OST-249: Chapter 7 - Musculoskeletal
System (20000 series) Test Questions
All Solved Correctly.
Arthroscope was inserted into the right shoulder. The rotator cuff showed fraying; however, not
significant enough to require repair. Will follow patient if progresses and surgical intervention
needed. - Answer 29805-RT
(Diagnostic shoulder arthroscopy only performed; therefore, 29805-RT only assigned.)
Bunionectomy with distal first metatarsal osteotomy including K wire fixation, right foot.
Curvilinear incision made over the first metatarsal joint. Prominent hyperostosis was then
removed and all bony edges rasped smooth. The corresponding hyperostosis along the medial
aspect of the base of the proximal phalanx was removed and rasped smooth. A drill hole from
medial to lateral was made through the first metatarsal bed, forming the apex of the osteotomy.
A cut was made in the bone and a similar cut made inferiorly, resulting in a separated fragment
of bone. Second osteotomy was performed laterally and impacted back upon the first
metatarsal shaft, aligning the articular surfaces. The osteotomy was secured utilizing a single K-
wire. - Answer 28299-RT
(Bunionectomy was performed with two/dual osteotomies to correct the misalignment.
Therefore, 28299-RT would be appropriate.)
Treatment/reduction of left tibial shaft fracture with application of short leg walking cast -
Answer 27750-LT
(Initial cast application is included in fracture care; therefore, only the fracture care would be
assigned. Fracture care not further specified; therefore, assumed to be closed without
manipulation, code 27750-LT.) WRONG
Diagnostic arthroscopy, left shoulder with arthroscopic subacromial decompression performed
to visualize rotator cuff. Unable to complete repair arthroscopically; therefore, open repair of
torn rotator cuff was completed. - Answer 23410-LT
(Subacromial decompression would be considered included in the definitive procedure because
it was being performed to visualize the rotator cuff. After attempt, converted to open repair of
rotator cuff, code 23410-LT.) WRONG
Left diagnostic knee arthroscopy with partial lateral meniscectomy and chondroplasty - Answer
29881-LT
(Diagnostic knee arthroscopy is considered bundled in the definitive surgical procedures of the
meniscectomy and, therefore, not separately reportable. Only lateral meniscectomy was
performed; therefore, 29881-LT would be assigned.)
Repair of fractured tibia with syndesmosis injury. With c-arm control and "tight rope" Arthrex
system, a stab incision was made under c-arm control and the drill utilized to drill across the
, syndesmosis. The syndesmosis was held in place using a large clamp and being in good position
using the c-arm for evaluation. The tight rope was then placed through the fibula and tibia and
secured tight and tied. - Answer 27829
(Repair fractured tibia with syndesmodic disruption is assigned 27829.)
Incision carried down to the right metacarpophalangeal joint. Incision was made directly over
the capsule exposing the metacarpophalangeal joint. The extensor digitorum brevis tendon was
exposed and a tendon graft taken from the extensor digitorum brevis tendon. A drill hole was
made at the previous attachment of the ulnar collateral ligament and exiting dorsally on the
proximal phalanx. Through this hole, the extensor digitorum brevis tendon was re-routed exiting
the ulnar side of the joint. Two similar holes were then drilled on the metacarpal head of the
thumb and the tendon graft was pulled through these two hole reestablishing ulnar collateral
ligaments. With the reconstruction of the ulnar collateral ligament completed, the tendon was
folded back on itself and sutured. - Answer 26541-RT
(Reconstruction of the collateral ligament was completed with the use of a graft; therefore,
26541-RT would be assigned.) WRONG
Excision Lesion Shoulder, 1.5 cm - Answer 23075
(Codable as Excision, Tumor, Soft Tissue, Subcutaneous, < 3 cm. Assign code 23075.) WRONG
Transverse incision was made at the right proximal wrist crease. A trocar was passed from the
proximal to distal end, and incision was made in the palm to bring the trocar through. Scope
was then brought in to visualize the transverse carpal ligament, and the carpal ligament was
divided. - Answer 29848-RT
(The carpal ligament was performed arthroscopically; therefore, CPT code 29848 would be
appropriate with modifier RT to indicate right wrist.) WRONG
Incision and drainage of tendon sheath of the right index finger - Answer 26020
(Assign 26020 found in Incision, Hand/Fingers, Incision Tendon Sheath, Finger.) WRONG
Patient fell and fractured right tibia/fibula. ORIF treatment of these shaft fractures with
placement of a plate was performed. - Answer 27758-RT
(ORIF was performed on right tibia/fibular fracture; therefore, 27758-RT would be appropriate.)
Arthroscopic meniscus repair, right medial posterior horn - Answer 29882-RT
(Repair, not excision, of meniscus was performed; therefore, 29882-RT would be appropriate.)
Diagnostic knee arthroscopy, left knee with medial meniscus repair - Answer 29882-LT
(Diagnostic arthroscopy included in arthroscopic surgical procedure; therefore, only 29882-LT
would be assigned.) WRONG
System (20000 series) Test Questions
All Solved Correctly.
