2019 Final Exam – Student Copy

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. Which coding manuals do outpatient coders focus on learning?

a. CPT®, HCPCS Level II, ICD-10-CM, ICD-10-PCS

b. ICD-10-CM and ICD-10-PCS

c. CPT®, HCPCS Level II and ICD-10-CM

d. CPT® and ICD-10-CM

____ 2. What form is used to submit a provider’s charge to the insurance carrier?

a. UB-04 c. ABN

b. CMS-1500 d. Provider reimbursement form

____ 3. The OIG recommends that provider practices enforce disciplinary actions through well publicized compliance

guidelines to ensure actions that are ______.

a. Frequent c. Consistent and appropriate

b. Swift and enforceable d. Permanent

____ 4. The OIG releases a ____ outlining its priorities for the fiscal year ahead and beyond.

a. Compliance Plan c. Work Plan

b. Self-referral law d. CIA yearly review

____ 5. Which provider is NOT a mid-level provider?

a. Physician Assistant c. Anesthesiologist

b. Nurse Practitioner d. All choices are mid-level providers

____ 6. Which of the following is NOT a function of skin?

a. Acts as a gland by synthesizing vitamin A.

b. Excretes water, salt, and small amounts of waste.

c. Houses sensory receptors for touch, pressure, pain, and temperature

d. Plays an important role in regulation of body temperature.

____ 7. Which layer is NOT considered part of the skin?

a. Stratum corneum c. Epidermis

b. Stratum germinativum d. Hypodermis

____ 8. Which of the following is true of the stratum germinativum?

a. It is composed of about 30 layers of dead, flattened, keratinized cells.

b. It is composed of dense fibrous connective tissue.

c. It lies on top of the dermis and has access to a rich supply of blood.

d. It is the surface layer of the epidermis.

____ 9. Which of the following does NOT circulate fluids throughout the body?

a. Endocrine system c. Arterial system

b. Venous system d. Lymphatic system

____ 10. Which of the following best describes constituent components of the human lymphatic system?

a. Lymph nodes, lymphatic vessels, spleen, thoracic duct

b. Lymph nodes, lymphatic vessels, tonsils, liver

c. Lymph nodes, lymphatic vessels, bone marrow, kidneys

d. Lymph nodes, lymphatic vessels, thymus gland, pancreas

____ 11. The term hemic specifically refers to what bodily fluid?

a. Bile interstitial fluid c. Blood

b. Lymph d. Interstitial fluid

____ 12. What is the function of the Cowper’s glands?

a. Produces sperm food

b. Delivers spermatozoa to the urethra

c. Promotes maturation of the egg

d. Helps lubricate the urethra

____ 13. If a woman has a Pap smear performed by her gynecologist, what part of the female anatomy is involved?

a. Cervix c. Endometrium

b. Corpus uteri d. Fallopian tube

____ 14. The corpus luteum secretes progesterone. What is an effect of this secretion?

a. Enlargement and development of the organs of the female reproductive system

b. Deposition of fat beneath the skin

c. Closure of the epiphyseal discs in long bones

d. Thickens the endometrium for implantation and is necessary to sustain pregnancy

____ 15. Which of the following is true about the function of the cochlea?

a. It helps with balance and sound transmission

b. It helps with balance only

c. It transmits sound only

d. Its function is to excrete cerumen (wax) to help keep the ear clean

____ 16. A respiratory disease characterized by overexpansion and destruction of the alveoli is identified as:

a. Cystic fibrosis c. Emphysema

b. Pneumoconiosis d. Respiratory distress syndrome

____ 17. A procedure widening a narrowed vessel or obstructed blood vessel is called a(n):

a. Valvotomy c. Angioplasty

b. Angiography d. Thrombectomy

____ 18. Splenorrhaphy is described as:

a. Dissection of the spleen c. Hemorrhage of the spleen

b. Suture of a wound of the spleen d. Softening of the spleen

____ 19. A deficiency of cells in the blood is defined as:

a. Erythremia c. Cytopenia

b. Phagocytosis d. Bacteremia

____ 20. The root word for mouth is:

a. Gloss/o c. Stomat/o

b. Bucc/o d. Dent/o

____ 21. Melasma is defined as:

a. Brownish pigmentation appearing on the face

b. A dark vertical line appearing on the abdomen

c. A discharge of mucus and blood

d. Lines where the skin has been stretched

____ 22. A condition where the thyroid is overactive is called:

a. Thyrotoxicosis c. Panhypopituitarism

b. Ketosis d. Thyroiditis

____ 23. A 6 year-old patient is seen in the office for acute otitis media, coded as H66.90. This is an example of a ____

code.

a. Category c. NEC

b. Etiology/manifestation code d. NOS

____ 24. Refer to the Tabular List and identify the code that contains an instructional note that indicates that two

related conditions cannot occur together.

a. A18.01 c. K31.84

b. N94.2 d. S04.0-

____ 25. What is the ICD-10-CM code for UTI?

a. A54.00 c. T80.29XA

b. N71.9 d. N39.0

____ 26. What ICD-10-CM code(s) is/are reported for enlargement of the prostate with a symptom of urinary

retention?

a. N40.1, R33.8 c. N40.0

b. N40.1 d. N40.3, R33.8

____ 27. Patient with coronary arteriosclerosis disease (CAD) sees his cardiologist to discuss a coronary artery bypass

graft (CABG). This will be the patient’s first CABG. What ICD-10-CM code is reported?

a. I25.810 c. I25.759

b. I25.720 d. I25.10

____ 28. A patient has been diagnosed with CAD of his bypass graft with angina. The patient had a CABG one year

ago. What diagnosis codes are reported?

a. I25.10, Z95.1 c. I77.9, Z95.1

b. I25.709, Z95.1 d. I67.9, Z95.1

____ 29. A patient with metastatic bone cancer (primary site unknown) presents to the oncologist’s office for a

chemotherapy treatment. On examination the oncologist finds the patient to be severely dehydrated and

cancels the chemotherapy. The patient receives intravenous hydration in the office and reschedules the

chemotherapy treatment. What ICD-10-CM codes are reported?

a. C40.30, E86.0, C79.51 c. C79.51, E86.0

b. E86.0, C79.51, C80.1 d. E86.0, C80.1, C79.51

____ 30. A 22 year-old patient status post-surgery developed a postoperative infection. The patient quickly deteriorated

and became septic, developed gas gangrene (gas bacillus infection) and went into postprocedural septic shock.

