EXAM 1

60500

Assign appropriate CPT code for the following procedure. Parathyroidectomy

F4

Left hand, fifth digit

64721-50

A patient undergoes carpal tunnel releases of the median nerve on both the left and right wrists.

Simple

A superficial repair that primarily involves the epidermis, dermis, or subcutaneous tissues without significant involvement of deeper structures, and requires simple one layer closure.

Intermediate

A superficial repair that requires that one or more of the deeper layers of the subcutaneous tissue and superficial (non muscle), in addition to the skin (epidermal and dermal) closure.

The recommendation is for using modifier 51 (15734, 15734-51); however, note that some third-party payers may require modifier 59 instead of 51 since modifier 51 is not reported for hospital claims.

According to CPT Assistant, December 2012(Mobile APP Pathway under Island Pedicle Flaps, scrolling down to Frequently Asked Questions), what modifier is recommended for reporting 15734 twice.

17111

Assign appropriate CPT code for the following procedure. Laser removal of sixteen benign skin lesions from the back. (see chapter table 4.2)

78

April 1: Patient treated for tibial fracture. May 15: Patient returns complaining of pain at the site of the external fixator. The surgeon immediately returns the patient to OR to remove the fixator. What physician modifier would be appended to the removal of the external fixator due to pain?

29876-LT

Assign appropriate CPT code and modifier for the following procedure. Arthroscopic synovectomy of the medial and lateral tibiofemoral compartments and the patellofemoral compartment of the left knee

29846-LT

Assign appropriate CPT code and modifier for the following procedure. Arthroscopy of the left wrist with repair of triangular fibrocartilage and joint debridement

31238-LT, 31238 LT

Assign appropriate CPT code and modifier for the following procedure. Left nasal endoscopy for control of epistaxis

24515-LT

Assign appropriate CPT code and modifier for the following procedure. Open reduction with internal fixation (screws), for a fracture of the left humeral shaft

21811

Assign appropriate CPT code and modifier for the following procedure. Open treatment with internal fixation of three rib fractures

27372-LT, 27372 LT

Assign appropriate CPT code and modifier for the following procedure. Removal of splinter embedded deep in the left kne

28285-T6, 28285 T6

Assign appropriate CPT code and modifier for the following procedure. Repair of hammertoe, second digit of right foot

24345-RT

Assign appropriate CPT code and modifier for the following procedure. Repair of medial collateral ligament of right elbow using local tissue

27781-LT

Assign appropriate CPT code and modifier for the following procedure. The orthopedic surgeon reduces a fracture of the left proximal fibula. After closed treatment and skeletal traction, the physician applies a short leg cast(not coded).

31577

Assign appropriate CPT code for the following procedure . Flexible laryngoscopy performed for removal of a dime lodged in the patient's larynx

31652

Assign appropriate CPT code for the following procedure. Bronchoscopy with EBUS-guided transbronchial sampling of two mediastinal lymph nodes

49521

Assign appropriate CPT code for the following procedure. Recurrent incarcerated inguinal hernia repair with implantation of mesh (56-year old patient)

12001

Assign appropriate CPT code for the following procedure. A child is seen in the physician's office for a superficial laceration of the right knee. The physician repairs the 2.5 cm laceration with simple suturing

58150

Assign appropriate CPT code for the following procedure. Abdominal hysterectomy with salpingo-oophorectomy (uterus weight 270 g)

31641

Assign appropriate CPT code for the following procedure. Bronchoscopy for removal of tumor using argon plasma coagulation

31628

Assign appropriate CPT code for the following procedure. Bronchoscopy with transbronchial biopsy of lung

50920

Assign appropriate CPT code for the following procedure. Closure of ureterocutaneous fistula

52282

Assign appropriate CPT code for the following procedure. Cystoscopy with insertion of permanent urethral stent Tip: Cystoscopy to view urethra.

52352

Assign appropriate CPT code for the following procedure. Cystoscopy with ureteroscopy for removal of ureteral stone

52356-LT

Assign appropriate CPT code for the following procedure. Cystoscopy, left ureteroscopy with laser lithotripsy

58120

Assign appropriate CPT code for the following procedure. D&C performed for a patient with dysfunctional bleeding

11043

Assign appropriate CPT code for the following procedure. Debridement of below-knee amputation stump. The necrotic wounds were sharply excised down to and including the fascia with a 10-blade scalpel (15 sq cm).

