OST-249: Chapter 11 - Nervous System
Coding (60000 Series) Test Questions
All Solved.
Trigger point injections. Patient with myofascial pain syndrome in the lower lumbar and upper
sacral areas. Palpation of the longissimus muscle and the multifidus muscle for a total of eight
trigger points. Trigger points were marked, and Marcaine 0.25% was injected into each trigger
point. - Answer 20552
(Two muscles were injected; therefore, code 20552 should be assigned, located in the
Musculoskeletal section, General Introduction/Removal section.)
Cervical epidural steroid injections. Five cc of normal saline with 40 mg of Depo-Medrol was
injected through the epidural space and the needle was removed. - Answer 62320
(Assign code 62320 when cervical epidural injection is performed without imaging. Found in the
Nervous System, Surgical Procedure, Spine and Spinal Canal section.)
Paravertebral joint injection, C1-C2 - Answer 64490
(Code 64490 is assigned for joint injection into the paravertebral joint.)
Extracapsular cataract extraction with IOL, right eye - Answer 66984-RT
(When cataract extraction with intraocular lens (IOL) implanted during same session is
performed, assign code 66984-RT (no documentation of complex).)
Suture of three (3) digital nerves of hand - Answer 64831, 64832 x 2
(Suturing of three digital nerves of the hands would be assigned 64831 for the first nerve, and
64832 x 2 for the two additional nerves. Found in the Nervous System section, Neurorrhaphy.)
Extracapsular cataract with IOL for cataract of the left eye - Answer 66984-LT
(Removal of extracapsular cataract with lens implant is assigned 66984-LT.)
Elevation of simple skull fracture - Answer 62000
(Code 62000 should be assigned for the elevation of a simple skull fracture found in the Nervous
System section, Surgical Procedures of the Skull, Meninges, Brain, Repair Procedures on the
Skull, Meninges, and Brain.)
Right L2/L3, L3/4, L4/5 lumbar facet injections - Answer 64493-RT, 64494-RT, 64495-RT
, (The assignment would be 64493-RT for first joint, 64494-RT for second joint, and 64495-RT for
third joint at lumbar level. As codes 64494 and 64495 are add-on codes, no modifier -51 is
necessary.)
Cataract of left eye. Crescent blade was used to shelve into the cornea. Keratome used to enter
anterior chamber. Paracentesis was created at the temporal limbus. Tip of the knife was used to
perform capsulorrhexis. A phacoemulsification instrument was used to remove the nuclear
cataract and a lens was then placed into position. - Answer 66984-LT
(Removal of extracapsular cataract with lens implant is assigned 66984-LT. Cataract removal was
performed extracapsular as noted by the fact that the keratome only entered the anterior
chamber.)
A 15 blade was used to make a stab incision for extracapsular lens extraction and the nucleus of
the lens was hydrodissected. Phacoemulsification of the lens was carried out and residual cortex
aspirated. An Allergan Model AR20, 15 diopter lens was introduced and placed in the right eye. -
Answer 66984-LT
(Removal of extracapsular cataract with lens implant is assigned 66984-LT.)
Strabismus surgery, two horizontal muscles, right eye - Answer 67312
(When strabismus surgery is performed on two horizontal muscles, code 67312 is assigned.
Found in the Eye section, Ocular Adnexa, Extraocular Muscle.)
Repair of carpal tunnel nerve - Answer 64721
(When performed open, carpal tunnel, also referred to as the median nerve at the carpal
tunnel, repair should be assigned 64721 found in the Nervous System section, Surgical
Procedures on Extracranial Nerve and Autonomic Nervous System, Neuroplasty section.)
A new patient presents to office with complaints of ear pain. The physician takes the patient's
history, performs an examination, and diagnoses an abscess of the external ear that is incised
and drained. - Answer 69000 and E/M-25
(Evaluation and management (E/M) is necessary to determine problem and treatment. E/M
would be assigned with modifier -25 to indicate "significantly separately identifiable E/M."
Incision and drainage were then performed of the external ear, code 69000.)
A patient placed in the sitting position and palpation of the longissimus muscle and multifidus
muscle revealed seven trigger points. These were marked, skin prepped, and each trigger point
injected with Marcaine 0.25%. - Answer 20552
(When one to two muscle groups are injected, code 20552 is assigned, not the number of
trigger point injections.)