With aggressive intravenous antibiotic management, the patient improved. What ICD-10-CM codes are

reported?

a. T81.12XA, R65.21, A48.0 c. R65.21, A48.0, T81.12XA

b. A48.0, R65.21, T81.44XA d. T81.44XA, A48.0, T81.12XA

____ 31. A patient sees the nephrologist for a B-12 injection to treat erythropoietin resistant anemia due to stage 3

chronic kidney disease. What ICD-10-CM codes are reported?

a. D63.1, N18.3 c. D63.8, N18.9

b. N18.3, D63.1 d. N18.9, D63.8

____ 32. An HIV positive patient was admitted with skin lesions on the chest and back. Biopsies were taken, and the

pathologic diagnosis was Kaposi’s sarcoma. Leukoplakia of the lips and splenomegaly were also noted on

physical examination. Discharge diagnoses: (1) HIV infection, (2) Kaposi’s sarcoma, back and chest, (3)

leukoplakia (4) splenomegaly. What ICD-10-CM codes should be reported?

a. B20, C46.0, K13.21, R16.1 c. B20, C46.0, K13.21, R16.1, Z21

b. Z21, C46.0, K13.21, R16.1 d. R16.1, C46.0, R16.1, Z21

____ 33. A patient with type 2 diabetes presents with diabetic macular edema and proliferative diabetic retinopathy in

the right eye. What ICD-10-CM code(s) is/are reported?

a. E11.311, E11.3519 c. E11.3511

b. E11.3519 d. E11.9, E11.311, E11.3519

____ 34. According to the ICD-10-CM Official Guidelines for Coding and Reporting, Chapter 15: Pregnancy,

Childbirth, and the Puerperium (O00-O9A), codes in this range have sequencing priority over what codes?

a. Chapter 15 codes do not have sequencing priority over other codes.

b. All codes including Z33.1

c. Codes from all other chapters.

d. Codes from Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99).

____ 35. What ICD-10-CM codes are reported on the maternal record for a delivery of triplets that are all liveborn at

32 weeks of pregnancy?

a. O30.103, Z37.51, Z3A.32 c. Z37.61, O30.103, Z3A.32

b. Z37.9, Z3A.32 d. O30.109, Z37.9, Z3A.00

____ 36. A patient has an open displaced fracture of the second cervical vertebra. This is her fifth visit and the fracture

is healing normally. What ICD-10-CM code is reported?

a. S12.9XXD c. S12.190D

b. S12.190A d. S12.9XXS

____ 37. A 32 year-old who is 21 weeks pregnant (antepartum) presents with vaginal bleeding. She is admitted to the

observation unit to rule out a spontaneous abortion. What ICD-10-CM code(s) is/are reported?

a. O46.92, Z3A.21 c. Z33.1

b. O03.9 d. Z34.92, Z3A.21

____ 38. A pregnant woman in her 40th week has gestational diabetes which is controlled by diet. What ICD-10-CM

code(s) is/are reported?

a. O24.113, O24.410, Z3A.40 c. O24.913

b. O24.410, O24.913 d. O24.410, Z3A.40

____ 39. A 3 year-old is brought to the burn unit after pulling a pot of hot soup off the stove and spilling it on herself.

She sustained 18% second degree burns on her legs and 20% third degree burns on her chest and arms. Total

body surface area burned is 38%. What ICD-10-CM codes are reported for the burns (do not include external

cause codes for the accident)?

a. T21.21XA, T22.20XA, T24.209A, T31.23

b. T21.31, T22.20, T24.209, T31.32

c. T21.31XA, T22.399A, T24.299A, T31.32

d. T21.31XA, T22.20XA, T24.209A, T31.32

____ 40. A baby boy is born by cesarean section in the hospital. ABO incompatibility was documented, but the

Coomb's test was negative, ruling out the ABO incompatibility, so no treatment was given. What ICD-10-CM

codes are reported for the newborn’s record?

a. O36.1190, Z38.01, Z03.79 c. Z38.01, P55.1

b. Z38.01, Z05.8 d. P01.8, Z38.01

____ 41. A patient is coming in for follow up of a second-degree burn on the left forearm. The provider notes the burn

is healing well. He is to come back in two weeks for continued care to checkup on the healing of the burn.

What ICD-10-CM code is reported?

a. T22.212S c. T22.219D

b. T22.212D d. T22.212A

____ 42. After suffering a fracture of the ankle three months ago, a 69 year-old patient presented with what was found

to be a malunion fracture. She was treated with additional surgery and discharged. Which injury diagnosis

code(s) is/are assigned?

a. S82.899A c. S82.899A, S82.899P

b. S82.899A, S82.899S d. S82.899P

____ 43. A 28 year-old male was rushed to the ED after being found unconscious. Information from family members

indicated the patient had left a suicide note and taken a large amount of LSD (a hallucinogenic). What ICD-

10-CM codes are reported?

a. T40.8X2A, R40.2440 c. T40.8X1A, R40.2440

b. T40.8X2A, R40.20 d. T40.8X1A, R40.4

____ 44. A patient is dependent on a respiratory ventilator and has a tracheostomy in need of revision due to redundant

scar tissue formation surrounding the site at the skin of the neck. Under general anesthesia and establishing

the airway to maintain ventilation, the scar tissue is resected and then repair is accomplished using skin flap

rotation from the adjacent tissue of the neck. What ICD-10-CM codes are reported?

a. L90.5, Z43.0 c. J95.09, L90.5, Z43.0, Z99.11

b. J95.09, L90.5, Z99.11 d. J95.09, J39.8, Z43.0

____ 45. The Global Surgical Package applies to services performed in what setting?

a. Hospitals c. Physician’s offices

b. Ambulatory Surgical Centers d. All of the above

____ 46. What does the acronym HCPCS stand for?

a. Healthcare Physician Coding Standards

b. Healthcare Common Procedure Coding System

c. Healthcare Physician Communicating System

d. Health Codes for Physicians and Coding Surgeries

____ 47. How many days does it take CMS to implement HCPCS Level II Temporary Codes that have been reported

as added, changed or deleted?

a. 365 c. 30

b. 90 d. 60

____ 48. What is the correct CPT® code for the excision of a benign lesion on the scalp with an excised diameter of

2.3 cm?

a. 11403 c. 11423

b. 11603 d. 11623

____ 49. What is the correct CPT® code for the extensive excision of nasal polyps?

a. 30124 c. 30110

b. 30125 d. 30115

____ 50. What is the correct CPT® coding for a cystourethroscopy with brush biopsy of the renal pelvis?

a. 52007 c. 52000, 52007

b. 52005 d. 52005, 52007

____ 51. What is the appropriate modifier to use when two surgeons perform separate distinct portions of the same

procedure?

a. 66 c. 62

b. 80 d. 59

____ 52. What is the full description for code 11001?

a. Debridement of extensive eczematous or infected skin; up to 10% of body surface; each

additional 10% of the body surface, or part thereof (List separately in addition to code for

primary procedure).

b. Debridement of extensive eczematous or infected skin; each additional 10% of the body

surface, or part thereof (List separately in addition to code for primary procedure)

c. Each additional 10% of the body surface, or part thereof (List separately in addition to

code for primary procedure)

d. Debridement of extensive eczematous or infected skin; up to 10% of body surface

____ 53. What CPT® code(s) would best describe treatment of 9 plantar warts removed and 6 flat warts all destroyed

with cryosurgery during the same office visit?

a. 17110, 17111-52 c. 17110, 17003

b. 17110 d. 17111

____ 54. While whittling a piece of wood, the patient sustained an avulsion injury to a portion of his left index finger

and underwent formation of a direct pedicle graft with transfer from his left middle finger. What CPT® code

is reported?

a. 15574 c. 15750

b. 15740 d. 15758

____ 55. A patient presents to the ED physician with multiple burns. After examination the physician determines the

patient has third-degree burns of the anterior and posterior portion of his left leg, starting at the knee

extending above the ankle (12.5%). He also has third-degree burns of the anterior portion of the left side of

his chest (4.5%). The patient also has second-degree burns on his left upper arm (7%). What ICD-10-CM

codes are reported?

a. T24.292A, T24.192A, T31.21

b. T21.399A, T21.39XA, T22.299A, T31.31

c. T24.109A, T25.112A, T21.21XA, T22.392A, T31.31XA

d. T24.392A, T21.31XA, T22.232A, T31.21

____ 56. A patient presents with a recurrent seborrheic keratosis of the left cheek. The area was marked for a shave

removal. The area was infiltrated with local anesthetic, prepped and draped in a sterile fashion. The lesion

measuring 1.8 cm was shaved using an 11-blade. Meticulous hemostasis was achieved using light pressure.

