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Module1 Xam

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1.

An anesthesiologist provides general anesthesia for a 72-year-old patient with mild


systemic disease who is undergoing a ventral hernia repair. How would you report the
anesthesia service?
a. 00834-P2, 99100
b. 00832-P2, 99100
c. 49560, 00834, 91000-P2
d. 00832

3. A patient is having knee replacement surgery. The surgeon requests that in addition to the
general anesthesia for the procedure that the anesthesiologist also insert a lumbar epidural for
postoperative pain management. The anesthesiologist performs postoperative management for
two postoperative days.
A. 01400-AA, 62319
B. 01402-AA, 01996 x 2
C. 01402-AA, 62319, 01996 x 2
D. 01400-AA, 62319

4. Why should the add-on code 99100 for qualifying circumstances not be reported with the
following codes: 00326, 00561, 00834, and 00836?
a. Age of the patient is not a factor with any anesthesia codes or add-on codes
b. Age of the patient as older than 70 years is part of the code; therefore, it does not require the
add-on code
c. Age of child as older than 1 year is part of the code; therefore, it does not require the add-on
code
d. Age of child as younger than 1 year is part of the code; therefore, it does not require the addon
code
5. A patient with a third-degree burn of 54% of his body is being treated under anesthesia for
excision, debridement, and extensive skin grafting. The patient’s condition is listed as severe,
and he is not expected to survive without the operation. The operation is further complicated by
the emergency condition of the patient, and delaying this procedure could lead to loss of body
parts. How should the anesthesiologist report her services with this procedure?
a. 01952-P5, 01953-P5 x 5, 99140
b. 01952-P5, 01953-P5
c. 01951, 01952, 01953 x 4
d. 01951, 01952, 01953 x 5, 99140-51
6. The physician is called in to perform repairs for a 17-year-old girl involved in a motor vehicle
accident. She sustained an 8.6 cm laceration to her forehead, a 5.5 cm laceration to her right
cheek, a 4
cm laceration to her left cheek, a 4 cm laceration across her chin, and a 12.5 cm laceration to her
chest.
The wound on her chin required a layered closure. All other wounds required complex closure.
A. 13132, 13133 x 4, 13101, 12052
B. 13132, 13133 x 3, 13133-52, 13101, 13102, 12052
C. 13132, 13133 x 3, 13101, 13102, 12052
D. 13131, 13132, 13133 x 3, 13101, 13102, 12052
7. The patient is a 32-year-old female who was discovered to have breast cancer on the right side.
She
was treated with mastectomy followed by chemotherapy and radiation therapy. She now elects to
proceed with reconstruction by TRAM flap. Code for the reconstruction.
A. 19364 B. 19361
C. 19316 D. 19367

8. This 37-year-old paraplegic has developed a sacral decubitus ulcer. He is brought to the OR
today for debridement of the pressure ulcer with a split-thickness skin graft to cover the defect.
The patient was placed prone on the operative table after induction of adequate endotracheal
anesthesia. The sacral area was prepped and draped sterilely, and the ulcer is inspected. The area is
debrided extensively tohealthy tissue. Involved bone, including part of the coccyx, was also
removed. Once the area was clear of necrotic tissue, the site was prepared for a skin graft. A split-
thickness skin graft was harvested fromthe thigh with a dermatome. Total graft size was 25 sq. cm.
The graft was sutured in place using 6-0 Vicryl. The harvest site was closed primarily with skin
staples. Dressings were applied. Needle counts were correct x 2. The patient tolerated the
procedure well. Code the procedure(s).
A. 15002, 15100-51 B. 15937, 15100-51
C. 15937 D. 15937, 15100-51, 15002

9. Which codes should be reported for the following case?


Preoperative diagnosis: Lesion, left hand Confirmed by pathology postoperative diagnosis: Primary
malignant carcinoma, left hand.Procedure performed: Excision of malignant carcinoma, left hand
Anesthesia: General; 40 ml of lidocaine was infiltrated into the wound prior to making the incision
Procedure: The patient was brought to the operative suite where the left hand was prepped and
dressed. A circular incision was made to include the 1-cm lesion with narrowest margins of 0.6 cm
with dissection down to subcutaneous tissue. Homeostasis was obtained; the wound was closed with
simple mattress sutures. The patient tolerated the procedure well and was returned to the
recovery room in good condition with sterile dressing in place.
a. 11603, 173.6
b. 11622, 173.6
c. 11423, 198.2
d. 11403, 198.2

