OST-249: Chapter 6 - Integumentary
System (10000 series) Final Exam With
100% Correct Answers 2026 Update.
Patient presents to the ED with a 1 cm laceration of the scalp for repair. Area was prepped and
draped and the wound cleansed. Skin closure was accomplished with the two sutures. - Answer
12001
(Assigned 1 cm repair/scalp as complexity not stated would assume simple.)
Excision of benign lesion: 4.0 cm arm, 2.0 cm leg, and 2.0 cm back - Answer 11404, 11402-51,
11402-59
(Three lesions were excised; therefore, three codes are needed. Arm lesion largest, therefore,
most significant, 11404; leg and back lesions are of same code, therefore, modifier -59 is
assigned to the second 11402 code to indicate separate, distinct lesion. Append modifier -51
when multiple surgical procedures of the skin are performed during the same surgical session.)
WRONG
Excision of benign right forehead lesion. Right temple lesion was clearly evident, 1 x 1 cm,
pigmented, mole-type lesion being excised due to sudden appearance. Area was cleaned,
infiltrated with Xylocaine, and then excised completed and submitted to pathology. - Answer
11441
(Lesion is 1 cm, benign, face. Therefore, code 11441 would be appropriate.)
Replacement of deflated breast implant. Patient noted implant increasingly smaller and soft. A
pinpoint hole on the posterior aspect of the implant was located. The new implant was
inspected, prepared, and inserted using a no-touch technique and inflated with normal saline to
450 cc. - Answer 19325
(New breast augmentation with prosthetic (implant) performed. Removal of old prosthetic is
included in new procedure.) WRONG
Morpheaform basal cell carcinoma of the nose. Incision was made along with marked areas,
measuring 4 cm. Left preauricular incision was made and elliptical FTSG was taken and sutured
into place. - Answer 11644, 15260
(Malignant lesion nose, 4 cm codes to 11644. Full thickness skin graft is coded to the recipient
site, nose; therefore, 15260 would be appropriate.)
Lumpectomy, right breast with axillary node dissection. An elliptical incision was made above
the areola. Incision was made removing the tumor down to the pectoralis fascia. Axillary
dissection was carried out and Jackson-Pratt placed into the axilla and secured. Breast incision
was closed. - Answer 19302-RT
,(Partial mastectomy was performed (19301) with axillary lymphadenectomy. Since the
dissection was completed, code 19302 (partial mastectomy with axillary lymphadectomy) would
be assigned.)
Repair of right index finger laceration. Severely lacerated distal interphalangeal joint of finger
from skill saw. Block performed, and extensive debridement performed prior to closing with 4-0
black Ethilon. - Answer 12041
(When extensive cleaning prior to closure is documented, it qualifies for intermediate closure.
Therefore, intermediate, finger, smallest size (size not stated), code 12041 would be
appropriate.)
Excision malignant lesion, 2.0 cm leg with 0.5 cm margins - Answer 11603
(Assigned malignant lesion, leg, 2.0 cm + margins (0.5 + 0.5) for a total of 3.0 cm. Therefore,
code 11603 would be appropriate.) WRONG
Procedure: Wide excision of left axillary hidradenitis suppurativa. The elliptical marking was
done to the whole area and taken down through the fatty tissue with electrocautery where the
excision was taken deep to accommodate prior sinuses and abscess pockets that reached deep
into the tissue. - Answer 11450
(Excision of lesion codes is not appropriate in this instance, as there is a specific code for
removal of hidradenitis (11450). Simple removal is assigned as the extent of the repair was not
documented and, therefore, assumed to be simple.) WRONG
Redundant skin of the superior eyelids was demarcated and the skin and orbicularis was incised,
elevated, and excised. Protruding fat pads were isolated and excised. - Answer 15822-50
(Superior eyelids would be the upper eyelids and blepharoplasty was performed. Despite the
fact that stated fat pad excised, it does not indicate weighing down lid; therefore, 15822 would
be appropriate. To report bilaterally, append modifier -50 to CPT code 15822.) WRONG
Right modified radical mastectomy was performed as follows: Superior and inferior flaps
developed and breast taken off chest wall and axillary nodes removed as well. - Answer
19307-RT
(Modified radical mastectomy was performed with axillary lymphadenectomy. Therefore, code
19307-RT would be appropriate.)
A patient presents for a 2.5 cm excision of a left foot mass identified as a ganglion cyst on
pathology with simple closure. - Answer 28090-LT
(Mass extends into musculoskeletal tissue; therefore, codes from musculoskeletal section are
assigned. Code 28090 is for excision of foot lesion. Simple closure is included in all procedures in
the musculoskeletal section.)
, Excision of 2.5 cm malignant lesion of arm with 0.5 cm margins. Also removal of 1.5 cm
malignant lesion from scalp was performed. - Answer 11622, 11604-51
(Two lesions were excised; therefore, two codes would be assigned. The lesions were specified
as malignant. Code 11622 for the arm lesion (2.5 cm + 1.0 total margins = 3.5 cm), code 11622.
