RESOLVE MEDICODE-Coimbatore,Bangalore,Madurai (8148452460)

CPC Mock Exam - 1

Name:

Date: Time: 5h 40M

1. Dr. Smith performed a cryosurgery to destroy three premalignant lesions for a patient. Which code(s)
should you report for this procedure?

a)17106 b)17260 c)17003x3 d)17000, 17003x2

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

Preoperative diagnosis : Lesion, left hand

Confirmed by pathology postoperative diagnosis : Primary malignant carcinoma, left hand.

Procedure performed : Excision of malignant carcinoma, left hand

Anesthesia : General, 40 ml of lidocaine was infiltrated into the wound prior to making the incision.

Procedure : The patient was brought to the operative suite where the left hand was prepped and
dressed. A circular incision was made to include the 1-cm lesion with narrowest margins of 0.6 cm with
dissection down to subcutaneous tissue. Homeostasis was obtained the wound was closed with simple
mattress sutures. The patient tolerated the procedure well and was returned to the recovery room in
good condition with sterile dressing in place.

a)11603, C44.609 b)11622, C44.609 c)11423, C79.2 d)11403, C79.2

3. Nancy underwent a fine needle aspiration with imaging guidance for a lesion in the right breast.
During the aspiration procedure, a percutaneous metallic clip was placed in the right breast under ultra
sound guidance. Which codes describe this procedure?

a)10022-RT, 19285-RT c)10022-RT, 19083RT

b)10021-Rt, 19285-RT d)10021-RT, 19083RT

4. Which of the following procedures could be coded with a breast reconstruction with free flap?

a)Harvesting of the flap

b)Micro vascular transfer

c)Closure of the donor site and inset shaping the flap into a breast
d)None of the above.

5. Barry underwent a complex incision and drainage due to a postoperative wound infection, which
acquired an extensive secondary closure of the surgical site. Which codes describe this procedure?

a)13160, 10081-59 c)13160, 10180 – 51

b)10121, 12020 – 51 d)10061, 12021 – 59

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

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

b)17313, 17314 x 2, 17315-59

c)17311, 17312 x 2, 17315

d)17311, 17312 x 4, 17315-59, 11101-51, 88331-51.

7. Mark cut his hand and arm while working on his car. Dr. Bill applied sutures to both the arm and hand
wounds. An intermediate closure of 16 cm was placed in the arm and a simple closure of 3.6 cm was
place in the hand. Which codes should Dr. Bill report?

a)12004, 12035-59 c)12035, 1200-59

b)12035, 12042-59 d)13132, 12036-51

8. A patient underwent an excision of a 2.1-cm diameter lesion on her nose. An 11.2-sq- cm adjacent
tissue transfer was required to repair the primary and secondary defect sites. How should you code this
procedure?

a)11643, 14061-59 c)11646,13152-51, 13153-51

b)14061 d)11443, 12054-59

9. Glen required a replacement to his nonbiodegradable drug delivery implant system. Glen was taken
into the procedure suite where he was prepped,Dr.Roberts injected a local anesthetic and made a 3.2-
cm incision in the skin for removal of the previous cylinder. He then replaced the cylinder a sutured the
new device in place with a single running stitch. The 3.2-cm trunk wound was closed with simple
sutures. The device was tested, with excellent results. The patient tolerated the procedure well and was
released from care with a sterile dressing in place. How should this procedure be coded?
a)11983, 12032-51 c)11981, 11982-51, 11983-51, 12002-59

b)11977, 12032-59 d)11983, 12002-51

MUSCULOSKELETAL SYSTEM

10.A patient reports a history of right groin pain, which is worse with sitting and rising from a sitting
position Physical examination, x-rays, and CT scans confirm a cam lesion in the right femoral head-neck
region and noted as the cause for loss of rotation. Dr. Curtis completed an arthroscopy of the right hip
with debridement and a femoroplasty. How should Dr. Curtis report her procedure?

a)29914-RT c)29861-RT, 29862, 29914

b)29862-RT, 29914-59 d)29860-RT, 29862-59, 29914-59

11.Dr. Reese completed a deep transfer of the anterior tibial and flexor digitorum tendons. Which
code(s) should be used to report this procedure?

a)27658 x 2 c)27691, 27692

b)27690, 27692-51 d)27691, 27692 x 2

12.Which code(s) should you report for the following case ?

Preoperative diagnosis : procedures :Left knee medial collateral ligament tear Exam under anesthesia

Anterior cruciate ligament tear Diagnostic arthroscopy of left knee

Possible meniscus tear Left knee arthroscopic repair of lateral Meniscus.

Postoperative diagnosis :Same

Tourniquet time : 2.5 hours

Procedure : The patient was taken to the operating room and positioned, and an epidural anesthetic
was placed. Once the anesthetic had taken effect, the patient’s left leg was examined under anesthesia
and noted to have increased valgus laxity with end poi8nt, a positive Lachman test, and positive pivot-
shift test. The patient was prepped and draped in the normal fashion, exsanguinated, and the tourniquet
applied to a 350 mmHg. The knee was then insuffiated and irrigated with fluid. Using the arthroscopic
sheath, visualization of the knee joint began. Attention was turned to the lateral meniscus where the
tear was debrided. Using the arthroscope, the lateral meniscus was sutured with two mattress-type
sutures of non-absorbale 2-0 material. The sutures were then tied and visualized witharthoroscopy to
reveal the meniscus to be in excellent shape and stable position. The 3.5-cm wound was thoroughly
irrigated and closed with intermediate subcutaneous sutures. A sterile compression dressing was
applied. The patient was placed in a TED hose a Watco brace, setting the brace between 40 and 60 of
free motion. He was then taken to the recovery room in stable condition. The instrument, sponge, and
needle counts were correct.

a)29882, 29877-52, 29870-51 c)29870, 29882, 12032

b)29866, 29868 d)29882

13.Two weeks ago, Sam underwent an open repair of his lower femur due to a traumatic fracture
suffered while snow skiing. His leg is healing as expected, and no new treatment is required to the
femur. Today, he return as planned for an application of a new long leg cast. The cast application is
completed by the same physician who performed the surgery. How should today’s services be reported?

a)29345-58, S72.409D c)29345, 29700-59, 99024, S72.409A

b)99024, S72.409D d)29345.76,S72.409A

14.What type of soft tissue tumor resection is commonly used for malignant tumors or very aggressive
benign tumors?

a)Manipulative soft tissue resection c)Residual soft tissue resection

b)Radical soft tissue resection d)Manageable soft tissue resection

15.A patient was stabbed in the right arm. A surgeon took the patient to an operating suite and
completed wound exploration. Thesurgeon widened the wound to achieve proper visualization and
completed subcutaneous debridement and ligation of minor subcutaneous blood vessels. No further
procedures were required for this wound exploration. The arm wound was closed and dressed in the
usual fashion. The patient tolerated the procedure well and was returned to the recovery room in good
condition. How would you report this procedure ?

a)20103, 11011-51 c)20103, 11011-59

b)20103 d)11043, 12036-59, 20103-51

16.A patient underwent an anterior interbody arthrodesis with discectomy, osteophytectomy, fusion,
and decompression of nerve roots at level C3, C4 and C5. The fusion was explored and then stabilized
with application of anterior instrumentation placed from C3 to C5.

Which codes would you use to report this procedure?

a)22551, 22585 x 2, 22845-51, 22830-59 c)22600, 22614, 22842, 22830-59

b)22554, 22585 x 2, 22845, 22830-51 d)22551, 22552 x 2, 22845, 22830-51

17.Which code(s) would you report for an aspiration and injection of a ganglion cyst to the bone of the
left great toe?

a)20600 b)20612 c)20615 d)20600, 20612-59

18.A patient suffering from a nonhealing knee tendon underwent a platelet-rich plasma injection under
imaging guidance. How should you report this procedure?

a)0232T b)20551 c)20551, 77002 d)0232T, 20551, 77002.

