Question 1

What is a result of a nasal polyp?
A)It will cause nose cancer in the affected patient
B)It can change the shape of the nose and necessitate rhinoplasty
C)It results in the release of histamine causing an allergic reaction
D)It can obstruct the nasal passageway making it difficult to breathe

Accepted Answer

A nasal polyp can obstruct the nasal passageway making it difficult to breathe. If this is the case, surgical removal of the nasal polyps may be necessary. They are normally benignant generally do not cause cancer in the patient. In addition, they are not large enough to change the shape of the nose or release histamines that cause allergic reactions, although they can develop as a result of chronic inflammation.

Question 2

SURGICAL NOTE PATIENT: JOHNSON, GOLDIE
AGE: 36
DATE: 01/15/2017
A 36-year-old woman with a history of multiple complicated ectopic pregnancies presented to the clinic for abdominal hysterectomy. Two days ago, an advanced interstitial uterine ectopic pregnancy was discovered and after careful consideration the patient elected to have a full hysterectomy. After the patient was prepped and anesthetized, the obstetrician performed a full incisional hysterectomy with removal of ectopic pregnancy, without removal of ovaries. Patient tolerated the procedure well and was sent to post-operational recovery.
How should the OB code for this surgical procedure?
A)58150
B)59120
C)59135
D)59136

Accepted Answer

The OB should code for this surgical procedure with code 59135 (Surgical Treatment of Ectopic Pregnancy; Interstitial, Uterine Pregnancy Requiring Total Hysterectomy). Code 58150 is inappropriate because it is used for a total hysterectomy performed, for other reasons, not for an ectopic pregnancy. Code 59120 is also inappropriate because it is used for the removal of an ectopic pregnancy located on the fallopian tube or ovary, not in the uterus. Code 59136 codes for the removal of an interstitial uterine pregnancy, but it does not take into account the resection of the uterus.

Question 3

PRE-PROCEDURAL NOTE PATIENT: Carter, Clara
AGE: 46
DATE: 04/10/2014
PREOPERATIVE DIAGNOSIS: Primary Malignancy, Thyroid
PROCEDURE PLANNED: Thyroidectomy
Patient is being treated unsuccessfully for primary malignancy of the thyroid and has elected to have a subtotal removal of the left thyroid. The physician will perform a partial thyroid lobectomy without isthmusectomy. How should the physician code for the procedure?
A)60212 -LT
B)60210 -LT
C)60220 -LT
D)60210 -50

Accepted Answer

The physician should code for this service with CPT code 60210 (Partial Thyroid Lobectomy, Unilateral; With or Without Isthmusectomy). Modifier -LT should be appended to indicate that the procedure was performed on the left side. Modifier -50 would not be used because it indicates that a bilateral service was performed not a unilateral service.

Question 4

A 23-year old woman, pregnant with her second child, received antepartum care from her physician in Atlanta, GA. After 9 visits with her physician in Atlanta, the patient moved to Albuquerque, NM where she continued her prenatal care with a new doctor. The new physician saw the patient for the remaining antepartum visits. The new physician also performed vaginal delivery and postpartum care, which included the 6-week postpartum checkup. How should the physician in Atlanta code for his services?
A)59426
B)59425
C)59410
D)59430

Accepted Answer

The physician in Atlanta should code for his services with code 59426 (Antepartum Care Only, 7 or More Visits).The patient only saw her Atlanta physician 9 times, therefore the Atlanta physician can only code for the antepartum care that he provided. Code 59425 is only 4-6 antepartum visits. Codes 59410 and 59430 are also incorrect because they refer to postpartum care, which in this case, was provided by the physician in Albuquerque.

Question 5

The term "alopecia" is commonly referred to as what?
A)Athlete's foot
B)Hair loss
C)Heat rash
D)Head lice

Accepted Answer

The term "alopecia" is commonly referred to as hair loss. Alopecia can be acute or chronic, resulting in baldness. It can be an inherited trait but can also be the result of chemotherapy, a hormonal imbalance, infections, severe stress, or a medication side-effect.

Question 6

What is the correct code for a parathyroidectomy with parathyroid autotransplantation performed on a 42-year-old male patient?
A)60512
B)60500, 60512
C)60500, 60512 -51
D)60500

Accepted Answer

The correct codes for a parathyroidectomy with parathyroid autotransplantation on a 42-year-old male patient are: 60500 (Parathyroidectomy or Exploration of Parathyroid(s)) and 60512 (Parathyroid Autotransplantation). Code 60512 is an add-on code so it must be used in conjunction with the code for the primary procedure (without modifier -51). Add-on codes are considered modifier -51 exempt.

Question 7

An adolescent patient's hard contact lenses were shattering when a bouncy ball that he was playing with at school bounced up at hit him in the eye. The patient was transported to the emergency department where the on-call physician removed the contact lens fragments from his cornea, using a slit lamp. What is the correct code for the procedure?
A)65205
B)65210
C)65220
D)65222

Accepted Answer

The correct code for the procedure is 65222 (Removal of Foreign Body, External Eye; Corneal, with Slit Lamp). Code 65220 is inappropriate because it does not include the use of the slit lamp, and codes: 65205 and 65210 are inappropriate because they do not include the removal of a foreign body from the cornea. Furthermore, codes: 65205 and 65210 do not include the use of a slit lamp. A slit lamp is a small lamp that consists of a high-intensity light source. This lamp can be used to aid surgeons in the removal of small foreign bodies.

