question

Nonessential modifiers are enclosed in:

answer

parentheses

question

A diagnostic descriptor that is listed in italics is a(n):

answer

code that must be reported first

question

The abbreviation UHDDS refers to the:

answer

Uniform Hospital Discharge Data Set

question

Diagnoses described as "suspected" "possible" "probable" "likely" and "still to be ruled out" are reported if present at the time of discharge for ___________records.

answer

inpatient

question

For patients receiving therapeutic services in the outpatient setting for chemotherapy, radiation therapy, or rehabilitation, the first listed reported diagnosis is:

answer

The appropriate V code

question

When multiple burns are present the first sequenced diagnosis is the:

answer

highest degree burn

question

A coding professional may assume a cause and effect relationship between hypertension and which of the following complications?

answer

hypertension and chronic kidney disease

question

Codes that describe the behavior of cells in neoplasms are called:

answer

morphology codes

question

New ICD-9-CM codes go into effect on _____ of each year.

answer

October 1

question

Supplementary classifications include:

answer

V codes and E codes

question

The neoplasm table includes:

answer

the nature and status (primary, secondary, in situ) for malignancies

question

V codes can be used as:

answer

either principal diagnosis or secondary diagnosis, depending on the code and the circumstances of the admission

question

Terms listed in the Alphabetic index in boldface type are known as:

answer

main terms

question

Manifestation codes:

answer

can never be reported first, are printed in italicsin the tabular list, describe a condition that results from another, underlying condition

question

Codes that contain the descriptive abbreviation NOS are to be used:

answer

when the coder lacks sufficient information to assign a more specific code

question

A patient is admitted as an inpatient to receive radiation and chemotherapy for distal esophageal carcinoma. What is the appropriate principal diagnosis?

answer

Either V58.0 or V58.11

question

When a patient is admitted to the hospital for radiation therapy for a primary malignancy that is still present, what code is reported as the principal diagnosis?

answer

v58.0

question

Neoplasms at the cellular level that are incapable of spreading to distant sites are called:

answer

benign neoplasms

question

Which of the following neoplasm types is correct for sympathicoblastoma?

answer

malignant (neoplasm composed of immature undifferentiated cells derived from the blastoma of an organ or tissue)

question

Myxofibrosarcoma is a malignant neoplasm that affect what type of tissue?

answer

connective tissue

question

The site at which a malignant neopolasm originated is known as the:

answer

primary site

question

In the diagnostic statement "urinary tract infection due to Escherichia coli" which condition is coded as the principal diagnosis?

answer

UTI

question

In the diagnostic statement "tuberculous prostatis" which condition is coded as the principal diagnosis in icd9cm?

answer

tuberculosis

question

CPT: Category II codes cover all but one of the following topics. Which is not addressed by Category II codes? a. patient management b. new technology c. therapeutic, preventive, or other interventions d. patient safety

answer

B. New technology (in Category III codes)

question

CPT: During the performance of a femoral angioplasty, a patient develops additional areas of occlusion. A diagnostic angiogram of the affected artery is performed. Is it appropriate to code this diagnostic study in addition to the therapeutic procedure?

answer

Yes. Per revised coding guidelines if there is a clinical change during an interventional procedure that requires further diagnostic study, the diagnosticangiogram may be reported in addition to the therapeutic procedure.

question

CPT: a list of codes describing procedures that include conscious sedation, if administered by the same surgeon as performs the procedure, can be found in:

answer

Appendix G

question

CPT: True or False? Category II codes may be used as the first listed CPT code when the patient is seen only for counseling.

answer

False

question

CPT: Which of the appendices would a neurologists practice consult to determine the nerve conduction code to assign for a study of the suprascapular motor nerve to the infraspinatus?

answer

Appendix J

question

CPT: in order to be included in the CPT manual, a procedure must meet which of the following criteria?

answer

a. It must be commonly performed by many physicians across the country b. it must be consistent with contemporary medical practice

question

CPT: Which of the following statements about CPT Category III codes is FALSE? a. they are updated only once every 2 years b. they were developed to reflect emerging technologies and procedures c. they are archived after 5 years if the code has not been accepted for inclusion in the main body of CPT d. reimbursement for these services is dependent on individual payer policy

answer

a. they are updated only once every 2 years

question

CPT: per cpt guidelines a separate procedure:

answer

is considered to be an integral part of another larger service

question

Which of the following statements is (are) true of cpt codes? a. they are numeric b. they describe nonphysician services c. they are updated annually by cms d. all of the above

answer

a. they are numeric

question

cpt was developed and is maintained by:

answer

AMA (the ama publishes the cpt manual)

question

Cpt is updated:

answer

annually for the main body of codes and every 6 months for category III codes

question

cpt: for reporting of physician services e/m codes are usually based on:

answer

documentation of history, physical examination, and medical decision making

question

when counseling consumes more than half the total visit time _______ may be used as the criterion for assigning the e/m code

answer

time

question

cpt: a physician sees a patient in his office in the morning, then again in the aearly afternoon, at which time he sends the patient to the hospital in observation status. Later that day he visits the patient in the hospital and admits him as a full inpatient. What E/M codes should be assigned for the day of care?

answer

one code for the inpatient admission only

question

Which of the following are considered components of the social history? a. occupational history b. marital history c. allergic history d. a and b above

answer

A and B : occupational history and marital history

question

Per cpt guidelines a presenting problem of moderate severity is one that:

answer

has a moderate risk of morbidity without treatment, a moderate risk of mortality without treatment, uncertain prognosis, or increased probability of functional impairment

question

cpt: dr. smith sees a patient in consultation in the hospital at the request of dr. Jones. He renders an opinion. He then takes over the management of a portion of the patients care. What codes should dr. smith use to bill for his subsequent hospital visits? a. inpatient consultation codes b. initial inpatient hospital care codes c. subsequent hospital care codes d. no codes; the initial consultation includes all subsequent visits

answer

C. subsequent hospital care codes

question

Per cpt guidelines, a concise statement describing the symptom, problem, condition, diagnosis, or other factor that is the reason for the encounter, usually stated in the patients words, is the definition of the:

answer

chief complaint

question

Which e/m codes are used to report services to patients in a facility that provides room, board, and other personal assistance services, generally on a long-term basis?

