MOCK-2

Medical Terminology

1. what is the characteristic of macrocytic anemia-

A)usually large red blood cells B)too many red blood cells

B)not enough red blood cells D)unusually small red blood cells

2.A dacryocystectomy describes-

A)Excision of the lacrimal sac B)Excision of the cornea

C)Excision of the pupil D)Excision of the sclera

3.a surgical procedure to correct a deviated septum is-

A)Septoplasty B)Maxillectomy

C)Rhinectomy D)Rhinoplasty

4.the medical term transcutaneous found in the code description for code 91132 means:

A)Mechanically vibrating the skin to contract

B)Cutting into the skin for removal

C)Puncturing the skin with a punch device

D)penetrating or passing through the intact skin

Anatomy
5.The document state In addition, we left a very important swath of pedicle emanating from the ventral
surface of the skin that was feeding the corpus spongiosum in between each corporal body.What anatomical
structure is being referred to?

A)Foot B)chest C)Breast D)Penis

6.The operative note indicates that the patient was placed in prone

A)Lying at an angle B)Lying down on the back with face up

C)Lying face down on the back with face up D)Erect,facing forward

7.With a blood pressure of 120/80, the number 120 systolic and 80 diastolic,what do systolic diastolic mean?
A)sytolic is the blood pressure when the heart is pumping ,diastolic is the blood pressure when the heart rate
is rest

B)sytolic is when the patient enhaling,diastolic is when the patient inhaling

C) diastolic is when the patient enhaling,sytolic is when the patient inhaling D)sytolic is the blood pressure
when the heart rate is rest ,diastolic is the blood pressure when the heart is pumping

8.Sciatica is caused by a defect in the lumbosacral nerve roots and usually manifests itself as:

A) A unilateral leg pain B)bilateral foot pain

C)bilateral ankle pain D)A unilateral arm pain

Coding Concepts
9.when does anesthesia time begin according to CPT guidelines?

A)when the surgon starts the surgery

B)when the anaesthesiologist wheels the patient to the hospital

C)when the patient is registered in the hospital

D)when he anestheiologist prepare the patient for the surgery

10.Which code set is NOT used by physician to identify diagnoses and procedures in a outpatient

A)CPT B)ICD-10-CM C)ICD-10-PCS D)HCPCS Level II

11. According to PT®️ coding guidelines for radiology code range 76881-76886, which codes are reported for
spectral and colour Doppler evaluations of the extremities

a. 93925-93931, 93970, 93971

b.73700-73702

c. 76881, 76882

d.73560-73565

12. When a patient is asymptomatic and tests positive for COVID is code U07.1 COVID-19 reported?

a. No, report code Z11.52 Encounter for screening for COVID-19.

b. No, report code Z01.84 Encounter for antibody response examination.

c. No, report code Z20.822 Contact with and (suspected) exposure to COVID-19.

d. Yes, report U07.1 COVID-19 because the patient has tested positive and is considered to have the
infection
13. When a final diagnosis has not been established by the provider, it is acceptable to report codes for the
presenting
signs and symptoms.

a.True

b.False

14. Initial, local treatment, first-degree burn, of back of hand, 5% body surface. The burn was caused by
steam from a pipe at his home that accidentally was connected improperly.
CPT Code(s): ___________________
ICD-10-CM Code(s): _______________

15. According to ICD-10-CM coding guidelines when is a poisoning code (T36-T50) NOT reported as a primary
code?

a. Assault poisoning

b. adverse effects

c. accidental poisoning

d. Intentional poisoning

ICD-10-CM
16.The patient is documented as having COPD with moderate persistent asthma.what is reported?

A)J44.0,J45.998 B)J44.1 C)J44.9,J45.901 D)J44.9,J45.40

17. A type 1 diabetic patient presents to the emergency department is uncontrolled ketoacidosis.after
evaluation by the emergency department physician,it is determine that the patient’s insulin pump
malfunctioned resulting in an underdose of insulin for the past 24-hours the patient is admitted to the
hospital for treatment to control the ketoacidosis,according to ICD-10-CM coding guied lines how is this
reported?

A)T85.6141,T38.3X6A,E10.10 B)E13.10,T38.3X1A,T85.614A

C)E10.10,T85.614A,T38.3X1A D) T38.3X1A, T85.614A,E08.10

18.The patient undergoes surgery for a ruptured tubal pregnancy.what is the ICD_10_CM?

A)O00.109 B)O00.219 C)O00.90 D)O00.80

19.A patient who is undergoing chemotherapy for primary liver cancer is seen today for management of
dehydration due to the effects of chemotherapy, the patient receives IV rehydration therapy for 2.5 hours to
restore stable hydration volume ,patient did not recive chemotherapy .what diagnosis codes are reported for
this patient encounter.

A)C22.8,E86.0 B)C78.7,E86.0 C)E86.0,C22.8 D)E86.0,C78.7

20.A patient is seen in the emergency department for epigastric abdominal pain,nausea and vomiting.the
patient is examined, and tests come back showing acute appendicitis with generalized peritonitis.what is the
ICD-1O-CM

A)K35.20,R10.13,R11.2 B)K35.80,K65.9,R10.13,R11.0,R11.10 C)K36 D)K35.20

HCPCS
21.Medicare patient is given a pneumonia vaccine.What codes is reported for the administration of the
vaccine?

A)G9280 B)G8864 C)90471 D)G0009

22.The patient is given a joint injection of 40 mg Depo-Medrol into the right shoulder?How is the medication
reported?

A)J1020 B)J1040 C)J1030 D) J1050

23.What is the HCPCS level II code for a short arm plaster cast for 9-year-old patient?

A)Q4011 B)Q4013 C)Q4007 D)Q4009

Compliance & Regulatory

24.Which one of the following is paid under part B for medicare?

