Test 10, 11, 12

Q:1-Dr. Brown, a dermatologist, opened and drained multiple complicated acne pustules and
comedones on a 19-year-old patient with severe acne. For one of the more complicated acne
pustules, Dr. Brown incised, drained, and marsupial zed the acne cyst by suturing the right and left
sides, leaving the cyst open for drainage. What is the correct code for the procedure?

Mark one answer:

A. 10060
B. 10061, 10040
C. 10040
D. 10061

Q:2-Dr. Brown, a dermatologist, is seeing a patient for an acne surgery follow-up that was performed
eight months ago. The surgery was successful and the patient’s skin condition has rapidly improved
due to a strict hygiene regimen and acne medications. Today the patient stated that he would like to
reduce acne scarring by having dermabrasion on his entire face. Although the patient requested the
entire face, the dermatologist only performed the dermabrasion on the areas on the patient’s face
that were not currently prone to acne breakouts (his forehead and brow area). What is the correct
code for this procedure?

Mark one answer:

A. 15781
B. 15780
C. 15786
D. 15788

Q:3-A physician biopsied the skin on a 30-year-old woman’s upper eyelid, with a possible fungal
infection. Three sites were biopsied. How should the physician code for this procedure?

Mark one answer:

A. 11100, 11101 (X2)

B. 11100 (X3)
C. 11100, 67810
D. 67810

Q:4-The physician performed the excision of two 1.5 cm malignant lesions on a patient’s upper back.
During the surgery, the physician noted four additional lesions, which looked to be pre-malignant.
These lesion excisions were 0.3, 0.7, 1.0, and 1.45 cm, respectively. The suspect lesions were sent to
pathology lab, where they were determined to be benign. What are the appropriate codes for the
service?

Mark one answer:

 A. 11400 (X4), 11602 (X2)
B. 11400, 11401 (X2), 11402
C. 11404, 11603
D. 11400, 11401 (X2), 11402, 11602 (X2)

Q:5-A 22-year-old woman with excessive skin of her upper eyelid presented to her physician’s office
for the revision of her right eyelid. Her physician decided that she would perform a blepharoplasty of
the right eyelid, during which she would remove the excessive skin weighing down the lid. When the
physician performs this procedure, what code should she report?

Mark one answer:

A. 15822
B. 15823
C. 15823-50
D. 15820

:6-Two weeks ago, a 32-year-old male suffered a thumb injury at work. He was using a belt grinder
on a small piece of steel when the belt caught the tip of his left thumb in the grinder. His thumb was
ground down to the tip, his thumb nail was removed and a small piece of his anterior phalange bone
was broken off. The patient has an appointment scheduled today to see if his nail bed on his left
thumb can be reconstructed using a graft from his left great toe. What is code for this procedure?

Mark one answer:

A. 11760-LT
B. 11765a
C. 11762-LT
D. 11730, 11732

Q:7-A 10-year-old boy was running through his house and ran into a sliding glass door, breaking the
glass and suffering severe lacerations on his trunk and arms and minor lacerations on his face and
legs. The emergency department physician performed the simple closure of one 2 cm laceration on
the boy’s cheek and two 2.3 cm lacerations on the boy’s left leg. The physician performed the simple
closure of one 4 cm laceration on the right arm and the layered closure of two lacerations on the left
arm, which were 1.5 and 3 cm, respectively. The physician treated the 5 cm laceration on the boy’s
chest, which required the removal of particulate glass and a single layer closure. What are the
correct codes for the wound repair performed by the emergency department physician?

Mark one answer:

A. 12001, 12002 (X2), 12032 (X2)

B. 12005, 12011-51, 12032-51
C. 12004, 12011-51, 12032 (X2)
D. 12004, 12011-51, 12034-51
Q:8-A 32-year old woman with severe gynecomastia and a prevalent family history of breast cancer
elected to have a complete bilateral mastectomy with immediate insertion of breast prosthesis
implants. What is/are the correct code(s) for the procedure?

Mark one answer:

A. 19300-50, 19340-50
B. 19300-50, 19340-50
C. 19303, 19357
D. 19300-50, 19357-50

Q:9-A 56-year-old male presents to a podiatry office with complaints of recurrent problems with an
ingrown toenail on his right great toe. He has been treated multiple times with antibiotics, but the
pain and swelling is causing him difficulty wearing his work boots. He currently does not have an
infection, although the ingrown toenail is present and painful. The doctor performs a wedge excision
of the skin of the nail fold to his right great toe. Which of the following codes should you use?

Mark one answer:

A. 10060
B. 11760
C. 1176511765
D. 11750

Q:10-A 10-year-old girl comes to her pediatrician’s office after smashing the nail of her right 2nd
digit in the car door the previous night. This morning, the tip of her finger is edematous, there is a
large amount of ecchymosis present, and the pain is worse than when the injury initially occurred.
The pediatrician uses a disposable Bovie high-temperature cautery pen to cauterize a hole in the nail
to allow the subungual hematoma to drain. A small amount of serosanguineous fluid is removed and
pain rapidly decreased. Which of the following codes should you use?

