BC 2020 QUESTIONS AND ANSWERS CPC Prep Test: 1

BC 2020 QUESTIONS AND ANSWERS CPC Prep Test: 1 Multiple Choice Identify the choice that best completes the statement or answers the question. 1. A medical record contains information on all but what areas? a. Observations c. Treatment outcomes b. Medical or surgical interventions d. Financial records 2. Technicians who specialize in coding are called: a. Coding specialists c. Medical Assistants b. Information technologists d. LPN’s 3. HIPAA was made into law in what year? a. 1992 c. 1997 b. 1995 d. 1996 4. HITECH provides a day window which any violation not due to willful neglect may be corrected without penalty? a. 40 c. 45 b. 30 d. 60 5. Which of the following is a BENEFIT of electronic transactions? a. Payment of claims c. Timely submission of claims b. Security of claims d. None of the above 6. Each October the OIG releases a outlining its priorities for the fiscal year ahead. a. Compliance Plan c. Work Plan b. Self-referral laws d. CIA yearly review 7. How many lobes make up the right lung? a. one c. three b. two d. four 8. Which of the following does NOT circulate fluids throughout the body? a. Endocrine system c. Arterial system b. Venous system d. Lymphatic system 9. In order, starting with the innermost layer, what are the four walls of the digestive tract? a. Muscle, submucosa, mucosa, serosa b. Mucosa, submucosa, serosa, muscle c. Mucosa, submucosa, muscle, serosa d. Serosa, mucosa, submucosa, muscle 10. What is Bowman’s capsule? a. A basin collecting urine made by the kidneys b. Cuplike edges of the renal pelvis c. C-shaped structure partially surrounding the glomerulus d. Peritubular capsules surrounding the renal tube 11. What is vernix caseosa? a. When the mother first feels the fetus move b. The fine, downy hair covering the fetus c. A white cheeselike substance covering the lanugo d. A spontaneous abortion 12. A thin membrane lining the chambers of the heart and valves is called the: a. Myocardium c. Pericardium b. Endocardium d. Epicardium 13. A procedure widening a narrowed vessel or obstructed blood vessel is called a(n): a. Valvotomy c. Angioplasty b. Angiography d. Thrombectomy 14. Adrenomegaly is defined as: a. Any disease of the adrenal gland c. Enlargement of the adrenal gland b. A tumor of the adrenal gland d. Infection of the adrenal gland 15. The term for a shaking or involuntary movement is: a. Tremor c. Epilepsy b. Convulsion d. Seizure 16. The meaning of the root “myring/o” is: a. Eustachian tube c. Tympanic membrane b. Labyrinth d. Cochlea 17. Who are the parties responsible for providing the guidelines to ICD-10-CM? a. AAPC and AMA c. NCHS and CMS b. AMA and CMS d. WHO and CMS 18. In the ICD-10-CM Index to Diseases and Injuries (Alphabetic Index), what is the code next to the main term called? a. Category Code c. Default Code b. Subcategory Code d. Unspecified Code 19. What does ICD-10-CM stand for? a. International Code Diagnosis-10-Coding Medical b. International Class Diagnosis -10th Book-Clinical Medicine c. Infections Classified Diseases-10th Revision-Clinical Modification d. International Classification of Diseases-10th Revision-Clinical Modification 20. In the Index to Diseases and Injuries (Alphabetic Index), next to Hypertension, what do the terms in parentheses indicate? a. Hypertension cannot be coded unless one of those words is documented with hypertension in the diagnosis. b. Hypertension needs two codes assigned. c. Supplementary words that can be present or absent with the diagnosis hypertension and does not affect the code to which it is assigned. d. Looking at another main term to find that type of hypertension. 21. What is the sequencing order when coding a sequela (late effect)? a. The cause of the late effect is coded first and the residual condition is coded second. b. The symptom is coded first followed by the residual condition and the late effect code. c. The cause of the late effect is coded first, the residual condition is coded second followed by the symptoms. d. The residual condition is coded first, and the code(s) for the cause of the late effect are coded as secondary. 22. What is the ICD-10-CM code for hives? a. L50.9 c. L29.9 b. T78.40XA d. L29.8 23. A 50-year-old female presents to her physician with symptoms of insomnia and upset stomach. The physician suspects she is pre-menopausal. His diagnosis is impending menopause. What diagnosis code(s) should be reported? a. G47.00, K30 c. N95.9, G47.00, K30 b. N95.9 d. E28.319 24. What is the ICD-10-CM code for a laceration on the left shoulder, subsequent encounter? a. S46.001B c. S51.801B b. S41.019B d. S51.009B 25. In ICD-10-CM, what condition is reported as the default code when the provider documents urosepsis? a. Urinary tract infection (UTI) b. Sepsis c. Severe Sepsis d. The provider must be queried before an ICD-10-CM code can be applied. 26. According to ICD-10-CM Guidelines, when a patient is seen for management of anemia due to malignancy, how is it reported? a. Anemia is the only condition reported. b. The malignancy is the only condition reported. c. The malignancy is reported first, followed by the code for the anemia. d. Anemia is reported first, followed by the code for the malignancy. 27. According to ICD-10-CM Guidelines, what is the length of time for a myocardial infarction to be considered acute? a. One week c. Eight weeks b. Four weeks (28 days) d. Only at the time of occurrence 28. A nine-year-old with a history of RAD was admitted into overnight observation with complaints of a two day history of increased wheezing. Parents stated that nebulizer treatments were not helping. After monitoring and additional treatments given while in observation, breathing was stabilized. Documented diagnosis is RAD exacerbation. What ICD-10-CM code(s) is/are reported? a. J45.901, R06.2 c. J45.909, R06.2 b. J45.901 d. R06.2 29. What ICD-10-CM codes are reported for uncontrolled hypertension with stage 3 chronic kidney disease? a. N18.9, I12.3 c. N18.3, I12.9 b. I12.9, N18.3 d. I12.9, N18.9 30. A patient with amyloidosis being treated for glomerulonephritis. What ICD-10-CM codes are reported? a. E85.3, N08 c. N08, E85.3 b. N08, E85.4 d. E85.4, N08 31. A patient with type 2 diabetes presents with diabetic macular edema and proliferative diabetic retinopathy. What ICD-10-CM code(s) is/are reported? a. E11.311, E11.359 c. E11.351 b. E11.359 d. E11.9, E11.311, E11.351 32. A physician performed an aspiration via thoracentesis on a patient in observation status in the hospital. The patient has advanced right lung cancer that has metastasized to the pleura with malignant pleural effusion. Later the same day, due to continued accumulation of fluid, the patient was returned to the procedure room and the same physician performed a repeat thoracentesis. What ICD-10-CM codes are reported? a. C78.2, C34.91 c. C34.91, C78.2, J91.0 b. C78.2, C34.91, J91.0 d. J91.0 33. In which circumstances would an external cause code be reported? a. Delivery of a newborn b. Causes of injury or health condition c. Chemotherapy treatment of neoplasms d. Only for the cause of motor vehicle accidents 34. What does the root word colp/o stand for? a. Cervix c. Uterus b. Vagina d. Fallopian Tubes 35. What does the 7th character A indicate in Chapter 19? a. Initial encounter c. Subsequent encounter b. Sequela d. Adverse effect 36. What is NOT an example of active treatment for pathological fractures? a. Surgical treatment b. Emergency department encounter c. Evaluation and treatment by a new physician d. Cast change 37. The patient is in for an initial replacement of a leaking dialysis catheter. What ICD-10-CM code is reported? a. Z49.02 c. T82.41XB b. T82.43XA d. T85.611A 38. What is/are the External cause code(s) for a passenger involved in a MVA that lost control on the highway and hits a guardrail? a. V47.62XA c. Y92.411 