Question 1

Choose the appropriate CPT code for a care plan oversight service for a patient under the care of home health agency performed by a physician for 45 minutes.

Accepted Answer

99375 is the correct CPT code for care plan oversight services provided by a physician for a patient in a home health agency setting for 30-60 minutes.

Question 2

A 50-year-old male patient presents to the office today for his annual preventive visit. During the visit, Dr. Jones becomes concerned about the patient's hypertension and believes that this needs some evaluation and management beyond the preventive visit. Dr. Jones changes the patient's medications and orders lab work. Which modifier would be reported to the payer in order to be reimbursed for both the preventive visit and the office visit?

Accepted Answer

Modifier 25 is used to indicate that on the day of a procedure or service identified by a CPT code, the patient's condition required a significant, separately identifiable E/M service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. In this scenario, Dr. Jones provided an additional evaluation and management service (changing the patient's medications and ordering lab work) that was significant and separately identifiable from the preventive visit, making modifier 25 the correct choice to ensure reimbursement for both services.

Question 3

June was admitted to the hospital with atrial fibrillation by her PCP, and cardiology was consulted at the time of admission. On the next day, the cardiologist made rounds and checked on Mary's progress. An expanded problem-focused interval history was obtained, and an expanded problem-focused exam was performed. Mary has been on IV therapy and is showing improvement. Select the code for the cardiologist encounter on the second day.

Accepted Answer

The encounter on the second day involved an expanded problem-focused interval history and exam, which aligns with the requirements for code 99232, a subsequent hospital care code.

Question 4

Mrs. Jones is in the operating room today for repair of a nontraumatic tear of the rotator cuff of the right shoulder. The physician performs an arthroscopy subacromial decompression with an open repair of the rotator cuff. Select the appropriate ICD-10-CM and CPT code(s):

Accepted Answer

M75.101 is the ICD-10-CM code for an unspecified rotator cuff tear or rupture of the right shoulder, not specified as traumatic. CPT code 23412 is for open repair of the rotator cuff, and 29827-59 is for arthroscopic subacromial decompression, with modifier 59 indicating a distinct procedural service.

Question 5

Tommy was climbing the tree in front of his house, fell, and sustained a greenstick fracture of the ulna of his left arm. The orthopedic surgeon performed a closed manipulation and applied a short arm cast. Select the appropriate ICD-10-CM and CPT code(s):

Accepted Answer

The answer of Tommy was climbing the tree in front...

Question 6

A 2-year-old with osteogenesis imperfecta was brought to the OR for application of a halo with placement of seven pins. Select the appropriate ICD-10-CM and CPT code(s):

Accepted Answer

Q78.0 is the ICD-10-CM code for osteogenesis imperfecta. 20664 is the CPT code for the application of a halo, including the placement of pins.

Question 7

The patient was seen for I&D of a subfascia soft tissue abscess on the left thigh. Code this procedure with the appropriate ICD-10-CM and CPT code(s):

Accepted Answer

The correct ICD-10-CM code for a subfascial soft tissue abscess on the left thigh is L02.416, and the appropriate CPT code for incision and drainage (I&D) of a subfascial abscess is 20005.

Question 8

Mrs. Jones was brought to the OR for open reduction by posterior approach of fractures to vertebrae at L4 and L5 as a result of a car accident. Select the appropriate ICD-10-CM and CPT code(s):

Accepted Answer

The correct ICD-10-CM codes for fractures to vertebrae at L4 and L5 are S32.049A and S32.059A, indicating fractures at these specific locations with the "A" denoting an initial encounter. The correct CPT codes are 22325 for the open reduction of the vertebral fracture and 22328 for the posterior approach, which are necessary for the described surgical procedure.

Question 9

The surgeon performed a correction of hallux valgus with sesamoidectomy using the Joplin procedure on the left foot to correct a bunion. Select the appropriate ICD-10-CM and CPT code(s):

Accepted Answer

The correct ICD-10-CM codes are M20.12 (Hallux valgus (acquired), left foot) and M21.612 (Bunion of left foot), and the correct CPT code is 28292, which is for correction, hallux valgus (bunion), with or without sesamoidectomy; other than distal metatarsal osteotomy. This combination accurately reflects the diagnosis and the specific procedure performed on the left foot.