Second lesion, scalp, 1.5 cm code, 11604-51. Modifier -51 is appropriate for multiple procedures
on the skin during the same surgical session.)
In a 30-year-old patient, two actinic keratoses were removed by cryotherapy, each 0.5 cm in
size. The physician also applied liquid nitrogen to a wart located on the left thumb. - Answer
17000, 17003, 17110-51
(Actinic keratoses are assigned codes in the 17000 series. Two were removed; therefore, 17000
would be assigned for the first lesion, and 17003 for the second lesion. The wart would be
assigned 17110-51 as an additional procedure. 17003 does not need modifier -51 as it is
designated as an "add-on procedure," which does not require modifier -51.)
Diagnosis: Ductal carcinoma in situ, left breast. Procedure: Right partial mastectomy. Incision
was deepened through skin and subcutaneous tissue. We dissected a large ball of breast tissue
out from the medial right breast and used silk suture to close the lumpectomy site. - Answer
19301-RT
(Partial breast was removed; therefore, mastectomy code is appropriate. Code 19301 is
assigned for partial. RT is assigned for right breast.)
Repair of three lacerations as follows: Upper arm, deep subcutaneous layer closed with 4-0
Nylon, skin with 4-0 Vicryl. Second wound on the lower left arm required only skin closure.
Third laceration on the lower leg required 4-0 Nylon for deep subcutaneous layer and 4-0 Nylon
for skin repair measuring 2.8 cm. - Answer 12032, 12001-51
(Only size of third laceration was specified as 2.8 cm. All lacerations/closures of same
complexity and same anatomical groupings are added together. Therefore, the upper arm
laceration and lower leg would be added: 0 cm (size not specified) + 2.8 cm = 2.8 cm
intermediate, arms/legs = 12032. Second wound of arm was simple only. Size was not indicated;
therefore, 12001-51 would be assigned. Modifier -51 is appropriate for multiple procedures
performed on the skin in the same surgical session.)
A 1.3 cm nasal lesion excised from nasal labial area. Pedicle flap was elevated along the nasal
labial area and rotated into position. - Answer 14060
(When adjacent tissue transfers are performed, lesions excised are not separately codable.
Therefore, only 14060 would be appropriate in this instance.)
Excision of benign lesion trunk, 2.7 cm with simple closure
1400
none of these codes
11402
System (10000 series) Final Exam With
100% Correct Answers 2026 Update.
Patient presents to the ED with a 1 cm laceration of the scalp for repair. Area was prepped and
draped and the wound cleansed. Skin closure was accomplished with the two sutures. - Answer
12001
(Assigned 1 cm repair/scalp as complexity not stated would assume simple.)
Excision of benign lesion: 4.0 cm arm, 2.0 cm leg, and 2.0 cm back - Answer 11404, 11402-51,
11402-59
(Three lesions were excised; therefore, three codes are needed. Arm lesion largest, therefore,
most significant, 11404; leg and back lesions are of same code, therefore, modifier -59 is
assigned to the second 11402 code to indicate separate, distinct lesion. Append modifier -51
when multiple surgical procedures of the skin are performed during the same surgical session.)
WRONG
Excision of benign right forehead lesion. Right temple lesion was clearly evident, 1 x 1 cm,
pigmented, mole-type lesion being excised due to sudden appearance. Area was cleaned,
infiltrated with Xylocaine, and then excised completed and submitted to pathology. - Answer
11441
(Lesion is 1 cm, benign, face. Therefore, code 11441 would be appropriate.)
Replacement of deflated breast implant. Patient noted implant increasingly smaller and soft. A
pinpoint hole on the posterior aspect of the implant was located. The new implant was
inspected, prepared, and inserted using a no-touch technique and inflated with normal saline to
450 cc. - Answer 19325
(New breast augmentation with prosthetic (implant) performed. Removal of old prosthetic is
included in new procedure.) WRONG
Morpheaform basal cell carcinoma of the nose. Incision was made along with marked areas,
measuring 4 cm. Left preauricular incision was made and elliptical FTSG was taken and sutured
into place. - Answer 11644, 15260
(Malignant lesion nose, 4 cm codes to 11644. Full thickness skin graft is coded to the recipient
site, nose; therefore, 15260 would be appropriate.)
Lumpectomy, right breast with axillary node dissection. An elliptical incision was made above
the areola. Incision was made removing the tumor down to the pectoralis fascia. Axillary
dissection was carried out and Jackson-Pratt placed into the axilla and secured. Breast incision
was closed. - Answer 19302-RT
,(Partial mastectomy was performed (19301) with axillary lymphadenectomy. Since the
dissection was completed, code 19302 (partial mastectomy with axillary lymphadectomy) would
be assigned.)
