question

Mr. smith is seen in his primary care physicians office for his annual physical examination. He has a digital rectal examination and is given three small cards to take home and return with fecal samples to screen for colorectal cancer. Assign the cpt code to report this occult blood sampling. a. 82270 b. 82271 c. 82273 d. 82274

answer

a. 82270

question

Coes 96360 and 96361 are used to report infusion of: a. chemotherapeutic agents b. sequential drugs of the same drug family c. hormonal antineoplastics d. prepackaged fluids and/or electrolytes

answer

d. prepackaged fluids and/or electrolytes

question

a 7 year old patient is seen for a minor routine therapeutic service that required the administrtion of moderate sedation for 40 minutes performed by a physician other than the physician performing the therapeutic service. a. 99143 b. 99144 c. 99149 d. 99149, 99150

answer

d. 99149 (1st 30 minutes), 99150 (next 10 minutes)

question

True or false? when reported by the physician, the "initial service" code under Hydration, infusions and Chemotherapy is chosen based on the first substance infused.

answer

True

question

select the appropriate code(s) to report an injection of rabies immune globulin performed undeer direct physician supervision a. 96372 b. 90471 c. 90375, 93672 d. 90375, 90473

answer

c. 90375 (rabies product), 96372 (therapeutic, prophylactic, or diagnosistic injection (specify substance or drug); subcutaneous or intramuscular product + administration

question

if a patient undergoes an inpatient procedure and the final summary diagnosis is different from the diagnosis on the pathology report, the coder should: a. code only from the discharge diagnosis b. code the diagnosis reflected on the pathology report c. code the most severe symptom d. query the attending physician as to the final diagnosis

answer

d. query the attending physician as to the final diagnosis

question

removal of corneal foreign body using slit lamp

answer

65222 removal, foreign body, cornea, slit lamp

question

penetrating keratoplasty, aphakic eye

answer

65750 keratoplasty, penetrating, in aphakia

question

repair of entropion by thermocauterization

answer

67922 entropion, repair, thermocauteerization

question

laser photocoagulation of retina for prophylaxis of retinal detachment

answer

67145 retina, repair, prophylaxis, detachment (67141-67145)

question

myringotomy with aspiration under geneeral anesthesia

answer

69421 myringotomy (range 69420-69421)

question

tympanoplasty with mastoidectomy with ossicular chain reconstruction

answer

69642 tympanoplasty, with mastoidectomy, with ossicular chain reconstruction

question

xray of mandible, 3-views

answer

70100

question

chest xray, AP and lateral

answer

71020

question

true or false? code 76856 ultrasound, pelvic (nonobstetrical), real time with image documentation, complete, can be used to describe examinations of either the male or female pelvis

answer

true

question

ct scan of the abdomen and pelvis without contrast material would be coded: a. 72192, 74176 b. 74178 c. 74176 d. 74178, 74177

answer

c. 74176 computed tomography, abdomen and pelvis; without contrast material

question

If a patient has undergone an outpatient echocardiogram and the cardiologist concludes in the report that the patient has mitral regurgitation the coder should: a. assign a diagnostic code for mitral regurgitation b. query the physician about the diagnosis c. code the anormal finding of the echocardiogram d. no code should be assigned

answer

a. assign a diagnostic code for mitral regurgitation

question

a chest xray done to evaluate a cough revealed an asymptomatic compression fracture of a lumbar vertebrae. No further evaluation was undertaken. The coder should: a. not assign a code for an acute but assign a code for chronic compression fracture b. assign a code for a pathologic lumbar compression fracture c. assign a code for acute traumatic vertebral fracture d. not assign a code for this condition

answer

d. not assign a code for this condition

question

consultation

answer

advice or opinion from one physician to another physician

question

admission

answer

attention to an acute illness or injury that results in hospitalization

question

office visit

answer

face to face encounter in an office between the physician and the patient

question

newborn care

answer

evaluation and determination of care for a newborn infant

question

established patient

answer

one who has received professional service from the physician or another physician in the exact same specialty and subspecialty in the same group within the last 3 years