A)Vitamins B)Clinical infusion C)Hospital nursing care D)Inpatient dialysis

25.Which is NOT included in the global surgical package?

A)A visit unrelated to the diagnosis for which the surgical procedure was performed

B)Immediate postoperative care

C)preoperative visit on the day of the procedure

D)Tropical anesthesia
26.which is an example of fraud?

A)reporting services rendered in cardiac catheter lab

B)performing a diagnostic X-ray without provider’s order

C)hydration services performed in conjuction with chemotherapy services

D)observation services for a patient with an AMI requiring constant monitoring?

E/M 99202-99499
27. Bob was on a cruise in Mexico when he developed nausea, vomiting, and diarrhea. Bob in his cabin a
detailed history was obtained and an expanded problem focused was performed. The medical doctor
advised bob to hydrate and to avoid alcohol and rich/spicy food for 48 hours. What E/M is reported?

A.99342 B.99325 C.99326 D.99343

28. A 45-yaers old patient sees Dr. Woods in his office for a consult at the request of her primary care
physician Dr. Shleds for an ongoing problems with allergies. The patient has failure Claritin and Alavert and
feels her symptoms continue to worse. Dr. woods performs an expanded focused history and exam discusses
options with the patient allergy management. The MDM moderate complexity. The patient agrees she
would like to be tested to possible gain better control of her allergies. Dr. Woods sends a written report
that includes his findings and the date the patient is scheduled for allergy testing. What E/M codes is
reported by Dr. Woods?

A.99213 B.99242 C.99252 D.99202

29. The provider visits his patient in the hospital on the morning rounds and spends 20 minutes with the
patient. Later that same day, he sees the patient and discharges her and providing detailed exam, spending
another 20minutes on the discharge. What is reported for the discharge service?

A.99238 B.99234 C.99239 D.99217

30. A 31-years old patient sees his treating physician and collaborative care management for depression. The
total time spent with patient is 85 Minutes. What E/M code is reported?

A.99493, 99494 B.99492 C.99493 D.99492, 99494

31. A 26-yaers old patient presents to his longtime family practice physician Dr. Garrett, complaining of LT
arm pain at bedtime. patient was last evaluation by Dr. Garrett four years ago, physician documents a
comprehensive history and exam , EKG reveals a normal sinus rhythm, MDM is low, A/P, anxiety, reassured
the patient that his heart is fine discussed relaxation techniques and patient will follow up if symptoms
worsen. What is the level of E/M and diagnosis codes for his patient encounter?

A. 99215, F41.9 B. 99203, F41.9 C. 99202, F41.1 D.99213, F41.9

32. Medical review and documentation of an established patient supports a detailed history of four elements
of HPI, Five elements of ROS, and completes past family social history also supported by the documentation
is and comprehensive examination of 8 organ systems. the physician documents a moderate complexity
MDM what established patient office evaluation and Management?

A. 99215 B. 99213 C.99214 D.99212

Anesthesia 00100-01999
33.A patient who suffers from chronic left elbow pain receives high energy extracorporeal shock wave
therapy(ESWT) for musculoskeletal therapy,what is the CPT coding to report for this procedure?

A)0101T B)28890 C)0512T D)0102T

34. A 53-year old female had a left radical mastectomy for cancer.she presents to surgery today for left
breast reconstruction with supercharging,the anaesthesiologist provided general endotracheal
anesthesia.What CPT anaesthesia code is reported?

A)00402 B)00404 C)00406 D)00400

35.A 67-year old female in good physical health is having an appendectomy. The anaesthesiologist begins to
prepare this patient for surgery at 10:30 AM and ends at 12:00.The anaesthesiologist releases the patient to
the PACU nurses at 12:15PM .what is the anaesthesia time and anaesthesia code are reported?

A)2 hours, 15 minutes;00790 B)1 hour, 30 minutes;00840

C)1 hour, 15 minutes;00790 D)1 hours, 45 minutes;00840

36.A 30-year old suffered an injury to his left knee in a work –related altercation when he was tripped by the
suspect without falling.This resulted in a tear of his anterior cruciate lingament and a near of his lateral
meniscus.He is having an arthroscopic ACL reconstruction and lateral meniscal repair.What anesthesia code
is reported?

A)01320 B)01402 C)01400 D)01380

Radiology 70010 – 79999

37.The cardiologist believes Mrs.Keely is at risk for heart failure.A cardiac MRI without contrast and
adenosine injection for stress imaging is ordered.The MRI results will determine if there is any narrowing or
blockage in the heart.what CPT code is reported?
A)75559 B)75557 C)75563 D)75561

38.An ultrasound of the transplanted kidney is performed without a duplex Doppler.How is this coded?

A)76775 B)76700 C)76776 D)76705

39.A 30- year old male has been complaining of chronic headaches,A brain imaging metabolic positron
emission tomography scan is perfomed.The scan shows an enhancing abnormally in the region of the frontal
lobe.A diagnosis of malignant neoplasm of the frontal lobe of the brain is documented.what CPT and
ICD_10_CM codes are reported?

A)70450,C71.1,R51 B)78600,C71.1 C)78610,C71.1,R51 D)78608,C71.1

40.A patient has disc herniation at cervical C5-C6 and T2-T3,the radiologist performs a myelography of the
cervical and thoracic regions to detect further cord impingements.what CPT coding is required?

A)72270-26 B)72270-26,72270-26 C)72285-26 D)72240-26,72255-26

41.A patient who may have blockage in the right leg is undergoing an angiogram in which the left femoral
artery is cannulated with catheter and advanced into the aorta and then into the right external iliac
artery.Contrast medium is injectd.There is an 80% lesion in the popliteal artery.What CPT codes are reported
for Professional component?