Mark one answer:

A. 11720
B. 11730
C. 11740
D. 11750

Q:1-A 31-year-old male arrives at general surgery for a pilonidal cyst that has been unresponsive to
antibiotic therapy at his primary care physician’s (PCP) office. There is a large amount of tenderness
and edema at the site and the area is erythematic and warm to the touch. The patient’s pain has
been increasing and, on palpation, the surgeon notes that the cyst is larger than six cm in diameter
and appears to be deep. After discussion with the patient, it is decided to perform an incision and
drainage (I&D) at the surgeon’s office, with \ no sedation other than local use of Lidocaine. The area
was prepped and numbed with Lidocaine and an incision was made, allowing a large amount of
purulent drainage to be expressed. The area was packed with gauze and the procedure was
completed without any complications. The patient will follow up in the office in one week for
recheck and is to continue on the antibiotic prescribed by his PCP. Which of the following codes
should you use?

Mark one answer:

A. 10060
B. 10061
C. 10080
D. 10081

Q:2-A 35-year-old male returns to the general surgeon’s office with recurrent episodes of infected
pilonidal cysts. He has had the cyst incised and drained (I&D) once at his primary care physician’s
office and once at the surgeon’s office. The last I&D was approximately four months ago. He returns
to the office today to discuss further treatment. It is decided that he will undergo outpatient surgery
so he can be sedated and the cyst will be excised with the base curetted. During surgery, it was
noted that there was an extensive sinus tract. The wound will be packed open, requiring daily
dressing changes and he will return to the postop clinic for a recheck in one week. Which of the
following codes should you use?

Mark one answer:

A. 11771
B. 11772
C. 11770
D. 10080

Q:3-A surgeon is doing a pilonidal cyst incision and drainage with excision in the operating room.
What he initially thought was an uncomplicated but deep pilonidal cyst developed into an
extensively complicated cyst excision with a z-plasty required to repair the incision. How would you
code this procedure?

Mark one answer:

A. 11770
B. 11772
C. 10081
D. 11771

Q:4-A 22-year-old male was chopping wood with his friends and accidently slashed his right lower
leg with the axe. Upon assessment at the emergency room, it was determined that he had sliced
through all layers of skin and the wound was down to muscle, but no arteries were involved. He
required layered sutured closure including the deeper layers of subcutaneous tissue, and superficial
fascia as well as the epidermis and dermis. His wound was measured at approximately 25 cm. How
would you code this procedure?

Mark one answer:

A. 12035
 B. 12036
C. 12045
D. 12046

Q:5-A 6-year-old boy was bitten by a dog and sustained multiple lacerations as a result. He has a 5
cm laceration on his right lower arm, a 2 cm laceration on his left hand, and a 2.6 cm laceration to
the right side of his lower cheek. While in the ER, the wounds were flushed, then the patient was
sedated and the arm and hand lacerations were repaired. Intermediate repair was necessary for the
facial laceration due to the depth of the wound and layered closure was performed. The patient was
also given a tetanus shot and started on antibiotics. What CPT codes would you use for the
laceration repairs of this child and what order is correct?

Mark one answer:

A. 12002, 12013
B. 12002, 12013 -59
C. 12032, 12002 -59
D. 12032, 12002

Q:6-A 78-year-old male arrives at a dermatology office with multiple skin tags on his arms, neck, and
torso. There are a total of 14 lesions that need to be removed and the dermatologist removes all 14
tags within the office. What is the correct code for this procedure?

Mark one answer:

A. 11101
B. 11200
C. 11201
D. 11300

Q:7-A 60-year-old woman presents to her dermatologists office with a reddish brown lesion on her
right upper arm. It is approximately 0.8 cm in diameter and is raised. The patient and provider
decide to proceed with a shave excision and will send this to pathology for confirmation. The
dermatologist suspects this is a benign angiofibroma. The patient receives local anesthetics at the
site and the area is excised with a sharp razor. What is the correct code for this procedure?

Mark one answer:

A. 11300
B. 11301t
C. 11302
D. 11305

Q:8-A 12-year-old boy presents to his pediatrician’s office with multiple molluscumcontagiosum on
his face, neck and upper right shoulder. They have been present for about 15 months and are getting
larger. His parents are concerned about his appearance and that he keeps scratching them. He was
treated once for a local infection on his neck, about three months ago. His parents would like to
have these removed or be referred to dermatology. The pediatrician discusses options and the
parents opt to use cryotherapy with Histofreeze that the pediatrician has in his office. In total, there
are six lesions on his right shoulder, eight on his neck and five on his cheek. What CPT code would
you use?

