AAPC CPC PRACTICE QUESTIONS
qf
WITH SOLUTIONS
A 46-year-qf
old female had a previous biopsy that indicated positive malignant margins anteriorly
qf qf qf qf qf qf qf qf qf qf qf q
on the right side of her neck. A 0.5 cm margin was drawn out and a 15 blade scalpel
f qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
was used for full excision of an 8 cm lesion. Layered closure was performed after the
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
removal. The specimen was sent for permanent histopathologic examination. What
qf qf qf qf qf qf qf qf qf qf qf
are the CPT® code(s) for this procedure?
qf qf qf qf qf qf
A. 11626 qf
B. 11626, 12004-51
qf qf
C. 11626, 12044-51
qf qf
D. 11626, 13132-51, 13133 - ANSWERS-C. 11626, 12044-51
qf qf qf qf qf qf qf
A 30-year-qf
old female is having 15 sq cm debridement performed on an infected ulcer with esch
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ar on the right foot. Using sharp dissection, the ulcer was debrided all the way to dow
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
n to the bone of the foot. The bone had to be minimally trimmed because of a sharp
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
point at the end of the metatarsal. After debriding the area, there was minimal bleedi
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ng because of very poor circulation of the foot. It seems that the toes next to the ulce
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
r may have some involvement and cultures were taken. The area was dressed with s
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
terile saline and dressings and then wrapped. What CPT® code should be reported?
qf qf qf qf qf qf qf qf qf qf qf qf
A. 11043 qf
B. 11012 qf
C. 11044 qf
D. 11042 - ANSWERS-C. 11044
qf qf qf qf
A 64-year-qf
old female who has multiple sclerosis fell from her walker and landed on a glass tabl
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
e. She lacerated her forehead, cheek and chin and the total length of these laceratio
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ns was 6 cm. Her right arm and left leg had deep cuts measuring 5 cm on each extre
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
mity. Her right hand and right foot had a total of 3 cm lacerations. The ED physician r
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
epaired the lacerations as follows: The forehead, cheek, and chin had debridement a
qf qf qf qf qf qf qf qf qf qf qf qf
nd cleaning of glass debris with the lacerations being closed with one layer closure,
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
6-0 Prolene sutures. The arm and leg were repaired by layered closure, 6-
qf qf qf qf qf qf qf qf qf qf qf qf
0 Vicryl subcutaneous sutures and Prolene sutures on the skin. The hand and foot w
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ere closed with adhesive strips. Select the appropriate procedure codes for this visit.
qf qf qf qf qf qf qf qf qf qf qf qf
A. 99283-25, 12014, 12034-59, 12002-59, 11042-51
qf qf qf qf qf
B. 99283-25, 12053, 12034-59, 12002-59
qf qf qf qf
C. 99283-25, 12014, 12034-59, 11042-51
qf qf qf qf
D. 99283-25, 12053, 12034-59 - ANSWERS-D. 99283-25, 12053, 12034-59
qf qf qf qf qf qf qf qf
A 52-year-qf
old female has a mass growing on her right flank for several years. It has finally gotte
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
n significantly larger and is beginning to bother her. She is brought to the Operating
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
Room for definitive excision. An incision was made directly overlying the mass. The
qf qf qf qf qf qf qf qf qf qf qf qf qf
mass was down into the subcutaneous tissue and the surgeon encountered a well e
qf qf qf qf qf qf qf qf qf qf qf qf qf
,ncapsulated lipoma approximately 4 centimeters. This was excised primarily bluntly
qf qf qf qf qf qf qf qf qf qf
with a few attachments divided with electrocautery. What CPT® and ICD-10-
qf qf qf qf qf qf qf qf qf qf
CM codes are reported?
