COC 2023 FINAL EXAM STUDY
QUESTIONS AND ANSWERS
14 year-old status post injury over one year ago to her left wrist presented with
recurrent wrist pain. The patient was taken to the operating room and placed
under general anesthesia. She was placed in wrist traction. The radiocarpal joint
was entered endoscopically through sharp skin incisions and blunt dissection into
the joint. There was found to be mild synovitis in the dorsal ulnar aspect of the
wrist. This was debrided arthroscopically with a shaver. There was a peripheral
tear of the triangular fibrocartilage. This area was shaved to promote healing.
Using outside in technique, a PDS suture was placed across the TFCC and into the
capsule. There was synovitis within the midcarpal joint, but there was no articular
injury. All instruments were removed and the wounds were closed with
interrupted nylon sutures. What CPT ® code is reported? - answer29846-LT
44-year-old male with biplanar deformity, acquired limb length discrepancies and
tibial nonunion has undergone deformity correction. He now requires exchange of
an external fixation strut 45 days postoperatively. The intraoperative mounting
parameters, deformity parameters, and initial strut settings are inserted into the
computer prior to Jim's discharge and a daily schedule is generated for him to
perform the gradual deformity correction necessary. What CPT® code(s) should be
reported? - answer20697
56 year-old pro golfer is having Mohs micrographic surgery for skin cancer on his
forehead. The surgeon takes him back for two stages. The first stage has 4 tissue
blocks and the second stage has 6 tissue blocks. What is the best way to code for
both stages? - answer17311, 17312, 17315
66 year-old male with a history of anemia presents for a liver core biopsy to
evaluate for possible cirrhosis. The patient was brought to the CAT scan suite in
which limited CT images of the upper abdomen were performed for biopsy needle
placement. The appropriate site for the liver core biopsy was chosen. The
patient's skin was then marked with the computer coordinates. An
18-gauge needle was advanced into the appropriate site and a sample was
obtained. What CPT ® codes are reported for the facility? - answer47000, 77012
,A must include cholesterol, serum total (82465), Lipoprotein, direct measurement,
high density cholesterol (HDL cholesterol) (83718), and Triglycerides (84478) -
answerLipid Panel (80061)
,A patient presents to the hospital-based outpatient surgery department for a left knee
medial meniscus repair. She had recurrent locking, swelling and catching of the knee.
A diagnostic arthroscopy was performed. Under direct visualization, a medial portal
was established and debridement of the posterior horn of the medial meniscus was
performed. A shaver was then introduced to trim the meniscus back to a stable rim.
The remainder of the knee was probed. The scope was then withdrawn and the wound
was closed with #4-0 Vicryl. The discharge diagnosis was a bucket-handle tear of the
medial meniscus. The patient tolerated the procedure well. What are the correct
procedure and diagnosis codes for this encounter? - answer29881, S83.212A
A 12 year-old child presents to the ED with an acute exacerbation of asthma. The
patient is wheezing and is having difficulty breathing. She is not responding to the
therapy. The physician documents as the final diagnosis asthma with status
asthmaticus. What ICD-10-CM code(s) is/are reported? - answerJ45.902
A 12 year-old's diabetes mellitus is well controlled with oral antidiabetic
medications . The patient has no complications. Applying the coding concept from
ICD-10-CM guidelines I.C.4.a.l, I.C.4.a.2, and I.C.4.a.3, what ICD-10-CM code(s)
is/are reported? - answerE11.9, Z79.84
A 13 year-old is seen in the emergency department with a sudden onset of nausea,
fever and diarrhea. A stool culture indicated Salmonella bacterium. The patient
stated that she had been at a family reunion and recalls eating some salad, ice-
cream and chicken. Diagnosis made was salmonella gastroenteritis. Report the
diagnosis code(s) for the visit. - answerA02.0
A 14-year-old male is brought to the ER by his parents after hitting his left knee
on the base when sliding into base at a baseball game in a public park. After X-
rays were obtained, it revealed a sprain to the knee. The patient was instructed to
keep his leg elevated and keep weight off of it as much as possible for the next
two weeks. What diagnosis codes are reported for this encounter? -
answerS83.92XA, W21.89XA, Y92.830, Y93.64
A 15 year old female undergoing treatment for Hodgkin's lymphoma presents to
the behavioral health clinic to be evaluated for increasing acute panic attacks
during her cancer treatments. The psychologist spent 1 hour and 15 minutes face-
to-face with the patient. The patient was diagnosed with adjustment disorder with
anxiety and a treatment plan was initiated. She will be seen for a reassessment in
, 30 days. What are the correct CPT ® and ICD-10-CM codes to report this service?