19. Dr. Bender completed a therapeutic manipulation of the temporomandibular joint. An

anaesthesiologist placed this healthy 54-year-old patient under general anesthesia and monitored the
patient during the procedure. The intraservice time was noted as one hour. The patient tolerated the
procedure well and was returned to the recovery room in good condition. How would Dr. Bender’s
services be reported?

a)21071, 99144, 99145 x 2 b)21480 c)21073 d)21480, 99149, 99150 x 2

RESPIRATORY AND CARDIOVASCULAR SYSTEME

20. Dr. Walters performed a subsequent thoracentesis of the pleural cavity for aspiration with needle
fluoroscopic guidance. Which codes should Dr. Walters report for his professional services ?

a)32554 b)32555 c)32556 d)32557

21. Alicia is 20 months old and suffering from chronic inflammation of the trachea, which is causing
difficulty in breathing. Dr.Marion inserted a planned incisional tracheal tube for Alicia. This procedure
was completed under general endotracheal anesthesia. sThe patient tolerated the procedure well and
was returned to the recovery room in stable condition. How should Dr. Marion report

this procedure?

a)31610 b)31601 c)31830 d)31615.

22. Dr. Manning, a thoracic surgeon, was asked to consult with Nancy, a 66-year- old female with
atherosclerotic heart disease. The patient, who requested the visit, is well known to Dr. Manning, who
performed thoracic surgery on her two years ago. She was seen in his office Monday morning for a
consultative visit with mild complaints of fatigue and shortness of breath. Dr. Manning dictated
acomprehensive history, comprehensive examination, and high-complexity decision-making. During this
consultation, Dr. Manning made the decision toreoperate on Nancy. He sent a written report back to her
cardiologist, Dr. Shaw, regarding the need for another surgery to take place the following day. Monday
evening, Nancy was admitted to the hospital to start the prep for the planned bypass surgery Tuesday
morning.

Tuesday’s operative report

Preoperative diagnostis : Atherosclerotic heart disease.

Postoperative diagnosis : Same

Anesthesia : General

Procedure : The patient was brought to the operating room and placed in the supine position. With the
patient under general intubation anesthesia, the anterior chest, abdomen, and legs were prepped and
draped in the usual fashion. Review off a postoperative angiography showed severe, recurrent, two-
vested disease with normal ventricular function. A segment of the femoropopliteal artery was harvested
using endoscopic vein-harvesting technique and prepared for grafting. The patient was heparinised and
placed on cardiopulmonary bypass. The patient was cooled as necessary for the remainder of the
procedure and an aortic cross-clamp was placed. The harvested vein was anastomosed to the left
subclavian artery and brought down to the left anterior descending and anastomosed into place. The
aortic cross-clamp was removed after 55 minutes with spontaneous cardioversion to a normal sinus
rhythm. The patient was warmed and weaned from the bypass without difficulties after 104
minutes.The patient achieved homeostasis. The chest was drained and closed in layers in the usual
fashion. The leg was closed in the usual fashion. Sterile dressings were applied and the patient returned
to intensive care recovery in satisfactory condition.

How should Dr. Manning report his services for Monday and Tuesday in this case ?

a)Monday : 99255-57 ; Tuesday : 33511, 33517, 35600

b)Monday : 99215-57 ; Tuesday : 33533, 33517-51, 35572-80, 33530-51

c)Monday : 99255-57 ; Tuesday : 33533, 33510, 33572, 33530

d)Monday : 99215-57 ; Tuesday : 33533, 33517, 35572, 33530.

23. A patient had a temporary transvenous pacemaker system inserted with electrodes placed in the
right a trial and ventricular chambers. How should you report this service?

a)33211 b)33208 c)33213, 33208-51 d)33211, 33208-51

24. Marvin, a 51-year- old patient, required a conversion of a single-chamber pacemaker system to a
dual-chamber system. The previously placed electrode was removed transvenously. The skin pocket was
opened and the pulse generator removed. The skin pocket was then relocated and a dual system was
placed with transvenous electrodes in both the right atrial and ventricular chambers. The system was
tested and the new skin pocket was then closed. The patient tolerated the procedure well. How should
you report these services ?

a)33208, 33234-51, 33233-51, 33222-51, 33214-51 c)33208, 33234-51, 33233-51, 33222-51

b)33208, 33214-51, 33223-51 d)33214, 33222-51

25. A patient required a battery change for a single-chamber pacing cardioverter-defibrillator system.
The battery was taken out in a subcutaneous fashion and a new battery placed. The cardioverter-
defibrillator was then reattached to the electrodes, which were intact and tested, and the skin pocket
was then closed. How should these services be reported ?

a)33263 b)33241, 33240 c)33262 d)33227

26. Dr. Lim completed and external ECG with 48-hour continuous rhythm testing during which analysis
was performed for Mr. Brown. The report was reviewed and interpretation completed for evaluation of
change to the pacemaker system. The report conclusion stated predominant rhythm of atrial fibrillation
with non-controlled left ventricular rate. Dr. Lim scheduled Mr. Brown for placement of a biventricular
pacemaker, which will be connected to his current pacemaker system. How should Dr. Lim report her
services for the cardiovascular monitoring ?

a)33224 b)33244, 93224-59 c)93224 d)33208, 33225-51, 93225-59

27. A patient had an endarterecomy during the same surgical session for a repair to a coronary
arteriovenous chamber fistula. The fistula repair did not require cardiopulmonary bypass to complete
the procedure. How should these services be reported ?

a)33572, 33501 b)33500, 33572-59 c)33501 d)33507, 33501-59

28. A patient suffering from chronic inflammation of the maxillary sinus underwent a surgical endoscopic
transnasal balloon dilation procedure torestore normal sinus function. During this procedure, maxillary
antrostomy with removal of tissue was completed. How should you report these procedure ?

a)31295 c)31295, 31256-59, 31267-59

b)31267, 31295-59 d)31297

29. A patient underwent a recurrent destruction of the laryngeal nerve for therapeutic purposes. How
would you report this procedure ?

a)31595 b)31599 c)31595, 64681-59 d)64614, 31599-59

DIGESTIVE SYSTEM

30.A patient with ongoing symptoms of weight loss, constipation, and blood in stool verified with occult
testing underwent a rectal approach colonoscopy with snare removal of three colonic polyps. The
pathology report, which was returned to the plysician the same day of the procedure, revealed benign
colon polys. How should you report this?

a)44401, K63.5 c)45378, 45385 x 3, D12.6

b)45385 x 3 K63.5 d)45385, K63.5

31. A patient was fully prepped or a diagnostic colonoscopy; however, an object then shifted into the
descending colon just below the splenic lexure. The physician was unable to advance the scope beyond
the splenic flexure. How would you report this diagnostic colonoscopy ?

a)44388-52 b)45330 c)45378-53 d)None of the above.

32. Jennifer, a 3-year- old patient swallowed a marble that became lodged in her esophagus. An
esophagotomy via thoracic approach was completed for removal of the foreign body. The patient
tolerated the procedure well and was returned to the recoveryroom in good condition. How should you
code this procedure ?

a)43045 b)43020 c)43215 d)43135

33. An otherwise healthy 22-yearold patient was scheduled for repair of an incarcerated bilateral
recurrent inguinal hernia. The

patient was taker into a same-day OR, where she was prepped, positioned, and draped in the usual
fashion. The anesthesiologic administered general anesthesia and indicated the patient was ready for
the surgery to begin. The surgeon created the incision and started the procedure. At this point, the
patient went into shock due to the anesthisia and the procedure was halted. The patient was stabilized
and returned to the recovery room. How should the surgeon report this procedure ?

a)49507-74, T88.2XXA, K40.3XX, Z53.09

b)49521-53, K40.01, T88.2XXX, Z53.09

c)00830-P1, 49521-51, K40.30. T81.10XA, Z5309

d)49521-47, K40.01, T88.2XXA, Z53.09

34.How would the following case be coded ?