b. V47.62XA,Y92.411 d. V47.61XA 39. A patient was referred to the radiology department for chronic low back pain. The radiology report indicated there was no marrow abnormality identified, and the conus medullaris is unremarkable. L4–L5: There is a minor diffusely bulging annulus at L4–L5. A small focal disc bulge is seen in far lateral position on the left at L4–L5 within the neural foramen. No definite encroachment on the exiting nerve root at this site is seen. No significant spinal stenosis is identified. L5–S1: There is a diffusely bulging annulus at L5–S1, with a small focal disc bulge centrally at this level. There is minor disc desiccation and disc space narrowing at L5–S1. No significant spinal stenosis is seen at L5–S1. The final diagnosis is minor degenerative disc disease at L4–L5 and L5–S1, as described. What ICD-10-CM code(s) is/are reported? a. M51.37 c. M51.36 b. M51.37, M54.5 d. M51.36, M54.5 40. A 12-month-old receives the following vaccinations: Hepatitis B, Hib, Varicella, and Mumps-measles-rubella. What ICD-10-CM code(s) should be reported for the vaccinations? a. B19.10, B01.9, B26.9, B05.9, B06.9 b. B19.10, B01.9, B26.9, B05.9, B06.9, Z23 c. Z23 d. Z23, B19.10, B01.9, B26.9, B05.9, B06.9 41. A patient visits the ED for ringing in the ears, nausea, vomiting and drowsiness. During the history taking, the provider learns the patient has been taking 2 aspirins every hour for the last three days. After examination and performing blood tests the provider diagnosis the patient with aspirin poisoning. What ICD-10-CM codes should be reported? a. T39.011A, H93.13, R11.2, R40.0 c. T39.011A b. H93.13, R11.2, R40.0, T39.011A d. H93.13, R11.2, R40.0 42. A seven-year-old female patient was seen in the emergency department after being bitten by a dog. The child received treatment for the puncture wounds to her left leg. She also received a rabies vaccine because the dog was known to have rabies. What ICD-10-CM codes are reported? a. S81.812A, Z20.3, W54.0XXA c. S81.852A, W54.0XXA b. S81.852A, Z20.3, W54.0XXA d. S81.812A, A82.9, W54.0XXA 43. What surgical status indicator represents the Surgical Global Package for endoscopic procedures (without an incision)? a. XXX c. 000 b. 010 d. 090 44. When procedures are “mandated” by third party payers, what modifier would you use? a. 26 c. 32 b. 52 d. 76 45. What is the correct HCPCS Level II code for parenteral nutrition solution amino acid, 3.5%? a. B4176 c. B4168 b. B4172 d. B4178 46. A patient is seen in the physician’s office for a 2,400,000 U injection of Bicillin LA. What is the code to represent this drug? a. J2540 x 4 c. J2510 x 4 b. J0561 x 24 d. J0558 x 24 47. What is the correct CPT® coding for a cystourethroscopy with brush biopsy of the renal pelvis? a. 52007 c. 52000, 52007 b. 52005 d. 52005, 52007 48. What is the CPT® code used to report a right heart cardiac catheterization for congenital anomalies? a. 93451 c. 93453 b. 93530 d. 93531 49. How are new additions and revisions indicated in the CPT® codebook each year? a. Italic print c. Green print b. Red print d. Bold print 50. What hernia repair codes can be reported with add-on code 49568? a. c. b. d. 49570-49572 51. A 63-year-old patient arrives for skin tag removal. As previously noted in her other visit, she has 3 located on her face, 4 on her shoulder and 15 on her back. The physician removes all the skin tags with no complications. What CPT® code(s) should be reported for this encounter? a. 11201 c. 11200, 11201-52 b. 11201, 11201-51 d. 11200, 11201 52. Patient presents with a suspicious lesion on her left arm. With the patient’s permission the physician marked the area for excision. The lesion measured 0.9 cm. The wound measuring 1.2 cm was closed in layers using 4-0 Monocryl and 5-0 Prolene. Pathology later reported the lesion to be a sebaceous cyst. What codes are reported? a. 11401, D22.62 c. 13121, 11401-51, D22.62 b. 12031, 11401-51, L72.3 d. 11402, L72.3 53. Most categories in ICD-10CM Injury and Poisoning have three main seventh character extenders (with the exception of fractures). What does seventh character D indicate? a. Initial encounter b. Subsequent encounter c. Sequela d. Seventh character extenders are not applicable for injury and poisoning. 54. What is used for a placeholder when a code that does not have six characters to keep the seventh character extender in the seventh position? a. A dash (-) c. The letter x b. An asterisk (*) d. A space 55. The patient presents today for closed reduction of the nasal fracture. The depressed right nasal bone was elevated using heavy reduction forceps while the left nasal bone was pushed to the midline. This resulted in good alignment of the external nasal dorsum. What CPT® code is reported for this procedure? a. 21325 c. 21315 b. 21310 d. 21337 56. 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 by a transverse incision through the subcutaneous tissue to the bone. The retained Kirschner wire was located within the distal phalanx. It was removed and closed with sutures. What CPT® code is reported? a. 10120-F4 c. 20670-F4 b. 20680-F4 d. 10121-F4 57. A 66-year-old sustained a left proximal humerus fracture. Standard deltopectoral approach was used and dissection was carried down to the fracture site. The fracture site was identified and fragments were mobilized and the humeral head fragments removed. Once this was done, the stem was prepared up to a size 10. A trial reduction was carried out with the DePuy trial stem and implant head. Sutures were placed in key positions for closure of the tuberosities down to the shaft including sutures through the shaft. The shaft was then prepared and cement was injected into the shaft. The implant was placed. Once the cement was hardened, the head was placed on Morse taper and reduced. A bone graft was placed around the area where the tuberosities were being brought down. The tuberosities were then tied down with a suture previously positioned. This gave excellent closure and coverage of the significant motion at the repair sites. The wound was thoroughly irrigated. The skin was closed with Vicryl over a drain and also staples in the epidermis. A sterile dressing and sling was applied. The patient was taken to recovery in stable condition. No immediate complications. What CPT® code is reported? a. 23616-LT c. 23615-LT b. 23605-LT d. 23670-LT 58. A patient presented with a closed, displaced supracondylar fracture of the left elbow. After conscious sedation, the left upper extremity was draped and closed reduction was performed, achieving anatomical reduction of the fracture. The elbow was then prepped and with the use of fluoroscopic guidance, two K-wires were directed crossing the fracture site and piercing the medial cortex of the left distal humerus. Stable reduction was obtained, with full flexion and extension. K-wires were bent and cut at a 90 degree angle. Telfa padding and splint were applied. What CPT® code is reported? a. 24535-LT c. 24582-LT b. 24538-LT d. 24566-LT 59. This 45-year-old male presents to the operating room with a painful mass of the right upper arm. Upon deep dissection a large mass in the soft tissue of the patient's shoulder was noted. The mass appeared to be benign in nature. With deep blunt dissection and electrocautery, the mass was removed and sent to pathology. What CPT® code is reported? a. 23076-RT c. 23075-RT b. 23066-RT d. 23030-RT 60. A 3-year-old is brought into the ER crying. He cannot bend his left arm after his older brother twisted it. The physician performs an X-ray to diagnose the patient has a dislocated nursemaid’s elbow. The ER physician reduces the elbow successfully. The patient is able to move his arm again. The patient is referred to an orthopedist for follow-up care. What CPT® and ICD-10-CM codes are reported? a. 24640-54-LT, S53.032A, W50.2XXA b. 24565-54-LT, S53.194S, Y33.XXXA c. 24640-54-LT, S53.091A, W50.2XXA