Question 1

Preoperative Diagnosis: Right knee degenerative arthritis
Postoperative Diagnosis: Same
Operation Performed: Arthroscopic irrigation and debridement of same with partial synovectomy
Estimated Blood Loss: Minimal
Complications: None
Description of Operation: The patient was placed on the table in supine position. The right lower extremity was prepped and draped without a tourniquet. The knee was injected with 30 mL of normal saline and standard arthroscopy portals were created. The arthroscopy was inserted and a complete diagnostic was performed. The knee was copiously irrigated with 9 L of irrigant. A partial synovectomy was performed in all compartments. Minimal amount of polyethylene wear was noted. The knee was then drained and the arthroscopic instruments were removed. The portals were closed with 4-0 nylon and local anesthetic was injected. A sterile dressing was applied; the patient was awakened from anesthesia and transported to the recovery room in stable condition.
Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct codes are 27441-RT for the arthroscopic irrigation and debridement of the right knee with partial synovectomy, and M17.11 for the right knee degenerative arthritis.

Question 2

Pre-operative Diagnosis: Tumor on muscle of right arm
Post-operative Diagnosis: same
After localized anesthesia, a percutaneous bore needle was used to pierce into the muscle to obtain a biopsy of the muscle tissue. Tissue sample will be sent to pathology. No complications resulted to the patient, and he left the office in good condition.
Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

20206-RT is the correct CPT code for a biopsy of muscle performed percutaneously, and D49.2 is the correct ICD-10-CM code for a neoplasm of unspecified behavior of bone, soft tissue, and skin, which includes muscle.

Question 3

CPT codes that fall in the range titled "Introduction and Removal" in the Surgery/Musculoskeletal System include:

Accepted Answer

The "Introduction and Removal" section within the Surgery/Musculoskeletal System of CPT codes includes procedures such as implant or prosthesis removal, removal of foreign bodies, and the application of fixation devices.

Question 4

Electrical stimulation and ultrasound to aid bone healing are included in which of the following codes?

Accepted Answer

The answer of Electrical stimulation and ultrasound to aid bone...

Question 5

A 78-year-old male is hospitalized for removal of a foreign object from the left shoulder after a previously performed Neer hemiarthoplasty.
Select the appropriate CPT code.

Accepted Answer

23333-LT is the correct CPT code for removal of a foreign body from the shoulder area when a previous shoulder arthroplasty (such as a Neer hemiarthoplasty) has been performed. This code specifically addresses the removal of a foreign body in the context of a patient with a history of shoulder joint replacement.

Question 6

The surgeon applies a cranial halo with eight pins in order to stabilize the cervical spine on a 6-year-old patient with osteogenesis imperfecta.
Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code for applying a cranial halo with pins is 20664, and the appropriate ICD-10-CM code for osteogenesis imperfecta is Q78.0.

Question 7

A 49-year-old patient has arthritis of the right and left knee with ongoing pain and swelling. The physician performed an arthrocentesis for the patient's condition. Patient was prepped and fluid withdrawn from the left knee joint. The patient tolerated the procedure well and was instructed to return for a follow up visit in one week to aspirate the right knee joint. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code for arthrocentesis of a major joint like the knee is 20610. The ICD-10-CM code M17.0 is for bilateral primary osteoarthritis of the knee, which aligns with the patient's condition. The procedure was performed on the left knee, hence the LT modifier.

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 permanent removal of a portion of the toenail is 11750, and the modifier T5 indicates 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. The CPT (Current Procedural Terminology) definition of lesion destruction typically includes methods such as cryosurgery, electrosurgery, laser, and chemical treatment, but scraping (also known as curettage) is considered a separate procedure, often associated with biopsy or removal rather than destruction.

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 correct CPT code for the excision of a benign lesion (such as a sebaceous cyst) with a diameter of 0.8 cm on the thigh is 11401 with the modifier -LT to indicate the left thigh. The appropriate ICD-10-CM code for a sebaceous cyst is L72.3.

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

Papillomas are considered benign tumors, which means they are non-cancerous growths. Basal cell and squamous are types of skin cancer, and carcinoma refers to a malignant tumor.

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 "-LT" modifier indicates the procedure is performed on 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 correct CPT codes are 11976 for removal and 11980-51 for reinsertion of the Norplant capsule. The ICD-10-CM code Z30.49 is used for surveillance of other contraceptives.

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

When coding for multiple wound repairs, you should list the procedures from most complex to least complex, using separate codes for each repair type and adding modifier -51 for additional procedures. The codes 12032 and 12013 represent intermediate and simple repairs on the scalp, respectively, while 12001 represents a simple repair on the face. The ICD-10-CM codes S01.01XA and S01.411A indicate a laceration on the scalp and face, respectively.

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

For the removal of multiple skin tags, CPT codes 11200 (for the removal of up to and including 15 skin tags) and 11201 (for each additional 10 skin tags or part thereof) are used. Since 27 skin tags were removed, code 11200 covers the first 15, and 11201 is used twice to cover the additional 12 tags. The ICD-10-CM code L91.8 (Other hypertrophic disorders of the skin) is appropriate for skin tags.

Question 18

A patient taking warfarin for atrial fibrillation reports to the lab for a venous draw for prothrombin time for her monthly INR evaluation. This is her third such visit in the past 90 days. She will see her physician in two days to review the results. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct coding involves 36415 for the venous draw, 85610 for the prothrombin time test, Z51.81 for encounter for therapeutic drug monitoring, Z79.01 for long term (current) use of anticoagulants, and I48.91 for unspecified atrial fibrillation. These codes accurately describe the procedure and the reasons for the patient's visit and treatment.

Question 19

After a work-related accident, a drug screen was performed to determine the presence of alcohol, marijuana, opiates, barbiturates, or amphetamines in the patient's system. A multiplexed screening kit was used and one procedure was performed. All tests were negative. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The answer of After a work-related accident, a drug screen...

Question 20

A physician interprets and writes a report on a tier 1 molecular pathology procedure for BRCA1 and BRCA2 gene analysis for a 20-year-old female with a family history of breast cancer. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

81162 includes both BRCA1 and BRCA2 gene analysis, and the modifier -26 indicates that only the professional component (interpretation and report) is being billed. Z80.3 is the correct ICD-10-CM code for a family history of breast cancer, which is relevant to the patient's situation.

Quiz 27: Coding and Surgical Procedures