Professional Review Guide - CPT Coding

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Injection of anesthesia for nerve block of the brachial plexus. A. 64415 B. 64413 C. 64530 D. 64510

A. 64415

Lagophthalmos correction with implantation using gold weight. A. 67912 B. 67911 C. 67901 D. 67121

A. 67912

Drainage of simple external ear abscess. A. 69000 B. 69100 C. 10060 D. 69020

A. 69000

[Surgery - Auditory] Patient comes into the office for removal of impacted earwax. A. 69210 B. 69200 C. 69222 D. 69000

A. 69210

Myringoplasty. A. 69620 B. 69635 C. 69610 D. 69420

A. 69620

CT scan of the head with contrast. A. 70460 B. 70542 C. 70551 D. 70470

A. 70460

Obstetric patient comes in for a pelvimetry with placental placement. A. 74710 B. 76946 C. 76805 D. 76825

A. 74710

Laminectomy and excision of intradural lumbar lesion. A. 63272 B. 63267 C. 63282 D. 63252

A. 63272

Code anesthesia for corneal transplant. A. 00144 B. 00140 C. 00147 D. 00190

A. 00144

Code anesthesia for placement of vascular shunt in forearm. A. 01844 B. 01850 C. 00532 D. 01840

A. 01844

Patient presents to the operating room for excision of three lesions. The 1.5-cm and 2-cm lesions of the back were excised with one excision. The 0.5-cm lesion of the hand was excised. The pathology report identified both back lesions as squamous cell carcinoma. The hand lesion was identified as seborrheic keratosis. A. 11604, 11420 B. 11402, 11420,114 C. 11403, 11642,1164' D. 11602, 11402

A. 11604, 11420

Patient presents to the operating room where the physician performed, using imaging guidance, a percutaneous breast biopsy utilizing a rotating biopsy device. A. 19081 B. 19125,19283 C. 19120 D. 19000

A. 19081

Open I&D of a deep abscess of the cervical spine. A. 2201O B. 22015 C. 10060 D. 10140

A. 2201O

Patient presents to the emergency room following a fall from a tree. X-rays were ordered for the left upper arm, which showed a fracture of the humerus shaft. The emergency room physician performed a closed reduction of the fracture and placed the patient in a long arm spica cast. Code diagnoses and procedures, excluding the x-ray. A. 24505-LT B. 24515-LT C. 24505-LT, 29065 D. 24500-LT

A. 24505-LT

Patient presents to the emergency room following a fall. X-rays were ordered for the lower leg results showed a fracture of the proximal left tibia. The emergency room physician performed a closed manipulation of the fracture with skeletal traction. A. 27532-LT B. 27536-LT C. 27530-LT D. 27524-LT

A. 27532-LT

Patient had been diagnosed with a bunion. Patient was taken to the operating room where a simple resection of the base of the proximal phalanx along with the medial eminence was performed. Kirschner wire was placed to hold the joint in place. A. 28292 B. 28290 C. 28293 D. 28294

A. 28292

Patient presents to the surgical unit and undergoes unilateral nasal endoscopy, partial ethmoidectomy, and maxillary antrostomy. A. 31254, 31256-51 B. 31201, 31225-51 C. 31290, 31267-51 D. 31233, 31231-51

A. 31254, 31256-51

Lye burn of the larynx repaired by laryngoplasty A. 31599 B. 16020 C. 31360 D. 31540

A. 31599

Patient with laryngeal cancer has a tracheoesophageal fistula created and has a voicebox inserted A. 31611 B. 31580 C. 31395 D. 31502

A. 31611

Patient has recurrent spontaneous pneumothorax, which has resulted in a chemical pleurodesis by thoracoscopy A. 32650 B. 32310,32601 C. 32601 D. 32960

A. 32650

Patient has a history of PVD for many years and experiences chest pains. The patient underwent Doppler evaluation, which showed a common femoral DVT. Patient is now admitted for thromboendarterectomy A. 35371 B. 35372 C. 37224 D. 35256

A. 35371

[Surgery-Cardiovascular System] Patient returns to the operating room following open-heart bypass for exploration of blood vessel to control postoperative bleeding in the chest. A. 35820 B. 20101 C. 35761 D. 35905

A. 35820

The physician punctures the left common femoral to examine the right common iliac. A. 36245 B. 36246 C. 36247 D. 36140

A. 36245

transfusion of three units of packed red blood cells A. 36430 B. 36430,36430,36430 C. 36460 D. 36455

A. 36430

Patient has a bone marrow aspiration of the iliac crest and of the tibia. A. 38220, 38220-59 B. 38221 C. 38230 D. 38220

A. 38220, 38220-59

Laparoscope" with multiple biopsies of retroperitoneal lymph nodes. A. 38570 B. 38571 C. 38570-22 D. 38572

A. 38570

Laparoscopic retroperitoneal lymph node biopsy A. 38570 B. 38780 C. 49323 D. 38589

A. 38570

Cannulation of the thoracic duct. A. 38794 B. 36810 C. 36260 D. 38999

A. 38794

Ultrasonic guidance for the needle biopsy of the liver. Code the complete procedure. A. 47000,76942 B. 47000,76937 C. 47000,76999 D. 47000,77002

A. 47000,76942

Nephrectomy with resection of half of the ureter. A. 50220 B. 50234 C. 50230, 50650 D. 50546

