1.
INTEGUMENTARY SYSTEM SECTION :Patient presents to the hospital for skin grafts due to previous third-degree burns. The burn eschar of the back was removed. Once the eschar was removed, the defect size measured 10 cm x 10 cm. A skin graft from a donor bank was placed onto the defect and sewn into place as a temporary wound closure.
Correct Answer
D. 15002, 15273
Explanation
INTEGUMENTARY SECTION ----- QUESTIONS 1 - 12
2.
Patient presents to the operating room for excision of a 4.5 cm malignant melanoma of the left forearm. A 6 cm x 6 cm rotation flap was created for closure.
Correct Answer
C. 14301
Explanation
A rotation flap is a type of surgical procedure used to close a wound. In this case, a 6 cm x 6 cm rotation flap was created to close the wound after excision of the malignant melanoma. The correct answer, 14301, refers to the creation of a rotation flap for closure.
3.
Female patient has a percutaneous needle biopsy of the left breast lesion in the lower outer quadrant. Following the biopsy frozen section results, the physician followed this with an excisional removal of the same lesion.
Correct Answer
C. 19120-LT
Explanation
The correct answer is 19120-LT. This code represents the excisional removal of the same lesion that was biopsied. The "-LT" modifier indicates that the procedure was performed on the left breast. The other codes listed do not accurately describe the excisional removal of the same lesion.
4.
Ten-square-centimeters epidermal autograft to the face from the back.
Correct Answer
B. 15115
Explanation
The correct answer is 15115. This code is used for the application of a skin graft to the face, specifically using a ten-square-centimeters epidermal autograft taken from the back. This code accurately describes the procedure being performed and the area of the body involved.
5.
Patient presents to the emergency room with lacerations of right lower leg that involved the fascia. Lacerations measured 5 cm and 2. 7 cm.
Correct Answer
B. 12034
Explanation
The correct answer is 12034. This code is appropriate for the given scenario because it represents the repair of a wound on the leg that involves the fascia. The lacerations are measured at 5 cm and 2.7 cm, which falls within the range of this code.
6.
Nonhuman graft for temporary wound closure. Patient has a 5 cm defect on the scalp.
Correct Answer
C. 15275
Explanation
The correct answer is 15275. This code represents the use of nonhuman graft for temporary wound closure. Since the patient has a 5 cm defect on the scalp, this code accurately reflects the procedure performed.
7.
Patient is admitted for a blepharoplasty of the left lower eyelid and a repair for a tarsal strip of the left upper lid.
Correct Answer
B. 67917-E1; 15820-E2
Explanation
The correct answer is 67917-E1; 15820-E2. The reason for this is that the patient is admitted for a blepharoplasty of the left lower eyelid, which is represented by code 67917-E1. Additionally, they are also undergoing a repair for a tarsal strip of the left upper lid, which is represented by code 15820-E2.
8.
Patient presents to the emergency room with lacerations sustained in an automobile accident. Repairs of the 3.3 cm skin laceration of the left leg that involved the fascia, 2.5 cm and 3 cm lacerations of the left arm involving the fascia, and 2.7 cm of the left foot, which required simple sutures, were performed. Sterile dressings were applied.
Correct Answer
C. 12034; 12002-59
Explanation
The correct answer is 12034; 12002-59. The CPT code 12034 is used for the repair of a wound that involves the subcutaneous tissue and deeper structures such as fascia or muscle, which matches the description of the lacerations in the question. The CPT code 12002-59 is used for the repair of a superficial wound, which matches the description of the laceration on the left foot. The modifier -59 is used to indicate that these procedures are distinct and separate from each other.
9.
Patient presents to the operating room for excision of three lesions. The 1.5 cm and 2 cm lesions of the back were excised with one excision. The 0.5 cm lesion of the hand was excised. The pathology report identified both back lesions as squamous cell carcinoma. The hand lesion was identified as seborrheic keratosis.
Correct Answer
A. 11604; 11420
Explanation
The correct answer is 11604; 11420. The CPT code 11604 is used for excision of malignant skin lesions, and the back lesions were identified as squamous cell carcinoma, which is a type of skin cancer. The CPT code 11420 is used for excision of benign skin lesions, and the hand lesion was identified as seborrheic keratosis, which is a benign skin growth. Therefore, the correct CPT codes for this scenario would be 11604 for the back lesions and 11420 for the hand lesion.
10.
Patient presents to the operating room where a 3.2 cm malignant lesion of the shoulder was excised and repaired with simple sutures. A 2 cm benign lesion of the cheek was excised and was repaired with a rotation skin graft.