answer

domiciliary, rest home, or custodial care services

question

cpt: preventive medicine services are based on which of the following criteria? a. documentation of history, physical exam, and medical decision making b. age of the patient c. amount of time spent with the patient d. thefinal diagnosis for the visit

answer

b.age of the patient

question

cpt: mohs micrographic surgery involves the surgeon acting as:

answer

both surgeon and pathologist

question

cpt: true or false? complex wound repair 13100-13160 may require extensive undermining, placement of stents, or retention sutures

answer

True

question

cpt: true or false? a debridement is always considered a separate procedure and should always be reported.

answer

False

question

icd: this 52 year olf male stayed one week in hospital a for an st elevation lateral wall myocardial infarction (stemi) and was then transferred to hospital b for further treatment. A cardiac catheterization was performed at hospital B which revealed severe occlusive disease, and a coronary bypass grafting was carried out. The physicians final diagnostic statement at hospital b list, "Acute lateral wall STEMI due to severe coronary atherosclerosi." What is the appropriate PRINCIPAL DIAGNOSIS for Hospital B?

answer

410.51 (ischemic heart disease of other lateral wall) fifth digit of 1 b/c initial episode of care regardless of facility site for a newly diagnosed myocardial infarction. And, assigned regardless of the number of times a patient is transferred.

question

Henry was playing baseball and slid for home base where he collided with another player. He presents to the ER complaining of pain in the distal portion of his right middle finger. It is swollen and deformed. The physician orders an xray and iagnoses Henry with a tuft fracture. He splints the finger, provides narcotics for pain, and instructs Henry to folow up with his orthopedist in 2 wseeks. a. 816.02, E007.3 b. 815.03, E917.0 c. 814.09, E007.3 d. 815.04, E917.0

answer

A. 816.02, E007.3

question

the suffix -ectomy means?

answer

surgical removal

question

the acronym MMRV stands for:

answer

measles, mumps, rubella and varicella

question

MRI stands for:

answer

magnetic resonance imaging

question

the term salpingo-oophorectomy refers to:

answer

the removal of the fallopian tubes and ovaries

question

PERRLA stands for

answer

pupils equal, round, reactive to light and accomodation

question

Cryopreservation is a means of preserving something through

answer

freezing

question

Which of the following desxribes removal of fluid from a body cavity? a. arthrocentesis b. amniocentesis c. pericardiocentesis d. paracentesis

answer

D. paracentesis (puncture of a cavity)

question

If a surgeon cuts into a patients stomach he has performed a: a. gastrectomy b. gastrotomy c. gastronomy d. gastrorraphy

answer

B. gastrotomy

question

True or False? The terms nephro and renal refer to the same organ.

answer

true

question

In the medical term myopathy the term pathy means disease. What is diseased? a. mind b. muscle c. eye d. nervous system

answer

b. muscle

question

The radius is the: a. outer bone located in the forearm b. outer bone located in the leg c. inner bone located in the forearm d. inner bone located in the leg

answer

a. outer bone located in the forearm

question

The spleen belongs to what organ system: a. endocrine b. hemic and lymphatic c. digestive d. nervous

answer

b. hemic and lymphatic

question

the portion of the femur bone that helps make up the knee cap is considered what? a. the posterior portion b. the proximal portion c. the distal portion d. the dorsal portion

answer

the distal portion

question

How many regions are in the abdominopelvic cavity?

answer

9 (nine)

question

the midsagittal plane refers to what portion of the body? a. top b. middle c. bottom d. back

answer

middle

question

Which of the following is NOT part of the small intestine? a. duodenum b. ileum c. jejunum d. cecum

answer

cecum

question

the round window is located in a. pericardium b. anterior aqueous chamber of the eye c. inner ear d. middle ear

answer

c. inner ear

question

the point of an organ or body part nearest the point of attachment is: a. distal b. proximal c. lateral d. medial

answer

b. proximal

question

One of the six major scapulohumeral muscles: a. temporalis b. trapezius c. teres d. trigone

answer

c. teres

question

the cardia fundus is: a. part of the heart all that causes infarction b. where the esophagus joins the stomach c. a fungal infection that attacks the heart d. part of the femal reproductive system

answer

b. where the esophagus joins the stomach

question

cpt codes 22840-22848 are modifier -62 exempt: true or false

answer

true

question

an ABN must be signed when: a. once the insurance company has denied payment b. before the service or procedure is provided to the patient c. after services are rendered but before the claim is filed d. once the denied claim has been apapealed at the highest level

answer

b. before the service or procedure is provided to the patient

question

Wound exploration codes include the following: a. exploration and repair b. exporation, including enlargement, removal of foreign body, repair c. exploration, including enlargement, repair, and necessary grafting d. exploration, including enlargement, debridement, removal of foreign body, minor vessel ligation, and repair

answer

D

question

Medical necessity means: a. without treatment the patient will suffer permanent disability or death b. the service requires medical treatment c. the condition of the patient justifies the service provided d. the care provided met quality standards

answer

C. the condition of the patient justifies the service provided

question

The following statement does NOT apply to what code type: These codes are NEVER stand-alone codes and NEVER primary codes. a. e codes b. add on codes c. late effect codes d. v codes

answer

d. v codes

question

which of the following codes allows the use of modifier -51? a. 20975 b. 93600 c. 31500 d. 45392

answer

d. 45392 (modifier 51 is multiple procedure other than E/M operatie session surgery

question

category III codes are temporary codes for emerging technology, services and procedures. If a category III code exists it should be used instead of an "unlisted procedure" code in category I. True or false

answer

true

question

which of the folloiwng satements is NOT true regarding Medicare part A? a. it helps cover home health care charges b. it helps cover skilled nursing facility charges c. it helps cover hospice charges d. it helps cover outpatient charges

answer

d is not true about Medicare A. It does not cover outpatient charges.