A. 50220

Patient comes to the hospital with a history of right flank pain. Urine tests are negative. Radiology examination reveals that the patient has renal cysts. Patient is now admitted for laparoscopic ablation of the cysts. A. 50541 B. 50390 C. 50280 D. 50920

A. 50541

Patient presents to the operating room for fulguration of bladder tumors. The cystoscope was inserted and entered the urethra, which was normal. Bladder tumors measuring approximately 1.5 cm were remove A. 52234 B. 50957 C. 52214 D. 51530

A. 52234

[Surgery—Urinary System] Patient is admitted for contact laser vaporization of the prostate. The physician performed a TURP and transurethral resection of the bladder neck at the same time. A. 52648 B. 52648, 52450, 52500 C. 52450, 53500 D. 52648, 52450

A. 52648

Excision of Cowper's gland. A. 53250 B. 53450 C. 53260 D. 53220

A. 53250

Laser destruction of penile condylomas. A. 54057 B. 17106 C. 17270 D. 54055

A. 54057

Scrotal wall abscess drainage A. 55100 B. 55150 C. 54700 D. 55110

A. 55100

Hydrocelectomy of spermatic cord, A. 55500 B. 55000 C. 55041 D. 55520

A. 55500

Amniocentesis. A. 59000 B. 59200 C. 57550 D. 57530

A. 59000

Patient is admitted to the hospital following an ultrasound at 25 weeks, which revealed fetal pleural effusion. A fetal thoracentesis was performed. A. 59074 B. 32554 C. 32555 D. 76815

A. 59074

A D&C is performed for postpartum hemorrhage. A. 59160 B. 58120 C. 58558 D. 58578

A. 59160

Patient in late stages of labor arrives at the hospital. Her OB physician is not able to make the delivery and the house physician delivers the baby vaginally. Primary care physician resumes care after delivery. Code the delivery A. 59409 B. 59612 C. 59620 D. 59400

A. 59409

D&C performed for patient with a diagnosis of incomplete abortion at 8 weeks. A. 59812 B. 59820 C. 58120 D. 59160

A. 59812

Patient undergoes total thyroidectomy with parathyroid autotransplantation. A. 60240,60512 B. 60520,60500 C. 60260,60512 D. 60650,60500

A. 60240,60512

Laparoscopic adrenalectomy, complete. A. 60650 B. 60650-50 C. 60659 D. 60540

A. 60650

Patient with Parkinson's disease is admitted for insertion of a brain neurostimulator pulse generator with one electrode array A. 61885 B. 61850,61863 C. 61888 D. 61867,61870

A. 61885

Basic metabolic panel (calcium, total) arid total bilirubin. A. 80048, 82247 B. 80052 C. 80053 D. 82239,80400, 80051

A. 80048, 82247

Chlamydia culture. A. 87110 B. 87106 C. 87118 D. 87109, 87168

A. 87110

Cytopathology of cervical Pap smear with automated thin-layer preparation utilizing computer screening and manual rescreening under physician supervision. A. 88175 B. 88148 C. 88160,88141 D. 88161

A. 88175

Osteopathic manipulative treatment to three body regions. A. 98926 B. 98941 C. 97110 D. 97012

A. 98926

Patient with hematochromatosis had a therapeutic phlebotomy performed on an outpatient basis. A. 99195 B. 36522 C. 36514 D. 99199

A. 99195

An established patient returns to the physician's office for follow-up on his hypertension and diabetes. The physician takes the blood pressure and references the patient's last three glucose tests. The patient is still running above-normal glucose levels, so the physician decides to adjust the patient's insulin. An expanded history was taken and a physical examination was performed. A. 99213 B. 99232 C. 99202 D. 99214

A. 99213

Patient has right sacroiliac joint dysfunction and requires a right S2-S3 paravertebral facet joint anesthetic nerve block with image guidance. A. 62311 B. 64493 C. 54490 D. 61796

B. 64493

Code anesthesia for decortication of left lung. A. 01638 B. 00542 C. 00546 D. 00500

B. 00542

Code anesthesia for vaginal hysterectomy. A. 00846 B. 00944 C. 30840 D. 01963

B. 00944

Code anesthesia for cesarean section. A. 00840 B. 01961 C. 00940 D. 01960

B. 01961

Patient presents to the emergency room with lacerations of right lower leg that involved the fascia. Lacerations measured 5 cm and 2.7 cm. A. 11406, 11403 B. 12034 C. 12032, 12031 D. 12032

B. 12034

patient presents to the operating room where a 3.2-cm malignant lesion of the shoulder was excised and repaired with simple sutures. A 2-cm benign lesion of the cheek was excised and was repaired with a rotation skin graft. A. 11604, 11442, 14040, 12001 B. 14040, 11604 C. 15002, 15120 D. 17264, 17000, 12001

B. 14040, 11604

A 10-square-centimeter epidermal autograft to the face from the back. A. 15110 B. 15115 C. 15110, 15115 D. 15120

B. 15115

Chronic nontraumatic rotator cuff tear. Arthroscopic subacromial decompression with coracoacromial ligament release, and open rotator cuff repair. A. 29823 B. 23412,29826-59 C. 29826,29821 D. 23410

B. 23412,29826-59

Patient presents to the hospital with a right index trigger finger. Release of the trigger finger was performed. A. 26060-F7 B. 26055-F6 C. 26170-F6 D. 26110

B. 26055-F6

Laryngoscopy stripping of vocal cords for leukoplakia of the vocal cords. A. 31535 B. 31540 C. 31541 D. 31570