question

inpatient

answer

one who has been formally admitted to an acute health care facility

question

new patient

answer

one who has not received professional service from the physician or another physician in the exact same specialty

question

outpatient

answer

one who has not been formally admitted to a health care facility

question

dermis

answer

second layer of skin holding blood vessels, nerve endings, sweat glands, and hair follicles

question

epidermis

answer

outer layer of skin

question

subcutaneous

answer

tissue below dermis, primarily fat cells that insulate the body

question

incision and drainage

answer

to cut and withdraw fluid

question

abscess

answer

localized collection of pus that will result in the disintegration of tissue over time

question

cyst

answer

closed sac containing matter or fluid

question

debridement

answer

cleansing of or removing dead tissue from a wound

question

paring

answer

horizontal or transverse removal of dermal or epidermal lesions, without full thickness excision

question

shaving

answer

removal of thin layers of skin by peeling or scraping

question

biopsy

answer

removal of a small piece of living tissue for diagnostic purposes

question

List the four types of medical decisionmaking in order of complexity from MOST to LEAST

answer

high complexity moderate complexity low complexity straight forward

question

What 2 words describe a decreased level of consciousness that does not put patients completely to sleep and that allows the patients to breathe on their own during a surgical procedure?

answer

moderate (conscious) sedation

question

What does CRNA stand for?

answer

certified registered nurse anesthetist

question

CMA publishes an annual list of ____ ____ values for anesthesia codes.

answer

base unit

question

The M in the anesthesia formula stands for ____unit

answer

modifying

question

What is the term that describes the services provided to a patient by the physician before surgery?

answer

preoperative

question

what is another term for the time after surgery when the physician provides services to the patient?

answer

postoperative

question

the _____ factor for the locale is multiplied by the number of base units in the procedure plus the time units to determine the price of the anesthesia service.

answer

conversion

question

abdominal orchiopexy to release undescended intra-abdominal testes

answer

orchiopexy, abdominal approach 54650 code: 54650-50 mod 50 bilateral because procedure was on testes (both)

question

hemilaminectomy, posterior approach, with decompression of 2 nerve roots and with excision of herniated disc at L1-L2 and foraminotomy at L2-L3

answer

hemilaminectomy (range 63020-63044) Code: 63030

question

Ms. Jones has a pseudoaneurysm of her left iliac arteery that has developed proximal to an area of occlusion. She is admitted to Community Hospital for iliac artery endovascular revascularization and repair. She undergoes percutaneous transluminal balloon angioplasty of the area of occlusion with placement of a drug-eluting stent, and an endovascular repair of the psydoaneurysm using ilio-iliac tube endoprothesis. An endovascular ultrasound is performed after the procedure to assure potency of the vessel. Assign the appropriate CPT codes. Do not assign modifiers.

answer

33881, 33883, 33884

question

the patient was seen in the physicians office after injuring her ankle. The physician performed a brief HPI, a problem focused exam, and the decision making was straightforward. What component(s) of the history is missing from this scenario?

answer

PFSH past family social history

question

a new patient is seen in the physicians office for dull ache in his left side. The physician performs a detailed history and physical exam and the MDM was of moderate complexity. What is the correct e/m code for this service?

answer

99203 (2 of the 3) and cannot code up

question

a 49 year old established patient visits his family physician for a physical that is required by his place of employment. The physician documents a comprehensive history, exam and orders a series of routine tests such as a chest xray and EKG. In addition, the physician counsels the patient about his smoking habit. What CPT code would be selected to represent this service?

answer

99396 established patient, periodic comprehensive preventive medicine, 40-64 years old.

question

they physician documents that the patient has a cough, fever, and muscle aches. a review of systems is performed, a detailed account of present illness is documented and the physician outlines the management options, complexity o the treatment plan and orders tests. What key e/m coponent is missing from this documentation?

answer

history (pfsh)

question

a patient is seen on january 23, 2014 by a preimary care physician who is a member of Univ. Associates. a cardiologist (also a member of Univ. Associates) sees the patient on November 24, 2014. Would the visit on 11/24 be classified as a new or an established patient?

answer

new patient

question

an established patient is seen in the physicians office for counseling after having an extremely high cholesterol reading and hypertension. Which range of codes would be used to select the appropriate cpt code for these services?