question

which of the following is not one of the 3 components of HIPAA that is enforced by the office for civil rights? a. protecting the privacy of individually identifiable health information b. setting national standards for the security of electronic protected health information c. protecting identifiable information being used to analyze patient safety events and improve patient safety d. setting national standards regarding the transmission and use of protected health information

answer

D is not one of the 3 components

question

what is the corect icd 9 codes(s) for malignant hypertension with state 3 kidney disease? a. 401.0, 585.3 b. 403.00 c. 401.0 d. 403.00, 585.3

answer

d. 403.00, 585.3

question

Lucy was standing on a chair in her kitchen trying to change a light bulb when she slipped and fell. she struck the glass top stove which shattered. She presents to the er with a simple laceration to her forearm that has embedded glass particles. a. 881.00, e888.0, e849.0 b. 881.10, e888.0, e920.8 c. 881.00, e888.1, e849.0 d. 881.10, e888.1, e920.8

answer

d. 881.10, e888.1, e920.8

question

jim was at a bonfire when he tripped and fell into the flames. Jim sustained multiple burns. He came to the ER via an ambulance and was treated for second and third degree burns on his face, second degree burns on his shoulders and forearms, and third degree burns on the front of his thigh. a. 941.20, 941.30, 943.25, 943.21, 945.36, 948.42, E891 b. 941.30, 945.36, 943.29, 948.42, E897 c. 941.09, 943.09, 945.09, 948.64, E897 d. 941.30, 943.29, 945.36, 948.64, e897

answer

b. 941.30, 945.36, 943.29, 948.42, E897

question

a 35 year old woman who is pregnant with her frist child is admitted to the hospital. She experiences a prolonged labor during the first stage and eventually births a healthy baby boy. a. 662.00, 659.6, v27.0 b. 650, v27.0 c. 650, 662.01, 659.6, v27.0 d. 662.01, 659.5, v27.0

answer

d. 662.01(prolonged 1st stage labor), 659.5 (elderly primigravida), v27.0 (births a healthy baby boy)

question

A patient has a home health aide come to his home to clean and dress a burn on his lower leg. The aide uses a special absorptive, sterile dressing to cover 20 sq. cm area. She also covers a 15 sq. cm area with a self adhesive sterile gauze pad. a. A6204, A6403 b. a6252, a6403 c. a6252, a6219 d. a6204, a6219

answer

c. a6252 (special absorptive sterile dresing to cover 20 sq. cm), a6219 (self adhesive sterile gauze pad to cover 15 sq. cm)

question

A 12 year old arrives in his pediatricians office after colliding with another player during a soccer game. He is complaining of pain in his right wrist. The physician orders an xray and diagnoses him with a hairline fracture of the distal radius. He has a short arm fiberglass cast applied and discharges him with follow up instructions.l a. q4009 b. q4012 c. q4022 d. q4010

answer

D. q4010 (cast supplies, short arm cast, adult 11 years +, fiberglass

question

A patient with Hodgkins disease takes Neosar as paart of his chemotherapy regiment. He receives 100 mg once a week through intravenous infusion. a. a9100 b. j7502 c. j9070 d. j8999

answer

c. j9070 (neosar, 100 mg, IV, J9070)

question

A patient with diabetes is fitted for custom molded shoes. What is the code range for such a fitting? a. L3201-L3649 b. A5500-A5513 c. K0001-0899 d. E0100-E8002

answer

B. A5500-A5513

question

A 300 pound paraplegic needs a special sized wheelchair with fixed arm rests and elevating leg rsts. a. E1195 b. E1222 c. E1160 d. E1087

answer

b. E1222 (wheelchair with fixed arm, elevating legrests)

question

A patient comes into her doctors office for her weekly blood sugar check. Her blood is drawn by the LPN on staff, the visit takes about 5 minutes total. a. 99201 b. 99212 c. 99211 d. 99363

answer

c. 99211 (established patient may not require presence of physician)

question

a 3 year old child is brought into the ER after swallowing a penny. A detailed history and exam are taken on the child and medical decision making is of moderate complexity. The child is admitted to observation for 3 hours and is then discharged home. a. 99218 b. 99235 c. 99218, 99217 d. 99234

answer

d. 99234 (observation or inpatient care services ... admitted and discharged same date ... 99234 has 2 of the 3 (detailed, detailed)..cannot code up to 99235

question

A 20 month old is admitted to the hospital with pneumonia and acute respiratory distress. The physician spends 3 minutes intubating the child and spends 90 minutes of critical care time stabilizing the patient a. 99291, 99292-25, 31500, 518.81, 486 b. 99471-25, 31500, 786.09, 486 c. 99291-25, 99292-25, 31500, 786.90, 486 d. 99471, 518.81, 486

answer

99291 (critical care first 30-74 minutes) 99292-25 (critical care + each additional 30 minutes ...mod 25 significant separate procedure) 31500 (intubation) 518.81 (acute respiratory failure) 486 (pneumonia)