- answer96150 x 5, F43.22, C81.90
QUESTIONS AND ANSWERS
14 year-old status post injury over one year ago to her left wrist presented with
recurrent wrist pain. The patient was taken to the operating room and placed
under general anesthesia. She was placed in wrist traction. The radiocarpal joint
was entered endoscopically through sharp skin incisions and blunt dissection into
the joint. There was found to be mild synovitis in the dorsal ulnar aspect of the
wrist. This was debrided arthroscopically with a shaver. There was a peripheral
tear of the triangular fibrocartilage. This area was shaved to promote healing.
Using outside in technique, a PDS suture was placed across the TFCC and into the
capsule. There was synovitis within the midcarpal joint, but there was no articular
injury. All instruments were removed and the wounds were closed with
interrupted nylon sutures. What CPT ® code is reported? - answer29846-LT
44-year-old male with biplanar deformity, acquired limb length discrepancies and
tibial nonunion has undergone deformity correction. He now requires exchange of
an external fixation strut 45 days postoperatively. The intraoperative mounting
parameters, deformity parameters, and initial strut settings are inserted into the
computer prior to Jim's discharge and a daily schedule is generated for him to
perform the gradual deformity correction necessary. What CPT® code(s) should be
reported? - answer20697
56 year-old pro golfer is having Mohs micrographic surgery for skin cancer on his
forehead. The surgeon takes him back for two stages. The first stage has 4 tissue
blocks and the second stage has 6 tissue blocks. What is the best way to code for
both stages? - answer17311, 17312, 17315
66 year-old male with a history of anemia presents for a liver core biopsy to
evaluate for possible cirrhosis. The patient was brought to the CAT scan suite in
which limited CT images of the upper abdomen were performed for biopsy needle
placement. The appropriate site for the liver core biopsy was chosen. The
patient's skin was then marked with the computer coordinates. An
18-gauge needle was advanced into the appropriate site and a sample was
obtained. What CPT ® codes are reported for the facility? - answer47000, 77012
,A must include cholesterol, serum total (82465), Lipoprotein, direct measurement,
high density cholesterol (HDL cholesterol) (83718), and Triglycerides (84478) -
answerLipid Panel (80061)
,A patient presents to the hospital-based outpatient surgery department for a left knee
medial meniscus repair. She had recurrent locking, swelling and catching of the knee.
A diagnostic arthroscopy was performed. Under direct visualization, a medial portal
was established and debridement of the posterior horn of the medial meniscus was
performed. A shaver was then introduced to trim the meniscus back to a stable rim.
The remainder of the knee was probed. The scope was then withdrawn and the wound
was closed with #4-0 Vicryl. The discharge diagnosis was a bucket-handle tear of the
medial meniscus. The patient tolerated the procedure well. What are the correct
procedure and diagnosis codes for this encounter? - answer29881, S83.212A
A 12 year-old child presents to the ED with an acute exacerbation of asthma. The
patient is wheezing and is having difficulty breathing. She is not responding to the
therapy. The physician documents as the final diagnosis asthma with status
asthmaticus. What ICD-10-CM code(s) is/are reported? - answerJ45.902
A 12 year-old's diabetes mellitus is well controlled with oral antidiabetic
medications . The patient has no complications. Applying the coding concept from
ICD-10-CM guidelines I.C.4.a.l, I.C.4.a.2, and I.C.4.a.3, what ICD-10-CM code(s)
is/are reported? - answerE11.9, Z79.84
A 13 year-old is seen in the emergency department with a sudden onset of nausea,
fever and diarrhea. A stool culture indicated Salmonella bacterium. The patient
stated that she had been at a family reunion and recalls eating some salad, ice-
cream and chicken. Diagnosis made was salmonella gastroenteritis. Report the
diagnosis code(s) for the visit. - answerA02.0
A 14-year-old male is brought to the ER by his parents after hitting his left knee
on the base when sliding into base at a baseball game in a public park. After X-
rays were obtained, it revealed a sprain to the knee. The patient was instructed to
keep his leg elevated and keep weight off of it as much as possible for the next
two weeks. What diagnosis codes are reported for this encounter? -
answerS83.92XA, W21.89XA, Y92.830, Y93.64
A 15 year old female undergoing treatment for Hodgkin's lymphoma presents to
the behavioral health clinic to be evaluated for increasing acute panic attacks
during her cancer treatments. The psychologist spent 1 hour and 15 minutes face-
to-face with the patient. The patient was diagnosed with adjustment disorder with
anxiety and a treatment plan was initiated. She will be seen for a reassessment in
, 30 days. What are the correct CPT ® and ICD-10-CM codes to report this service?
- answer96150 x 5, F43.22, C81.90
