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NEW QUESTION # 49
View MR 001394
MR 001394
Operative Report
Procedure: Excision of 11 cm back lesion with rotation flap repair.
Preoperative Diagnosis: Basal cell carcinoma
Postoperative Diagnosis: Same
Anesthesia: 1% Xylocaine solution with epinephrine warmed and buffered and injected slowly through a 30-gauge needle for the patient's comfort.
Location: Back
Size of Excision: 11 cm
Estimated Blood Loss: Minimal
Complications: None
Specimen: Sent to the lab in saline for frozen section margin control.
Procedure: The patient was taken to our surgical suite, placed in a comfortable position, prepped and draped, and locally anesthetized in the usual sterile fashion. A #15 scalpel blade was used to excise the basal cell carcinoma plus a margin of normal skin in a circular fashion in the natural relaxed skin tension lines as much as possible The lesion was removed full thickness including epidermis, dermis, and partial thickness subcutaneous tissues. The wound was then spot electro desiccated for hemorrhage control. The specimen was sent to the lab on saline for frozen section.
Rotation flap repair of defect created by foil thickness frozen section excision of basal cell carcinoma of the back. We were able to devise a 12 sq cm flap and advance it using rotation flap closure technique. This will prevent infection, dehiscence, and help reconstruct the area to approximate the situation as it was prior to surgical excision diminishing the risk of significant pain and distortion of the anatomy in the area. This was advanced medially to close the defect with 5 0 Vicryl and 6-0 Prolene stitches.
What CPT coding is reported for this case?
- A. 14001, 11606-51, 12034-51
- B. 14001, 11606-51
- C. 0
- D. 1
Answer: C
NEW QUESTION # 50
View MR 006399
MR 006399
Operative Report
Preoperative Diagnosis: Chronic otitis media in the right ear
Postoperative Diagnosis: Chronic otitis media in the right ear
Procedure: Eustachian tube inflation
Anesthesia: General
Blood Loss: Minimal
Findings: Serous mucoid fluid
Complications: None
Indications: The patient is a 2-year-old who presented to the office with chronic otitis media refractory to medical management. The treatment will be eustachian tube inflation to remove the fluid. Risks, benefits, and alternatives were reviewed with the family, which include general anesthetic, bleeding, infection, tympanic membrane perforation, routine tubes, and need for additional surgery. The family understood these risks and signed the appropriate consent form.
Procedure in Detail: After the patient was properly identified, he was brought into the operating room and placed supine. The patient was prepped and draped in the usual fashion. General anesthesia was administered via inhalation mask, and after adequate sedation was achieved, a medium-sized speculum was placed in the right ear and cerumen was removed atraumatically using instrument with operative microscope. The tube is dilated, an incision is made to the tympanum and thick mucoid fluid was suctioned. The patient was awakened after having tolerated the procedure well and taken to the recovery room in stable condition.
What CPT coding is reported for this case?
- A. 69433-RT
- B. 69421-RT
- C. 69420-RT
- D. 69436-RT
Answer: B
NEW QUESTION # 51
A patient is diagnosed with sepsis and associated acute respiratory failure.
What ICD-10-CM code selection is reported?
- A. A41.9, R65.21, J96.00
- B. A41.9
- C. A41.9, J96.00
- D. A41.9, R65.20, J96.00
Answer: C
NEW QUESTION # 52
A 55-year-old patient with suspected liver cancer was seen by the physician to obtain a biopsy. The special biopsy needle was placed using ultrasonic guidance. The physician obtained a small tissue sample from the liver, which was then sent to pathology.
What CPT codes are reported?
- A. 47000, 10005
- B. 47100, 77012-26
- C. 47000, 76942-26
- D. 47000, 77002-26
Answer: C
NEW QUESTION # 53
A patient complains of tarry, black stool, and epigastric tightness. An esophagogastroduodenoscopy is recommended to evaluate the source of the bleeding. The endoscope is inserted orally. The esophagus appears normal on scope insertion. No evidence of bleeding in the stomach. The scope is then passed into the duodenum, where a polyp is found and removed with hot biopsy forceps. No evidence of bleeding post procedure.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: C
NEW QUESTION # 54
A patient suffering from idiopathic dystonia is seen today and receives the following Botulinum injections: three muscle injections in both upper extremities and seven injections in six paraspinal muscles.
