COC 2020 Final Exam Study Questions - Set 1 (Complete Solutions, Answered)

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COC 2020 Final Exam Study Questions - Set 1 (Complete Solutions, Answered) 14 year-old status post injury over one year ago to her left wrist presented with recurrent wrist pain. The patient was tak... en to the operating room and placed under general anesthesia. She was placed in wrist traction. The radiocarpal joint was entered endoscopically through sharp skin incisions and blunt dissection into the joint. There was found to be mild synovitis in the dorsal ulnar aspect of the wrist. This was debrided arthroscopically with a shaver. There was a peripheral tear of the triangular fibrocartilage. This area was shaved to promote healing. Using outside in technique, a PDS suture was placed across the TFCC and into the capsule. There was synovitis within the midcarpal joint, but there was no articular injury. All instruments were removed and the wounds were closed with interrupted nylon sutures. What CPT ® code is reported? 29846-LT 44-year-old male with biplanar deformity, acquired limb length discrepancies and tibial nonunion has undergone deformity correction. He now requires exchange of an external fixation strut 45 days postoperatively. The intraoperative mounting parameters, deformity parameters, and initial strut settings are inserted into the computer prior to Jim's discharge and a daily schedule is generated for him to perform the gradual deformity correction necessary. What CPT® code(s) should be reported? 20697 56 year-old pro golfer is having Mohs micrographic surgery for skin cancer on his forehead. The surgeon takes him back for two stages. The first stage has 4 tissue blocks and the second stage has 6 tissue blocks. What is the best way to code for both stages? 17311, 17312, 17315 66 year-old male with a history of anemia presents for a liver core biopsy to evaluate for possible cirrhosis. The patient was brought to the CAT scan suite in which limited CT images of the upper abdomen were performed for biopsy needle placement. The appropriate site for the liver core biopsy was chosen. The patient's skin was then marked with the computer coordinates. An 18-gauge needle was advanced into the appropriate site and a sample was obtained. What CPT ® codes are reported for the facility? 47000, 77012 A must include cholesterol, serum total (82465), Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718), and Triglycerides (84478) Lipid Panel (80061) A patient presents to the hospital-based outpatient surgery department for a left knee medial meniscus repair. She had recurrent locking, swelling and catching of the knee. A diagnostic arthroscopy was performed. Under direct visualization, a medial portal was established and debridement of the posterior horn of the medial meniscus was performed. A shaver was then introduced to trim the meniscus back to a stable rim. The remainder of the knee was probed. The scope was then withdrawn and the wound was closed with #4-0 Vicryl. The discharge diagnosis was a bucket-handle tear of the medial meniscus. The patient tolerated the procedure well. What are the correct procedure and diagnosis codes for this encounter? 29881, S83.212A A 12 year-old child presents to the ED with an acute exacerbation of asthma. The patient is wheezing and is having difficulty breathing. She is not responding to the therapy. The physician documents as the final diagnosis asthma with status asthmaticus. What ICD-10-CM code(s) is/are reported? J45.902 A 12 year-old's diabetes mellitus is well controlled with oral antidiabetic medications . The patient has no complications. Applying the coding concept from ICD-10-CM guidelines I.C.4.a.l, I.C.4.a.2, and I.C.4.a.3, what ICD-10-CM code(s) is/are reported? E11.9, Z79.84 A 13 year-old is seen in the emergency department with a sudden onset of nausea, fever and diarrhea. A stool culture indicated Salmonella bacterium. The patient stated that she had been at a family reunion and recalls eating some salad, ice-cream and chicken. Diagnosis made was salmonella gastroenteritis. Report the diagnosis code(s) for the visit. A02.0 A 14-year-old male is brought to the ER by his parents after hitting his left knee on the base when sliding into base at a baseball game in a public park. After X-rays were obtained, it revealed a sprain to the knee. The patient was instructed to keep his leg elevated and keep weight off of it as much as possible for the next two weeks. What diagnosis codes are reported for this encounter? S83.92XA, W21.89XA, Y92.830, Y93.64 A 15 year old female undergoing treatment for Hodgkin's lymphoma presents to the behavioral health clinic to be evaluated for increasing acute panic attacks during her cancer treatments. The psychologist spent 1 hour and 15 minutes face-to-face with the patient. The patient was diagnosed with adjustment disorder with anxiety and a treatment plan was initiated. She will be seen for a reassessment in 30 days. What are the correct CPT ® and ICD-10-CM codes to report this service? 96150 x 5, F43.22, C81.90 A 15 year-old has been taken to surgery for crushing his index and middle fingers, injuring his digital nerves of the left hand. The physician located the damaged nerves in both fingers and sutures them to restore sensory function. What CPT® and ICD-10-CM codes are reported? 