question

At the request of a physician who is delivering for a high risk pregnancy, Dr. smith, a pediatrician, is present in the delivery room to assist the infant if needed. After 30 minutes the infant is born, but is not breathing. the delivering physician hands the infant to Dr. smith who provides chest compressions and resuscitates the infant. The pediatrician then performs the initial evaluation and management and admits the healthy newborn to the nursery. What codes should Dr. Smith submit on a claim? a. 99360, 99465 b. 99465, 99460 c. 99360, 99460 d. 99360, 99465, 99460

answer

99360 (standby service for each 30 minutes) 99465 (newborn care services ...initial hospital or birthing center care PER DAY for e/m of normal newborn infant admittd and discharged on the same date 99460 (newborn care services ...initial hospital or birthing center care PER DAY, for e/m of normal newborn infant)

question

Mr. Johnson is a 79 year old established male patient that is seen by Dr. anderson for his annual physical exam. During the exam Dr. A notices a suspicious mole on Mr. J's back. The doctor comletes the annual exam and documents a detailed history and exam and the time discussing the patients need to quit smoking. Dr A then turns his attention to the mole and does a complete workup. He documents a comprehensive history and exam and medical deicision making of moderate complexity. He also called a local dermatologist and made an appointment for Mr. J to see him the next day for an evaluation and biopsy. a. 99387, 99205 b. 99387, 99215 c. 99397, 99205 d.99397, 99215

answer

99397 (established patient ... 65 years and older ... periodic comprehensive preventive medicine) 99215 (establ. patient ... office or other outpatient visit ... comprehensive history and comprehensive exam) need 2 of the 3 keys components

question

An E/M is made up of 7 components, six of which are used in defining the levels of e/m services. the 7 components include history, exam, medical decision making, counseling, coordination of care, nature of presenting problem, and time. which of the 6 of these 7 parts help define the level of the e/m service? C. HISTORY, EXAM, MEDICAL DECISION MAKING, COUNSELING, COORDINATION OF CARE, and nature of presenting problem

answer

C. Time is NOT a part that helps define the level of the e/m service

question

the correct anesthesia code for a ventral hernia repair on a 13 month old child is: a. 00830 b. 00834 c. 00832 d. 00820

answer

c. 00832 (anesthesia, hernia, lower abdomen ... ventral and incisional hernia)

question

A patient is placed under anesthesia to have an exploratory surgery done on her wrist. The surgeon utilizes a small fiber optic scope and investigates the radius, ulna, and surrounding wrist bones. What should the anesthesiologist code for? a. 01829 b. 01820 c. 01830 d. 29840

answer

a. 01829 (anesthesia for diagnostic arthroscopic procedurs on the wrist)

question

when does anesthesia time begin? a. after the induction of anesthesia is complete b. during the pre-op exam prior to entering the OR c. When the anesthesiologist begins preparing the patient for the induction of anesthesia d. once the supervising physician signs over the patients care to the anesthesiolgist

answer

c. when the anesthesiologist begins preparing the patient for the induction of anesthesia

question

A five month old is brought into the OR for open heart surgery. The surgeon performs a repair of a small hole that ws found in the lining surrounding the patients heart. Anesthesia was provided as well as the assistance of an oxygenator pump. a. 00560, 99100 b. 00561 c. 00567, 99100 d. 00561, 99100

answer

b. 00561 (intrathoracic ... anesthesia for procedures on heart, pericardial sac, and great vesselsof chest...with pump oxygenator, younger than 1 year of age) code 99100 is not used with 00561

question

a 72 year old male with a history of severe asthma is placed under anesthesia to have a long tendon in his upper arm repaired. a. 01712-P4, 99100 b. 01716-P3 c. 01714-P3 d. 01714-P4

answer

c. 01714-P3 (p3 for severe asthma)

question

Which of the following procedures can be coded separately when performed by the anesthesiologist? a. administration of blood b. monitoring of a central venous lines c. capnography d. monitoring of an EKG

answer

b. monitoring of a central venous line(s). The other choices are part of the service.

question

a female who is 17 weeks pregnant is rushed into the OR due to ruptured tubal pregnancy. she has a severe hemorrhage and has an emergency laparoscopic tubal ligation. a. 00851-P5, 99140 b. 00880-P4 c. 01965-P5 d. 00880-P5, 99140

answer

a. 00851-P5 (anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy ... tubal ligation/transection ...P5 not expected to survive without the operation) +99140 (anesthesia complicated by emergency conditions (list separately in addition to code for primary anesthesia procedure)

question

A healthy 5 year old male is placed under anesthesia to have a biopsy taken from his left ear drum. a. 00120-p1 b. 00124-p2 c. 00170-p2 d. 00126-p1

answer

00126-p1 anesthesia for tympanotomy

question

a patient presents to her dermatologists office with 3 suspicious looking lesions. The dermatologist evaluates them and determines that the 1.3 cm lesion of the scalp is benign. the 1.5 cm lesion of the neck is premalignant. the 2.5 cm on the dorsal surface of the patients hand is also evaluatd and is determined to be malignant. The dermatologist chooses to ablate all 3 lesions using electrosurgery. a. 17273, 17003, 17110 b. 17273, 17000, 17003 c. 17273, 17000, 17110 d. 17273, 17003

answer

c. 17273 destruction malignant lesion 17000 destruction premalignant lesion 17110 destruction benign lesion

question

an 18 year old female presents with a cyst of her left breast and her physician performs a puncture aspiration. a. 10160 b. 10060 c. 10021 d. 19000

answer

d. 19000 puncture aspiration of cyst of breastg

question

a patient with a non healing burn wound on her right cheek, and is admitted to the OR for surgery. The physician had the patient prepped with a Betadine scrub and draped in the normal sterile fashion. The cheek was anesthetized with 1% Lydocain with 1:800,000 epinephrine (6cc) and SeptiCare was applied. A skin graft of the epidermis and a small portion of the dermis was taken with a Goulianweck blade with a six-thousands-of an inch thick shimon the blade. the 25 sq cm graft was flipped and sewn to the adjacent defect with running 5-0 vicryl. the wound was then dressed with Xeroform and the patient was taken to recovery. a. 14041 b. 15115 c. 15120 d. 15758

answer

A 14041 adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet ...defect 10.1 sq cm to 30.0 sq cm

question

The size of an excision of a benign lesion is determined by: a. adding together the lesion diameter and the widest margins necessary to adequately excise the lesion b. adding together the lesion diameter and the narrowest margins to adequately excise the lesion c. the diameter of the lesion only, excluding any margins excised with it d. the depth of the lesion plus the full diameter of the lesion

answer

b. adding together ...the narrowest margins ....

