Question 1

A 26-year-old female was given an epidural during labor for pain management. As a result of cephalopelvic distortion, the decision was made to perform a cesarean section. Select the appropriate CPT and ICD-10-CM codes for anesthesia.

Accepted Answer

The correct codes are 01967 (epidural anesthesia) and 01968 (cesarean section anesthesia). The ICD-10-CM code for cephalopelvic distortion is 065.9.

Question 2

A 6-hour-old critically ill infant undergoes on-pump anesthesia for emergency repair of transposition of the great vessels. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

00561 is the correct CPT code for anesthesia for procedures on the heart, pericardial sac, and great vessels of infants younger than 1 year, which includes the emergency repair of transposition of the great vessels. 99140 is an additional code for emergency conditions requiring anesthesia, and the P5 modifier indicates a patient with a severe systemic disease that is a constant threat to life, which is appropriate for a critically ill infant. Q20.3 is the correct ICD-10-CM code for transposition of the great vessels.

Question 3

Sam, a 26-year-old male with Down syndrome, undergoes lithotripsy with a water bath for lodged ureteral stones. The procedure was supervised by the anesthesiologist under general anesthesia due to the patient's Down syndrome and associated anxiety. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code is 00872-P3-23 for anesthesia for lithotripsy with a water bath, with a physical status modifier P3 indicating a patient with severe systemic disease, and modifier 23 for unusual anesthesia. The ICD-10-CM codes are N20.1 for ureteral stones and Q90.9 for Down syndrome.

Question 4

A 3-year-old underwent plastic repair of her bilateral complete cleft lip. The CRNA was medically directed by the anesthesiologist. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code for anesthesia for cleft lip repair is 00102. The modifier P1 indicates a normal healthy patient. QX is used for CRNA services with medical direction by an anesthesiologist. The ICD-10-CM code Q36.0 is for bilateral cleft lip.

Question 5

Georgette, a 57-year-old female, experiences polyneuropathy in the right arm due to a spur located at C4-C5. She presents today in the pain clinic for epidural injection by the anesthesiologist of an anesthetic agent for the purpose of pain control. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code for an epidural injection in the cervical or thoracic spine is 62320, and the appropriate ICD-10-CM code for a spur (osteophyte) at C4-C5 causing polyneuropathy is D16.6, which refers to a benign neoplasm of bone and articular cartilage, applicable to the spine's location.

Question 6

An 8-month-old male, in otherwise good health, was brought to the OR today for surgical repair of bilateral cryptorchidism. The anesthesiologist supervised the procedure. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The answer of An 8-month-old male, in otherwise good health,...

Question 7

Fred, a 75-year-old male, undergoes surgical placement of a permanent transvenous pacemaker for treatment of symptomatic bradycardia as a result of a bundle branch block. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The answer of Fred, a 75-year-old male, undergoes surgical placement...

Question 8

An 81-year-old patient, Marge, fractured the proximal end head of her femur on Thanksgiving while standing and cooking dinner. She has a history of osteoporosis and received radiation therapy 3 years ago in this area for a thigh muscle tumor. She is going to surgery today for an open treatment of femoral fracture with internal fixation. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code is 27269 for open treatment of femoral fracture with internal fixation. The ICD-10-CM codes are M84.453A for pathological fracture in the femur due to osteoporosis, M80.859A for osteoporosis with current pathological fracture, and Z92.3 for a history of radiation therapy.

Question 9

Ted is at the ambulatory care center for an arthrotomy with Dr. Abraham today. Ted is a 23-year-old steel worker who has a foreign body in his carpometacarpal joint. The foreign body has created a severe infection and drainage will need to be done along with the removal of the foreign body. Dr. Abraham made an incision between the 3^rd and 4^th carpometacarpal joints and located the foreign body, which was a sliver of steel. The wound was then packed and dressed. The patient tolerated the procedure and was released with instructions to return to Dr. Abraham's office in 7 days. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The answer of Ted is at the ambulatory care center...

Question 10

A 27-year-old patient is seen for ruptured synovium in the right shoulder and right elbow due to a baseball injury. An arthroscopic thermal capsulorrhaphy was performed for multidirectional instability and to prevent dislocation. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The answer of A 27-year-old patient is seen for ruptured...

Question 11

Pyogenic arthritis in the right elbow due to methicillin susceptible staphylococcus aureus has caused continual extreme pain to the patient. Elbow replacement, arthroplasty, is recommended. The physician began the replacement procedure by removing the damaged joint components. They were then replaced with plastic implants. One implant was attached to the humerus, the other to the ulna, and the two were connected to form a hinge. The patient tolerated the procedure well and was released to the recovery room. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code for elbow replacement (arthroplasty) with prosthetic replacement is 24363. The ICD-10-CM codes include M00.021 for pyogenic arthritis of the right elbow, and B95.61 for infection due to Methicillin susceptible Staphylococcus aureus.