43275

Assign appropriate CPT code for the following procedure. Endoscopic Retrograde Cholandiopancreatography (ERCP) with removal of biliary stent

10007

Assign appropriate CPT code for the following procedure. Fine needle aspiration biopsy of mass in chest, under fluoroscopic guidance

31572

Assign appropriate CPT code for the following procedure. Flexible laparoscopy with laser destruction of lesion, left vocal cor

55250

Assign appropriate CPT code for the following procedure. For elective sterilization, the surgeon performs a vasectomy

55100

Assign appropriate CPT code for the following procedure. Incision into abscess of scrotal wall to drain pus

60650

Assign appropriate CPT code for the following procedure. Laparoscopic adrenalectomy, complete Tip: This on can be trick so make sure the code description matches

43659

Assign appropriate CPT code for the following procedure. Laparoscopic pyloroplasty Tip: Look up the term pyloroplasty and see pg 145-146 of CPT/HCPCS textbook or laparoscopic procedures

49656

Assign appropriate CPT code for the following procedure. Laparoscopic repair of recurrent incisional hernia

43644

Assign appropriate CPT code for the following procedure. Laparscopic gastric bypass and Roux-en-Y gastroenterostomy performed for obesity

11056

Assign appropriate CPT code for the following procedure. Paring of three hyperkeratotic lesions from the patient's foot.

32557

Assign appropriate CPT code for the following procedure. Percutaneous drainage of pleural cavity via indwelling catheter, with imaging

36904

Assign appropriate CPT code for the following procedure. Percutaneous thrombectomy of forearm AV graft that was inserted for dialysis treatment

45315

Assign appropriate CPT code for the following procedure. Proctosigmoidoscopy with removal of two polyps with the use of hot biopsy forceps

54056

Assign appropriate CPT code for the following procedure. Removal of conylomas of the penis with use of cryosurgery

31575

Assign appropriate CPT code for the following procedure. The patient has a history of persistent hoarseness. The surgeon performs a flexible laryngoscopy to evaluate the larynx

15576

Assign appropriate CPT code for the following procedure. The surgeon performed a tubed pedicle flap from the forehead to cover the defect on the nose.

47533

Assign appropriate CPT code for the following procedure. Under fluoroscopy, the physician percutaneously places an external biliary catheter into the bile duct for drainage

56620

Assign appropriate CPT code for the following procedure. Vulvectomy, partial removal of skin and superficial subcutaneous tissues

64702-F3

Assign appropriate CPT codes and modifier for the following procedures. The physician performs a neuroplasty of the left ring finger.

11104

Assign appropriate CPT codes for the following procedure. In the physician's office, the patient had a punch biopsy of a 1.0 cm skin lesion of the neck.

Answer for blank # 1 31253, 31257 Answer for blank # 2: 31253, 31257

Assign appropriate CPT codes for the following procedures. Endoscopic anterior and posterior ehtmoidectomy with sphenoidotomy and frontal sinus exploration

36833

Assign appropriate CPT codes for the following procedures. Open revision of AV fistula with thrombectomy, patient receiving hemodialysis

33361

Assign appropriate CPT codes for the following procedures. The patient has been diagnosed with severe aortic stenosis. Through a percutaneous incision in the leg (transfemoral), the surgeon performs a transcatheter aortic valve replacement (TAVR).

_01472

Assign only the code for the anesthesia services. Anesthesia provided for repair of a ruptured Achilles tendon (assign only the code for anesthesia services)

__20606_

Assign the appropriate CPT code. Aspiration of excess fluid from the bursa of the elbow with ultrasound guidance (includes recording and reporting)

_72196__

Assign the appropriate CPT code. Diagnostic MRI of the pelvis with contrast material

58356

Assign the appropriate CPT code. Endometrial cryoablation with ultrasound guidance

_0184T

Assign the appropriate CPT code. Excision of rectal tumor, TEMS(transanal endoscopic microsurgery) approach

_47564

Assign the appropriate CPT code. Laparoscopic cholecystectomy with exploration of common bile duct

_49557_

Assign the appropriate CPT code. Repair of recurrent, incarcerated femoral hernia

49322

Assign the surgical CPT code for the following procedure. Laparoscopic aspiration of ovarian cys

49580-49587

Based on the documentation provided in the Operative Report #3 found on pg 36 of your textbook, what code selections were listed in the index entry for the main terms describing the procedure?

49585

Based on the documentation provided in the Operative Report #3 found on pg 36 of your textbook, what is the correct code for the procedure?

73

CPT modifier approved for hospital outpatient use only

3p

Category II modifier used as a performance measure exclusion due to patient reasons such as patient decline, economic, social, or religious reasons, or other patient reasons.

64611-52

Chemodenervation of salivary glands (two glands injected).

11005

Choose the appropriate CPT code for the following procedure. The surgeon performs debridement down to and including the fascia of the abdominal wall due to necrotizing fascitis.

