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The CPT® code book provides full descriptions of medical procedures, although some descriptions require the use of a semicolon (;) to distinguish among closely related procedures.
What is the full description of CPT® code 69644?
Tympanoplasty with mastoidectomy (including canalplasty. middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction
Without ossicular chain reconstruction with intact or reconstructed canal wall, with ossicular chain reconstruction
With intact or reconstructed canal wall with ossicular chain reconstruction
Tympanoplasty with mastoidectomy (including canalplasty. middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction with intact or reconstructed canal wall, with ossicular chain reconstruction
Which statement regarding lesion excision is TRUE?
Lesion excision codes include removal of a lesion, with margins, and simple (nonlayered) closure when performed
Lesion excision codes are selected by measuring the greatest clinical diameter of a lesion excluding the margins required to complete the excision
Lesion excision codes include removal of a lesion, with margins, and intermediate closure when performed
Lesion excision codes include removal of a lesion with margins, and complex closure when performed
Which one of the following is an example of a case in which a diabetes-related problem exists and the code for diabetes is never sequenced first?
If the patient has hyperglycemia that Is not responding to medication
If the patient has an underdose of insulin due to an insulin pump malfunction
If the patient is being treated for secondary diabetes
If the patient is being treated for type 2 diabetes
A patient suffering from idiopathic dystonia is seen today and receives the following Botulinum injections: three muscle injections in both upper extremities and seven injections in six paraspinal muscles.
How are these injections reported according to the CPT® guidelines? A. 64644, 64647 x 7
B. 64642-50, 64643-50, 64647
C. 64642, 64643, 64647
D. 64642 x 3, 64642 x 3, 64647 x 7
According to the Application of Cast and Strapping CPT® guidelines, what is reported when an orthopedic provider performs initial fracture care treatment for a closed scaphoid fracture of the wrist, applies a short arm cast, and the patient will be returning for subsequent fracture care?
A. 25622
B. 29075
C. 25622, 29075
D. 29075-22
A patient is diagnosed with diabetic polyneuropathy.
Using ICD-10-CM coding guidelines, what ICD-10-CM coding is reported? A. E10.42
B. E11.9, G62.9
C. E10.9, G62.9 D. E11.42
An elderly patient comes into the emergency department (ED) with shortness of breath. An ECG is performed. The final diagnosis at discharge is impending myocardial infarction.
According to ICD-10-CM guidelines, how is this reported? A. I20.0
B. R06.02
C. I20.0, R06.02 D. I21.3, R06.02
Patient had polyps removed on a previous colonoscopy. The patient returns three months later for a follow-up examination for another colonoscopy. No new polyps are seen.
What diagnosis coding is reported for the second colonoscopy? A. Z09, Z86.010
B. K63.5
C. Z86.010, K63.5
D. Z09, K63.5
A patient is diagnosed with sepsis and associated acute respiratory failure. What ICD-10-CM code selection is reported?
A. A41.9, R65.20, J96.00 B. A41.9
C. A41.9, R65.21, J96.00 D. A41.9, J96.00
A 44-year-old female patient with chest pains had a CT of her chest that identified a mass in her left lower lung. The patient currently has ovarian cancer with metastases to the liver. The radiologist suspects the cancer has spread to her lungs. The physician performed an outpatient bronchoscopic biopsy and the pathology report documents the mass as a tumor of uncertain behavior.
What ICD-10-CM codes are reported for this patient? A. R91.8, C56.9, C78.7
B. C56.9, C78.7, C78.02
C. C78.02, C22.9, C79.82 D. D38.1, C56.9, C78.7
A 35-year-old female has cancer in her left breast. The surgeon performs a mastectomy, removing the breast tissue, skin, pectoral muscles, and surrounding tissue, including the axillary and internal mammary lymph nodes.
Which mastectomy code is reported? A. 19303
B. 19305
C. 19306
D. 19307
A 30-year-old patient with a scalp defect is having plastic surgery to insert tissue expanders. The provider inserts the implants, closes the skin, and increases the volume of the expanders by injecting saline solution. Tissue is expanded until a satisfactory aesthetic outcome is obtained to repair the scalp defect.
What CPT® code is reported?
A. 11960
B. 11970
C. 15777
D. 19357
A 5-year-old is brought to the QuickCare in the ED to repair two lacerations: a 3 cm laceration on her right arm and 2 cm laceration on her nose. Her arm is repaired with a simple one-layer closure with sutures. Her nose is repaired with a simple repair using tissue adhesive, 2-cyanoacrylate.