Preoperative diagnosis : Lesion, buccalsubmucosa, right lower lip

Postoperative diagnosis : Same

Procedure performed : Excision of lesion, buccalsubmucosa, right lower lip.

Anesthesia : Local

Procedure : The patient wasplaced in the supine position. A measured 7x8 mm hard lesion is felt under
the submucosa of the right lower lip. After application of 1% Xylocaine with 1:1000 epinephrine, the
lesion was completely excised. The lesion does not extend into the muscle layer. The 8-cm wound was
closed with complex mattress sutures to the submucosal level and dressed in typical sterile fashion. The
patient tolerated the procedure well and returned to the recovery area in satisfactory condition.

a)40816, D10.39 c)40814, K13.70

b)40814, 40831-51, D10.39 d)40814, D10.39

35. A patient underwent an EGD with transendoscopic ultrasound-guided transmural fine needle
aspiration. How should you code this procedure ?

a)43242, 76942-26 c)43235, 43238-59

b)43242 d)43235, 43242-51, 76942-26

36. A patient underwent a laparoscopic repair of a paraesophageal hernia with fundoplasty with
implantation of mesh. During the procedure, a laparoscopic esophageal lengthening was completed.
Which codes capture this procedure?

a)43327, 43282-59 c)43281, 432825-59, 43283-51

b)43333, 43283-51 d)43282, 43283

37. A patient underwent an enterectomy in the small intestine with four resections and anastomoses.
How should you report this type of procedure ?

a)44130 b)44120 x 4 c)44111 d)44120, 44121 x 3

38. Veronica, a 55-year- old patient, has left upper quadrant pain with a negative ultrasound. Veronica’s
physician explains the need for a diagnostic and possible surgical procedure to determine the cause of
this pain. She agrees to the procedure, completes overnight fast and prep, signs a consent for surgery,
and is then taken to a procedure room. After nasal spray of 2% Xylocaine is administered, the tube is
introduced through one nostril, down the back of the throat, and positioned into the stomach as the
patient swallows. The diagnostic duodenal intubation and aspiration is completed. However, the
physician decides to reposition the tube under fluoroscopic guidance and obtain multiple duodenal fluid
specimens during the same operative session. The patient tolerates the procedure well and is move to
the recovery suite. How would you report the physician services ?

a)43757 b)43756,43757-52 c)43755 d)43755, 43756-59, 43757-59

39. A patient has an adjustable gastric restrictive device component removed and replaced via a
laparoscopic procedure. How should you code this procedure ?

a)43773 b)43772, 43773-51 c)43888 d)43845

Urinary System, Male and Female Genital Systems

40. A patient had three needle biopsies of the prostate completed under imaging and guidance. Which
codes capture the professional services for this procedure ?
a)55700 x 3, 76942-26 c)55700, 76942-26

b)10022, 55700 x 3, 76942-26 d)55705 x 3, 10022, 76942-26.

41. Newborn baby boy Martinez underwent a procedure to slit the prepuce to relieve constriction that
prevented retraction of the foreskin over the head of the penis. The slit tissue was sutured at the
divided skin to control bleeding. The patient tolerated the procedure well. How would Dr. David report
his services for this procedure ?

a)54000-63 b)54000 c)54001-52 d)54001-63

42. A patient underwent destruction of extensivecondyloma lesions on the penis. The documentation
stated 12 or more lesions were visible and treated during this session. The procedure was completed by
laser technique. The patient received follow-up and post-procedure care instruction and was discharged
in good condition. How should you report this procedure ?

a)54057 x 12, 54065-59 b)54065 x 12 c)54057-22 d)54065

43. A patient underwent an injection procedure for voiding urethrocystography with contrast. During
the same investigative session, the physician completed all components of a urethral pressure profile
study and a simple UFR including interpretation of the results. How should you report the professional
services for this procedure ?

a)51600, 74455-26, 51727-51, 51736-51

b)51605, 74430-26, 51727-26, 51741-51

c)51600, 744430-26, 51727-26, 51797-51

d)51605, 74455 TC, 51727-26, 51736-51

44. A physician completed a cystourethroscopy with insertion of two permanent urethral stents. How
should you report this?

a)53855 x 2 b)52282 x 2 c)52281, 53855-59 d)52282 x 2, 52305-59

45. What modifier should be reported with the procedure code for transurethral resection of residual,
or regrowth of, obstructive prostate tissue when the procedure is performed by the sme physician
during a postoperative period ?

a)-22 b)-52 c)-77 d)-78

46. Dr. Laura completed a vaginal delivery in the hospital for Stephanie, a 30-years- old patient. This is
Stephanie’s first child and she delivered a healthy baby boy. Dr. Laura has taken care of Stephanie during
the entire pregnancy and followed her through the postpartum period. Dr. Laura’s documentation
stated that during the delivery admission, Stephanie required prophylactic antibiotic
because she has mitral valve prolapsed. How should Dr. Laura report the delivery care and diagnosis fort
his patient ?

a)O80, I34.1, Z38.00, 59400 c)O99.42, I34.1, Z37.0, 59400

b)I34.1, O99342, Z38.00, 59510 d)I34.1, O99.42, Z37.0, 59614

47. Diane suffered a spontaneous incomplete miscarriage during the second trimester and required
surgical completion of this event. How should this procedure be reported ?

a)59812 b)59820 c)59821 d)59840

48. An established patient required medical attention for removal of an impacted foreign body from the
vaginal canal. Her physician documented a detailed history, detailed examination including enlargement
of the vaginal opening with introduction of speculum, and identification of the foreign body as a
tampon. The patient was asked to return to the office is she hand any complications, fever, or abnormal
discharge or heavy bleeding. How should you report the procedure ?

a)99214-25, 57415 b)99214 c)57415 d)57415-52

49. One week ago, Marion underwent a surgical laparoscopy with vaginal hysterectomy including
removal of a 275-g uterus tube and ovaries due to cancer of the endomtrium. Today she was admitted
for a planned insertion off a vaginal radiation afterloading apparatus for clinical brachytherapy. During
this procedure, the surgeon inserted the device and took x-rays to ensure placement. Once the device
was in the proper location, it was fixed into position by tightening the applicator base plate and locking
mechanism. Marion tolerated the procedure well and was sent to the recovery suite in satisfactory
condition. How should today’s professional services be reported ?

a)58554, 57156-58 c)58554, 57156-59, 77326-26

b)57156-59, 77326-26 d)57156-58

50. What code should be reported for a diagnostic dilation and curettage for a patient experiencing
heavy bleeding that is not associated with pregnancy ?

a)58120 b)59160 c)57800 d)57700

Nervous System, Eye and Ocular Adnexa, and Auditory System

51. A 43-year- old patient who suffer from severe intermittent vertigo has been definitively diagnosed
with Meniere’s disease. After a year of various treatments, medications, tests, and behaviour/lifestyle
changes that have failed to lessen the symptoms, she now presents for a transcanal chemical
labyrinthotomy to the right ear. Dr. Miller visualizes the tympanic membrane with an operating
microscope, cleans the ear canal and makes a small incision into the tympanic membrane. Gentamicin is
delivered into the right ear. The ent is repositioned with the right ear up an monitored by the nurse. The
perfusion is repeated to achieve the maximum result. The ear is suctioned, cleaned, and carefully
examined for bleeding. The patient tolerated the procedure well and is returned to the recovery area in
satisfactory condition. How would Dr. Miller report his professional services ?

a)69801 x 2, 69990-51 c)69801, 69990

b)69905 x 2, 69990-51 d)69905, 69990

52. What code(s) would be reported for the following case ?

Preoperative diagnosis : Bilateral impacted ventilating tube

Postoperative diagnosis : Same

Anesthesia : General

Procedure perfomed : Removal and replacement of new tubes, bilaterally via tympanostomy.

