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CPC Certified Professional Coder (CPC) Exam Questions and Answers

Questions 4

View MR 099405

MR 099405

CC: Shortness of breath

HPI: 16-year-old female comes into the ED for shortness of breath for the last two days. She is an asthmatic.

Current medications being used to treat symptoms is Advair, which is not working and breathing is getting worse. Does not feel that Advair has been helping. Patient tried Albuterol for persistent coughing, is not helping. Coughing 10-15 minutes at a time. Patient has used the Albuterol 3x in the last 16 hrs. ED physician admits her to observation status.

ROS: No fever, no headache. No purulent discharge from the eyes. No earache. No nasal discharge or sore throat. No swollen glands in the neck. No palpitations. Dyspnea and cough. Some chest pain. No nausea or vomiting. No abdominal pain, diarrhea, or constipation.

PMH: Asthma

SH: Lives with both parents.

FH: Family hx of asthma, paternal side

ALLERGIES: PCN-200 CAPS. Allergies have been reviewed with child’s family and no changes reported.

PE: General appearance: normal, alert. Talks in sentences. Pink lips and cheeks. Oriented. Well developed. Well nourished. Well hydrated.

Eyes: normal. External eye: no hyperemia of the conjunctiva. No discharge from the conjunctiva

Ears: general/bilateral. TM: normal. Nose: rhinorrhea. Pharynx/Oropharynx: normal. Neck: normal.

Lymph nodes: normal.

Lungs: before Albuterol neb, mode air entry b/l. No rales, rhonchi or wheezes. After Albuterol neb. improvement of air entry b/l. Respiratory movements were normal. No intercostals inspiratory retraction was observed.

Cardiovascular system: normal. Heart rate and rhythm normal. Heart sounds normal. No murmurs were heard.

GI: abdomen normal with no tenderness or masses. Normal bowel sounds. No hepatosplenomegaly

Skin: normal warm and dry. Pink well perfused

Musculoskeletal system patient indicates lower to mid back pain when she lies down on her back and when she rolls over. No CVA tenderness.

Assessment: Asthma, acute exacerbation

Plan: Will keep her in observation overnight. Will administer oral steroids and breathing treatment. CXR ordered and to be taken in the morning.

What E/M code is reported?

Options:

A.

99221

B.

99284

C.

99285

D.

99222

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Questions 5

Refer to the supplemental information when answering this question:

View MR 874276

What E/M code is reported?

Options:

A.

99282

B.

99285

C.

99284

D.

99283

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Questions 6

From a left femoral access, the catheter is placed within the proper hepatic artery, dye is injected, and imaging is obtained. A stenosis within this artery is identified. A percutaneous

transluminal angioplasty is performed on the proper hepatic (visceral) artery in the outpatient radiology department.

What CPT® coding is reported?

Options:

A.

36253, 75736-26-59, 37248-51

B.

36247, 75726-26-59, 37246-51

C.

36247, 75736-26-59, 37248-51

D.

36253, 75726-26-59, 37246-51

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Questions 7

The evisceration of ocular contents was performed using a surgical microscope for enhanced visualization. The procedure was performed on the left eye and an implant was not placed in the ocular cavity.

What CPT® coding is reported?

Options:

A.

65093-LT

B.

65091-LT, 69990-51

C.

65093-LT, 69990

D.

65091-LT

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Questions 8

What does the prefix “sub-” signify in medical terminology?

Options:

A.

Outside

B.

Above

C.

Within

D.

Below

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Questions 9

The patient has a ruptured aneurysm in the popliteal artery. The provider makes an incision below the knee and dissects down and around the popliteal artery. After clamping the distal and

proximal ends of the artery, the provider cuts out the defect, sutures the remaining ends of the artery together, and places a patch graft to fill the gap. What is the correct CPT® code for the

aneurysm repair?

Options:

A.

35081

B.

35151

C.

35152

D.

35045

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Questions 10

An established patient presents with fever and sore throat. Rapid strep test is positive.

What CPT® and ICD-10-CM codes are reported?

Options:

A.

99212-25, 87880, R50.9, J02.9

B.

99212-25, 87880, J02.0, R50.9, J02.9

C.

99213-25, 87880, J02.0

D.

99213-25, 87880, J02.0, R50.9, J02.9

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Questions 11

(A 5-year-old patient has a fractured radius. The orthopedist providesmoderate sedationand the reduction. The intra-service sedation time is documented as21 minutes. What CPT® code is reported for the moderate sedation?)

Options:

A.

99152

B.

99155

C.

99151

D.

99156

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Questions 12

A 19-year-old is seen by his, primary care physician for an annual exam. His last exam with the primary care physician was four years ago. He has no complaints.

What CPT code is reported?

Options:

A.

99385

B.

99395

C.

99394

D.

99384

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Questions 13

A woman at 36-weeks gestation goes into labor with twins. Fetus 1 is an oblique position, and the decision is made to perform a cesarean section to deliver the twins. The obstetrician who delivered the twins, provided the antepartum care, and will provide the postpartum care.

What CPT® coding is reported for the twin delivery?

Options:

A.

59510, 59515

B.

59510 x 2

C.

59510, 59514, 59515

D.

59510

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Questions 14

A physician prescribes carbamazepine to treat a patient with epileptic seizures. After six months, the physician performs a therapeutic drug test to monitor the total level of the drug in the patient.

What CPT® and ICD-10-CM coding is used for the six month-evaluation?

Options:

A.

80156, R56.9

B.

80157, R56.9

C.

80157, G40.909

D.

80156, G40.909

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Questions 15

A patient undergoes a laparoscopic appendectomy for chronic appendicitis.

What CPT® and diagnosis codes are reported?

Options:

A.

44950, K35.80

B.

44950, K35.80, R11.2, R10.31

C.

44970, K36

D.

44970, K36, R11.2, R10.31

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Questions 16

A catheter is placed from the femoral artery into the right common carotid, with imaging of the ipsilateral extracranial carotid and bilateral external carotids.

Which CPT® codes are reported?

Options:

A.

36222, 36227 ×2

B.

36223, 36227 ×2

C.

36224-50, 36227-51 ×2

D.

36225, 36227-51 ×2

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Questions 17

A patient has a bone infection being treated with vancomycin. A therapeutic drug assay is performed to measure the concentration of vancomycin in the patient's blood.

What lab test is reported?

Options:

A.

80197

B.

80202

C.

80184

D.

80299

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Questions 18

A patient presents with 26 skin tags on the neck and shoulder. The provider removes all using a scissoring technique.

What CPT® coding is reported?

Options:

A.

11200, 11201 ×2

B.

11200, 11201-51

C.

11200, 11201 ×25

D.

11200, 11201

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Questions 19

A patient underwent a colonoscopy, where the gastroenterologist biopsied two polyps from the colon. Each polyp was sent to pathology as separately identified specimens. The gastroenterologist was requesting a pathology consult while the patient was still on the table. Tissue blocks and frozen sections were then prepared and examined as follows:

Specimen 1: First Tissue Block—Three Frozen Sections Second Tissue Block—One Frozen Section Specimen 2: First Tissue Block—Two Frozen Sections Second Tissue Block—One Frozen Section

What CPT® coding is reported?

Options:

A.

88331 x 4, 88332 x 3

B.

88331,88332

C.

88331 X 2, 88332 x 2

D.

88331 x 3, 88332x2

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Questions 20

(Full Case:Chief complaint:Syncope.HPI:68-year-old male arrives to ED inrespiratory distressafter sudden syncope/collapse while shopping; unresponsive; EMS: weak pulse, labored respirations, unresponsive. History:CABG 5 years ago, no chest pain since.ROS:unobtainable (unconscious).Allergies:none.Meds:Coumadin.PMH:HTN.Social:lives with wife.Exam/Vitals:BP 82/62, pulse 79, RR 12 shallow, O2 sat 90% on high flow O2; monitor shows right bundle branch block. Neuro: initially eyes closed, opens to questions, responds to some questions, later unresponsive. HEENT pupils sluggish equal; unable EOM/fundus. Neck supple, no JVD/bruits. Lungs mild rhonchi. Heart regular without murmurs. Abdomen benign. Extremities symmetric, no edema/cyanosis. Skin no rash. Neuro no focal deficits.Hospital course:IV x2; NS 1000 cc bolus with little response; dopamine drip 10 → 20 mcg/kg/min; O2 sat drops, respirations slow; becomes unresponsive; progresses tocardiac arrest; CPR; multiple adrenaline/atropine; defibrillation; ABG pH 7.1 etc; bicarbonate x2; no effect; pronounced dead 13:32.Critical care time:77 minutes continuous.Diagnosis:Cardiorespiratory arrest.Question:What is the E/M coding reported for this encounter?)