d. 24600-54-LT, S53.002A, W49.9XXA 61. Which statement is true regarding code selection for lumbago in ICD-10-CM? a. There is only one generalized code for lumbago that cannot be further specified. b. Lumbago is not assigned an ICD-10-CM code; instead, the code for the cause of the lumbago is assigned. c. Codes for lumbago with sciatica do not further specify laterality. d. Codes exist to indicate whether the sciatica is present with the low back pain. 62. What is the largest single mass of lymphatic tissue? a. Spleen c. Peyer’s Patches b. Thymus d. Tonsils 63. What CPT® code is reported for a major thoracotomy for post-op hemorrhage following an endoscopic upper lobectomy? a. 32110 c. 32310 b. 32100 d. 32120 64. Johnny has a penny removed from his left nostril in the doctor’s office. What CPT® code is reported? a. 30320 c. 30100 b. 30300 d. 30160 65. What ICD-10-CM code is reported for a patient that has RSV, respiratory syncytial virus pneumonia? a. B97.4 c. J21.0 b. J18.9 d. J12.1 66. The provider performs a diagnostic thoracoscopy followed by the thoracoscopic excision of a pericardial cyst. What CPT® code(s) is/are reported? a. 32601, 32662-51 c. 32658 b. 32601, 32661-51 d. 32661 67. A patient’s nose was hit with a baseball during a high school baseball game. At that time reconstruction was performed, with local grafts. Patient returns now as an adult, discontent with the bony prominence along the bony pyramid and flat look of the tip of the nose. He underwent major repair with osteotomies and nasal tip work. What CPT® code is reported? a. 30410 c. 30450 b. 30435 d. 30462 68. A patient is seen in the OR for removal of a hepatic adenoma, which has invaded the diaphragm. The resection of the diaphragm portion of the mass was repaired with primary sutures. What CPT® code is reported for the diaphragmatic mass resection? a. 39540 c. 39560 b. 39545 d. 39561 69. An operative report lists excisional bilateral biopsies of deep cervical nodes and biopsy of right deep axillary nodes as the procedures performed. The pathology report comes back confirming lymphadenitis. What CPT® codes are reported? a. 38520-50, 38505-59, 38740-59-RT c. 38510-50, 38525-51-RT b. 38510, 38525-51-RT d. 38520-50, 38525-51-RT 70. An ICU diabetic patient who has been in a coma for weeks as the result of a head injury becomes conscious and begins to improve. The physician performs a tracheostomy closure and since the scar tissue is minimal, the plastic surgeon is not needed. What CPT® and ICD-10-CM codes are reported for this procedure? a. 31820, E11.641, Z93.0 c. 31825, Z43.0, E11.641, S06.9X9D b. 31820, Z43.0, S06.9X9D, E11.9 d. 31825, Z43.0, E11.9, S06.9X9D 71. A 27-year-old girl has been on the lung transplant list for months and today she will be receiving a LT and RT lung from an individual involved in an MVA. This person was DOA at the hospital and is an organ donor. The donor pneumonectomy was performed by physician A, the backbench work by physician B and the transplant of both lungs into the prepped and waiting patient by physician C. What is the correct coding for the removal (physician A), preparation (physician B) and insertion (physician C) of the lungs? a. 32850, 32851 x 2, 32856 c. 32850, 32851-50, 32855 x 2 b. 32850, 32851, 32855 d. 32850, 32853, 32856 72. A patient with a diagnosis of chronic sphenoidal sinusitis undergoes a bilateral sinusotomy. While the physician examines the diseased sphenoid sinus, she takes a biopsy of the sphenoidal masses and removes the mucosa with several polyps. Transseptal sutures are placed and the intraoral incision is closed in a single layer. The nose is packed and external nasal dressings are placed. What CPT® and ICD-10-CM codes should be reported? a. 31237-50, J32.3 c. 31288-50, J32.9 b. 31090, , J32.9 d. 31051-50, J32.3, J33.8 73. Intracoronary stents are placed percutaneously in the right coronary and left anterior descending arteries for a patient with stenosis. Percutaneous transluminal balloon angioplasty is performed on the left circumflex coronary artery. Choose the correct CPT® codes for this procedure. a. 92928-RC, 92928-LD, 92920-LC c. 92933-RC, 92934-LD, 92934-LC b. 92928-RC, 92929-LD, 92920-LC d. 92928-RC, 92920-LD, 92920-LC 74. Physician replaces a single chamber permanent pacemaker with a dual chamber permanent pacemaker. a. 33213, 33233-51 c. 33214 b. 33213, 33233-51, 33235-51 d. 33212, 33233-51 75. A patient presents to the outpatient surgery department for revision to his autogenous radiocephalic fistula so he can continue his hemodialysis. The correct CPT® code is: a. 36825 c. 36831 b. 36832 d. 36870 76. What is included in all vascular injection procedures? a. Catheters, drugs, and contrast material b. Selective catheterization c. Just the procedure itself d. Necessary local anesthesia, introduction of needles or catheters, injection of contrast media with or without automatic power injection, and/or necessary pre-and post-injection care specifically related to the injection procedure. 77. Patient undergoes a three-artery CABG. A surgical assistant procures the artery used for the grafts. Code for the assistant surgeon. a. 33535-80 c. 33510-80 b. 33533-80, 35600-80 d. 33517-80, 35600-80 78. What is the eponym for a pancreatoduodenectomy? a. Hartmann’s procedure c. Whipple procedure b. Kasai procedure d. Meckel’s procedure 79. What CPT® code(s) is/are reported for when a physician makes two separate incisions to perform a laparoscopic appendectomy and laparoscopic cholecystectomy? a. 44960, 47562 c. 47562, 44970-51 b. 47562 d. 47562, 44970-59 80. 42-year-old patient is brought to the operating room for a repair of a recurrent incarcerated incisional hernia using mesh. What CPT® and ICD-10-CM codes are reported? a. 49561, K40.90 c. 49566, 49568, K43.0 b. 49566, K43.0 d. 49561, 49568, K43.1 81. A patient was taken to the emergency room for severe abdominal pain, nausea and vomiting. A WBC (white blood cell count) was taken and the results showed an elevated WBC count. The general surgeon suspected appendicitis and performed an emergent appendectomy. The patient had extensive adhesions secondary to two previous Cesarean-deliveries. Dissection of this altered anatomical field and required the surgeon to spend 40 additional intraoperative minutes. The surgeon discovered that the appendix was not ruptured nor was it hot. Extra time was documented in order to thoroughly irrigate the peritoneum. What CPT® and ICD-10-CM codes are reported? a. 44960-22, R10.9, R11.2, D72.829, K35.3 c. 44960-22, K35.2 b. 44950-22, R10.9, R11.2, D72.829 d. 44005, 44955, R10.9, R11.2, K35.2 82. A patient with hypertension is scheduled for same day surgery for removal of her gallbladder due to chronic gallstones. She is examined preoperatively by her cardiologist to be cleared for surgery. What ICD-10-CM codes are reported by the cardiologist? a. K80.21, Z01.89, I10 c. Z01.810, K80.20, I10 b. K80.20, I10, Z01.810 d. I10, Z01.818, K80.20 83. 