BC3030X cpt mock exam 2021

Question 1 1.2 out of 1.2 points Margaret has a cholecystoenterostomy with a Roux-en-Y; five hours later she has an enormous amount of pain, abdominal swelling and a spike in her temperature. She is returned to the OR ...

Question 1 1.2 out of 1.2 points Margaret has a cholecystoenterostomy with a Roux-en-Y; five hours later she has an enormous amount of pain, abdominal swelling and a spike in her temperature. She is returned to the OR for an exploratory laparotomy and subsequent removal of a sponge that remained behind from surgery earlier that day. The area had become inflamed and peritonitis was setting in. What is the correct coding for the subsequent services on this date of service? The same surgeon took her back to the OR as the one who performed the original operation. What CPT? code is reported? Selected Answer: 49402-78 Correct Answer: 49402-78 Response Feedback: CPT? code 49402 represents the removal of a foreign body (sponge from previous surgery) from the peritoneal cavity. In the CPT? Index, look for Removal/Foreign Body/Peritoneum. Modifier 78 indicates this was an unplanned return to the OR, by the same physician for a related procedure following an initial procedure during the initial procedures postoperative period. • Question 2 • 0 out of 1.2 points The process of preserving cells or whole tissues at extremely low temperatures is known as: Selected Answer: Cryotherapy Correct Answer: Cryopreservation 2 7 5 0 6 - R T , 1 1 0 1 2 - 5 1 - R T , S 7 2 . 3 0 1 B , V 0 3 . 1 0 X A • Question 3 • 1.2 out of 1.2 points A patient has a history of chronic venous embolism in the superior vena cava (SVC) and is having a radiographic study to visualize any abnormalities. In outpatient surgery the physician accesses the subclavian vein and the catheter is advanced to the superior vena cava for injection and imaging. The supervision and interpretation of the images is performed by the physician. What codes are reported for this procedure? Selected Answer: 36010, 75827-26 Correct Answer: 36010, 75827-26 Response Feedback: A radiographic study of the superior vena cava is performed to visualize and evaluate any abnormalities. For the insertion of the catheter look in the CPT® Index for Catheterization/Vena Cava referring you to code 36010. For the radiology code look in the CPT® Index for Venography/Vena Cava guiding you to code range 75825- 75827. Radiology code 75827 is correct for the superior vena cava. Modifier 26 is appended to the radiology code, because the physician is performing the procedure in an outpatient facility setting. • Question 4 • 1.2 out of 1.2 points A physician uses cryotherapy for removal trichiasis. What CPT? and ICD-10-CM codes are reported? Selected Answer: 67825, H02.059 Correct Answer: 67825, H02.059 Response Feedback: In the CPT? Index, look for Trichiasis/Repair/Epilation, by Other than Forceps. Verify this code in the numerical Index. Code 67825 describes the correction of trichiasis by other than forceps, eg cryotherapy. In the ICD-10- CM Index to Diseases, look for Trichiasis/eyelid that directs to code H02.059 and is verified in the Tabular List as Trichiasis without entropian. • Question 5 • 1.2 out of 1.2 points A patient with primary hyperparathyroidism undergoes parathyroid sestamibi (nuclear medicine scan) and ultrasound and is found to have only one diseased parathyroid. A minimally invasive parathyroidectomy is performed. What CPT? and ICD-10-CM codes are reported for the surgery? Selected Answer: 60500, E21.0 Correct Answer: 60500, E21.0 Response Feedback: In the CPT ? Index, look for Parathyroidectomy or Parathyroid Gland/Excision and you are directed to code range 60500-60505. The diseased gland is determined prior to the surgery, so only the parathyroidectomy is coded with 60500. In the ICD-10-CM Index to Diseases, look for Hyperparathyroidism/primary and you are directed to E21.0. Verification in the Tabular list confirms code selection. • Question 6 • 1.2 out of 1.2 points Which cells produce hormones to regulate blood sugar? Selected Answer: Pancreatic islets Correct Answer: Pancreatic islets • Question 7 • 1.2 out of 1.2 points A patient with hypertensive end stage renal failure, stage V, and secondary hyperparathyroidism is evaluated by the physician and receives peritoneal dialysis. The physician evaluates the patient once before dialysis begins. What CPT? and ICD-10-CM codes are reported? Selected Answer: 90945, I12.0, N18.6, N25.81 Correct Answer: 90945, I12.0, N18.6, N25.81 Response Feedback: In the CPT? Index, look for Dialysis/Peritoneal, you are directed to codes 90945, 90947 & 4055F (an outcomes measurement code). The peritoneal dialysis with one physician evaluation is reported with 90945. A combination code is reported for a patient with hypertension and renal failure. The two conditions are not reported separately. In the Hypertension Table, look for