Options:

A.

99291, 99285

B.

99285

C.

99291

D.

99291, 99292

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Questions 21

A 45-year-old has a dislocated patella in the left knee after a car accident. She taken to the hospital by EMS for surgical treatment. In the surgery suite, the patient is placed under general anesthesia. After being prepped and draped, the surgeon makes an incision above the knee joint in front of the patella. Dissection is carried through soft tissue and reaching the patella in attempt to reduce the dislocation. When the patella is exposed, it is severely damaged due to cartilage breakdown. The tendon is dissected and using a saw the entire patella is freed and removed. The tendon sheath is closed with sutures.

What procedure code is reported for this surgery?

Options:

A.

27562-LT

B.

27552-LT

C.

27556-LT

D.

27566-LT

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Questions 22

The patient, who is at 32 weeks pregnant, has been hospitalized due to an infection of COVID-19.

What ICD-10-CM codes are reported?

Options:

A.

O98.513, U07.1, Z3A.32

B.

U07.1, R06.02, R50.81, Z33.1, Z3A.32

C.

U07.1, O98.513, Z3A.32

D.

O98.513, U07.1, R06.02, R50.81, Z3A.32

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Questions 23

CPC Question 23

Refer to the supplemental information when answering this question:

View MR 003264

What is the procedural coding?

Options:

A.

33020-58

B.

35820-78

C.

32658-78

D.

32120-58

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Questions 24

In rhinoplasty:

Options:

A.

The nose is reconstructed

B.

The brow is reconstructed

C.

The lips are reconstructed

D.

The chin is reconstructed

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Questions 25

A pathologist performs fluorescent microscopy for chromosomal abnormalities, but no specific CPT® code exists.

Which unlisted CPT® code is reported?

Options:

A.

84999

B.

88749

C.

88199

D.

88299

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Questions 26

A physician orders an obstetric panel that includes syphilis screening using the non-treponemal antibody approach, an automated CBC with manual differential WBC count, HBsAg, rubella antibody, a serum antibody screen, and ABO and Rh blood typing.

What CPT® coding is reported?

Options:

A.

80055

B.

80055, 85027, 85007, 87340, 86762, 86780, 86850, 86900, 86901

C.

85027, 85007, 87340, 86762, 86780, 86850, 86900, 86901

D.

80081, 86780

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Questions 27

The CPT® code book provides full descriptions of medical procedures, although some descriptions require the use of a semicolon (;) to distinguish among closely related procedures.

What is the full description of CPT® code 44361?

Options:

A.

With biopsy, single or multiple

B.

Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, with biopsy, single or multiple

C.

Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure), with biopsy, single or multiple

D.

Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with biopsy, single or multiple

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Questions 28

Preoperative diagnosis: Right thigh benign congenital hairy nevus. *1

Postoperative diagnosis: Right thigh benign congenital hairy 0 nevus.

Operation performed: Excision of right thigh benign congenital>1

nevus, excision size with margins 4.5 cm and closure size 5 cm.

Anesthesia: General.0

Intraoperative antibiotics: Ancef.0

Indications: The patient is a 5-year-old girl who presented with her parents for evaluation of her right thigh congenital nevus. It has been followed by pediatrics and thought to have changed over the past year. Family requested excision. They understood the risks involved, which included but were not limited to risks of general

anesthesia, infection, bleeding, wound dehiscence, and poor scar formation. They understood the scar would likely widen as the child grows because of the location of it and because of the age of the patient. They consented to proceed.

Description of procedure: The patient was seen preoperatively in > I the holding area, identified, and then brought to the operating room. Once adequate general anesthesia had been induced, the patient's right thigh was prepped and draped in standard surgical fashion. An elliptical excision measuring 6 x 1.8 cm had been marked. This was injected with Lidocaine with epinephrine, total of 6 cc of 1% with 1:100,000. After an adequate amount of time, a #15 blade was used to sharply excise this full thickness.

This was passed to pathology for review. The wound required □ limited undermining in the deep subcutaneous plane on both sides for approximately 1.5 cm in order to allow mobilization of the skin for closure. The skin was then closed in a layered fashion using 3-0 Vicryl on the dermis and then 4-0 Monocryl running subcuticular in the skin, the wound was cleaned and dressed with Dermabond and Steri-Strips.

The patient was then cleaned and turned over to anesthesia for S extubation.

She was extubated successfully in the operating room and taken S to the recovery room in stable condition. There were no complications.

Which CPT® and ICD-10-CM codes are reported for this procedure?

Options:

A.

65420-LT, H11.002

B.

65426-LT, H11.002

C.

65400-LT, H11.062

D.

65426-LT, H11.062

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Questions 29

(Which statement accurately reflects CPT® parenthetical guidance for codes69209and69210?)

Options:

A.

Report codes 69209 and 69210 when both are performed on the same ear.

B.

The cerumen must be stated asimpactedto report either 69209 or 69210.

C.

When 69209 or 69210 is performed on both ears report the codetwice.

D.

Report an E/M code and either 69209 or 69210 when the cerumen is impacted.

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Questions 30

The documentation states:

He was then sterilely prepped and draped along the flank and abdomen in the usual sterile fashion. I first made a skin incision off the tip of the twelfth rib, extending medially along the banger’s lines of the skin. This was approximately 3.5 cm in length. Once this incision was carried sharply, electrocautery was used to gain access through the external oblique, internal oblique, and transverse abdominis musculature and fascia.

What surgical approach was used for this procedure?

Options:

A.

Percutaneous

B.

Laparoscopic

C.

Cannot determine based on the documentation

D.

Open

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Questions 31

A patient arrives for a PEG placement. The patient requires tube feeds for nutrition but frequently pulls out the dobhoffs tube. An EGD was performed. Several attempts were made to place the

PEG tube without success so the procedure was aborted. During the withdraw of the scope, a small hiatal hernia was noted in the stomach. The scope was removed the the patient transferred

to recovery.

What CPT and ICD-10-CM coding is reported?

Options:

A.

:43830-52, Z43.1

B.

43246-53, K94.29, K44.9

C.

49450-53, K94.29, K44.9

D.

43246, K94.29, Z93.1

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Questions 32

911 is called by the physician for an ambulance with non-emergency basic life support to pick up a patient from his office that had fainted. The patient was taken to the hospital. What HCPCS

Level II coding is reported for the ambulance's service?

Options:

A.

A0428-QM-PH

B.

A0429-QM-PH

C.

A0428-QM-HP

D.

A0429-QM-HP

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Questions 33

(Full Case:Preoperative diagnosis:Recurrent dysphagia.Postoperative diagnosis:Hiatal hernia with obstruction.Procedure:EGD with dilation.Consent:PAR conference; informed consent signed; premedication given.Position/monitoring:left lateral decubitus; monitored with BP cuff and pulse oximeter throughout.Topical:Hurricaine spray to posterior pharynx.Scope passage:flexible endoscope passed under direct visualization through cricopharyngeus into esophagus; advanced with identification of EG junction into stomach; rugal folds visualized; advanced to antrum/pylorus; pylorus cannulated; duodenal bulb and second portion visualized; retroflexed views of cardia/fundus/lesser curvature.Dilation technique:guidewire placed in antrum; scope removed; wire positioned by markings;#14 French dilatorpassed into stomach area;esophageal dilation performed over guidewire.Findings:tortuous/shortened esophagus; large sliding hiatal hernia; EG junction ~30 cm; stomach abnormal with very large sliding hiatal hernia; duodenum normal.Question:What CPT® coding is reported?)