Procedure : Sammie, a 16-year- old patient, was admitted and taken to the operative suite and placed
under general anesthesia by inhalation. When adequate sedation was achieved, a 3.8-mm speculum was
inserted into the left ear, wax removed, and speculum removed. The impacted tube was then removed.
A new site was achieved within the same tympanosderotic plaque and a new tube placed. The same
procedure was repeated to the right ear. Sammie was sent to the recovery suite in stable condition.

a)69424-50, 69436-50 b)69433-50 c)69436-50 d)69424-50, 69433-50

53. James returned two weeks after surgery, as planned, for a change in his drug delivery system. Today
Dr.Harvey opened the previous incision site. The previously placed reservoir was removed and a new
programmable subcutaneous pump was connected to the catheter and secured with sutures, tested,
and programmed. The subcutaneous incision was closed in layers with a sterile dressing placed. The
patient tolerated the procedure well. How should Dr. Harvey report this service?

a)62362-58 b)62365, 62362-59 c)62350-58 d)62350, 62355-59

54. Dr.Adams completed an anterior discectomy with decompression including osteophytectomy to

levels C3-C5. During the same session, he stabilized C3-C5 with anterior cervical interbody fusion. For
proper visualization, Dr. Adams used an operating microscope during all phases of the procedure. How
should Dr. Admas report this procedure?

a)63075, 63075-51, 22551, 22254 x 2, 69990-51

b)63075, 63078-51, 22551 x 2, 69990-51

c)63075, 63076, 22554 x 2

d)63075, 63076, 22551, 22552

55. With which code set or individual codes can add-on code 61781 be correctly reported?

a)61720-61791 b)62201 or 77432 c)77371-77373 d)None of the above

56. Carl, a 28-year- old patient, has a history of epilepsy with recurrent seizures. His seizures are
intolerable even with medication management. He does not experience non-epileptic seizures, which
was confirmed by EEG recordings. Today he underwent an open procedure for implantation of cranial
nerve neurostimulator electrode array, which was coiled around the vagus nerve. The pulse generator
was connected to the neurostimulator array, tested, and repositioned to ensure maximum
effectiveness. The pulse generator was placed and sutured into a created subcutaneous pocket. Again,
the system is tested to ensure proper functionality. The subcutaneous tissues and skin are closed with
deep sutures and skin staples. Carl tolerated the procedure well and was returned to the recovery suite
in stable condition. Which code(s) should be reported for today’s services ?

a)61885, 64568-59 b)64568 c)61531 d)64570, 61888-29, 64568-59

57. A 6-month- old patient required a bilateral subdural tap through a suture. How would this initial
procedure be reported?

a)61000 b)61001-63 c)61000-50 d)61020-63, 61000-50

58. A patient with Bell’s palsy is unable to squint, blink, or close her left eyelid. To protect the eye, Dr.
Risser completes a temporary tarsorrhaphy with a Frost suture technique. How would you report this
procedure ?

a)67875-LT b)67710-LT c)67840-LT d)67950-LT

59.What code(s) should be reported with the following case ?

Preoperative diagnosis : Total retinal detachment, right eye

Postoperative diagnosis : Same

Procedure performed : Complex repair of retinal detachment with photocoagulation, sclera buckle,
sclerotomy/vitrectomy.

Anesthesia : Local

Procedure : The patient was placed, prepped, and draped in the usual manner. Adequate local
anesthesia was administered. The operating microscope was used to visualize the retina, which has
fallen into the posterior cavity. The vitreous was extracted using a VISC to complete the posterior
sclerotomy. Minimal scar tissue was removed to release tension from the choroids. The retina was
repositioned and attached using photocoagulation laser, a gas bubble, and a suture placement of a
sclera buckle around the eye.The positioning of the retina was checked during the procedure to ensure
proper alignment. Antibiotic ointment was applied to they eye prior to placement of a pressure patch.
The patient tolerated the procedure well and returned to the recovery suite in satisfactory condition.

a. 67113-RT, 67107-51, 67145-51, 66990-51

b. 67113-RT, 69990-RT

c. 67115-RT, 66990-RT

d.67113-RT, 67107-51, 67145-51, 66990-51

60.A patient had a bilateral strabismus surgery involving the medial and lateral rectus muscles. The
surgeon explored and repaired a detached extraocular muscle in the right eye and place bilateral
posterior fixation sutures with muscle recession. How should you report this procedure ?

a)67316-50, 67332-RT, 667334-50 c)67312-50, 67340-RT, 67334-50

b)67316-50, 67332-RT, 67335-50 d)67312-50, 67340-RT, 67335-50

Evaluation and Management

61.Dr. June dictated the following chart note. Which code would be reported for this evaluation and
management visit ?

Subjective : Mae is a 41-year- old female well known to me. She presents for her annual examination.
Menses are regular without intermenstrual bleeding. When seen a year ago., she felt fatigued, blood
work at that time showed her to be hypokalemic. She resumed a potassium supplement at that time and
feels much better. She has no headaches or other complaints. She reports slight vaginal itching during
the summer months but is not experiencing this problem today.

Medications :Parodel 2.5 mg hid, chlorthalidene 60 mg daily, potassium supplement daily, OTC
multivitamin supplement daily.

Objective : Breasts without masses, bilateral galactorrhea, no axillary adenopathy. Abdomen soft and
non-tender. Pelvic exam reveals external genitalia normal ; vagina rugous with small amount of yellow
discharge, cervix clean, uterus anterior mobile, non- tender, and normal in size, shape, and consistency.
Adnexa clear and non-tender. Pap smear obtained, wet smear is unremarkable.

Assessment :

1. Long history of galactorrhea well controlled on Parlodel, as are her menses.

2. Has taken chlorthalidone daily for many years for fluid retention.

Plan :

1. Yearl refills for parlodel 2.5 mg po bid, chlorthalidone 60 mg daily and potassium supplement one
daily.

2. Continue on OTC multivitamin supplement daily.

3. Ordered annual mammography.

4. Ordered annual serum prolactine and serum potassium levels.

5. Patient doing well should return in one year or as needed

a)99213 b)99396 c)99386 d)99203

62. Today Glen was discharged form a nursing facility after recovering from a hip replacement. It took
Dr. Loma 45 minutes to complete the final detailed examination ; review detailed history, surgery notes,
and lab work ; write refills for prescriptions; complete orders for continued physical therapy ; and
provide detailed verbal instruction to Glenand his family regarding his ongoing care. How would Dr.
Loma report her services?

a)99024 b)99239 c)99309, 99316 d)99316

63. Dr. Mayer admitter Sally to observation status Monday afternoon related to minor changes to an
EKG and a dizzy spell. His dicated note for initial observation status included a comprehensive history,
comprehensive examination, and moderate decision- making. He started here on new medication and
wanted to continue to observe her until he was sure here condition was stable. On Tuesday, Dr. Mayer
saw Sally, who was still receiving observation services as an outpatient, and dictated a chart note related
to her changes since his last visit. The note consisted of an expanded problem-focused examination, and
straightforward decision-making.