B. 31540

[Surgery-Respiratory] Patient has a bronchoscopy with endobronchial biopsies of three sites. A. 31625, 31625, 31625 B. 31625 31622, 31625 D. 31622, 31625, 31625, 31625

B. 31625

Patient was admitted with hemoptysis and underwent a bronchoscopy with transbronchial lung biopsy. Following the bronchoscopy/ the patient was taken to the operating room where a left lower lobe lobectomy was performed without complications. Pathology reported large cell carcinoma of the left lower lobe. A. 31625 B. 31628,32480 C. 32405,32484 D. 32440

B. 31628,32480

Patient undergoes construction of apical aortic conduit with an insertion of a single-ventricle ventricular assist device. A. 33404 B. 33975 C. 33977 D. 33975,33404

B. 33975

Patient complains of recurrent syncope following carotid thromboendarterectomy. Patient returns 2 weeks after initial surgery and undergoes repeat carotid thromboendarterectomy A. 33510 B. 35301 C. 35201 D. 35301,35390

B. 35301

Patient undergoes percutaneous transluminal iliac artery balloon angioplasty. A. 37228 B. 37220 C. 37222 D. 37224

B. 37220

Excision of mediastinal cyst. A. 11400 B. 39200 C. 17000 D. 39400

B. 39200

Two-year-old patient returns to the hospital for cleft palate repair where a secondary lengthening procedure takes place. A. 40720 B. 42220 C. 42226 D. 42145

B. 42220

Patient has a history of hiatal hernia for many years, which has progressively gotten worse. The decision to repair the hernia was made and the patient was sent to the operating room where the took place via the thorax and abdomen. A. 39545 B. 43336 C. 43332 D. 39503

B. 43336

[Surgery-Male Genital System] Removal of nephrostomy tube with fluoroscopic guidance. A. 50387 B. 50389 C. 99212 D. 99213

B. 50389

Closure of ureterocutaneous fistula. A. 50930 B. 50920 C. 57310 D. 50520

B. 50920

Patient presented to the operating room where an incision was made in the epigastric region for a repair of ureterovisceral fistula. A. 50526 B. 50930 C. 50520 D. 50525

B. 50930

Female with 6 months of stress incontinence. Outpatient therapies are not working and the patient decides to have the problem fixed. Laparoscopic urethral suspension was completed. A. 51992 B. 51990 C. 51840 D. 51845

B. 51990

Male with urinary incontinence. Sling procedure was performed 6 months ago and now the patient has returned for a revision of the sling procedure. A. 53449 B. 53442 C. 53440 D. 53431

B. 53442

Patient has been diagnosed with benign prostatic hypertrophy and undergoes a transurethral destruction of the prostate by radiofrequency thermotherapy A. 52648 B. 53852 C. 52601 D. 53850

B. 53852

Patient has been followed by his primly care physician for elevated PSA. Patient underwent prostate needle biopsy in the physician's office 2 weeks ago and the final pathology was positive for carcinoma. Patient is admitted for prostatectomy. The frozen section of the prostate and one lymph node is positive for prostate cancer with metastatic disease to the lymph node. Prostatectomy became a radical perineal with bilateral pelvic lymphadenectomy A. 55845 B. 55815 C. 55815, 38562 D. 38770

B. 55815

Patient has been diagnosed with uterine fibroids and undergoes a total abdominal hysterectomy with bilateral salpingo-oophorectomy. A. 58200 B. 58150 C. 58262 D. 58150, 58720

B. 58150

Hysteroscopy with D&C and polypectomy A. 58563 B. 58558 C. 58120,58100,58555 D. 58558,58120

B. 58558

Patient is 24 weeks pregnant and arrives in the emergency room following an automobile accident. No fetal movement or heartbeat noted. Patient is taken to the OB ward where prostaglandin is given to induce abortion. A. 59200 B. 59855 C. 59821 D. 59410

B. 59855

Unilateral partial thyroidectomy A. 60252 B. 60210 C. 60220 D. 60520

B. 60210

Patient undergoes enucleation of left eye, and muscles were reattached to an implant. A. 65135-LT B. 65105-LT C. 65730-LT D. 65103-LT

B. 65105-LT

Correction of trichiasis by incision of lid margin A. 67840 B. 67830 C. 67835 D. 67850

B. 67830

Patient is admitted for a blepharoplasty of the left lower eyelid and a repair for* a tarsal strip of the left upper lid. A. 67917-E1, 15822-E2 B. 67917-E1, 15820-E C. 67917-E1 D. 67917-E1, 15823-E2

B. 67917-E1, 15820-E

Modified radical mastoidectomy. A. 69511 B. 69505 C. 69635 D. 69641

B. 69505

Patient came in for excision of a middle ear lesion. A. 11440 B. 69540 C. 69552 D. 69535

B. 69540

Patient presents to the hospital for a two-view chest x-ray for a cough. The radiology report comes back negative. What would be the correct code to report to the insurance company? A. 71010 B. 71020 C. 71035

B. 71020

Patient comes into the outpatient department at the local hospital for an MRI of the cervical spine contrast. Patient status post automobile accident. A. 72156 B. 72142 C. 72149 D. 72126

B. 72142

SPECT bone imaging A. 76977 B. 78320 C. 77080 D. 76977

B. 78320

Partial thromboplastin time utilizing whole blood. A. 85732 B. 85730 C. 85245 D. 85246