A)36216,75716-26 B)36216,75736-26

C)36246,75710-26 D)36246,75716-26

42.A 50- year old male on examination has couple thyroid nodules without clinical symptoms of
hyperthyroidism.Blood thyroid function tests indicate euthyroidism.The physician images the thyroid gland
by intravenously administering radio iodine.Multiple images are acquired from different angles and
documenting the patients position,the vascular flow in around the nodules is looked at to determine benign
from malignant flow characteristics.What radiology code is reported?

A)78013 B)78012 C)78070 B D)78015

Pathology and Laboratory 80047 - 89398

43.A 25-year –old female with a family history of breast cancer is tested for BRCA1 and 2 on the same
day.The test includes full sequence and duplication analysis to determine her risk of developing
cancer.Testing revealed she is BRCA1 postive.How is this testing reported?

A)81162 B)81163,81164
C)81165,81216 D)81165,81166,81216,81167

44.A patient with a sudden abnormal weight gain and fatigue is suspected of having hypothyroidism.The
provider orders TSH and T$ free lab work.What CPT and ICD-10-cm codes are reported for the lab work?

A)84443,84445,E03.9 B)84443,84439,R63.5,R53.83
C)84436,84445,E03.9 D)84436,84439,R63.5,R53.83

45.A patient with diabetic ketoacidosis had two blood test to check her potassium level after the initial
potassium value, a subsequent blood test was ordered and performed on the same date.What is the coding?

A)84132,84132-76 B)84132,84132-91

C)84132,84132-51 D)84132,84132-90

46. A young man is found dead in his apartment.The physician perfoms a limited gross autopsy of organs and
tissue within a region of the body to determine the cause of death.what code is reported for the physician’s
service?

A)88020 B)88045 C)88036 D)88040

47. A female patient with AIDS and a compromised immune system presents with fever,shartness of breath,
and productive cough.The physician suspects pneumocytosis.A Total of four sputum strain samples are taken
for scrrning and interpretation,which lab test is reported for this service?

A)88162 B)88160 C)88312 D)88172

48.A 30-year old male arrives in the ED by EMS.He hass been in the ED before and is well known for drug
abuse.He is in and our of consciousness.The ED physician orders presumptive drug testing,running 12
immunoassay o a multiplex automated chemistry analyser.The test comes back positive for
alcohol.Barbiturates.and mariiuana.A definitive confirmation drug test is performed for barbiturates,select
the correct codes?

A)80307 X12,80345 B)80305 X12,80320,80349,80345

C)80307,80345 D)80305 X3,80345

Medicine 90281 - 99607

49. Mrs. Kinder has 20 actinic keratoses on the trunk of a body. Physician assistants apply the reasons for the
photosensitizing drugs to the lesions. The physician assistant asks the patient to come back later in the day
of falling application of the drug. When the patient returns later the day the position assistant then exposes
the area to blue light. The photosensitizing drug in the lesion observes the light and produces an active form
of oxygen that destroys abnormal cells. What CPT coding is reported for this procedure?

A. 96567x20 B. 96573

C. 965 67 D. 965 73x20

50. A 41 years old patient is seen for somatic dysfunction in multiple body areas, osteopathic manipulative
treatment is performed to the following regions, cervical, thoracic, lumbar, sacrum pelvis both and
abdominal. what CPT code is reported?
 A.98928 B.98928X2 C.98928X9 D.98928X7

51. A Physiotherapist performs a physical re-evaluation of a basketball player's right knee sprain of the
cruciate ligament to determine training status. An exam including a renew of history, standardized tests and
measures, and a revision plan of care is provided. What are the CPT and ICD-10-CM codes for reporting?

A.97164, S86.911A B.97168, S86.91XA C.97164,S83.501A

D.97161, S83.61XA

52. A patient is seen in the radiology clinic for numbness and tingling of both arms and legs. The vision
suspects it is related to thoraces outlet syndrome. The radiologist performs a completed literal multiple level
segmental Doppler waveform analysis of the 8 years both upper and Lower Limbs. what CPT coding is
reported for this and counter?

A.93923 B.93923-22

C.93923-50, 93923-50 D.93923, 93923-59

53. A patient has breast cancer and is in the oncology office for her due to chemotherapy. during the
encounter, she receives IV hemotherapy medication for 1 hour and 16 minutes. what is the coding for the
encounter according to CPT and ICD 10 cm guidelines?

A.96413, 96415, C50.919 B.96413, Z51.11, C50.919

C.96413, 96415, Z51.11, C50.919 D.96413, C50.919, C51.11

54. A 65 years old come into the ED with atrial fibrillation. Two paddles are placed on the patient's chest any
direct current of 120J of synchronized biphasic shock is delivered but aerial fibrillation appeared to persist
after a few sinuses beat. Therefore a 200j of synchronized biphasic shock was delivered, and this time sinus
rhythm was restore and persisted and persisted. How is the procedure reported?

A.92960 B. 92961 C.92970 D.92950

Integumentary 10021-19499
55. A 40 years old patient who has type 1 diabetes develop a diabetic ulcer on her lower left foot which wear
debrided and crafted last weekend she is scheduled to return to the operating suite for split-thickness
autografting. The homografts are taking quite nicely, the wounds appear to be fairly clear, with good
hemostasis a donor site was then obtained on the right anterior thigh, measuring 135 CM. The wound was
then crafted with a split-thickness autographed that was harvested with a patcher brown dermatomal set
12000 off an inch thick. This was measured 1.5;1. The donor site was infiltrated with bupivacaine and
dressed. The skin graft was then applied over the wound measured approximately 125 CM in dimension on
the left foot. what CPT coding is reported?

A. 15120-58, 15121-58 B. 15120 C. 15120-78 D. 15120-78, 15121-78

56. A 50-year-old years old male with years of Sun exposure sees his Dermatologist for a yearly skin. The
Dermatologist finds two malignant lessons. The lesion on his scalp is 1.5cm and the lesion on his arm 2.5cm.
Methods of removal or Iske side and patient agree to cryosurgery to remove the lesions. The provider places
liquid nitrogen to both lesions. What CPT code would you report?