answer

99211-99215 established patient, office visit

question

a patient is seen in the e/r for severe low back pain. The physician performs an expanded problem focused history, problem focused exam, and the MDM was of moderate complexity. what is the correct e/m code assignment for this service?

answer

99283

question

physician documents that critical care services were provided to a 12 year old patient for 90 minutes. Whatis the correct e/m code?

answer

99291,99292

question

a patient (post lasiksurgery) visits a new ophthalmologist for extreme dry eyes. The physician performs an expanded problem focused history and exam and prescribes eye drops as necessary. What is the correct e/m service?

answer

99202 (expanded, expanded, straight forward)

question

patient is admitted for uterine fibroids and dysmenorrhea. The surgeon performs a vaginal hysterectomy. Anesthesia code?

answer

anesthesia, hysterectomy, vaginal 00944

question

patient is admitted for a right ureteral stent placement. the surgeon performs a cystoscopy with insertion of ureteral stent. anesthesia code?

answer

anesthesia, urethra 00910

question

the patient is a male with a chronic right sided submandibulaar swelling occurring over the last few years. The diagnosis of right sialoadenitis was made. An excision of right submanibular gland was performed. anesthesia code?

answer

anesthesia, salivary glands 00100

question

patient is treated for a lateral meniscus tear. The surgeon performs an arthroscopy meniscetomcy. Anesthesia code?

answer

anesthesia, popliteal area code 01400

question

the patient is a 65 year old male who was recently treated for a low anterior resection for a stage II superior rectal cancer. Adjuvant chemotherapy is planned. Placement of long term venous access device was requested. Surgeoninserts a port-a-cath. Anesthesia code?

answer

anesthesia, central venous circulation 00532

question

the patient is a 76 year old male with substantial underlying pulmonary disease. He has required mechanical ventilation for approximately 2 to 3 weeks and failed several attempts to be completely taken off mechanicalventilation. He was brought to the OR for placement of a tracheostomy tube. Anesthesia code?

answer

anesthesia, trachea 00320

question

the patient is a male who presented to the ENT clinic with a history of left sided nasal obstruction. The following procedures were performed: left maxillary sinusotomy, left anterior ethmoidectomy, and removal of left nasal polyposis. Anesthesia code?

answer

anesthesia, nose 00160

question

the patient is a male previously diagnosed with pancreatic cancer. The surgeon performs a partial excision of the pancreas. anesthesia code?

answer

anesthesia, pancreas 00794

question

patient has a diagnosis of urinary retention. The surgeon performs a transurethral resection of the prostate. Anesthesia code?

answer

anesthesia, transurethral procedure TURP 00914

question

as a result of injury, the surgeon sutures a lacerated digital nerve of the right hand.

answer

suture, nerve (range 64831-64876) Code 64831-RT

question

the patient undergoes a tranforaminal epidural injection of an anesthetic agent at the L5 facet joint.

answer

see epidural injection, transforaminal (range 64479-64480, 64483-484) Code: 64483

question

the patient was diagnosed with an encephalocele at the base of the skull. For surgical intervention, a craniotomy for repair was performed.

answer

craniotomy, for encephalocele Code: 62121

question

with the use of an operating microscope, the surgeon performed a repair of lacerated digital nerve of right index finger, and right thumb.

answer

repair, nerve, micro repair 64831-F5, 64832-F6, 69990

question

preop: left hydrocele postop: same procedure: left hydrocelectomy (removal of hydrocele) additional info: left hemiscrotum, hydrocele removed, the testicle and spermatic cord were then replaced

answer

hydrocele, excision, unilateral, tunica vaginalis 55040

question

true or false? all sinus codes are reported as bilateral procedures only.

answer

false

question

with the exception of incicisional and ventral hernias, the use of mesh or other prosthesis is not separately reported when performing hernia repairs. True or False.