How are these injections reported according to the CPT guidelines?
- A. 64642 x 3, 64642 x 3, 64647 x 7
- B. 64642-50, 64643-50, 64647
- C. 64642, 64643, 64647
- D. 64644, 64647 x 7
Answer: C
NEW QUESTION # 55
A 45-year-old has a dislocated patella in the left knee after a car accident. She taken to the hospital by EMS for surgical treatment. In the surgery suite, the patient is placed under general anesthesia. After being prepped and draped, the surgeon makes an incision above the knee joint in front of the patella. Dissection is carried through soft tissue and reaching the patella in attempt to reduce the dislocation. When the patella is exposed, it is severely damaged due to cartilage breakdown. The tendon is dissected and using a saw the entire patella is freed and removed. The tendon sheath is closed with sutures.
What procedure code is reported for this surgery?
- A. 27552-LT
- B. 27556-LT
- C. 27562-LT
- D. 27566-LT
Answer: D
NEW QUESTION # 56
The gastroenterologist performs a simple excision of three external hemorrhoids and one internal hemorrhoid, each lying along the left lateral column. The operative report indicates that the internal hemorrhoid is not prolapsed and is outside of the anal canal.
What CPT and ICD-10CM codes are reported?
- A. 46320, 46945, K64.0, K64.9
- B. 46250, 46945, K64.0, K64.4
- C. 46255, K64.0, K64.4
- D. 46250, K64.0, K64.9
Answer: D
NEW QUESTION # 57
A cardiologist attempted to perform a percutaneous transluminal coronary angioplasty of a totally occluded blood vessel. The surgeon stopped the procedure because of an anatomical problem creating risk for the patient and preventing performance of the catheterization.
What modifier is appended to the procedure code?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: B
NEW QUESTION # 58
Dr. Burns sees newborn baby James at the birthing center on the same day after the cesarean delivery. Dr. Burns examined baby James, the maternal and newborn history, ordered appropriate blood test tests and hearing screening. He met with the family at the end of the exam.
How would Dr. Bums report his services?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: B
NEW QUESTION # 59
A patient with a history of chronic venous embolism in the inferior vena cava has a radiographic study to visualize any abnormalities. In outpatient surgery the physician accesses the subclavian vein and the catheter is advanced to the inferior vena cava for injection and imaging. The supervision and interpretation of the images is performed by the physician.
What codes are reported for this procedure?
- A. 36010, 75827-26
- B. 36000, 75825-26
- C. 36010, 75825-26
- D. 36000, 75827-26
Answer: C
NEW QUESTION # 60
Mr. Woolridge has had a suspicious lesion on his left shoulder for approximately eight weeks that is not healing. On the dermatologist's exam of left shoulder blade, there is excoriation and scabbing and the lesion not healing. Patient agrees and wishes to proceed with a punch biopsy of the lesion. A punch biopsy is taken of the lesion and sent to pathology. A simple repair is performed at the biopsy site.
What CPT and ICD-10-CM codes are reported?
- A. 11104, D49.2
- B. 11102, 12001-51, D49.2
- C. 11104,12001-51, L98.9
- D. 11102, L98.9
Answer: A
NEW QUESTION # 61
A patient is diagnosed with diabetic polyneuropathy.
Using ICD-10-CM coding guidelines, what ICD-10-CM coding is reported?
- A. E10.9, G62.9
- B. E10.42
- C. E11.9, G62.9
- D. E11.42
Answer: D
NEW QUESTION # 62
When a patient has ESRD, which system is affected?
- A. Genitourinary
- B. Respiratory
- C. Neurologic
- D. Cardiovascular
Answer: A
NEW QUESTION # 63
The surgeon performs Roux-en-Y anastomosis of the extrahepatic biliary duct to the gastrointestinal tract on a 45-year-old patient.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: C
NEW QUESTION # 64
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