B. 85730

Hepatitis C antibody. A. 86804 B. 86803 C. 87522 D. 87520

B. 86803

Pathologist performs a postmortem examination, including the brain, of an adult. Tissue is sent to the lab for microscopic examination. A. 88309 B. 88025 C. 88099 D. 88028

B. 88025

A physician performs a PTCA with drug-elutirtg stent placement in the left anterior descending artery and angioplasty only in the right coronary artery A. 92928-LD, 92929-RC B. 92928-LD, 92920-B C. 92928-LD, 92920-RC D. 92920-RC, 92929-LD

B. 92928-LD, 92920-B

Which code listed below would be used to report an esophageal electrogram during; an EPS? A. 93600 B. 93615 C. 93612 D. 93616

B. 93615

Comprehensive electrophysiologic evaluation (EPS) with induction of arrhythmia. A. 93618,93620 B. 93620 C. 93640,93623 D. 93619,93620

B. 93620

[Medicine Section] IV push of one antineoplastic drug. A. 96401 B. 96409 C. 96411 D. 96413

B. 96409

One-half hour of IV chemotherapy by infusion followed by IV push of a different drug. A. 96413 B. 96413,96411 C. 96413,96409 D. 96409,96411

B. 96413,96411

An out-of-town patient presents to a walk-in clinic to have a prescription refilled for a nonsteroidal anti-inflammatory drug. The physician performs a problem-focused history and physical examination with a straightforward decision A. 99211 B. 99201 C. 99212 D. 99202

B. 99201

An office consultation is performed for a postmenopausal woman who is complaining of spotting in the past 6 months with right lower-quadrant tenderness. A detailed history and physical examination were performed with a low-complexity medical decision. A. 99242 B. 99243 C. 99253 D. 99254

B. 99243

Patient arrives in the emergency room via a medical helicopter. The patient has sustained multiple life-threatening injuries due to a multiple car accident. The patient goes into cardiac arrest 10 minutes after arrival. An hour and 30 minutes of critical care time is spent trying to stabilize the patient. Code only critical care. A. 99285, 99288, 99291 B. 99291, 99292 C. 99291, 99292, 99285 D. 99282

B. 99291, 99292

Patient was involved in an accident and has been sent to the hospital. During transport the patient develops breathing problems and, upon arrival at the hospital, an emergeny transtracheal tracheostomy was performed. Following various x-rays, the patient was diagnosed with traumatic pneumothorax. A thoracentesis with insertion of tube was performed. A. 31603, 31612 B. 31610, 32555 C 31603, 32554 D. 31603, 32555

C 31603, 32554

[Anesthesia] Code anesthesia for upper abdominal ventral hernia repair. A. 00832 B. 00750 C. 00752 D. 00830

C. 00752

Code anesthesia for procedures on bony pelvis. A. 00400 B. 01170 C. 01120 D. 01190

C. 01120

Patient presents to the hospital for debridement of a diabetic ulcer of the left ankle. The patient has a history of recurrent ulcers. Medication taken by the patient includes Diabeta and the patient was covered in the hospital with insulin sliding scales. The decubitus ulcer was debrided down to the bone. A. 11043, +11047 B. 11043,+11046 C. 11044 D. 11044,+11047

C. 11044

Patient presents to the emergency room with lacerations sustained in an automobile accident. Repairs of the 3.3-cm skin laceration of the left leg that involved the fascia, 2.5-cm and 3-cm lacerations of the left arm involving the fascia, and 2.7 cm of the left foot, which required simple sutures, were performed. Sterile dressings were applied. A. 12032, 12032-59, 12031-59, 12002-59 B. 12002, 12002-59 C. 12034, 12002-59 D. 13151, 12032-59, 12032-59, 12001-59

C. 12034, 12002-59

patient presents to the operating room for excision of a 4.5-cm malignant melanoma of the left forearm. A 6 cm x 6 cm rotation flap was created for closure. A. 14021 B. 11606, 14020 C. 14301 D. 11606, 15100

C. 14301

Nonhuman graft for temporary wound closure. Patient has a 5-cm defect on the scalp. A. 15275,15276 B. 15271 C. 15275 D. 15271,15272

C. 15275

Facelift utilizing the superficial musculoaponeurotic system (SMAS) flap technique. A. 15825 B. 15788 C. 15829 D. 15828

C. 15829

Patient was admitted to the hospital for removal of excessive tissue due to massive weight loss. Liposuction of the abdomen and bilateral thighs was performed. A. 15830 B. 15830,15833,15833 C. 15877,15879-50 D. 15839

C. 15877,15879-50

Female patient has a percutaneous needle biopsy of the left breast lesion in the lower outer quadrant. Following the biopsy frozen section results, time physician followed this with an excisional removal of the same lesion. A. 19100, 19125 B. 19100, 19120-LT C. 19120-LT D. 19100, 19120, 19120

C. 19120-LT

Patient presents to the emergency room following an assault. Examination of the patient reveals blunt trauma to the face. Radiology reports that the patient suffers from a fracture to the frontal skull and a blow-out fracture of the orbital floor. Patient is admitted and taken to the operating room where a periorbital approach to the orbital fracture is employed and an implant is inserted. A. 21407, 21275 B. 21387, 61330 C. 21390 D. 61340, 21401

C. 21390

Patient presents with a traumatic partial amputation of the second, third, and fourth fingers on the right hand. Patient was taken to the operating room where completion of the amputation of three fingers was performed with direct closure. A. 26910-F6, 26910-F7, 26910-F8 B. 26843-RT C. 26951-F6, 26951-F7, 26951-F8 D. 26550-RT