Question 8

A patient is injured in a motor-cross accident and shattered two of his vertebrae. Now he is paralyzed from the chest down and can move his arms, but not his legs. At what level is his injury?
A)Cervical
B)Lumbar
C)Thoracic
D)Sacral

Accepted Answer

The patient's level of injury is at the thoracic level, which is in the middle of the back. This is indicated by his ability to move his arms, but not his legs. If it was in the cervical area he would be paralyzed from the neck down and would not be able to move his arms. If it was in the lumbar area he would still be able to move his arms, but not his legs because his injury would be lower than the chest area.

Question 9

PROCEDURAL NOTE PATIENT: Ortiz, Pamela
AGE: 12
DATE: 04/16/2015
PREOPERATIVE DIAGNOSIS: Obstructive Sleep Apnea
POSTOPERATIVE DIAGNOSIS: Obstructive Sleep Apnea
PROCEDURE: Tonsillectomy and Adenoidectomy
The patient was anesthetized and placed on the operating table in a supine position. Her mouth was set open to allow access to the tonsils at the beginning of the pharynx. Both tonsils and adenoids appeared to be grossly enlarged. Using electrocautery, the patient's tonsils were dissected from the subcapsular plane and removed from the pharynx. Minimal bleeding was noted on the right side of the tonsillar excision, which was cauterized to stop the bleeding. Adenoids were dissected in the same manner and no bleeding was noted. Thrombin was applied to both sides of the tonsillar excision to induce clotting and stop any additional bleeding that might occur postoperatively. The patient tolerated the procedure well and was given a pain medication prescription for possible throat pain. The physician recommended that the patient only consume cold foods and liquids for postoperative pain management. The patient was scheduled for a follow-up exam in one week.
How should you code this procedure?
A)42820, 327.23, 474.10
B)42821, 327.23, 474.10
C)42826, 42831, 474.10
D)42826, 42836, 474.10

Accepted Answer

The correct codes for the procedure are: 42821 (Tonsillectomy and Adenoidectomy; Age 12 and Over), diagnosis codes 327.23 (Obstructive Sleep Apnea) and 474.10(Hypertrophy of Tonsils and Adenoids). Code 42820 is incorrect because it is used for patients under 12 years of age. In addition, tonsillectomy and adenoidectomy codes should be coded separately (42826 and 42831). Code 42821 includes both procedures.

Question 10

The physician performed a partial Nissen Fundoplasty via a lower thoracic incision. What is the correct code for this procedure?
A)43327
B)43328
C)43325
D)43331

Accepted Answer

The correct code for this procedure is 43328 (Esophagogastric Fundoplasty; Thoracotomy). The code 43327 is correct because it is used for the same procedure, but it refers to a laparotomy and the note states that the procedure was performed using a lower thoracic incision. Code 43325 is also correct because it includes a fundic patch. In this case, the notes did mention a fundic patch.

Question 11

What is the difference between a craniotomy and a craniectomy?
A)A craniotomy removes a part of the skull and allows the surgeon to perform the craniectomy
B)They are the same thing
C)A craniotomy removes a part of the skull and replaces it once the procedure is finished. A craniectomy removes a part of the skull and does not replace it.
D)A craniotomy allows access into the patient's spinal column. A craniectomy is repairs the patient's spinal column.

Accepted Answer

The difference between a craniotomy and a craniectomy is that a craniotomy temporarily removes part of the patient's skull to allow access inside the skull or brain during the procedure. The skull is then replaced once the procedure is completed, while a craniectomy removes a part of the patient's skull and does not replace it once the procedure is completed.

Question 12

If a patient is in the prone position, he is:
A)Lying flat on his back
B)Lying flat on his stomach
C)Sitting up straight
D)Lying flat on his back with his feet elevated

Accepted Answer

If a patient is in the prone position, he is lying flat on his stomach. If the patient lies flat on his back he is in the supine position. If the patient lies flat on his back with his feet elevated he is in the Trendelenburg position. If the patient is sitting up straight he is in the Fowler's position.

Question 13

A doctor performed a partial pneumonectomy on a patient. This procedure included:
A)Removing part of the patient's lung
B)Cutting into the patient's abdomen
C)Creating an opening in the patient's chest
D)Removing a patient's entire spleen

Accepted Answer

This procedure included removing part of the patient's lung. The term "partial" refers to something less than total and the suffix "-ectomy" means removal, rather than cutting into or creating an opening into. The prefix "pnuemo-" refers to the lung.

Question 14

Which of the following is a type of connective tissue?
A)Adipose tissue
B)Epithelial tissue
C)Nerve tissue
D)Cardiac tissue

Accepted Answer

Adipose tissue, also known as fat, is a connective tissue that helps the body function. Epithelial tissue covers and lines different areas of the body, rather than connecting it together. Nervous tissue transfers messages throughout the body, and cardiac tissue is a type of muscle tissue.