A.17000, 17003 B.17263, 17272-51 C.17106x2

D.17110x2

57. A single layer repair is performed to close a 5cm laceration on the right leg that required copious
irrigation and extensive cleaning to remove a large amount of embedded debris. According to the repair CPT
guidelines which report code is reported?

A.12032 B.12002 C.13121 D.12042

58. A 77 years old female has stage 4 coccygeal ulcers. An elliptical incision was performed with 10 blade
scalpel to the ulcerated region. The ulcerated tissue around the sacrum region down to the bone was
removed. coccyx was excised to the hello draining of the presacral space. What's CPT and ICD-10-CM codes
are reported?

A.15922, L89.154 B.15922, L98.426 C.15920, L89.154

D.15920, L98416

59. A 25-year-old female has third-degree burns of the upper right leg and ARM with circulatory
compromise. An escharotomy is performed on the right leg with three incisions and two incisions on the
arm. What CPT codes are reported?

A.16030, 16035, 16036 B.16035, 16036

C. 16035, 16036x4 D.16030, 16036x5

60. Follow-up debridement of necrotizing fasciitis on the left leg and right arm. The position debrided 65
sq.cm subcutaneously on the left leg. A total of 45 sq.cm was also debrided for the right arm down to the
muscle, what debridement codes are reported?

A. 11044, 11047x3, 11043, 11046x2 B.11044, 11047x2, 11042, 11045x3

 C.11043, 11046x2, 11042, 11045x3 D.11043, 11046, 11042, 11045x2

Musculoskeletal 20100-29999
61. An orthopedic surgeon performed subsequent treatment for non-Union tibial fracture using a graft that
slides into the defect to the bone fragments. What are CPT and ICD-10-cm codes?

A. 27722, S82.202G B. 27724, S82.202S

C. 27722, S82.202K D. 27724, S82.202M

62. A general surgeon performs an exploration of a penetrating wound of the chest following an accident, it
requires an intermediate repair of am 8cm wound , what CPT codes are reported?

A. 20101, 12034 B. 20102, 12031 C. 20101, 12031 D. 20102, 12034

63. A 25-years old has effusion of the right wrist and needs fluid removed. The site is marked and prepared in
sterile fashion, lidocaine is introduced into joint space. Samples were sent to the lab for analysis. What CPT
code is reported for the surgical procedure?

A. 25031-RT B. 25115-RT C. 20606-RT D. 20605-RT

64. A 70-years old male has pathological fractures of the C6 and C7 spine due to senile osteoporosis
vertebropiasty is performed by advancing bone filler devices into the vertebrai body anteriorly near the
midline and depositing 1.75ml of radiopaque bone cement on the right and left sides at the C6 level and and
5.5m at the C7 level on the right sides. What CPT codes and diagnosis codes are reported?

A. 22510, 22512, M80.08XA B. 22510-50, 22512X2, M80.08XA

C. 22510, 22512, S12.9XXA M81.0 C. 22513, 22515, M80.00XA

65. A patient sustained a fracture of the humerus shaft in his right arm after being in an ATV accident. The
ED physician assess the humerus fracture and determines the fracture does not require a reduction. The ED
physician immobilizes the right arm in a splint to hold it in position for healing. Applying CPT guidelines, what
coding is reported?

A. 2500, 29105-51 B. 24505 C. 24500 D. 24505, 29105-51

66. The patient was diagnosed with carpal tunnel syndrome of the right and left wrist. The pain management
physician injected both wrists corticosteroids. What CPT coding is reported?

A. 20551-50 B. 20526 C.20526-50 D.20551

Respiratory, Cardiovascular 30000-39599
67. A patient had your recent angiogram demonstrating diffuse. High grade left superficial femoral
artery(SFA) stenosis and also separate server stenosis in the tibiopernoneal trunk, right femoral access is
made and a contralateral sheath is placed. A wire is able to cross both vessel stenosis and placed into the
posterior and is placed into the tibial artery. An atherectomy is performed of diffusers SFA segment. Stent
placement is also performed in the mid-SFA due to occlusion at the a therectomy site next, the tibioperoneai
trunk a smaller atherectomy device is placed for the stenosis. Completion lower extremity angiogram is
performed demonstrating Restoration of follow. Which CPT coding is reported?

A.37224, 37229 B. 37236 C.37227, 37229 D. 37227, 37 233,7 5774

68. A 52 years old male had an IVC filter place 4 weeks earlier. A follow-up risk and identified Migration of
the IVC filter. Using ultrasound guidelines for vascular access, 5 French sheaths are placed in the jugular vein.
A catheter is advanced to the IVC filter. Through a filter retrieval sheath, a snare is placed over the tip of the
filter cone. The filter is collapsed into the sheath, preposition, and redeployed proper repositioning is
confirmed. The filter delivery sheath is removed and hemostatic is obtained. What CPT coding is reported for
the procedure?

A. 37 193 B. 37193, 76942-26 C. 37 192 D. 37 192 76942-26

69. An ethmoidectomy is performed, Diseased tissue is surgically removed from the anterior and posterior
with homemade sinus by UN international surgical approach. A curette is used to remove the diseased
tissue. What CPT code is reported for this procedure?

A.31255 B.31201 C.31202 D.31200

70. An oncologist performs a bone marrow aspiration and biopsy on the right posterior iliac spine during the
same encounter. Select the appropriate code?

A. 38221, 38220 B. 38221 C. 38222 D. 38220

71. The patient is brought to the ED with an obstructed airway. The provider immediately makes an incision
through the cricothyroid and inserts a tracheotomy tube to assist the patient's breathing. What code is
reported for this scenario?