45-year-old patient with liver cancer is scheduled for a liver transplant. The patient’s brother is a perfect match and will be donating a portion of his liver for a graft. Segments II and III will be taken from the brother and then the backbench reconstruction of the graft will be performed, both a venous and arterial anastomosis. The orthotopic allotransplantation will then be performed on the patient. What CPT® codes are reported? a. 47140, 47146, 47147, 47135 c. 47140, 47147, 47146, 47399 b. 47141, 47146, 47135 d. 47141, 47146, 47399 84. What ICD-10-CM code is reported for acute gastritis with bleeding? a. K29.00 c. K29.70 b. K29.01 d. K29.71 85. Patient is status post radical retro pubic prostatectomy with erectile dysfunction, presenting for penile implant. An inflatable penile prosthesis is inserted. What CPT® code is reported for this service? a. 54400 c. 54408 b. 54416 d. 54401 86. If a woman is hospitalized with severe pre-eclampsia in the 30th week of her pregnancy what is the diagnosis code for her daily visits? a. O14.10, Z3A.30 c. O14.13, Z3A.30 b. O14.12, Z3A.30 d. O14.03, Z3A.30 87. Patient with genital warts has cryotherapy of an extensive number of lesions on her mons pubis, labia, and perineum. How is this procedure coded? a. 57065 c. 17004 b. 56515 d. 57511 88. What modifier is appropriate for a separately billable antenatal service during the global OB package period? a. 24 c. 57 b. 25 d. No modifier is needed 89. A 56-year-old woman with biopsy-proven carcinoma of the vulva with metastasis to the lymph nodes has complete removal of the skin and deep subcutaneous tissues of the vulva in addition to removal of her inguinofemoral, iliac and pelvic lymph nodes bilaterally. The diagnosis of carcinoma of the vulva with 7 of the nodes also positive for carcinoma is confirmed on pathologic review. What are the CPT® and ICD-10- CM codes reported for this procedure? a. 56637, C51.9, C79.89 c. 56632-50, D07.1 b. 56640-50, C51.9, C77.4 d. 56633, 38765-50, C51.9, C77.4 90. A woman presents for hysterectomy after ECC (endocervical curettage) and EMB (endometrial biopsy) indicates endometrial cancer. Transabdominal approach (incision) is chosen for exposure of all structures possibly affected. The abdomen is thoroughly inspected with no gross disease outside the enlarged uterus but several lymph nodes are enlarged and the decision is made to perform a hysterectomy with bilateral removal of tubes and ovaries and bilateral pelvic lymphadenectomy with periaortic lymph node sampling. Specimens sent to pathology confirm endometrial cancer but find normal tissue in the lymph nodes. What are the CPT® and ICD-10-CM codes reported for this service? a. 58548, C54.1 c. 58210, C54.1 b. 58200, C55, C77.5 d. 58150, 38770-51, C54.1, C77.5 91. 62-year-old woman with a history of urinary incontinence and incomplete bladder emptying presents for sling urethropexy and repair of a cystocele. The sling urethropexy is performed using a prosthetic mesh. The anterior repair is also performed without difficulty and both repairs are made vaginally. What are the CPT® codes reported for this service? a. 57288, 57240-51 c. 53440, 57240-51, 57267 b. 57288, 57267, 57240-51 d. 53440, 57240 92. What does contralateral mean? a. Affecting or originating in the opposite side. b. Pertaining to the same side of the body. c. Lateral contractions. d. Contractions occurring on opposite sides of the body. 93. When coding for surgery performed on the Skull Base (), what term describes the method used to gain exposure to the lesion? a. Definitive procedure c. Repair procedure b. Radical procedure d. Approach 94. 50-year-old male is diagnosed with a tumor of the skull base just below the occipital tonsils. The neurosurgeon performs a transpetrosal approach to the posterior cranial fossa. He then performs an intradural removal of the tumor of the midline skull base. Dural repair is done and the area is closed with Neurolon. What CPT® code(s) is/are reported? a. 61521 c. 61598, 61608-51 b. 61524 d. 61597, 61608-51 95. A patient has a right thyroid lobectomy for a thyroid follicular lesion. An incision is made two cm above the sternal notch and carried through the platysma. The right thyroid was dissected free from the surrounding tissues. The isthmus was divided from the left thyroid lobe. The left thyroid lobe was explored revealing a single nodule. The right thyroid lobe was completely removed from the trachea and surrounding tissues. It was marked and sent off the table as a specimen. What CPT® code is reported? a. 60200 c. 60220 b. 60210 d. 60240 96. What diagnosis code is used for spinal meningitis? a. A39.9 c. G04.90 b. G03.9 d. A87.9 97. A patient with a herniated cervical disc undergoes a cervical laminotomy with a partial facetectomy and excision of the herniated disc for cervical interspace C3-C4. What CPT® and ICD-10-CM codes are reported? a. 63050, M50.21 c. 63020, 63035, M50.91 b. 63020, M50.21 d. 63050, M50.91 98. 15-year-old has been taken to surgery for crushing his index and middle fingers, injuring his digital nerves. The physician located the damaged nerves in both fingers and sutures them to restore sensory function. What CPT® codes are reported? a. 64831, 64872 c. 64831, 64837-51 b. 64834, 64837-51 d. 64831, 64832 99. 55-year-old man presents with uncontrolled tremors that have become quite severe and are now disabling. A trial of a deep brain stimulator electrode is recommended. The patient is placed in the head-holder adapter for the frame. The scalp is incised exposing the skull using a perforator to make a single burr hole 2.5 cm from the midline at the level of the coronal suture exposing the dura and is punctured for access. Microelectrode recording (MER) and stimulation is done to target and reposition the electrodes to determine the best placement for the neurostimulator electrode. The neurostimulator electrode array is placed in the thalamus and fastened into position with radiographic image monitoring placement. The lead is coiled in a pocket under the galea, which is sutured closed, followed by skin closure. What CPT® code is reported? a. 61850 c. 61867 b. 61863 d. 61870 100. Migraines are reported from what category in ICD-10-CM? a. F02 c. G30 b. G00 d. G43 101. What does IOL stand for? a. Interoptic laser c. Interdimensional ocular lengths b. Intraocular lens d. Iridescence over lamina 102. Michael has bilateral lazy eyes and undergoes strabismus surgery of the superior oblique muscle for both eyes. What CPT® code is reported? a. 67311-50 c. 67318-50 b. 67318 d. 67345 103. A patient has heavy skin and muscle (myogenic) that is drooping down and blocking his vision due to ptosis of upper muscular eyelid disorder. The physician performed a bilateral upper blepharoplasty. What ICD-10- CM code is reported? a. H02.423 c. H02.31, H02.34 b. H02.421, H92.422 d. H02.531, H02.534 104. 65-year-old patient presents with ectropion of the right lower eyelid. Repair with tarsal wedge excision is performed for correction. Attention was then directed to the left eye. The patient also has an ectropion of the left lower eyelid, which is repaired by suture repair. What CPT® code(s) is/are reported? a. 67916-50 c. 67914-50 b. 67916-E4, 67914-E2 d. 67923-E4, 67921-E2 105. A patient is diagnosed with nuclear sclerotic cataract, right eye. She is taken to the operating room and a phacoemulsification with intraocular lens, right eye is performed. What code(s) is/are reported? a. 66984-RT c. 66984-RT, 66990 b. 66982-RT d. 66984-RT, V2632 106. 12-year-old male patient has an abscess located at the external auditory meatus. The ENT incises the abscess and packs it to absorb the drainage. What CPT® code is reported? a. 69000 c. 69200 b. 69005 d. 69020 107. The patient was taken to the operating room. The physician everts the upper eyelid and places clamps across the everted undersurface of the upper lid. The tissue distal to the clamps is excised or resected. This tissue includes conjunctiva, tarsus, Muller’s muscle and the distal insertion of the levator aponeurosis. The remaining tissue is reattached and sutured. What CPT® code is reported? a. 67901 c. 67906 b. 67903 d. 67908 108. A patient with mixed conductive and sensorineural hearing loss in the right ear has tried multiple medical therapies without recovery of her hearing. Patient has consented to have an electromagnetic bone conduction hearing device implanted. What CPT® and ICD-10-CM codes are reported? a. 69710-RT, H90.11 c. 69710-RT, H90.71 b. 69714-RT, H90.8 d. 69930-RT, H90.0 109. 