Advanced Coding: Integumentary/Cardiovascular/Sensory Essay

1.   A 38-year-old patient is admitted to the hospital due to a lesion in her right breast, and a painful lump and nipple discharge from the left breast. The physician places a percutaneous needle localization device in the right breast under ultrasound guidance, excises the right breast lesion, and then excises the lactiferous duct fistula in the left breast. What CPT codes should be assigned?

   A. 19129-RT, 19284-RT, 19122-LT   B. 19125-RT, 19285-RT, 19112-LT   C. 19127-RT, 19283-RT, 19132-LT   D. 19122-RT, 19275-RT, 19142-LT
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2.   A 92-year-old female patient experiences difficulty hearing in her left ear. She is prescribed a BICROS hearing aid that she can wear behind the ear. What HCPCS code is assigned?

A. V5250   B. V5320   C. V5220   D. V5240

3.   A 57-year-old patient is admitted to the hospital for a hip arthroscopy procedure. The patient is a normal healthy patient with no systemic disease. What CPT code should be assigned?

A. 01612-P1   B. 01402-P1   C. 01202-P1   D. 01312-P1

4.   An 80-year-old patient is admitted to the hospital with congestive heart failure. What ICD-10-CM code should be assigned?

A. K15.0   B. L50.5   C. K52.9   D. I50.9

5.   A 44-year-old female patient comes to the hospital for removal of a 4 cm malignant lesion from the arm. During the course of the procedure, the patient undergoes a 14 sq. cm adjacent tissue transfer from the right leg, as well as a 20 sq. cm split-thickness skin graft from the left arm. What CPT codes are assigned?

A. 14021, 15100-51   B. 14045, 15400   C. 14032, 15207   D. 14044, 15350

6.   A patient has a breast localization device placed through the skin using stereotactic guidance in order to treat two lesions. What codes would be assigned?

A. 19285, 19286   B. 19287, 19288   C. 19283, 19284   D. 19296, 19297

7.   A 19-year-old patient is diagnosed with acne vulgaris. The physician performs laser dermabrasion of the facial skin. What codes are assigned?

A. L50.5, 0HB1XZZ   B. L70.0, 0HD1XZZ   C. L70.5, 0HA1XZZ   D. L70.6, 0HQ1XZZ

8.   Implantation of a patient-activated cardiac event recorder is assigned to code

A. 33286.   B. 33282.   C. 33285.   D. 33284.

9.   A 27-year-old patient is diagnosed with a chalazion on the upper left eyelid, which is excised using an external approach. What ICD-10 diagnosis and procedure codes are assigned?

A. H04.16, 08BQXZZ   B. H02.14, 08BTXZZ   C. H00.14, 08BPXZZ   D. H07.19, 08BRXZZ

10.   A 77-year-old patient is diagnosed with an ear infection. She receives an injection of 40 mg of gentamicin sulfate. What HCPCS code should be assigned?

A. J1452   B. J1472   C. J1675   D. J1580

11.   A patient undergoes a transcanal labyrinthectomy. What code would be assigned?

A. 69930   B. 69915   C. 69955   D. 69905

12.   A 92-year-old patient is diagnosed with senile cataracts and bilateral sensorineural hearing loss. The physician performs a bilateral cataract extraction. What ICD-10 codes are reported?

A. H27.9, H90.3, 08KJ3ZZ, 08MK3ZZ   B. H26.9, H90.3, 08EJ3ZZ, 08LK3ZZ   C. H25.9, H90.3, 08DJ3ZZ, 08DK3ZZ   D. H21.9, H90.3, 08PJ3ZZ, 08NK3ZZ

13.   Mr. Oliver is an elderly gentleman who has been having problems with his vision for the previous three weeks. He is diagnosed with keratoconus, as well as hypertension with stage III chronic kidney disease, and diabetes mellitus, for which he takes long-term insulin. The anesthesiologist provided general anesthesia for this patient with severe systemic disease. After the administration of anesthesia, the surgeon performs an endothelial keratoplasty. Prior to performing the endothelial keratoplasty, the surgeon performs backbench preparation of the allograft. Code this scenario (including the anesthesiology service).  Advanced Coding: Integumentary/Cardiovascular/Sensory Essay

A. 65756, 65757, 00144-P3; H18.609, E11.65, R46.89, Z79.4   B. 65754, 65727, 00134-P1; H18.609, E11.40, I12.9, N18.4, Z79.899   C. 65756, 65757, 00144-P3; H18.609, E11.9, I12.9, N18.3, Z79.4   D. 65757, 65787, 00142-P2; H18.229, E11.51, I12.0, N18.9

14.   A 47-year-old female patient is seen for a worrisome lesion on the back of her hand. What ICD-10-CM code should be assigned?

A. L94.9   B. L98.9   C. L91.5   D. L97.4

15.   Breast reconstruction with transverse rectus with a TRAM flap would be assigned to code

A. 19370.   B. 19342.   C. 19369.   D. 19316.

16.   Ms. Nelson comes to the emergency room due to sustaining multiple lacerations after being pushed into a glass door during a physical altercation with her husband at a hotel. She sustained a 5 cm laceration on her right hand and a 7 cm cut on her neck. She also has a 5.0 benign lesion removed from her left arm. The physician performs a simple repair on the lacerations on her hand and neck. Code this scenario.

A. 11443, 12008-59; S61.209A, S31.652A, Y04.0XXA, W45.8XXA, V97.29XA   B. 11422, 12007-59; S51.809A, S61.351A, W86.8XXA, Y04.0XXA   C. 11409, 12005-59; S58.119A, S11.22XA, X19.XXXA, V95.13XA   D. 11406, 12004-59; S61.401A, S11.90XA, Y04.0XXA, W45.8XXA, Y92.29

17.   Biopsy of the lacrimal gland is assigned to code

A. 68520.   B. 68811.   C. 68815.   D. 68510.

18.   A patient comes to the emergency room complaining of lightheadedness and difficulty hearing. The physician examines her and determines that she has Ménière’s disease. The physician performs an endolymphatic sac decompression (excision of the right inner ear using an open approach). What ICD-10 diagnosis and procedure codes are assigned?

A. H81.03, 09BF0ZZ   B. H83.03, 09BK0ZZ   C. H81.03, 09BD0ZZ   D. H82.03, 09BG0ZZ

19.   A physician performs a biopsy of the cornea. What code should be assigned?

A. 65420   B. 65410   C. 65419   D. 65415

20.   Injection of contrast medium for dacryocystography is assigned to code

A. 68853.   B. 68854.   C. 68850.   D. 68851.

Advanced Coding: Integumentary/Cardiovascular/Sensory Essay