C. 26951-F6, 26951-F7, 26951-F8

Patient with a deviated nasal septum that was repaired by septoplasty A. 30400 B. 30620 C. 30520 D. 30630

C. 30520

Tracheostoma revision with flap rotation A. 31830 B. 31750 C. 31614 D. 31613

C. 31614

Patient presents to the operating room and undergoes an endovascular repair of an infrarenal abdominal aortic aneurysm utilizing a unibody bifurcated prosthesis. A. 34800,34813 B. 34802 C. 34804 D. 35081

C. 34804

Eighty-year-old patient has carcinoma and presents to the operating room for placement of a tunneled implantable centrally inserted venovis access port. A. 36558 B. 36571 C. 36561 D. 36481

C. 36561

Patient is admitted with alcohol cirrhosis and has a TIPS procedure performed. A. 35476, 36011, 36481 B. 37183 C. 37182 D. 37140

C. 37182

Patient diagnosed with cystic hygroma of the axilla, which was excised. A. 38555 B. 11400 C. 38550 D. 38300

C. 38550

Injection snoreplasty for treatment of palatal snoring. A. 42299 B. 42145 C. 42999 D. 40899

C. 42999

Caloric vestibular test using air, monothermal. A. 92543,92700 B. 92543,92543 C. 92538 D. 92543

C. 92538

Cardioversion of cardiac arrhythmia by external forces. A. 92961 B. 92950 C. 92960 D. 92970

C. 92960

Patient has a history of chronic alcohol abuse with portal hypertension. Patient has been vomiting for the past 3 days and presented to his physician's office. Patient was sent to the hospital for evaluation and an EGD was performed. Biopsy findings showed gastritis, esophagitis, and bleeding esophageal varices, which were injected with sclerosing solution. A. 43235,43244,43204 B. 43239,43244 C. 43239,43243 D. 43239,43243,43204

C. 43239,43243

[Surgery—Digestive System] Laparoscopic gastric banding A. 43842 B. 43843 C. 43770 D. 43771

C. 43770

Patient presents to the emergency room with right lower abdominal pains. Emergency room physician suspects possible appendicitis. Patient was taken to the operating room where a laparoscopic appendectomy was performed. Pathology report was negative for appendicitis. A. 44950 B. 44950, 49320 C. 44970 D. 44979

C. 44970

Patient underwent anoscopy followed by colonoscopy. The physician examined the colon to 60 cm. A. 46600, 45378 B. 46600, 45378-59 C. 45378 D. 45999

C. 45378

Patient was admitted for right upper quadrant pain. Workup included various x-rays that showed cholelithiasis. Patient was taken to the operating room where a laparoscopic cholecystectomy was performed. During the procedure, the physician was unable to visualize through the ports and an open cholecystectomy was elected to be performed. An intraoperative cholangiogram was performed. Pathology report states acute and chronic cholecystitis with cholelithiasis. A. 47563 B. 47563, 47605 C. 47605

C. 47605

Patient has extensive bladder cancer. She underwent a complete cystectomy with bilateral pelvic lymphadenectomy and creation of ureteroileal conduit. A. 51575, 50820 B. 50825, 51570, 38770 C. 51595 D. 51550, 38770

C. 51595

Excision of 2.5-cm bladder tumor with cystoscopy A. 51550 B. 51530 C. 52235 D. 51060

C. 52235

Litholapaxy, 3 cm calculus A. 52353 B. 50590 C. 52318 D. 52317

C. 52318

Priapism operation with spongiosum shunt. A. 54450 B. 54352 C. 54430 D. 55899

C. 54430

Patient undergoes laparoscopic orchiopexy for intra-abdominal testes. A. 54650 B. 54699 C. 54692 D. 55899

C. 54692

Male presented to operating room for sterilization by bilateral vasectomy. A. 55200 B. 55400 C. 55250 D. 55450

C. 55250

Laser destruction of extensive herpetic lesions of the vulva. A. 17106 B. 17004 C. 56515 D. 56501

C. 56515

Patient was admitted with a cystocele and rectocele. An anterior colporrhaphy was performed. A. 57250 B. 57260 C. 57240 D. 57110

C. 57240

Patient undergoes hysteroscopy with excision uterine fibroids. A. 58545 B. 58140 C. 58561 D. 58140,49320

C. 58561

Laparoscopic tubal ligation utilizing Endoloop. A. 58670 B. 58615 C. 58671 D. 58611

C. 58671

A pregnant patient has an incompetent cervix, which was repaired using a vaginal cerclage. A. 57700 B. 57531 C. 59320 D. 59325

C. 59320

Attempted vaginal delivery in a previous cesarean section patient, which resulted in a repeat cesarean section. A. 59409 B. 59612 C. 59620 D. 59514

C. 59620

Left carotid artery excision for tumor of carotid body. A. 60650 B. 60600 C. 60605 D. 60699

C. 60605

Patient is admitted to the hospital with facial droop and left-sided paralysis. CT scan of the brain shows subdural hematoma. Burr holes were performed to evacuate the hematoma. A. 61156 B. 61314 C. 61154 D. 61150

C. 61154

Patient has metastatic brain lesions. Patient undergoes stereotactic radiosurgery gamma knife of two lesions. A. 61533 B. 61500 C. 61796,61797 D. 61796