53-year-old woman with scarring of the right cornea has significant corneal thinning with a high risk of perforation and underwent reconstruction of the ocular surface. The eye is incised and an operating microscope is used with sponges and forceps to debride necrotic corneal epithelium. Preserved human amniotic membrane is first removed from the storage medium and transplanted by trimming the membrane to fit the thinning area of the cornea then sutured. This process was repeated three times until the area of thinning is flushed with surrounding normal-thickness cornea. All of the knots are buried and a bandage contact lens is placed with topical antibiotic-steroid ointment. What CPT® code is reported? a. 65780 c. 65710 b. 65781 d. 65435 110. The surgeon performed an insertion of an intraocular lens prosthesis. Treatment plan was established and discussed with the patient six weeks earlier when cataract was removed (by the same surgeon). What CPT® code is reported? a. 66985-58 c. 66984 b. 66983-58 d. 66985 111. A physician extracts a tumor, using a frontal approach, from the lacrimal gland of a 14-year-old patient. What CPT® and ICD-10-CM codes are reported? a. 68500, C69.50 c. 68520, D31.50 b. 68505, C69.51 d. 68540, D49.89 112. What information does ICD-10-CM add too many of the codes for eye disorders or injuries? a. Severity of the injury. b. Laterality (eye affected) c. Manifestations of the disease or illness. d. Stage of the disease or illness. 113. What ICD-10-CM code is reported for an encounter for cataract screening? a. H26.8 c. Z13.5 b. H26.9 d. Z13.9 114. What are the three classifications of anesthesia? a. General, Regional and Epidural b. General, Regional and Monitored Anesthesia Care c. General, MAC and Conscious Sedation d. General, Regional and Moderate Sedation 115. What intraperitoneal organs are found in the lower abdomen? a. Appendix, cecum, ileum, and sigmoid colon b. Liver, appendix, gallbladder, ileum, sigmoid colon c. Gallbladder, cecum, spleen, ileum, sigmoid colon d. Spleen, liver, appendix, spleen, cecum 116. Using your CPT® Index, look up anesthesia for a shoulder arthroscopy, which became an open procedure, on the shoulder joint. What CPT® code is reported for the anesthesia? a. 01622 c. 01638 b. 01630 d. 01682 117. Anesthesia start time is reported as 7:14 am, and the surgery began at 7:26 am. The surgery finished at 8:18 am and the patient was turned over to PACU at 8:29 am, which was reported as the ending anesthesia time. What is the anesthesia time reported? a. 7:14 am to 8:18 am (64 minutes) c. 7:26 am to 8:18 am (52 minutes) b. 7:14 am to 8:29 am (75 minutes) d. 7:26 am to 8:29 am (63 minutes) 118. Code 00350 Anesthesia for procedures on the major vessels of the neck; not otherwise specified has a base value of ten (10) units. The patient is a P3 status, which allows one (1) extra base unit. Anesthesia start time is reported as 11:02 am, and the surgery began at 11:14 am. The surgery finished at 12:34 am and the patient was turned over to PACU at 12:47 am, which was reported as the ending anesthesia time. Using fifteen- minute time increments and a conversion factor of $100, what is the correct anesthesia charge? a. $1,500.00 c. $1,700.00 b. $1,600.00 d. $1,800.00 119. 5- year-old patient is experiencing atrial fibrillation with rapid ventricular rate. The anesthesia department is called to insert a non-tunneled central venous (CV) catheter. What CPT® code is reported? a. 00400 c. 36556 b. 36555 d. 36557 120. 72-year-old patient is undergoing a corneal transplant. An anesthesiologist is personally performing monitored anesthesia care. What CPT® code and modifier(s) are reported for anesthesia? a. 00144, 99100 c. 00144-AA-QS, 99100 b. 00144-AA, 99100 d. 00144-QK-QS, 99100 121. An anesthesiologist is medically supervising six cases. What modifier is reported for the CRNA’s medically directed service? a. AD c. QX b. QK d. QZ 122. Mr. Johnson, age 82, having been in poor health with diabetes and associated peripheral neuropathy, is having a fem-pop bypass. The anesthesiologist documents he has severe systemic disease. What is/are the correct anesthesia code(s) for this patient? a. 01260-P2, 99100 c. 01272-P2, 99100 b. 01272-P3 d. 01270-P3, 99100 123. What ICD-10-CM code is reported for a reaction to anesthesia, initial encounter? a. T88.2XXA c. T88.52XA b. T88.4XXA d. T88.59XA 124. An axillary view might be included in an X-ray of what part of the skeleton? a. Neck c. Forearm b. Shoulder d. Pelvis 125. A non-Medicare patient reports for a bilateral screening mammography with CAD. What CPT® code(s) is/are reported? a. 77056 c. 77057 b. 77056, 77052 d. 77057, 77052 126. A 32-year-old patient with cervical cancer is in an outpatient facility to have HDR brachytherapy. The cervix is dilated and under ultrasound guidance six applicators are inserted with iridium via the vagina to release its radiation dose. The placement is in the cervical cavity (intracavitary). What CPT® code is reported for the physician service? a. 77761-26 c. 77799-26 b. 77762-26 d. 77789-26 127. A patient has a history of chronic venous embolism in the superior vena cava (SVC) and is having a radiographic study to visualize any abnormalities. In outpatient surgery the physician accesses the subclavian vein and the catheter is advanced to the superior vena cava for injection and imaging. The supervision and interpretation of the images is performed by the physician. What codes are reported for this procedure? a. 36010, 75827-26 c. 36000, 75827-26 b. 36000, 75820-26 d. 36010, 75820-26 128. A patient is positioned on the scanning table headfirst with arms at the side for an MRI of the thoracic spine and spinal canal. A contrast agent is used to improve the quality of the images. The scan confirms the size and depth of a previously biopsied leiomyosarcoma metastasized to the thoracic spinal cord. What CPT® and ICD-10-CM codes are reported? a. 72255, D49.2 c. 72070, C72.0 b. 72157, D48.0 d. 72147, C79.49 129. Tests in the Chemistry section of CPT® are what types of tests unless specified otherwise? a. Qualitative c. Semi-quantitative b. Quantitative d. Surgical 130. A patient presents with worries she is at risk for cancer. She asks for tests to verify whether she has cancer. The test comes back normal. What type of service is this considered? a. Signs and symptoms c. Screening services b. Cancer d. Abnormal findings 131. A patient presents with right upper quadrant pain, nausea, and other symptoms of liver disease as well as complaints of decreased urination. Her physician orders an albumin; bilirubin, both total and direct; alkaline phosphatase; total protein; alanine amino transferase; aspartate amino transferase, and creatinine. What CPT® code(s) is/are reported? a. 82040, 82247, 82248, 84075, 84155, 84460, 84450, 82565 b. 80076, 82565 c. 80076 d. 80076-22 132. What is/are the code(s) for thawing 4 units of fresh frozen plasma? a. 86927 c. 86931 b. 86927 x 4 d. 86931 x 4 133. A urine pregnancy test is performed by the office staff using the Hybritech ICON (qualitative visual color comparison test). What CPT® code is reported? a. 84703 c. 81025 b. 84702 d. 81025, 36415 134. Mr. Bowen is having a pre-employment physical (screening). His doctor ordered the following serum blood tests: CBC, automated comprehensive metabolic panel, and a thyroid stimulating hormone (TSH) assay. Code the services for these labs. a. 80050 c. 80050-26 b. 80048 d. 80053, 84443 135. A soccer player hits his head during an indoor game and is admitted to observation to watch for head trauma. Admit date/time: 01/21/20XX 8:12 PM Detailed History, Detailed Exam, Low MDM Discharge date/time: 01/22/20XX 8:15 AM Discharge time: 20 minutes What CPT® code(s) is/are reported for the admission and discharge to Observation Care? a. 99234 c. 99217 b. 99221, 99238 d. 99218, 99217 136. A new patient visits the internal medicine clinic today for diabetes, chronic constipation, arthritis and a history of cardiac disease. The physician performs a detailed history, comprehensive exam and a medical decision making of moderate complexity. What CPT® code should be reported? a. 99213 c. 99203 b. 99214 d. 99204 137. 