11005 11008

Choose the appropriate CPT codes for the following procedures. The patient had a mesh inserted during an inguinal hernia repair a couple of years ago. The patient presents for a removal of the infected mesh and debridement of the necrotic tissue. The physician performed a debridement of the wound, including the fascia, and removed the mesh. (Choose all that apply)

Category I CPT Codes

Consist of six main sections known as Evaluation and Management, Anesthesia, Surgery, Radiology, Pathology and Laboratory, and Medicine. Ex: 76641

why what

ICD-10-CM diagnosis codes explains_____ a patient is seeking services and HCPCS codes explains ____ services were performed

Category III

Identify the location of code 0511T.

Category II

Identify the location of code 4013F

Category I

Identify the location of code 76604.

Category I

Identify the location of code 88307.

Category I

Identify the location of code 92986.

Category I

Identify the location of code 99218.

Complex

Includes repair of wounds requiring more than layered closure and documentation may include scar revision, debridement, extensive undermining, stents, or retention sutures.

Category III Codes

Includes temporary codes that represent emerging medical technologies, services, and procedures that have not yet been approved for general use by the FDA and are not otherwise covered by CPT codes. Ex: 0085T

___95955__

Intraoperative EEG performed during carotid endarterectomy procedure (code only EEG)

CPT

On December 3, 2018, Dr. Smith saw a Medicare patient with a diagnosis of rectal abscess in Central Hospital. She performed an incision and drainage in the outpatient surgery department? Which coding system would Central Hospital use to bill for its surgical services?

CPT

On December 3, 2018, Dr. Smith saw a Medicare patient with a diagnosis of rectal abscess in Central Hospital. She performed an incision and drainage in the outpatient surgery department? Which coding system would Central Hospital use to report her surgical services?

ICD-10-CM

On December 3, 2018, Dr. Smith saw a Medicare patient with a diagnosis of rectal abscess in Central Hospital. She performed an incision and drainage in the outpatient surgery department? Which coding system would describe the rectal abscess?

P5

Physical status(anesthesia) modifier

14021

Physician performs a wide resection of a 3.0-cm malignant skin lesion of the left leg. The defect required an adjacent tissue transfer measuring 15 sq cm. Tip: See pg 76 and 85 Excision of Lesion Followed by Adjacent Tissue Transfer and Adjacent Skin Grafts

Appendix A

Provides a complete list of modifiers for use with CPT Level I and HCPCS Level II (National) codes

Appendix D

Provides a description of CPT Add-on codes.

Appendix B

Provides a summary of additions, deletions, and revisions as part of the yearly CPT revision process.

Category II Codes

Provides supplementary tracking codes that are designed for use in performance assessment and quality improvement activities. Ex: 1000F

the documentation needed for this would be what is the reason to partially remove vulva.

Refer to CPT code 56630. What documentation in the operative report would be needed to support the use of this code? (Use instructional notes/information provided for sections)

11730, 11732

Refer to CPT codes 11730 and 11732. Assume that a physician performed a complete avulsion of the nail plate of the thumb and index finger. What would be the correct code assignment?

15200, 15201, 15201

Refer to CPT codes 15200 and 15201. If the surgeon performed a free skin graft of the back that totaled 45 sq cm, what would be the correct code assignment

25073

Refer to CPT codes 25071 through 25076. Assume that a surgeon removed a 3.5 cm soft tissue mass from the forearm that extended into the deep fascia. Which code should be assigned? (Note that the CPT codes are out of sequence)

27788-LT

Refer to ED Report #2 on pg 102-103 of the CPT/HCPCS textbook. Choose the correct procedure code and modifier for the operative report (OP). Tip: Manipulation refers to repositioning the bone back to its original position and surgeons often refer to this procedure as fracture reduction.

12032, 12005-59

Refer to ED Report #2 on pg 83 of the CPT/HCPCS textbook. Choose the correct procedure codes for the ED report. Tips: See pg 88 Instructions for listing services at the time of wound repair (#2) of CPT Code book. Several lacerations fall into same classification.

11603, 12031

Refer to ED Report #4 on pg 84-85 of the CPT/HCPCS textbook. Choose the correct procedure codes for the ED report. Tips: An excision and wound repair were completed. See calculation of diameter and margins example on pg 75-76.

31628, 31623

Refer to OP Report #2 on pg 118 of the CPT/HCPCS textbook. Choose the correct procedure code for the OP report

36590

Refer to OP Report #2 on pg 130 of the CPT/HCPCS textbook. Choose the correct procedure code for the OP report.

45384

Refer to OP Report #2 on pg 140 of the CPT/HCPCS textbook. Choose the correct procedure code for the OP report. Tip: There are two combined procedures being performed.

15100

Refer to OP Report #2 on pg 90 of the CPT/HCPCS textbook. Choose the correct procedure code for the OP report. Tip: See pgs 86-87 of CPT/HCPCS textbook.

Answer for blank # 1: 13101 Answer for blank # 2: 13102

Review the range of CPT codes 13100 through 13102. What is the correct code assignment for a 7.7 cm complex wound repair of the chest?