Mark one answer:

A. 17111
B. 17110
C. 17000
D. 17004

Q:9-A 24-year-old woman found a lump in her right breast during a routine exam. She had a
mammogram, which confirmed the lump, and then met with a surgeon for a needle biopsy without
imaging. What code would you use for this procedure?

Mark one answer:

A. 19085
B. 19100
C. 19101
D. 19086

Q:10-A 22-year-old female is concerned about her inverted nipples. She would like them to be
corrected and sees a plastic surgeon for a consult. She is self-conscious about this issue and wants to
fix it. The plastic surgeon explains her options and they decide to correct this complaint. What code
would you use for this procedure?

Mark one answer:

A. 19350
B. 19357
C. 19355
D. 19499

Q:1-What is the difference between biopsy codes located in the integumentary section and those
found in the musculoskeletal section?

Mark one answer:

A. The biopsy codes found in the integumentary section are only for codes related to malignant
neoplasms
B. There are no biopsy codes found in the musculoskeletal section
C. The codes in the musculoskeletal system include biopsies for bone only, whereas the biopsy
codes found in the integumentary section include codes for biopsies of subcutaneous
structures including bone
 D. The biopsy codes found in the integumentary section are for biopsies of the skin and
subcutaneous structures whereas the biopsy codes found in the musculoskeletal section are
for deeper structures

Q:2-A physician took an impression of a 47-year-old woman’s left orbital socket and created a
custom prosthesis. What is the correct code for this service?

Mark one answer:

A. 21076
B. 21089 -LT
C. 21088 -LT
D. 21077 -LT

Q:3-The physician performed an arthroscopy of TMJ with biopsy of soft tissue. What is the
appropriate CPT code?

Mark one answer:

A. 29800
B. 29804
C. 2970s
D. 21010

Q:4-PROCEDURAL NOTE

PATIENT: Trohoske, Janine

AGE: 62

DATE: 01/13/2017

PREOPERATIVE DIAGNOSIS: Degenerative Disc Disease

POSTOPERATIVE DIAGNOSIS: Degenerative Disc Disease

PROCEDURE: Arthrodesis of L4-L2 utilizing autogenous bone graft

An anesthetized patient was placed in the prone position on the operating table and draped in the
usual manner. An incision was made along the spinal column, from the area of the L1 to L5, and skin
and subcutaneous tissues were pinned back to allow access to the L4-L2 vertebral spaces. A separate
fascial incision was made to obtain morselized bone graft segments for arthrodesis procedure.
Posterior arthrodesis was then performed along the L4-L2 vertebrae. No additional fixation or
instrumentation was placed. Incision was then closed, stapled together, and dressed with a sterile
dressing. What is the appropriate code for this procedure?

Mark one answer:

A. 22612, 20937
 B. 22612, 22614
C. 22612, 22614 (X2), 20937
D. 22612, 22614 (X2), 20936

Q:5-A physician excised the head of the humeral bone and replaced it with the appropriate implant.
What is the correct code for this procedure?

Mark one answer:

A. 23195
B. 23470
C. 23195, 23470
D. 23472

Q:6-A physician performed the following trigger point injections:

Two injections into the flexor carpi muscle

One injection into the extensor carpi muscle

Three injections into the triceps brachii

One injection into the biceps brachii

What is the correct code for these injections?

Mark one answer:

A. 20553 (X7)
B. 20553
C. 20552 (X2), 20553 (X5)
D. 20552, 77021

Q:7-A patient suffered a comminuted fracture of the right arm due to a crush injury. The physician
implanted three pins in a single plane above the fracture and two pins and one wire along the same
plane under the fracture location on the humerus of the right arm. What is the correct code for this
service?

Mark one answer:

A. 20690
B. 20962
C. 20690 (X6)
D. 20692 (X6)

Q:8-PROGRESS NOTE

PATIENT: FINKE, ISABEL

AGE: 15

DATE: 3/14/2015

NOTE: The patient states that she was riding her bicycle on the side of the road when a large dog ran
out in front of her and forced her to crash into a drainage ditch. The patient hit her left arm on a
cement drain pipe, suffering an oblique fracture to her left radius. The fracture was set with
manipulation of the radial shaft. The arm was then casted in the usual fashion. The patient tolerated
the procedure well and was asked to return to the office in one month for follow up x-ray and
removal of the cast. How should you code for this fracture repair?

Mark one answer:

A. 25505
B. 25500
C. 25515
D. 25535

Q:9-The patient returned to the office one month later for removal of cast on her left lower arm. The
original attending physician removed the cast. The physician also examined the arm and determined
that no further casting or follow-up was necessary. What is the appropriate code for this service?

Mark one answer:

A. 25250
B. 99214
C. No code would be reported
D. 29799

Q:10-What code would you use to report the enlargement and exploration of a penetrating 5 cm
stab wound to the upper thigh, with ligation of minor muscular blood vessel, and appropriate
intermediate closure?

Mark one answer:

A. 12032
B. 20103, 12032
C. 20103
D. 12031