3-year-old critically ill child is admitted to the PICU from the ER with respiratory failure due to an exacerbation of asthma not manageable in the ER. The physician starts continuous bronchodilator therapy and pharmacologic support along with cardiovascular monitoring and possible mechanical ventilation support. The physician documents a comprehensive history and exam and orders are written after treatment is initiated. What is the CPT ® code for this encounter? a. 99284 c. 99476 b. 99475 d. 99291 138. 33 year-old male was admitted to the hospital on 12/17/XX from the ER, following a motor vehicle accident. His spleen was severely damaged and a splenectomy was performed. The patient is being discharged from the hospital on 12/20/XX. During his hospitalization the patient experienced pain and shortness of breath, but with an antibiotic regimen of Levaquin, he improved. The attending physician performed a final examination and reviewed the chest X-ray revealing possible infiltrates and a CT of the abdomen ruled out any abscess. He was given a prescription of Zosyn. The patient was told to follow up with his PCP or return to the ER for any pain or bleeding. The physician spent 20 minutes on the date of discharge. What CPT® code is reported for the 12/20 visit? a. 99221 c. 99238 b. 99231 d. 99283 139. The physician was called to the hospital floor for the medical management of a 56-year-old patient admitted one day ago with aspiration pneumonia and COPD. No chest pain at present, but still SOB and some swelling in his lower extremities. Patient was tachypenic yesterday; lungs reveal course crackles in both bases, right worse than left. The physician writes instructions to continue with intravenous antibiotic treatment and respiratory support. He reviewed chest X-ray and labs. Patient is improving and a pulmonary consultation has been requested. What CPT® code is reported? a. 99218 c. 99232 b. 99221 d. 99231 140. An established 47-year-old patient presents to the physician’s office after falling last night in her apartment when she slipped in water on the kitchen floor. She is complaining of low back pain and no tingling or numbness. Physician documents that she has full range motion of the spine, with discomfort. Her gait is within normal limits. Straight leg raising is negative. She requested no medication. It is recommended to use heat, such as a hot water bottle. Doctor’s Assessment: Lower Back Muscle Strain. What E/M and ICD-10- CM codes are reported for this service? a. 99212, S39.012A, W18.30XA, Y92.030 b. 99213, S39.012A, W01.0XXA, Y92.030 c. 99213, S33.9XXA, W18.40XD, Y92.030 d. 99212, S39.012A, W19.XXXD, Y92.030 141. 59-year-old male experienced left arm pain while cleaning the garage. There was no injury. His physician scheduled a 30-minute stress test using the Bruce Protocol at the hospital. There was no arm pain while on the treadmill; he did have a slight heart rhythm abnormality. The patient rested for 2 minutes. He had no further symptoms or pain. The cardiologist supervised the study, interpreted the test and dictated a report. What CPT® code(s) is/are reported? a. 93015 c. 93016, 93018 b. 93015-26 d. 93018 142. A teenager has been chronically depressed since the separation of her parents 1 year ago and included moving to a new city. Her school grades continued to slip and she has not made new friends. She has frequent crying episodes and is no longer interested in her appearance. She has attended the community mental health center and participates in group sessions. Recently her depression exacerbated to the point inpatient admission was required. The physician diagnosed adjustment disorder with emotional and conduct disturbances. Due to the length of the depression and no real improvement, the physician discussed electroconvulsive therapy with her mother. After discussing benefits and risks, the mother consented to the procedure. What CPT® and ICD- 10-CM codes are reported for the electroconvulsive therapy? a. 90882, F43.25 c. 90867, F43.24, F43.25 b. 90870, F43.25 d. 90870, F43.24, F43.25 143. A patient with chronic respiratory failure is visited at home by a certified respiratory therapist to manage his home oxygen therapy. What CPT® and ICD-10-CM codes are reported? a. 99503, J96.10 c. 99510, 99507-59, J96.10 b. 99504, J98.4 d. 99504, J95.821 144. A patient has an open wound on his left lower leg caused by a cat bite. The animal tested negative for rabies, but the wound has failed to heal and became infected by Clostridium perfringens. The patient underwent hyperbaric oxygen therapy attended and supervised by the physician. What CPT® and ICD-10-CM codes are reported? a. 99183, S81.852A, B96.7, W55.01XA b. 97597, S81.001A, T63.891A c. 97605, S81.802A, B95.5, W55.03XA d. 97597, S81.852A, W55.01XA 145. A post-MI (myocardial infarction) patient has been receiving cardiac rehabilitation. At this session, the physician evaluates the patient, determines he shows satisfactory progress and may increase his normal daily activities. Continuous EKG is not used at this session. What CPT® code is reported? a. 93798 c. 93797 b. 99213 d. 93799 146. 54-year-old female with uncontrolled Type 1 insulin dependent diabetes and related peripheral vascular disease presents with a deep diabetic ulceration on the bottom of her right foot. The wound reaches into the fascia and appears to be draining. She acknowledges going barefoot frequently and is not certain how or when the wound occurred. After the physician discusses the seriousness of her condition he debrides the wound, using a water jet and surgical scissors. Size of wound is 70 sq. cm. He applied topical ointment and a sterile dressing. He counseled the patient about the need to wear shoes at all times, and inspect her feet daily. He advised the patient to wear a water protective covering on her lower leg when taking a shower and to change the dressing daily, using ointment provided. A surgical shoe was provided. Patient is to return weekly until the wound heals and continue her insulin regime. If satisfactory progress does not occur, a graft may be considered. What codes are reported? a. 97602, L3260, E10.51, L97.502, Z79.4 b. 97597, 97598 x 3, L3260, E10.621, E10.51, L97.513 c. 97597 x 4, L3260, E10.621, L97.313 d. 97598 x 4, L3265, E10.52, L97.502, Z79.4 147. A patient with Sickle cell anemia with painful sickle crisis received normal saline IV, 100 cc per hour to run over 5 hours for hydration in the physician’s office. She will be given Morphine & Phenergan, prn (as needed). What codes are reported? a. 96360, 96361 x 4, J7050 x 2, D57.00 c. 96360, 96361 x 3, J7030, D57.00 b. 96360 x 5, J7050, D57.1 d. 96360, J7030, D57.819 148. 