Question 15

Which of the following answers below identifies all three different types of blood cells?
A)Neutrophils, Eosinophils, and Basophils
B)Monocytes, Leukocytes, and Platelets
C)Erythrocytes, Leukocytes, and Thrombocytes
D)Erythrocytes, Monocytes, and Leukocytes

Accepted Answer

The three types of blood cells are erythrocytes, leukocytes, and thrombocytes (or platelets). Neutrophils, eosinophils, and basophils are all types of leukocytes. Monocytes and leukocytes contain the same types of blood cells because a monocyte is a type of leukocyte.

Question 16

In the electrical conduction system of the heart, the sinoatrial node is located in the right atrium near the superior vena cava. It serves as the normal pacemaker of the heart. There is another node, which is located in the right atrium on the septal wall. This node slows the impulses of the heart so that the atria can fill with blood before it contracts. What is the name of this node?
A)Sinoatrial Node
B)Bundle of His
C)Purkinje Fibers
D)Atrioventricular Node

Accepted Answer

The atrioventricular node is located in the right atrium on the septal wall. This node slows the impulses of the heart so that the atria can fill with blood before it contracts. The bundle of his is a group of muscle fibers in the center of the heart on the septum. The bundle of his receives electrical impulses that branch off to the right and left. The Purkinje fibers lie across the surface of the ventricles and give the final signal for the ventricles to contract.

Question 17

A pacemaker or pacing cardioverter-defibrillator that has pacing and sensing functions in three or more chambers of the heart is considered a:
A)Multiple Lead
B)Dual Lead
C)Single Lead
D)Triple Lead

Accepted Answer

A pacemaker or pacing cardioverter-defibrillator that has pacing and sensing functions in three or more chambers of the heart is considered a multiple lead system. Pacemaker or cardioverter-defibrillator systems have electrical stimulation leads that help shock the heart into rhythm. Depending on the individual needs of the patient, some systems may have only one lead, while others may have two, three, or more electrical leads. Correct code selection depends on how many leads the system has.

Question 18

A 38-year-old female patient presented to the office for an extended ophthalmoscopy with retinal drawing. The physician also performed interpretation and report of the findings. The physician performing the procedure also performed the anesthesia service for the patient, due to the fact that the anesthesiologist was not available. What are the correct codes for the procedure?
A)00148-47
B)92225-47
C)92225, 00148-47
D)92225-47, 00148

Accepted Answer

The correct code is 92225-47, (Ophthalmoscopy, extended, with retinal drawing, with interpretation and report). Modifier -47, (Anesthesia by Surgeon) must be appended to indicate that the anesthesia service was performed by the physician performing the procedure. According to modifier guidelines, modifier -47 is not to be used on the anesthesia procedure code, but rather appended to the basic service code which in this case is 92225. The anesthesia service code, 00148, should not be reported.

Question 19

The nasal turbinates are part of which anatomical system?
A)Digestive
B)Respiratory
C)Cardiovascular
D)Integumentary

Accepted Answer

The nasal turbinates are part of the respiratory system. The nasal turbinates help to humidify the air that we breathe, as well as provide intonation for the voice, thus, they are part of the respiratory system. They also serve to reduce pressure in the head.

Question 20

The patient, a 35-year-old female with well-controlled Type I diabetes mellitus, received anesthesia for a regular vaginal delivery with no complications. Code for the anesthesia services only.
A)01961 - P3
B)62310
C)01960 - P3
D)01960 - P2

Accepted Answer

The correct anesthesia codes for this service is 01960 (Anesthesia for vaginal delivery only), and the correct physical status modifier is P2, which indicates that the patient has a mild systemic disease. It is necessary to report that the patient has well-controlled Type I diabetes mellitus, which in this case is not a severe systemic disease. This condition should be reported with physical status modifier P2.

Quiz 1: Free Coding Specialist

What is a result of a nasal polyp?

The term "alopecia" is commonly referred to as what?

What is the correct code for a parathyroidectomy with parathyroid autotransplantation performed on a 42-year-old male patient?

A patient is injured in a motor-cross accident and shattered two of his vertebrae. Now he is paralyzed from the chest down and can move his arms, but not his legs. At what level is his injury?

The physician performed a partial Nissen Fundoplasty via a lower thoracic incision. What is the correct code for this procedure?

What is the difference between a craniotomy and a craniectomy?

If a patient is in the prone position, he is:

A doctor performed a partial pneumonectomy on a patient. This procedure included:

Which of the following is a type of connective tissue?

Which of the following answers below identifies all three different types of blood cells?

A pacemaker or pacing cardioverter-defibrillator that has pacing and sensing functions in three or more chambers of the heart is considered a:

The nasal turbinates are part of which anatomical system?

The patient, a 35-year-old female with well-controlled Type I diabetes mellitus, received anesthesia for a regular vaginal delivery with no complications. Code for the anesthesia services only.