Options:

A.

43235, 43248

B.

43235, 43249

C.

43249

D.

43248

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Questions 34

A 3-day-old died in her sleep. The pediatrician determined this was the result of crib death syndrome. The parents give permission to refer the newborn for a necropsy. The pathologist receives the newborn with her brain and performs a gross and microscopic examination. The physician issues the findings and reports they are consistent with a normal female newborn.

What CPT® code is reported?

Options:

A.

88028

B.

88012

C.

88029

D.

88014

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Questions 35

A patient with a history of a right-hand mass presents for outpatient surgical excision. The surgeon excises the 1.5 cm mass with margins using a scalpel with dissection extending through the dermis into the subcutaneous tissue. Hemostasis is achieved with electrocautery, and the wound is closed. Final pathology confirms the mass is a subcutaneous arteriovenous hemangioma.

Which CPT® and ICD-10-CM codes are reported?

Options:

A.

26111, D18.01

B.

26111, D21.01

C.

26115, D18.01

D.

26115, D21.11

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Questions 36

A 32-year-old vialled a provider due to skin itching and ongoing irritation and watering of the eyes. Suspecting an allergy, the provider suspects an allergic reaction and decides to conduct allergy testing. A prick on the skin of the patient's forearm is performed by introducing a small amount of an allergen and monitored for signs of an allergic reaction.

What CPT® code is reported?

Options:

A.

95060

B.

95024

C.

95056

D.

95004

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Questions 37

A 7-year-old boy was brought 10 the ED by his mother after he had been playing with small beads and one got lodged in his right external ear canal. After examination, the physician decided to remove the foreign body from the external auditory canal using alligator forceps without anesthesia.

What CPT® code is reported?

Options:

A.

69110

B.

69105

C.

69200

D.

69205

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Questions 38

A patient presents to the office with dysuria and lower abdominal pain. The physician suspects she has a UTI. A non-automated urinalysis is done in the office and is negative. UTI is ruled out

for the final diagnosis.

What CPT and ICD-10-CM codes are reported?

Options:

A.

81000, N39.0

B.

81000, R30.0, R10.30

C.

81002, R30.0, R10.30

D.

81002, N39.0

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Questions 39

A patient with severe diverticulitis in the sigmoid colon presents to surgery for a partial colectomy. The physician performs an exploratory laparoscopic laparotomy to verify the location of the diverticulitis. Once identified, it was noted that there was bleeding from the diverticulitis. The physician transects the descending colon and then transects at the line of the rectum.

The physician mobilizes the splenic flexure in order to create a colostomy with the proximal portion of the remaining colon. The distal portion of the colon is closed. The physician washes the patient's abdomen with saline, removes all trocars and instruments, and then closes the abdomen with sutures.

What CPT® and ICD-10-CM codes are reported?

Options:

A.

44206, 44213-51, K57.41

B.

44212, 44213-51, K57.41

C.

44206, 44213, K57.33

D.

44212, 44213, K57.33

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Questions 40

(A patient is seen by her podiatrist to treat a painfulleft ingrown toenailon the big toe. The podiatrist performs awedge excisionof the skin of the nail fold at the lateral margin. Local anesthetic is administered, and an elliptical incision is made through subcutaneous tissue of the affected nail groove. A wedge-shaped piece of soft tissue from the nail margins is removed. What CPT® code is reported?)

Options:

A.

11755-TA

B.

11730-TA

C.

11750-TA

D.

11765-TA

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Questions 41

Preoperative diagnosis: Right thigh benign congenital hairy nevus. *1

Postoperative diagnosis: Right thigh benign congenital hairy 0 nevus.

Operation performed: Excision of right thigh benign congenital>1

nevus, excision size with margins 4.5 cm and closure size 5 cm.

Anesthesia: General.0

Intraoperative antibiotics: Ancef.0

Indications: The patient is a 5-year-old girl who presented with her parents for evaluation of her right thigh congenital nevus. It has been followed by pediatrics and thought to have changed over the past year. Family requested excision. They understood the risks involved, which included but were not limited to risks of general

anesthesia, infection, bleeding, wound dehiscence, and poor scar formation. They understood the scar would likely widen as the child grows because of the location of it and because of the age of the patient. They consented to proceed.

Description of procedure: The patient was seen preoperatively in > I the holding area, identified, and then brought to the operating room. Once adequate general anesthesia had been induced, the patient's right thigh was prepped and draped in standard surgical fashion. An elliptical excision measuring 6 x 1.8 cm had been marked. This was injected with Lidocaine with epinephrine, total of 6 cc of 1% with 1:100,000. After an adequate amount of time, a #15 blade was used to sharply excise this full thickness.

This was passed to pathology for review. The wound required □ limited undermining in the deep subcutaneous plane on both sides for approximately 1.5 cm in order to allow mobilization of the skin for closure. The skin was then closed in a layered fashion using 3-0 Vicryl on the dermis and then 4-0 Monocryl running subcuticular in the skin, the wound was cleaned and dressed with Dermabond and Steri-Strips.

The patient was then cleaned and turned over to anesthesia for S extubation.

She was extubated successfully in the operating room and taken S to the recovery room in stable condition. There were no complications.

What is the radiology coding for this encounter?

Options:

A.

73560-LT

B.

73562-26

C.

73560-26-LT

D.

73562

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Questions 42

(A patient’s left eye is damaged beyond repair due to a work injury. The provider fabricates aprosthesisfromsilicon materialsand makes modifications to restore the patient’s cosmetic appearance. What CPT® code is reported?)

Options:

A.

21080

B.

21086

C.

21077

D.

21088

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Questions 43

A child returns for stage 2 surgical repair of double outlet right ventricle, including removal of pulmonary artery band, arterial switch repair, and ECMO cannulation.

What CPT® codes are reported?

Options:

A.

33778-78, 33953-78, 33985-78

B.

33779-78, 33953-78, 33985-78

C.

33778-58, 33955-58, 33985-58

D.

33779-58, 33955-58, 33985-58

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Questions 44

Which one of the following activities, when performed, is NOT considered when selecting an E/M service level based on time?

Options:

A.

Ordering medications, tests, and/or procedures.

B.

Preparing to see the patient (e.g., review of tests).

C.

Time spent on other services that are reported separately.

D.

Documenting clinical information in the patient’s medical record.

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Questions 45

A three-year-old patient is in the operative suite for stage 2 of treatment for double right outlet syndrome. The patient previously had the pulmonary artery banded and is returning for removal of

the pulmonary band and transposition repair of the great vessels via aortic pulmonary reconstruction.

The surgeon performs a time-out and pre-incision review of respiration and BP then the previous sternal incision site is inspected and lightly painted with povidone. Next, reopens the sternal

cavity and inserts central cannulae in the IVC, SVC and ascending aorta for extra corporeal membrane oxygenation (ECMO) bypass, chemical cardioplegia is initiated, stopping the heart and

ECMO is initiated. A physician assistant monitors vitals and oxygenation until heart function resumes. The surgeon carefully incised and removes the Dacron band encircling the pulmonary

artery, with nominal need for dilation. A section of coronary ostia is removed and sutured to the root of the pulmonary trunk. The pulmonary trunk and aortic root are then transected and

transposed to allow for ideal cardiac circulation. Once structural integrity is visually confirmed, the physician assistant is permitted to administer the cardioplegia reversal solution and the

surgeon removes the central cannulae after heart function safely resumes. The sternotomy is closed and the patient is transported to the NICU.

What CPT® codes are reported for the surgery today?

Options:

A.

33778-78, 33953-78, 33985-78

B.

33779-58, 33955-58, 33985-58

C.

33779-78, 33953-78, 33985-78

D.

33778-58, 33955-58, 33985-58

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Questions 46

Refer to the supplemental information when answering this question:

View MR 000281

What anesthesia and diagnosis codes are reported for this case?

Options:

A.

00812, D62, N18.6, Z99.2

B.

00811, D64.9, K62.5, N18.6, Z99.2

C.

00812, D64.9, K62.5, N18.6, Z99.2

D.

