(B) (a)11100 (b)67810 (c) 6!10 (d)"one of t#e abo$e Rationale: CPT code 11100 s#o%ld be reported only if a more speci&c code of t#e anatomic area t#at is biopsied does not e'ist in t#e medical record. (. CPT code for debridement of 11.) of infected s*in (C) (a)11000 (b)11000+( (c) 11000, 11001 (d)11001 Rationale: To %se CPT code 11001 t#e proced%re need not to #a$e doc%mentation of additional 10) debridement. -. CPT code for &ne needle aspiration of li$er cyst %nder %ltraso%nd g%idance (.) (a)!7000 (b)!7000, !7001, 76/!( (c) !7000, 8817( (d)100((, 76/!( Rationale: 100(1 and 100(( are %sed for 0"1 of any site of t#e body. !. 1 dermatologist performed re2e'cision of a malignant lesion of ( cm diameter 3it# 0. cm margins from t#e nec* of a patient after initial e'cision of t#e lesion d%ring t#e post2operati$e period. Code t#e proced%re. (C) (a)116(- (b)11!(- (c) 116(- 4 8 (d)11!(- 4 78 Rationale: 1ccording to CPT g%idelines a re2e'cision of malignant lesion s#o%ld be reported 3it# modi&er 8 if done d%ring global period.
. 1 dermatologist performed intralesional in5ection administration on t#e scalp of a patient on / di6erent lesions of alopecia. 7n eac# lesion ( in5ections 3ere gi$en. (C) (a)11/00, 11/01 (b)11/01+( (c) 11/01 (d)/6!06 Rationale: "%mber of in5ections gi$en in t#e lesion is not a factor in deciding t#e code. 1lopecia is not a malignant condition so c#emot#erapy code is not applicable. 6. 1 dermatologist remo$ed t3o benign lesions of s*in from t#e face of a patient of 0. cm diameter eac#, sit%ated 0.7 cm apart by a single e'cision 3it# 0. cm margins. Code t#e proced%re. (C) (a)11!!1+( (b)11!!(+( (c) 11!!- (d)11!!1, 11!!128 Rationale: Since single e'cision is done so collecti$e si8e of t#e t3o lesions 3it# t#e distance bet3een t#em and margins are added 9 coded 3it# a single code. So :esion 1 0.cm ; :esion B 0.cm ; .istance 0.7cm ; <argins 0.cm ; 0.cm = (.7cm. 7. 1 dermatologist performed e'cision of a 0. cm malignant lesion 3it# 0. cm margins from t#e scalp of a patient in t#e morning. 0ro8en section st%dy re$eals incomplete e'cision> #e #as to perform a re2e'cision on t#e same day in t#e same session for additional 0. cm margins. (1) (a)116(- (b)116(( (c) 116((, 116((2/ (d)116((, 116((28 Rationale: 1 re2e'cision performed for complete t%mor remo$al d%ring t#e same session 3it# a single code by ta*ing t#e 3idest diameter si8e after t#e last e'cision. 8. .estr%ction of 16 &broc%taneo%s s*in tags electroca%tery may be coded as (C) (a)1700! (b)17111 (c) 11(00, 11(01 (d)17000, 1700- Rationale: .estr%ction of s*in tags are not coded from t#e destr%ction codes instead it is coded 3it# codes %nder remo$al of s*in tags. /. ?o%nd repair done by %sing ad#esi$e strips only may be coded as (.) (a)Simple repair (b)7ntermediate repair (c) Comple' repair (d)"one of t#e abo$e Rationale: ?o%nd clos%re %tili8ing ad#esi$e strips as t#e sole repair material s#o%ld be coded by appropriate @A< code. 10. 7f a lesion is e'cised and t#e defect is closed 3it# ad5acent tiss%e transfer> code t#e enco%nter for (B) (a)@'cision only (b)1d5acent tiss%e transfer only (c) Code for bot# (d)"one of t#e abo$e Rationale: T#e lesion e'cision is incl%ded in t#e ad5acent tiss%e transfer code and is not coded separately. 11. 7f dressings are done for t#e treatment of b%rn in5%ry of partial t#ic*ness on an area abo%t 6) of body s%rface on eac# arm, code t#e enco%nter as (C) (a)160(+( (b)160(20 (c) 160-0 (d)160-020 Rationale: 7f dressings are done on t3o e'tremities report only one code by c%m%lating t#e total body s%rface area of bot# sides. 1(. 7n case prior biopsy is not performed for a lesion and biopsy 9 <o#s s%rgery is performed on t#e same day (.) (a)Bot# <o#s s%rgery 9 Biopsy may be coded on same day (b)Biopsy codes may not be reported only <o#s s%rgery s#o%ld be coded (c) Bnly biopsy s#o%ld be coded (d)Bot# <o#s s%rgery 9 biopsy may be coded on same day 3it# modi&er / to biopsy code(s)