A. 31605 B. 31610 C. 31603 D. 31600

72. A patient suffers a non-ruptured infrarenal abdominal aortic aneurysm requiring endovascular repair. an
aorta-aortic tube end graft is positioned in the aorta from the level of the renal arteries. The graph is in the
correct position and free of end leaks. What CPT code does the vascular surgeon used to report the
procedure?

A. 34701 B. 34707 C. 34708 D. 31600

Digestive 40490-49999
73. A 75 years old has mid-esophageal adenocarcinoma, and your decision has made for him to undergo
surgical resection. The ENT surgeon performs the McKeown esophagectomy technique using thoracoscopic
Axes to remove the esophagus, removing part of the stomach using laparoscopic access, and then connects
the stomach to the pharynx via an open cervical approach. What CPT code is reported?

A.43310 B. 43300 C. 43 287 D. 43288

74. The physician performs an endoscopic retrograde cholangiopancreatography using side using flexible
fiberoptic endoscope to remove a stent from the common bile duct. Select Correct CPT coding for the
procedure?

A. 43 276 B. 43 247 C. 43275, 43260 D. 43275

75. A 40-year-old female has an infected peritoneal abscess. The surgeon insists on the admin and drains the
abscess. What CPT code is reported?

A. 49020 B. 49082 C. 49083 D. 49040

76. If 49 year old female with chronic abstraction of them bile ducts arrives for a cholecystectomy withroux-
en-Y enterostomy, incision is made over the right upper quadrant. The gallbladder and liver bed inspector
with normal findings except that the common bile duct is dilated with an upper and obstruction. The bird
that is disselected from its attachments bahut tha gallbladder and the intention. Value for small bro is
brought up to the gallbladder Pasand Tak to the surface of the gallbladder. A cholecystem is performed and
returned from the gallbladder. The patient old dated the procedure without difficulty. What CPT coding is
reported for this surgery?

A.47570 B. 477 40 C. 47720 D. 477 80

77. A patient is seen in the gastroenterologist's clinic for a Diagnostic colonoscopy. While performing the
service, physician notes suspicious looking polyps priya and removes three of the these using hot biopsy
forcepts to sent to pathology for further testing. What is the procedure coding?

A. 45378, 45380-51 B. 45384 C. 45378, 45384-51 D. 45380

78. A patient diagnosed with 4 tumors is taken to the operation room. the physician you just say needle
electrode to go through the skin administering cryoablation of destruction of dumas, ultrasound guidance e
was used to verify the needle was placed in the correct spots and to monitor treatment. What are the
procedure and diagnosis codes?

A. 47383, 769 40-26, D49.0 B. 47 381, 769 40-26, D49.0

C. 47 383x4, 769 40-26, D13.4 D. 47 381x4, 769 40-26, C22.0

Urinary, Male Genital, and Female Genital Systems 50010 – 59899

79. A patient with erectile dysfunction is presenting for removal of a non-inflatable penile prosthesis through
an infected field.The penile prosthesis is removed and replaced with a new one.The infected subcutaneous
tissue is also debrided and irrigated with antibiotic solutions .what cpt coding reported for this service?

A.54417,11042 B.54410 C.54401,11042 D.54417

80.A patient pregnant with twins goes to the labor at 36 weeks gestation.The first baby is delivered
vaginally.The second baby’s cord prolapsed and an emergency caesarean section was performed under
general endotracheal anesthesia.The physician who delivered the twin also performed the antepartum care
and will provide postpartum care.Both babies are well and healthy.what CPT coding is reported for the twin
delivery?

A.59510 x2 B.59514,59404-51 C.59510,59409-51 D.59400x2

81.A percutaneous nephrostolithotomy with lithotripsy is performed to crush a kidney stone measuring a
3cm.what is the correct CPT code.

A.50075 B.50060 C.50080 D.50081

82.A 30-year old female has adhesions that have formed around her right fallopian tubes the provide
perfomes lysis the adhesions.The patient is placed is in supine on the OR table place under general
anesthesia,scrubbed and draped in a usual sterline manner.The abdomen is cannulated and insufflated with
co2 and ports are placed scope is inserted and a laser is used to lysis the adhesions.All ports are removed
and port sites sutured closed with 2-o prolene .What is the procedure is reported?

A.58661 B.58660 C.58662 D.58740

83.A 60-year old male presents in the emergency department with acute urinary retention for eight
hours.The ED physician places a temporary indwelling catheter and empties 300cc of urine .what CPT code is
reported?
A.51701 B.51703 C.51700 D.51702

84.A 12- weeks of pregnancy,lilly was already much bigger than with either of her other two
pregnancies.When she started bleeding,she was directed to see her doctor.An ultrasound revealed a “snow-
flake” pattern with a diagnosis given for molar pregnancy.The next day she had an evacuation and
curettage.What are the CPT and ICD-10-CM Codes.

A.59812,O01.0 B.59120,O02.0 C.59100,O01.9 D.59870,O02.0

Endocrine, Nervous, Ocular, and Auditory Systems 60000 – 69990

85.A patient presents with a temporal bone based Xomed osseointegranted implant with speech
processor,which requires replacement.This osseointegrated implant was removed via post auricular incision
and replaced with a new one.The wound was irrigated and repaired with sutures.What is the CPT coding?

A.69711,69717 B.69711 C.69710 D.69717

86.A 45- year old female had a closed fracture of the T4-T8 vertebrate 15 years ago and now has
displacement of the thoracic intervertebral disc.The surgeon will decompress the spinal cord involving one
segment of the thoracic spine.The surgeon performs the surgery by using a transpedicular approach going
through pedicle on the side of the disc bulge to reach herniated disc the lamina and face joint are removed
along with disc fragments.What is the correct procedure code?

