WGU C211 SECOND OA EXAM REVIEW
SOLVED QUESTIONS WITH VERIFIED ANSWERS
◉ What is the correct 7th character, in ICD-10-CM, for a healing
comminuted fracture of the right fibula, open, type 1?
Answer: Look up Fracture/fibula/comminuted S82.45-. Verification
in the Tabular List indicates the correct 6th character is 1 for the
right side. The correct 7th character is E, for subsequent encounter,
open fracture Type 1. See the list of 7th digits under category S82.
Per chapter 19 guidelines, "A fracture not indicated whether
displaced or not displaced should be coded as displaced."
◉ Colles fracture
Answer: distal radius is broken by falling onto an outstretched hand
◉ Smith's fracture (reverse Colles' fracture)
Answer: fracture of distal radius, displace toward the palm
◉ Jones Fracture
Answer: fracture of the base of the 5th metatarsal
◉ subluxation/dislocation
Answer: partial dislocation of a joint
,◉ What is being removed for hallux valgus surgery
Answer: Bunion
◉ Bunionectomies: Cheilectomy
Answer: involve removal of part of the bone
◉ A patient presents to the ED with back pain and is diagnosed with
a lumbar sprain. What ICD-10-CM code is reported?
a. M53.3
b. M54.5
c. S33.8XXA
d. S33.5XXA
Answer: S33.5XXA
◉ Nursemaid's elbow
Answer: partial dislocation of elbow / radial head, common in small
children
◉ A 22-year-old female has a retained Kirschner wire in the left
little finger. Using local anesthesia, the left upper extremity was
thoroughly cleansed with Betadine. The end portion of the little
finger was opened with a transverse incision through the
,subcutaneous tissue to the bone. The retained Kirschner wire was
located within the distal phalanx. It was removed and the skin was
closed with sutures. What CPT® code is reported?
Answer: 20680-F4
Look in the General section of the musculoskeletal system -->
Introduction or removal --> Removal of implant DEEP. ('through the
subcutaneous to the bone")
◉ A 22-year-old female sustained a dislocation of the right elbow
with a medial epicondyle fracture while on vacation. The patient was
given general anesthesia and the elbow was reduced and was stable.
The medial epicondyle was held in the appropriate position and was
reduced in acceptable position and elevated. A long arm splint was
applied. The patient is referred to an orthopedist when she returns
to her home state in a few days.
Answer: 24565-54-RT, 24605-54-51-RT
Rationale: In the CPT® Index look for
Fracture/Humerus/Epicondyle/Closed Treatment. You are referred
to code 24560-24565. Review the codes to choose the appropriate
service. 24565 is the correct code to report the alignment of an
epicondyle fracture with manipulation (reduced) without a surgical
incision. In the CPT® Index, look for Dislocation/Elbow/Closed
Treatment. You are referred to 24600, 24605. Review the codes to
choose appropriate service. 24605 is the correct code because the
patient was given general anesthesia for the procedure. Modifier 54
is appended to report the physician performed the surgical portion
, only. The patient is referred to an orthopedist for follow up or
postoperative care. Modifier 51 is needed to report multiple
procedures were performed. Append modifier RT to indicate the
procedure is performed on the right side.
◉ An 85 year-old has developed a lump in her right groin. An
incision over the lesion was made and tissue was dissected through
the skin and subcutaneous tissue going deep through the femoral
fascia. Sharp dissection of the mass was performed, freeing it from
surrounding structures. The 3 cm mass was isolated and excised.
The incision was closed, the area was cleaned and dried, and a
dressing applied. What CPT® code is reported?
Answer: 27048. Rationale: In the CPT® Index look for
Excision/Tumor/Pelvis. You are referred to 27043, 27045, 27047,
27048, 27049 and 27059. Review the codes to choose the
appropriate service. 27048 is the correct code to report the removal
of the 3 cm mass below the fascia.
◉ A patient is seen in the hospital's outpatient surgical area with a
diagnosis of a displaced fracture of the lateral condyle, right elbow.
An ORIF (open reduction) procedure was performed and included
the following techniques: An incision was made in the area of the
lateral epicondyle. This was carried through subcutaneous tissue,
and the fracture site was easily exposed. Inspection revealed the
fragment to be rotated in two places about 90 degrees. It was
possible to manually reduce this quite easily, and the manipulation
resulted in an almost anatomic reduction. This was fixed with two
pins driven across the humerus. The pins were cut off below skin
SOLVED QUESTIONS WITH VERIFIED ANSWERS
◉ What is the correct 7th character, in ICD-10-CM, for a healing
comminuted fracture of the right fibula, open, type 1?