answer

true

question

the term that describes destruction by removing, usually by cutting is: a. laser b. biopsy c. incision d. ablation

answer

d. ablation

question

What are the 3 sections of the cpt manual that you use to code many cardiovascular services? a. anesthesia, surgery, radiology b. pathology, radiology, surgery c. medicine, surgery, anesthesia d. surgery, radiology, medicine

answer

d. surgery, radiology, medicine

question

when lesions are excised from multiple sites, which of the following is the correct coding protocol? a. add all the dimensions and assign one code based on the total area b. code each lesion separately c. code only the largest lesion and add a modifier d. add all the dimensions for each body part, and assign as many codes as there are body parts treated.

answer

b. code each lesion separately

question

fracture codes are based on: a. treatment type b. diagnosis c. fracture type d. patient age

answer

a. treatment type

question

when a diagnostic colonoscopy is coded, the code includes: a. proctosigmoidoscopy b. anoscopy c. sigmoidoscopy d. all of the above

answer

d. all of the above

question

this type of lymphadenectomy is the removal of the lymph nodes, glands, and surrounding tissues: a. modified b. radical c. limited d. partial

answer

b. radical

question

code 36000 (introduction of needle or intracatheter, vein) is an example of: a. selective catheterization b. non-selective catheterization c. injection procedure d. none of the above

answer

b. non-selective catheterization

question

surgical and fracture repair codes in the musculoskeletal subsection: a. include the application and removal of all casts, splints and strapping b. include the application and removal applied by an urgent care/emergency room physician when the urgent care/emregency room physician is not providing the fracture care c. do not include casts, splints, or strapping, therefore allowing the physician to charge separately for these services d. include the application and removal of the initial casts, splints, or strapping applied by the treating physician

answer

d.

question

casting is separately reported: a. when applied to stabilize or for comfort, by a separate physician b. for initial application by a physician who does not perform the fracture care c. when recasting is done during fracture follow-up d. all of the above

answer

d. all of the above

question

what is the name of the electrodes that are placed into the atrium and/or ventricle of the heart when a pacemaker is inserted? a. leads b. catheters c. threads d. guidewires

answer

a. leads

question

Removal of 37 skin tags by electrosurgical destruction: a. 11200, 11201 x 3 units b. 11200, 11201 x 2 units c. 11200 x 3 units d. none of the above

answer

skin, tag, removal 11200-11201 11200 (up to 15 tags), 11201 (each additional 10 or part therof) x 3 a. 11200, 11201 x 3

question

when coding 3 biopsies of the skin, performed at the same visit, the reporting would be: a. 11100 x 3 b. 11100 x 2 and 11101 x 1 c. 11100, 11101 x 2 d. none of the above

answer

skin, biopsy 11100-11101 c. 11100, 11101 x 2

question

excision defined as full thickness would be through the: a. muscle b. dermis c. subcutaneous tissue d. epidermis

answer

b. dermis

question

the lymph node excision category codes are based on what 2 things: a. method and number of nodes b. location and number of nodes c. extent and depth d. method and location

answer

d. method and location

question

if an orthopedic surgeon attempted to reduce a fracture but was unsuccessful in obtaining acceptable alignment, what type of code should be assigned for the procedure? a. an e/m code only b. an unlisted procedure code c. a "with manipulation" code d. a 'without manipulation" code

answer

c. a "with manipulation" code

question

fine needle aspiration of the breast without imaging: a. 19030 b. 19000 c. 10021 d. 19100

answer

c. 10021

question

open treatment of a fracture is when the: a. bone is protruding through the skin b. physician reduces the fracture c. fracture site is surgically opened and visualized or opened remotely d. physician uses an arthroscope

answer

c. fracture site is surgically opened and visualized or opened remotely

question

a ____ arthroscopy is always included in a surgical arthroscopy: a. separate procedure b. biopsy c. debridement d. diagnostic

answer

d. diagnostic

question

per the coding guidelines, if a lesion is biopsied and then the remainder of the lesion is removed, what code(s) is (are) assigned? a. a code for the biopsy and one for the lesion extraction b. a code for the lesion excision only c. a code for the biopsy only d. hospital specific coding procedures determine what is coded

answer

b. a code for the lesion excision only

question

full thickness graft, free, to the axillae, including direct closure of donor site, 12 sq cm: a. 15340 b. 15200 c. 15260 d. 15240