qf qf qf
A. 21932, D17.39
qf qf
B. 21935, D17.1
qf qf
C. 21931, D17.1
qf qf
D. 21925, D17.9 - ANSWERS-C. 21931, D17.1
qf qf qf qf qf qf
Question 5 qf
PREOPERATIVE DIAGNOSIS: Right scaphoid fracture. TYPE OF PROCEDURE: O qf qf qf qf qf qf qf qf
pen reduction and internal fixation of right scaphoid fracture. DESCRIPTION OF PR
qf qf qf qf qf qf qf qf qf qf qf
OCEDURE: The patient was brought to the operating room; anesthesia having been
qf qf qf qf qf qf qf qf qf qf qf qf
administered. The right upper extremity was prepped and draped in a sterile manner. qf qf qf qf qf qf qf qf qf qf qf qf
The limb was elevated, exsanguinated, and a pneumatic arm tourniquet was elevate
qf qf qf qf qf qf qf qf qf qf qf qf
d. An incision was made over the dorsal radial aspect of the right wrist. Skin flaps we
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
re elevated. Cutaneous nerve branches were identified and very gently retracted. Th
qf qf qf qf qf qf qf qf qf qf qf
e interval between the second and third dorsal compartment tendons was identified a
qf qf qf qf qf qf qf qf qf qf qf qf
nd entered. The respective tendons were retracted. A dorsal capsulotomy incision w
qf qf qf qf qf qf qf qf qf qf qf
as made, and the fracture was visualized. There did not appear to be any type of sig
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
nificant defect at the fracture site. A 0.045 Kirschner wire was then used as a guidew
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ire, extending from t - ANSWERS-A. 25628-RT
qf qf qf qf qf qf
An infant with genu valgum is brought to the operating room to have a bilateral medi
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
al distal femur hemiepiphysiodesis done. On each knee, the C-
qf qf qf qf qf qf qf qf qf
arm was used to localize the growth plate. With the growth plate localized, an incisio
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
n was made medially on both sides. This was taken down to the fascia, which was o
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
pened. The periosteum was not opened. The Orthofix® figure-of-
qf qf qf qf qf qf qf qf
eight plate was placed and checked with X-
qf qf qf qf qf qf qf
ray. We then irrigated and closed the medial fascia with 0 Vicryl suture. The skin was
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
closed with 2-0 Vicryl and 3-0 Monocryl®. What procedure code is reported?
qf qf qf qf qf qf qf qf qf qf qf qf
A. 27470-50
qf
B. 27475-50
qf
C. 27477-50qf
D. 27485-50 - ANSWERS-D. 27485-50
qf qf qf qf
The patient is a 67-year-
qf qf qf qf
old gentleman with metastatic colon cancer recently operated on for a brain metasta
qf qf qf qf qf qf qf qf qf qf qf qf
sis, now for placement of an Infuse-A-
qf qf qf qf qf qf
Port for continued chemotherapy. The left subclavian vein was located with a needle
qf qf qf qf qf qf qf qf qf qf qf qf qf
and a guide wire placed. This was confirmed to be in the proper position fluoroscopic
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ally. A transverse incision was made just inferior to this and a subcutaneous pocket c
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
reated just inferior to this. After tunneling, the introducer was placed over the guide w
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ire and the power port line was placed with the introducer and the introducer was pe
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
eled away. The tip was placed in the appropriate position under fluoroscopic guidanc
qf qf qf qf qf qf qf qf qf qf qf qf
e and the catheter trimmed to the appropriate length and secured to the power port d
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
evice. The locking mechanism was fully engaged. The port was placed in the subcut
qf qf qf qf qf qf qf qf qf qf qf qf qf
aneous pocket and everything sat very nicely fluoroscopically. It was secured to the
qf qf qf qf qf qf qf qf qf qf qf qf qf
underlying soft tissue - ANSWERS-C. 36561, 77001-26 qf qf qf qf qf qf
Question 8 qf
,A CT scan identified moderate-sized right pleural effusion in a 50 year-
qf qf qf qf qf qf qf qf qf qf qf
old male. This was estimated to be 800 cc in size and had an appearance of fluid on
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
the CT Scan. A needle is used to puncture through the chest tissues and enter the pl
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