Correct Answer
B. 14040; 11604
Explanation
The correct answer is 14040; 11604. The CPT code 14040 is used for the excision of a subcutaneous tumor or cyst, while the CPT code 11604 is used for the excision of a malignant skin lesion. In this case, a 3.2 cm malignant lesion of the shoulder was excised, which corresponds to code 11604. Additionally, a 2 cm benign lesion of the cheek was excised and repaired with a rotation skin graft, which corresponds to code 14040. Therefore, the correct answer is 14040; 11604.
11.
Patient presents to the radiology department where a fine-needle aspiration of the breast is performed utilizing computed tomography.
Correct Answer
D. 10022; 77012
Explanation
The correct answer is 10022; 77012. The patient underwent a fine-needle aspiration of the breast, which is coded as 10022. Additionally, computed tomography was utilized during the procedure, which is coded as 77012.
12.
Patient was admitted to the hospital for removal of excessive tissue due to massive weight loss. Liposuction of the abdomen and bilateral thighs was performed.
Correct Answer
C. 15877; 15879-50
Explanation
The correct answer is 15877; 15879-50. This answer is correct because it includes the correct codes for the procedures performed on the patient. Liposuction of the abdomen and bilateral thighs was performed, which would be coded as 15877. Additionally, the use of modifier -50 indicates that the procedure was performed bilaterally. Modifier -50 is used to indicate a bilateral procedure, so it is appropriate in this case. Modifier -50 should be appended to the primary procedure code, which in this case is 15877. The code 15879 is not applicable in this scenario and should not be included.
13.
MUSCULOSKELETAL SYSTEM SECTION:Patient presents to the hospital with ulcer of the right foot. Patient is taken to the operating room where a revision of the right metatarsal head is performed.
Correct Answer
D. 28899-RT
Explanation
MUSCULOSKELETAL SYSTEM ------ QUESTIONS 13 - 21.
14.
Patient presents to the emergency room following a fall. X-rays were ordered for the lower leg and results showed a fracture of the proximal left tibia. The emergency room physician performed a closed manipulation of the fracture with skeletal traction.
Correct Answer
A. 27532-LT
Explanation
The correct answer is 27532-LT. This code represents a closed manipulation of a fracture with skeletal traction. In this scenario, the patient presented to the emergency room with a fracture of the proximal left tibia after a fall. The physician performed a closed manipulation, which means they manipulated the fracture without making an incision. Additionally, skeletal traction was used to stabilize the fracture. Therefore, the correct code for this procedure is 27532-LT.
15.
Trauma patient was rushed to the operating room with multiple injuries. Open reduction with internal fixation of intertrochanteric femoral fracture; open reduction of the tibial and fibula shaft with internal fixation was performed.
Correct Answer
D. 27244; 27758
16.
Open I & D of a deep abscess of the cervical; spine.
Correct Answer
A. 22010
17.
Patient presents to the emergency room following an assault. Examination of the patient reveals blunt trauma to the face. Radiology reports that the patient suffers from a fracture to the frontal skull and a blow-out fracture of the orbital floor. Patient is admitted and taken to the operating room where a periorbital approach to the orbital fracture is employed and an implant is inserted.
Correct Answer
C. 21390
Explanation
The correct answer, 21390, is the appropriate CPT code for the procedure described in the question. The patient presented with blunt trauma to the face, resulting in a fracture to the frontal skull and a blow-out fracture of the orbital floor. The patient was admitted and taken to the operating room where a periorbital approach to the orbital fracture was employed and an implant was inserted. CPT code 21390 specifically describes the repair of an orbital floor fracture, which aligns with the procedure performed in this case.
18.
Patient presents with a traumatic partial amputation of the second, third, and fourth fingers on the right hand. Patient was taken to the operating room where completion of the amputation of three fingers was performed with direct closure.
Correct Answer
C. 26951-F6; 26951-F7; 26951-F8
Explanation
The correct answer is 26951-F6; 26951-F7; 26951-F8. This answer is correct because it includes the correct CPT codes for the completion of the amputation of three fingers on the right hand. The codes 26951-F6, 26951-F7, and 26951-F8 specifically represent the completion of amputation of the second, third, and fourth fingers respectively. The "F6," "F7," and "F8" modifiers indicate that these procedures were performed on separate fingers.
19.
Patient is brought to the emergency room following a shark attack. The paramedics have the patient's amputated foot. The patient is taken directly to the operating room to reattach the patient's foot.
Correct Answer
D. 20838
Explanation
In this scenario, the correct answer is 20838. This answer is most likely the correct one because it is the only option that does not seem to be a time duration. Given the context of the question, which describes a patient being brought to the emergency room following a shark attack and the need to reattach their amputated foot, it is reasonable to assume that the answer should be a code or a medical procedure rather than a time. Therefore, 20838 is the most logical choice.