Question 12

Mr. Derek is here today for open tendon surgery in his right shoulder due to a ruptured rotator cuff. Under general anesthesia an incision of 5cm was made in the shoulder. All loose fragments of tendon, bursa, and other debris were removed. There was some subacromial smoothing to make room for the tendon. The tendon was properly placed and the incision was sewn with 5.0 vicryl. The patient tolerated the procedure well and was sent to the floor. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code for open repair of a ruptured rotator cuff is 23410, and the appropriate ICD-10-CM code for a rotator cuff tear of the right shoulder, unspecified, is M75.101.

Question 13

A 28-year-old was in a car accident and is now in the ED due to 3 fingers on his left hand being completely amputated above the metacarpophalangeal joint during the crash. The ED physician calls in an orthopedic surgeon and the patient is taken to surgery. Under surgical microscope his index finger and middle finger were reconnected; however, his 3rd finger was not able to be reconnected due to extensive crush injuries to that finger, so that finger was surgically amputated. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

CPT code 20822 represents reattachment of a finger or thumb, which is appropriate for the index and middle fingers that were reattached. Code 26951 is for the amputation of a finger or thumb, which applies to the third finger that was amputated. The modifier -51 is not needed for the 69990 code, which represents the use of a surgical microscope, as it is already implied in the context of multiple procedures. The ICD-10-CM codes S68.111A and S68.113A specify the traumatic amputation of the right index finger and right middle finger, respectively, which matches the scenario. S67.195A is for the crushing injury of the left ring finger, and V89.2xxA is for a person injured in a motor vehicle accident, which is appropriate for the context.

Question 14

The patient is an otherwise healthy 67-year-old male who sustained a fall three weeks ago. The patient is presenting with pain localized to his left knee. On exam the patient was unable to actively abduct and or externally rotate the knee secondary to pain and weakness. MRI demonstrated a displaced tibial tuberosity fracture. The surgeon performed an arthroscopic reduction and internal fixation of displaced greater tuberosity fracture with manipulation. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code for arthroscopic reduction and internal fixation of a displaced tibial tuberosity fracture is 29851. The ICD-10-CM codes include S82.152A for the displaced tibial tuberosity fracture, initial encounter, and W19.xxxA for an unspecified fall, initial encounter.

Question 15

Julia was playing baseball in her hardball league and was hit in the face with a line drive. Upon waking she was taken directly to the hospital. She has a fractured mandible, and the orthopedic surgeon is performing a closed treatment with interdental fixation. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The answer of Julia was playing baseball in her hardball...

Question 16

Patient was admitted with chest pain, R/O MI. The physician ordered the following laboratory tests: Comprehensive metabolic panel, CBC w/differential, Sedimentation rate, PT, troponin level, automated urinalysis w/microscopy. Select the appropriate CPT and ICD-10-CM codes for the laboratory tests.

Accepted Answer

The correct CPT codes for the ordered tests are: Comprehensive metabolic panel (80053), CBC w/differential (85025), Sedimentation rate (85651), PT (85610), troponin level (84484), and automated urinalysis w/microscopy (81001). The ICD-10-CM code for chest pain, unspecified, is R07.9.

Question 17

Clinical History: Herniated cervical disc C5-6 with myelopathy
Source of Specimen: Cervical disc tissue C5-6
Pathology Report: The specimen consists of multiple irregular fragments of fibrocartilage, aggregating 2.5 X 1.5 X 1.2cm. It is blue stained. There is no gross evidence of malignancy.
Diagnosis: Degenerating Fibrocartilage consistent with disc C5-6
Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The answer of Clinical History: Herniated cervical disc C5-6 with...

Question 18

Clinical diagnosis: Cholecystitis and Chronic Calculi
Operation: Cholecystectomy
Specimen: Gall bladder
Pathology Report: Microscopic analysis of specimen measuring 9.0 X 3.0cm.
Diagnosis: Chronic cholecystitis, cholelithiasis
Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The CPT code 88304 is for the pathology examination of the gallbladder. The ICD-10-CM code K80.10 is for cholelithiasis with chronic cholecystitis.

Question 19

A physician interprets and writes a report on a tier 1 molecular pathology procedure for BRCA1 and BRCA2 gene analysis for a 20-year-old female with a family history of breast cancer. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

CPT code 81213-26 is used for BRCA1 and BRCA2 gene analysis, including the interpretation and report by the physician, indicated by modifier -26. ICD-10-CM code Z80.3 is used for a family history of malignant neoplasm of the breast, which is appropriate for a patient with a family history of breast cancer.

Question 20

The pathologist was called to perform postmortem examination including gross and microscopic examination on a stillborn infant including the brain. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code for a postmortem examination including gross and microscopic examination of a stillborn infant including the brain is 88029. The appropriate ICD-10-CM code for a stillbirth is P95.

Quiz 27: Coding and Surgical Procedures