answer

full thickness graft (15200-15261) d. 15240

question

the major division of the cardiovascular subsection is whether a procedure involved a ___vessel. a. selective or nonselective b. bypassed or native c. coronary or noncoronary d. damaged or healthy

answer

c. coronary or noncoronary

question

what 2 words are important factors in coding hernia repair? a. open/closed b. definitive/exploratory c. hemorrhage/nonhemmorrhage d. incarcerated/strangulated

answer

d. incarcerated/strangulated

question

athrocentesis is: a. puncture of a joint cavity b. an aspiration of fluid from the joint c. an injection into the joint d. all of the above

answer

d. all of the above

question

in which type of catheter placement is the catheter moved, manipulated, or guided into a part of the arterial system other than the vessel punctured? a. infiltrated b. infused c. selective d. localized

answer

c. selective

question

single layered closure of heavily contaminated wounds that require extensive cleaning or removal of particulate matter constitutes what typeof repair? a. complex b. simple c. intermediate d. none of the above

answer

c. intermediate

question

if catheterization is performed on the coronary arteries, in which section would you find the codes? a. radiology b. surgery c. medicine d. all of the above

answer

catherization, coronary artery 93455 c. medicine section

question

the correct code for repairing the following lacerations: 4.2 cm simple repair of the trunk 1.3 simple repair of the arm 2.8 intermediate repair of the scalp a. 12032, 12001-59, 12002-59 b. 12004 c. 12034 d. 12032, 12002-59

answer

d. 12032 (intermediate), 12002-59 (separate procedure)

question

in what surgery subsection would you find the code for the incision and drainage of a nasal abscess using an external approach to the abscess? a. respiratory system b. E/M c. integumentary system d. medicine

answer

nose, abscess (range 30000-30020) see NOTE that states for external approach use 10060, 10140 which is in the integumentary system d. integumentary system

question

which modifier would you use if polyps were removed from both the left and the right sides of the nose? a. 54 b. 21 c. 50 d. 47

answer

c. 50 bilateral procedure

question

a diagnostic endoscopic procedure is reported only when: a. no surgical procedure is performed during the same operaative session

answer

a.

question

synthetic aortobifemoral bypass graft:

answer

bypass graft,venous, aortobifemoral Code: 35646

question

open trreatment of a hip fracture of proximal neck with prosthetic femoral hip replacement.

answer

27236

question

flexible sigmoidoscopy with biopsy and removal of 3 polyps by snare technique.

answer

sigmoidoscopy, removal, polyp 45333, 45338 Code: 45338 do not use 45331 because it does not state what technique was used

question

insertion of a single chamber pacing cardioverter-debibrillator pulse generator

answer

insertion, pacing cardiodefibbrillator, pulse generator Code: 33240

question

repair of a 5.0 cm laceration of the left cheek and a 3.2 cm laceration of the forehead.Also, repair a 7.2 cm laceration of the left chest utilizing layered closure.

answer

12032, 12015-59 (59 modifier separate procedure)

question

bilateral endoscopic biopsy of lung nodules.

answer

lung, biopsy, thoracoscopic 32607-32608 Code: 32608-50 (mod 50 for bilateral)

question

open reduction, internal fixation, humerus shaft fracture, with cast application.

answer

humerus, fracture, shaft, open treatment Code: 24515

question

excision of basal cell carcinoma, abdominal wall, 1.2 cm in diameter, with 1.0 cm margin all around

answer

excision, lesion, skin, malignant Code: 11604 (1.2 cm + 1.0 cm + 1.0 cm)

question

a diagnostic esophagoscopy was performed. during the procedure an esophageal polyp was found and removed by hot biopsy forceps.

answer

esophagoscopy, removal, polyp code: 43216

question

percutaneous transcatheter placement of coronary artery stent, right coronary artery.

answer

92928-RC

question

functional endoscopic sinus surgery (FESS) with frontal sinus polyp removal

answer

sinus, frontal, exploration, with nasal/sinus endoscopy Code: 31276

question

scar revision of amputation site lower right arm (ulna and radius)

answer

25907-RT

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