Question 1

Which of the following is the area of the sinus that is located at the top of the nasal cavities between the eyes?

Accepted Answer

The ethmoid sinus is located at the top of the nasal cavities between the eyes.

Question 2

A patient is diagnosed with deep vein thrombosis of a lower extremity. Which of the following veins could be involved?

Accepted Answer

Popliteal vein is a deep vein located in the lower extremity, and it can be involved in deep vein thrombosis.

Question 3

The patient underwent radical neck dissection with laryngectomy for carcinoma of the larynx and true vocal cords. Choose the correct codes:

Accepted Answer

Radical neck dissection with laryngectomy is coded as 31365. Carcinoma of the larynx and true vocal cords is coded as C32.0.

Question 4

Michael, a 40-year-old male, presented for insertion of a permanent pacemaker by transvenous approach. A pocket was created for the insertion of the generator, and the electrodes were placed in the right atrium and ventricle. Michael is diagnosed with atrial fibrillation. Select the correct codes:

Accepted Answer

33208 is the correct code for the insertion of a dual-chamber pacemaker, which matches the procedure described. I48.91 is the correct diagnosis code for atrial fibrillation, unspecified.

Question 5

A 35-year-old female patient receives biopsies of both breasts. The biopsies are done using fine-needle aspiration without imaging guidance. What is the correct CPT code to use for this procedure?

Accepted Answer

CPT code 10021 is used for fine-needle aspiration without imaging guidance. The "-50" modifier indicates that the procedure was performed bilaterally.

Question 6

Boris presents to the clinic today for completion of a series of injections into his shoulder for shoulder pain. The physician gives the patient an injection into the left shoulder. Choose the correct CPT and ICD-10-CM codes:

Accepted Answer

20610-LT, M25.512 is the correct combination because 20610 represents an injection into a major joint or bursa with the modifier LT indicating the left side, and M25.512 specifies pain in the left shoulder, accurately reflecting the procedure and the patient's condition.

Question 7

A female patient had breast cancer 3 years ago, underwent a radical mastectomy, and received radiation and chemotherapy. She has not had treatment in the last 20 months. How is the status of the cancer reported for the patient?

Accepted Answer

Z85.3 is the correct code for a personal history of breast cancer, which is appropriate for a patient who has had breast cancer in the past but is not currently receiving treatment for it.

Question 8

Timmy, a 5-year-old, was playing with his toys and decided to stick a bead from his sister's necklace up his nose. The bead was lodged in his nasal passage, and after several unsuccessful attempts by his mother and father to remove it, they took him to the emergency room. After triaging the patient, the physician utilized a surgical instrument to help remove the bead from Timmy's nasal passage. Code the physician services:

Accepted Answer

30300 represents the removal of a foreign body from the nasal passage without incision, which is the procedure described. T17.1XXA is the ICD-10 code for a foreign body in the nose, initial encounter, which matches Timmy's situation.

Question 9

Operation: Left transaxillary subpectoral mammoplasty with saline-filled implant.
Preoperative diagnosis: Left hypomastia.
Postoperative diagnosis: Left hypomastia.
Anesthesia: General.
Procedure: After first obtaining a suitable level of general anesthesia with the patient in the supine position, the breasts were prepped with Betadine scrub and solution. Sterile towels, sheets, and drapes were placed in the usual fashion for surgery of the breasts. Following prepping and draping, the anterior axillary folds and the inframammary folds were infiltrated with a total of 20 cc of 0.5 percent Xylocaine with 1:200,000 units of epinephrine.
After a suitable hemostatic waiting period, transaxillary incisions were made, and dissection was carried down to the edge of the pectoralis fascia. Blunt dissection was then used to form a bilateral subpectoral pocket. Through the subpectoral pocket a sterile suction tip was introduced, and copious irrigation with sterile saline solution was used until the irrigant was clear.
Following completion of irrigation, 250-cc saline-filled implants were introduced. They were first filled with 60 cc of saline and checked for gross leakage; none was evident. They were overfilled to 300 cc of saline each. The patient was then placed in the seated position, and the left breast needed 10 cc of additional fluid for symmetry.
Following completion of the filling of the implants and checking the breasts for symmetry, the patient's wounds were closed with interrupted vertical mattress sutures of 4-0 Prolene. Flexan dressings were applied, followed by the patient's bra. She seemed to tolerate the procedure well.
Choose the appropriate CPT and ICD-10-CM codes:

Accepted Answer

The correct CPT code for this procedure is 19325-LT, indicating augmentation mammoplasty with a prosthetic implant, performed on the left side. The ICD-10-CM code N64.82 corresponds to hypomastia, which matches the preoperative and postoperative diagnosis.