The specimen was sent for permanent pathology. The patient tolerated the procedure well. What CPT® code

is reported?

a. 11200 c. 11442

b. 11312 d. 11642

____ 57. The patient is here to see us about some skin tags on her neck and both underarms. She has had these lesions

for some time; they are irritated by her clothing, itch, and at times have a burning sensation. We discussed

treatment options along with risks. Informed consent was obtained and we proceeded. We removed 16 skin

tags from the right axilla, 16 skin tags from the left axilla, 10 from the right side of the neck and 17 from the

left side of the neck. What CPT® and ICD-10-CM codes are reported?

a. 11057, D23.5, D23.4 c. 11200, 11201 x 4, 11201-52, L91.8

b. 11200, 11201-51 x 5, D23.5, D23.4 d. 11200, 11201 x 5, L91.8

____ 58. A 50 year-old female has telangiectasias of the face on both cheeks. She is very bothered by this and presents

to have them destroyed via laser. The physician lasers one cutaneous vascular lesion on each cheek; each

lesion measuring 2 sq. cm. What CPT® code(s) is/are reported?

a. 17106 c. 17000, 17003

b. 17110 d. 17263

____ 59. A 14 year-old boy was thrown against the window of the car on impact. The resulting injury was a star-

shaped pattern cut to the top of his head. In the ED, the MD on call for plastic surgery was asked to evaluate

the injury and repair it. The total length of the intermediate repair was 5+4+4+5 cm (18 cm total). The star-

like shape allowed the surgeon to pull the wound edges together nicely in a natural Y-plasty in two spots.

What CPT® code is reported for the repair?

a. 14041 c. 13121

b. 14040 d. 12035

____ 60. Patient has returned to the operating room for aspiration of a seroma that developed from a genitourinary

surgical procedure performed two days ago. A 16-gauge needle is used to aspirate 600 cc of non-cloudy

serosanguinous fluid. What codes are reported?

a. 10160-78, N99.842 c. 10140-78, S20.20XS

b. 10180-58, N99.820 d. 10140-58, N99.89

____ 61. Operative Report

PREOPERATIVE DIAGNOSIS: Diabetic foot ulceration.

POSTOPERATIVE DIAGNOSIS: Diabetic foot ulceration.

OPERATION PERFORMED: Debridement and split thickness autografting of left midfoot.

ANESTHESIA: General endotracheal.

INDICATIONS FOR PROCEDURE: This patient with multiple complications from type 2 diabetes

developed skin ulcerations which were debrided with homograft last week. The homograft is taking quite

nicely; the wounds appear to be fairly clean. He is ready for autografting.

DESCRIPTION OF PROCEDURE: After informed consent the patient is brought to the operating room and

placed in the supine position on the operating table. Anesthetic monitoring was instituted; general anesthesia

was induced. The left lower extremity is prepped and draped in a sterile fashion. Staples were removed and

the homograft was debrided from the surface of the wounds. One wound appeared to have healed; the

remaining two appeared to be relatively clean. We debrided this sharply with good bleeding in all areas.

Hemostasis was achieved with pressure, Bovie cautery, and warm saline soaked sponges. With good

hemostasis a donor site was then obtained on the left anterior thigh, measuring less than 100 cm2. The wounds

were then grafted with a split-thickness autograft that was harvested with a patch of Brown dermatome set at

12,000 of an inch thick. This was meshed 1.5:1. The donor site was infiltrated with bupivacaine and dressed.

The skin graft was then applied over the wound, measured approximately 60 cm2 in dimension on the left

midfoot. This was secured into place with skin staples and was then dressed with Acticoat 18's, Kerlix

incorporating a catheter, and gel pad. The patient tolerated the procedure well. The right foot was redressed

with skin lubricant sterile gauze and Ace wrap. Anesthesia was reversed. The patient was brought back to the

ICU in satisfactory condition.

What CPT® and ICD-10-CM codes are reported?

a. 15220-58, 15004-58-51, L97.421, E11.621

b. 15120-58, 15004-58-51, E11.621, L97.421

c. 15950-78, 15004-78-51, E11.9, I70.244

d. 11044-78, 15120-78-51, 15004-78, E11.621, L97.421

____ 62. A malignant lesion of the forehead measuring 1.0 cm was removed. The operative report states skin margins

are 1.1 cm on all sides. Layered closure of 3.5 cm was performed. How is this coded?

a. 11644, 12052-51 c. 11604

b. 11602, 12052-51 d. 11602, 12051-51

____ 63. What is being removed for hallux valgus surgery?

a. Bunion c. Tendon

b. Big Toe d. A bone in one of the toes

____ 64. A 44 year-old male with biplanar deformity, acquired limb length discrepancies and tibial nonunion has

undergone deformity correction. He now requires exchange of an external fixation strut 45 days

postoperatively. One of the struts for his multiplane external fixation device is removed and then replaced

with an adjustable strut. The intraoperative mounting parameters, deformity parameters and initial strut

settings are entered into the computer prior to Jim’s discharge and a daily schedule is generated for him to

perform the gradual deformity correction necessary. What CPT® code(s) is/are reported?

a. 20696 c. 20694

b. 20697 d. 20692, 20697

____ 65. A 49 year-old presents with an abscess of the right thumb. The physician incises the abscess and purulent

sanguineous fluid is drained. The wound is packed with iodoform packing. What CPT® code is reported?

a. 10061-F5 c. 10060-F5

b. 26010-F5 d. 26011-F5

____ 66. A 6 year-old male suffered a fracture after falling off the monkey bars at school. He fell on an outstretched

hand and suffered a transcondylar fracture of the left humerus. After prep and drape, a manipulation was

done to achieve anatomic reduction. Once the joint was adequately reduced, pins were placed through the skin

distally and proximally into the bone to maintain excellent fixation and anatomic reduction. The pins were

bent, trimmed and covered with a sterile dressing and a posterior splint was placed on the patient’s arm. What

CPT® code is reported?

a. 24516-LT c. 24538-LT

b. 24530-LT d. 24546-LT

____ 67. A 45 year-old presents to the operating room with a right index trigger finger and left shoulder bursitis. The

left shoulder was injected with 1 cc of Xylocaine, 1 cc of Celestone and 1 cc of Marcaine. An approximately

1-inch incision was made over the A1 pulley in the distal transverse palmar crease. This incision was taken

through skin and subcutaneous tissue. The A1 pulley was identified and released in its entirety. The wound

was irrigated with antibiotic saline solution. The subcutaneous tissue was injected with Marcaine without

epinephrine. The skin was closed with 4-0 Ethilon suture. Clean dressing was applied. What CPT® codes are

reported?

