Question 1

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 pacemaker with leads in both the atrium and ventricle, which matches the procedure described. I48.91 is the correct diagnosis code for atrial fibrillation, unspecified, fitting the patient's diagnosis.

Question 2

The patient presents to the ED with severe shortness of breath. After testing, the ED physician diagnoses the patient as having ARDS. Select the appropriate ICD-10-CM code:

Accepted Answer

J80 is the correct ICD-10-CM code for Acute Respiratory Distress Syndrome (ARDS).

Question 3

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

Accepted Answer

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

Question 4

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 malignant neoplasm of the breast, which is appropriate for a patient who has had breast cancer in the past but is not currently receiving treatment for it.

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

10021-50 is the correct CPT code for fine-needle aspiration biopsy without imaging guidance. The "-50" modifier indicates a bilateral procedure, which is appropriate for biopsies of both breasts.

Question 6

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

Accepted Answer

The popliteal vein is a deep vein located in the lower extremity. It is one of the veins that could be involved in deep vein thrombosis of a lower extremity.

Question 7

Jeremy presents to the clinic today for severe wrist pain. After Dr. Wilkins examines it, she diagnoses him with a ganglion cyst of the right wrist. Dr. Wilkins decides to give Jeremy a cortisone injection as a treatment plan. Code the correct CPT and ICD-10-CM:

Accepted Answer

CPT code 20612 represents an injection into a ganglion cyst, and the "-RT" modifier indicates the procedure was performed on the right side. ICD-10-CM code M67.431 specifies a ganglion cyst of the right wrist, accurately reflecting the diagnosis and side of the body treated.

Question 8

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 9

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 10

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

Accepted Answer

Basal cell carcinoma is the most common form of skin cancer and is known for its slow growth and low potential for metastasis compared to other forms of skin cancer, such as malignant melanoma.

Question 11

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 12

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 correct CPT codes are 20670-LT for the removal of the superficial hardware (K-wires), 27860-LT for the manipulation of the ankle joint under anesthesia, and 76000-26 for the use of fluoroscopy.

Question 13

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 14

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

Accepted Answer

The popliteal vein is a deep vein located in the lower extremity, and it is commonly involved in deep vein thrombosis (DVT). The saphenous vein is a superficial vein, while the brachial and cephalic veins are located in the upper extremity.

Question 15

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

Accepted Answer

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

Question 16

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 ultrasound guidance, and the LT modifier indicates that the left side was treated. M25.512 specifies pain in the left shoulder, which directly correlates with the patient's condition and treatment site.

Question 17

Sarah, a 24-year-old female, was walking her dog this morning, and when she wasn't paying attention, she tripped and fell over the curb. The patient states that she fell to the ground using her right hand and arm to brace herself. She states that she heard a "crunch"; the resultant x-ray indicated a compound fracture to the ulna of her right arm. With the patient under general anesthesia, the area was opened and irrigated. The shaft of the ulna was fractured and had to be repaired using screws to hold it into place. The surrounding tissue was repaired, irrigated, and closed in a usual manner. Select the correct CPT code for the repair of the ulna:

Accepted Answer

The answer of Sarah, a 24-year-old female, was walking her...

Question 18

A chronic or acute infection of the bone usually caused by bacteria or fungi is called:

Accepted Answer

Osteomyelitis is the correct term for a bone infection, which can be either acute or chronic and is most commonly caused by bacteria or fungi.

Question 19

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, which represents augmentation mammoplasty with an implant, and the procedure was performed on the left side, hence the modifier -LT. The ICD-10-CM code N64.82 corresponds to hypomastia, which matches the preoperative and postoperative diagnosis.

Question 20

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 malignant neoplasm of the breast. This code is used for patients who have had cancer in the past but currently do not have the disease.

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

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:

The patient presents to the ED with severe shortness of breath. After testing, the ED physician diagnoses the patient as having ARDS. Select the appropriate ICD-10-CM code:

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

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?

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?

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

Jeremy presents to the clinic today for severe wrist pain. After Dr. Wilkins examines it, she diagnoses him with a ganglion cyst of the right wrist. Dr. Wilkins decides to give Jeremy a cortisone injection as a treatment plan. Code the correct CPT and ICD-10-CM:

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:

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

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

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

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:

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

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

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:

A chronic or acute infection of the bone usually caused by bacteria or fungi is called:

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?