20.
Patient presents to the hospital with a right index trigger finger. Release of the trigger finger was performed.
Correct Answer
B. 26055-F6
Explanation
The correct answer is 26055-F6. This code represents the release of a trigger finger, which is a condition where the finger gets stuck in a bent position and then suddenly pops straight. The code specifically includes the release of the right index finger, which matches the patient's presentation. The -F6 modifier indicates that the procedure was performed under local anesthesia.
21.
Patient had been diagnosed with a bunion. Patient was taken to the operating room where a simple resection of the base of the proximal phalanx along with the medical eminence was performed. Kirschner wire was placed to hold the joint in place.
Correct Answer
A. 28292
Explanation
The correct answer is 28292. This code is used for the simple resection of the base of the proximal phalanx along with the medial eminence, which was performed in this case. The placement of the Kirschner wire to hold the joint in place is not included in this code, so the answer is not 28290. Codes 28293 and 28294 are not relevant to the procedure described.
22.
RESPIRATORY SYSTEM SECTION :Patient has a bronchoscopy with endobronchial biopsies of three sites
Correct Answer
B. 31625
Explanation
The correct answer is 31625. This code represents a bronchoscopy with endobronchial biopsies of three sites. The other codes listed either do not include the endobronchial biopsies or do not specify the number of sites. Therefore, they are not the correct answer.
23.
Patient presents to the surgical unit and undergoes unilateral nasal endoscopy; partial ethmoidectomy and maxillary antrostomy.
Correct Answer
A. 31254; 31256-51
Explanation
The correct answer is 31254; 31256-51. This answer is correct because it includes the codes for the procedures performed during the nasal endoscopy, partial ethmoidectomy, and maxillary antrostomy. Code 31254 represents the nasal endoscopy procedure, and code 31256 represents the partial ethmoidectomy and maxillary antrostomy. The -51 modifier is appended to indicate that multiple procedures were performed during the same surgical session.
24.
Patient has been diagnosed with metastatic laryngeal carcinoma. Patient underwent subtotal supraglottic laryngectomy with radical neck dissection.
Correct Answer
D. 31368
Explanation
The correct answer is 31368 because this code represents a subtotal supraglottic laryngectomy with radical neck dissection. This procedure involves the removal of a portion of the supraglottis (the area above the vocal cords) and the surrounding lymph nodes in the neck. The code accurately describes the specific surgical procedure performed on the patient.
25.
Patient was involved in an accident and has been sent to the hospital. During transport the patient develops breathing problems and, upon arrival at the hospital, an emergency transtracheal tracheostomy was performed. Following various x-rays, the patient was diagnosed with traumatic pneumothorax and a thoracentesis with insertion of tube was performed.
Correct Answer
C. 31603; 32555
26.
Patient with laryngeal cancer has a tracheoesophageal fistula created and has a voicebox inserted.
Correct Answer
A. 31611
Explanation
The correct answer is 31611. This code represents the creation of a tracheoesophageal fistula and the insertion of a voicebox in a patient with laryngeal cancer. This procedure is commonly performed to restore speech in patients who have had their larynx removed. The code accurately describes the specific intervention and is the most appropriate choice for this scenario.
27.
Upper lobectomy of the right lung with repair of the bronchus.
Correct Answer
D. 32480, 32501
Explanation
The correct answer is 32480, 32501. Upper lobectomy of the right lung involves the removal of the upper lobe of the right lung. This procedure is often performed to treat conditions such as lung cancer or severe infections. Repair of the bronchus refers to the reconstruction or closure of the bronchus, which is the airway leading into the lung. The codes 32480 and 32501 accurately represent the upper lobectomy and bronchus repair procedures respectively.
28.
Patient with a deviated nasal septum that was repaired by septoplasty.
Correct Answer
C. 30520
Explanation
The correct answer is 30520. This code represents the repair of a deviated nasal septum through septoplasty. Septoplasty is a surgical procedure performed to correct a deviated nasal septum, which is the cartilage and bone that divides the two nostrils. This code accurately reflects the specific procedure performed on the patient.
29.
Lye burn of the larynx repaired by laryngoplasty.
Correct Answer
A. 31588
Explanation
The correct answer is 31588. This number is the most suitable option because it is the only one that is related to the given information about a lye burn of the larynx being repaired by laryngoplasty. The other options do not have any connection to this specific medical procedure or condition.
30.
Bronchoscopy with multiple transbrochial right upper and right lower lobe lung biopsy with fluoroscopic guidance.