A.63085 B.63077 C.63064 D.63055

87.A 2-year-old child with congenital hydrocephalus is seeing her neurologist for reprogramming of her
programmable CSF shunt system.The neurologist adjust the pressure setting to an acceptable cerebrospinal
fluid flow level.What is the correct code for this procedure?

A.62230 B.62252 C.62225 D.62258

88.The patient has esotropia of the left eye an presence to the operating space suit for the strabismus
surgey.The physician resect the medial rectus horizontal muscle of the eye and secures with
sutures.Extensive scar tissue is noted due to previous surgery.The scar tissue is release on the inferior rectus
vertical muscle.what CPT code is reported for this surgery?

A.67316 B.67311,67343 C.67311,67332 D.67312

89.a patient is taken to the operating room for a partial thyroid right lobectomy and grater portion of the left
lobe was removed with isthmusectomy.what CPT code is used to report this procedure?
A.60240 B.60225 C.60220 D.60212

90.A patient has excess hormone production due to tumors in adrenal gland.The endocrinologist makes a
vertical incision in the middle of the abdomen and removes both adrenal glands.How is this reported?

A.60540-50 B.60540 C.60650-50 D.60650

Case Studies
91. PRE OP DIAGNOSIS: Left Breast Abnormal MMX or Palpable Mass; Other Disorders of Breast
PROCEDURE: Automated Stereotactic Biopsy Left Breast
FINDINGS: Lesion is located in the lateral region, just at or below the level of the nipple on the 90 degree
lateral view. There is a subglandular implant in place. I discussed the procedure with the patient today
including risks, benefits and alternatives. Specifically discussed was the fact that the implant would be
displaced out of the way during this biopsy procedure. Possibility of injury to the implant was discussed with
the patient. Patient has signed the consent form and wishes to proceed with the biopsy. The patient was
placed prone on the stereotactic table; the left breast was then imaged from the inferior approach. The
lesion of interest is in the anterior portion of the breast away from the implant which was displaced back
toward the chest wall. After imaging was obtained and stereotactic guidance used to target coordinates for
the biopsy, the left breast was prepped with Betadine. 1% lidocaine was injected subcutaneously for local
anesthetic. Additional lidocaine with epinephrine was then injected through the indwelling needle. The
SenoRx needle was then placed into the area of interest. Under stereotactic guidance we obtained 9 core
biopsy samples using vacuum and cutting technique. The specimen radiograph confirmed representative
sample of calcification was removed. The tissue marking clip was deployed into the biopsy cavity
successfully. This was confirmed by final stereotactic digital image and confirmed by post core biopsy
mammogram left breast. The clip is visualized projecting over the lateral anterior left breast in satisfactory
position. No obvious calcium is visible on the final post core biopsy image in the area of interest. The patient
tolerated the procedure well. There were no apparent complications. The biopsy site was dressed with Steri-
Strips, bandage and ice pack in the usual manner. The patient did receive written and verbal post-biopsy
instructions. The patient left our department in good condition.
IMPRESSION: 1. SUCCESSFUL STEREOTACTIC CORE BIOPSY OF LEFT BREAST CALCIFICATIONS. 2. SUCCESSFUL
DEPLOYMENT OF THE TISSUE MARKING CLIP INTO THE BIOPSY CAVITY 3. PATIENT LEFT OUR DEPARTMENT IN
GOOD CONDITION TODAY WITH POST-BIOPSY INSTRUCTIONS. 4. PATHOLOGY REPORT IS PENDING; AN
ADDENDUM WILL BE ISSUED AFTER WE RECEIVE THE PATHOLOGY REPORT. What are the codes for the
procedures?

A. 19081
B. 19283
C. 19081, 19283
D. 19100, 19283

92. PREOPERATIVE DIAGNOSIS: Displaced impacted Colles fracture, left distal radius and ulna.
POSTOPERATIVE DIAGNOSIS: Displaced impacted Colles fracture, left distal radius and ulna.
OPERATIVE PROCEDURE: Reduction with application external fixator, left wrist fracture
FINDINGS:The patient is a 46-year-old right-hand-dominant female who fell off stairs 4 to 5 days ago
sustaining an impacted distal radius fracture with possible intraarticular component and an associated ulnar
styloid fracture. Today in surgery, fracture was reduced anatomically and an external fixator was applied.
PROCEDURE: Under satisfactory general anesthesia, the fracture was manipulated and C-arm images were
checked. The left upper extremity was prepped and draped in the usual sterile orthopedic fashion. Two small
incisions were made over the second metacarpal and after removing soft tissues including tendinous
structures out of the way, drawing was carried out and blunt-tipped pins were placed for the EBI external
fixator. The frame was next placed and the site for the proximal pins was chosen. Small incision was made.
Subcutaneous tissues were carried out of the way. The pin guide was placed and 2 holes were drilled and
blunt-tipped pins placed. Fixator was assembled. C-arm images were checked. Fracture reduction appeared
to be anatomic. Suturing was carried out where needed with 4-0 Vicryl interrupted subcutaneous and 4-0
nylon interrupted sutures. Sterile dressings were applied. Vascular supply was noted to be satisfactory. Final
frame tightening was carried out. What CPT® code(s) is/are reported?

A. 25600-LT, 20692-51
B. 25605- LT, 20690-51
C. 25606-LT
D. 25607-LT

93. Pre-operative diagnosis: Acute MI severe left main arteriosclerotic coronary artery disease.

Procedure performed: Placement of an IABP right common femoral Attari.

Description of the procedure: The patient's right groin was prepped and draped in the usual sterile fashion.
The right common formal artery is found, an incision is made over the artery exposing it. The artery is
opened transversely, and the tip of the balloon catheter was placed in the right common femoral artery.
Double pump and a good way for. The balance capita is secured to the skin after local anesthesia of 2CC of
1%of xylocaine is used to number tie area. The balloon pump is secured with 0 suture. The patient has a
sterile dressing placed. The patient tolerated the procedure there were no complications what CPT code is
reported for this procedure?