Answer: Look up Fracture/fibula/comminuted S82.45-. Verification
in the Tabular List indicates the correct 6th character is 1 for the
right side. The correct 7th character is E, for subsequent encounter,
open fracture Type 1. See the list of 7th digits under category S82.
Per chapter 19 guidelines, "A fracture not indicated whether
displaced or not displaced should be coded as displaced."
◉ Colles fracture
Answer: distal radius is broken by falling onto an outstretched hand
◉ Smith's fracture (reverse Colles' fracture)
Answer: fracture of distal radius, displace toward the palm
◉ Jones Fracture
Answer: fracture of the base of the 5th metatarsal
◉ subluxation/dislocation
Answer: partial dislocation of a joint
,◉ What is being removed for hallux valgus surgery
Answer: Bunion
◉ Bunionectomies: Cheilectomy
Answer: involve removal of part of the bone
◉ A patient presents to the ED with back pain and is diagnosed with
a lumbar sprain. What ICD-10-CM code is reported?
a. M53.3
b. M54.5
c. S33.8XXA
d. S33.5XXA
Answer: S33.5XXA
◉ Nursemaid's elbow
Answer: partial dislocation of elbow / radial head, common in small
children
◉ A 22-year-old female has a retained Kirschner wire in the left
little finger. Using local anesthesia, the left upper extremity was
thoroughly cleansed with Betadine. The end portion of the little
finger was opened with a transverse incision through the
,subcutaneous tissue to the bone. The retained Kirschner wire was
located within the distal phalanx. It was removed and the skin was
closed with sutures. What CPT® code is reported?
Answer: 20680-F4
Look in the General section of the musculoskeletal system -->
Introduction or removal --> Removal of implant DEEP. ('through the
subcutaneous to the bone")
◉ A 22-year-old female sustained a dislocation of the right elbow
with a medial epicondyle fracture while on vacation. The patient was
given general anesthesia and the elbow was reduced and was stable.
The medial epicondyle was held in the appropriate position and was
reduced in acceptable position and elevated. A long arm splint was
applied. The patient is referred to an orthopedist when she returns
to her home state in a few days.
Answer: 24565-54-RT, 24605-54-51-RT
Rationale: In the CPT® Index look for
Fracture/Humerus/Epicondyle/Closed Treatment. You are referred
to code 24560-24565. Review the codes to choose the appropriate
service. 24565 is the correct code to report the alignment of an
epicondyle fracture with manipulation (reduced) without a surgical
incision. In the CPT® Index, look for Dislocation/Elbow/Closed
Treatment. You are referred to 24600, 24605. Review the codes to
choose appropriate service. 24605 is the correct code because the
patient was given general anesthesia for the procedure. Modifier 54
is appended to report the physician performed the surgical portion
, only. The patient is referred to an orthopedist for follow up or
postoperative care. Modifier 51 is needed to report multiple
procedures were performed. Append modifier RT to indicate the
procedure is performed on the right side.
◉ An 85 year-old has developed a lump in her right groin. An
incision over the lesion was made and tissue was dissected through
the skin and subcutaneous tissue going deep through the femoral
fascia. Sharp dissection of the mass was performed, freeing it from
surrounding structures. The 3 cm mass was isolated and excised.
The incision was closed, the area was cleaned and dried, and a
dressing applied. What CPT® code is reported?
Answer: 27048. Rationale: In the CPT® Index look for
Excision/Tumor/Pelvis. You are referred to 27043, 27045, 27047,
27048, 27049 and 27059. Review the codes to choose the
appropriate service. 27048 is the correct code to report the removal
of the 3 cm mass below the fascia.
◉ A patient is seen in the hospital's outpatient surgical area with a
diagnosis of a displaced fracture of the lateral condyle, right elbow.
An ORIF (open reduction) procedure was performed and included
the following techniques: An incision was made in the area of the
lateral epicondyle. This was carried through subcutaneous tissue,
and the fracture site was easily exposed. Inspection revealed the
fragment to be rotated in two places about 90 degrees. It was
possible to manually reduce this quite easily, and the manipulation
resulted in an almost anatomic reduction. This was fixed with two
pins driven across the humerus. The pins were cut off below skin
