Question 1

Patient presents with a traumatic partial amputation of the second, third, and fourth fingers on the right hand. Patient was taken to the operating room where completion of the amputation of three fingers was performed with direct closure.

Accepted Answer

The procedure performed was completion of amputation of three fingers, which is coded as 26951. The fingers amputated were the second, third, and fourth fingers, which are coded with F6, F7, and F8 respectively. The modifier -F6, -F7, and -F8 indicate specific fingers involved.

Question 2

Patient presents to the emergency room following an assault. Examination of the patient reveals blunt trauma to the face. Radiology reports that the patient suffers from a fracture to the frontal skull and a blow-out fracture of the orbital floor. Patient is admitted and taken to the operating room where a periorbital approach to the orbital fracture is employed and an implant is inserted.

Accepted Answer

The correct code for this scenario is 21390, which represents the treatment of a fracture of the orbital floor via an external approach. None of the other codes provided accurately describe the procedure performed.

Question 3

Patient presents to the surgical unit and undergoes unilateral endoscopy, partial ethmoidectomy, and maxillary antrostomy.

Accepted Answer

The correct codes for unilateral endoscopy with partial ethmoidectomy and maxillary antrostomy are 31254 for the ethmoidectomy and 31256-51 for the maxillary antrostomy, with the -51 modifier indicating multiple procedures.

Question 4

Patient with a deviated nasal septum that was repaired by septoplasty

Accepted Answer

30520 is the correct code for septoplasty due to a deviated nasal septum. 30400 is incorrect because it is for a nasal dorsum fracture, not a septum repair. 30620 and 30630 are incorrect because they are for a turbinectomy, a procedure to remove or reduce the size of the nasal turbinates, which is not the same as a septoplasty.

Question 5

Patient presents to the radiology department where a fine-needle aspiration of the breast is performed utilizing computer tomography.

Accepted Answer

The correct codes for a fine-needle aspiration of the breast under CT guidance are 10022 for the aspiration procedure and 77012 for the CT guidance.

Question 6

Lye burn of the larynx repaired by laryngoplasty

Accepted Answer

CPT code 31588 is used for laryngoplasty procedures, which is the surgical repair of the larynx.

Question 7

Open IandD of a deep abscess of the cervical spine

Accepted Answer

Open I&D of a deep abscess of the cervical spine is coded with 22010.

Question 8

Patient presents to the emergency room following a fall. X-rays were ordered for the lower leg and results showed a fracture of the proximal left tibia. The emergency room physician performed a closed manipulation of the fracture with skeletal traction.

Accepted Answer

The correct code is 27532-LT, which represents closed treatment of a tibial fracture with manipulation and skeletal traction.

Question 9

Patient had been diagnosed with a bunion. Patient was taken to the operating room where a simple resection of the base of the proximal phalanx along with the medial eminence was performed. Kirschner wire was placed to hold the joint in place.

Accepted Answer

Simple resection of the base of the proximal phalanx along with the medial eminence is a bunionectomy.

Question 10

Patient was involved in an accident and has been sent to the hospital. During transport the patient develops breathing problems and, upon arrival at the hospital, an emergency transtracheal tracheostomy was performed. Following various x-rays, the patient was diagnosed, with traumatic pneumothorax and a thoracentesis with insertion of tube was performed.

Accepted Answer

31603 is the code for transtracheal tracheostomy, which was performed in the emergency due to breathing problems during transport. 
32422 represents thoracentesis with insertion of tube, which was done due to traumatic pneumothorax. Therefore, option C, which includes both codes, is the correct choice.

Question 11

Upper lobectomy of the right lung with repair of the bronchus

Accepted Answer

Upper lobectomy of the right lung is coded with 32480. Repair of the bronchus is coded with 32501.

Question 12

Patient with laryngeal cancer has a tracheoesophageal fistula created and has a voicebox inserted.

Accepted Answer

31611 is the correct code for the creation of a tracheoesophageal fistula with insertion of a voicebox.

Question 13

Patient has been diagnosed with metastatic laryngeal carcinoma. Patient underwent subtotal supraglottic laryngectomy with radical neck dissection.

Accepted Answer

The procedure described is a subtotal supraglottic laryngectomy with radical neck dissection, which corresponds to CPT code 31368.

Question 14

Patient presents to the operating room where a 3.2 cm malignant lesion of the shoulder was excised and repaired with simple sutures. A 2.0 cm benign lesion of the cheek was excised and was repaired with a rotation skin graft.

Accepted Answer

Codes 11604 and 11442 are used for the excision of the malignant lesion on the shoulder. Code 14040 is used for the repair of the benign lesion on the cheek with a rotation skin graft. Code 12001 is not necessary since the repair of the shoulder lesion was done with simple sutures, not a complex closure. Codes 15002 and 15120 are not appropriate for this scenario as they are for complex repairs of the face and scalp. Code 17264 is not appropriate for this scenario since it is for the removal of a scar, tattoo or birthmark, which is not indicated here. Code 17000 is also not necessary since skin grafting was not performed on the shoulder lesion.

Question 15

Patient is brought to the emergency room following a shark attack. The paramedics have the patient's amputated foot. The patient is taken directly to the operating room to reattach the patient's foot.

Accepted Answer

The answer of Patient is brought to the emergency room...

Question 16

Patient has a bronchoscopy with endobronchial biopsies of three sites.

Accepted Answer

CPT code 31625 is used for bronchoscopy with biopsy, and it should be reported only once regardless of the number of biopsies performed during the same session.

Question 17

Patient was admitted to the hospital for removal of excessive tissue due to massive weight loss. Liposuction of the abdomen and bilateral thighs was performed.

Accepted Answer

The correct codes for liposuction of the abdomen and bilateral thighs are 15877 for the abdomen and 15879-50 for the bilateral thighs, with the modifier -50 indicating a bilateral procedure.

Question 18

Patient presents to the hospital with a right index trigger finger. Release of the trigger finger was performed.

Accepted Answer

The correct code for release of trigger finger is 26055. The -F6 modifier should be added to indicate that the procedure was performed on the fingers.

Question 19

Patient presents to the hospital with ulcer of the right foot. Patient is taken to the operating room where a revision of the right metatarsal head is performed.

Accepted Answer

The answer of Patient presents to the hospital with ulcer...

Question 20

Trauma patient was rushed to the operating room with multiple injuries. Open reduction with internal fixation of intertrochanteric femoral fracture; open reduction of the tibial and fibula shaft with internal fixation was performed.

Accepted Answer

The answer of Trauma patient was rushed to the operating...

Exam 1: Registered Health Information Administrator