42820

Review the range of CPT codes 42820 through 42836. What is the correct code assignment for a 4-year old who had a tonsillectomy and adenoidectomy?

Bullet •

Symbol before a code identifies a code as a new addition.

Triangle Λ

Symbol before a code identifies a revision to the narrative description accompanying that code.

Semicolon ;

Symbol signifies that the main entry applies to, and is part of all indented entries that follow with their codes.

Plus symbol +

Symbol used to indicate a procedure is commonly carried out with another procedure and may be designated as an add-on code and should not be used alone.

Facing Triangles ><

Symbol used to indicate the beginning and ending of new or revised text within the guidelines and instruction notes.

95

The modifier that is to be appended to CPT codes 90792 Pyschiatric diagnostic evaluation, to indicate the the service was performed using synchronous telemedicine

Current Procedural Terminology (CPT)

a coding system designed to numerically describe medical procedures and services.

53

The modifier used when a physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure due to extenuating circumstances or those that threaten the well being of the patient.

2

The reporting of CPT codes 28150 and 28150 indicates the removal of how many toes?

67800-E2

The surgeon excised a chalazion of the left lower eyelid

50949

The surgeon performed a laparoscopic reconstruction of the ureter. Refer to code 50700. Is this the correct code for the laparoscopic approach? If not, what is the correct coding action?

False

The surgeon will always describe the procedure in the exact term to look up in the alphabetic index so the coder does not have to use alternative terms.

Modifiers are reported along with cpt codes to indicate that a particular event modified the service/procedure but with no change to its basic definition.

What are modifiers and why are they used?

Is a combination of individual services provided during on surgical operation.

What is the CPT definition of surgical package?

ICD-10-CM

What is the classification system that consist of diagnosis codes that are required for Medicare and private third-party payers to support medical necessity of procedures and services?

Colectomy, total, adbominal, without proctectomy, with continent ileostomy.

What is the complete description of code 44151?

Repair recurrent inguinal hernia, any age; incarcerated or strangulated.

What is the complete description of code 49521?

Urethrectomy, total, including cystostomy; male

What is the full description for code 53215?

Repair blood vessel, direct; hand, finger

What is the full description of code 35207?

ICD-10-PCS

What is the procedural system developed for use to report inpatient procedures according to the principles of a classification?

cms-1500 Claim form

What is the standard paper billing document used for physician claims

Healthcare Common Procedure Coding System (HCPCS)

What is the two-part system developed by CMS to standardize the coding system used to process Medicare claims use for all services?

American Medical Association

What organization is responsible for development and maintenance of Level I CPT codes?

CMS

What organization is responsible for the development and maintenance of Level II HCPCS codes?

(CPT Level I Modifiers, CPT Level I, Level I)

What type modifiers are approved for hospital outpatient use?

CD-10-CM diagnostic and ICD-10-PCS procedural codes for inpatient hospital services ICD-10-CM diagnostic codes and CPT/HCPCS procedural codes for hospital outpatient services, including laboratory and radiology procedures ICD-10-CM diagnostic codes and CPT/HCPCS procedural codes for medical services provided by physicians and allied health professionals

What types of coded information does Medicare require for reimbursement claims for services provided to Medicare Beneficiaries?

Electronic format 837I (CMS-1450 or UB-04)

Which form is used primarily by hospitals for both outpatient and inpatient services?

ICD-10-CM and ICD-10-PCS

Which type of codes are required per Medicare regulations for services provided to Medicare beneficiaries for inpatient hospital services?

The American Medical Association (AMA) developed the Current Procedural Terminology (CPT) to provide a uniform language that could be used to accurately designate medical, surgical, and diagnostic services.

Why did the American Medical Association (AMA) develop Current Procedural Terminology (CPT)?

NCCI was Implemented to promote corret coding. The 0 modifier means that the edit can neer be bypassed even if a modifier is used. The 1 modifier means that an edit may be bypassed with the use of an apporpriate modifier. the 9 modifier means that edits are not applicable.

Why was the National Correct Coding Initiative (NCCI) implemented and what do the modifier indicators (0,1,9) indicate?

Healthcare Common Procedure Coding System (HCPCS)

a standardized coding system developed by the federal government that is used primarily to identify products, supplies an services not included in CPT

The International Classification of Diseases, Procedure Coding System (ICD-10-PCS)

a system for coding medical procedures performed in the inpatient departments for hospitals.

The International Classification of Diseases, Clinical Modification (ICD-10-CM)

a system used to describe and report the illnesses, conditions, and injuries of patients who require medical services.

(HCPCS Level I, HCPCS Level I (CPT))

codes were developed by CMS for use in reporting medical services not covered in CPT such as injectable drugs, ambulance services, prosthetic devices, and provider service