00811, D62, N18.6, Z99.2

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Questions 47

Which one of the following is an example of a case in which a diabetes-related problem exists and the code for diabetes is never sequenced first?

Options:

A.

If the patient has hyperglycemia that Is not responding to medication

B.

If the patient has an underdose of insulin due to an insulin pump malfunction

C.

If the patient is being treated for secondary diabetes

D.

If the patient is being treated for type 2 diabetes

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Questions 48

Refer to the supplemental information when answering this question:

View MR 138093

What E/M coding is reported?

Options:

A.

99285-25, 99291-25, 92950, 31500, 82803

B.

99291-25, 92950, 31500, 82803

C.

99285

D.

99291-25, 99292-25, 92950, 31500

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Questions 49

A patient undergoes right thyroid lobectomy for malignancy and removal of a suspicious parathyroid gland.

What CPT® codes are reported?

Options:

A.

60500, 60210-59

B.

60505, 60240-59

C.

60505, 60220-59

D.

60500, 60220-59

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Questions 50

A 55-year-old patient with suspected liver cancer was seen by the physician to obtain a biopsy. The special biopsy needle was placed using ultrasonic guidance. The physician obtained a small tissue sample from the liver, which was then sent to pathology.

What CPT® codes are reported?

Options:

A.

47000, 77002-26

B.

47000, 10005

C.

47100, 77012-26

D.

47000, 76942-26

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Questions 51

A 63-year-old is seen by his. primary care physician for an annual exam. His last exam with the primary care physician was four years ago. He has no complaints.

What CPT code is reported?

Options:

A.

99386

B.

99396

C.

99397

D.

99387

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Questions 52

A physician performs excisional debridement on multiple wounds:

Lower back: 12 cm, involving fascia

Left shoulder: 8 cm, involving subcutaneous tissue

Left lower leg: 16 cm, involving subcutaneous tissue

What CPT® codes are reported?

Options:

A.

11043, 11046

B.

11042, 11045

C.

11043, 11042-59, 11045

D.

11043, 11042-59, 11042-59

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Questions 53

Dr. Burns sees newborn baby James at the birthing center on the same day after the cesarean delivery. Dr. Burns examined baby James, the maternal and newborn history, ordered appropriate blood test tests and hearing screening. He met with the family at the end of the exam.

How would Dr. Bums report his services?

Options:

A.

99463

B.

99460

C.

99461

D.

99462

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Questions 54

A 67-year-old patient has osteomyelitis of the shoulder blade and is in surgery to remove the sequestered section of dead infected fragment bone from surrounding bone.

What CPT® code is reported?

Options:

A.

23180

B.

23182

C.

23172

D.

23170

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Questions 55

(A patient is in her otolaryngologist’s office to receive therapeutic treatment forasthmatic bronchitis with status asthmaticus. A subcutaneous injection ofomalizumab (150 mg)is given in her left upper arm. What is the CPT® and ICD-10-CM coding?)

Options:

A.

96369, J2357 × 30, J45.52

B.

90460, J2357 × 30, J45.52

C.

90471, J2357 × 30, J45.902

D.

96372, J2357 × 30, J45.902

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Questions 56

A patient with suspected gynecologic malignancy undergoes laparoscopic staging including bilateral pelvic lymphadenectomy, periaortic lymph node sampling, peritoneal washings, peritoneal and diaphragmatic biopsies, and omentectomy.

What CPT® coding is reported?

Options:

A.

38573

B.

38571, 38573

C.

38572-50, 38573-50

D.

38573-50

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Questions 57

(ESTABLISHED PATIENT VISIT: A 37-year-old woman presents with coughing, congestion, upper respiratory symptoms, and headache for two days. Complete ROS negative except as noted. No significant past/family history. Exam: stable vitals, nasal congestion, normal TMs, occasional rhonchi, no wheezing, normal heart, soft abdomen. Assessment/Plan:Acute upper respiratory infection, fluids,amoxicillinfor 5–7 days, return precautions. What CPT® code is reported?)

Options:

A.

99214

B.

99213

C.

99212

D.

99215

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Questions 58

A wedge excision of soft tissue at the lateral margin of an ingrown toenail on the left great toe is performed.

What CPT® code is reported?

Options:

A.

11750-TA

B.

11765-TA

C.

11755-TA

D.

11730-TA

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Questions 59

According to the Application of Cast and Strapping CPT® guidelines, what is reported when an orthopedic provider performs initial fracture care treatment for a closed scaphoid fracture of the wrist, applies a short arm cast, and the patient will be returning for subsequent fracture care?

Options:

A.

25622

B.

29075

C.

25622, 29075

D.

29075-22

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Questions 60

Ms. C is diagnosed with a supratentorial intracerebral hematoma, and the neurologist performs a craniectomy to access the hematoma. The hematoma is accessed, and a suction device is

used to remove it.

What CPT@ code is reported?

Options:

A.

61314

B.

61154

C.

61313

D.

61312

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Questions 61

(Procedure date:01/12/20XX

Surgeon:MD |Assistant:PA

Preoperative diagnosis:Dry gangrene of the left foot in the setting of peripheral vascular disease. Non-pressure chronic ulcer on toe.

Postoperative diagnosis:Dry gangrene of the left foot in the setting of peripheral vascular disease. Non-pressure chronic ulcer on toe.

Procedure:Amputation at the metatarsophalangeal joint of the left third toe

Indication:63-year-old female with peripheral vascular disease; vascular workup determined no further interventions to improve vascularity; third toe became progressively dusky; wound formed distally with chronic ulcer; amputation necessary; risks/benefits discussed.

Description:Left foot and third toe marked; 1 g Ancef given; general anesthesia; supine; calf tourniquet; timeout; tourniquet inflated (no Esmarch); total tourniquet time 5 minutes; tennis racquet incision with longitudinal arm over third metatarsal encircling joint proximal to closure; extensor/flexor tendons and collateral ligaments excised sharply; toe removed; tourniquet released; superficial bleeders cauterized; washed out; skin closed with 3-0 nylon; dry dressing; to PACU in good condition; signed 01/19/20XX 09:41.

Question:What CPT® and ICD-10-CM coding is reported?)

Options:

A.

28820-T2, L97.528, I70.262

B.

28810-T2, I70.262, L97.528

C.

28820-T2, I70.262, L97.528

D.

28810-T2, L97.528, I70.262

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Questions 62

A 26-year-old male presents with a deep laceration from a kitchen knife to his right hand. The surgeon washes the open wound with sterile saline. Clamps are applied. The provider cleans the

vessel and prepares the edges of thee wound. She then repairs the bleeding vessel with sutures. The clamps are removed and the provider uses a Doppler probe to check the blood flow pattern

through the repaired vessel.

What CPT® code is reported?

Options:

A.

35207-RT

B.

35206-RT

C.

35702-RT

D.

35236-RT

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Questions 63

A 42-year-old male is diagnosed with a left renal mass. An abdominal incision along with rib resection is made to expose and access the kidney. The left kidney is removed, along with surrounding fat, adrenal gland, lymph nodes in the area, and the incision site is sutured. What CPT ® code is reported for this procedure?

Options:

A.

50230

B.

50545

C.

50543

D.

50220

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Questions 64

A 53-year-old male arrived at the ER due to severe ocular trauma to the right eye. He was at work on a metal drilling machine and a metallic item penetrates his right eyeball. A foreign body is in

the posterior segment of the eye and corneal laceration with multiple posterior perforated sites were noted. He is brought back to the surgical suite. The surgeon removes the metallic foreign

body using large retinal forceps. The laceration of the cornea is sutured and the provider also performs a pars plana lensectomy.

What is the CPT® and ICD-10-CM codes are reported?

Options:

A.

65265-RT, 66852-51-RT, 65280-51-RT, S05.51XA, W31.1XXA

B.

65235-RT, 66852-51-RT, 65275-51-RT. S05.51XA, W31.1XXA

C.

65265-RT, 66852-51-RT, 65275-51-RT, S05.31XA, W31.0XXA

D.