55-year-old male has had several episodes of tightness in the chest. His physician ordered a PTCA (percutaneous transluminal coronary angioplasty) of the left anterior descending coronary artery. The procedure revealed atherosclerosis in the native vessel. It was determined a stent would be required to keep the artery open. The stent was inserted during the procedure. a. 92928-LD, I25.10 c. 92920-LD, 92928, I25.811, I25.750 b. 92920-LD, 92929-59, I25.811 d. 92920-LD, 92928-59, I25.10 149. A qualified genetics counselor is working with a child who has been diagnosed with fragile X syndrome. After extensive research about the condition, she meets with the parents to discuss the features of the disease and the child’s prognosis. The session lasted 45 minutes. a. 96040, Q99.9 c. 96040 x 2, Q99.8 b. 96040, Q99.2 d. 96040 x 2, Q99.2 150. Mrs. Salas had angina decubitus that lasted for 30 minutes and was admitted to the Coronary Care Unit with a diagnosis of R/O MI. The cardiologist (private practice based) takes her to the cardiac catheterization suite at the local hospital for a left heart catheterization. Injection procedures for selective coronary angiography and left ventriculography were performed and imaging supervision and interpretation for the selective coronary angiography and left ventriculography was provided. What CPT® code(s) is/are reported for the services? a. 93452-26 c. 93453-26 b. 93458-26 d. 93453-26, 93462 CPC Prep Test: 1 Answer Section MULTIPLE CHOICE 1. ANS: D Rationale: Every time a patient receives health care, a record is maintained of the observations, medical or surgical interventions, and treatment outcomes. PTS: 1 DIF: Moderate 2. ANS: A Rationale: Technicians who specialize in coding are called medical coders or coding specialists. PTS: 1 DIF: Moderate 3. ANS: D Rationale: HIPAA was adopted into law in 1996 PTS: 1 DIF: Moderate 4. ANS: B Rationale: HITECH also “lowers the bar” for what constitutes a violation, but provides a 30-day window during which any violation not due to willful neglect may be corrected without penalty PTS: 1 DIF: Moderate 5. ANS: C Rationale: Electronic claims benefit the provider office by allowing timely submissions to the insurance carrier and proof of transmissions of the claims. PTS: 1 DIF: Moderate 6. ANS: C Rationale: The OIG Work Plan sets forth various projects to be addressed during the fiscal year by the Office of Audit Services, Office of Evaluation and Inspections, Office of Investigations, and Office of Counsel to the Inspector General PTS: 7. ANS: 1 C DIF: PTS: Moderate 1 DIF: Moderate 8. ANS: A PTS: 1 DIF: Moderate 9. ANS: C PTS: 1 DIF: Moderate 10. ANS: C PTS: 1 DIF: Moderate 11. ANS: C PTS: 1 DIF: Moderate 12. ANS: B PTS: 1 DIF: Moderate 13. ANS: C PTS: 1 DIF: Moderate 14. ANS: C PTS: 1 DIF: Moderate 15. ANS: A PTS: 1 DIF: Moderate 16. ANS: C PTS: 1 DIF: Moderate 17. ANS: C Rationale: ICD-10-CM official guidelines introduction, the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) provide the guidelines for coding and reporting using ICD-10-CM. PTS: 1 DIF: Easy 18. ANS: C Rationale: The Index to Diseases and Injuries (Alphabetic Index) in ICD-10-CM utilizes the same main term/subterm indexing systems. In ICD-10-CM, the code listed next to the main term is considered the default code. The default code represents the condition most commonly associated with the main term. As with all code assignment, always verify the default code in the Tabular List to assure proper reporting. Refer to ICD- 10-CM coding guidelines Section I.A.18. PTS: 1 DIF: Easy 19. ANS: D Rationale: Per the Introduction page of the ICD-10-CM codebook, the abbreviation stands for International Classification of Diseases, 10th Revision, Clinical Modification. PTS: 1 DIF: Easy 20. ANS: C Rationale: Coding guideline Section I.A.7 states parentheses are used to enclose supplementary words that may be present or absent in the statement of disease or procedure, without affecting the code number to which it assigned. PTS: 1 DIF: Moderate 21. ANS: D Rationale: Per General Coding Guideline Section 1.B.10, coding of sequelae (late effects) generally require two codes sequenced in the following order: The condition or nature of the late effect is sequenced first and the late effect code is sequenced second. An exception to this guideline are those instance where the code for the late effect is followed by a manifestation code in the Tabular List and title, or the late effect code has been expanded to include the manifestation. PTS: 1 DIF: Moderate 22. ANS: A Rationale: Look in the ICD-10-CM Alphabetic Index for Hives and you are directed to see Urticaria. Urticaria directs you to L50.9. Verify code selection in the Tabular List. PTS: 1 DIF: Moderate 23. ANS: A Rationale: ICD-10-CM coding guideline I.B.11 tells us to reference the Alphabetic Index to determine if the condition has a subentry for “impending” or “threatened” and also reference main term entries for “Impending” and “Threatened.” If the subterms are listed, assign the given code. If the subterms are not listed, code the existing underlying condition(s) and not the condition described as impending or threatened. Look in the Alphabetic Index for Impending. There is not a subterm for menopause; therefore, the symptoms are coded. Look for insomnia G47.00. Next, look for Upset/stomach K30. Verify both codes in the Tabular List. PTS: 1 DIF: Difficult 24. ANS: B Rationale: Look in the ICD-10-CM Alphabetic Index for Laceration/shoulder S41.019-. In the Tabular List, sixth character 2 is selected for the left shoulder. This code also indicates a seventh character is required. B is selected for the subsequent encounter. PTS: 1 DIF: Difficult 25. ANS: D Rationale: In ICD-10-CM, the term urosepsis does not have a default code. If the physician documents urosepsis without additional information, the provider must be queried before an ICD-10-CM code can be applied. PTS: 1 DIF: Easy REF: ICD-10-CM 26. ANS: C Rationale: In ICD-10-CM Guidelines I.C.2.c.1, when the patient is being seen for management of the anemia associated with malignancy (D63.0), the code for the malignancy is reported first, followed by the code for the anemia. PTS: 1 DIF: Easy REF: ICD-10-CM 27. ANS: B Rationale: In ICD-10-CM Guidelines I.C.9.e, myocardial infarctions are classified as acute if the duration is four weeks (28 days) or less. PTS: 1 DIF: Easy REF: ICD-10-CM 28. ANS: B Ratioanle: RAD is an acronym for Reactive Airway Disease. Look in the ICD-10-CM Alphabetic Index for Disease, diseased/reactive airway and you are directed to see Asthma. Look for Asthma, asthmatic/with/exacerbation (acute) J45.901. Verify code selection in the Tabular List. According to the ICD- 10-CM Guidelines, when a definitive diagnosis is known, the related symptoms are not coded. PTS: 1 DIF: Moderate 29. ANS: B Rationale: Per guidelines Section I.C.9.a. 2, Assign codes from category I12, Hypertension/kidney disease, when conditions classified to category N18. In the ICD-10-CM Alphabetic Index, look for Hypertension/kidney/with/stage 1 through stage 4 chronic kidney disease. In the Tabular List, there is a note to use an additional code to identify the stage of chronic kidney disease (N18.1-N18.4 or N18.9). Look in the ICD-10-CM Alphabetic Index for Disease/kidney/chronic/stage 3 N18.3. Verify in the Tabular List. PTS: 1 DIF: Difficult 30. ANS: D Rationale: In the ICD-10-CM Alphabetic Index, look for Glomerulonephritis/in (due to) amyloidosis guiding you to codes E85.4 [N08]. In the Tabular List, code N08 has a “code first” instructional note to first code amyloidosis (E85.4). Your primary code is E85.4, for Amyloidosis followed by N08 for the manifested Glomerulonephritis. PTS: 1 DIF: Difficult 31. ANS: C Rationale: Look in the ICD-10-CM Alphabetic Index Diabetes, diabetic/type2/with/retinopathy/proliferative/with macular edema E11.351. Verify code selection in the Tabular List. PTS: 1 DIF: Difficult 32. ANS: B Rationale: The patient has malignant pleural effusion. Look in the ICD-10-CM Alphabetic Index for Effusion/pleura, pleurisy, pleuritic, pleuropericardial/malignant J91.0. In the Tabular List, there is a note under J91.0 to code the malignant neoplasm first, if known. In this case, it is known. According to ICD-10- CM Guideline Section I.C.2.b. when treatment is directed to the secondary cancer, the secondary cancer is reported first. The primary cancer is reported second. Treatment is due to the accumulation of fluid due to metastasis to the pleura. Look in the Alphabetic IndexTable of Neoplasms for Neoplasm, neoplastic/pleura, pleural (cavity) and use the code from the Malignant/Secondary column C78.2. The primary malignancy should also be reported. Look in the Table of Neoplasms for Neoplasm, neoplastic/lung and use the code from the Malignant Primary column C34.9-. In the Tabular List, fifth character 1 is selected for the right lung. The Guidelines I.C.2.f indicate that for thoracentesis the primary or appropriate