eural cavity to insert a guidewire under ultrasound guidance. A pigtail catheter is the
qf qf qf qf qf qf qf qf qf qf qf qf qf
n inserted at the length of the guidewire and secured by stitches. The catheter will re
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
main in the chest and is connected to drainage system to drain the accumulated fluid
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
. The CPT® code is:
qf qf qf qf
A. 32557 qf
B. 32555 qf
C. 32556 qf
D. 32550 - ANSWERS-A. 32557
qf qf qf qf
The patient is a 59-year-
qf qf qf qf
old white male who underwent carotid endarterectomy for symptomatic left carotid st
qf qf qf qf qf qf qf qf qf qf qf
enosis a year ago. A carotid CT angiogram showed a recurrent 90% left internal caro
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
tid artery stenosis extending into the common carotid artery. He is taken to the opera
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ting room for re- qf qf qf
do left carotid endarterectomy. The left neck was prepped and the previous incision
qf qf qf qf qf qf qf qf qf qf qf qf qf
was carefully reopened. Using sharp dissection, the common carotid artery and its br
qf qf qf qf qf qf qf qf qf qf qf qf
anches were dissected free. The patient was systematically heparinized and after a f
qf qf qf qf qf qf qf qf qf qf qf qf
ew minutes, clamps were applied to the common carotid artery and its branches. A l
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ongitudinal arteriotomy was carried out with findings of extensive layering of intimal h
qf qf qf qf qf qf qf qf qf qf qf qf
yperplasia with no evidence of recurrent atherosclerosis. A silastic balloon-
qf qf qf qf qf qf qf qf qf
tip shunt was inserted first proximally and then distally, with restoration of flow. Sever
qf qf qf qf qf qf qf qf qf qf qf qf qf
al layers of intima were removed and the endart - ANSWERS-B. 35301, 35390
qf qf qf qf qf qf qf qf qf qf qf qf
A 52-year-
qf
old patient is admitted to the hospital for chronic cholecystitis for which a laparoscopi
qf qf qf qf qf qf qf qf qf qf qf qf qf
c cholecystectomy will be performed. A transverse infraumbilical incision was made s
qf qf qf qf qf qf qf qf qf qf qf
harply dissecting to the subcutaneous tissue down to the fascia using access under
qf qf qf qf qf qf qf qf qf qf qf qf qf
direct vision with a Vesi- qf qf qf qf
Port and a scope was placed into the abdomen. Three other ports were inserted und
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
er direct vision. The fundus of the gallbladder was grasped through the lateral port, w
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
here multiple adhesions to the gallbladder were taken down sharply and bluntly: The
qf qf qf qf qf qf qf qf qf qf qf qf qf
gallbladder appeared chronically inflamed. Dissection was carried out to the right of t
qf qf qf qf qf qf qf qf qf qf qf qf
his identifying a small cystic duct and artery, was clipped twice proximally, once dista
qf qf qf qf qf qf qf qf qf qf qf qf qf
lly and transected. The gallbladder was then taken down from the bed using electroc
qf qf qf qf qf qf qf qf qf qf qf qf qf
autery, delivering it into an endo- qf qf qf qf qf
bag and removing it from the abdominal cavity with the umbilical port. What CPT® a
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
nd ICD-10-C - ANSWERS-B. 47562, K81.1
qf qf qf qf qf
A 70-year-
qf
old female who has a history of symptomatic ventral hernia was advised to undergo l
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
aparoscopic evaluation and repair. An incision was made in the epigastrium and diss
qf qf qf qf qf qf qf qf qf qf qf qf
ection was carried down through the subcutaneous tissue. Two 5-
qf qf qf qf qf qf qf qf qf
mm trocars were placed, one in the left upper quadrant and one in the left lower qua
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
drant and the laparoscope was inserted. Dissection was carried down to the area of t
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
he hernia where a small defect was clearly visualized. There was some omentum, w
qf qf qf qf qf qf qf qf qf qf qf qf qf
hich was adhered to the hernia and this was delivered back into the peritoneal cavity.
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
, The mesh was tacked on to cover the defect. What procedure code(s) is (are) report
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ed?