65235-RT, 66852-51-RT, 65280-51-RT. S05.31XA, W31.0XXA

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Questions 65

A 52-year-old woman has been experiencing discomfort and itching In the vulvar area for several months. She has a history of abnormal Pap smears and a recent biopsy revealed vulvar intraepithelial neoplasia (VIN III). Decision has been made to perform a vulvectomy.

Procedure: Under general anesthesia, the surgeon made an incision in the vulvar area and removed the vulva (more than 80%), including the affected skin and deep subcutaneous tissue.

What CPT® and ICD-10-CM codes are reported?

Options:

A.

56620, N90.1

B.

56630. N90.1

C.

56633, D07.1

D.

56625, D07.1

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Questions 66

A 43-year-old female with a history of joint pain and fatigue presents to the office with swollen salivary glands. Patient agrees to have a labial gland biopsy performed in office. Patient is

numbed with a local anesthetic. Then an incision is made on the lower labial mucosa and tissue samples from the salivary gland are removed with tweezers. The incision is sutured. Pathology

report findings are consistent with Sjogren's syndrome.

What CPT® code is reported?

Options:

A.

42408

B.

42405

C.

42400

D.

42450

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Questions 67

A patient with compression fractures of L5 and the sacrum undergoes vertebroplasty, with cement injected into two vertebral bodies, performed bilaterally.

What CPT® coding is reported?

Options:

A.

22514-50, 22515-50

B.

22511, 22512

C.

22514, 22515

D.

22511-50, 22512-50

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Questions 68

A surgeon performed Mohs micrographic surgery on a lesion on the right arm. This required one stage with six tissue blocks.

What CPT@ codes are reported for the Mohs surgery?

Options:

A.

17313, 17314, 17315

B.

17311, 17315

C.

17313, 17315

D.

17311, 17312, 17315

E.

85B2-335

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Questions 69

A 42-year-old with chronic left trochanteric bursitis is scheduled to receive an injection at the Pain Clinic. A 22-gauge spinal needle is introduced into the trochanteric bursa under ultrasonic guidance, and a total volume of 8 cc of normal saline and 40 mg of Kenalog was injected.

What CPT® code should be reported for the surgical procedure?

Options:

A.

20610-LT

B.

20611-LT, 76942

C.

20611-LT

D.

20610-LT, 76942

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Questions 70

A provider orders LC-MS definitive drug testing for suspected acetaminophen overdose.

What CPT® code is reported?

Options:

A.

80324

B.

80329

C.

80299

D.

80143

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Questions 71

A patient receives 200 mg IM Depo-Testosterone.

What HCPCS Level II coding is reported?

Options:

A.

J1071, 90471

B.

J1071 ×200, 96372

C.

J1071, 96372

D.

J1071 ×200, 90471

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Questions 72

(A 7-year-old child presents with third-degree circumferential burns of his chest, resulting in restricted chest expansion and concern for respiratory compromise. To relieve pressure caused by the eschar, the surgeon performs anescharotomy. During the procedure,two incisionsare made through the eschar down to the subcutaneous tissue to release the constrictive effects. The burns are full-thickness and involve10% TBSA, resulting in all third-degree burns. What CPT® and ICD-10-CM codes are reported for this service?)

Options:

A.

16035 × 2, T21.39XA, T31.10

B.

16035, 16036, T21.31XA, T31.11

C.

16035, 16036 × 2, T21.31XA, T31.11

D.

16035, 16036-51, T21.39XA, T31.10

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Questions 73

A 50-year-old patient presented with a persistent cough has not responded to standard treatments. The patient's physician decides to perform a flexible bronchoscopy with bronchial biopsies to further investigate the cause. A flexible bronchoscope is inserted through the patient's mouth and into the bronchial tubes. Five biopsies are taken for further testing. The biopsies were sent to the lab for analysis to determine the next steps in the patient's treatment plan.

What CPT® coding is reported?

Options:

A.

31625

B.

31628 x 5

C.

31628

D.

31625 x 5

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Questions 74

(Preoperative diagnoses:Bradycardia.

Postoperative diagnosis:Bradycardia.

Procedure performed:Dual-chamber pacemaker implantation.

Brief history:77-year-old female with recurrent syncope; evaluation revealed first-degree AV block, sinus bradycardia, bundle-branch block; bradyarrhythmia suspected; after discussion with her sister, dual-chamber pacemaker recommended; risks explained; consent obtained.

Procedure details:Taken to cardiac catheterization lab; positioned on cath table; prepped/draped standard; procedure challenging due to agitation despite adequate sedation; left infraclavicular area anesthetized with 0.5 cc Xylocaine; pacemaker pocket created; hemostasis with cautery; 9-French peel-away sheath used to introduce an atrial and a ventricular lead; leads positioned with excellent thresholds; secured with O-silk sutures over sleeves; pulse generator connected; pocket flushed with antibiotic solution; pacemaker/leads placed in pocket; incision closed in two layers; performed under fluoroscopic guidance.

Complication:None.

Plan:Return to recovery; discharge later this evening to nursing home with routine post-pacemaker care.

Question:What CPT® coding is reported for this procedure?)

Options:

A.

33208

B.

33206

C.

33207

D.

33206, 33207

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Questions 75

(A patient suffering fromlateral epicondylitisin the left elbow is sent to the operating room tomanipulate the elbow. The patient is placed undergeneral anesthesiaby the anesthesiologist. The physician manipulates the elbow through stretching and rotation to restore motion. What CPT® coding is reported for the physician?)

Options:

A.

24300, 01710

B.

24605

C.

24300

D.

24605, 01710

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Questions 76

Preoperative diagnosis: Right thigh benign congenital hairy nevus. *1

Postoperative diagnosis: Right thigh benign congenital hairy 0 nevus.

Operation performed: Excision of right thigh benign congenital>1

nevus, excision size with margins 4.5 cm and closure size 5 cm.

Anesthesia: General.0

Intraoperative antibiotics: Ancef.0

Indications: The patient is a 5-year-old girl who presented with her parents for evaluation of her right thigh congenital nevus. It has been followed by pediatrics and thought to have changed over the past year. Family requested excision. They understood the risks involved, which included but were not limited to risks of general

anesthesia, infection, bleeding, wound dehiscence, and poor scar formation. They understood the scar would likely widen as the child grows because of the location of it and because of the age of the patient. They consented to proceed.

Description of procedure: The patient was seen preoperatively in > I the holding area, identified, and then brought to the operating room. Once adequate general anesthesia had been induced, the patient's right thigh was prepped and draped in standard surgical fashion. An elliptical excision measuring 6 x 1.8 cm had been marked. This was injected with Lidocaine with epinephrine, total of 6 cc of 1% with 1:100,000. After an adequate amount of time, a #15 blade was used to sharply excise this full thickness.

This was passed to pathology for review. The wound required □ limited undermining in the deep subcutaneous plane on both sides for approximately 1.5 cm in order to allow mobilization of the skin for closure. The skin was then closed in a layered fashion using 3-0 Vicryl on the dermis and then 4-0 Monocryl running subcuticular in the skin, the wound was cleaned and dressed with Dermabond and Steri-Strips.

The patient was then cleaned and turned over to anesthesia for S extubation.

She was extubated successfully in the operating room and taken S to the recovery room in stable condition. There were no complications.

What CPT® and ICD-10-CM codes are reported?

Options:

A.

27380, S76.911A

B.

27385, S76.911A

C.

27380, S76.311A

D.

27385, S76.311A

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Questions 77

(Which one of the following isNOTa cardiac valve?)

Options:

A.

Mitral valve

B.

Femoral valve

C.

Aortic valve

D.

Tricuspid valve

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Questions 78

(A 6-month-old child was brought to the hospital with severe breathing difficulties. After testing, the child was diagnosed withtracheal stenosis present from birth. The pediatric surgeon performed atracheoplasty(surgical widening of the trachea). What CPT® and ICD-10-CM codes are reported?)

Options:

A.

00320, 99100, Q32.1

B.

00326, 99100, J39.8

C.

00326, Q32.1

D.

00320, J39.8

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Questions 79

According to the ICD-10-CM Guidelines, what code is reported as an additional code when the blood pressure of a patient with hypertension remains above goal in spite of the use of antihypertensive medications?