Question 10

John underwent disarticulation at the knee as a result of a traumatic crushing injury to the right tibia and fibula caused by a motorcycle accident. Select the appropriate ICD-10-CM and CPT code(s):

Accepted Answer

John underwent disarticulation at the knee, which is a type of amputation. The ICD-10-CM code for disarticulation at the knee is S87.81xA. The CPT code for disarticulation at the knee is 27598.

Question 11

Mr. Dell is a farrier, and he was kicked in the sacral-coccygeal area by a horse that he was shoeing. The injury was significant enough to require an open treatment to repair the coccygeal fracture. Select the appropriate ICD-10-CM and CPT code(s):

Accepted Answer

The correct ICD-10-CM code for a coccygeal fracture is S32.2xxA, indicating a fracture of the coccyx with an initial encounter for a closed fracture. The correct CPT code for an open treatment of a coccygeal fracture is 27202, which involves the surgical repair of the fracture.

Question 12

The patient underwent partial excision of the posterior C7 and L1 and L2 vertebrae to remove intrinsic bony lesions. Two surgeons worked simultaneously as primary surgeons to remove the lesions. Surgeon A removed the lesion at C7, and surgeon B removed the lesions at L1 and L2. Code the services of surgeon B with the appropriate ICD-10-CM and CPT code(s):

Accepted Answer

Surgeon B worked on the lumbar vertebrae (L1 and L2), so the appropriate CPT codes would be for those locations. The modifier -62 indicates two surgeons working together. The ICD-10-CM code M84.88 specifies a disorder of continuity of bone, site unspecified, which would be appropriate for intrinsic bony lesions. The codes 22102-62 and 22103-62 specifically refer to partial excision of vertebral body at the lumbar region, with the second code indicating each additional segment, which matches the work done by Surgeon B on L1 and L2.

Question 13

Mrs. Jones, an established patient, is seen by the rheumatologist for repeated pain in her left knee due to osteoarthritis. Today she presents with pain and swelling. The rheumatologist performs an arthrocentesis of the left knee followed by injection of Dexa-Methasone sodium phosphate, 5 mg. No E/M service is performed. Select the appropriate ICD-10-CM and CPT code(s):

Accepted Answer

The correct ICD-10-CM code for osteoarthritis of the left knee is M17.12. The CPT code 20610 is for arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa) without ultrasound guidance, which matches the procedure described. J1100 is the HCPCS code for Dexamethasone sodium phosphate, 1 mg, and "5u" indicates the dosage used, which is 5 mg in this case. No E/M service was performed, so no E/M code is applicable.

Question 14

Mr. Jones is a patient with recurrent stage IV colon carcinoma of the sigmoid colon. He had previously undergone a laparoscopic low anterior resection (LAR). He was brought to the operating room today and under general anesthesia underwent a laparoscopic lysis of adhesions. The small bowel loops were found to be adherent to the anterior abdominal wall and also near the colostomy. These adhesions were lysed. There was one loop of small bowel that was adherent to the anterior abdominal wall of the RLQ, and this adhesion was not disturbed. Select the appropriate ICD-10-CM and CPT code(s):

Accepted Answer

The answer of Mr. Jones is a patient with recurrent...

Question 15

Jeremy presented to the ED complaining of severe odynophagia after eating chicken wings. Upon initial x-rays, no perforation of the esophagus was noted. The gastrointestinal specialist was called, and the patient was taken to the endoscopy suite. There, with the patient under moderate sedation, the gastroenterologist performed an esophagoscopy and removed a small chicken bone lodged in the esophagus above the diaphragm. Select the appropriate ICD-10-CM and CPT code(s):

Accepted Answer

The correct ICD-10-CM code for a foreign body (chicken bone) lodged in the esophagus is T18.128A, indicating a foreign body in the esophagus causing injury, with the "A" denoting an initial encounter. The correct CPT code for the procedure (esophagoscopy with removal of a foreign body) is 43215. This code accurately describes the service provided by the gastroenterologist.

Question 16

The patient underwent a hemorrhoidectomy for removal of two columns of prolapsed internal hemorrhoids, third-degree, and resolution of a chronic anal fissure-fissurectomy. Select the appropriate ICD-10-CM and CPT code(s):

Accepted Answer

K64.2 represents third-degree hemorrhoids, K60.1 represents a chronic anal fissure, and 46261 is the CPT code for hemorrhoidectomy, internal, by surgical excision; including removal of anal fissure or fistula, when performed, which accurately describes the procedures performed.