A. 49560, 49568
qf qf
B. 49652 qf
C. 49653 qf
D. 49652, 49568 - ANSWERS-B. 49652
qf qf qf qf qf
The patient is a 50-year-
qf qf qf qf
old gentleman who presented to the emergency room with signs and symptoms of ac
qf qf qf qf qf qf qf qf qf qf qf qf qf
ute appendicitis with possible rupture. He has been brought to the operating room. A
qf qf qf qf qf qf qf qf qf qf qf qf qf
n infraumbilical incision was made which a 5-
qf qf qf qf qf qf qf
mm VersaStep™ trocar was inserted. A 5-mm 0-
qf qf qf qf qf qf qf
degree laparoscope was introduced. A second 5-
qf qf qf qf qf qf qf
mm trocar was placed suprapubically and a 12-
qf qf qf qf qf qf qf
mm trocar in the left lower quadrant. A window was made in the mesoappendix using
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
blunt dissection with no rupture noted. The base of the appendix was then divided a
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
nd placed into an Endo-catch bag and the 12-
qf qf qf qf qf qf qf qf
mm defect was brought out. Select the appropriate code for this procedure:
qf qf qf qf qf qf qf qf qf qf qf
A. 44970 qf
B. 44950 qf
C. 44960 qf
D. 44979 - ANSWERS-A. 44970
qf qf qf qf
A 45-year-
qf
old male is going to donate his kidney to his son. Operating ports where placed in sta
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ndard position and the scope was inserted. Dissection of the renal artery and vein w
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
as performed isolating the kidney. The kidney was suspended only by the renal arter
qf qf qf qf qf qf qf qf qf qf qf qf qf
y and vein as well as the ureter. A stapler was used to divide the vein just above the
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
aorta and three clips across the ureter, extracting the kidney. This was placed on ice
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
and sent to the recipient room. The correct CPT® code is:
qf qf qf qf qf qf qf qf qf qf
A. 50543 qf
B. 50547 qf
C. 50300 qf
D. 50320 - ANSWERS-B. 50547
qf qf qf qf
A 67-year-
qf
old female having urinary incontinence with intrinsic sphincter deficiency is having a
qf qf qf qf qf qf qf qf qf qf qf qf
cystoscopy performed with a placement of a sling. An incision was made over the mi
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
d urethra dissected laterally to urethropelvic ligament. Cystoscopy revealed no penet
qf qf qf qf qf qf qf qf qf qf
ration of the bladder. The edges of the sling were weaved around the junction of the
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
urethra and brought up to the suprapubic incision. A hemostat was then placed betw
qf qf qf qf qf qf qf qf qf qf qf qf qf
een the sling and the urethra, ensuring no tension. What CPT® code(s) is (are) repor
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ted?
A. 57288 qf
B. 57287 qf
C. 57288, 52000-51
qf qf
D. 51992, 52000-51 - ANSWERS-A. 57288
qf qf qf qf qf
A 16-day-
qf
old male baby is in the OR for a repeat circumcision due to redundant foreskin that c
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
qf
WITH SOLUTIONS
A 46-year-qf
old female had a previous biopsy that indicated positive malignant margins anteriorly
qf qf qf qf qf qf qf qf qf qf qf q
on the right side of her neck. A 0.5 cm margin was drawn out and a 15 blade scalpel
f qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
was used for full excision of an 8 cm lesion. Layered closure was performed after the
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
removal. The specimen was sent for permanent histopathologic examination. What
qf qf qf qf qf qf qf qf qf qf qf
are the CPT® code(s) for this procedure?
qf qf qf qf qf qf
A. 11626 qf
B. 11626, 12004-51
qf qf
C. 11626, 12044-51
qf qf
D. 11626, 13132-51, 13133 - ANSWERS-C. 11626, 12044-51
qf qf qf qf qf qf qf
A 30-year-qf
old female is having 15 sq cm debridement performed on an infected ulcer with esch
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ar on the right foot. Using sharp dissection, the ulcer was debrided all the way to dow
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
n to the bone of the foot. The bone had to be minimally trimmed because of a sharp
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
point at the end of the metatarsal. After debriding the area, there was minimal bleedi
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ng because of very poor circulation of the foot. It seems that the toes next to the ulce
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
r may have some involvement and cultures were taken. The area was dressed with s
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
terile saline and dressings and then wrapped. What CPT® code should be reported?
qf qf qf qf qf qf qf qf qf qf qf qf
A. 11043 qf
B. 11012 qf
C. 11044 qf
D. 11042 - ANSWERS-C. 11044
qf qf qf qf
A 64-year-qf
old female who has multiple sclerosis fell from her walker and landed on a glass tabl
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
e. She lacerated her forehead, cheek and chin and the total length of these laceratio
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ns was 6 cm. Her right arm and left leg had deep cuts measuring 5 cm on each extre
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
mity. Her right hand and right foot had a total of 3 cm lacerations. The ED physician r
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
epaired the lacerations as follows: The forehead, cheek, and chin had debridement a
qf qf qf qf qf qf qf qf qf qf qf qf
nd cleaning of glass debris with the lacerations being closed with one layer closure,
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
6-0 Prolene sutures. The arm and leg were repaired by layered closure, 6-
qf qf qf qf qf qf qf qf qf qf qf qf
0 Vicryl subcutaneous sutures and Prolene sutures on the skin. The hand and foot w
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ere closed with adhesive strips. Select the appropriate procedure codes for this visit.
