CPC PRACTICE EXAM 2 VERIFIED TEST PAPER
QUESTIONS AND SOLUTIONS
◉ Benign hypertrophy of prostate.
Answer: N40.0
The diagnosis of benign prostatic hypertrophy did not indicate any
lower urinary symptoms; therefore, the benign hypertrophy of the
prostate without lower urinary symptoms is correct, ICD-10 code
N40.0. Code N40.1 is for benign prostatic hypertrophy with lower
urinary symptoms; however, these symptoms are not specified in
this scenario. N42.9 is for unspecified disease of the prostate and
only be assigned when there is not sufficient documentation to
assign a more specific code. Q55.4 is for a congenital prostatic
disease. The student should recognize that "Q" codes are for
congenital anomalies, and therefore, a code beginning with "Q" is
not appropriate in this encounter.
◉ What is the CPT code for the decompression of the median nerve
found in the space in the wrist on the palmar side?.
Answer: 64721
Code 64721 is assigned for decompression of the median nerve at
carpal tunnel. The remaining selections are for decompression of
other nerves, such as the ulnar nerve at the wrist, nerve of the
hand/foot or major peripheral nerve.
,◉ Repair, 6.0 cm leg, intermediate.
Answer: 12032
Since the laceration was specified as intermediate, a code from
repair/closure, intermediate is assigned based on location (leg) and
size 6.0 cm. CPT code 12032 covers intermediate repairs/closures of
the leg 2.5-7.0 cm. The remaining selections represent simple
repairs or repairs to anatomical areas or sizes that are not
represented in this scenario.
◉ Left and right mammogram for benign fibrocystic breast disease.
Answer: 77066
Diagnostic mammogram code 77066 is already bilateral, therefore,
there is no need for modifier -50. The remaining selections are for
unilateral diagnostic mammogram or an MRI of the breast and,
therefore, are not correct in this instance.
◉ Topical tetracaine was applied along with YAG capsulotomy lens
for left cataract extraction. Good visualization of posterior capsular
opacification was obtained and a total of 41 shots at 2 millijoules
were utilized to open the posterior capsule.
Answer: 66821-LT
YAG laser is utilized to treat cataract (posterior capsular
opacification), which codes to 66821-LT. There was no mention that
an intraocular lens was implanted at the time of the cataract
extraction, therefore, codes for cataract extraction with intraocular
lens are not appropriate. The remaining selection is for cataract
,extraction, however, by stab incision which was not the case in this
instance.
◉ Triglycerides.
Answer: Triglycerides are assigned code 84478. Two (2) of the
remaining selections are for thyroid testing, and SGOT, neither of
which were performed in this instance.
◉ Treatment of molluscum contagiosum by cryotherapy. Patient was
given light sedation and the two lesions were exposed. Curettage
was attempted, but the lesions were not easily removed; therefore,
cryotherapy was used to treat each of the lesions through two
freeze/thaw cycles..
Answer: Two (2) lesions were involved, both molluscum
contagiosum, which according to the CPT is assigned 17110 for
destruction benign lesions other than skin tags or cutaneous
vascular proliferative lesions, up to 14 lesions. The remaining
selections are for destruction of premalignant lesions, or benign
lesions other than skin tags or cutaneous vascular proliferative
lesions 15 and over.
◉ Upper GI with barium contrast for abdominal pain, nausea. There
is mild esophageal dysmotility, followed by multiple contractions in
the distal esophagus. Esophageal mucosa appears normal. No
evidence of esophagitis, stomach is negative. No ulcer seen..
, Answer: Assign CPT code 74240 for upper gastrointestinal study
with barium contrast from diagnostic X-ray, gastrointestinal tract.
The remaining selections are for swallowing studies, small intestine
follows through upper GI, however, performed with double contrast,
which is not documented in this scenario.
◉ This Physician Self-Referral Law prohibits a physician from
making referrals for certain designated health services payable by
Medicare to an entity with which he or she (or an immediate family
member) has a financial ownership interest or compensation
arrangement, unless an exception applies:.
Answer: Under the Stark Law, physicians are prohibited from
making referrals to entities in which they have a financial
ownership. The Medicare False Claims Program was enacted for the
purpose of identifying potential fraud and abuse practices. The
Medicare Integrity Program safeguards the Medicare Program
against fraud, abuse and waste. The Zone Program Integrity
Contractor (ZPIC) was established by CMS to combat fraud, waste
and abuse.
◉ The patient is a 42-year-old female who was discovered to have
breast cancer on the right side. She was treated with mastectomy
followed by chemotherapy and radiation therapy. She now elects to
proceed with reconstruction by single pediculate myocutaneous
TRAM flap, which is performed uneventfully..