64831-LT, 64832-LT, S64.491A, S64.493A A 16 year-old male is brought to the ED by his mother. He was riding his bicycle in the park when he fell off the bike. The patient's right arm is painful to touch, discolored, and swollen. The X-ray shows a closed fracture of the ulna. What ICD-10-CM codes are reported? S52.201A, V18.0XXA, Y92.830 A 19 year-old female is seen in the hospital-based outpatient department for surgical implantation of birth control. Once prepped and draped, the surgeon makes a small incision in the skin on the inside of the patient's left upper arm. Using a trocar, six 3.0 cm Norplant II (Levonorgestrel) capsules are implanted subdermally. After all capsules were placed, the incision was closed with a simple repair. What are the correct procedure and diagnosis codes for this encounter? 11981, J7306, Z30.017 A 2 month-old is seeing his pediatrician for a routine health check examination. The physician notices a diaper rash and prescribes an ointment to treat it. What ICD-10-CM code(s) is/are reported? Z00.121, L22 A 2 year-old girl is brought to the ED. She is pulling on her ears. After examination, the ED physician determines the patient has acute serousotitis media in both ears. What diagnosis is reported? H65.03 A 21 year-old male is brought into the ED by his father who states that his son is dizzy and has anxiety. The ED provider runs a drug screen test and the test comes back positive for marijuana use. The final diagnosis is documented as marijuana abuse with anxiety disorder. What ICD-10-CM code is reported? F12.180 A 22 year-old female is admitted to ICU for acute renal (kidney) failure due to sepsis (causal organism unknown). Applying the coding concept from ICD-10-CM guideline I.C.l.d.l.b, what ICD-10-CM codes are reported (in the correct sequencing)? A41.9, R65.20, Nl7.9 A 22 year-old female has a retained Kirschner wire in the left little finger. Using local anesthesia, the left upper extremity was thoroughly cleansed with Betadine. The end portion of the little finger was opened by a transverse incision through the subcutaneous tissue to the bone. The retained Kirschner wire was located within the distal phalanx. It was removed and closed with sutures. What CPT ® code is reported? 20680-F4 A 22 year-old female suffered a 10-cm laceration on her cheek, a 4-cm laceration on her chin, and a 9-cm laceration on the dorsum of her right hand when she slipped on loose pavement while riding her bicycle. All lacerations were contaminated with dirt and gravel and required cleansing with debridement and copious saline irrigation before layered closure. How should this be coded? 13132, 13133 x 4 A 22 year-old is in an outpatient facility for an inguinal hernia repair. Just before surgery, the surgeon discovers the patient is positive for MRSA and the surgery is canceled. Which ICD-10-CM code(s) should be reported for the outpatient service? K40.90, A49.02, Z53.09 A 22 year-old is taken to the ED by her husband. She is in her 16th week of pregnancy and is experiencing dizziness and swelling in the hands and feet. The ED physician performs a detailed history and examination. Final assessment is mild preeclampsia with edema. She is instructed to follow-up with her OB physician tomorrow. What diagnosis and CPT codes are reported for this mid-level visit? 99283, O14.02, Z3A.16 A 24 year-old woman developed a keloid scar as a result of a third degree burn on the left upper arm. What ICD-10-CM code(s) is/are reported? L91.0, T22.332S A 25 year-old female presents to the same day surgery unit for the removal of a dislodged plastic biliary stent. The esophagogastroduodenoscope was inserted in the posterior oropharynx. The previously placed stent, which is now dislodged was identified in the upper duodenum and was removed with a polypectomy snare. What CPT® code is reported for the procedure? 43247 A 26 year-old female with a one-year history of a left tympanic membrane perforation has consented to have it repaired. A postauricular incision was made under general anesthesia. Dissection was carried down to the temporalis fascia and a 3 x 3 cm segment of fascia was harvested and satisfactorily desiccated. The tympanic membrane was excised. Using a high-speed drill, a canaloplasty was performed until the entire annulus could be seen. The ossicular chain was examined, it was found to be freely mobile. The previously harvested skin was trimmed and placed in the anterior canal angle with a slight overlapping over the temporalis fascia. Packing is placed in the ear canal, external incisions are closed, and dressings are applied. What CPT ® code is reported? 69631-LT A 26 year-old male patient with left lower-lobe bronchial cancer has an obstructed bronchus in the left lower lobe of the lung. Airway is viewed using a flexible bronchoscope introduced through the oral airway, following administration of conscious sedation. Fluoroscopic guidance assists in identifying the obstruction. A laser probe is introduced through the scope to eradicate and relieve the tumor obstruction. What CPT ® and ICD-10-CM codes are reported? [Show More]

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