Question 1

A 67-year-old man is scheduled for a radical perineal prostatectomy with bilateral pelvic lymphadenectomy including external iliac, hypogastric and obturator nodes all occurring during the same procedure.

Accepted Answer

55815 is the correct code for a radical perineal prostatectomy with bilateral pelvic lymphadenectomy including the external iliac, hypogastric and obturator nodes on the same day.
Code 55801 is incorrect because this code is for a perineal subtotal prostatectomy. Code 55810 is incorrect because this code is for a radical perineal prostatectomy. Code 55812 is incorrect because this code is for a radical perineal prostatectomy with limited lymph node biopsies.

Question 2

A young woman has an abscess in her Bartholin's gland. She is able to have this incised and drained at her gynecologist's office. What CPT code can be used for this procedure?

Accepted Answer

56420 is the correct code for incision and drainage of Bartholin's gland abscess.
Code 56405 is incorrect because this is for an incision and drainage of a vulva or perineal abscess. Code 56440 is incorrect because this is the code for marsupialization of Bartholin's gland cyst. Code 56441 is incorrect because this code is for the lysis of labial adhesions.

Question 3

A young female had to have a partial hymenectomy due to an imperforate hymen. What CPT code should be used for this procedure?

Accepted Answer

56700 is the correct code for a partial hymenectomy.
Code 56442 is incorrect because this code is for a simple incision hymenectomy. Code 56620 is incorrect because this code is for a partial simple vulvectomy. Code 56800 is incorrect because this code is for plastic repair of the introitus.

Question 4

A 22 year old had a positive pap smear and must undergo colposcopy within the gynecologist's office. During this procedure, multiple biopsies of the cervix will be taken. What is the correct CPT code for this procedure?

Accepted Answer

57421 is the correct code for a colposcopy with biopsies of the vagina/cervix.
Code 57200 is incorrect because this code is for colporrhaphy. Code 57282 is incorrect because this code is for a colpopexy and 57420 is incorrect because this code is for colposcopy without biopsies.

Question 5

A 55-year-old woman developed a rectovaginal fistula and is scheduled to have this closed by a vaginal approach. What is the correct CPT code for this procedure?

Accepted Answer

57300 is the correct code for closure of rectovaginal fistula by either vaginal or transanal approach.
Code 57305 is incorrect because this code is for closure of a rectovaginal fistula through the abdominal approach. Code 57310 is incorrect because this code is for the closure of urethrovaginal fistula and 57320 is incorrect because this code is for the closure of a vesicovaginal fistula using the vaginal approach.

Question 6

A postpartum mother is scheduled to have an intrauterine device (IUD) inserted. What is the correct CPT code for this procedure?

Accepted Answer

58300 is the correct code for intrauterine device insertion.
Code 58301 is incorrect because this code is for the removal of the intrauterine device. Code 58321 is incorrect because this code is for intracervical artificial insemination. Code 58346 is incorrect because this code is for the insertion of Heyman capsules for clinical brachytherapy.

Question 7

A 48-year-old woman is scheduled for a total abdominal hysterectomy with removal of tubes and without removal of ovaries. What CPT code is appropriate for this procedure?

Accepted Answer

58150 is the correct code for a total abdominal hysterectomy with or without removal of tube(s), with or without removal of ovary(s).
Code 58200 is incorrect because this code is for a total abdominal hysterectomy including partial vaginectomy with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s). Code 58260 is incorrect because this code is for vaginal hysterectomy for uterus 250 grams or less and 58285 is incorrect because this code is for a radical vaginal hysterectomy.

Question 8

A postpartum woman decides to have her tubes tied. She opts to wait until six weeks postpartum to have this procedure performed because she had a rough delivery. What is the correct CPT code for a bilateral tubal ligation when not performed at the same time as the postpartum hospitalization?

Accepted Answer

58600 is the correct answer for the ligation or transection of fallopian tube(s), using the abdominal or vaginal approach and either providing a unilateral or bilateral ligation.
Code 58605 is incorrect because this code is for this procedure when done during the postpartum hospitalization. Code 58611 is incorrect because this is an "add-on" code to a cesarean delivery or other intra-abdominal surgery visit. Code 58615 is incorrect because this is the code for occlusion of the fallopian tubes by device (band, clip, Falope ring) using a vaginal or suprapubic approach.

Question 9

A 24-year-old woman is scheduled to have surgical laparoscopy with lysis of fallopian tube adhesions. What is the correct CPT code for this procedure?

Accepted Answer

58660 is the correct code for surgical laparoscopy with lysis of adhesions (salpingolysis, ovariolysis).
Code 58661 is incorrect because this is a surgical laparoscopy with removal of adnexal structures. Code 58671 is incorrect because this is the code for surgical laparoscopy with occlusion of oviducts by device (band, clip or Falope ring). Code 58673 is incorrect because this code is for surgical laparoscopy with salpingostomy.

Question 10

A young woman is set to undergo a fimbrioplasty to help repair the portion of the fallopian tube tissue near the ovary that it meant to sweep the egg into the fallopian tube. What is the correct CPT code for this procedure?

Accepted Answer

58760 is the correct code for a fimbrioplasty.
Code 58672 is incorrect because this code is for surgical laparoscopy with fimbrioplasty and there was no mention of a laparoscopic procedure being performed. Code 58673 is incorrect because this code is for a surgical laparoscopy with salpingostomy and 58770 is incorrect because this code is for salpingostomy.