C. 61796,61797

Patient has rhinorrhea, which requires repair of the CSF leak with craniotomy. A. 63707 B. 63709 C. 62100 D. 62010

C. 62100

Patient comes in for steroid injection for lumbar herniated disk. Marcaine and Aristocort were injected into the L2-L3 space. A. 64520 B. 64483 C. 62322 D. 64714

C. 62322

[Surgery-Nervous System] Patient comes in through the emergency room with a wound that was caused by an electric saw. Patient is taken to the operating room where two ulna nerves are sutured. A. 64837 B. 64892,69990 C. 64836,64837 D. 64856,64859

C. 64836,64837

comes in through the emergency room with a laceration of the posterior tibial nerve. Patient is taken to the operating room where the nerve requires transposition and suture. A. 64856 B. 64831,64832,64876 C. 64840,64874 D. 54834,64859,64872

C. 64840,64874

Patient presents for procedure for aphakia penetrating corneal transplant. A. 65755 B. 65730 C. 65750 D. 65765

C. 65750

Insertion of cochlear device inner ear. A. 69711 B. 69949 C. 69930 D. 69960, 69990

C. 69930

Patient with Bell's palsy requiring a total facial nerve decompression. A. 64742 B. 64771 C. 69955 D. 64864

C. 69955

Patient undergoes x-ray of the foot with three views. A. 73620 B. 3610 C. 73630 D. 27648,73615

C. 73630

Pregnant female comes in for a complete fetal and maternal evaluation via ultrasound A. 76856 B. 76805 C. 76811 D. 76810

C. 76811

Patient has carcinoma of the breast and undergoes proton beam delivery of radiation to the breast with a single port. A. 77523 B. 77432 C. 77520 D. 77402

C. 77520

A physician orders a lipid panel on a 54-year-old male with hypercholesterolemia, hypertension, a family history of heart disease. The lab employee in his office performs and reports the total holesterol and HDL cholesterol only. A. 80061 B. 80061-52 C. 82465,83718 D. 82465,84478

C. 82465,83718

Creatinine clearance. A. 82550 B. 82565 C. 82575 D. 82585

C. 82575

Patient presents to the emergency room with chest pains. The patient is admitted as a 23-ho-n observation. The cardiologist orders cardiac workup and the patient undergoes left heart catheterization via the left femoral artery with visualization of the coronary arteries and left ventriculography- The physician interprets the report- Code the heart catheterization. A. 93452,93455 B. 93452,93458 C. 93458 D. 93459

C. 93458

A 69-year-old established female patient presents to the office with chronic obstructive lung disease, congestive heart failure, and hypertension. The physician conducts a comprehensive history and physical examination and makes a medical decision of moderate complexity. Physician admits the from the office to the hospital for acute exacerbation of CHF. A. 99214 B. 99223 C. 99222 D. 99212

C. 99222

[Evaluation and Management] Patient is admitted to the hospital with acute abdominal pain. The attending medical physician requests a surgical consult. The consultant agrees to see the patient and conducts a comprehensive history and physical examination. To rule out pancreatitis, the physician orders lab work, along with an ultrasound of the gallbladder and an abdominal x-ray. Due to the various diagnosis possibilities and the tests reviewed, a moderate medical decision was made. A. 99244 B. 99222 C. 99254 D. 99204

C. 99254

Services were provided to a patient in the emergency room after the patient twisted her ankle stepping down from a curb. The emergency room physician ordered x-rays of the ankle, which. came back negative for a fracture. A problem-focused history and physical examination were performed and ankle strapping was applied. A prescription for pain was given to the patient. Code the emergency room visit only: A. 99201 B. 99282 C. 99281 D. 99211

C. 99281

The physician provided services to a new patient who was in a rest home for an ulcerative sore on the hip. A problem-focused history and physical examination were performed and a straightforward medical decision was made. A. 99304 B. 99325 C. 99324 D. 99334

C. 99324

Orient undergoes ocular resurfacing construction utilizing stem cell allograft from a cadaver. A. 67320 B. 66999 C. 68371 D. 65781

D. 65781

Trauma patient was rushed to the operating room with multiple injuries. Open reduction with internal fixation of intertrochanteric femoral fracture, and open reduction of the tibial and fibula shaft with internal fixation was performed. A. 27245, 27759 B. 20690 C. 27248, 27756 D. 27244, 27758

D. 27244, 27758

Code anesthesia for total hip replacement. A. 01210 B. 01402 C. 01230 D. 01214

D. 01214

Code anesthesia for total shoulder replacement. A. 01760 B. 01630 C. 01402 D. 01638

D. 01638

Patient presents to the radiology department where a fine-needle aspiration of the breast is performed utilizing computed tomography* A. 19085, 77012 B. 19100 C. 19125 D. 10022, 77012

D. 10022, 77012

[Surgery—Integumentary System] Patient presents to the hospital for skin grafts due to previous third-degree burns. The burn eschar of the back was removed. Once the eschar was removed, the defect size measured 10 cm x 10 cm. A skin graft from a donor bank was placed onto the defect and sewn into place as a temporary wound closure. A. 15002, 15130 B. 15002, 15271, 15272, 15272, 15272 C. 15002, 15200 D. 15002, 15273

D. 15002, 15273

Patient is brought to the emergency room following a shark attack. The paramedics have the patient's amputated foot. The patient is taken directly to the operating room to reattach the patient's foot. A 28800 B. 28200,28208 C. 28110 D. 20838