a. 26055-F6, 20610-76-LT c. 26055-F6, 20610-51-LT

b. 20552-F6, 20605-52-LT d. 20553-F6, 20610-51-LT

____ 68. The patient is a 17 year-old male who was struck on the elbow by another player’s stick while playing

hockey. He is found to have a fracture of the olecranon process. The patient was brought to the OR,

anesthetized and intubated. The right upper extremity was prepped with Betadine scrub and draped free in the

usual sterile orthopedic manner. The arm was then elevated and exsanguinated and the tourniquet inflated to

250 mm/Hg. A five-inch incision was made with the scalpel on the extensor side of the elbow, beginning

distally and proceeding in an oblique fashion up the proximal forearm. Dissection was carried through

subcutaneous tissue and fascia, and bleeding was controlled with electrocautery. We then subperiosteally

exposed the proximal ulna and olecranon to visualize the fracture site. The fracture could be seen at the base

of the olecranon process. We irrigated the site thoroughly and reduced the fracture fragments without

difficulty. Extending the elbow, we inserted two smooth K-wires across the fracture site. Through a drill hole

in the proximal ulnar shaft, we threaded an 18-gauge wire through it and wrapped it around the K-wires in a

figure-of-eight manner to further stabilize the fixation. Wires were then twisted and placed into soft tissues.

The K-wires in the olecranon were advanced slightly after being bent and cut. Sterile dressing was applied

and the patient was placed in a splint. What CPT® code is reported?

a. 24685-RT c. 24675-RT

b. 24635-RT d. 24586-RT

____ 69. This 36 year-old female presents with an avulsed anterior cruciate ligament off the femoral condyle with a

complete white on white horizontal cleavage tear of the posterior horn of the medial meniscus, causing

instability. A general endotracheal anesthesia was performed, and the patient was placed supine on the

operating table. The right lower extremity was prepped with Betadine and draped free. Standard arthroscopic

portals were created, and the knee was systematically examined and probed. The posterior horn of the medial

meniscus was noted to be buckled and frayed. This area was carefully probed and found to be irreparable. It

was decided that our best option was to proceed with a limited partial meniscectomy, with the goal being to

leave as much viable meniscal tissue as possible. Therefore, a medial infrapatellar portal was developed with

a longitudinal stab wound. A series of straight-angled and curved basket punches was used to perform a

saucerization of the damaged portion of the meniscus, leaving the intact portion of the medial meniscus in

place. Debris was meticulously removed with the 4.0 meniscal cutter. Approximately 50% of the medial

meniscus remained. Next, our attention was turned to the ACL repair. Through a 5 cm longitudinal anterior

incision, a central one-third tendon bone was harvested. A 10 mm graft was taken and bone plug sculpted.

Anterolateral notchplasty was done with a curette and polished with the burr. All debris was removed and

instruments were used to ensure proper isometry. The graft was tightened in extension about 2.5 mm and

actually lengthened in flexion, and this was considered acceptable. Endoscopic guides were used to create the

tibial and femoral tunnels, and the edges were rasped smooth. Using a percutaneous guide pin, the graft was

placed retrograde to the knee and secured proximally with an 8 x 25 mm interference screw. The knee was put

through range of motion, and with the leg in 30 degrees of flexion with the posterior drawer applied to the

proximal tibia; an 8 x 20 mm interference screw was used to secure the bone plug distally. The graft was

tight, isometric and without adverse features. The wound was copiously irrigated with Kantrex1. Cancellous

bone fragments from bone plugs were used to graft the donor site defect in the patella. The paratenon was

closed over this to house the graft with a running #1 Vicryl. The edge of the distal bone plug was beveled

with the rongeur. The subcutaneous tissue was closed with triple-0 Vicryl. Skin was closed with double-0

Prolene in a subcuticular fashion. Steri-Strips, sterile dressing, cryo cuff and hinged knee brace were applied.

The patient was awakened and taken to the recovery room in satisfactory condition. What CPT® codes are

reported?

a. 29888-RT, 29880-51-RT c. 29888-RT, 29881-51-RT

b. 29888 -RT, 29882-51-RT d. 29889-RT, 29880-51-RT

____ 70. What CPT® code is reported for an emergency endotracheal intubation to save the patient’s life?

a. 31502 c. 31603

b. 31500 d. 31600

____ 71. Johnny has a penny removed from his left nostril in the provider’s office. What CPT® code is reported?

a. 30320 c. 30100

b. 30300 d. 30160

____ 72. A patient with AML (Acute Myelogenous Leukemia) has just learned his sister is an HLA (Human Leukocyte

Antigen) match for him. Stem cells taken from the donor (the patient’s sister) will be transplanted into the

patient to help with his treatment. What CPT® code is used to report the harvesting of the stem cells from the

donor (his sister)?

a. 38204 c. 38206

b. 38205 d. 38207

____ 73. A patient is seen in the OR for removal of a hepatic adenoma which has invaded the diaphragm. The resection

of the diaphragm portion of the mass was repaired with primary sutures. What CPT® code is reported for the

diaphragmatic mass resection?

a. 39540 c. 39560

b. 39545 d. 39561

____ 74. An 18 month-old patient is seen in the ED unable to breathe due to a toy he swallowed which had lodged in

his throat. Soon brain death will occur if an airway is not established immediately. The ED provider performs

an emergency transtracheal tracheostomy. What CPT® and ICD-10-CM codes are reported?

a. 31601, J34.9, T17.298A c. 31603, T17.220A

b. 31601, 31603, T17.228A d. 31603, T17.290A

____ 75. The pulmonologist in a multispecialty group refers a patient to the otolaryngologist because he thinks that the

shortness of breath that the patient is experiencing may be due to sinusitis and laryngopharyngeal reflux

(LPR). The otolaryngologist decides to perform a rigid bilateral nasal endoscopy to get a better look at what is

going on in the sinuses and a flexible laryngoscopy to determine if (LPR) is contributing to the problems

because he could not get adequate visualization on manual exam. First the bilateral nasal endoscopy is

performed and the otolaryngologist diagnosis chronic pansinusitis. Next a flexible fiberoptic laryngoscope is

introduced nasally and the larynx and trachea are inspected. The diagnosis is chronic laryngitis/tracheitis and

LPR. He prescribes Singulair and Nexium and proposes endoscopic surgery will be considered in the future if

the current treatment does not fully take care of the problems experienced by the patient. What CPT® and

ICD-10-CM codes are reported for the procedure?

a. 31575, 31231-59, J32.4, J37.1

b. 31575, 31231-50-59, J32.4, J37.1

c. 31576, 31231-51, J32.4, J02.9, J41.8

d. 31576, 31237-50-59, J32.4, J37.0, J41.8

____ 76. Which statement is TRUE regarding coding COPD with asthma in ICD-10-CM?

a. The type of asthma is reported along with the COPD.

b. Only the COPD is reported.

c. COPD with bronchitis is reported for COPD with asthma.

d. Only the asthma is reported.

