Question 1

A patient with thyroid cancer had a thyroidectomy with a radical cervical lymphadenectomy. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code for a thyroidectomy with radical cervical lymphadenectomy is 60254, and the appropriate ICD-10-CM code for thyroid cancer is C73.

Question 2

Preoperative Diagnosis: Advanced primary open angle glaucoma, right eye, with related cortical cataract, right eye.
Procedure: Trabeculectomy.
Phacoemulsification and posterior chamber IOL insertion.
Postoperative Diagnosis: Advanced primary open angle glaucoma, right eye, with related cortical cataract, right eye.
Operation: The patient was brought in to the operating room on an eye stretcher and placed in the supine position. A peribulbar block using an equal concentration of 2% lidocaine and 0.5% Marcaine was administered and the right eye was draped and prepped in the usual sterile ophthalmic fashion and the microscope was brought in position. We placed a Lieberman lid speculum between the lid fissures on the right eye, then placed a superior rectus bridle suture to stabilize the eye. We created a superior peritomy using Vannas scissors and Bishop forceps. Next we used the cautery to outline a 3x4mm rectangular scleral flap. After applying mitomycin 0.2 mg/mL to the sclera and conjunctiva for two minutes per the clock, I thoroughly irrigated the area with saline. I then dissected the scleral flap using a #68 Beaver blade. I created a 2.70mm incision on the cornea under the scleral flap using a standard blade and created a primary posterior capsulorhexis using a cystotome and forceps. Hydrodissection of the lens nucleus was performed, then we did the phacoemulsification without difficulty and the area was irrigated with saline and the cortical remnants removed. We inserted an AcrySof® Aspheric IOL Model SN60WF +25 into the capsular sac and centered it without difficulty. We then created the internal sclerostomy under the scleral flap, measuring 1x2.5mm. We removed the limbal material with a Kelly punch.
Next we created a peripheral iridectomy using Dewecker scissors and closed the scleral flap using 5 interrupted 10-0 nylon sutures, being attentive to carefully control the tension. When the tension allowed egress of aqueous, we tied off and buried the sutures. We reapproximated the conjunctival flap and suture it into position using 9-0 nylon mattress sutures and 8-0 Vicryl running sutures. We checked intraolcular pressure manually with a cannula and it was within normal limits. We applied Gentamicin 20 mg under the conjunctiva and erythromycin on the conjunctiva. We removed the lid speculum, closed the eyelids and placed a patch and shield over the eye. The patient tolerated the procedure well and was transferred to recovery in good condition.
Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

Trabeculectomy with cataract extraction is coded with 66170 and 66984.

Question 3

A patient with a recent total detached retina on the left eye underwent scleral buckling. A vitrectomy was also performed in order for the surgeon to adequately visualize the structures using the operating microscope. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

67108-LT is the CPT code for repair of retinal detachment with scleral buckling, and H33.052 is the ICD-10-CM code for total retinal detachment of the left eye.

Question 4

The physician used cryotherapy to correct an ingrown eyelash on the left upper lid. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

CPT code 67825 corresponds to correction of trichiasis (ingrown eyelash), which includes epilation by forceps or other means, and is specific to the eyelid. The ICD-10-CM code H02.054 accurately describes trichiasis of the left upper eyelid, matching the procedure's description.

Question 5

Procedure Description: Under anesthesia via endotracheal intubation, the ears were inspected with the operating microscope. Anterior inferior quadrant myringotomy incisions were performed bilaterally. Armstrong tubes were inserted.
Diagnosis: Recurrent acute otitis media, bilateral middle ear effusions
Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The procedure described is a bilateral myringotomy with tube insertion, which corresponds to CPT code 69436-50. The diagnosis of recurrent acute otitis media with bilateral middle ear effusions is best represented by ICD-10-CM code H65.196.

Question 6

A patient with a benign tumor on the parotid gland had a parotidectomy. Nerves were dissected off the gland and left intact. A suction drain was inserted, which will be removed in two days. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code for a parotidectomy with nerve preservation is 42420, and the ICD-10-CM code for a benign neoplasm of the parotid gland is D11.0.

Question 7

A 22-year-old patient presents to the physician's office with a migraine headache, stiff neck, and fever. Dr. Blue performs a lumbar puncture in the office and confirms the condition of meningitis. The patient tolerated the procedure well. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

62270 is the CPT code for a diagnostic lumbar puncture, which is the procedure performed by Dr. Blue. G03.9 is the ICD-10-CM code for meningitis, unspecified, which matches the patient's condition as the specific cause of meningitis is not mentioned.