A.33970 B.33975 C.33973 D.33967

94. OPERATIVE REPORT:

Preoperative diagnosis:Anal fissure

Postoperative diagnosis:Anal fissure

Procedures performed:Internal anal fissure removed

Anesthesia:General
Description of procedure:The patient was placed on the opening table in the dorsal lithotomy position after
the induction of adequate general anesthesia.The perianal area was steriley prepped and drapped and
infiltrated with a 0.25% Marcaine with epinephrine solutions using a total of 30CC.anal retractors were
inserted,and the patient was noted to have an anterior fissure.Tightness to the internal anal sphincter
muscle was also noted.An incision was made around the fissue dissecting it free of underlying sphincter
muscle and the fissure is excited and internal anal sphincterotomy was then performed in the lfet lateral
intersphincteric groove with a microsurgical knife.Excellent relaxation of the anal canal was
noted.Hemostasis was easily achieved with pressure to the area.No other abnormalities were noted.She was
returned to the supine position and taken to the recovery area in stable condition.

Estimated blood loss:less than 5cc.

Complications:None

What is CPT and ICD-10-CM codes are reported for this patient encounter?

A.46080,K60.1 B.46275,K60.0 C.46200,K60.2 D.46270,K60.3

95. PREOPERATIVE AND POSTOPERATIVE DIAGNOSIS: Grade 1 endometrial cancer.

PROCEDURE: Radical hysterectomy and pelvic lymph node sampling.

ANESTHESIA: General.

ESTIMATED BLOOD LOSS: 400 mL.

COMPLICATIONS: None.

SPECIMENS: Submitted to the laboratory labeled as pelvic washings, uterus, tubes, ovaries, and pelvic lymph
nodes

FLUIDS ADMINISTERED: 2 L crystalloid.

DESCRIPTION OF PROCEDURE: Patient was placed under general anesthesia. She was converted to a frog-leg
position perineum and prepped in a sterile fashion. A transurethral Foley catheter wasthenplaced. A midline
vertical incision was made from the umbilicus to the symphysis, and the abdomen was entered. The
peritoneum over the left and right paracolic gutter, surface of the spleen,liver, and left and right
heridiaphragm were normal. The gallbladder did not contain stones. The small bowel was examined from the
ligament of Treitz to the lleocecal valve and was normal. Therewas no paraaortic adenopathy. The omentum
was normal, both kidneys were palpable. Examination of the pelvis and perineum revealed normal
peritoneum in all 4 quadrants. The uterus was well-suspended; It was normal in size. There was no obvious
tumor. Both adnexa were normal: The Bookwalter@) retractor was placed. Bowel was packed into the
abdomen. Washinas were collected usinanormal saline. The uterus was rasped with Kocher clamps. The right
round ligament was transected with electrocautery. The retroperitoneal space were opened and fully
developed. We saw noadenopathy.The ureter was visualized. The ovarian vessels were isolated, cross-
clamped,transected, and llgated x 2 with O Vicryl&. Similarly the left round ligament was transected
withelectrocautery, the retroperitoneal space was opened and fully developed with no adenopathy, Bladder
flap was then taken down sharply with electrocautery. The uterine arterles, the uterosacralligaments, and
the cardinal ligaments were crossclamped with curved Heaney clamps, and pedicles were formed and llgated
with O Vicry1@. The uterus was removed, the vagina was closed withinterrupted sutures of O Vicryl@. We
then performed lymph node sampling on the left followed by the right, all lymphatic tissue was removed
from the bifurcation of the external and internal Illacartery down to the drumflex iliac vein and inferiorly to
the obturator nerve. The uterus was inspected. It appeared the volume of the tumor occupying the
endometrial surface was approximately40%, with less than 50% myometrial invasion. The abdomen was
irrigated and the fascia was closed with a running nonlocking suture of #1 PDS. The subcutaneous tissues
were reapproxdmatedwith2-0 Vicryi. The skin was closed using staples. The patient tolerated the procedure
well and left the suite in good condition. What CPT codes are reported?

a. 58548, 38770

b.58210

c. 58200

d. 58210, 38770

96. Impression:Elevated intraocular pressure poorly controlled glaucoma

Indications:45-year old has a poorly functioning or encapsulated bleb following filtering eye surgery 5 days
ago.Repair of anterior segment of the eye is.Needed for this post-op complication.The tratement i
recommended is to break up scar tissue underneath the bleb with a needle for the purpose of improving
flow of aqueous humor,the fluid inside the left eye,into the bleb. Patient understand the risks involved and
elect to proceed with bleb needing.she will return to the operating room for the procedure.

PROCEDURE: A mixture of 50:50 lidocaine with epinephrine and 0.2mg/ml MMC (total 0.2 ml)was injected in
the superior subconjunctival space.She was prepped in the standard fashion and a lid speculum was placed
she was positioned under the microscope .A leaderer’s needle was used to breakup any conjunctival scar
tissue and tenon’s cyst and to elevate the sclera flap.This was done on both sides of the bleb as need.The
area was checked afterward for leaking and combination of pressure with cotton swab and low temperature
cautery was applied as needed.What CPT coding is reported?

A.66680-58 B.66680-22 C.66250-79 D.66250-78

97. Myocardial perfusion imaging

Indication : central chest Pain

Procedure: Resting tomographic myocardial perfusion images are obtained following injection of 10 mCI of
Intravenous cardiolite.At peak exerciser 30mcl of intravenous cardiolite was injected, and post- stress
tomographic myocardial perfusion images were obtained.Post stress gated images of the left ventricle were
also acquired.Myocardial perfusion images were compared in the standard fashion.