____ 77. What is the term for the divider between the heart chamber walls?

a. SA node c. Septum

b. Bundle branch d. Mitral

____ 78. A physician performs a four-vessel autogenous (one venous, three arterial) coronary bypass on a patient who

had a previous CABG two years ago, utilizing the saphenous vein, radial artery and the left and right internal

mammary arteries. Select the CPT® codes for this procedure.

a. 33535, 33510-51, 33530, 35600 c. 33533, 33519, 33530, 35600

b. 33534, 33518, 33530 d. 33535, 33517, 33530, 35600

____ 79. Intracoronary stents are placed percutaneously in the right coronary and left anterior descending arteries for a

patient with stenosis. Percutaneous transluminal balloon angioplasty is performed on the left circumflex

coronary artery. Choose the correct CPT® codes for this procedure.

a. 92928-RC, 92928-LD, 92920-LC c. 92933-RC, 92934-LD, 92934-LC

b. 92928-RC, 92929-LD, 92920-LC d. 92928-RC, 92920-LD, 92920-LC

____ 80. A patient is brought to the operating suite when she experiences a large output of blood in her chest tubes post

CABG. The physician performing the original CABG yesterday is concerned about the post-operative

bleeding. He explores the chest and finds a leaking anastomosis site and he resutured.

a. 35761 c. 35820-78

b. 35761-78 d. 35241

____ 81. Patient undergoes a mitral valve repair with a ring insertion and an aortic valve replacement, on

cardiopulmonary bypass. Which are the correct CPT® codes?

a. 33464, 33406-51 c. 33430, 33405-51

b. 33426, 33405-51 d. 33468, 33426-51

____ 82. Preoperative Diagnosis: Coronary artery disease associated with congestive heart failure. In addition, the

patient has diabetes and massive obesity.

Postoperative Diagnosis: Same

Anesthesia: General endotracheal

Incision: Median sternotomy

Indications: The patient had presented with severe congestive heart failure associated with her severe

diabetes. She had significant coronary artery disease, consisting of a chronically occluded right coronary

artery but a very important large obtuse marginal artery coming off as the main circumflex system.

She also has a left anterior descending artery which has moderate disease and this supplies quite a bit of

collateral to her right system. The decision was therefore made to perform a coronary artery bypass grafting

procedure particularly because she is so symptomatic. The patient was brought to the operating room.

Description of Procedure: The patient was brought to the operating room and placed in supine position.

Myself, the operating surgeon was scrubbed throughout the entire operation. After the patient was prepared,

median sternotomy incision was carried out and conduits were taken from the left arm as well as the right

thigh. The patient weighs almost three hundred pounds and with her obesity there was some concern as to

taking down the left internal mammary artery. Because the radial artery appeared to be a good conduit, she

should have an arterial graft to the left anterior descending artery territory. She was cannulated after the aorta

and atrium were exposed and after full heparinization.

Attention was turned to the coronary arteries. The first obtuse marginal artery was a very large target and the

vein graft to this target indeed produced an excellent amount of flow. Proximal anastomosis was then carried

out to the foot of the aorta. The left anterior descending artery does not have severe disease but is also a very

good target, and the radial artery was anastomosed to this target, and the proximal anastomosis was then

carried out to the root of the aorta.

Sternal closure was then done using wires. The subcutaneous layers were closed using Vicryl suture. The skin

was approximated using staples.

a. 33533, 33510 c. 33533, 33517

b. 33511 d. 33533, 33517, 35600

____ 83. What parts make up the large intestine?

a. Ileum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum and

anus

b. Jejunum, ileum, duodenum, cecum

c. Cecum with vermiform appendix, ascending colon, transverse colon, descending colon,

sigmoid colon, rectum and anus

d. Appendix, cecum, ileum, jejunum, duodenum, rectum and anus

____ 84. Bile empties into the duodenum through what structure?

a. Biliary artery c. Pyloric sphincter

b. Common hepatic duct d. Common bile duct

____ 85. What is the correct coding for a physician who performs an UGI radiological evaluation of the esophagus,

stomach and first portion of the duodenum with barium and double-contrast in the hospital GI lab? (Physician

is not employed by the hospital)

a. 74246 c. 74246-26

b. 74249 d. 74249-26

____ 86. A 40 year-old male patient is in the surgical suite to have an incarcerated hernia of his belly button repaired.

What are the correct CPT® and ICD-10-CM codes reported?

a. 49582, K42.0 c. 49590, K42.9

b. 49587, K42.0 d. 49572, K42.9

____ 87. A patient presents with a 2 cm benign lip lesion. The provider decides to remove the lesion along with a

portion of the lip by performing a wedge excision. Single-layer suture repair is performed. What CPT®

code(s) is/are reported for this service?

a. 11442, 12011-51 c. 40510

b. 11442, 40510 d. 40510, 12011-51

____ 88. What is the correct CPT® coding for a partial distal gastrectomy with Roux-en-Y reconstruction with

vagotomy?

a. 43621, 43635 c. 43633, 43635

b. 43634, 43635 d. 43633, 43640-51

____ 89. A 56 year-old patient complains of occasional rectal bleeding. His physician decides to perform a rigid

proctosigmoidoscopy. During the procedure, two polyps are found in the rectum. The polyps are removed by

a snare. What CPT® and ICD-10-CM codes are reported?

a. 45320, K62.1 c. 45309, 45309, K63.5

b. 45385, K63.5 d. 45315, K62.1

____ 90. A patient with hypertension is scheduled for same day surgery for removal of her gallbladder due to chronic

gallstones. She is examined preoperatively by her cardiologist to be cleared for surgery.

What ICD-10-CM codes are reported by the cardiologist?

a. K80.21, Z01.89, I10 c. Z01.810, K80.20, I10

b. K80.20, I10, Z01.810 d. I10, Z01.818, K80.20

____ 91. Transurethral resection of bladder neck and nodular prostatic regrowth. What CPT® code is reported for this

service?

a. 55801 c. 52640

b. 52630 d. 52500

____ 92. Patient is status post radical retropubic prostatectomy with erectile dysfunction, presenting for penile implant.

An inflatable penile prosthesis is inserted. What CPT® code is reported for this service?

a. 54400 c. 54408

b. 54416 d. 54401

____ 93. Patient presents today for treatment of benign prostatic hypertrophy (BPH) and urinary retention by

transurethral microwave thermotherapy (TUMT). What CPT® and ICD-10-CM codes are reported for this

service?

a. 53850, N40.0, R33.8 c. 53850, N40.1, R33.8

b. 52648, N40.1, R33.8 d. 52648, N40.1

____ 94. A 63 year-old male presents for the insertion of an artificial inflatable urinary sphincter for urinary

incontinence. A 4.5 cm cuff, 22 ml balloon, 61-70 mmHg artificial inflatable urinary sphincter was inserted.