Carpal tunnel surgery, left, performed arthroscopically - Answer 29848-LT
Coding (60000 Series) Test Questions
All Solved.
Trigger point injections. Patient with myofascial pain syndrome in the lower lumbar and upper
sacral areas. Palpation of the longissimus muscle and the multifidus muscle for a total of eight
trigger points. Trigger points were marked, and Marcaine 0.25% was injected into each trigger
point. - Answer 20552
(Two muscles were injected; therefore, code 20552 should be assigned, located in the
Musculoskeletal section, General Introduction/Removal section.)
Cervical epidural steroid injections. Five cc of normal saline with 40 mg of Depo-Medrol was
injected through the epidural space and the needle was removed. - Answer 62320
(Assign code 62320 when cervical epidural injection is performed without imaging. Found in the
Nervous System, Surgical Procedure, Spine and Spinal Canal section.)
Paravertebral joint injection, C1-C2 - Answer 64490
(Code 64490 is assigned for joint injection into the paravertebral joint.)
Extracapsular cataract extraction with IOL, right eye - Answer 66984-RT
(When cataract extraction with intraocular lens (IOL) implanted during same session is
performed, assign code 66984-RT (no documentation of complex).)
Suture of three (3) digital nerves of hand - Answer 64831, 64832 x 2
(Suturing of three digital nerves of the hands would be assigned 64831 for the first nerve, and
64832 x 2 for the two additional nerves. Found in the Nervous System section, Neurorrhaphy.)
Extracapsular cataract with IOL for cataract of the left eye - Answer 66984-LT
(Removal of extracapsular cataract with lens implant is assigned 66984-LT.)
Elevation of simple skull fracture - Answer 62000
(Code 62000 should be assigned for the elevation of a simple skull fracture found in the Nervous
System section, Surgical Procedures of the Skull, Meninges, Brain, Repair Procedures on the
Skull, Meninges, and Brain.)
Right L2/L3, L3/4, L4/5 lumbar facet injections - Answer 64493-RT, 64494-RT, 64495-RT
, (The assignment would be 64493-RT for first joint, 64494-RT for second joint, and 64495-RT for
third joint at lumbar level. As codes 64494 and 64495 are add-on codes, no modifier -51 is
necessary.)
Cataract of left eye. Crescent blade was used to shelve into the cornea. Keratome used to enter
anterior chamber. Paracentesis was created at the temporal limbus. Tip of the knife was used to
perform capsulorrhexis. A phacoemulsification instrument was used to remove the nuclear
cataract and a lens was then placed into position. - Answer 66984-LT
(Removal of extracapsular cataract with lens implant is assigned 66984-LT. Cataract removal was
performed extracapsular as noted by the fact that the keratome only entered the anterior
chamber.)
A 15 blade was used to make a stab incision for extracapsular lens extraction and the nucleus of
the lens was hydrodissected. Phacoemulsification of the lens was carried out and residual cortex
aspirated. An Allergan Model AR20, 15 diopter lens was introduced and placed in the right eye. -
Answer 66984-LT
(Removal of extracapsular cataract with lens implant is assigned 66984-LT.)
Strabismus surgery, two horizontal muscles, right eye - Answer 67312
(When strabismus surgery is performed on two horizontal muscles, code 67312 is assigned.
Found in the Eye section, Ocular Adnexa, Extraocular Muscle.)
Repair of carpal tunnel nerve - Answer 64721
(When performed open, carpal tunnel, also referred to as the median nerve at the carpal
tunnel, repair should be assigned 64721 found in the Nervous System section, Surgical
Procedures on Extracranial Nerve and Autonomic Nervous System, Neuroplasty section.)
A new patient presents to office with complaints of ear pain. The physician takes the patient's
history, performs an examination, and diagnoses an abscess of the external ear that is incised
and drained. - Answer 69000 and E/M-25
(Evaluation and management (E/M) is necessary to determine problem and treatment. E/M
would be assigned with modifier -25 to indicate "significantly separately identifiable E/M."
Incision and drainage were then performed of the external ear, code 69000.)
A patient placed in the sitting position and palpation of the longissimus muscle and multifidus
muscle revealed seven trigger points. These were marked, skin prepped, and each trigger point
injected with Marcaine 0.25%. - Answer 20552
(When one to two muscle groups are injected, code 20552 is assigned, not the number of
trigger point injections.)
Carpal tunnel surgery, left, performed arthroscopically - Answer 29848-LT