Options:

A.

110, Essential (primary) hypertension.

B.

A code from category 127, Other pulmonary heart diseases.

C.

Ol1A.0, Resistant hypertension.

D.

A code from category 116, Hypertensive crisis.

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Questions 80

A 1-year-old patient has bilateral supernumerary digits:

Left digit contains bone and joint → amputated

Right digit is a soft-tissue nubbin → simple excision

What CPT® coding is reported?

Options:

A.

26587-LT, 11200-RT

B.

26910-50

C.

26910-LT, 11200-RT

D.

26951-50, 11200-50

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Questions 81

(A patient with age-related osteoporosis is hospitalized after a slip and fall resulting in fractures to both hips. The physician ordersthree-view imaging of both hips and the pelvis, interpreted by the hospital radiologist. Later the same day, the patient falls from bed and the doctor ordersthree additional viewsof both hips and pelvis, interpreted by thesame radiologist. What CPT® coding is reported?)

Options:

A.

73522, 73522-76

B.

73522-76, 73522-51

C.

73523, 73523-77

D.

73523-76, 73523-51

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Questions 82

A patient is diagnosed with sepsis due to enterococcus. What ICD-10-CM code is reported?

Options:

A.

A41.52

B.

A41.9, R65.20

C.

A41.81

D.

A41.9

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Questions 83

(A 65-year-old male patient passed away due to unknown causes. An autopsy was ordered by the attending physician to determine the cause of death. The pathologist performed agross and microscopic examination autopsy, that includes thebrain and spinal cord. What CPT® coding is reported?)

Options:

A.

88016

B.

88027

C.

88020

D.

88028

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Questions 84

A woman with vulvar intraepithelial neoplasia (VIN II) undergoes a partial vulvectomy (<80%) with removal of skin and deep subcutaneous tissue.

What CPT® and ICD-10-CM codes are reported?

Options:

A.

56625, N90.1

B.

56633, D07.1

C.

56620, N90.3

D.

56630, N90.1

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Questions 85

A 40-year-old woman with progressive sensory neural hearing loss in the right ear since the age of 13 has not gained benefit from her hearing aid. She has normal hearing in the left ear. A cochlear implant is placed for the right ear. Anesthesia is provided by a CRNA with medical direction by an anesthesiologist who is concurrently directing 5 CRNAs. PS is 3.

What anesthesia CPT® and ICD-10-CM codes are reported by the Anesthesiologist?

Options:

A.

00300-QX-P3. H90.5

B.

00120-AA-P3, H90.41

C.

00120-AD-P3.H90.41

D.

00300-QY-P3, H90.5

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Questions 86

Which place of service code is submitted on the claim for a service that is performed in a skilled nursing facility?

Options:

A.

32

B.

20

C.

22

D.

31

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Questions 87

The provider orders a bile test for a patient that has chronic hepatitis that is undergoing treatment. Lab analyst quantitates the total bile acids with an enzymatic method. What CPT® code is

reported for the test?

Options:

A.

82248

B.

82247

C.

82239

D.

82252

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Questions 88

A patient presents with recurrent spontaneous episodes of dizziness of unclear etiology. Caloric vestibular testing is performed irrigating both ears with warm and cold water while evaluating the patient’s eye movements. There is a total of three irrigations.

What CPT® coding is reported?

Options:

A.

92537-52

B.

92537-50-52

C.

92538-50

D.

92537-50

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Questions 89

An 8-year-old undergoes tonsillectomy with adenoidectomy for chronic tonsillitis and adenoiditis with hypertrophy.

What CPT® and ICD-10-CM codes are reported?

Options:

A.

42825, 42830, J35.03

B.

42825, 42830, J35.03, J35.3

C.

42820, J35.03, J35.3

D.

42820, J35.03

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Questions 90

Patient is admitted in observation care on 12/2/20XX in the morning for acute asthma exacerbation. The ED physician requires the patient to stay overnight. Next day, 12/3/20XX the patient is

discharged from observation care in the afternoon. Patient's total stay in observation was 16 hours.

What E/M categories and code ranges are appropriate to report?

Options:

A.

Hospital Inpatient or Observation Care Services (Including Admission and Discharge Services) (99234-99236) and Hospital Inpatient or Observation Discharge services (99238-99239)

B.

Initial Hospital Inpatient or Observation Care (99221-99223) and Subsequent Hospital Inpatient or Observation Care (99231-99233)

C.

Hospital Inpatient or Observation Care Services (Including Admission and Discharge Services) (99234-99236) and Subsequent Inpatient or Observation Care (99231-99233)

D.

Initial Hospital Inpatient or Observation Care (99221-99223) and Hospital Inpatient or Observation Discharge services (99238-99239)

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Questions 91

A patient arrives at the clinic experiencing pain due to a chest injury caused by blunt force. The provider takes X-ray imaging with 6 views of the chest.

What CPT® coding is reported?

Options:

A.

71048

B.

71047

C.

71048x6

D.

71047x2

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Questions 92

A 55-year-old female patient is diagnosed with renal cell carcinoma. She is having a resection of the affected kidney, a portion of the ureter, and rib resection, open aproach. The procedure is complicated due to a prior surgical procedure performed on the same kidney.

What CPT® coding is reported?

Options:

A.

50548

B.

50545

C.

50236

D.

50225

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Questions 93

A patient is diagnosed with compression fractures of the C6, C7 and T1 vertebrae. The patient agrees to have vertebroplasty. Bone cement is injected in the vertebral space until each of the two whole vertebral body is filled. The procedure is performed bilaterally.

What CPT® coding is reported?

Options:

A.

22513, 22515

B.

22510-50, 22512-50 x 2

C.

22510, 22512 x 2

D.

22513-50, 22513-50

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Questions 94

View MR 005398

MR 005398

Operative Report

Preoperative Diagnosis: Nonfunctioning right kidney with ureteral stricture.

Postoperative Diagnosis: Nonfunctioning right kidney with ureteral stricture.

Procedure: Right nephrectomy with partial ureterectomy.

Findings and Procedure: Under satisfactory general anesthesia, the patient was placed in the right flank position. Right flank and abdomen were prepared and draped out of the sterile field. Skin incision was made between the 11th and 12th ribs laterally. The incision was carried down through the underlying subcutaneous tissues, muscles, and fascia. The right retroperitoneal space was entered. Using blunt and sharp dissection, the right kidney was freed circumferentially. The right artery, vein, and ureter were identified. The ureter was dissected downward where it is completely obstructed in its distal extent. The ureter was clipped and divided distally. The right renal artery was then isolated and divided between 0 silk suture ligatures. The right renal vein was also ligated with suture ligatures and 0 silk ties. The right kidney and ureter were then submitted for pathologic evaluation. The operative field was inspected, and there was no residual bleeding noted, and then it was carefully irrigated with sterile water. Wound closure was then undertaken using 0 Vicryl for the fascial layers, 0 Vicryl for the muscular layers, 2-0 chromic for subcutaneous tissue, and clips for the skin. A Penrose drain was brought out through the dependent aspect of the incision. The patient lost minimal blood and tolerated the procedure well.

What CPT® coding is reported for this case?

Options:

A.

50234

B.

50220

C.

50230

D.

50240

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Questions 95

A patient suffers a ruptured infrarenal abdominal aortic aneurysm requiring emergent endovascular repair. An aorto-aortic tube endograft is positioned in the aorta and a balloon dilation is performed at the proximal and distal seal zones of the endograft. The balloon angioplasty is performed for endoleak treatment.

What CPT® code does the vascular surgeon use to report the procedure?

Options:

A.

34702

B.

34701

C.

34707

D.

34708

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Questions 96

Which circumstance supports medical necessity for a payment by the insurance company?

Options:

A.

Speech therapy for a lisp.

B.

Tummy tuck after a pregnancy.

C.

Second rhinoplasty for a smaller nose.

D.

Removing excess skin in losing weight from a gastric bypass.

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Questions 97

(A patient is diagnosed with agangrenous ulceron theright thighwith thefat layer exposedand is currently being treated. What ICD-10-CM coding is reported?)

Options:

A.

