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1. The left breast was prepped and draped in a D. 19101, N64.51
sterile fashion. An incision from the 3 around
to the 9 o'clock position on the areolar bor-
der on its inferior aspect was made in the skin
and extended to the subcutaneous tissue. The
breast mass was excised by sharp dissection.
The mass was found to be approximately 1.5 -
2 cm in maximum dimension. Hemostasis was
made adequate using electrocautery and the
Argon beam coagulator. After this was accom-
plished, the skin margins were reapproximat-
ed with running inverted 3-0 Vicryl subcuticu-
lar suture. Select the procedure and diagnosis
codes.
A. 19120, N63.20
B. 19301, D49.3
C. 19125, N60.82
D. 19101, N64.51
2. A 50-year-old female saw her dermatologist for C.11606, 12034-51
removal of a basal cell carcinoma on her right According to CPT® guidelines for
arm. An 8.0 cm lesion that included the margins excision-malignant lesions - Repair
was drawn out and a 15-blade scalpel was used by intermediate or complex closure
for full excision of the lesion. A layered closure should be reported separately. The
was performed after the removal. The speci- coding scenario indicates that the clo-
men was sent for permanent histopathologic sure was a layered closed reporting
examination. What CPT® coding is reported? code 12034. Modifier 51 is append-
ed to indicate multiple procedures
performed during the same operative
A. 11606
session.
B. 11606, 12004-51
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C. 11606, 12034-51
D. 11606, 13121-51, 13122
3. A 25-year-old male has a ruptured distal biceps B. 24340
tendon at the proximal end of the radius. An Tenodesis is suturing of the end a ten-
incision is made overlying the antecubital fos- don to a bone. There is a ruptured
sa. The biceps tendon was tagged using #1 distal biceps tendon at the proximal
Vicryl-suture. The second incision made on the end of the radius which is a tendon
superior border of the ulna. The supinator was injured around the elbow joint, elim-
incised deep to expose the radial tuberosity. inating multiple choice A. This also
Drill holes are made at the radial tuberosity eliminates multiple choice C, a long
in which sutures and the distal biceps tendon tendon bicep runs over the top of
are placed in the hole of the radial tuberosity. the humerus bone (upper arm) and
Two sutures are placed in the biceps tendon attaches to the top of the shoulder.
in horizontal mattress type fashion pulled tight There is no documentation of a re-
and secured. The distal biceps tendon is reat- section or transplantation of a bicep
tached to the radius to restore elbow function. tendon, eliminating multiple D.
Closure was then accomplished with sutures
and staples. What is the correct code for this
procedure?
A. 24342
B. 24340
C. 23430
D. 23440
4. Patient complains of chronic/acute arm and D. 20553
shoulder pain following bilateral carpal tunnel Trigger point is your key term in this
surgery. Patient is followed by pain manage- scenario, eliminating choice C. Trig-
ment for over a year. Physician finally diag- ger points are coded by the num-
noses patient with reflex dystrophy syndrome ber of muscles that the injections are
(RSD). Physician performs six trigger point in- performed on, not by the number
jections into four muscle groups. How is this of trigger point injections. The sce-
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encounter reported? nario tells you that six trigger points
A. 20552 were injected into four muscle groups
B. 20553 x 6 which lead you to the procedure code
C. 20551 x 6 20553.
D. 20553
5. A Grade I, high velocity type 1 open right femur B. 27506, 11012-51, S72.301B,
shaft fracture was incurred when a 15 year-old V03.90XXA, Y93.01
female pedestrian was hit by a car. She was tak- One way to start finding the correct
en to the operating room within four hours of answer is to look up the diagnosis in
her injury for thorough irrigation and debride- the ICD-10-CM codebook. Look in the
ment, including excision of devitalized bone. ICD-10-CM Alphabetic Index for Frac-
The patient was then reprepped, redraped, and ture, traumatic/femur/shaft referring
repositioned. Intramedullary rodding was then you to code S72.30-. In the Tabular
carried out with proximal and distal locking List the complete code is S72.301B,
screws. What are the correct codes for this di- for right femur, type 1 open frac-
agnosis and procedure? ture eliminating codes C and D. The
A. 27506, 11044-51, S72.301B, V03.90XXA, only difference between choices A
Y93.01 and B are the second procedure
B. 27506, 11012-51, S72.301B, V03.90XXA, codes. Code 11012 is the correct code
Y93.01 because extensive debridement was
C. 27507, 11012-51, S72.301A, V03.90XXA, performed all the way to the bone on
Y93.01 an open fracture.
D. 27507, 11044-51, S72.91XA, V03.90XXA,
Y93.01
6. This 25-year-old male presents with deviated C. 30620
nasal septum. After intubation, a left hemi- The multiple choice answers are be-
transfixion incision was made with elevation tween a rhinoplasty and septoplas-
of the mucoperichondrium. Cartilage from the ty for which you will need to know
bony septum was detached and the nasosep- the difference. Rhinoplasties are per-
tum was realigned and removed in a piece- formed on patients that are having