Hypertension/with/chronic kidney disease/stage V or end stage renal disease/Unspecified column directs you to 403.91. The instructions for category 403 state to use an additional code to identify the stage of CKD. In the ICD-10-CM Index to Diseases, look for Disease/renal/end-stage, directing you to N18.6 for end stage renal disease. The patient also has secondary hyperparathyroidism reported with N25.81, found in the Index to Diseases under Hyperparathyroidism. • Question 8 • 0 out of 1.2 points 66-year-old female is admitted to the hospital with a diagnosis of stomach cancer. The surgeon performs a total gastrectomy with formation of an intestinal pouch. Due to the spread of the disease, the physician also performs a total en bloc splenectomy. What CPT? codes are reported? Selected Answer: 43622, 38100-51 Correct Answer: 43622, 38102 • Question 9 • 0 out of 1.2 points An anesthesiologist is medically supervising six cases concurrently. What modifier is reported for the anesthesiologist’s service? Selected Answer: QX Correct Answer: AD • Question 10 • 1.2 out of 1.2 points INDICATIONS FOR SURGERY: The patient is an 82-year-old white male with biopsy-proven basal cell carcinoma of his right lower eyelid and cheek laterally. I marked the area for rhomboidal excision and I drew my planned rhomboid flap. The patient observed these markings in a mirror, he understood the surgery and agreed on the location and we proceeded. DESCRIPTION OF PROCEDURE: The area was infiltrated with local anesthetic. The face was prepped and draped in sterile fashion. I excised the lesion as drawn into the subcutaneous fat. Hemostasis was achieved using Bovie cautery. Modified Mohs analysis showed the margin to be clear. I incised the rhomboid flap as drawn and elevated the flap with a full-thickness of subcutaneous fat. Hemostasis was achieved in the donor site, the Bovie cautery was not used, hand held cautery was used. The flap was rotated into the defect. The donor site was closed and flap inset in layers using 5-0 Monocryl and 6-0 Prolene. The patient tolerated the procedure well. The total site measured 1.3 cm x 2.7 cm What CPT? code(s) should be reported? Selected Answer: 14060 Correct Answer: 14060 Response Feedback: A rhomboid flap is a tissue transfer flap, coded from range 14000-14350. In the CPT? Index, see Tissue/Transfer/Adjacent/Skin. Because the surgeon indicated the rhomboid flap extended into the lower eyelid area, you only code for the eyelid flap. The final measurement of the flap is 3.51 cm2 (1.3 x 2.7 = 3.51) directing us to CPT? 14060. • Question 11 • 1.2 out of 1.2 points A virus is identified by observing growth patterns on cultured media. What is this type of identification is called? Selected Answer: Presumptive Correct Answer: Presumptive Response Feedback: Presumptive identification identifies microorganisms like viruses by observing growth patterns and other characteristics. • Question 12 • 0 out of 1.2 points A 47-year-old patient was previously treated with external fixation for a Grade III left tibial fracture. There is now nonunion of the left proximal tibia and he is admitted for open reduction of tibia with bone grafting. Approximately 30 grams of cancellous bone was harvested from the iliac crest. The fracture site was exposed and the area of nonunion was osteotomized, cleaned, and repositioned. Intrafragmentary compression was applied with three screws. The harvested bone graft was packed into the fracture site. What CPT? and ICD-10-CM codes are reported? Selected Answer: 27724-LT, S82.101K Correct Answer: 27724-LT, S82.102K • Question 13 • 1.2 out of 1.2 points A couple with inability to conceive has fertility testing. The semen specimen is tested for volume, count, motility and a differential is calculated. The findings indicate infertility due to oligospermia. What CPT? and ICD-10-CM codes are reported? Selected Answer: 89320, N46.11 Correct Answer: 89320, N46.11 Response Feedback: Choose the CPT? code completely identifying the service. Only use multiple codes if there is no code describing everything performed. Only use V codes when there is no final diagnosis. In this case, a very specific diagnosis is known and the code is used. In the CPT? Index, look for Semen Analysis directing you to code range 89300-89322. Code 89320 reports all of the tests performed. For the ICD-10-CM diagnosis, code, look in the Index to Diseases, for Infertility/male/oligospermia leading you to N46.11. • Question 14 • 1.2 out of 1.2 points The meaning of the root “blephar/o” is: Selected Answer: Eyelid Correct Answer: Eyelid • Question 15 • 0 out of 1.2 points A patient is diagnosed with an injury to the facial nerve. The surgeon performs a neurorrhaphy with nerve graft to restore innervation to the face using microscopic repair. The surgeon created a 2 cm incision over the damaged nerve, dissected the tissues and located the nerve. The damaged nerve was resected and rem