Repair of right index finger laceration. Severely lacerated distal interphalangeal joint of finger
from skill saw. Block performed, and extensive debridement performed prior to closing with 4-0
black Ethilon. - Answer 12041
(When extensive cleaning prior to closure is documented, it qualifies for intermediate closure.
Therefore, intermediate, finger, smallest size (size not stated), code 12041 would be
appropriate.)
Excision malignant lesion, 2.0 cm leg with 0.5 cm margins - Answer 11603
(Assigned malignant lesion, leg, 2.0 cm + margins (0.5 + 0.5) for a total of 3.0 cm. Therefore,
code 11603 would be appropriate.) WRONG
Procedure: Wide excision of left axillary hidradenitis suppurativa. The elliptical marking was
done to the whole area and taken down through the fatty tissue with electrocautery where the
excision was taken deep to accommodate prior sinuses and abscess pockets that reached deep
into the tissue. - Answer 11450
(Excision of lesion codes is not appropriate in this instance, as there is a specific code for
removal of hidradenitis (11450). Simple removal is assigned as the extent of the repair was not
documented and, therefore, assumed to be simple.) WRONG
Redundant skin of the superior eyelids was demarcated and the skin and orbicularis was incised,
elevated, and excised. Protruding fat pads were isolated and excised. - Answer 15822-50
(Superior eyelids would be the upper eyelids and blepharoplasty was performed. Despite the
fact that stated fat pad excised, it does not indicate weighing down lid; therefore, 15822 would
be appropriate. To report bilaterally, append modifier -50 to CPT code 15822.) WRONG
Right modified radical mastectomy was performed as follows: Superior and inferior flaps
developed and breast taken off chest wall and axillary nodes removed as well. - Answer
19307-RT
(Modified radical mastectomy was performed with axillary lymphadenectomy. Therefore, code
19307-RT would be appropriate.)
A patient presents for a 2.5 cm excision of a left foot mass identified as a ganglion cyst on
pathology with simple closure. - Answer 28090-LT
(Mass extends into musculoskeletal tissue; therefore, codes from musculoskeletal section are
assigned. Code 28090 is for excision of foot lesion. Simple closure is included in all procedures in
the musculoskeletal section.)
, Excision of 2.5 cm malignant lesion of arm with 0.5 cm margins. Also removal of 1.5 cm
malignant lesion from scalp was performed. - Answer 11622, 11604-51
(Two lesions were excised; therefore, two codes would be assigned. The lesions were specified
as malignant. Code 11622 for the arm lesion (2.5 cm + 1.0 total margins = 3.5 cm), code 11622.
Second lesion, scalp, 1.5 cm code, 11604-51. Modifier -51 is appropriate for multiple procedures
on the skin during the same surgical session.)
In a 30-year-old patient, two actinic keratoses were removed by cryotherapy, each 0.5 cm in
size. The physician also applied liquid nitrogen to a wart located on the left thumb. - Answer
17000, 17003, 17110-51
(Actinic keratoses are assigned codes in the 17000 series. Two were removed; therefore, 17000
would be assigned for the first lesion, and 17003 for the second lesion. The wart would be
assigned 17110-51 as an additional procedure. 17003 does not need modifier -51 as it is
designated as an "add-on procedure," which does not require modifier -51.)
Diagnosis: Ductal carcinoma in situ, left breast. Procedure: Right partial mastectomy. Incision
was deepened through skin and subcutaneous tissue. We dissected a large ball of breast tissue
out from the medial right breast and used silk suture to close the lumpectomy site. - Answer
19301-RT
(Partial breast was removed; therefore, mastectomy code is appropriate. Code 19301 is
assigned for partial. RT is assigned for right breast.)
Repair of three lacerations as follows: Upper arm, deep subcutaneous layer closed with 4-0
Nylon, skin with 4-0 Vicryl. Second wound on the lower left arm required only skin closure.
Third laceration on the lower leg required 4-0 Nylon for deep subcutaneous layer and 4-0 Nylon
for skin repair measuring 2.8 cm. - Answer 12032, 12001-51
(Only size of third laceration was specified as 2.8 cm. All lacerations/closures of same
complexity and same anatomical groupings are added together. Therefore, the upper arm
laceration and lower leg would be added: 0 cm (size not specified) + 2.8 cm = 2.8 cm
intermediate, arms/legs = 12032. Second wound of arm was simple only. Size was not indicated;
therefore, 12001-51 would be assigned. Modifier -51 is appropriate for multiple procedures
performed on the skin in the same surgical session.)
A 1.3 cm nasal lesion excised from nasal labial area. Pedicle flap was elevated along the nasal
labial area and rotated into position. - Answer 14060
(When adjacent tissue transfers are performed, lesions excised are not separately codable.
Therefore, only 14060 would be appropriate in this instance.)
Excision of benign lesion trunk, 2.7 cm with simple closure
1400
none of these codes
11402