1-. 7f a s%rgeon performed ablated t3o ad5acent &broadenomas by one insertion of t#e cryoprobe, code it as (1) (a)1/10 (b)1/10+( (c) 1/10, 76/!( (d)1/10+(, 76/!( Rationale: 7nstances 3#en t3o ad5acent &broadenomas are treated 3it# one insertion of t#e cryoprobe, code 1/10 s#o%ld be reported once. T#e code also incl%des %ltraso%nd g%idance. 1!. Closed treatment is %sed to describe proced%res t#at treat fract%res by t#e follo3ing met#odsC (@) (a)?it#o%t manip%lation (b)?it# manip%lation (c) ?it# or 3it#o%t traction (d)1 9 B only (e)1, B 9 C 1. CPT codes (0( and (0- are %sed to report trigger2point in5ections (C) (a)Bnce per session regardless of n%mber of trigger points (b)Bnce per session regardless of n%mber of m%scles in5ected (c) Bot# 1 9 B (d)"one of t#e abo$e Rationale: Codes (0( and (0- are %sed to report trigger2point in5ections once per session, regardless t#e n%mber of trigger points or m%scles in5ected.
16. 7f t3o s%rgeons 3or* toget#er on a spine s%rgery as primary s%rgeons performing distinct parts of a proced%re, eac# s%rgeon s#o%ld report #is or #er distinct operati$e 3or* by adding modi&er 6( to t#e proced%re code and any associated add2on codes for t#at proced%re (C) (a)Tr%e (b)0alse (c) Tr%e b%t e'cept instr%mentation 9 bone graft codes (d)Tr%e b%t e'cept bone graft codes Rationale: <odi&er 6( s#o%ld not be appended to bone graft codes and spinal instr%mentation codes, b%t to ot#er add2on codes it can be appended. 17. CPT codes ((! and ((6-0 (.) (a)S#o%ld not be reported 3it# modi&er 0 (b)S#o%ld not be reported t3ice (c) Bnly 1 is correct (d)Bot# 1 9 B are correct Rationale: T#e proced%re in ((! in$ol$es a midline approac# and t#e code description in CPT code ((6-0 does not di6erentiate t#e proced%re as %nilateral or bilateral. So modi&er 0 s#o%ld not be %sed 3it# t#em.
18. 7f t3o metal cages are placed d%ring spine s%rgery one bet3een :-2:! and anot#er bet3een :2S1 report t#e ser$ice as (B) (a)((81 once (b)((81+( (c) ((812(( (d)"one of t#e abo$e Rationale: T#is code is to be reported only one time per interspace, regardless of t#e n%mber of de$ices placed at t#at interspace. Do3e$er, if metal cages are placed at t3o di6erent interspaces t#en t#e add2on code ((81 may be reported t3ice. 1/. Code t#e proced%re for closed treatment of distal radial fract%re 3it# manip%lation along 3it# closed repair of %lnar styloid process fract%re done on rig#t side. (.) (a)(60, (60 (b)(602ET2(( (c) (602ET, (602ET (d)(602ET Rationale: CPT code (600 and (60 incl%des t#e 3or* of (60. (0. CPT codes (8(/02(8(// incl%des (@) (a)Caps%lotomy (b)Syno$ectomy (c) Tenodesis (d)1ll t#e abo$e (e)1 9 B only Rationale: Tenodesis is not incl%ded in (8(/02(8(// (1. 