CPC PRACTICE EXAM 3 COMPREHENSIVE
QUESTIONS AND ANSWERS GRADED A+
◉ Procedure Diagnosis: Squamous cell carcinoma, neck. Procedure:
Wide local excision of 3.0 cm with 0.3 cm margin squamous cell
carcinoma of the neck with a 4 cm closure. Procedure: The area of
the patient's neck was examined. The site of intended excision was
marked out. The site was then prepped. The patient was then
prepped and draped in the usual fashion. A 15 blade scalpel was
then used to make an incision in the previously marked site. It was
carried down through the epidermis and there was extensive
undermining. The lesion was then sharply dissected off underlying
tissue bed using a 15-blade scalpel. It was tagged for pathologic
orientation. The hyfrecator was used for hemostasis. The wound was
then closed by advancing the tissue surrounding the lesion and
closing in multilayers with 3-0 Vicryl for the deep layer, followed by
5-0 Prolene for the skin. The skin closure was in a running
subcuticular fashion. Steri.
Answer: A. 13132, 11624-51, C44.42
◉ This 52 year-old female presents to the general surgeon for I&D of
a reoccurring carbuncle at the base of her neck. When the patient is
appropriately prepped, and anesthetized, the provider makes a
circumferential incision over the area of the abscess. The incision is
deepened through the vascular inner layer of skin and down to the
deep level of abscess cavity. The surgeon opens the abscess and
excises the inflamed fatty and dead tissues within the cavity and
,drains the pus completely. The abscess cavity is packed with gauze
and left open with a drain for continuous discharge of fluids. A
sample of the abscess contents of pus was sent to the lab. The
patient is given instructions on wound care, prescribed an antibiotic
and will return to the surgeon's office in 10 days for follow up. The
lab report returned the presence of Staphylococcus aureus.
What CPT® and ICD-10-CM codes are reported?
A. 10061, L02.13, B95.61.
Answer: A. 10061, L02.13, B95.61
◉ A 45 year-old male patient diagnosed with spinal stenosis L3 to
L5 level presents for an arthrodesis and laminectomy. The patient is
prepped and anesthetized and placed in the prone position. Using a
posterior interbody technique, the provider makes an incision in the
lower back over the L3-L5. With retractors, the soft tissues are
separated to gain access to the vertebrae. Fragments from nearby
cortical bone and articular cartilage are excised. The lamina was
excised and the bone chips were inserted to fuse L3-L4 interspace
and L4-L5 interspace. The area was irrigated and a layered closure
was used to close the incision.
What CPT® codes are reported?
A. 22630, 22632 x 3
B. 22630, 22632
, C. 22633, 22634 x 2
D. 22612, 22614.
Answer: B. 22630, 22632
◉ A 52 year-old female is scheduled for surgery for a radical
resection of a sarcoma on her back. After administration of proper
anesthesia, the operative site is prepped and draped in the usual
fashion. A curvilinear incision is made around the tumor site. The
incision is further extended deep and around the tumor. The fascial,
and subfascial layers are raised to adequately expose the underlying
anatomy. Neurovascular structures in the area are identified and
preserved. The tumor is localized and dissected from the
surrounding tissue margin, and removed. To rule out further
malignancy, an additional surrounding wide area of margin is also
dissected and removed. After satisfactory radical removal of the
tumor and surrounding margin the incision is repaired in the
layered fashion. The excised diameter of the tumor is 4.5 cm.
Which CPT® and diagnosis are reported?
A. 21932, C49.6
B. 21935, D17.1
C. 21935, C49.6
D. 2192.
Answer: B. 21935, D17.1
QUESTIONS AND ANSWERS GRADED A+
◉ Procedure Diagnosis: Squamous cell carcinoma, neck. Procedure:
Wide local excision of 3.0 cm with 0.3 cm margin squamous cell
carcinoma of the neck with a 4 cm closure. Procedure: The area of
the patient's neck was examined. The site of intended excision was
marked out. The site was then prepped. The patient was then
prepped and draped in the usual fashion. A 15 blade scalpel was
then used to make an incision in the previously marked site. It was
carried down through the epidermis and there was extensive
undermining. The lesion was then sharply dissected off underlying
tissue bed using a 15-blade scalpel. It was tagged for pathologic
orientation. The hyfrecator was used for hemostasis. The wound was
then closed by advancing the tissue surrounding the lesion and
closing in multilayers with 3-0 Vicryl for the deep layer, followed by
5-0 Prolene for the skin. The skin closure was in a running
subcuticular fashion. Steri.
Answer: A. 13132, 11624-51, C44.42
◉ This 52 year-old female presents to the general surgeon for I&D of
a reoccurring carbuncle at the base of her neck. When the patient is
appropriately prepped, and anesthetized, the provider makes a
circumferential incision over the area of the abscess. The incision is
deepened through the vascular inner layer of skin and down to the
deep level of abscess cavity. The surgeon opens the abscess and
excises the inflamed fatty and dead tissues within the cavity and
,drains the pus completely. The abscess cavity is packed with gauze
and left open with a drain for continuous discharge of fluids. A
sample of the abscess contents of pus was sent to the lab. The
patient is given instructions on wound care, prescribed an antibiotic
and will return to the surgeon's office in 10 days for follow up. The
lab report returned the presence of Staphylococcus aureus.
What CPT® and ICD-10-CM codes are reported?
A. 10061, L02.13, B95.61.
Answer: A. 10061, L02.13, B95.61
◉ A 45 year-old male patient diagnosed with spinal stenosis L3 to
L5 level presents for an arthrodesis and laminectomy. The patient is
prepped and anesthetized and placed in the prone position. Using a
posterior interbody technique, the provider makes an incision in the
lower back over the L3-L5. With retractors, the soft tissues are
separated to gain access to the vertebrae. Fragments from nearby
cortical bone and articular cartilage are excised. The lamina was
excised and the bone chips were inserted to fuse L3-L4 interspace
and L4-L5 interspace. The area was irrigated and a layered closure
was used to close the incision.
What CPT® codes are reported?
A. 22630, 22632 x 3
B. 22630, 22632
, C. 22633, 22634 x 2
D. 22612, 22614.
Answer: B. 22630, 22632
◉ A 52 year-old female is scheduled for surgery for a radical
resection of a sarcoma on her back. After administration of proper
anesthesia, the operative site is prepped and draped in the usual
fashion. A curvilinear incision is made around the tumor site. The
incision is further extended deep and around the tumor. The fascial,
and subfascial layers are raised to adequately expose the underlying
anatomy. Neurovascular structures in the area are identified and
preserved. The tumor is localized and dissected from the
surrounding tissue margin, and removed. To rule out further
malignancy, an additional surrounding wide area of margin is also
dissected and removed. After satisfactory radical removal of the
tumor and surrounding margin the incision is repaired in the
layered fashion. The excised diameter of the tumor is 4.5 cm.
Which CPT® and diagnosis are reported?
A. 21932, C49.6
B. 21935, D17.1
C. 21935, C49.6
D. 2192.
Answer: B. 21935, D17.1