I96, L97.102

B.

L97.112

C.

I96, L97.112

D.

L97.112, I96

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Questions 98

(From the left femoral artery, the catheter was advanced into the abdominal aorta, andaortographywas performed to view the location of the left inferior phrenic artery. Next the catheter was advanced into theleft inferior phrenicand into theleft superior suprarenal (adrenal) arteryand angiography was performed. The angiography showed no blockage of the left adrenal artery. What CPT® codes are reported?)

Options:

A.

36245, 36246, 75731

B.

36245, 36246, 75733-50

C.

36246, 75731

D.

36200, 36246, 75733-50

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Questions 99

A patient is sent to the hospital by his family care provider for admission due to a high fever and neck pain The patient is admitted to the hospital to rule out bacterial meningitis. The hospitalist admits the patient and orders a CBC. CMR Blood culture, CT of the head and chest, and a lumbar puncture (spinal tap). After review of the results, he determines the patient has bacterial meningitis and starts the patient on IV antibiotics.

What CPT® and ICD-10-CM codes are reported for the admission?

Options:

A.

99222, R50.81.M54.2

B.

99284, G00.9

C.

99222, G00.9

D.

99264, R50.81.M54.2

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Questions 100

(Which one of the following is an anesthesiaphysical status modifier?)

Options:

A.

2P

B.

QS

C.

P1

D.

AA

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Questions 101

An interventional radiologist performs an abdominal paracentesis using fluoroscopic guidance to remove excess fluid. The procedure is performed in the hospital. What CPT® coding is reported?

Options:

A.

49082

B.

49083,77001-26

C.

49083

D.

49083.77002-26

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Questions 102

What is the medical term for a procedure that creates an opening between the bladder and the rectum?

Options:

A.

Gastroenterocolostomy

B.

Cystoproctostomy

C.

Colocholecystostomy

D.

Nephropyelostomy

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Questions 103

A patient undergoes CABG using the right internal mammary artery anastomosed to three coronary arteries.

What CPT® coding is reported?

Options:

A.

33535

B.

33533, 33511

C.

33533, 33518

D.

33512

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Questions 104

In medical terminology, suffixes indicate the procedure, condition, disorder, or disease.

Which term contains a suffix?

Options:

A.

malaise

B.

ambidextrous

C.

neuralgia

D.

hypotension

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Questions 105

What is the HCPCS Level II code for a standard wheelchair?

Options:

A.

K0010

B.

K0002

C.

K0001

D.

E1130

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Questions 106

A patient had surgery a year ago to repair two extensor tendons in his wrist. He is in surgery for a secondary repair for the same two tendons with free graft. What CPT® coding is reported?

Options:

A.

25270

B.

25274 x 2

C.

25270 x 2

D.

25272

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Questions 107

A provider performs a mastoidectomy and complete labyrinthectomy for right-sided peripheral vertigo.

What CPT® and ICD-10-CM codes are reported?

Options:

A.

69905, 69990-51, R42

B.

69910, 69990, H81.391

C.

69905, 69990, H81.391

D.

69910, 69990-51, R42

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Questions 108

(The physician performs adiagnostic ERCPof the common bile duct with insertion of astentinto the biliary duct. What CPT® coding is reported?)

Options:

A.

43276

B.

43274

C.

43260, 43274

D.

43275, 43274

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Questions 109

(A patient presents with dysuria and lower abdominal pain. The physician suspects UTI. Anautomated urinalysis without microscopyis done in the office and isnegative. UTI is ruled out for the final diagnosis. What CPT® and ICD-10-CM codes are reported?)

Options:

A.

81003, N39.0, R30.0, R10.30

B.

81003, R30.0, R10.30

C.

81001, N39.0, R30.0, R10.30

D.

81001, N39.0

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Questions 110

Patient is diagnosed with dacryocystitis, which is the inflammation of?

Options:

A.

Cornea

B.

Fingernail

C.

Eardrum

D.

Lacrimal sac

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Questions 111

What ICD-10-CM coding is reported for a patient who has hypertension and CKD stage 2?

Options:

A.

I12.0, N18.2

B.

I12.9, N18.2

C.

E03.9

D.

I10, E66.9

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Questions 112

(A female patient underwent a mastectomy on herleft breastlast year due to breast cancer. The surgery was successful in eliminating the cancer and no further treatment was required. However, a recent diagnosis now includes cancer thatmetastasized to her liver. What ICD-10-CM coding is reported?)

Options:

A.

C22.9, C50.912

B.

C78.7, Z85.3

C.

C78.7, C50.912

D.

C78.7, C79.81

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Questions 113

Which statement regarding lesion excision is TRUE?

Options:

A.

Lesion excision codes include removal of a lesion, with margins, and simple (nonlayered) closure when performed

B.

Lesion excision codes are selected by measuring the greatest clinical diameter of a lesion excluding the margins required to complete the excision

C.

Lesion excision codes include removal of a lesion, with margins, and intermediate closure when performed

D.

Lesion excision codes include removal of a lesion with margins, and complex closure when performed

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Questions 114

The procedure is performed at an outpatient radiology department. From a left femoral access, the catheter is placed in the abdominal aorta and is then selectively placed in the celiac trunk and manipulated up into the common hepatic artery for an abdominal angiography. Dye is injected, and imaging is obtained. The provider performs the supervision and interpretation.

What CPT® codes are reported?

Options:

A.

36246, 75716-26

B.

36246, 75726-26

C.

36246, 75635-26

D.

36246, 75741-26

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Questions 115

Which entity offers compliance program guidance to form the basis of a voluntary compliance program for a provider practice?

Options:

A.

Centers for Medicare & Medicaid Services (CMS)

B.

American Medical Association (AMA)

C.

Office of Inspector General (OIG)

D.

Office for Civil Rights (OCR)

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Questions 116

A 13-year-old established patient is seen for an annual preventive exam. Last visit was two years ago.

What CPT® code is reported?

Options:

A.

99393

B.

99383

C.

99382

D.

99394

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Questions 117

When a provider’s documentation refers to use, abuse, and dependence of the same substance (e.g., alcohol), which statement is correct?

Options:

A.

If both use and abuse are documented, assign abuse first and use as an additional code.

B.

If both abuse and dependence are documented, assign only the code for abuse.

C.

If both use and dependence are documented, assign only the code for dependence.

D.

If use, abuse, and dependence are documented, report all three codes separately.

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Questions 118

A patient comes in complaining of pain in the lower left back, which is accompanied by a numbing sensation that extends into the leg. Attempts to alleviate the pain with home treatments have been unsuccessful. The provider orders an MRI of the lumbar spine initially without, and then with, contrast material. The images are interpreted by the physician, the final diagnosis is left-sided low back pain with sciatica.

What CPT® and ICD-10-CM codes are reported?

Options:

A.

72158,M54.42

B.

72148,72149, M54.42

C.

72148,72149, M54.42. M54.50

D.

72158,M54.42,M54.50

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Questions 119

View MR 099401

MR 099401

Established Patient Office Visit

Chief Complaint: Patient presents with bilateral thyroid nodules.

History of present illness: A 54-year-old patient is here for evaluation of bilateral thyroid nodules. Thyroid ultrasound was done last week which showed multiple thyroid masses likely due to multinodular goiter. Patient stated that she can “feel" the nodules on the left side of her thyroid. Patient denies difficulty swallowing and she denies unexplained weight loss or gain. Patient does have a family history of thyroid cancer in her maternal grandmother. She gives no other problems at this time other than a palpable right-sided thyroid mass.

Review of Systems:

Constitutional: Negative for chills, fever, and unexpected weight change.

HENT: Negative for hearing loss, trouble swallowing and voice change.

Gastrointestinal: Negative for abdominal distention, abdominal pain, anal bleeding, blood in stool, constipation, diarrhea, nausea, rectal pain, and vomiting

Endocrine: Negative for cold Intolerance and heat intolerance.

