment of the bowel was then retracted and secured with a TA
stapler, ensuring a full thickness bowel wall insertion into the staple line. The additional two thirds
were also isolated and, with the TA stapler, clamped, ensuring that all layers of the bowel wall
were incorporated into the anastomosis. A third staple line was fired, and the integrity of the
anastomosis was checked. First complete hemostasis was noted. There was well beyond a

21
finger width lumen within the large bowel. The linen-shod clamps were released, and gas and
bowel fluid were moved through the anastomosis aggressively with intact staple line, no leakage
of gas or fluid. The abdomen was then irrigated, and water was left over the anastomosis. The
anastomosis was manipulated with no extravasation of air. The abdomen and pelvis were then
irrigated aggressively. The Mesenteric trap was then reapproximated with interrupted 3-0 silk
suture ligatures. All sites were inspected and noted to be hemostatic. Attention was directed
towards closing.

a. 44140, C18.8, C18.4, C18.3

b. 44160, C18.8
c. 44140, 44139, C18.8
d. 44147, 44139, C18.3, C18.4

22