1 PCP performed application of s#ort leg cast on a patient 3it# sprain in t#e an*le and remo$ed t#e same after - 3ee*s of immobili8ation. Code for bot# enco%nters. (1) (a)(/!0 (b)(/!0, (/7// (c) (/!0, (/7// (d)(/!0 Rationale: T#e codes for application of casts and strapping incl%de t#e remo$al proced%re. Eemo$al is reported only 3#en a p#ysician is remo$ing a cast t#at 3as applied by anot#er p#ysician. ((. CPT codes -1(-1 4 -1(- incl%de inspection of t#e follo3ing str%ct%res. (@) (a)"asal ca$ity (b)<iddle 9 s%perior meat%s (c) T%rbinates (d)Sp#enoet#moid recess (e)1ll t#e abo$e (-. Code t#e direct laryngoscopy proced%re, diagnostic performed in a - year old female %nder general anest#esia (.) (a)-112(- (b)-1(0 (c) -1(2(-26- (d)-1(2(- Rationale: <odi&er (- is %sed for %n%s%al anest#esia. (!. Code t#e CPT proced%re for collection of t3o bronc#ial m%cosal biopsy specimens in a single session by bronc#oscopy %tili8ation endobronc#ial %ltraso%nd. (C) (a)-161 (b)-16(, -16(021 (c) -16(, -16(0 (d)-16(/,-16-- Rationale: Bronc#ial m%cosal biopsies are reported once only 3it# CPT code -16( regardless of t#e n%mber of specimens collected. CPT code -16(0 is an add2on code so modi&er 1 s#o%ld not be appended. (. Code t#e proced%re for remo$al of t3o lobes of l%ngs. Bne from t#e rig#t 9 t#e ot#er from t#e left l%ng. (C) (a)-(!8( (b)-(!8(20 (c) -(!8020 (d)-(!8!20 Rationale: Bilobectomy code -(!8( is not to be reported for remo$al of one lobe from t#e rig#t l%ng and one lobe from t#e left l%ng. 7t is %sed only for bilobectomy of rig#t l%ng. (6. Code t#e proced%re for coronary artery bypass proced%re done by t3o sap#eno%s $ein grafts on rig#t coronary artery branc#es. .%ring t#e same session t#e p#ysician also performed transmyocardial laser re$asc%lari8ation of left coronary artery. (.) (a)--11, --1!0 (b)--10, (c) --18, --1!1 (d)--11, --1!1 Rationale: CPT code --1!1 is %sed to report transmyocardial laser re$asc%lari8ation done along 3it# ot#er open cardiac proced%res.
(7. 1 single c#amber cardio$erter2de&brillator may possess (C) (a)Bne electrode (b)<ore t#an one electrode (c) Bot# 1 9 B (d)T3o electrodes (8. 1ssessment and reassessment of t#e pacing cardio$erter2 de&brillator electrodes related to sensing, pacing and electrode impedance c#aracteristics at t#e time of insertion, repair, re$ision or replacement is additionally reported %sing codes (C) (a)/-6!0 (b)/-6!0, /-6!1, /-6!( (c) /-6!0, /-6!1 (d)/-6!( Rationale: CPT codes /-6!0 and /-6!1 are %sed for electrodes assessment 9 reassessment. CPT code /-6!( is %sed for assessment 9 reassessment of cardio$erter2de&brillator. (/. T3o p#ysicians operating as primary s%rgeons performed insertion of a d%al c#amber pacema*er system 3it# electrodes placement. S%rgeon 1 performed insertion 9 placement of t#e electrode and s%rgeon B performed creation of s%bcla$ic%lar s*in poc*et for p%lse generator. Code t#e proced%re. (C) (a)S%rgeon 1 --(08, S%rgeon B --(!0 (b)S%rgeon 1 --(082(, S%rgeon B --(082( (c) S%rgeon 1 --(0826(, S%rgeon B --(0826( (d)S%rgeon 1 --(11, S%rgeon B --(1- Rationale: S%rgical creation of a poc*et for t#e p%lse generator is incl%ded 3#en t#e codes for pacema*er and pacing cardio$erter2 de&brillator proced%res are reported. Fse of modi&er 6( becomes necessary 3#en t3o p#ysicians participate as primary s%rgeons d%ring a single proced%re. -0. 1 cardiologist performed repair of atrial trans$eno%s electrode in a patient 3#o is on a d%al c#amber cardio$erter2de&brillator pacing system. (1) (a)--(18 (b)--((0 (c) --(182(( (d)--((02( Rationale: T#e appropriate met#od for reporting t#e repair of only one trans$eno%s electrode for a d%al2c#amber de$ice is to append modi&er (, to code --((0. -1. 1 cardiot#oracic s%rgeon performed redo triple coronary bypass operation after t#ree years of t#e original proced%re in a patient %sing t3o sap#eno%s $ein grafts and an internal mammary artery graft. (B) (a)----, --18 (b)----, --18, ---0 (c) ----, --18, -00 (d)--1( Rationale: CPT code ---0 is reported to reGect t#e increased diHc%lty associated 3it# t#e redo proced%re. -(. 