How are the repairs reported? A. 12013
B. 12032, 12041-59
C. 12002
D. 12002, 12011-59
A 25-year-old woman underwent percutaneous breast biopsy on the right breast with placement of a Gelmark clip. The procedure was performed using stereotactic imaging.
What CPT® codes will be reported? A. 19081
B. 19100, 76098
C. 19101, 19283
D. 19081, 19283
A patient with three thyroid nodules is seen for an FNA biopsy. Using ultrasonic guidance, the provider inserts a 25- gauge needle into each nodule. Nodular tissue is aspirated and sent to pathology.
What CPT® coding reported? A. 10005, 10006 x 2, 76942
B. 10006 x 3
C. 10005, 10006 x 2
D. 10021, 10004 x 2, 76942
Mr. Woolridge has had a suspicious lesion on his left shoulder for approximately eight weeks that is not healing. On the dermatologist's exam of left shoulder blade, there is excoriation and scabbing and the lesion not healing. Patient agrees and wishes to proceed with a punch biopsy of the lesion. A punch biopsy is taken of the lesion and sent to pathology. A simple repair is performed at the biopsy site.
What CPT® and ICD-10-CM codes are reported? A. 11102, 12001-51, D49.2
B. 11102, L98.9
C. 11104, D49.2
D. 11104,12001-51, L98.9
A surgeon performs midface LeFort I reconstruction on a patientâs facial bones to correct a congenital deformity. The reconstruction is performed in two pieces in moving the upper jawbone forward and repositioning the teeth of the maxilla of the mid face.
What CPT® code is reported? A. 21146
B. 21141
C. 21142
D. 21145
A patient had surgery a year ago to repair two flexor tendons in his forearm. He is in surgery for a secondary repair for the same two tendons.
Which CPT® coding is reported?
A. 25263
B. 25272 x 2
C. 25272
D. 25263 x 2
A 45-year-old has a dislocated patella in the left knee after a car accident. She taken to the hospital by EMS for surgical treatment. In the surgery suite, the patient is placed under general anesthesia. After being prepped and draped, the surgeon makes an incision above the knee joint in front of the patella. Dissection is carried through soft tissue and
reaching the patella in attempt to reduce the dislocation. When the patella is exposed, it is severely damaged due to cartilage breakdown. The tendon is dissected and using a saw the entire patella is freed and removed. The tendon sheath is closed with sutures.
What procedure code is reported for this surgery? A. 27562-LT
27552-LT
27556-LT D. 27566-LT
A 42-year-old with chronic left trochanteric bursitis is scheduled to receive an injection at the Pain Clinic. A 22-gauge spinal needle is introduced into the trochanteric bursa under ultrasonic guidance, and a total volume of 8 cc of normal saline and 40 mg of Kenalog was injected.
What CPT® code should be reported for the surgical procedure? A. 20610-LT
B. 20611-LT, 76942
C. 20611-LT
D. 20610-LT, 76942
A 60-year-old male suffering from degenerative disc disease at the L3-L4 and L5-S1 levels was placed under general anesthesia. Using an anterior approach, the L3-L4 disc space was exposed. Using blunt dissection, the disc space was cleaned. The disc space was then sized and trialed. Excellent placement and insertion of the artificial disc at L3-L4 was noted. The area was inspected and there was no compression of any nerve roots. Same procedure was performed on
L5-S1 level. Peritoneum was then allowed to return to normal anatomic position and entire area was copiously irrigated. The wound was closed in a layered fashion. The patient tolerated the discectomy and arthroplasty well and was returned to recovery in good condition.
What CPT® coding is reported for this procedure? A. 22857 x 2
B. 22857, 22860
C. 22857
D. 22899
A 67-year-old male presents with DJD and spondylolisthesis at L4-L5 The patient is placed prone on the operating table and, after induction of general anesthesia, the lower back is sterilely prepped and draped. One incision was made over L1-L5. This was confirmed with a probe under fluoroscopy. Laminectomies are done at vertebral segments L4 and L5 with facetectomies to relieve pressure to the nerve roots. Allograft was packed in the gutters from L1-L5 for a
posterior arthrodesis. Pedicle screws were placed at L2, L3, and L4. The construct was copiously irrigated and muscle; fascia and skin were closed in layers.
Select the procedure codes for this scenario. A. 63005 x 2, 22612, 22614 x 3, 22842
B. 63042, 63043, 22808, 22841 x 3
C. 63047, 63048, 22612, 22614 x 3, 22842
D. 63017, 63048, 22612, 22808, 22842 x 3