How should Dr. Mayer report Tuesday’s visit?

a)99220-25, 99232 b)99220, 99226-25 c)99232 d)99225

64. Dr. Peters is Tim’s family physician. During today’s visit with Dr. Peters, Tim complained of fatigue,
light headedness, and intermediate chest pains, Dr. Peters called Dr. Counsel, a cardiologist, and asked
for a work-in visit for Tim. Dr. Counsel saw Tim in the office later that afternoon, performed a
comprehensive examination, and obtained an exended history of the present illness with complete past
family, social, and personal history. Dr. Counsel’s decision-making was based on review of extensive
records and test results provided by the patient, the high risk of complications, and the extensive
management options. Dr. Counsel sent a written report back to Dr. Peters outlining the visit and plans
for insertion of a pacemaker in the next few days. How would Dr. Counsel report today’s visit?

a)99214 b)99245 c)99244 d)99205

65. Dr. Mike asked Dr. Susan to conduct a follow-up consultation with Lou, a 15-year- old patient who
had a tympanotomy three days ago. Dr. Susan consulted for Lou the day after surgery for a fever and
mild seizures. The patient was stable until today when Lou’s fever returned and he suffered another
mild seizure. Dr. Susan dictated a detailer history and physical examination and high decision-making
related to her findings. How would Dr. Susan report her services for today’s visit ?

a)99253 b)99234 c)99233 d)99252

66. A physician provided 185 minutes of critical care for an 82-year- old patient suffering from heart
failure. The physician documented an additional 20 minutes, outside the critical care time, which was
dedicated to insertion of a peripherally inerted venous access device. During this encounter, the
physician obtained a fronted chest x-ray, pulse oximetry and arterial puncture for blood gases. How
should these services be reported ?

a)99291-25, 99292 x 4, 36571 c)99291, 99292 x5

b)99291-25, 99292 x 4, 71010, 94760, 36600 d)99291, 99292 x 4

67. Warfarin thereapy management anticoagulation codes 99363-99363 describe what type of
management ?

a)Outpatient management c)Online in conjunction with inpatient management

b)Inpatient management d)Online in conjunction with outpatient management

68.Baby Jones is 26 days old and requires continued intensive care services but is not considered
critically ill. Her present body weight is 1,400 grams. Dr. Rob initially admitted Baby Jones to her service
on Monday. Dr. Rob completed a visit with Baby Jones and her parents on Tuesday and Wednesday.
How would Dr. Rob report all three days of service?

a)99468, 99469 x2 b)99477, 99478 x 2 c)99460, 99462 x2 d)99291, 99292 x 2

69. Today Dr. Miller completed an annual assessment with Mary, an established patient. Mary has been
living in a nursing facility for the past three years. Today’s documentation included an assessment of her
overall condition, her continued need for 24-hours nursing assistance, and her decline in mental acuity.
Dr. Miller dictated a comprehensive history, comprehensive examination, high decision-making, and
notes related to discussions with her extended family. Additionally, he completed the required resident
assessment instrument and protocols and Minimum Data Set paperwork. Which code(s) should D. Miller
report for today’s visit ?

a)99306 b)99215 c)99318 d)99310-25, 99318

70. What is the time requirement for reporting subsequent units of physician standby services ?

a) Second and subsequent periods of stand by beyond the first 15 minutes may not be reported even if
and additional 15 minutes are spent on the unitor floor.
b) Second and subsequent periods of stand by beyond the first 15 minutes may be reported only if a full
15 minutes of standby was provided for each init of service reported.

c) Second and subsequent periods of stand by beyond the first 30 minutes may be reported only if a full
30 minutes of standby was provided for each init of service reported.

d) Second and subsequent periods of standby beyond the first 30 minutes may be reported if greater
than 15 minutes of standby was provided for each unit of service reported.

Anesthesia

71. An anaesthesiologist provide general anesthesia for open repair of a fractured pelvis column
involving the acetabulum for a 74- year-old patient. Further documentation for this patient includes
severe hypertension and uncontrolled diabetes. How should the anaesthesiologist report her services ?

a)01173-P3, 99100 b)27226, 01190-P3, 99100 c)01190-P4, 99100-51 d)01173-P4

72. Dr. Burns, a surgeon, provided regional anesthesia and completed and exploration for postoperative
hemorrhage in the neck on a 55-year- old patient with moderate cardiovascular disease. How would Dr.
Burns report his services for this case ?

a)00350-P2, 35800 b)35800-47 c)00351-P2 d)00350-47

73.Why should the add-on code 99100 for quailing circumstances not be reported with the following
codes : 00326, 00561, 00834 and 00836 ?

a) Age of the patient is not a factor with any anethesia codes or add-on codes.

b) Age of the patient as older than 70 years in part of the code ; therefore, it does not require the add-
on code

c) Age of child as older than 1 year is part of the code ; therefore, it does not require the add-on code

d) Age of child as younger than 1 year is part of the code ; therefore ; it does not require the add-on
code

74.A patient undergoing a cervical surgery received general anesthesia for a procedure performed in a
sitting position. The patient is 54 years old and healthy aside from the current cervical problem. How
should the anaesthesiologist report his services ?

a)00604 b)00600-P1 c)00604-P1 d)00620

75.A 40 years-old patient underwent drainage of a ovarian abscess via transvaginal approach. The
patient was under moderate sedation for the procedure which was provided by the same operating
physician. The intraservice time was clocked at 45 minutes.

How should the sedation services be reported for this procedure ?

a)58820, 00940 c)58820, 99152,99153x2

b)00940-P2 d)58820-P2, 99156,99157x2

76.According to the anesthesia guidelines, what forms of monitoring are not included or bundled with
anesthesiaservices?

a)Intra-arterial b)Central Venous c)Swan-Ganz d)All of the above

77.Dr. Will, and anaesthesiologist, provided three days of hospital management for epidural continuous
drug administration. These services were performed afte insertion of the epidural catheter. How should
Dr. Will report these days of care ?

a)01996-P1 x 3 b)01996 c)64999-P1 d)64999

78.A patient with a third-degree burn of 54% of his body is being treated under anesthesai for excision,
debridement, and extensive skin grafting. The patient’s condition is listed as severe, and he is not
expected to survive without the operation. The operation is further complicated by the emergency
condition of the patient and delaying this procedure could lead to loss of body parts. How should the
anaesthesiologist report her services with this procedure ?

a)01952-P5, 01953-P5 x 5, 99140 c)01951, 01952, 01953 x 4

b)01952-P5, 01953-P5 d)01951, 01952, 01953 x 5, 99140-51

Radiology

79.How should you report services for a 3-D radiation therapy simulation field setup?

a)77290 b)77295 c)77263 d)77280, 77295

80.A patient with a history of family breast cancer is now suffering from swelling in both arms and
undergoes a bilateral lymphangiography. How should the professional services and diagnoses be
reported for this procedure ?

a)75807-26, M79.89, Z85.3 c)75803-26, M79.89, Z85.3

b)75801-26, M79.89, Z80.3 d)75803-26, M79.89, Z80.3

81.Angela, a 28-year- old patient, is pregnant with triplets. She is in her second trimester and is being
evaluated by transabdominal ultrasound with real-time imaging for fetal sizes. This is her third follow-up
ultrasound to ensure the adequacy of fetal growth, development, and weight. How would you report
this service ?

a)76816, 76816-59, 76816-59 c)76830, 76830-59, 76830-59

b)76816, 76810 x 2 d)76805, 76810 x 2

82. A patient had an MRI of the face without contrast materials followed by contrast for six further
sequences during the same scanning session. How should this professional service be reported?

a)70540-26, 70542 x 5 b)70540, 70542-26 c)70543-26 d)70543 x 5

83. The code set 74176-74178 should be reported how many times per CT session of the abdomen and
pelvis?

a)For each organ scanned c)Twice

b)Once d)This code set has been deleted for 2011

84. A therapeutic radiologist performed a comprehensive history, comprehensive examination and high
complexity decision-making when admitting a patient. After admission, the same physician placed 12
interstitial ribbons for clinical brachytherapy. How would you report these service?

a)77778 b)99223, 77778 c)99223, 77763 d) 77763

85. A patient underwent a whole-body diagnostic nuclear medicine test because of thyroid carcinoma
metastases with uptake. How would these lsevice, radiopharmaceuticals, and/or drugs be reported?

a)78018, 78020 : services do not include radiopharmaceuticals or drugs that are reported separately.

b)78070, 78020-51 : Service do not include radiopharmaceuticals or drugs that are reported separately.

c)79005, 72020 : Services include radiopharmaceuticals or drugs

d)78018, 78020 : Service include radiopharmaceuticals or drugs.