Arthroscope was inserted into the right shoulder. The rotator cuff showed fraying; however, not
significant enough to require repair. Will follow patient if progresses and surgical intervention
needed. - Answer 29805-RT
(Diagnostic shoulder arthroscopy only performed; therefore, 29805-RT only assigned.)
Bunionectomy with distal first metatarsal osteotomy including K wire fixation, right foot.
Curvilinear incision made over the first metatarsal joint. Prominent hyperostosis was then
removed and all bony edges rasped smooth. The corresponding hyperostosis along the medial
aspect of the base of the proximal phalanx was removed and rasped smooth. A drill hole from
medial to lateral was made through the first metatarsal bed, forming the apex of the osteotomy.
A cut was made in the bone and a similar cut made inferiorly, resulting in a separated fragment
of bone. Second osteotomy was performed laterally and impacted back upon the first
metatarsal shaft, aligning the articular surfaces. The osteotomy was secured utilizing a single K-
wire. - Answer 28299-RT
(Bunionectomy was performed with two/dual osteotomies to correct the misalignment.
Therefore, 28299-RT would be appropriate.)
Treatment/reduction of left tibial shaft fracture with application of short leg walking cast -
Answer 27750-LT
(Initial cast application is included in fracture care; therefore, only the fracture care would be
assigned. Fracture care not further specified; therefore, assumed to be closed without
manipulation, code 27750-LT.) WRONG
Diagnostic arthroscopy, left shoulder with arthroscopic subacromial decompression performed
to visualize rotator cuff. Unable to complete repair arthroscopically; therefore, open repair of
torn rotator cuff was completed. - Answer 23410-LT
(Subacromial decompression would be considered included in the definitive procedure because
it was being performed to visualize the rotator cuff. After attempt, converted to open repair of
rotator cuff, code 23410-LT.) WRONG
Left diagnostic knee arthroscopy with partial lateral meniscectomy and chondroplasty - Answer
29881-LT
(Diagnostic knee arthroscopy is considered bundled in the definitive surgical procedures of the
meniscectomy and, therefore, not separately reportable. Only lateral meniscectomy was
performed; therefore, 29881-LT would be assigned.)
Repair of fractured tibia with syndesmosis injury. With c-arm control and "tight rope" Arthrex
system, a stab incision was made under c-arm control and the drill utilized to drill across the
, syndesmosis. The syndesmosis was held in place using a large clamp and being in good position
using the c-arm for evaluation. The tight rope was then placed through the fibula and tibia and
secured tight and tied. - Answer 27829
(Repair fractured tibia with syndesmodic disruption is assigned 27829.)
Incision carried down to the right metacarpophalangeal joint. Incision was made directly over
the capsule exposing the metacarpophalangeal joint. The extensor digitorum brevis tendon was
exposed and a tendon graft taken from the extensor digitorum brevis tendon. A drill hole was
made at the previous attachment of the ulnar collateral ligament and exiting dorsally on the
proximal phalanx. Through this hole, the extensor digitorum brevis tendon was re-routed exiting
the ulnar side of the joint. Two similar holes were then drilled on the metacarpal head of the
thumb and the tendon graft was pulled through these two hole reestablishing ulnar collateral
ligaments. With the reconstruction of the ulnar collateral ligament completed, the tendon was
folded back on itself and sutured. - Answer 26541-RT
(Reconstruction of the collateral ligament was completed with the use of a graft; therefore,
26541-RT would be assigned.) WRONG
Excision Lesion Shoulder, 1.5 cm - Answer 23075
(Codable as Excision, Tumor, Soft Tissue, Subcutaneous, < 3 cm. Assign code 23075.) WRONG
Transverse incision was made at the right proximal wrist crease. A trocar was passed from the
proximal to distal end, and incision was made in the palm to bring the trocar through. Scope
was then brought in to visualize the transverse carpal ligament, and the carpal ligament was
divided. - Answer 29848-RT
(The carpal ligament was performed arthroscopically; therefore, CPT code 29848 would be
appropriate with modifier RT to indicate right wrist.) WRONG
Incision and drainage of tendon sheath of the right index finger - Answer 26020
(Assign 26020 found in Incision, Hand/Fingers, Incision Tendon Sheath, Finger.) WRONG
Patient fell and fractured right tibia/fibula. ORIF treatment of these shaft fractures with
placement of a plate was performed. - Answer 27758-RT
(ORIF was performed on right tibia/fibular fracture; therefore, 27758-RT would be appropriate.)
Arthroscopic meniscus repair, right medial posterior horn - Answer 29882-RT
(Repair, not excision, of meniscus was performed; therefore, 29882-RT would be appropriate.)
Diagnostic knee arthroscopy, left knee with medial meniscus repair - Answer 29882-LT
(Diagnostic arthroscopy included in arthroscopic surgical procedure; therefore, only 29882-LT
would be assigned.) WRONG