What CPT® code is reported for this service?

a. 53446 c. 53448

b. 53447 d. 53445

____ 95. A clamp circumcision is performed without dorsal block on a newborn. What CPT® code is reported for this

service?

a. 54150 c. 54150-52

b. 54160 d. 54160-52

____ 96. Removal of a malfunctioning AMS 700 inflatable penile prosthesis and all components and implantation of

an inflatable multi-component AMS Tambocor 14 mm diameter 15 mm length with 2 cm rear tip extender

bilaterally in the same surgery session. What CPT® code is reported for this service?

a. 54408 c. 54410

b. 54406 d. 54411

____ 97. In ICD-10-CM when both CKD and ESRD are reported what code(s) is/are reported?

a. N18.5 c. N18.5, N18.6

b. N18.6 d. N18.6, N18.5

____ 98. What ICD-10-CM code is reported for male stress incontinence?

a. N39.3 c. N39.46

b. N39.41 d. N39.498

____ 99. Patient has TAH-BSO. What CPT® code is reported?

a. 58150 c. 58180

b. 58152 d. 58200

____ 100. A pregnant patient presents to the ED with bleeding, cramping, and concerns of loss of tissue and material per

vagina. On examination, the physician discovers an open cervical os with no products of conception seen.

He tells the patient she has had an abortion. What type of abortion has she had?

a. Missed c. Spontaneous

b. Induced d. None of the above

____ 101. Patient wishes permanent sterilization and elects laparoscopic tubal ligation with Falope ring. What is the

CPT® code reported for this service?

a. 58671 c. 58615

b. 58600 d. 58670

____ 102. A woman with a long history of rectocele and perineal scarring from multiple episiotomies develops a

rectovaginal fistula with perineal body relaxation. She has transperineal repair with perineal body

reconstruction and plication of the levator muscles. What are the CPT® and ICD-10-CM codes reported for

this procedure?

a. 57250, N81.6 c. 57300, 56810-51, N82.3, N81.89

b. 57308, N82.3, N81.89 d. 57330, N82.3

____ 103. A 37 year-old woman presents with abdominal pain, bleeding unrelated to menses and an abnormal pap

showing LGSIL (low grade squamous intraepithelial lesion). Treatment is hysteroscopy with thermoablation

of the endometrium and cryocautery of the cervix. This is performed without difficulty. What are the CPT®

and ICD-10-CM codes reported for this procedure?

a. 58555, 58353-51, C54.9 c. 58350, 57510-51, C54.9

b. 58565, 57511-51, R87.612 d. 58563, 57511-51, R87.612

____ 104. A 62 year-old woman with a history of urinary incontinence and incomplete bladder emptying presents for

sling urethropexy and repair of a cystocele. The sling urethropexy is performed using a prosthetic mesh.

The anterior repair is also performed without difficulty and both repairs are performed vaginally. What are

the CPT® codes reported for this service?

a. 57288, 57240-51 c. 53440, 57240-51, 57267

b. 57288, 57267, 57240-51 d. 53440, 57240

____ 105. What is the code for ultrasound evaluation of a fetus and mother, usually performed early in pregnancy (first

trimester), to confirm fetal age, set an anticipated delivery date, for qualitative assessment of amniotic fluid

volume/gestational sac shape and examination of the maternal uterus and adnexa?

a. 59025 c. 76801

b. 76819 d. 76815

____ 106. A 26 year-old gravida 2 para 1 female has been spotting and has been on bed rest. She awoke this morning

with severe cramping and bleeding. Her husband brought her to the hospital. After examination, it was

determined she has an incomplete early spontaneous abortion. She is in the 12th week of her pregnancy. She

was taken to the OR and a dilation and curettage (D&C) was performed. There were no complications from

the procedure. She will follow-up with me in the office. She has had four antepartum visits during her

pregnancy.

a. 59812, 59425, O03.9 c. 58120, 59425, O03.1

b. 59812, 59425, O03.4 d. 58120, 59425, O03.9

____ 107. What ICD-10-CM category is used to report the weeks of gestation of pregnancy?

a. E11 c. O20

b. I24 d. Z3A

____ 108. What ICD-10-CM codes are reported for an encounter for full-term uncomplicated delivery of a single live

birth at 41 weeks of pregnancy?

a. O80, Z37.0, Z3A.41 c. O82, Z37.0, Z3A.41

b. O80, Z37.1, Z3A.41 d. O82, Z37.1, Z3A.41

____ 109. What ICD-10-CM code is reported for VIN III?

a. D07.0 c. N87.1

b. D07.1 d. N90.1

____ 110. The provider removes the thymus gland in a 27 year-old female with myasthenia gravis. Using a transcervical

approach the blood supply to the thymus is divided and the thymus is dissected free from the pericardium and

the thymus is removed. What CPT® code is reported for this procedure?

a. 60520 c. 60522

b. 60521 d. 60540

____ 111. A patient with a right side, benign adrenal adenoma has a laparoscopic adrenalectomy. What CPT® and ICD-

10-CM codes are reported?

a. 50545, D35.01 c. 60540, C47.9

b. 60650, D35.01 d. 60545, C47.9

____ 112. A 41 year-old female has carpal tunnel syndrome in her left hand. The patient underwent release of the carpal

ligament with internal neurolysis. An incision was made directly over the carpal ligament through the skin to

the carpal ligament. Under direct vision the carpal ligament was divided then internal neurolysis of the

median nerve was performed using a magnifying loupes. What CPT® code is reported?

a. 64704-LT c. 64721-LT

b. 64719-LT d. 64722-LT

____ 113. A 55 year-old man presents with uncontrolled tremors that have become quite severe and are now disabling.

A trial of a deep brain stimulator electrode is recommended. The patient is placed in the head holder adapter

for the frame. The scalp is incised exposing the skull using a perforator to make a single burr hole 2.5 cm

from the midline at the level of the coronal suture exposing the dura and is punctured for access.

Microelectrode recording (MER) and stimulation is done to target and reposition the electrodes to determine

the best placement for the neurostimulator electrode. The neurostimulator electrode array is placed in the

thalamus and fastened into position with radiographic image monitoring placement. The lead is coiled in a

pocket under the galea, which is sutured closed, followed by skin closure. What CPT® code is reported?

a. 61850 c. 61867

b. 61863 d. 61870

____ 114. What ICD-10-CM code is reported for Addisonian crisis?

a. E27.0 c. E27.2

b. E27.1 d. E27.40

____ 115. What ICD-10-CM code is reported for mild nonproliferative diabetic retinopathy with macular edema?

a. E11.3219 c. E11.3399

b. E11.3599 d. E11.3199

____ 116. What CPT® code(s) is/are reported for the placement of two adjustable sutures during strabismus surgery

involving the horizontal muscles?

a. 67318 c. 67334, 67335-51

b. 67312, 67335 d. 67316, 67335-51

____ 117. A 65 year-old patient presents with an ectropion of the right lower eyelid. Repair with tarsal wedge excision is

performed for correction. Attention was then directed to the left eye. The patient also has an ectropion of the

left lower eyelid which is repaired by suture repair. What CPT® code(s) is/are reported?

a. 67916-50 c. 67914-50

b. 67916-E4, 67914-E2 d. 67923-E4, 67921-E2

____ 118. A patient with right and left prominent ears presents for an otoplasty. What CPT® and ICD-10-CM codes are

reported?

a. 69300, Q17.5 c. 69310, H61.113

b. 69300-50, Q17.5 d. 69320, H61.113

____ 119. A provider uses cryotherapy for removal trichiasis of the right upper eyelid. What CPT® and ICD-10-CM

codes are reported?

