A patient sustained a 2-cm chin laceration, a 3-cm cheek laceration, and a 4-cm forearm laceration.
He also suffered a 5-cm thigh laceration and 6 cm laceration of his calf. The lacerations of the forearm
and thigh required 9-cm simple closure of the skin and subcutaneous tissues. The deep calf laceration
required 6 cm intermediate closure. The facial lacerations were deep and quite dirty, requiring
complex closure. Report code(s) _____. - Answers 13132, 12032-51, 12004-51
Nick was riding his dirt bike and collided with a tree. The EMTs stabilized Nick at the scene and
transported him to the nearest hospital. His doctor, Dr. Shanequa, had been contacted by the family
and would meet them at the hospital emergency room. In the emergency room, Dr. Shanequa
completed a history and a comprehensive physical, and ordered lab work and x-rays of the head,
neck, and back, along with the right leg, because Nick was complaining of severe pain in the lower
portion of the leg. Dr. Shanequa determined that although Nick was pretty banged up and should not
ride the dirt bike for a while, he was fine. The x-rays showed a bad sprain in the ankle area, but
nothing was broken. The total time spent treating the patient was 35 minutes.
(Hint: Keep in mind that Dr. Shanequa is Nick's primary care physician, not the ED doctor.) - Answers
99214
Daisy, a 10-year-old girl, was very sick when she presented for an office visit at her pediatrician's
office. She was running a high fever, was very lethargic, had swollen glands, and showed signs of
dehydration because of the vomiting she had been doing the previous night. The doctor decided, after
a comprehensive history and physical, that Daisy needed to be admitted to the hospital for lab
workup, rehydration, antibiotics, and monitoring. Daisy's pediatrician stopped into the hospital that
evening to evaluate her condition and check on lab results. Medical decision making was high
complexity. - Answers 99215-25, 99223
Mrs. Edison was having trouble eating some of the foods the nutritionists had set up on her diabetic
diet menu. Mrs. Edison talked with her doctor who, in turn, called the nutritionist overseeing Mrs.
Edison's diet. The doctor and the nutritionist were on the phone, had a lengthy phone conversation,
and decided to integrate a new menu that both of them felt would be more beneficial to Mrs. Edison
and for the management of her diabetes. The doctor then called the patient to discuss the diet
changes and decided to bill for the telephone call with the patient. The call length was 24 minutes. -
Answers 99443
An otherwise healthy 16-year-old high school baseball pitcher with recurring shoulder pain
underwent radiologic exam, which revealed osteochondritis dissecans. A surgical arthroscopic
procedure of the humeral head was performed under regional anesthesia. - Answers 01630
A type 1 diabetic 82-year-old female with a history of tobacco abuse was diagnosed with a malignancy
of her esophagus. She underwent a total esophagectomy under general anesthesia. What is the
anesthesia code? - Answers 00500,99100
A healthy 18-year-old male was driving his motorcycle and had an accident. He was brought to the
emergency department and after radiologic exam was diagnosed with a fractured pelvis. He
underwent emergency surgery during which closed treatment of a pelvic ring fracture was performed
under general anesthesia. What is the anesthesia code? - Answers 01120, 99140
A surgeon performed bilateral breast biopsies; the left breast mass was completely removed, but only
a portion of the right breast was removed due to its large size. Frozen section revealed the right
breast mass to be malignant; a modified radical mastectomy was performed during the same
operative session. Report code(s) _____ - Answers 19307-LT,19120-51-LT
A patient had avulsion of four nail plates. Report code(s) _____. - Answers 11730, 11732, 11732,
11732
Two simple repairs of the scalp are done; one laceration was 10 cm, and the other laceration was 5
cm. Report code(s) _____. - Answers 12005
Michael L. is scheduled for arthrodesis surgery of the left ankle or pantalar due to chronic
osteoarthritis because the medication is no longer controlling the joint pain. The Orthopedic Surgeon
performs the procedure under general anesthesia. What is the procedure code? - Answers 27870
Mr. Chung underwent open reduction with internal fixation of shaft fracture of the right tibia on June
20. Late during that same evening, the patient's wound site became inflamed and showed signs of
infection. Upon his return to the operating room, the site was reopened, a severe reaction to the