Question 11

A young female has multiple ovarian cysts. There is a large cyst approximately 10 cm in diameter on the right ovary. Due to discomfort, it is recommended to drain this cyst using a vaginal approach. What is the CPT code for this procedure?

Accepted Answer

58800 is the correct code for the drainage of ovarian cysts using the vaginal approach.
Code 58805 is incorrect because this is the code for drainage of ovarian cysts using an abdominal approach. Code 58820 is incorrect because this code is for the drainage of an ovarian abscess using an open vaginal approach. Code 58822 is incorrect because this code is used for the drainage of an ovarian abscess using the abdominal approach.

Question 12

A 56-year-old woman has been diagnosed with right ovarian cancer and is scheduled for a total right oophorectomy with pelvic lymph node biopsies with salpingectomy and omentectomy. What is the correct CPT code for this procedure?

Accepted Answer

58943 is the correct code for partial or total oophorectomy, unilateral or bilateral for ovarian, tubal or primary peritoneal malignancy with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies, diaphragmatic assessments with or without salpingectomy with or without omentectomy.
Code 58940 is incorrect because this code is for either a unilateral or bilateral partial or total oophorectomy without mention of malignancy. Code 58950 is incorrect because this code is for the resection of ovarian, tubal, or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy. Code 58953 is incorrect because this code is for a bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debunking.

Question 13

A 50-year-old woman is scheduled for a unilateral biopsy of the right ovary. What is the correct CPT code for this procedure?

Accepted Answer

58900 is the correct code for a unilateral or bilateral ovarian biopsy.
Code 58820 is incorrect because this code is used for the drainage of an ovarian abscess. Code 58920 is incorrect because this code is for a wedge resection or bisection of the ovary, either unilateral or bilateral. Code 58925 is incorrect because this code is for a unilateral or bilateral ovarian cystectomy.

Question 14

A 30-year-old woman discovered a lump on her thyroid, which turned out to be a malignancy. Her surgeon recommends total thyroidectomy with limited neck dissection to eliminate all cancerous tissue. What code should be used for this procedure?

Accepted Answer

60252 is the correct code for total thyroidectomy for malignancy with limited neck dissection.
Code 60220 is incorrect because this code is used for total unilateral thyroid lobectomy with or without isthmusectomy. Code 60240 is incorrect because this code is used for a total or complete thyroidectomy. Code 60254 is incorrect because, while this code is for a thyroidectomy for malignancy, it involves a radical neck dissection instead of the limited dissection that was described in the procedure above.

Question 15

A patient who has already had one exploration of her parathyroid(s) is scheduled for a re-exploration six months later. What CPT code should be used for the second procedure?

Accepted Answer

60502 is the correct code for re-exploration of the parathyroid(s).
Code 60500 is incorrect because this code is for parathyroidectomy or initial exploration of parathyroid(s). Code 60505 is incorrect because this code is for parathyroidectomy or exploration of parathyroid(s) with mediastinal exploration, using sternal split or transthoracic approach. Code 60512 is incorrect because this is an "add-on" code for parathyroid auto transplantation.

Question 16

A woman with myasthenia gravis is scheduled for a total thymectomy using the transcervical approach. What CPT code should be used for this procedure?

Accepted Answer

60520 is the correct code for a total thymectomy using the transcervical approach.
Code 60521 is incorrect because this code is for a thymectomy using the sternal split or transthoracic approach without radical mediastinal dissection. Code 60522 is incorrect because this code includes radical mediastinal dissection and 60540 is incorrect because this code is for an adrenalectomy.

Question 17

Thymoma are present in a woman's thymus. She is scheduled for a transthoracic total thymectomy with radical mediastinal dissection. What is the correct CPT code for this procedure?

Accepted Answer

60522 is the correct code for total thymectomy using the transthoracic approach with radical mediastinal dissection.
Code 60520 is incorrect because this code is for a partial or total thymectomy using the transcervical approach. Code 60521 is incorrect because this code is for partial or total thymectomy using a sternal split or transthoracic approach without radical mediastinal dissection. Code 60650 is incorrect because this code is for a surgical laparoscopy with adrenalectomy.

Question 18

A patient is scheduled for a thymectomy for myasthenia gravis without radical mediastinal dissection and will be performed through a sternal split. What is the CPT code for this procedure?

Accepted Answer

60521 is the correct code for a thymectomy using sternal split approach without radical mediastinal dissection.
Code 60520 is incorrect because this thymectomy uses a transcervical approach. Code 60522 is incorrect because this thymectomy includes radical mediastinal dissection. Code 60540 is incorrect because this code is for an adrenalectomy

Question 19

A young woman had a transabdominal surgical laparoscopy with complete adrenalectomy. What is the CPT code for this procedure?

Accepted Answer

60650 is the correct code for a surgical laparoscopy with total adrenalectomy.
Codes 60540 and 60545 are both incorrect because these codes are for adrenalectomies, but are not for the laparoscopic approach. Code 60659 is incorrect because this code is for an unlisted laparoscopic procedure of the endocrine system and there is a code listed for laparoscopic adrenalectomy.

Question 20

A patient needs to have a dorsal exploration of the adrenal gland with biopsy. What is the correct CPT code for this procedure?

Accepted Answer

60540 is the correct code for a partial or complete adrenalectomy or exploration of the adrenal gland with or without biopsy using either the transabdominal, lumbal or dorsal approaches.
Code 60545 is incorrect because there is no mention of removal of adjacent tumor. Codes 60650 and 60659 are both incorrect because this was not a laparoscopic procedure.

Quiz 2: Series