1 s%rgeon performed open repair of an infrarenal abdominal aortic ane%rysm in$ol$ing iliac $essels %sing t%be prost#esis after endo$asc%lar repair by %sing t3o doc*ing limb prost#esis failed. (B) (a)-!80-2-, -!8-0 (b)-!8-0 (c) -!80-, -10(2/ (d)-!80-, -!8-0 Rationale: CPT codes -!8-02-8!-( are reported to describe t#e con$ersion to an open s%rgical proced%re for repair of complications in$ol$ing a pre$io%sly placed prost#esis. --. 1n @"T s%rgeon performed control of %ncontrolled bleeding in a 1! year old boy after (! #o%rs of s%rgery by s%rgical inter$ention. T#e boy %nder3ent tonsillectomy on left side only for regro3n tonsil after t#e initial tonsillectomy in 1( years age. (C) (a)!(/7028 (b)!(/6(28 (c) !(/6(278 (d)!(8(62( -!. Do3 do yo% report diagnostic endoscopy of %pper gastrointestinal tract along 3it# t#at of diagnostic lo3er gastrointestinal tract endoscopy performed by t#e same p#ysician on t#e same day on t#e same patientI (C) (a)!-(-2(( (b)!-78, !-(-276 (c) !-78, !-(-2/ (d)!-782(( -. Do3 3ill yo% code transnasal endoscopic e'amination of esop#ag%s for diagnostic p%rpose in a patient 3it# $err%co%s carcinoma of tong%e ca%sing diHc%lty in passing t#e scope t#ro%g# mo%t#I (.) (a)!-(00 (b)!-(002(( (c) !-(002(- (d)!-!// Rationale: Trans2nasal endoscopy, a proced%re 3#ere a t#in Ge'ible endoscope is passed t#ro%g# nares into t#e esop#ag%s, is coded by %nlisted code !-!//. -6. 1 (! year old at#lete reported to #is p#ysicianJs oHce 3it# complaint of s3elling in t#e rig#t groin region 3it# mild pain %pon e'ertion. T#e p#ysician performed a midle$el #istory 9 e'amination of t#e patient and con&rmed t#e condition as rig#t ing%inal #ernia, red%cible, initial. T#e p#ysician performed medical red%ction of t#e #ernia, applied #ernia belt immediately and as* t#e patient to report after ! days for f%rt#er management. (C) (a)!/0 (b)!/0, //(1-2( (c) //(1- (d)!/0, //(1-27
Rationale: <edical red%ction is a temporary meas%re and does not#ing to c%re t#e %nderlying pat#ology. Kenerally, t#is red%ction is performed as part of @A< ser$ice and is not reported separately. "o s%rgery is done so no s%rgical CPT code is applicable. 0%rt#er no CPT code e'ists for medical red%ction of #ernia also. -7. Select t#e correct statement (.) (a)Dernia repairs are commonly done 3it# %se of mes# (b)CPT code !/68 is %sed to report placement of mes# d%ring #ernia repair (c) !/68 may be %se 3it# all #ernia repair codes if mes# is placed (d)1 9 B only (e)B 9 C only Rationale: CPT code !/68 is reported only 3it# codes !/602!/66
-8. Code t#e complete left renal transplantation proced%re performed in a patient s%6ering 3it# c#ronic renal fail%re. T#e s%rgeon performed t#e proced%re by #ar$esting t#e left *idney of a li$ing donor by laparoscopy, and after standard bac*benc# preparation 3it#o%t any reconstr%ction. T#e non f%nctional left *idney of t#e patient 3#o #ad rig#t nep#rectomy ( year before 3as also done d%ring t#e same session. (.) (a)0-(2:T, 0-602:T, 0-(02:T (b)0-(2:T, 0-62:T, 0-(02:T (c) 0-62:T, 0-(2:T, 0!72ET (d)0-62:T, 0-(2:T, 0!72:T -/. 1n %rologist performed trans%ret#ral electros%rgical resection of prostate in a patient on t#e &rst day. T#e ne't post2operati$e day #e performed $asectomy, and %ret#ral dilation of prostatic %ret#ra. Code t#e entire ser$ice. (1) (a)(601 (b)(601, -601, (02/ (c) (601, -600, (02/ (d)(601, -60028, (028, / Rationale: T#e minor proced%res indicated in t#e descriptor of code (601 3o%ld need to be performed before, d%ring, or after t#e s%rgery and cannot be reported separately. !0. Code t#e proced%re for cysto%ret#roscopic resection of bladder t%mor of -cm si8e sit%ated ad5acent to t#e left %reteral ori&ce by f%lg%ration. (C) (a)((-! (b)((-2:T (c) ((- (d)((82:T Rationale: CPT codes ((0! 