a. 67820-E3, H02.059 c. 67830-E3, H02.051

b. 67825-E3, H02.051 d. 67840-E3, B79

____ 120. The provider performs an iridotomy using laser on both eyes for chronic angle closure glaucoma that is

moderate; procedure includes local anesthesia. What CPT® and ICD-10-CM codes are reported?

a. 66710-50, H40.2212, H40.2222 c. 66762-50, 66990, H40.2432

b. 66625, H40.2290 d. 66761-50, H40.2232

____ 121. The provider creates an opening in the opaque posterior lens capsule of the patient’s right eye by cutting an

inverted U shape in the tissue. The cut is made using a YAG laser. The tissue within the inverted U falls

down, and out of the patient’s field of vision. The procedure is done to improve the vision of a patient with a

secondary cataract. What CPT® code is reported?

a. 66999-50 c. 66821-RT

b. 66830-50 d. 66762-RT

____ 122. What physical status modifier best describes a patient who has a severe systemic disease that is a constant

threat to life?

a. P1 c. P3

b. P2 d. P4

____ 123. A patient with diabetic peripheral circulatory disorder is having a lower leg amputation due to gangrene.

What ICD-10-CM code(s) is/are reported?

a. E11.52, I96 c. I96

b. I96, E11.52, I79.8 d. E11.52

____ 124. Following labor and delivery, the mother developed acute kidney failure. What ICD-10-CM code is

reported?

a. O26.839 c. O90.4

b. O35.8XX0 d. N19

____ 125. A 72 year-old patient is undergoing a corneal transplant. An anesthesiologist is personally performing

monitored anesthesia care. What CPT® code and modifier(s) are reported for anesthesia?

a. 00144, 99100 c. 00144-AA-QS, 99100

b. 00144-AA, 99100 d. 00144-QK-QS, 99100

____ 126. A 30 year-old patient had anesthesia for an extensive spinal procedure with instrumentation under general

anesthesia. The anesthesiologist performed all required steps for medical direction while directing one

CRNA. What modifier(s) and CPT® code(s) is/are reported for the anesthesiologist and CRNA services?

a. 00670-AA c. 00670-QK and 00670-QZ

b. 00670-QK and 00670-QX d. 00670-QY and 00670-QX

____ 127. An 8 month-old has a simple Fontan procedure to repair his tricuspid atresia. During the procedure, the heart-

lung machine is used. What are the correct CPT® and ICD-10-CM codes for this anesthesia service?

a. 00561, Q22.4 c. 00561, 99100, 99116, Q22.3

b. 00561, 99100, Q22.4 d. 00562, 99100, Q21.0

____ 128. A 40 year-old female is scheduled for a routine screening baseline bilateral mammogram with computer-aided

detection (CAD). What are the CPT® and ICD-10-CM codes reported?

a. 77062, 77063, Z12.31 c. 77067, Z12.31

b. 77067, R92.2 d. 77066, Z12.31

____ 129. A 40 year-old female has cholelithiasis with chronic cholecystitis. She is in the Ambulatory Surgical Center

to have a laparoscopic cholecystectomy. A dye was injected to perform an intraoperative cholangiogram.

The surgeon who performed the procedure included a separate report with his interpretation of the

cholangiogram that indicated there was normal, free flow into the duodenum, with no evidence of filling

defects with no stones or strictures seen. What CPT® codes are reported for the professional services of the

surgeon?

a. 47562, 74300 c. 47563, 74300-26

b. 47563, 74300 d. 47562, 74300-26

____ 130. A 66 year-old male with a history of anemia presents for a liver core biopsy to evaluate for possible cirrhosis.

The patient was brought to the CAT scan suite in which limited CT images of the upper abdomen were

performed for biopsy needle placement. The appropriate site for the liver core biopsy was chosen. The

patient's skin was then marked with the computer coordinates. An 18-gauge needle was advanced into the

appropriate site and a sample was obtained. What CPT® codes are reported?

a. 47100, 76942-26 c. 47100, 74150-26

b. 47000, 77012-26 d. 47000, 77002-26

____ 131. A 32 year-old patient with cervical cancer is in an outpatient facility to have HDR brachytherapy. The cervix

is dilated and under ultrasound guidance six applicators are inserted with iridium via the vagina to release its

radiation dose. The placement is in the cervical cavity (intracavitary). What CPT® code is reported for the

physician service?

a. 77761-26 c. 77799-26

b. 77762-26 d. 77789-26

____ 132. What ICD-10-CM code is reported for a routine chest X-ray?

a. R07.1 c. Z00.00

b. R07.9 d. Z00.01

____ 133. A patient has a cytopathology study performed by a fine needle aspiration. The results are quite unusual and

the slides as well as a copy of pertinent information from the patient’s record are sent to another

cytopathologist for consultation. The consulting pathologist reviews the slides and reviews the patient’s chart

material. A report is sent back to the original pathologist with the findings. What CPT® code is reported?

a. 80502 c. 80500

b. 99245 d. 88173

____ 134. A physician orders a General Health Panel, all tests except a creatinine, including CBC with automated

differential. What CPT® code(s) is/are reported?

a. 80050

b. 80050-52

c. 85025, 84443, 82040, 82247, 82310, 82374, 82435, 82947, 84075, 84132, 84155, 84295,

84460, 84450, 84520

d. 80050-22

____ 135. A patient’s mother and sister have been treated for breast cancer. She has blood drawn for cancer gene

analysis with molecular pathology testing. She has previously received genetic counseling. Blood will be

tested for full sequence analysis and common duplication or deletion variants (mutations) in BRCA1, BRCA2

(breast cancer 1 and 2). What CPT® code(s) is (are) reported for this molecular pathology procedure?

a. 81200 c. 81162

b. 81206 d. 81163, 81164

____ 136. A patient has partial removal of his lung which is sent in for gross and microscopic examination. The

pathologist also did gross and microscopic exam on biopsies for several lymph nodes in the patient’s chest

which are placed in one container. A consultation is performed on a tissue block of a single specimen

intraoperatively by frozen section. The pathologist also performs a trichrome stain. What CPT® codes are

reported for the lab tests performed?

a. 88309 x 2, 88313, 88329

b. 88309, 88305, 88313, 88331

c. 88307, 88305 x 2, 88332

d. 88309 x 2, 88307 x 2, 88313, 88331, 88332

____ 137. A couple has been trying to conceive for nine months without success. Preliminary studies show the woman

ovulates and the husband’s sperm count is good. A sperm sample is submitted for both a post coital Huhner

test and a hamster penetration test. Report the codes.

a. 89300, 89320 c. 89300, 89329

b. 89310, 89330 d. 89325, 89260

____ 138. A patient is seen by Dr. B who is covering on call services for Dr. A. The patient is an established patient

with Dr. A. but she has not been seen by Dr. B. before. Which E/M subcategory is appropriate to report the

services provided by Dr. B?

a. Established patient office visit c. Office consultation

b. New patient office visit d. Preventive medicine visit

____ 139. A pediatrician is asked to be in the room during the delivery of a baby at risk for complications. The

pediatrician is in the room for 45 minutes. The baby is born and is completely healthy, not requiring the

services of the pediatrician. What CPT® code(s) is/are reported by the pediatrician?

a. 99219 c. 99360

b. 99252 d. 99360 x 2

____ 140. A 77 year-old Medicare beneficiary has a digital rectal examination for prostate cancer screening and the

provider orders a PSA. How would this be reported?

a. 99397-25, 45990 c. 99387-25, 45990

b. G0027 d. G0102

____ 141. Patient comes in today at 4 months of age for a checkup. She is growing and developing well. Her mother is

concerned because she seems to cry a lot when lying down but when she is picked up she is fine. She is on

breast milk but her mother has returned to work and is using a breast pump but hasn’t seemed to produce

enough milk.