Question 17

Mrs. Jones presented with pain in the right upper quadrant. Upon a CT of the abdomen and an ultrasound of the gallbladder, a diagnosis of cholelithiasis and acute cholecystitis was confirmed, and the patient was taken to the operating room. The patient underwent a laparoscopic cholecystectomy with a normal intraoperative cholangiogram to remove the gallstones. Select the appropriate ICD-10-CM and CPT code(s):

Accepted Answer

The correct answer is A: K80.00, 47563. K80.00 is the ICD-10-CM code for cholelithiasis, and 47563 is the CPT code for laparoscopic cholecystectomy with cholangiogram.

Question 18

A 4-year-old male underwent a frenoplasty using the Z technique to correct his speech difficulty due to ankyloglossia. Select the appropriate ICD-10-CM and CPT code(s):

Accepted Answer

The answer of A 4-year-old male underwent a frenoplasty using...

Question 19

A 45-year-old male with pancreatic cancer presents with a distended abdomen. The ultrasound reveals fluid in the peritoneal cavity. The patient undergoes a therapeutic paracentesis with ultrasound imaging guidance to drain the fluid. Select the appropriate ICD-10-CM and CPT code(s):

Accepted Answer

C25.9 is the ICD-10-CM code for pancreatic cancer, unspecified, and 49083 is the CPT code for a therapeutic paracentesis with imaging guidance.

Question 20

A 1-year-old female underwent a uvulopalatopharyngoplasty to repair a congenital bilateral cleft lip and cleft hard palate. Select the appropriate ICD-10-CM and CPT code(s):

Accepted Answer

Q37.0 is the ICD-10-CM code for congenital bilateral cleft lip and cleft hard palate. 42145 is the CPT code for uvulopalatopharyngoplasty.

Quiz 27: Coding and Surgical Procedures

Choose the appropriate CPT code for a care plan oversight service for a patient under the care of home health agency performed by a physician for 45 minutes.

Mrs. Jones is in the operating room today for repair of a nontraumatic tear of the rotator cuff of the right shoulder. The physician performs an arthroscopy subacromial decompression with an open repair of the rotator cuff. Select the appropriate ICD-10-CM and CPT code(s) :

Tommy was climbing the tree in front of his house, fell, and sustained a greenstick fracture of the ulna of his left arm. The orthopedic surgeon performed a closed manipulation and applied a short arm cast. Select the appropriate ICD-10-CM and CPT code(s) :

A 2-year-old with osteogenesis imperfecta was brought to the OR for application of a halo with placement of seven pins. Select the appropriate ICD-10-CM and CPT code(s) :

The patient was seen for I&D of a subfascia soft tissue abscess on the left thigh. Code this procedure with the appropriate ICD-10-CM and CPT code(s) :

Mrs. Jones was brought to the OR for open reduction by posterior approach of fractures to vertebrae at L4 and L5 as a result of a car accident. Select the appropriate ICD-10-CM and CPT code(s) :

The surgeon performed a correction of hallux valgus with sesamoidectomy using the Joplin procedure on the left foot to correct a bunion. Select the appropriate ICD-10-CM and CPT code(s) :

John underwent disarticulation at the knee as a result of a traumatic crushing injury to the right tibia and fibula caused by a motorcycle accident. Select the appropriate ICD-10-CM and CPT code(s) :

Mr. Dell is a farrier, and he was kicked in the sacral-coccygeal area by a horse that he was shoeing. The injury was significant enough to require an open treatment to repair the coccygeal fracture. Select the appropriate ICD-10-CM and CPT code(s) :

The patient underwent a hemorrhoidectomy for removal of two columns of prolapsed internal hemorrhoids, third-degree, and resolution of a chronic anal fissure-fissurectomy. Select the appropriate ICD-10-CM and CPT code(s) :

A 4-year-old male underwent a frenoplasty using the Z technique to correct his speech difficulty due to ankyloglossia. Select the appropriate ICD-10-CM and CPT code(s) :

A 45-year-old male with pancreatic cancer presents with a distended abdomen. The ultrasound reveals fluid in the peritoneal cavity. The patient undergoes a therapeutic paracentesis with ultrasound imaging guidance to drain the fluid. Select the appropriate ICD-10-CM and CPT code(s) :

A 1-year-old female underwent a uvulopalatopharyngoplasty to repair a congenital bilateral cleft lip and cleft hard palate. Select the appropriate ICD-10-CM and CPT code(s) :