86. Joann had a diagnostic mammography of her left breast with computer-aided detection. During the
same session, two lesions were identified and mammographic guidance needle placements were
completed. How should these services be reported ?

a)19281, 77057-LT, 77052-LT c)19281, 19282, 77055-LT, 77051-LT

b)19281, 19282, 77056-LT, 77051-LT d)19281, 77055-LT, 77051-51

87. A patient completed three radiation treatment sessions for two separate treatment areas with use
of multiple blocks. Each session consisted of 8 meV of radiation being delivered. How should these
technical services be reported?

a)77407 x 3 – TC b)77407 x 3 c)77407 – TC d)77412 x 3 – TC

Laboratory and Pathology

88. Which code(s) should be reported for the following case?

Clinical history: Mass in the body of stomach

Gross description : Cavity effusion – two Diff-Quik four smears prepared with

Simple filter and interpretation.

Specimen received : Stomach mass touch prep.

Adequancy : Specimen satisfactory for cytological evaluation

Diagnosis : Primary malignant neoplasm – body of the stomach

Notes : Cytology completed on specimen. The malignant cells show subjective features suggestive of
small – cell carcinoma, however, cell size is more attuned with non-small- cell carcinoma.

a)C16.2, 88106 b)D3A.092, 88104 c)R19.00, C16.2, 88106 d)D3A.092, C16.1, 88108

89. Dr. Ross, a pathologist, completed both gross and microscopic surgical pathology after a lung wedge
biopsy. Dr. Miles, the surgeon, sent a single specimen to the laboratory after the completion of a limited
biopsy by thoracotomy. How would Dr. Ross report her services ?

a)88300, 88307 b)32151, 88305-26 c)88307 d)32095, 88307-26

90. Robert was sent to a local laboratory for pre-employment alcohol screening. He provided a blood
smaple to the laboratory technologist. The technologist completed a qualitative screening, including one
procedure for multiple drug classes using non- chromatographic methods with dipstick. The test was
negative and results were sent back to the requesting employer. How should you report this laboratory
service ?

a)80305 b)80306-91 c)80307 d)80306

91. Jane underwent a combined rapid anterior pituitary evaluation panel with multiple exposures and
suppressions and had a hepatic function panel. How should these tests be reported ?

a)82024 x 4, 83002 x 4, 83001 x 4, 84146 x 4, 830003 x 4, 82533 x 4, 84443 x 4

b)80418, 80076

c)80418, 82024, 83002, 83001, 84146, 83003, 82533, 84443

d)80076.

92. Dr. Thomas received a request for consultation that included records and specimens. Dr. Thomas did
not see the patient, but documented the patient as inpatient status with a comprehensive family history
of colon cancer. The patient takes multiple medications and is at high risk of complications due to
weight loss, chronic diarrhea, and a continued fever. His confirmative opinion, based on the review of
specimens and records, indicates positive small-cell caner. Dr. Thomas sent his written report back to
the requesting physician. How should Dr. Thomas report his services?

a)99254 b)88325 c)99254-25, 88325-26 d)88323

93. A patient’s blood sample was tested for ethanol using liquid chromatography mass spectrometry and
for opiates using direct operate observation. Code the procedure.

a)80361, 80320 b)80305 c)80320, 80305 d)80320, 80306

94. Larry had a venipuncture during his annual physical examination. The blood sample was used for the
following antibody tests : West Nile 1gM, Shigella, mumps, and total hepatitis B. How should you report
these tests ?

a)36415 c)86788, 86771, 86735, 86704

b)86486 d)36415-32, 86788, 86771, 8673, 86704

95. Today, an extended culture of five-day embryos was completed. The transfer tests will be completed
when the culture test results are confirmed. The culture test result are confirmed. The culture testing
results are scheduled for return within 48 hours. How should the culture service be reported ?

a)89272 b)89250 c)89258 d)89255, 89272

96. A patient had the following blood tests completed as part of her primary care physician’s described
metabolic panel : albumin, bilirubin total, calcium total, carbon dioxide, chloride, creainine, glucose,
phosphatise alkaline, potassium, protein total, sodium, transferase (ALT SGPT), transferase aspartate
(AST SGOT) urea nitrogen (BUN), bilirubin direct, and a hepatitis A IgM. How should theses services be
reported?

a)80053, 82248, 86709 d)80047, 80053, 80076

b)80053-22 c)80076-52, 80074-52, 80053-52

97. A patient had glucose tolerance testing completed on five specimens. How should these laboratory
services be reported ?

a)82947, 82951, 82952-51 b)82951, 82952 x 2 c)82947, 82952 x 5 d)82951 x 5

Medicine

98. Mae’s physician asked her to wear a glucose monitoring device to obtain more accurate information
about her blood sugars. She had sensors placed and was then hooked up to a calibrated wearable
device. Once this was complete, the technician provide Mae with training for the noninvasive
ambulatory continuous glucose monitoring device. After wearing the device for 72 hours, Mae’s
physician’s office removed the device, printed recordings, and downloaded analyses reports to its
computer system. Which code captures this services ?

a)99090 b)99091 c)95250 d)95251

99. Edna, a 72-year- old patient, returned to her regular pulmonologist for a follow-up visit. Dr. Harry
documented Edna’s chief complaint as fatigue after recovering from a minor fly. His documentation
supports a past history of smoking, COPD, and well-controlled diabetes. Edna lives with her husband,
maintains her weight with a balanced diet, and exercises in the warm weather but feels “shut in” during
the winter. Dr. Harry noted a detailed examination, reviewed multiple treatment options, and reviewed
moderate risks for complications, Dr. Harry completed as six-minute walking pulmonary stress test to
evaluate distance, dyspnea, desaturation, and heart rate. The stress test was repeated with adequate
rest walks, pre-/post- spirometry and oximetry, and interpretation and evaluation protocol for Edna’s
entry into a pulmonary rehabilitative program. Which code(s) should Dr. Harrry report for today’s
services ?

a)99214-25, 94620 b)99204-25, 94621 c)94799 d)99213-25, 94620 x 2

100. A 19-year- old patient received immunizations at her health clinic. The immunizations were
administered by a medical assistant at the same clinic. The patient was seen two weeks ago but was
unable to complete the immunizations due to a stomach virus. Today, she is symptom free and receives
an intramuscular H1N1 influenza pandemic formulation, preservative –free vaccine and an
intramuscular hepatitis A immunization. Which codes capture these services ?

a)99211-25, 90633, 90667, 90473-51, 90474-51

b)99213-25, 90632-51, 90666-51, 90471-51, 90472-51

c)90460, 90470, 90632-51, 90632-51

d)90632, 90666, 90471, 90472

101. What codes are not reported in conjunction with the following code descriptor?

Comprehensive electrophysiologic evaluations including insertion and repositioning of multiple

electrode catheters with indication or attempted inducation of arrhythmia ; with right atrial pacing and
recording, right ventricular pacing and recording, and His bundle recording.

a)93600, 93602, 93610, 93612, 93618, 93619

b)No codes are restricted from conjunction reporting with 93620

c)93600-51, 93602-51, 93610-51, 93612-51, 93618-51, 93619

d)Both a & c

102. An 11-year- old female with ESRD had one face-to- face visit with her physician in OP setting and
received three daily dialysis services during a complete one-month period prior to her kidney transplant.
How should these services be reported ?

a)90945 b)90968 x 3 c)90964 x 3 d)90956

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

Preoperative diagnosis : Coronary arteriosclerosis of native arteries, chronic occlusion of coronary

arteries.

Postoperative diagnosis : Same

Anesthesia : Conscious sedation by procedun physician with presente of trained observer.