10. Stephanie discovered a lesion on her trunk and was referred to Dr. Ralph, a trained Mohs
surgeon, for treatment. Stephanie had no prior pathology of this lesion; therefore, Dr. Ralph
completed a diagnostic skin biopsy with frozen section prior to the surgery. After reviewing the
biopsy results, Dr. Ralph took the patient to the procedure suite and performed a Mohs surgery
that same day. Dr. Ralpfinal report indicated the procedure required three stages, including five
tissue blocks in each stage. Hehad to take an additional four blocks in stage two to verify margins
and cell structure. Which codes should Dr. Ralph report for this entire encounter?

a. 17313, 17314 x 2, 17315 x 4, 11100-59, 88331-59


b. 17313, 17314 x 2, 17315-59
c. 17311, 17312 x 2, 17315
d. 17311, 17312 x 4, 17315-59, 11101-51, 88331-51
11. Sally suffered a burst fracture to her lumbar spine during a skiing accident. Dr. Phyllis
performed a partial corpectomy to L2 by a transperitoneal approach followed by anterior
arthrodesis of L1-L3. She also positioned anterior instrumentation and placed a structural
allograft to L1-L3. How would Dr. Phyllis report this procedure?

a. 63090, 22558-51, 22585, 22845, 20931


b. 63085, 22533, 22585-51, 22808-59
c. 22612 x 2, 22808, 22840-51, 20931
d. 22558, 22858-51, 22845-51, 20931-59

12. A patient had a unilateral percutaneous intradiscal electrothermal annuloplasty on L3-L5 with
fluoroscopic guidance for needle placement. How would you report this professional
serviceprocedure?

a. 22526, 22527
b. 22526, 22527, 77002-26
c. 22899, 77002-51
d. 22526, 22527, 77003-26

13. Mike had a bicycle accident and suffered deep hematomas in both knees. He underwent a
bilateral incision and drainage. How would you report the procedure?
a. 27301-50
b. 10040
c. 27303
d. 27301-59

15. A patient suffered a penetrating knife wound to his back. A surgeon performed wound
exploration with enlargement of the site, debridement, and removal of gravel from the site.
The surgeon decided a laparotomy procedure was not necessary at this time. How would you
report this procedure?
a. This procedure is bundled with the laparotomy
b. 49000, 97602-51, 20100-59
c. 49000, 20102-59
d. 20102

16. A patient had a bilateral strabismus surgery involving the medial and lateral rectus muscles. The
surgeon explored and repaired a detached extraocular muscle in the right eye and placed bilateral
posterior fixation sutures with muscle recession. How should you report this procedure?
a. 67316-50, 67332-RT, 67334-50
b. 67316-50, 67332-RT, 67335-50
c. 67312-50, 67340-RT, 67334-50
d. 67312-50, 67340-RT, 67335-50
17.An infant who has chronic otitis media was placed under general anesthesia and a radial incision
was made in the posterior quadrant of the left tympanic membrane. A large amount of mucoid
effusion was suctioned and then a ventilating tube was placed in both ears.

A. 69436-50,
B. 69436-50,
C. 69433-50
D. 69421-50,

18. A patient presents with a large mass on the left side of the neck. The patient is diagnosed with
a thyroid goiter. The surgeon performs a left total thyroid lobectomy. How should the surgeon’s
professional services be reported?

a. 60240-LT
b. 60220-LT
c. 60220
d. 60240

19. Jennifer was admitted to the hospital for an aspiration of two thyroid cysts. Her physician
completed
this procedure with CT guidance of the needle including interpretation and report. How would you
report the professional services?
a. 60300-26, 76942-26
b. 60300 x 2, 77012-26
c. 10021, 60300-51, 77012-26
d. 60300

20. A craniectomy is being performed on a patient who has Chiari malformation. Once the posterior
inferior scalp was removed a C-1 and a partial C-2 laminectomy was then performed. The right
cerebellar tonsil was dissected free of the dorsal medulla and a gush of cerebrospinal fluid gave
good
decompression of the posterior fossa content. Which CPT code should be used?
A. 61322
B. 61345
C. 61343
D. 61458

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