Question 1

Patient presents to the emergency room with lacerations sustained in an automobile accident. Repairs of the 3.3 cm skin laceration of the left leg that involved the fascia, 2.5 cm and 3.0 cm lacerations of the left arm involving the fascia, and 2.7 cm of the left foot, which required simple sutures, were performed. Sterile dressings were applied.

Accepted Answer

The repair codes for the lacerations are 12034 for the leg and 12002 for the arm and foot. Modifier -51 is added to indicate that multiple procedures were performed during the same encounter. The correct codes are 12034, 12002-51.

Question 2

Total shoulder replacement

Accepted Answer

The correct procedure code for a total shoulder replacement is 01638. Option A (01760) is for arthroscopic rotator cuff repair, option B (01630) is for closed treatment of fractured shoulder, and option C (01402) is for anesthesia for procedures on shoulder and clavicle.

Question 3

Cesarean section

Accepted Answer

The correct code for anesthesia for cesarean section is 01961, which is used for anesthesia for cesarean delivery only.

Question 4

Patient presents to the emergency room with lacerations of right lower leg that involved the fascia. Lacerations measured 5.0 cm and 2.7 cm.

Accepted Answer

The answer of Patient presents to the emergency room with...

Question 5

Procedures on bony pelvis

Accepted Answer

The answer of Procedures on bony pelvis
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Question 6

Patient presents to the hospital for skin grafts due to previous third-degree burns. The burn' eschar of the back was removed. Once the eschar was removed, the defect size measured 10 an a, 10 cm. A skin graft from a donor bank was placed onto the defect and sewn into place as a temporary wound closure.

Accepted Answer

The appropriate codes for skin grafting are 15002 for the first 100 sq. cm, and 15003 for each additional 100 sq. cm or part thereof. In this case, the defect size was 100 sq. cm, so code 15002 is appropriate. The fact that the skin graft came from a donor bank is not relevant to the coding. Therefore, the correct code is either 15002 by itself (answer choice B) or 15002 along with a code for the removal of the eschar (answer choice D). 15170 is a code for the repair of a cleft lip, which is not relevant to this case. 15200 is a code for the removal of a benign lesion, which is also not relevant. 15002 and 15003 can only be used once, so answer choice A is incorrect.

Question 7

Total hip replacement

Accepted Answer

The answer of Total hip replacement
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Question 8

Vaginal hysterectomy

Accepted Answer

The answer of Vaginal hysterectomy
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Question 9

Placement of vascular shunt in forearm

Accepted Answer

The code 01844 is used for anesthesia for procedures on the forearm, wrist, or hand, including placement of a vascular shunt.

Question 10

Decortication of left lung

Accepted Answer

The answer of Decortication of left lung
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Question 11

Nonhuman graft for temporary wound closure. Patient has a 5 cm defect on the scalp.

Accepted Answer

CPT code 15420 is the most appropriate code for a temporary wound closure using a nonhuman graft. This code specifically describes the use of skin substitute grafts, such as those made from animal collagen or human cells, for wound closure. The code includes preparation of the wound bed, application of the graft, and securing the graft in place with surgical dressings. CPT codes 15335 and 15400 both describe full-thickness grafts, which are typically used for more complex wound closures. CPT code 15430 is used for skin grafting to the scalp, but only when the graft is a split-thickness graft harvested from the patient's own skin. Therefore, the best choice for this scenario is CPT code 15420.

Question 12

Patient presents to the operating room for excision of a 4.5 cm malignant melanoma of the left forearm. A 6 cm x 6 cm rotation flap was created for closure.

Accepted Answer

The answer of Patient presents to the operating room for...

Question 13

Upper abdominal ventral hernia repair

Accepted Answer

CPT code 00752 is the correct code for repair of a ventral hernia in the upper abdominal area. Option A (00832) is a code for anesthesia during gastrointestinal endoscopy, option B (00750) is for repair of a diaphragmatic hernia, and option D (00830) is for repair of an umbilical hernia.

Question 14

Patient presents to the operating room for excision of three lesions. The 1.5 cm and 2.0 cm lesions of the back were excised with one excision. The 0.5 cm lesion of the hand was excised. The pathology report identified both back lesions as squamous cell carcinoma. The hand lesion was identified as seborrheic keratosis.

Accepted Answer

The correct codes are 11604 for the excision of malignant lesions on the back (totaling 3.5 cm) and 11420 for the excision of the benign lesion on the hand.

Question 15

10 sq cm epidermal autograft to the face from the back

Accepted Answer

The correct code for a 10 sq cm epidermal autograft is 15115, which is specifically for the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits. Code 15110 is for a similar procedure, but specifically for trunk, arms, or legs. Code 15120 is for larger grafts over 100 sq cm. Therefore, the most accurate code for a 10 sq cm epidermal autograft to the face from the back is 15115.

Question 16

Female patient has a percutaneous needle biopsy of the left breast lesion in the lower outer quadrant. Following the biopsy frozen section results, the physician followed this with an excisional removal of the same lesion.

Accepted Answer

The answer of Female patient has a percutaneous needle biopsy...

Question 17

An out-of-town patient presents to a walk-in clinic to have a prescription refilled for a j nonsteroidal anti-inflammatory drug. The physician performs a problem-focused history and physical examination with a straightforward decision.

Accepted Answer

The answer of An out-of-town patient presents to a walk-in...

Question 18

Patient is admitted for a blepharoplasty of the left lower eyelid and a repair for a tarsal strip of the left upper lid.

Accepted Answer

Code 67917-El is appropriate for the blepharoplasty of the left lower eyelid. Code 15820-E2 is used for repair of the tarsal strip of the upper eyelid, which is the correct code for this repair.

Question 19

Corneal transplant

Accepted Answer

Corneal transplant is coded as 00144.

Question 20

An office consultation is performed for a post-menopausal woman who is complaining of spotting in the past 6 months with right lower quadrant tenderness. A detailed history and physical were performed with a low-complexity medical decision.

Accepted Answer

A detailed history and physical exam were performed, which meets the requirements for a level 3 (99243) office consultation. The presence of right lower quadrant tenderness warrants additional workup, which increases the complexity of the medical decision-making.

Exam 1: Registered Health Information Administrator