Correct Answer
D. 31628-RT; 31632-RT
Explanation
The correct answer is 31628-RT; 31632-RT. This answer is correct because it includes the correct codes for the procedure described in the question, which is bronchoscopy with multiple transbronchial lung biopsies. The code 31628-RT represents the bronchoscopy procedure, and the code 31632-RT represents the transbronchial lung biopsy procedure. Therefore, this answer accurately reflects the specific procedures performed during the bronchoscopy.
31.
Patient has recurrent spontaneous pneumothorax which has resulted in a chemical pleurodesis by thoracoscopy.
Correct Answer
A. 32650
Explanation
The correct answer is 32650. This is the correct code for chemical pleurodesis by thoracoscopy. Pleurodesis is a procedure used to treat recurrent spontaneous pneumothorax, which is the condition described in the question. The code 32310 is for thoracentesis, not thoracoscopy. The code 32601 is for thoracoscopy with biopsy, not pleurodesis. The code 32960 is for thoracoscopy with drainage of pleural effusion, which is not the procedure performed in this case.
32.
Laryngoscopic stripping of vocal cords for leukoplakia of the vocal cords.
Correct Answer
B. 31540
33.
CARDIOVASCULAR SYSTEM :Patient returns to the operating room following open-heart bypass for exploration of blood vessel to control postoperative bleeding in the chest.
Correct Answer
A. 35820
Explanation
The correct answer is 35820. This code is used for the exploration of blood vessels in the chest to control postoperative bleeding after open-heart bypass surgery. It indicates that the patient had to return to the operating room for this procedure.
34.
Patient undergoes construction of apical aortic conduit with an insertion of a single-ventricle ventricular assist device.
Correct Answer
B. 33975
Explanation
The correct answer is 33975. This code represents the insertion of a single-ventricle ventricular assist device during the construction of an apical aortic conduit. The use of a ventricular assist device helps to support the function of the heart in patients with single ventricle physiology. This code accurately captures the specific procedure performed in this case.
35.
Patient presents to the operating room where a CABG X 3 is performed using the mammary artery and two sections of the saphenous vein.
Correct Answer
D. 33533; 33518
Explanation
The correct answer is 33533; 33518. In this scenario, the patient underwent a coronary artery bypass graft (CABG) procedure using three grafts. The mammary artery was used as one graft, and two sections of the saphenous vein were used as the other two grafts. The codes 33533 and 33518 specifically describe the use of the mammary artery and the saphenous vein in a CABG procedure, respectively.
36.
Patient complains of recurrent syncope following carotid thromboendarterectomy. Patient returns 2 weeks after initial surgery and undergoes repeat carotid thromboendarterectomy
Correct Answer
B. 35301
Explanation
The correct answer is 35301. This code represents a repeat carotid thromboendarterectomy, which is the surgical removal of a blood clot from the carotid artery. In this case, the patient complained of recurrent syncope (fainting) after the initial surgery, indicating that there may still be a clot present or that the procedure was not successful in preventing further clot formation. Therefore, a repeat surgery is necessary to address the issue.
37.
Patient is admitted with alcohol cirrhosis and has a TIPS procedure performed.
Correct Answer
C. 37182
Explanation
The TIPS procedure (Transjugular Intrahepatic Portosystemic Shunt) is a minimally invasive procedure used to treat complications of liver cirrhosis, such as portal hypertension. During the procedure, a shunt is created between the portal vein and the hepatic vein, which helps to divert blood flow and reduce pressure in the portal vein. Therefore, the correct answer, 37182, is most likely the code for the TIPS procedure performed on the patient with alcohol cirrhosis.
38.
Eighty-year-old patient has carcinoma and presents to the operating room for placement of a tunneled implantable centrally inserted venous access port.
Correct Answer
C. 36561
Explanation
The correct answer is 36561. This code is used for the placement of a tunneled implantable centrally inserted venous access port. This procedure involves creating a tunnel under the skin and inserting a catheter into a large vein for long-term access to administer medications or draw blood. The code 36561 specifically describes the placement of the port, making it the most appropriate choice for this scenario.
39.
Patient presents to the operating room and undergoes an endovascular repair of an infrarenal abdominal aortic aneurysm utilizing a unibody bifurcated prosthesis.
Correct Answer
C. 34804
Explanation
The correct answer is 34804. This code is used for the endovascular repair of an infrarenal abdominal aortic aneurysm using a unibody bifurcated prosthesis. The other codes listed are not specific to this procedure.
40.
The physician punctures the left common femoral to examine the right common iliac.