Question 10

Gary sees Dr. G on Monday regarding his atrial fibrillation. Gary is a new patient, and Dr. G performs a comprehensive history, an exam, and moderate medical decision making. Dr. G decides to insert a permanent dual-chamber pacemaker. The pacemaker is inserted on Tuesday. Dr. G sees Gary in the hospital on Wednesday and discharges Gary on Thursday. Which of the following is the correct coding of Gary's visits and procedures for Monday through Thursday?

Accepted Answer

The correct coding for Gary's visits and procedures from Monday through Thursday includes 99204-57 for the initial visit on Monday, which involved a comprehensive history, exam, and moderate medical decision making by Dr. G for a new patient, with the modifier -57 indicating that the decision for surgery was made during this visit. The code 33208 is used for the insertion of a dual-chamber pacemaker, which occurred on Tuesday. The subsequent hospital visits on Wednesday and the discharge on Thursday are not separately coded because they are included in the global surgical package for the pacemaker insertion.

Question 11

The physician performed thoracentesis with tube insertion to treat pleural effusion caused by small cell cancer of the middle lobe of the right lung. Select the appropriate CPT and ICD codes:

Accepted Answer

The answer of The physician performed thoracentesis with tube insertion...

Question 12

Amy presents to the office for destruction of a malignant 2.3-cm lesion of the skin of the neck. Select the appropriate ICD-10-CM and CPT codes for today's encounter:

Accepted Answer

The answer of Amy presents to the office for destruction...

Question 13

Amara presents to the office today as an established patient to have irritated skin tags removed from her neck and shoulders. Dr. Rose prepped her for the procedure and removed 20 skin tags using liquid nitrogen. Select the appropriate CPT code(s) for Amara's visit today:

Accepted Answer

CPT code 11200 is used for the removal of up to 15 skin tags, and 11201 is an add-on code for each additional 10 skin tags or part thereof. Since 20 skin tags were removed, 11200 covers the first 15, and 11201 covers the additional 5.

Question 14

The patient presents for a direct repair of an aneurysm and graft insertion without a patch graft for an aneurysm of the common iliac artery. Select the appropriate CPT code:

Accepted Answer

The answer of The patient presents for a direct repair...

Question 15

The patient presents for submucous resection of the middle turbinate, complete. Select the appropriate CPT code:

Accepted Answer

The answer of The patient presents for submucous resection of...

Question 16

Which of the following great vessels carries deoxygenated blood from the right ventricle to the lungs?

Accepted Answer

The pulmonary arteries are responsible for carrying deoxygenated blood from the right ventricle of the heart to the lungs for oxygenation.

Question 17

The form of skin cancer that rarely metastasizes is known as:

Accepted Answer

Basal cell carcinoma is the form of skin cancer that rarely metastasizes. It is the most common type of skin cancer and usually remains localized to the skin, with a very low risk of spreading to distant organs.

Question 18

Operative Report
Postoperative diagnosis:
1) Retained hardware, left foot.
2) Decreased range of motion, left ankle.
Procedure: The patient was placed under general anesthesia; her left lower extremity was prepped and draped in a sterile fashion. A time-out procedure was performed.
The patient then had a hardware removal performed on the transcutaneous K-wires, followed by examination of her ankle, which had approximately 5 to 10 degrees lacking of neutral. Gentle manipulation was performed, giving her dorsiflexion to 10 degrees. C- arm fluoroscopy was introduced to the field, taking confirmatory x-ray, and at this point the patient had a sterile dressing applied and was awakened from general anesthesia.
Select the appropriate CPT codes:

Accepted Answer

The answer of Operative Report
Postoperative diagnosis:
1) Retained hardware, left foot.
2)...

Question 19

Gavin presents to the hospital for an outpatient procedure for a diagnostic arthroscopy of the right knee. As the physician is performing the procedure, she identifies a medial meniscal tear and repairs it at that time. Choose the correct CPT and ICD-10-CM codes for this procedure:

Accepted Answer

The correct CPT code is 29882-RT for arthroscopic meniscal repair, and the ICD-10-CM code is S83.241A for a tear of the medial meniscus of the right knee.

Quiz 24: Coding for Surgical Procedures on Integumentary, Musculoskeletal, Respiratory, and Cardiovascular/Lymphatic Systems