question

A simple, single layered laceration requires extensive cleaning due to being heavily contaminated. The code selected would come from code range 12031-12057. true or false.

answer

True (it is considered an intermediate repair)

question

A skin graft where the donor skin comes from another human (often a cadaver) is known as a/an: a. autograft b. acellulargraft c. allograft d. xenograft

answer

c. allograft

question

a patient is being treated for third degree burns to his left leg and left arm which cover a total of 18 sq cm. The burns are scrubbed clean, anesthetized, and three incisions are made with a #11 scalpel, through the tough leathery tissue that is dead, in order to expose the fatty tissue below and avoid compartment syndrome. the burns are then re-dressed with sterile gauze. a. 97597 b. 97602 c. 16035, 16036 x 2 d. 16030, 16035, 16036 x 2

answer

c. 16035, 16036 x 2 16035 (escharotomy initial incision) + 16036 (each additional incision) x 2 ... he made a total of 3 incisions

question

medial and lateral meniscus repair performed arthroscopically. a. 27447 b. 29868 c. 29882 d. 29883

answer

d. 29883 (arthroscopy, knee surgical, with meniscus repair (medial AND lateral)

question

a scapulopexy is found under what heading? a. incision b. excision c. introduction d. repair, revision, and/or reconstruction

answer

d. repair, revision and/or reconstruction

question

a patient with muscle spasms in her back was seen in her physicians office for treatment. The area over the myofascial spasm was prepped with alcohol utilizing sterile technique. After isolating it between 2 palpating fingertips aa 25 gauge 5 inch needle was placed in the center of the myofascial spasms and a negatie aspiration was performed. Then 4 cc of Marcaine 0.5% was injected into three points in the muscle. the pat. tolerated the procedure well without any apparent difficulties or complications. The patient reported feeling full relief by the time the block was set. a. 64400 b. 20552 c. 64520 d. 20553

answer

d. 20553 injections single or multiple trigger points ... 3 or more muscles

question

A patient comes into his physicians office with a prior diagnosis of a colles type distal radius fracture. He complains that the cast he currently has on is too tight and is causing numbness in his fingers. The physician removes the cast and ensures the patients circulation is intact. He then reapplies a short arm fiberglass caset and checks the patients neurovascular status several times during the procedure. The patient is given instructions to follow up with his orthopedist within 7 days. a. 25600-77 b. 25600-52 c. 29702, 29075 d. 29075

answer

d. 29075 application cast ... elbow to finger (short arm)

question

A patient is brought into the OR for a diagnostic arthroscopy of the shoulder. The patient has been complaining of pain since his surgery 4 months ago. the surgeon explores the shoulder and discovers a metal clamp which had been left in from the prior surgery. The surgeon removed the clamp and closed the patient up. a. 29805, 23331 b. 29805, 29819 c. 29819-78 d. 29819

answer

d. 29819 athroscopy, surgical, shoulder, with removal of loosebody or foreign body do NOT use -78 because the procedure was done outside of the postop period

question

A pataient with chronic emphysema has surgery to remove both lobes of the left lung. a. 32440 b. 32482 c. 32663 x 2 d. 32310

answer

a. 32440 removal of lung, pneumonectomy (left lung has 2 lobes)

question

A thoracic surgeon makes an incision under the sternal notch at the base of the throat, introduces the scope into the mediastinal space and takes 2 biopsies of the tissue. He then retracts the scope and closes the small incision. a. 39400 b. 32606 c. 39000 d. 32405

answer

a. 39400 mediastinoscopy includes biopsy(ies), when performed (under endoscopy for the mediastinum and diaphragm)

question

a patient has endoscopic surgery done to remove his anterior and posterior ethmoid sinuses. The surgeon dilatd the maxillary sinus with a balloon using a transnasal approach, explored the front sinuses, remove two polyps from the maxillary sinus, and then performed the tissue removal. a. 31255, 31295, 31237 b. 31201, 31295, 31237 c. 31255, 31267 d. 31255, 31295, 31267

answer

a. 31255 (nasal/sinus endoscopy, surgical with ethmoidectomy, total anterior and posterior) 31295 nasal/sinus endoscopy, surgical with dilation of maxillary sinus ostium eg. balloon dilation, transnasal or via canine fossa 31237 nasal/sinus endoscopy surgical with biopsy, polypectomy or debridement

question

the patient was scheduled for an esophagogastroduodenoscopy. Upon arrival they were placed under conscious sedation and instructed to swallow a small flexible camera. The camera was then manipulated into the esophagus, and through the entire length of the esophagus. The esophagus appeared to be slightly inflamed but there was no sign of erosion or flame hemorrhage. A small 2 cm tissue sample was taken to look for gastroesophageal reflux disease. There was no stricture or Barrett mucosa. The body and the antrum of the stomach were normal without any acute peptic lesions. Retroflexion of the tip of the endoscope in the body of the stomach revealed an abnormal cardia. There were no acute lesions and no evidence of ulcer, tumor or polyp. Thepylorus was easily entered, and the first, second, and third portions of the duodenum were normal. a. 43202 b. 43206 c. 43235 d. 43239

answer

d. 43239

question

Diagnostic amniocentesis includes radiologic supervision and interpretation. True or False.