D. 20838

Patient comes into his physician's office complaining of wrist pain. Physician gives the patient an injection and sends the patient to the hospital for an arthrography. Code the complete procedure. A. 73115 B. 73100 C. 73110 D. 25246,73115

D. 25246,73115

[Surgery—Musculoskeletal] Patient presents to the hospital with ulcer of the right foot. Patient is taken to the operating room where a revision of the right metatarsal head is performed. A. 28104-RT B. 28111-RT C. 28288-RT D. 28899-RT

D. 28899-RT

Patient has been diagnosed with metastatic laryngeal carcinoma. Patient underwent subtotal supraglottic laryngectomy with radical neck dissection. A. 31540 B. 31367 C. 31365 D. 31368

D. 31368

Bronchoscopy with multiple transbronchial right upper and right lower lobe lung biopsy with fluoroscopic guidance. A. 31628-RT, 76000-RT B. 31717-RT, 31632-RT C. 32405-RT D. 31628-RT, 31632-RT

D. 31628-RT, 31632-RT

Upper lobectomy of the right lung with repair of the bronchus. A. 32480 B. 32486 C. 32320 D. 32480, 32501

D. 32480, 32501

Patient presents to the operating room where a CABG x 3 is performed using the mammary artery and two sections of the saphenous vein. A. 33534,33511 B. 33534,33518,33511 C. 33535 D. 33533,33518

D. 33533,33518

Trauma patient is rushed to the operating room with multiple injuries. The patient had his spleen removed due to a massive rupture, with repair of the lacerated diaphragm. A. 38115, 39501 B. 38120, 39599 C. 38102, 39540 D. 38100, 39501

D. 38100, 39501

Patient has been on the bone marrow transplant recipient list for 3 months. A perfect match was made and the patient came in and received a peripheral stem cell transplant. A. 38242 B. 38230 C. 38241 D. 38240

D. 38240

[Surgery—Hemic and Lymphatic Systems, Mediastinum, and Diaphragm] Patient has breast carcinoma and is now undergoing sentinel node biopsy. Patient was injected for sentinel node identification and two deep axillary lymph nodes showed up intensely. These two lymph nodes were completely excised. Path report was positive for metastatic carcinoirva. A. 38525, 38790 B. 38589 C. 38308, 38790 D. 38525, 38792

D. 38525, 38792

Young child presents with cleft lip and deft palate. This is the first attempt of repair, which includes major revision of the cleft palate and unilateral cleft lip repair. A. 42200, 40701 B. 42225, 40700 C. 42220, 40720 D. 42215, 40700

D. 42215, 40700

Tonsillectomy on a 14-year-old. A. 42820 B. 42821 C. 42825 D. 42826

D. 42826

Patient presents with a history of upper abdominal pain. Cholangiogram was negative and patient was sent to the hospital for ERCP. During the procedure the sphincter was incised and a stent was placed for drainage. A. 43260, 43262, 43264 B. 43262 C. 43275 D. 43274

D. 43274

Patient arrives to the hospital and has a Nissen fundoplasty done laparoscopically A. 43410 B. 43415 C. 43502 D. 43280

D. 43280

Laparoscopic repair of umbilical hernia. A. 49580 B. 49654 C. 49585 D. 49652

D. 49652

Patient undergoes partial nephrectomy for carcinoma of the kidney. A. 50234 B. 50220 C. 50340 D. 50240

D. 50240

Patient has ovarian vein syndrome and has ureterolysis performed. A. 58679 B. 58660 c. 52351 D. 50722

D. 50722

Ureterolithotomy completed laparoscopicalty A. 52352 B. 52325 C. 50600 D. 50945

D. 50945

Placement of double-J stent. A. 52341 B. 52320 C. 52330,52332 D. 52332

D. 52332

Patient presents to the hospital with right ureteral calculus. Patient is taken to the operating room where a cystoscopy with ureteroscopy is performed to remove the calculus. A. 52353 B. 52310 C. 51065 D. 52352

D. 52352

First-stage repair for hypospadias with skin flaps. A. 54300 B. 54308, 14040 C. 54322 D. 54304

D. 54304

Patient has been diagnosed with prostate cancer- Patient arrived in the operating room where a therapeutic orchiectomy is performed. A. 54560 B. 54530 C. 55899 D. 54520

D. 54520

Radial keratotomy. A. 92071 B. 65855 C. 65767 D. 55771

D. 55771

Patient has a Bartholin's gland cyst that was marsupialized. A. 54640 B. 10060 C. 58999 D. 56440

D. 56440

Patient has been diagnosed with carcinoma nf the vaeina, and she has a radical vaginectomy with complete removal of the vaginal wall. A. 57107 B. 57110 C. 58150 D. 57111

D. 57111

Patient suffers from strabismus and requires surgery. Recession of the lateral rectus (horizontal) muscle with adjustable sutures was performed. A. 67340,67500 B. 67314,67320 C. 67332,67334 D. 57311,67335

D. 57311,67335

[Surgery-Female Genital System] Patient was admitted to the hospital with sharp pelvic pains. A pelvic ultrasound was ordered and the results showed a possible ovarian cyst. The patient was taken to the operating room where a laparoscopic destruction of two corpus luteum cysts was performed. A. 49321 B. 58925 C. 58561 D. 58662

D. 58662

Patient is at a fertility clinic and undergoes intrauterine embryo transplant. A. 58679 B. 58322 C. 58323 D. 58974