Correct Answer
A. 36245
Explanation
The correct answer is 36245 because it is the CPT code for a diagnostic angiography of the right common iliac artery. The physician performs this procedure by puncturing the left common femoral artery and then advancing the catheter to the right common iliac artery to examine it. This code accurately describes the specific procedure performed by the physician.
41.
Patient has a history of PVD for many years and experiences chest pains. The patient underwent Doppler evaluation, which showed a common femoral DVT. Patient is now admitted for thromboendarterectomy.
Correct Answer
A. 35371
Explanation
The correct answer is 35371. This code represents a thromboendarterectomy, which is the surgical removal of a blood clot and the inner lining of an artery. In this case, the patient has a history of peripheral vascular disease (PVD) and is experiencing chest pains. The Doppler evaluation revealed a deep vein thrombosis (DVT) in the common femoral artery. Therefore, the patient is admitted for a thromboendarterectomy to remove the clot and restore blood flow in the affected artery.
42.
Patient undergoes percutaneous transluminal iliac artery balloon angioplasty.
Correct Answer
B. 37220
Explanation
The correct answer is 37220. Percutaneous transluminal iliac artery balloon angioplasty is a procedure used to open up a blocked or narrowed iliac artery using a balloon catheter. This procedure is coded as 37220. The other options (37228, 37222, 37224) are not appropriate for this specific procedure.
43.
HEMIC AND LYMpHATIC SYSTEMS, MEDIASTINUM, AND DIApHRAGMPatient has breast carcinoma and is now undergoing sentinel node biopsy. Patient was injected for sentinel node identification and two deep axillary lymph nodes showed up intensely. These two lymph nodes were completely excised. Path report was positive for metastatic carcinoma.
Correct Answer
D. 38525; 38792
Explanation
The correct answer is 38525; 38792. The patient underwent a sentinel node biopsy for breast carcinoma. Two deep axillary lymph nodes were identified and completely removed. The pathology report confirmed the presence of metastatic carcinoma in these lymph nodes. CPT code 38525 is used for the excision of axillary lymph nodes, and 38792 is used for the identification of sentinel lymph nodes.
44.
Patient has a history of hiatal hernia for many years, which has progressively gotten worse. The decision to repair the hernia was made and the patient was sent to the operating room where the repair took place via the thorax and abdomen.
Correct Answer
B. 43336
Explanation
The correct answer is 43336. This code represents the repair of a hiatal hernia via both the thorax and abdomen. The patient's history of hiatal hernia and the progressive worsening of the condition led to the decision for surgical repair. The code accurately reflects the specific procedure performed on the patient.
45.
Patient has a bone marrow aspiration of the iliac crest and of the tibia.
Correct Answer
A. 38220, 38220-59
Explanation
The correct answer is 38220, 38220-59. This is because the patient had a bone marrow aspiration performed on both the iliac crest and the tibia. Code 38220 represents bone marrow aspiration, and since it was done on two different sites (iliac crest and tibia), modifier 59 is used to indicate that these are separate and distinct procedures.
46.
Trauma patient is rushed to the operating room with multiple injuries. The patient had his spleen removed due to massive rupture with repair of lacerated diaphragm.
Correct Answer
D. 38100; 39501
Explanation
The correct answer is 38100; 39501. The patient had his spleen removed (38100) due to a massive rupture and his lacerated diaphragm repaired (39501). These two codes accurately represent the procedures performed on the trauma patient in the operating room.
47.
Laparoscopic retroperitoneal lymph node biopsy.
Correct Answer
A. 38570
48.
Excision of mediastinal cyst.
Correct Answer
B. 39200
Explanation
The correct answer is 39200. This code represents the excision of a mediastinal cyst. The term "excision" refers to the surgical removal of a cyst, and "mediastinal" indicates that the cyst is located in the mediastinum, which is the central area of the chest. This procedure involves removing the cyst to alleviate symptoms or prevent complications.
49.
Patient diagnosed with cystic hygroma of the axilla, which was excised.
Correct Answer
C. 38550
Explanation
The correct answer is 38550. Cystic hygroma is a fluid-filled sac that typically occurs in the neck or axilla. Excision of a cystic hygroma involves removing the entire sac and its contents. CPT code 38550 specifically describes the excision and removal of a cystic hygroma. Therefore, this is the appropriate code for the procedure performed on the patient with cystic hygroma of the axilla.
50.
Laparoscopy with multiple biopsies of retroperitoneal lymph nodes.
Correct Answer
A. 38570
Explanation
The correct answer is 38570 because it is the correct CPT code for the procedure described in the question. Laparoscopy with multiple biopsies of retroperitoneal lymph nodes is a specific procedure that is represented by this code. The other codes listed are not applicable to this particular procedure.