qf qf qf qf qf qf qf qf qf qf qf qf
A. 99283-25, 12014, 12034-59, 12002-59, 11042-51
qf qf qf qf qf
B. 99283-25, 12053, 12034-59, 12002-59
qf qf qf qf
C. 99283-25, 12014, 12034-59, 11042-51
qf qf qf qf
D. 99283-25, 12053, 12034-59 - ANSWERS-D. 99283-25, 12053, 12034-59
qf qf qf qf qf qf qf qf
A 52-year-qf
old female has a mass growing on her right flank for several years. It has finally gotte
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
n significantly larger and is beginning to bother her. She is brought to the Operating
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
Room for definitive excision. An incision was made directly overlying the mass. The
qf qf qf qf qf qf qf qf qf qf qf qf qf
mass was down into the subcutaneous tissue and the surgeon encountered a well e
qf qf qf qf qf qf qf qf qf qf qf qf qf
,ncapsulated lipoma approximately 4 centimeters. This was excised primarily bluntly
qf qf qf qf qf qf qf qf qf qf
with a few attachments divided with electrocautery. What CPT® and ICD-10-
qf qf qf qf qf qf qf qf qf qf
CM codes are reported?
qf qf qf
A. 21932, D17.39
qf qf
B. 21935, D17.1
qf qf
C. 21931, D17.1
qf qf
D. 21925, D17.9 - ANSWERS-C. 21931, D17.1
qf qf qf qf qf qf
Question 5 qf
PREOPERATIVE DIAGNOSIS: Right scaphoid fracture. TYPE OF PROCEDURE: O qf qf qf qf qf qf qf qf
pen reduction and internal fixation of right scaphoid fracture. DESCRIPTION OF PR
qf qf qf qf qf qf qf qf qf qf qf
OCEDURE: The patient was brought to the operating room; anesthesia having been
qf qf qf qf qf qf qf qf qf qf qf qf
administered. The right upper extremity was prepped and draped in a sterile manner. qf qf qf qf qf qf qf qf qf qf qf qf
The limb was elevated, exsanguinated, and a pneumatic arm tourniquet was elevate
qf qf qf qf qf qf qf qf qf qf qf qf
d. An incision was made over the dorsal radial aspect of the right wrist. Skin flaps we
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
re elevated. Cutaneous nerve branches were identified and very gently retracted. Th
qf qf qf qf qf qf qf qf qf qf qf
e interval between the second and third dorsal compartment tendons was identified a
qf qf qf qf qf qf qf qf qf qf qf qf
nd entered. The respective tendons were retracted. A dorsal capsulotomy incision w
qf qf qf qf qf qf qf qf qf qf qf
as made, and the fracture was visualized. There did not appear to be any type of sig
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
nificant defect at the fracture site. A 0.045 Kirschner wire was then used as a guidew
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ire, extending from t - ANSWERS-A. 25628-RT
qf qf qf qf qf qf
An infant with genu valgum is brought to the operating room to have a bilateral medi
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
al distal femur hemiepiphysiodesis done. On each knee, the C-
qf qf qf qf qf qf qf qf qf
arm was used to localize the growth plate. With the growth plate localized, an incisio
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
n was made medially on both sides. This was taken down to the fascia, which was o
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
pened. The periosteum was not opened. The Orthofix® figure-of-
qf qf qf qf qf qf qf qf
eight plate was placed and checked with X-
qf qf qf qf qf qf qf
ray. We then irrigated and closed the medial fascia with 0 Vicryl suture. The skin was
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
closed with 2-0 Vicryl and 3-0 Monocryl®. What procedure code is reported?