Procedure : The 64-year- old patient was propped, draped, and positioned in the usual fashion. After
adequate sedation was administered, and access site into the right femoral artery was achieved. The
catheter devices were advanced into position. Extensive review of the current anatomy was completed
along with review of the previous catheterization. The procedure continued as planned with placement
of two drug-eluting stents in the left circumflex, PTCA to the right coronary artery and atherectomy for
occlusion in the left anterior descending artery. Adequate flow was reviewed and confirmed via
angiograms upon completion of the procedures. The guiding catheter was withdrawn after flow
confirmation. Total intraservice time was noted at 1 hour 30 minutes. The sheath was secured to the
groin with asuture and the patient was moved to recovery in good condition. Standing orders were
given for sheath removal when the heparin effects are noted as normal through blood tests. Normal
pressure is to be applied at thegroin as needed with placement of a sandbag or ice bag.

a)92933 c)92924-LD,92928- LC, 92920-RC

b)92924-LD, 92929-LC, 92921-RC d)92943

104. A patient suffering from nystagmus completed a basic vestibular function evaluation with testing
and recording in five different positions with gaze fixation optokinetic, bidirectional, foveal, and
peripgeralstimulation ; and oscillation. An additional vertical electrode and vertical axis rotational testing
was employed during testing. How should this procedure be reported ?

a)92545, 92541-59, 92542-59, 92540-59 c)92540, 92546, 92547

b)92540, 92545, 92542, 92546, 92547 d)92545, 92547-51

105. A patient underwent a left heart catheterization by transseptalpurcture through an intact septum
with image supervision and interpretation and intraprocedural injection for left ventriculography. During
the procedure, pharmacologic agents were administrated and measured. An arm ergometry was
employed for exercise study to assess hemodynamics before and after the procedure. How should this
procedure be reported ?

a)93458, 93462, 93462, 93464 x 2 c)93452, 93566, 93462, 93463, 93464 x 2

b)93452, 93566, 93462, 934763, 93464 x 2 d)93452, 93462, 93463, 93464

106. A patient completed a diagnostic computerized ophthalmic scan of the retina on both eyes. The
physician’s interpretation and report included changes to the retina in the right eye from a previous
study. The left retina looked stable with no changes noted. The patient is scheduled for a follow-up
study in three weeks to assess any new changes and treatment as needed. How should the

physician report her services ?

a)92132-50, 92134-26 b)92132 c)92134 d)92134-50

107. Cameron received 60 minutes of insight-orented psychotherapy in an outpoatient facility. During

this same visit, Cameron complained of an upset stomach due to his new medications. The medication
were reviewed and new medication were prescribed, a flan-up his easonal allergies was documented,
and a persistent cough is noted. The documentation included the psychotherapy notes with an
additional 35 minutes dedicated to a problem-focused history, problem-focused examination, and low-
complexity decision-making. How would the physician services be reported?

a)90837 b)99213-25, 90838 c)90838 d)99213-25, 90837

Medical Terminology and Anatomy

108. What condition is caused by an accumulation of uric acid crystals in the basis joint of the large toe
and other joints of the feet and legs ?

a)Bursitis b)Fibrosis c)Arthritis d)Gout

109. What part of the eye is the white, outermostlayer of the eyeball, composed of tough connective
tissue ?
a)Pupil b)Iris c)Cornea d)Sclera

110. Whatterm describes a muscle shorteningits length in a resting state and then remaining in this
position ?

a)Contracture b)Atrophy c)Hypertrophy d)Contusion

111. Which of the following represents the correct pathway for electrical activity in the heart?

a)SAnode, Purkinje fibers, AV node, bundle branches

b)SAnode, AV node, bundle branches, Purkinje fibers

c)AVnode, Sa node, Purkinje fibers, bundle branches.

d)Purkinje fibers, bundle branches, Sa node, AV node.

112. Which term describes cancer of the largentestine and rectum ?

a)Gatrointestinalcancer c)Colorectal Cancer

b)Durdenal Cancer d)Colorectal gastrointestinal cancer.

113. What process describes blood cell formation occurring in the red bone marrow?

a)Syreresis b)Hematopoiesis c)Fibrinolysis d)Erythrocytosis

114. MIF is what type of laboratory test ?

a)Miler inventory fraction c)Migration inhibitory factor

b)Macro isolate freeze d)Minerva iodine filler

115. What is Travert ?

a)A procedure on nerve fibers c)An instrument for ear surgeries

b)A drug d)The outer plastic for cast material

116. What is the temporary circulation route has exists only between a developing baby and its mother?

a)Heratic Circulation c)Renal circulation

b)Fetacirculation d)Pulmonary circulation

117. What is the doughnut-shaped gland that surrounds the superior portion of the male urethra just
below the bladder ?

A) adrenal gland b)Prostate gland c)Spermatic gland d)Ejaculatory gland

118. Which joint movement is limited to flexion and extension in a single plane?

a)Hirge joint b)Ball-and- socket joint c)Pivot joint d)Suture joint

119. What does the prefix “aniso-“ mean ?

a) Superior b)Bilateral c)Unequal d)Like

120. The mphatic system is sometimes referred to as which other system?

a)Endocrine system c)Immune system

b)Respiratorsystem d)Blood circulatory system

121. Which term describes death of breast tissue resulting from interrupted blood flow to this area ?

a)Hyercirculation b)Agglutination c)Complement d)Infarction

122. Whatmuscles are found between the metacarpals that cause abduction of the proximal phalanges
of the fingers ?

a)Intercrosset b)Flexor pollicis c)Extensor indicis d)Pronator teres

123. What does a corneal pachymetrydetermine ?

a)Comeal thickness c)Cornealpoercalculation

b)Comeal body location d)Corneal position

ICD-10- CM

124. Six weeks ago, Terry underwent a biosy procedure and was diagnosed with secondary metastatic
liver carciroma. His doctors are uncertain about the location of the primary site and have ordered
further testingToday, erry is undergoing chemotherapy for the liver cancer. How should the diagnosis
codes be reported for today’s service?

a)C78.7, C80.1 Z51.11 c)Z51.11, C80.1, C22.9

b)Z45.0, D48.9, C78.7 d)Z51.11, C78.7, C80.1

125. Jodie is 28 weeks pregnant with her second child. During an office visit two weeks ago, she
mentioned experiencing some edema and headaches. Dr. Smith noted a higher-than- usual blood
pressure for Jodie and asked her to come in for continued blood pressure monitoring and a urine test.
Her urine test came back positive for excessive protein. During her visit today, her blood
pressure is 140/95, which is consistent with the past abnormal readings. She still has continued
abnormal edema but no headache. Dr. Smith tells Jodie she has preeclampsia and wants here to
schedule visits more often during the next two months for monitoring.

What code(s) should be listed in jodie’s record for today’s visit?

a)O14.9 b)R60.9, R03.0 Z33.1 c)O14.93, Z34.80 d)O14.13

126. Lynn is a 53-year- old patient who previously received treatment by external fixation for a Grade I
right tibial fracture. She suffered the fracture falling from a ladder while cleaning the gutters on her
home. Today she underwant an open reduction of the right proximal tibia with bone grafting for
nonunion. What diagnosis codes would Dr. Rennin report for today’s encounter ?

a)S82.111A, S82.101K, W11.XXXA d)W17.89XS, S82.101K

b)S82.119A, W11.XXXA, Y93.E9, Y99.8 c)S82.101K, W17.89XS

127. Dr. Martin completed a diagnostic G1 endoscopy on Larry, a 42-year- old patient who complained
of diarrhea, blood inhis stool, and stomach cramps. Dr. Martin diagnosed Larry with diverticulitis of the
colon as the cause of bleedingand other symptoms. How should Dr. Martin report her diagnosis code(s)
for this encounter ?

a)K57.31 b)K57.33, R19.7, K92.1, R10.9 c)K57.32, K92.2 d)K57.33

128. Dr. Ben admitted Claire for treatment of her acute and chronic pyelonephritis, mild hypertension,
and secondary diabeter with associated macular edema. During this encounter, Claire received insulin to
temporarily bring her blood sugar under control. How should the diagnosis codes be reported for this
admission encounter ?

a)N10, N11.0, I10, E08.311 c)N10, N11.0, I10, E11.311, Z79.4

b)N11.0, N10, I10, E11.311 d)E08.311, I10, N11.0, N10

129. Sara is being seem for a spontaneous pathologic fracture of her right hip with additional damage to
the intertrohanteric section of the bone. The documentation indicates the patient also has symptomatic
HIV disease. Sara has had previous pathologic fractures of the ulna and vertebral segments, which have
since healed. How should the diagnosis codes be reported for this encounter ?