answer

59000 amniocentesis, diagnostic does NOT include radiological supervision and interpretation (76946)

question

There are four subheadings in the radiology section. True or False.

answer

False. There are 7 subheadings in the radiology section.

question

True or False? reporting code 59300 is acceptable when reporting 59400.

answer

False. 59400 is the full surgical package.

question

True or False? the destruction codes in the posterior segment subsection include one or more sessions.

answer

true. posterior segment (eye) destruction codes includes one or more sessions that may occur at different encounters. these codes should be reported once during a defined treatment period.

question

true or false? radiology codes designated as a separate procedure should be reported in addition to the code for the total procedure or service.

answer

false. codes designated as separate procedure shouldnot be reported in addition to the code for the totl procedure if it is an integral part. Use mod -59 (distinct procedural service) if it is carried out independently or considered to be unrelatd to another procedure

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

true or false? when coding 51797 it is necessary to ad a modifier -51 (multiple procedure).

answer

false

question

true or false? The insertion and removal of a temporary stent during diagnostic or therapeutic cystourethroscopic interventtions is included in 52320-52355 and not reported separately.

answer

true. all include insertion and removal of temporary stents during the procedure even though code description doe not state this

question

urethral dilation codes are often divided based on this factor: a. initial or subsequent b. new or established c. patient status d. none of the above

answer

see manipulation on urethra and are divided based on initial or subsequent (see codes 53600-53665)

question

antepartum care includes:

answer

initial and subsequent history, physical exams, recording of weight, blood pressures, fetal heart tones and routine UA

question

During skull based surgery, if one surgeon performs the approach and a second physician performs the definitive procedure and a third physician performs the closure, what modifier is appended to the definitive procedure code? a. -62 co surgeons b. 66 team surgeons c. 80 assistant surgeon d. no modifier is used

answer

d. no modifier is used ... each surgeon reports only the code for the specific procedure performed (see page 342 in code book)

question

a fetal non-stress test is completed on a 36 week pregnancy. The correct code would be: a. 59050 b. 59012 c. 59020 d. 59025

answer

d. 59025 fetal non-stress test

question

There are _____ glands in the endocrine system of the body. a. 4 b. 5 c. 8 d. 9

answer

d. 9 There are 9 glands in the endocrine system but only 4 are included in 60000-60699.

question

In which of the following categories would you locate a code for the removal of an IUD? a. removal b. introduction c. manipulation d. excision

answer

b. introduction

question

A needle with a suture attached is passed through an incision into the stomach. The needle is snared and removed via the mouth. A gastrostomy tube is connected to the suture and passed through the mouth into the stomach and out the abdominal wall. what is the correct code for this procedure? a. 74230 b. 74340 c. 49440 d. none of the above

answer

d. none of the above ... use 43246 for a percutaneous placement of gastrostomy tube

question

within the endocrine system description, the terms subtotal and something less than the total. a. radical b. partial c. segmental d. limited

answer

b. partial

question

codes 76801 and 76802 include determination of the number of gestational sacs and fetuses, gestational sac/fetal measurements appropriate for gestation less than 14 weeks 0 days and, a. survey of visible fetal and placental anatomic structure b. qualitative assessment of amniotic fluid/gestational sac shape c. examination of the maternal uterus and adnexa d. all of the above

answer

d. all of the above

question

CT scan of brain, with and withoutout contrast medium enhancement

answer

Code 70470

question

laparoscopic myomectomy with removal of 8 intramural myomas

answer

Code 58546 myomectomy, laparoscopic 58545-58546

question

SPECT bone scan (single proton emission computed tomography and is a more sophisticated form of CT scanning

answer

78320, SPECT, bone/joint imaging 78320

question

laparoscopic sterilization procedure with Falope-rings, bilateral

answer

occlusion, fallopian tube, oviduct 58671

question

cystourethroscopy with biopsy of bladder wall

answer

cystourethroscopy, biopsy 52204

question

parathyroidectomy with mediastinal exploration

answer

parathyroidectomy 60505

question

YAG laser treatment of diabetic retinopathy

answer

retina, retinopathy, treatment, photocoagulation (67228-67229) code 67228

question

Suture of digital nerves to the left third and fourth fingers (neurorrhaphy)

answer

suture, nerve (64831-64876) code 64831-F2, 64832-F3

question

catherization with contrast injection for hysterosalpingogram

answer

58340 hysterosalpingography, injection procedure 58340 note: to fully report this procedure a radiological supervision and interpretation code would also be reported.

question

Assign a code for a cesarean delivery with postpartum care and a ligation of fallopian tubes performed at the same operative session

answer

59515, 58611 this is for a cesarean delivery, delivery and postpartum care only (no antepartum care), 59515. also report the add on code for the ligation of fallopian tubes, 58611 cesarean delivery, delivery with postpartum care ... 59515

question

liver imaging with vascular flow

answer

liver, nuclear medicine, vascular flow (NOT SPECT or 3D) code 78202

question

colposcopy of the cervix with a biopsy

answer

57455 colposcopy of the cervix only with biopsys do NOT use 57421 which is a colposcopy of cervix and vangina

question

nonselective pulmonaryt angiography, radiological supervision and interpretation

answer

angiography, pulmonary (range 75741-75746) Code 75746

question

removal of impacted cerumen from both ears

answer

cerumen, removal code 69210-50 (use mod 50 for bilateral removal)

question

stereotactic radiosurgery for eradication of 2.0 cm pituitary tumor

answer

brain, radiosurgery, for lesion (61796-61800) Code 61798 b/c a pituitary tumor is always considered complex regardless of the size

question

subtotal vitrectomy with endolaser panretinal photocoagulation

answer

vitrectomy, with endolaser panrrtinal photocoagulation (67040) code 67040-52 ... use mod 52 for subtotal reduced services)

question

myringotomy with aspiration under general anesthesia

answer

69421, myringotomy note: some doctors use tympanotomy which is synonymous with myringotomy. Myrinx is the greek root for eardrum. tympanum is the latin root for eardrum.