qf qf qf qf qf qf qf qf qf qf qf qf
A. 27470-50
qf
B. 27475-50
qf
C. 27477-50qf
D. 27485-50 - ANSWERS-D. 27485-50
qf qf qf qf
The patient is a 67-year-
qf qf qf qf
old gentleman with metastatic colon cancer recently operated on for a brain metasta
qf qf qf qf qf qf qf qf qf qf qf qf
sis, now for placement of an Infuse-A-
qf qf qf qf qf qf
Port for continued chemotherapy. The left subclavian vein was located with a needle
qf qf qf qf qf qf qf qf qf qf qf qf qf
and a guide wire placed. This was confirmed to be in the proper position fluoroscopic
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ally. A transverse incision was made just inferior to this and a subcutaneous pocket c
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
reated just inferior to this. After tunneling, the introducer was placed over the guide w
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ire and the power port line was placed with the introducer and the introducer was pe
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
eled away. The tip was placed in the appropriate position under fluoroscopic guidanc
qf qf qf qf qf qf qf qf qf qf qf qf
e and the catheter trimmed to the appropriate length and secured to the power port d
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
evice. The locking mechanism was fully engaged. The port was placed in the subcut
qf qf qf qf qf qf qf qf qf qf qf qf qf
aneous pocket and everything sat very nicely fluoroscopically. It was secured to the
qf qf qf qf qf qf qf qf qf qf qf qf qf
underlying soft tissue - ANSWERS-C. 36561, 77001-26 qf qf qf qf qf qf
Question 8 qf
,A CT scan identified moderate-sized right pleural effusion in a 50 year-
qf qf qf qf qf qf qf qf qf qf qf
old male. This was estimated to be 800 cc in size and had an appearance of fluid on
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
the CT Scan. A needle is used to puncture through the chest tissues and enter the pl
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
eural cavity to insert a guidewire under ultrasound guidance. A pigtail catheter is the
qf qf qf qf qf qf qf qf qf qf qf qf qf
n inserted at the length of the guidewire and secured by stitches. The catheter will re
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
main in the chest and is connected to drainage system to drain the accumulated fluid
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
. The CPT® code is:
qf qf qf qf
A. 32557 qf
B. 32555 qf
C. 32556 qf
D. 32550 - ANSWERS-A. 32557
qf qf qf qf
The patient is a 59-year-
qf qf qf qf
old white male who underwent carotid endarterectomy for symptomatic left carotid st
qf qf qf qf qf qf qf qf qf qf qf
enosis a year ago. A carotid CT angiogram showed a recurrent 90% left internal caro
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
tid artery stenosis extending into the common carotid artery. He is taken to the opera
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ting room for re- qf qf qf
do left carotid endarterectomy. The left neck was prepped and the previous incision
qf qf qf qf qf qf qf qf qf qf qf qf qf
was carefully reopened. Using sharp dissection, the common carotid artery and its br
qf qf qf qf qf qf qf qf qf qf qf qf
anches were dissected free. The patient was systematically heparinized and after a f
qf qf qf qf qf qf qf qf qf qf qf qf
ew minutes, clamps were applied to the common carotid artery and its branches. A l
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ongitudinal arteriotomy was carried out with findings of extensive layering of intimal h
qf qf qf qf qf qf qf qf qf qf qf qf
yperplasia with no evidence of recurrent atherosclerosis. A silastic balloon-
qf qf qf qf qf qf qf qf qf
tip shunt was inserted first proximally and then distally, with restoration of flow. Sever
qf qf qf qf qf qf qf qf qf qf qf qf qf
al layers of intima were removed and the endart - ANSWERS-B. 35301, 35390
qf qf qf qf qf qf qf qf qf qf qf qf
A 52-year-
qf
old patient is admitted to the hospital for chronic cholecystitis for which a laparoscopi
qf qf qf qf qf qf qf qf qf qf qf qf qf
c cholecystectomy will be performed. A transverse infraumbilical incision was made s
qf qf qf qf qf qf qf qf qf qf qf
harply dissecting to the subcutaneous tissue down to the fascia using access under
qf qf qf qf qf qf qf qf qf qf qf qf qf
direct vision with a Vesi- qf qf qf qf
Port and a scope was placed into the abdomen. Three other ports were inserted und
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
er direct vision. The fundus of the gallbladder was grasped through the lateral port, w
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
here multiple adhesions to the gallbladder were taken down sharply and bluntly: The
qf qf qf qf qf qf qf qf qf qf qf qf qf
gallbladder appeared chronically inflamed. Dissection was carried out to the right of t
qf qf qf qf qf qf qf qf qf qf qf qf
his identifying a small cystic duct and artery, was clipped twice proximally, once dista
qf qf qf qf qf qf qf qf qf qf qf qf qf
lly and transected. The gallbladder was then taken down from the bed using electroc
qf qf qf qf qf qf qf qf qf qf qf qf qf
autery, delivering it into an endo- qf qf qf qf qf
bag and removing it from the abdominal cavity with the umbilical port. What CPT® a
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
nd ICD-10-C - ANSWERS-B. 47562, K81.1
qf qf qf qf qf
A 70-year-
qf
old female who has a history of symptomatic ventral hernia was advised to undergo l
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
aparoscopic evaluation and repair. An incision was made in the epigastrium and diss
qf qf qf qf qf qf qf qf qf qf qf qf
ection was carried down through the subcutaneous tissue. Two 5-
qf qf qf qf qf qf qf qf qf
mm trocars were placed, one in the left upper quadrant and one in the left lower qua
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
drant and the laparoscope was inserted. Dissection was carried down to the area of t
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
he hernia where a small defect was clearly visualized. There was some omentum, w
qf qf qf qf qf qf qf qf qf qf qf qf qf
hich was adhered to the hernia and this was delivered back into the peritoneal cavity.