D. 58974

hysterotomy for hydatidifom mole and tubal ligation. A. 58285,58600 B. 58150,58605 C. 51900,58605 D. 59100,58611

D. 59100,58611

Patient is 6 weeks pregnant and complains of left-sided abdominal pains. Patient is suspected of having an ectopic pregnancy. Patient has a laparoscopic salpingectomy with removal of the ectopic tubal pregnancy A. 59120 B. 59200 C. 59121 D. 59151

D. 59151

Cesarean delivery with antepartum and postpartum care. A. 59610 B. 59514 C. 59400 D. 59510

D. 59510

[Surgery-Endocrine System] Patient comes in for a percutaneous needle biopsy of the thyroid gland. A. 60000 B. 60270 C. 60699 D. 60100

D. 60100

Spinal tap. A. 62272 B. 64999 C. 62268 D. 62270

D. 62270

Patient requires repair of a 6-cm meningocele A. 63700 B. 63709 C. 63180 D. 63702

D. 63702

[Surgery—Eye and Ocular Adnexa] Patient returns to the physician's office complaining of obscured vision. Patient has had cataract surgery 6 months prior. Patient requires laser discission of secondary cataract. A. 56821 B. 66940 C. 67835 D. 66830

D. 66830

Lacrimal fistula closure A. 68760 B. 68761 C. 68700 D. 67121

D. 67121

Patient with chronic otitis media requiring transtympanic eustachian tube catheterization. A. 69420 B. 69424 C. 69421 D. 69401

D. 69401

Patient with a traumatic rupture of the eardrum. Repaired with tymoanoDlasty with incision of the mastoid. Repair of ossicular chain not required. A. 69641 B. 69646 C. 69642 D. 69655

D. 69655

decompression internal auditory canal. A. 69979 B. 69915 C. 69970 D. 69960

D. 69960

Unilateral mammogram with computer-aided detection with further physician review and interpretation. A. 77065, 77067 B. 77065-22 C. 77066-52,77065 D. 77065

D. 77065

[Radiology] Administration of initial oral radionuclide therapy for hyperthyroidism. A. 78015 B. 77402 C. 78099 D. 79005

D. 79005

Vitamin B12 A. 84590 B. 82180 C. 84591 D. 82607

D. 82607

Clotting factor VII A. 85220 B. 85240 C. 85362 D. 85230

D. 85230

Pathologist bills for gross and microscopic examination of medial meniscus. A 88300 B. 88302,88311 C. 88325 D. 88304

D. 88304

[Pathology and Laboratory] What code is used for a culture of embryos less than 4 days old? A. 89251 B. 89272 C. 89268 D. 89250

D. 89250

Huhner test and semen analysis. A. 89325 B. 89258 C. 89310 D. 89300

D. 89300

Transesophageal echocardiography (TEE) with probe placement, image, and interpretation and report. A. 93307 B. 93303,93325 C. 93312,93313,93314 D. 93312

D. 93312

Patient presents to the Respiratory Therapy Department and undergoes a pulmonary stress test. CO2 production with O2 uptake with recordings was also performed. A. 94450 B. 94620 C. 94002 D. 94621

D. 94621

The patient is on vacation and presents to a physician's office with a lacerated finger. The physician repairs the laceration and gives a prescription for pain control and has the patient follow up with his primary physician when he returns home. The physician fills out the superbill as a problem-focused history and physical examination with straightforward medical decision making. Also checked is a laceration repair for a 1.5-cm finger wound. A. 99212,13131 B. 12001 C. 99212,12001 D. 99201-25

D. 99201-25

An established patient was seen in her primary physician's office. The patient fell at home and came to the physician's office for an examination. Due to a possible concussion, the patient was sent to the hospital to be admitted as an observation patient. A detailed history and physical examination were performed and the medical decision was low complexity, patient stayed overnight and was discharged the next afternoon. A. 99214,99234 B. 99214,99218,99217 C. 99218 D. 99218,99217

D. 99218,99217

Patient presents to the emergency room complaining of right forearm/elbow pain after racquetball last night. Patient states that he did not fall, but overworked his arm. Past medical history is negative and the physical examination reveals the patient is unable to supinate. A four-view x-ray of the right elbow is performed and is negative. The physician signs the patient out with right elbow sprain. Prescription of Motrin is given to the patient. A. 73080 B. 99281,73070 C. 73080,99282,73040 D. 99281-25,73080

D. 99281-25,73080

A doctor provides critical care services in the emergency department for a patient in respiratory failure. He initiates ventilator management and spends an hour and 10 minutes providing critical care for this patient- Code only critical care. A. 99281, 99291, 99292, 94002 B. 99291, 99292, 94002 C. 99291, 94002 D. 99291

D. 99291

Established 42-year-old patient comes into your office to obtain vaccines required for his trip to Sri Lanka. The nurse injects intramuscularly the following vaccines: hepatitis A and B vaccines, cholera vaccine, and yellow fever vaccine. As the coding specialist, what would you report on the CMS 1500 form? A. office visit, hepatitis A and B vaccine, cholera vaccine, and yellow fever vaccine B. office visit, intramuscular injection; HCPCS Level II codes C. office visit; administration of two or more single vaccines; vaccine products for hepatitis A and B, cholera, and yellow fever D. Administration of two or more single vaccines; vaccine products for hepatitis A. and B y cholera, and yellow fever

D. Administration of two or more single vaccines; vaccine products for hepatitis A. and B y cholera, and yellow fever


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