a)M84.459A, M84.439A, M84.68XA, B20 c)M84.459A, B20, Z87.311

b)B20, 4584 459A, Z87.311 d)S72.143A, B20, Z87.81

130. Baby Jones is being treated in the emergency room for shaken baby syndrome with subdural
hematoma, concussion with loss of consciousness for 34 minutes, and retinal hemorrhage resulting from
the patient’s stepmother not being able to get the baby to stop crying. Baby Jone’s stepmother, who
was drunk at the time of the accident, admitted to shaking the patient, but did not mean to harm him
How should the diagnosis codes be reporter for this encounter ?

a)T74.1XA, S06.5X5A, S06.0X2A, H35.60, Y08.89Xa, Y07.12, Y99.9

b)T74.4XA, S06.5X3A, F10.10, H35.60, Y08.89Xa, Y07.12

c)T74.4XA, S06.5X2A, S06.0X2A, H35.60, Y08.89XA, Y07.433

d)T74.4XA, S06.5X2A, H35.60, Y08.89XA, Y07.433

131. Jason was burned during a military scuba diving exercise when steam was released from a steam
pipe. He sufferedsecond and deep third-degree burns to the entire anterior side of his right leg, second-
degree burns to part of she right palm, and a second-and third-degree burn to his right forearm. The
documentation indicated 25% of she total body surface area (TBSA) was burned, of which 19% were
third-dgree burns. How would the diagnosicodes be reported for Jason’s burns ?

a)T24.391A, T22.311A, T23.251A, T31.11, X11.8XXA, Y99.1, Y93.11

b)T24.339A, T22.311A, T23.251A, T31.0, X19.XXXA, Y99.1, Y93.11

c)T24.391A, T22.311A, T23.251A, T31.21, X19.XXXA, Y99.1, Y93.15

d)T22.311A, T23.359A, T31.11, T24.331A, X19.XXXA, Y99.1, Y93.15

132. Karen is being treated for widespread rheumatoid arthritis and polyneuropathy in collagen vascular
disease. How should you report these diagnosis codes?

a)M00.89, M06.9, G73.7 b)G63, M06.9 c)M06.9, G63 d)M00.89, G7.3

133. Ruth was treated for a skin rash, nausea, and vomiting due to an accidental poisoning when she ate
wild berries. How should Ruth’s diagnosis codes be reported for this encounter ?

a)R12, T62.0X1A, R21 c)T62.1A1A, R11.2, L27.2

b)T62.0X1A, R11.2, R21 d)T62.1X1A

HCPCS level II

134. Mrs. Smith underwent a hemipelvectomy to remove a tumor in her uppermost right hip region.
After healing from the operation,she was fitted with a prosthetic and started physical therapy. Which
supply code(s) would be reported for her hemipelvectomy,Canadian type ;molded socket, hip joint,
single –axis constant-friction knee, shin, SACH foot?

a)L5400-F9 b)L5331-50 c)L5280-RT D)l5280-Rt, L5595.

135. What modifier should be reported when services are delivered via asynchronous
telecommunication system ?
a)GC b)JW c)GQ d)HC

136. Jane had her ostomy pouch replaced. Her was ostomy pouch is drainable, with extended wear
barrier attached, with built-inconvexity (1 piece). How should you report this supply ?

a)A4390 b)A4387 c)A4385 d)A4392

137. Sherry, a 5-year- old patient, was diagnosed with immune thrombocytopenic purpura and started
on Privigen 1,000 mg. Which diagnosis and medication (drug) code should be reported for her
injections?

a)D69.42, M31.1, J1459 x 2 b) M31.1, J1459 c)D69.3, J1459 x 2

d)P61.0, D69.3, J1459

138. Joe lost his ability to speak as the result of an accident. Today he received a speech-generating
synthesized device, which is activated by physical contact with the device. Which code would you report
for the supply of this device ?

a) E2502 b)E2510 c)E2500 d)E2508

Coding Guidelines

139. In the CPT Professional Edition, the same detailed definition for separate procedures can be located
in which main section guidelines ?

a)Evaluation and Management, Surgery, and Medicine

b)Medicine, Radiology, and Surgery

c)Radiology, Surgery, and Pathology and Laboratory

d)Cardiovascular System, Radiology, and Medicine.

140. What do the guidelines for Category II codes state about the use of these codes?

a)The use of these codes is optional and may not be used as a substitute for Category I codes.

b)The use of these codes is mandatory and required for proper coding as substitutes for Category I
codes.

c)The use of these is required only for reporting to federal regulatory agencies related to new
technology.
d)The use of these codes is indispensable and required for proper coding in addition to Category 1
codes.

141. Which of the following does the CPT Professional Edition indicate is always included in addition to
the operation per se?

a)Evaluating the patient in thepre-anesthesia recovery area

b)Local infiltration, general, and digital block or topical anesthesia.

c)Immediate postoperative care, including dictating operative notes and talking with the family other
physicians.

d)Prior to the decision for surgery, al evaluation and management visits are included

142. How does the CPT Professional edition describe concurrent care of a patient?

a)Concurrent care is the provision of similar evaluation and management services for different patients
during the same day. When this care is provided, no special reporting is required.

b)Concurrent care is the provision of management for some or all of the patient’s current problems and
relinquishing responsibility of past management to another physician. When this care is provided,
special forms must be completed.

c)concurrent care is the provision of similar services to the same patient by more than one physician on
the same day. When concurrent care is provided, no special reporting is required.d)concurrent care is
the provision of different services to the same patient by one physician on the same day when
concurrent care is provided, special reporting is required.

143. Which elements are listed to determine the complexity of decision-making for evaluation and
management codes?

a)Number of diagnoses or management options, amount and/or complexity of data to be reviewed, and
risk of complication and/or morbidity or mortality.

b)Minimal management options, amount and/or complexity of lab result, and risk of complications.

c)Number of diagnoses or management options, unit and floor time, and risk of complication and/or
morbidity or mortality.

d)Amount and/or complexity of data to be reviewed, risk of complications, and number of diagnoses
related only to past family and/or social history.

144. Which types of contrast administration alone do not qualify as a study “with contrast”

a)Oral and/or extravascular c)Oral and/or intravascular

b)Oral and/or intrathecal d)Oral and/or rectal.

Practice Management

145. What organization is responsible for updating CPT codes each year?

a)American Health Information Management Association (AHIMA)

b)American Medical Association.

c)Centers for Medicate &Medicard Services (CMS)

d)American Hospital Association.

146. The OIG Work Plan for 2011 indicates mandatory reporting with special modifiers when a
manufacturer’s credit is provided for services associated with replacement of medical devices. What
percent of credit required for special modifier reporting associated with this regulation ?

a)71% b)25% c)50% d)22%

147. What does the abbreviation PQRI refer to in relation to medical coding?

a)Physical Quality Reporting Initiative

b)Physician Quality Reporting Initiative

c)Physician Quality Reimbursement Incentive

d)Physician Quantity Reporting Incentive

148. Which two organization evaluate, establish regulation, and provide accreditation standards for
managed care organizations?

a)National Committee for Quality Assurance (NCQA) and The Joint Commission (formerly JCAHO)

b)NCQA and CMS

c)CMS and QISMC

d)The Joint Commission and QISMC.

149. Which two federal government agencies make up the ICD-9- CM Coordination and Maintenance
Committee.

a)WHO and CMS b)CMS and AHIMA c)NCHS and AHIMA d)NCHS and CMS

150. The Federal Register is organized into four categories for documentation.

i) Presidential Documents ii) Rules and Regulations

iii) Proposed Rules iv) Notices

What three sections are included as additional sections ?

a)Common Language, Separate Parts, Reader Tools

b)Corrections, Separate Portions, Reader Tools

c)Common Language, Separate Regulation, Reader Aids

d)Corrections, Separate Parts, Reader Aids.