question

the physician anesthetizes the vagus nerve

answer

vagus nerve, injection, anesthetic code 64408

question

excision neuroma, digital nerve, right fourth finger

answer

neuroma, excision, digital nerve (range 64776-64778) code: 64776-F8 (use hcpcs code for digit)

question

placement of indwelling bladder, catheter

answer

bladder, catheterization (range 51701-51703) Code 51702 note: 51701-51703 should be reported only when performed independently

question

stereotactic biopsy of intracranial lesion with magnetic resonance (MR) guidance. Do not assign the radiological supervision andinterpretation code.

answer

biopsy, brain, stereotactic (range 61750-61751) code: 61751 b/c of MR documentation

question

myringotomy and insertion of ventilating tube in right ear under general anesthesia

answer

tympanostomy b/c insertion of vent. tube and not using myringotomy code: 69436-RT mod RT for right ear

question

urethral biopsy

answer

urethra, biopsy (range 52204,53200) code: 53200

question

chest xray, AP and lateral

answer

xray, chest (range 71010-71035) Code: 71020 front to back (AP) and side to side (lateral) 2-view xray

question

bilateral repair of blepharoptosis with frontalis muscle technique.

answer

blepharoptosis, frontalis muscle technique 67901 Code: 67901-50 (use mod 50 for bilateral procedure)

question

vaginal hysterectomy (weight of uterus 283 g) with bilateral salpingooophorectomy

answer

hysterectomy, vaginal, (range 58260-58270, 58290-58294, 58550, and 58554). Code: 58291 uterus over 250 grams with the secondary procedure being the removal of the tubes and ovaries

question

acute gastrointestinal blood loss imaging scan

answer

nuclear medicine, gastrointestinal, blood loss study, 78278 code 78278

question

vaginal delivery with episiotomy and use of forceps

answer

vaginal delivery, delivery only (no mention of ante or postpartum care) Code: 59409

question

anesthetic injection of sphenopalatine ganglion

answer

injection, ganglion, anesthetic (range 64505, 64510) code: 64505 Section: surgery, nervous system

question

excision of chalazions (3) from left upper and left lower eyelids

answer

chalazion, excision, different lids 67805 Do not used modifiers with these codes for multiple chalzions

question

endoscopy with fulguration of 3 bladder tumors ranging in size from 0.4 to 1.6 cm

answer

fulguration, cysourethroscopy with, tumor (range 52234-52240) Code: 52234 note: the code is assigned once regarless of tghe number of tumors treatd. Each tumor should be measured individually to determine the appropriate category (e.g. small, medium, large). CPT code 52234 should be reported once for single or multiple tumors that individually measure 0.5-2.0 cm.

question

xray of mandible, five views

answer

mandible, xray, (range 70100-70110) Code: 70110 for 4+ views

question

anterior discectomy, T2-T4

answer

63077, 63078 an interspace t2-t4 = 2 interspaces...t2-t3 and t3-t4

question

cystoscopy with balloon dilation of UPJ, stenosis

answer

UPJ=ureteropelvic junction Index: cystourethroscopy, dilation, ureter, range 52341-52342 and range 52344-52345. Code: 52342 Remember: that indexing the main term endoscopy, ureter, will result in codes that describe lapaaroscopic procedures, rather than cystoscopic.

question

strabismus surgery with 6 mm recession of superior rectus muscle and 3 mm recession of inferior rectus muscle, with placement of adjustable sutureat inferior rectus

answer

strabismus, repair, two vertical muscles AND strabismus, repair, adjustable sutures, resulting in code 67316 for the primary procedure and add on code 67335 to report that adjustable sutures were used. This allows for fine tuning the alignment when the patient has awakened from anesthesia and is moing the eyeball.Because code 67335 is an add on code, no modifier such as 51 or 59 is needed.

question

cystourethroscopy with diagnostic ureteroscopy and removal of ureteral stones

answer

52352 Describes removal of a ureteral stone via a cystourethroscopy with ureteral catheterization cystourethroscopy, removal, calculus (52310, 52315, 52320, 52325, 52352)

question

radical retropubic prostatectomy

answer

protatectomy, retropub, radical, range 55840-55845 or code 55866. Code: 55840 b/c there is no mention of laparscopic (55866)

question

transmastoid excision of glomus tumor of ear

answer

excision, tumor, ear, middle, transmastoid, 69552

question

penetrating keratoplasty, aphakic eye

answer

keratoplasty, penetrating, in aphakia, 65750

question

retroperitoneal ultrasound of one organ

answer

ultrasound, retroperitoneal, range 76770-76775. Code: 76775 reports a limited retroperitoneal ultrasound such as one organ

question

removal of a bead from a toddlers external ear canal using conscious sedation

answer

removal, foreign bodies, auditory canal, external 69200 conscious sedation is not general anesthesia. it is a combination of medicines to help you relax and to block pain during a medical or dental procedure. general anesthesia induces a state of unconsciousness, along with the absence of pain sensation and the paralysis of skelatal muscles

question

total cystectomy with continent diversion using large intestine

answer

51596 cystectomy, complete, with continent diversion in this procedure the ureters are implanted into a segment of the large or small intestine with an opening onto the skin

question

laparaoscopic fulguration of endometrial implants on the peritoneum and broad ligament

answer

lapaaroscopy, destruction, lesion, ... code 58662

question

laser photocoagulation of retina for prophylaxis of retinal detachment

answer

retina, repair, prophylaxis, detachment ... (range 67141-67145) Code: 67145 due to laser being used

question

transurethral resection of prostate with control of postop bleeding

answer

prostate, excision, transurethral (codes 52402, 52601, 52630). Code: 52601 (b/c it is not a staged procedure)

question

totalabdominal hysterectomy, with an anterior/posterior colporrhaphy and an enterocele repair.