Question 8

Bill was involved in a MVA. He was taken to the ED where the following was performed: A 3 cm simple repair of the left ear, an intermediate repair of the left thigh which was 7.8 cm, and an intermediate repair of the left calf muscle which was 2.0 cm.
Select the appropriate CPT code(s) for the repairs only.

Accepted Answer

The correct codes are 12034 for the intermediate repair of the left thigh and calf (totaling 9.8 cm) and 12013-51 for the simple repair of the left ear.

Question 9

Pam presents at her podiatrist office for a right great toenail removal due to an ingrown nail. The podiatrist did a permanent removal of the distal half of the right great toenail. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code for a permanent removal of the toenail is 11750, and the T5 modifier indicates the procedure was performed on the right great toe. The appropriate ICD-10-CM code for an ingrown nail is L60.0.

Question 10

Which of the following is not included in the CPT definition of lesion destruction?

Accepted Answer

Scraping is not included in the CPT definition of lesion destruction. Lesion destruction typically involves methods like laser, cryosurgery, and electrosurgery, which are aimed at removing lesions by destruction rather than by physical removal methods like scraping.

Question 11

A 36-year-old female developed a sebaceous cyst on her left upper thigh. Lidocaine was injected to the area without complication. An elliptical incision around the cyst was made with a total excised diameter of .8 cm. After excision the wound was irrigated and the wound was closed with 3-0 Vicryl. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The answer of A 36-year-old female developed a sebaceous cyst...

Question 12

Joe Arrow came in to have a small lesion on his right cheek removed. After examination, his dermatologist decided to remove the 0.5 lesion by shaving. Select the appropriate CPT code(s).

Accepted Answer

The answer of Joe Arrow came in to have a...

Question 13

Which of the following tumors are considered to be benign?

Accepted Answer

Papilloma is considered a benign tumor, which means it does not invade nearby tissues or spread to other parts of the body.

Question 14

A 55-year-old male presents at his surgeon's office with Gynecomastia. The surgeon decides he will perform a mastectomy of the patient's left breast. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code for a mastectomy for gynecomastia is 19300, and the ICD-10-CM code for gynecomastia is N62. The modifier LT is used to indicate the left side.

Question 15

A 27-year-old female comes to her OB/GYN office for removal of her Norplant capsule because it is at the end of its efficacy. She is undecided on whether to have this capsule replaced. After discussion with her physician, she decides to continue the Norplant as a contraceptive. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The answer of A 27-year-old female comes to her OB/GYN...

Question 16

A patient was seen for a 2.0 cm scalp wound which required a simple repair, and a 7.5 cm scalp wound which required an intermediate repair. In addition, a 4.0 cm laceration on the face required a simple repair. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT codes are 12032 for the intermediate repair of the 7.5 cm scalp wound, 12013-51 for the simple repair of the 4.0 cm face laceration, and 12001-51 for the simple repair of the 2.0 cm scalp wound. The ICD-10-CM codes are S01.01XA for the scalp wound and S01.411A for the face laceration.

Question 17

A 40-year-old patient had 27 skin tags removed in the physician's office. Patient tolerated the procedure well and was instructed to return for a follow up visit in ten days. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT codes for the removal of 27 skin tags are 11200 for the first 15 lesions and 11201 for each additional 10 lesions, so 11201 is used twice. The ICD-10-CM code L91.8 is used for skin tags.

Question 18

A patient is seen in the office. His last visit was four years ago, although documentation in his record reveals that the physician has ordered prescription medicine several times in the past three years. The physician performed an expanded problem-focused history; expanded problem focused exam; straightforward medical decision-making. Which CPT code should be reported for the E/M service?

Accepted Answer

The patient is considered a new patient because he has not been seen in the office for over three years. The appropriate code for a new patient with an expanded problem-focused history and exam, and straightforward medical decision-making is 99202.

Question 19

A physician who is a member of a family practice group treats a patient for a sprained ankle. Two years later, a different physician from the same group practice sees the same patient for a knee injury. According to CPT definitions, this patient would be considered:

Accepted Answer

According to CPT (Current Procedural Terminology) definitions, a patient is considered established if they have received any professional services from the physician or another physician of the same specialty and in the same group practice within the past three years. Since the patient was seen by another physician in the same group practice within the past three years, they are considered an established patient.

Question 20

A 30-year-old male, who is a new patient, is brought into the physicians' office for the treatment of dermatitis. The physician's focus on the problem is a detailed history and examination. The MDM complexity is moderate. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The answer of A 30-year-old male, who is a new...

Quiz 27: Coding and Surgical Procedures