Finding: This is technically fair study > No stress induced electrocardiography changes noted there is no
significant reversible or fixed percussion defects.Noted gated images of the left ventricle reveal normal left
ventricular volumes ,normal left ventricular wall motion,and estimated left ventricular ejection fraction of
50%

Impression: no evidence of myocardial infraction.Normal left ventricular ejection fraction,what CPT and ICD-
10-CM codes are reported?

A)78452,I21.9,R07.9 B)78452,R07.9

C)78453,I21.9,R07.9 D)78453,R07.9

98.
37-year-old female is seen in the clinic for follow-up of lower extremity swelling.
HPI: Patient is here today for follow-up of bilateral lower extremity swelling. The swelling responded to
hydrochlorothiazide.
DATA REVIEW: I reviewed her lab and echocardiogram. The patient does have moderate pulmonary
hypertension.
Exam: Patient is in no acute distress.
ASSESSMENT:
1. Bilateral lower extremity swelling. This has resolved with diuretics, it may be secondary to problem

#2.
2. Pulmonary hypertension: Etiology is not clear at this time, will work up and possibly refer to a
Pulmonologist
PLAN: Will evaluate the pulmonary hypertension. Patient will be scheduled for a sleep study.
a. 99213 c. 99214
b. 99212 d. 99215

99. Office Visit

Chief Complaint: Seeing dermatologist for mole on upper left thigh,

History of Present Illness: A 50-year-old female I have not seen in the office for four years comes in for a
mole on the upper left thigh. It has been present for many

years, but she thinks it is getting bigger.

It is pruritic occasionally. The patient does not have a personal history of skin cancer and no family history of
skin cancer.

Review of Systems: Denies unusual allergic reactions, asthma, hay fever.

Past Medical History: None.

Medications: Wellbutrin.

Allergies: None,

Physical Examination: No apparent distress. Alert and oriented times 3. A complete and comprehensive skin
examination of the face, neck, chest, back, abdomen,bilateral upper extremities, bilateral lower extremities,
buttocks, digits, nails reveal the following findings: The nevi on the left posterior upper thigh is palpable.
There areother benign appearing nevi on her upper back and chest. All other areas were normal.

Minor Procedure: Consent obtained for a biopsy. Upper left thigh prepped with alcohol. Anesthetized with 1
percent Lidocaine and epinephrine. Sterilized with Hibidensand peroxide, A 6 mm punch biopsy on the left
posterior thigh. Polysporin and sterile pressure dressings were applied. Wound care instructions were given,

Assessment and Plan: Concerning nevi, rule out atypia.

1. She will follow up with us in a week.

2. In general, she will come back in six months for a full skin exam.

3.I will call her with the biopsy results, and we will proceed from there.

What CPT®️ coding is reported?

a.99213-25, 11104

b.99202-57, 11102

c. 99203-25, 11104

d. 99212-57, 11102

100. PATIENT NAME: HARROLD, CURTIS

DATE OF CONSULT: 08/16/2007.

REFERRING PHYSICIAN: Truc T. Tran, D.O.

SOURCE OF INFORMATION: History is obtained from the chart and the patient.

REASON FOR CONSULTATION: Nausea, vomiting, and hematochezia.

HISTORY OF PRESENT ILLNESS: The patient is a pleasant 48-year-old African-American gentleman
complaining of nausea, vomiting, and bloody stools for about two days. He denies any hematemesis or
coffee ground emesis. He does have bloody diarrhea. He denies any fever, pain, weight loss, or alteration in
the caliber the stools prior to onset of symptoms. He does have a previous episode of similar symptoms
about two years ago.

LABS: Reveal WBC 10.7, hemoglobin 10.7, hematocrit 32.1, and platelets 138. His hemoglobin was 13.4 on
August 15, 2007. Metabolic panel, sodium 134, potassium 3.4, albumin 2.4, and total protein 5.4.

PAST MEDICAL HISTORY: Peptic ulcer disease, chronic renal insufficiency, on hemodialysis, hypertension,
diabetes mellitus, congestive heart failure, vascular insufficiency, glaucoma, neuropathy, coronary artery
disease, and osteomyelitis.

PAST SURGICAL HISTORY: Bilateral below the knee amputation, amputation of three fingers, AV fistula, and
angioplasty.

CURRENT MEDICATIONS:

1. Nephro-Vite.

2. Lasix.

3. Nifedipine.

4. Prednisone.

5. Renagel.

6. Coreg.

7. Protonix.

8. Xalatan.

9. Marinol.

10. Lantus.

11. Reglan.

12. Restoril.

13. Vicodin.

14. Neurontin.
ALLERGIES: NO KNOWN DRUG ALLERGIES.

SOCIAL HISTORY: One of his records, he does smoke. On this current record, there is no tobacco and no
alcohol.

FAMILY HISTORY: Noncontributory.

REVIEW OF SYSTEMS: Positive for nausea, vomiting, diarrhea, rectal bleeding, and melena. Negative for
fever, abdominal pain, weight loss, hematemesis, or coffee ground emesis.

PHYSICAL EXAMINATION: He appears comfortable and older than his stated age. He has a lean body size.
Blood pressure is 124/75. Pulse is 101. He is 5’3” tall and weighs 59 kilos. Neurologic, he is alert and
oriented. Skin is warm and dry. Heart: Regular rate and rhythm with a late systolic murmur. Lungs are
clear. Abdomen is soft, nontender, and nondistended. Bowel sounds are present. There is no mass or
guarding.

IMPRESSION:

1. Nausea, vomiting, and diarrhea, which have resolved.

2. Hematochezia.

3. Valvular heart disease.

4. Electrolyte imbalance.

My differential diagnosis is ischemia with a vascular compromise.

PLAN: IV fluids. Monitor H&H. Conservative approach. If the hemoglobin drops or his symptoms recur, we
will plan to scope him. We will follow with you.

a. 99244 b. 99243 c. 99253 d. 99254