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
, The mesh was tacked on to cover the defect. What procedure code(s) is (are) report
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ed?
A. 49560, 49568
qf qf
B. 49652 qf
C. 49653 qf
D. 49652, 49568 - ANSWERS-B. 49652
qf qf qf qf qf
The patient is a 50-year-
qf qf qf qf
old gentleman who presented to the emergency room with signs and symptoms of ac
qf qf qf qf qf qf qf qf qf qf qf qf qf
ute appendicitis with possible rupture. He has been brought to the operating room. A
qf qf qf qf qf qf qf qf qf qf qf qf qf
n infraumbilical incision was made which a 5-
qf qf qf qf qf qf qf
mm VersaStep™ trocar was inserted. A 5-mm 0-
qf qf qf qf qf qf qf
degree laparoscope was introduced. A second 5-
qf qf qf qf qf qf qf
mm trocar was placed suprapubically and a 12-
qf qf qf qf qf qf qf
mm trocar in the left lower quadrant. A window was made in the mesoappendix using
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
blunt dissection with no rupture noted. The base of the appendix was then divided a
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
nd placed into an Endo-catch bag and the 12-
qf qf qf qf qf qf qf qf
mm defect was brought out. Select the appropriate code for this procedure:
qf qf qf qf qf qf qf qf qf qf qf
A. 44970 qf
B. 44950 qf
C. 44960 qf
D. 44979 - ANSWERS-A. 44970
qf qf qf qf
A 45-year-
qf
old male is going to donate his kidney to his son. Operating ports where placed in sta
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ndard position and the scope was inserted. Dissection of the renal artery and vein w
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
as performed isolating the kidney. The kidney was suspended only by the renal arter
qf qf qf qf qf qf qf qf qf qf qf qf qf
y and vein as well as the ureter. A stapler was used to divide the vein just above the
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
aorta and three clips across the ureter, extracting the kidney. This was placed on ice
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
and sent to the recipient room. The correct CPT® code is:
qf qf qf qf qf qf qf qf qf qf
A. 50543 qf
B. 50547 qf
C. 50300 qf
D. 50320 - ANSWERS-B. 50547
qf qf qf qf
A 67-year-
qf
old female having urinary incontinence with intrinsic sphincter deficiency is having a
qf qf qf qf qf qf qf qf qf qf qf qf
cystoscopy performed with a placement of a sling. An incision was made over the mi
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
d urethra dissected laterally to urethropelvic ligament. Cystoscopy revealed no penet
qf qf qf qf qf qf qf qf qf qf
ration of the bladder. The edges of the sling were weaved around the junction of the
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
urethra and brought up to the suprapubic incision. A hemostat was then placed betw
qf qf qf qf qf qf qf qf qf qf qf qf qf
een the sling and the urethra, ensuring no tension. What CPT® code(s) is (are) repor
qf qf qf qf qf qf qf qf qf qf qf qf qf qf
ted?
A. 57288 qf
B. 57287 qf
C. 57288, 52000-51
qf qf
D. 51992, 52000-51 - ANSWERS-A. 57288
qf qf qf qf qf
A 16-day-
qf
old male baby is in the OR for a repeat circumcision due to redundant foreskin that c
qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf qf