Answer: 19367-RT
QUESTIONS AND SOLUTIONS
◉ Benign hypertrophy of prostate.
Answer: N40.0
The diagnosis of benign prostatic hypertrophy did not indicate any
lower urinary symptoms; therefore, the benign hypertrophy of the
prostate without lower urinary symptoms is correct, ICD-10 code
N40.0. Code N40.1 is for benign prostatic hypertrophy with lower
urinary symptoms; however, these symptoms are not specified in
this scenario. N42.9 is for unspecified disease of the prostate and
only be assigned when there is not sufficient documentation to
assign a more specific code. Q55.4 is for a congenital prostatic
disease. The student should recognize that "Q" codes are for
congenital anomalies, and therefore, a code beginning with "Q" is
not appropriate in this encounter.
◉ What is the CPT code for the decompression of the median nerve
found in the space in the wrist on the palmar side?.
Answer: 64721
Code 64721 is assigned for decompression of the median nerve at
carpal tunnel. The remaining selections are for decompression of
other nerves, such as the ulnar nerve at the wrist, nerve of the
hand/foot or major peripheral nerve.
,◉ Repair, 6.0 cm leg, intermediate.
Answer: 12032
Since the laceration was specified as intermediate, a code from
repair/closure, intermediate is assigned based on location (leg) and
size 6.0 cm. CPT code 12032 covers intermediate repairs/closures of
the leg 2.5-7.0 cm. The remaining selections represent simple
repairs or repairs to anatomical areas or sizes that are not
represented in this scenario.
◉ Left and right mammogram for benign fibrocystic breast disease.
Answer: 77066
Diagnostic mammogram code 77066 is already bilateral, therefore,
there is no need for modifier -50. The remaining selections are for
unilateral diagnostic mammogram or an MRI of the breast and,
therefore, are not correct in this instance.
◉ Topical tetracaine was applied along with YAG capsulotomy lens
for left cataract extraction. Good visualization of posterior capsular
opacification was obtained and a total of 41 shots at 2 millijoules
were utilized to open the posterior capsule.
Answer: 66821-LT
YAG laser is utilized to treat cataract (posterior capsular
opacification), which codes to 66821-LT. There was no mention that
an intraocular lens was implanted at the time of the cataract
extraction, therefore, codes for cataract extraction with intraocular
lens are not appropriate. The remaining selection is for cataract
,extraction, however, by stab incision which was not the case in this
instance.
◉ Triglycerides.
Answer: Triglycerides are assigned code 84478. Two (2) of the
remaining selections are for thyroid testing, and SGOT, neither of
which were performed in this instance.
◉ Treatment of molluscum contagiosum by cryotherapy. Patient was
given light sedation and the two lesions were exposed. Curettage
was attempted, but the lesions were not easily removed; therefore,
cryotherapy was used to treat each of the lesions through two
freeze/thaw cycles..
Answer: Two (2) lesions were involved, both molluscum
contagiosum, which according to the CPT is assigned 17110 for
destruction benign lesions other than skin tags or cutaneous
vascular proliferative lesions, up to 14 lesions. The remaining
selections are for destruction of premalignant lesions, or benign
lesions other than skin tags or cutaneous vascular proliferative
lesions 15 and over.
◉ Upper GI with barium contrast for abdominal pain, nausea. There
is mild esophageal dysmotility, followed by multiple contractions in
the distal esophagus. Esophageal mucosa appears normal. No
evidence of esophagitis, stomach is negative. No ulcer seen..
, Answer: Assign CPT code 74240 for upper gastrointestinal study
with barium contrast from diagnostic X-ray, gastrointestinal tract.
The remaining selections are for swallowing studies, small intestine
follows through upper GI, however, performed with double contrast,
which is not documented in this scenario.
◉ This Physician Self-Referral Law prohibits a physician from
making referrals for certain designated health services payable by
Medicare to an entity with which he or she (or an immediate family
member) has a financial ownership interest or compensation
arrangement, unless an exception applies:.
Answer: Under the Stark Law, physicians are prohibited from
making referrals to entities in which they have a financial
ownership. The Medicare False Claims Program was enacted for the
purpose of identifying potential fraud and abuse practices. The
Medicare Integrity Program safeguards the Medicare Program
against fraud, abuse and waste. The Zone Program Integrity
Contractor (ZPIC) was established by CMS to combat fraud, waste
and abuse.
◉ The patient is a 42-year-old female who was discovered to have
breast cancer on the right side. She was treated with mastectomy
followed by chemotherapy and radiation therapy. She now elects to
proceed with reconstruction by single pediculate myocutaneous
TRAM flap, which is performed uneventfully..
Answer: 19367-RT