metastatic site is listed first. PTS: 1 DIF: Difficult 33. ANS: B Rationale: ICD-10-CM guideline I.C.20.a.1 General External Cause Code Coding Guidelines instructions state “An external cause code may be used with any code in the range of A00.0-T88.9, Z00-Z99, classification that is a health condition due to an external cause. Though they are most applicable to injuries, they are also valid for use with such things as infections or diseases due to an external source, and other health conditions, such as heart attack that occurs during strenuous physical activity” PTS: 1 DIF: Easy 34. ANS: B Rationale: Colp/o is the combining form referring to the vagina. As an example, colpocele (N81.5) and colpocystitis (N76.0) are medical conditions of the vagina. PTS: 1 DIF: Easy 35. ANS: A Rationale: ICD-10-CM Coding Guideline I.C.19.a. the 7th character A represents the initial encounter for active treatment for the condition. PTS: 1 DIF: Easy 36. ANS: D Rationale: According to ICD-10-CM guideline I.C.19.a Examples of active treatment are: surgical treatment, emergency department encounter, evaluation and treatment by a new physician. Case change is considered subsequent treatment. PTS: 1 DIF: Easy 37. ANS: B Rationale: A leaking dialysis catheter would be a complication. In the ICD-10-CM Alphabetic Index, look for Complication/catheter (device) NEC/dialysis (vascular)/mechanical/leakage guiding you to subcategory code T82.43. The Tabular List indicates seven characters are needed to complete the code. The sixth character is for the placeholder X and the seventh character is A for the initial encounter. T82.43XA is the correct code. PTS: 1 DIF: Moderate 38. ANS: B Rationale: In the ICD-10-CM External Cause of Injuries Index (after the Drug Table), look for Accident/transport/car occupant/passenger/collision (with)/stationary object (traffic) guiding you to subcategory, V47.62. In the Tabular List, 7th character A is necessary for the initial encounter. You would use an additional External cause code when a place of occurrence (example, home or parking lot) is documented. In this case, the location is documented as the highway. In the ICD-10-CM External Cause of Injuries Index, look for Place of occurrence/highway (interstate) guiding you to code Y92.411. Verify codes selection in the Tabular List. PTS: 1 DIF: Moderate 39. ANS: A Rationale: Look in the ICD-10-CM Alphabetic Index for Degeneration, degenerative/intervertebral disc/lumbosacral region M51.37. Verify code selection in the Tabular List. The low back pain is a symptom of the degenerative disc disease and is not reported separately. PTS: 1 DIF: Moderate 40. ANS: C Rationale: In the ICD-10-CM Alphabetic Index, look for Vaccination (prophylactic)/encounter for which guides you to code Z23. The patient does not have these diseases so you cannot code for them, only for the vaccine administration. PTS: 1 DIF: Difficult 41. ANS: A Rationale: Over-the-counter medication taken in an improper dosage is considered a poisoning. ICD-10-CM Coding Guideline, Section I.C.19.e.5.b states “When coding a poisoning or reaction to the improper use of a medication (e.g., overdose, wrong substance given or taken in error, wrong route of administration), first assign the appropriate code from categories T36-T50.” This was an accident (taken incorrectly). In the ICD10-CM Table of Drugs and Chemicals, look for Aspirin/Poisoning, Accidental (unintentional) column guiding you to T39.011. In the Tabular List the code needs a seventh character. The seventh character chosen is A. The first code to assign is the poisoning, T39.011A. The codes for the manifestations are assigned next and are found in the ICD-10-CM Alphabetic Index by looking for Tinnitus (ringing in the ear) H93.1-, fifth character 3 for both ears; Nausea/with vomiting (R11.2); and Drowsiness (R40.0). PTS: 1 DIF: Difficult 42. ANS: B Rationale: The child had puncture wounds to her leg. Look in the ICD-10-CM Alphabetic Index for Bite (s) (animal) (human)/leg (lower) S81.85-. In the Tabular List, sixth character 2 is reported for the left leg and seventh character A is applied for initial encounter because it is an ED visit. She did not have rabies, but was exposed to rabies because the dog was known to have rabies. Next, the exposure to rabies is reported. Look in the ICD-10-CM Alphabetic Index for Exposure (to)/rabies Z20.3. She received a rabies vaccination; however, according to ICD-10-CM Guideline Section I.C.21.c.2, vaccination code Z23 is used when it is the reason for the encounter or as a secondary code when given as a routine part of preventive health care. Z23 is not reported for this visit. Next, the circumstances for the injury are reported. The only thing we know is that it is a dog bite. Look in the ICD-10-CM Index to External Causes of Injuries for Bite, bitten by/dog W54.0-. In the Tabular List, seventh character A is applied for the intial encounter. Two placeholder Xs are used to keep the seventh character in the seventh position. PTS: 1 DIF: Difficult 43. ANS: C Rationale: Per CMS Internet-only manuals (IOM) Medicare Claims Processing Manual – surgical status indicator 000 = Endoscopic or minor procedure with related preoperative and postoperative relative values on the day of the procedure only included in the fee schedule payment amount; evaluation and management services on the day of the procedure generally not payable. PTS: 1 DIF: Moderate 44. ANS: C Rationale: Modifier 32 reports “mandated services” PTS: 1 DIF: Moderate 45. ANS: C Rationale: In the HCPCS Level II Index, look up Parenteral nutrition/solution. You are directed to codes B4164-B5200. When you review the B codes, code B4168 is reported. PTS: 1 DIF: Moderate 46. ANS: B Rationale: In the HCPCS Level II Table of Drugs, look up Bicillin LA, which directs you to code J0561. Because J0561 is for 100,000 U, 24 units are reported for 2,400,000 U. PTS: 1 DIF: Moderate 47. ANS: A Rationale: In the CPT® Index, look for Cystourethroscopy/Biopsy/Brush. The code you are directed to is 52007. PTS: 1 DIF: Moderate 48. ANS: B Rationale: In the CPT® Index, look for Catheterization/Cardiac and you are directed to See Cardiac Catheterization. Cardiac Catheterization/Right Heart/Congenital Cardiac Anomalies directs you to use is 93530. PTS: 1 DIF: Moderate 49. ANS: C Rationale: New additions and revisions are indicated in your CPT® codebook each year by green print. PTS: 1 DIF: Moderate 50. ANS: C Rationale: Look in your CPT® codebook for 49568. The parenthetical instruction under code 49568 states, “Use 49568 in conjunction with , .” PTS: 1 DIF: Moderate 51. ANS: D Rationale: Look in the CPT® Index for Removal/Skin Tags. Based on the documentation, the total number of skin tags removed is 22. Code 11200 is reported for the removal of “up to and including 15 lesions.” Notice the wording for 11201 “… each additional 10 lesions, or part thereof.” The words “part there of” in the code description means you do not need to have a complete total of 10 skin tags to report the add-on code. The add-on code can be reported if the additional skin tags are 10 and under; so it is not necessary to append modifier 52 to this add-on code. Code 11201 is an add-on code. Modifiers are not appended to add-on codes. PTS: 1 DIF: Moderate 52. ANS: B Rationale: Understanding a sebaceous cyst is benign, look in the CPT® Index for Skin/Excision/Lesion/Benign referring you to code range . The lesion is coded based on size and location for 11401. The note also indicates the wound was closed in layers allowing for intermediate closure, also coded based on location and size, 12031. In the ICD-10-CM Alphabetic Index, look for Cyst/sebaceous directs you to L72.3. Verify in the Tabular List. PTS: 1 DIF: Difficult 53. ANS: B Rationale: Most categories in ICD-10-CM Injury and Poisoning have a 7th character requirement for each applicable code. For mo