Physical Exam:

Vitals: BP: 140/72, Pulse: 96, Resp: 16, Temp: 97.6 °F (36.4 °C), Temporal SpO2: 97%

Weight: 89.8 kg (198 lbs ), Height: 165.1 cm (65”)

General Appearance: Alert, cooperative, in no acute distress

Head: Normocephalic, without obvious abnormality, atraumatic

Throat: No oral lesions, no thrush, oral mucosa moist

Neck: No adenopathy, supple, trachea midline, thyromegaly is present, no carotid bruit, no JVD

Lungs: Clear to auscultation, respirations regular, even, and unlabored

Heart: Regular rhythm and normal rate, normal S1 and S2, no murmur, no gallop, no rub, no click

Lymph nodes: No palpable adenopathy

ASSESSMENT/PLAN:

1) Multinodular goiter - the patient will have a percutaneous biopsy performed (minor procedure).

What E/M code is reported for this encounter?

Options:

A.

99212

B.

99214

C.

99213

D.

99215

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Questions 120

An air bag deployed when a driver lost control of the car and crashed into a guardrail on the side of the highway. The driver suffers partial impact resulting in a skull fracture of the anterior

cranial base. The fracture is diagnosed using the MRI scanner and cerebrospinal fluid is noted dripping via the sphenoid sinus into the right nasal passage. The patient requires a surgical nasal

sinus endoscopy to assess and repair the injury.

What is the correct procedure and diagnosis coding combination to report this service?

Options:

A.

31287, S02.19XA, V47.5XXA, Y92.411

B.

31291, S02.19XA, V47.5XXA, Y92.411

C.

31235, S02.91XA, V47.5XXA, Y92.411

D.

31291, 31231-59, S02.109A, V47.5XXA, Y92.411

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Questions 121

Where is a Warthin's tumor found?

Options:

A.

Ovary

B.

Bone

C.

Salivary gland

D.

Back of eye

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Questions 122

A 47-year-old female presents to the operating room for a partial corpectomy on one upper thoracic vertebral body, T3. Two surgeons are performing the surgery. One surgeon performs the transthoracic approach and excises the damaged portion of the vertebral body. The second surgeon inserts a bone graft into the vertebral gap, closing the gap, and inserts a metal plate. Both surgeons work together, each as a primary surgeon.

How does each surgeon report their portion of the surgery?

Options:

A.

63090-66, 63091-66

B.

63087-62, 63088-62

C.

63090-80, 63091-80

D.

63085-62, 63086-62

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Questions 123

A pediatrician is requested to attend a high-risk delivery and performs initial stabilization of the newborn after cesarean delivery.

What E/M service is reported?

Options:

A.

99464

B.

99465

C.

99464, 99465

D.

99460

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Questions 124

CPC Question 124

Refer to the supplemental information when answering this question:

View MR 623654

What CPTO coding is reported for this case?

Options:

A.

14001, 11606-51, 12034-51

B.

14001

C.

14001, 11606-51

D.

15271

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Questions 125

A 58-year-old with type 1 diabetes mellitus comes in for comprehensive eye examination. She is diagnosed with diabetic retinopathy with macular edema in the right eye. What ICD-10-CM coding is reported?

Options:

A.

E10.3211

B.

E10.3519

C.

E10.3511

D.

E10.311

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Questions 126

A 58-year-old male suffered an acute STEMI of the inferolateral wall while running a marathon on June 15 and had received treatment. Three weeks later, the patient presents to the ED complaining of SOB and left arm pain. An EKG is performed as well as blood tests. Patient is admitted for further evaluation.

What diagnosis code is reported for this encounter?

Options:

A.

122.2

B.

121.29

C.

121.19

D.

121.3

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Questions 127

The gallbladder is in which organ system?

Options:

A.

Urinary

B.

Respiratory

C.

Digestive

D.

Musculoskeletal

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Questions 128

A patient is having X-ray imaging of his abdomen following a traumatic episode. A decubitus, supine, and erect views are performed on the abdomen.

What CPT® is reported?

Options:

A.

74018-26

B.

74022-26

C.

74019-26

D.

74021-26

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Questions 129

(Full Case:Preoperative diagnosis:Low back pain; possible spinal stenosis L3–4.Postoperative diagnosis:No evidence of discogenic pathology or spinal stenosis at L3–4; normal discography L3–4.Procedure:Awake discography and injection, L3–4.Anesthesia:IV narcotic with reversal and local; propofol given transiently, then patient alert/responsive for pain response during injection.Technique:Patient to OR; right decubitus; sterile prep/drape; C-arm used to mark entry; local ethyl chloride + 1% Xylocaine; docking needle placed posterolateral at L3–4 under AP/lateral; inner needle advanced to disc nucleus center; contrast injected while monitoring patient response; normal bilocular pattern; 1.5 cc volume; no pain with pressurization.Documentation:No videotape; plain films available; post-discography CT planned/reviewed for other causes.Question:What CPT® and ICD-10-CM coding is reported?)

Options:

A.

62292, M54.50

B.

62290, M54.50

C.

62290, M48.061, M54.50

D.

62292, M48.07, M54.50

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Questions 130

A patient has swelling in both arms and lymphangitis is suspected. She is in the outpatient radiology department for a lymphangiography of both arms.

What CPT® coding is correct?

Options:

A.

75801, 75803

B.

75801-50

C.

75803

D.

75803-50

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Questions 131

View MR 099407

MR 099407

Emergency Department Visit

Chief Complaint: VOMITING.

This started just prior to arrival and is still present. He has had nausea and vomiting. No diarrhea, black stools, bloody stools or abdominal pain. Pt is diabetic and has been having elevated blood sugars (320 mg/dL).

REVIEW OF SYSTEMS: Unobtainable due to patient's altered mental status.

PAST HISTORY: Poorly controlled diabetes mellitus, with history of poor compliance.

Medications: See Nurses Notes.

Allergies: PCN.

SOCIAL HISTORY: Nonsmoker. No alcohol use or drug use.

ADDITIONAL NOTES: The nursing notes have been reviewed.

PHYSICAL EXAM

Appearance: Lethargic. Patient in mild distress.

Vital Signs: Have been reviewed-tachycardic.

Eyes: Pupils equal, round and reactive to light.

ENT: Dry mucous membranes present.

Neck: Normal inspection. Neck supple.

CVS: Tachycardia. Heart sounds normal. Pulses normal.

E D. Course: Insulin IV drip per protocol, at 10 units/hr.

Zofran 8 mg 01:33 Jul 13 2008 IVP.

Phenergan 25 mg IVP. 07:52.Discussed case with physician. Dr. X. Reviewed test results. Agreed upon treatment plan. Physician will see patient in hospital.

Total critical care time: 45 min.

Disposition: Admitted to Intensive Care Unit. Condition: stable.

Admit decision based on need for monitoring and IV hydration and medications.

CLINICAL IMPRESSION: Vomiting, diabetic ketoacidosis, probable diabetes insipidus.

What E/M code is reported for this encounter?

Options:

A.

99291

B.

99291, 99292

C.

99222

D.

99285

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Questions 132

(Patient presents to the office for the removal of15 actinic keratoseslesions. The provider destroys these lesions withlaser surgery. What CPT® coding is reported for this visit?)

Options:

A.

17000, 17003

B.

17004

C.

17111

D.

17110, 17111

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Questions 133

An inpatient, suffering from hypertension and chronic kidney disease, is administered continuous venovenous hemofiltration. The on-duty nephrologist performs a series repeated low-level evaluation and management services to monitor the patient's status.

What is the CPT® and ICD-10-CM coding'

Options:

A.

90935,112.9. N18.9

B.

90937,110, N18.9

C.

90947,112 9, N18.9

D.

90945.110, N18.9

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Questions 134

Mr. Roland has difficulty breathing and congestion with a productive cough. The physician takes frontal and lateral view chest X-rays in the office (the equipment is owned by the physician group). The physician reads the X-rays and determines a diagnosis of walking pneumonia. The physician’s interpretation is placed in the patient’s chart.

How does the physician bill for the chest X-ray?

Options:

A.

71046-26

B.

71046-26-TC

C.

71046-TC

D.

71046

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Exam Code: CPC
Exam Name: Certified Professional Coder (CPC) Exam
Last Update: Feb 20, 2026
Questions: 448

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