4 ((8 are ne$er reported 3it# modi&er 0 so also ET, :T. !1. 1 gynecologist performed instillation of a topical antif%ngal agent in t#e $agina of a patient 3#o is #a$ing #istory of allergy to imida8ole gro%p of oral antif%ngal agents. (C) (a)7180 (b)7010 (c) 710 (d)71 !(. 1 gynecologist performed loop electrode coni8ation proced%re by colposcopy to obtain a large tiss%e specimen from a patient 3it# abnormal Pap smear 3it# endocer$ical c%rettage in a single session. (B) (a)7!61, 7!62/ (b)7!61 (c) 7(0 (d)7(0, 761 Rationale: @ndocer$ical c%rettage is incl%ded in 7!61. @ndocer$ical c%rettage 9 dilatation and c%rettage are di6erent proced%re. !-. Do3 do yo% report loop electrode ablation of endometrial polyps performed by #ysteroscopy. (B) (a)88 (b)86- (c) 8-- (d)8-6 Rationale: Proced%re in code 86- in$ol$es t#e %se of #ysteroscope %tili8ing loop electrode (electros%rgery), roller ball or laser to ablate t#e tiss%e. !!. 1 gynecologist performed complete obstetric care 3it# forceps assisted deli$ery and post part%m care to a patient on #er ( nd pregnancy. T#e ne't day after t#e deli$ery s#e performed t%bal ligation as desired by t#e patient. T#e patient 3as disc#arged on t#e t#ird day after t#e deli$ery. Code bot# t#e ser$ices. (C) (a)/!002(( (b)/!00, 8600 (c) /!00, 860 (d)/!00, 8602/ Rationale: CPT code 860 is reported to t%bal ligation done d%ring same #ospitali8ation of a deli$ery episode. !. 1 blig#ted o$%m res%lting in prolonged retention of t#e embryo in t#e &rst #alf of pregnancy is terminated by a gynecologist. Code t#e proced%re. (B) (a)/81( (b)/8(0 (c) /8!0 (d)/86 Rationale: 1 blig#ted o$%m is a fertili8ed egg t#at fails to de$elop. 1 missed abortion refers to t#e prolonged retention of an embryoAfet%s t#at died in t#e &rst #alf of pregnancy. So t#e appropriate code for t#is proced%re is /8(0. !6. Code t#e proced%re for placement of an endoscope in t#e epid%ral space for diagnostic epid%roscopy. (.) (a)6(160 (b)6(161 (c) 6((81 (d)6!/// Rationale: "o codes e'ist in CPT for t#is proced%re. So report t#e %nlisted ner$o%s system code for diagnostic epid%roscopy. !7. Code t#e proced%re for repair of cerebrospinal G%id lea* from t#e sp#enoidal region by nasal sin%s endoscopy performed in a patient 3it# #ead in5%ry. (.) (a)61618 (b)6161/ (c) 6180 (d)-1(/1 !8. 1 ne%ros%rgeon performed craniotomy for implantation of t3o ne%rostim%lator electrode arrays in t#alam%s, glob%s pallid%s, s%bt#alamic n%cle%s, gray matter of peri$entric%lar and periaL%ed%ctal area along 3it# microelectrode recording for min%tes. Code t#e proced%re. (B) (a)61867 (b)61867, 61868 (c) 61867, 61868, //61 (d)61861, //61 Rationale: 7f anot#er p#ysician performs t#e ne%rop#ysiologic mapping, d%ring t#e s%rgery t#e second p#ysician s#o%ld report CPT codes //61, //6(. !/. 1 ne%ros%rgeon performed laminectomy of t#oracic spine bet3een T!2T8 and placed a ne%rostim%lator electrode plates epid%rally and performed a test stim%lation of t#e de$ice. Code t#e ser$ice. (1) (a)6-6 (b)6-6, //70 (c) 6-60, //70 (d)6-6, //71 Rationale: Test stim%lation $ia t#e implanted electrode is in#erent in code 6-6. Do3e$er, for initial programming of generator or transmitter2recei$er d%ring andAor immediately at t#e end of t#e implantation operation, %se //70 4 //7-. 0. Eemo$al of t#e entire eyeball (intraoc%lar contents and scleral s#ell), typically lea$ing only t#e e'traoc%lar m%scles and orbital fat. Code t#e proced%re (B) (a)60/1 (b)6101 (c) 6110 (d)61102(