PHYSICAL EXAM: Weight 12 lbs. 11 oz., Height 25in., OFC 41.5 cm. HEENT: Eye: Red reflex normal.

Right eardrum is minimally pink, left eardrum is normal. Nose: slight mucous Throat with slight thrush on the

inside of the cheeks and on the tongue. LUNGS: clear. HEART: w/o murmur. ABDOMEN: soft. Hip exam

normal. GENITALIA normal although her mother says there was a diaper rash earlier in the week.

ASSESSMENT

Four month-old well check

Cold

Mild thrush

Diaper rash

PLAN:

Okay to advance to baby foods

Okay to supplement with Similac

Nystatin suspension for the thrush and creams for the diaper rash if it recurs

Mother will bring child back after the cold symptoms resolve for her DPT, HIB and polio

What E/M code(s) is/are reported?

a. 99212 c. 99391, 99212-25

b. 99391 d. 99213

____ 142. A 60 year-old woman is seeking help to quit smoking. She makes an appointment to see Dr. Lung for an

initial visit. The patient has a constant cough due to smoking and some shortness of breath. No night sweats,

weight loss, night fever, CP, headache or dizziness. She has tried patches and nicotine gum which has not

helped. Patient has been smoking for 40 years and smokes 2 packs per day. She has a family history of

emphysema. A limited three system exam was performed. Dr Lung discussed in detail the pros and cons of

medications used to quit smoking. Counseling and education was done for 20 minutes of the 30-minute visit.

Prescriptions for Chantix and Tetracycline were given. The patient to follow up in 1 month. A chest X-ray

and cardiac work up was ordered. Select the appropriate CPT code(s) for this visit.

a. 99202 c. 99203, 99354

b. 99203 d. 99214, 99354

____ 143. A 65 year-old was admitted in the hospital two days ago and is being examined today by his primary care

physician, who has been seeing him since he has been admitted. Primary care physician is checking for any

improvements or if the condition is worsening.

CHIEF COMPLAINT: CHF

INTERVAL HISTORY: CHF symptoms worsened since yesterday.

Now has some resting dyspnea. HTN remains poorly controlled with systolic pressure running in the 160s.

Also, I’m concerned about his CKD, which has worsened, most likely due to cardio-renal syndrome.

REVIEW OF SYSTEMS: Positive for orthopnea and one episode of PND. Negative for flank pain,

obstructive symptoms or documented exposure to nephrotoxins.

PHYSICAL EXAMINATION:

GENERAL: Mild respiratory distress at rest

VITAL SIGNS: BP 168/84, HR 58, temperature 98.1.

LUNGS: Worsening bibasilar crackles

CARDIOVASCULAR: RRR, no MRGs.

EXTREMITIES: Show worsening lower extremity edema.

LABS: BUN 56, creatinine 2.1, K 5.2, HGB 12.

IMPRESSION:

1. Severe exacerbation of CHF

2. Poorly controlled HTN

3. Worsening ARF due to cardio-renal syndrome

PLAN:

1. Increase BUMEX to 2 mg IV Q6.

2. Give 500 mg IV DIURIL times one.

3. Re-check usual labs in a.m.

Total time: 20 minutes.

What E/M category is used for this visit?

a. Initial Hospital Visit (99221-99223)

b. Inpatient Consultation (99251-99255)

c. Subsequent Hospital Visit (99231-99233)

d. Established Patient Office/Outpatient Visit (99211-99215)

____ 144. A patient is diagnosed as having both acute and chronic tonsillitis. How is this reported in ICD-10-CM?

a. Only the acute tonsillitis is reported.

b. Only the chronic tonsillitis is reported.

c. The chronic tonsillitis is reported first; the acute tonsillitis is reported second.

d. The acute tonsillitis is reported first; the chronic tonsillitis is reported second.

____ 145. A 59 year-old male experienced left arm pain while cleaning the garage. There was no injury. His provider

scheduled a 30-minute stress test using the Bruce Protocol at the hospital. There was no arm pain while on

the treadmill; he did have a slight heart rhythm abnormality. The patient rested for 2 minutes. He had no

further symptoms or pain. The cardiologist supervised the study, interpreted the test and dictated a report.

What CPT® code(s) is/are reported?

a. 93015 c. 93016, 93018

b. 93015-26 d. 93018

____ 146. A patient has an open wound on his left lower leg caused by a cat bite. The animal tested negative for rabies,

but the wound has failed to heal and became infected by Clostridium perfringens. The patient underwent

hyperbaric oxygen therapy attended and supervised by the provider. What CPT® and ICD-10-CM codes are

reported?

a. 99183, S81.852A, B96.7, W55.01XA

b. 97597, S81.001A, T63.891A

c. 97605, S81.802A, B95.5, W55.03XA

d. 97597, S81.852A, W55.01XA

____ 147. A patient with bilateral sensory hearing loss is fitted with a digital, binaural, behind the ear hearing aid.

What HCPCS Level II and ICD-10-CM codes are reported?

a. V5140, H90.3, Z46.1 c. V5140, H90.6

b. V5261, Z46.1, H90.3 d. V5261, Z01.110, H90.3

____ 148. A patient with congestive heart failure and chronic respiratory failure with hypoxia is placed on home oxygen.

Prescribed treatment is 2L nasal cannula oxygen at all times. A home care nurse visited the patient to assist

with his oxygen management. What CPT® and ICD-10-CM codes are reported?

a. 99503, I50.9, J96.11 c. 99504, I50.1, J96.11

b. 99503, I50.9, J80 d. 99503, J50.1, J80

____ 149. A 49 year-old patient had several episodes of esophageal reflux and underwent a gastroesophageal reflux test

to measure the pH balance (a measure of the degree of acidity or alkalinity). The test was performed with a

mucosal attached capsule. The provider provided an interpretation and report. The provider stated the

diagnosis as gastroesophageal reflux. What CPT® and ICD-10-CM codes are reported?

a. 91034, K21.9 c. 91037, R12

b. 91034, K21.0 d. 91035, K21.9

____ 150. Mrs. Salas had angina decubitus that lasted for 30 minutes and was admitted to the Coronary Care Unit with a

diagnosis of r/o MI. The cardiologist (private practice based) takes her to the cardiac catheterization suite at

the local hospital for a left heart catheterization. Injection procedures for selective coronary angiography and

left ventriculography were performed and imaging supervision and interpretation for the selective coronary

angiography and left ventriculography was provided. What CPT® code(s) is/are reported for the services?

a. 93452-26 c. 93453-26

b. 93458-26 d. 93453-26, 93462