answer

hysterectomy, abdominal, total code 58150 colporrhaphy, anteriorposterior, with enterocele repair 57265-51 Use Mod 51 for multiple procedures

question

D&C was performed on a patient with dysfunctional uterine bleeding.

answer

dilationand currrettage, corpus uteri (which is the uterus) 58120 do not use 59160 postparten D&C which is not appropriate for this procedure

question

injection of bupivacaine and depo-medrol, L4 facet

answer

injection, spinal cord, anesthetic (range 62310-62319) Code: 62311 (injection of a steroid depo-medrol and anesthetic bupivacaine into a lumbar facet joint

question

scleral buckle for retinal detachment

answer

retina, repair, detachment, by scleral buckling (range 67107-67108, 67112-67113) code: 67107

question

injection of lidocaine, brachial plexus

answer

injection, nerve, anesthetic (range 01991-01992 or 64400-64530) Code: 64415 for brachial plexus

question

posterior hemilaminectomy with herniated discectomy L2 through L4

answer

hemilaminectomy (range 63020-63044) Code: 63030, 63035 x 2

question

extracapsular cataract extraction by phacoemulsification with placement of posterior chamber IOL

answer

cataract, removal/extraction, extracapsular (range 66982 or 66984) Code: 66984

question

drainage of abscess of external ear canal

answer

auditory canal, external, abscess, incisionand drainage code: 69020 Note: this is an abscess of the canal (auditory) and not just an abscess of the ear

question

removal and replacement of electgromagnetic hearing aid in temporal bone

answer

temporal bone, electromagnetic bone conducting hearing device, implantation/replacement Code: 69710

question

drainage of an infected thyroglossal duct cyst

answer

cyst, thyroglossal duct, incision and drainage Code: 60000

question

chest xray, 2 views, frontal and lateral;with fluoroscopy

answer

xray, chest, partial (2 views) with fluoroscopy Code: 71023

question

xray of fractured hip in the operating room to confirm reduction

answer

xray, hip, intraoperative Code: 73530

question

vaginal removal of a 230 gram uterus

answer

uterus, excision, vaginal (range 58260-58270) Code: 58260

question

laparoscopic ureterolithotomy

answer

ureterolithotomy, laparoscopic Code: 50945 ureterolithotomy can be performed cystoscopically or via laparoscopically

question

colposcopy of cervix with cervical curettage

answer

colposcopy, cervix (range 57420-421, 452, 454-456, 460-461 Code: 57456

question

total right sided thyroid lobectomy with isthmusectomy and subtotal resection of left thyroid

answer

thyroidectomy, partial (range 60210-60225) Code: 60225

question

bilateral salpingo-oophorectomy for ovarian malignancy with pelvic lymph node and peritoneal biopsies

answer

salpingo-oopherectomy, resection ovarian malignancy (range 58950-58958) Code: 58943

question

cervical myelogram, radiological supervision and interpretation

answer

myelography, spine, cervical Code: 72240 + code for injection of the contrast material ex

question

excision of posterior fossa meningioma tumor via craniectomy

answer

excision, meningioma (range 61512, 61519) Code: 61519

question

decompression craniectomy for treatment of intracranial hypertension

answer

craniectomy, decompression (range 61322-61323, 61340-61343) Code 61322

question

laminectomy for excision of intraspinal lesion, extradural, lumbar

answer

laminectomy, for excision, intraspinal lesion, othern than neoplasm Code: 63267

question

repeat dilation of urethral stricture with filiforms and followers, male patient

answer

dilation, urethral stricture (52281 and range 53600-53621) code: 53621 subsequent dilation of a male patient

question

MRI of brain with contrast

answer

magnetic resonance imaging, brain (range 70551-70555) Code: 70552

question

ventriculoperitoneal shunt procedure

answer

shunt, brain, creation (62180-62223) Code: 62223

question

intravenous pyelogram with KUB and tomograms

answer

pyelogram directs you to urography, intravenous (range 74400-74415) Code: 74400

question

phenol injection for destruction of the infraorbital branch of the trigeminal nerve

answer

destruction, nerve (64600-64681) code: 64600

question

subtemporal decompression procedure for pseudotumor cerebri

answer

decompression, skull (61322-61323 or 61340-61345). code: 61340

question

diagnostic lumbar spinal tap

answer

spinal tap, lumbar 62270 OR puncture, spinal cord, diagnostic = 62270

question

xray, neck, 6 views, including oblique and flexion

answer

xray, spine, cervical (72040, 72050, 72052) Code: 72052

question

xray, including fluoroscopy, of pharynx for foreign body

answer

xray, pharynx (70370, 74210) Code: 70370

question

excision of adenoma of thyroid

answer

excision, thyroid gland, tumor code 60200

question

tympanoplasty with mastoidectomy with ossicular chain reconstruction

answer

Code: 69642

question

donor nephrectomy, live donor

answer

nephrectomy, donor (50300-50320 or 50547) Code: 50320

question

pin-back procedure for protruding ear

answer

ear, external, reconstruction Code: 69300 OR use index main term otoplasty

question

barium enema with KUB

answer

barium enema (74270-74280) Code: 74270 KUB + kidneys, ureters, and bladder

question

extrcorporeal sound wave lithotripsy of large kidney stone

answer

lithotripsy, kidney (50590 or 52353) Code: 50590

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