COC 2020 Final Exam Study Questions - Set 2 (Complete Solutions, Answered)

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COC 2020 Final Exam Study Questions - Set 2 (Complete Solutions, Answered) A 7 year-old female was seen in the ED after being bit by a dog. The child received treatment for the bite to her left leg... . She also received a rabies vaccine because the dog was known to have rabies. What are the correct diagnosis codes for this patient encounter? S81.852A, Z20.3, Z23, W54.0XXA A 7 year-old is seen in the outpatient clinic. Blisters have appeared on the face, with some of them bursting open. After examination, the diagnosis is impetigo. What is the correct diagnosis code for this visit? L01.00 A 7 year-old patient with asthma was experiencing acute exacerbation of his condition. The parents rushed their son to the emergency department where the ED physician performed a midlevel E/M service. In addition, an albuterol treatment was performed. When the patient was stabilized, he was released in good condition to his parents. What modifier is appended to the E/M service for the facility? 25 A 70-year -old female patient presents with a complaint of left knee pain with weight bearing activities. She is also developing pain at rest. She denies any recent injury. There is pain with stair climbing and start up pain. AP, lateral and sunrise views of the left knee are ordered and interpreted. The diagnosis is left knee pain secondary to underlying primary degenerative arthritis. What ICD-10-CM code(s) is/are reported? M17.12 M17.12, A 70-year-old woman is evaluated in a clinic for symptoms of increasing claudication. After noninvasive vascular studies were performed, the decision was made to proceed with diagnostic angiography and possible angioplasty of the suspected left extern al iliac artery stenosis. After normal preparation for the angiography procedure, the left common femoral artery is punctured and the catheter is passed proximally into the left external iliac artery . Images were then taken and an 85 percent stenosis was noted. The decision was made to perform angioplasty. Using the Seldinger technique, the angiography catheter was removed and an angioplasty catheter with a balloon diameter of 8 mm was advanced into the left external iliac artery and into the lesion without difficulty. After two inflations to 8 mm, the follow-up angiography was performed and showed good flow across the lesion. Pressures measured confirm the adequacy of the therapy and that there is no residual gradient. 37220, 75710-59, 170.212 A 71 year-old patient presents to the outpatient clinic at the local hospital with COPD, congestive heart failure, and hypertension. After a comprehensive evaluation, the physician adjusts to the patient's hypertension medication due to the hypertension being uncontrolled. The patient's other conditions were stable. The patient is to follow-up in two weeks. What ICD-10-CM codes are reported? I11.0, I50.9, J44.9 A 72 year-old female sustained a left radius fracture, resulting in volar angulation, radial shortening and loss of radioulnar inclination. General anesthetic was administered. A standard dorsal central approach to the wrist was made. The capsule was opened in a T fashion and the malunion site was identified. A series of osteotomes was utilized to open the fracture site and the normal distal radial architecture was restored. The pie-plate was placed on the distal radius utilizing a combination of 2.0 and 1.8 screws and threaded pins for the distal segment and 2.7 screws proximally. Fragments were secured, and Norian SRS was packed into the defect and allowed to harden. With this completed, the wounds were copiously irrigated with normal saline. Soft tissue was closed over the plate and distal radius secured with 2-0 Vicryl. What CPT ® code is reported? 25400-LT A 74 year-old male Medicare patient was admitted to a trauma center ED. The ambulance personnel notified the trauma center of expected time of arrival and gave pertinent information on the patient's condition. Upon arrival the patient was examined immediately by the ED physician. 2 hours and 40 minutes of critical care were provided before the patient was transferred to another hospital for his head injury. In addition to critical care services the following services were performed: intubation (31500), EKG (93005), chest X-ray (71045), CT of cervical spine without contrast (72125), and CT of the head without contrast (70450). The critical care did not include time for the procedures provided. Report the facility services. G0390, 99291-25, 99292-25 x 3, 31500, 93005, 71045, 72125, 70450 A 74 year-old man was admitted by ambulance to a rural hospital ED with severe shortness of breath. Soon after admission the patient went into cardiac arrest. The ED physician intubated the patient and he was placed on a ventilator. Critical care time was 65 minutes and the intubation (31500) was not included in the critical care time. EKG (93005), chest X-ray (71045), and blood gases (82803) were performed. The patient with known congestive heart failure was then transferred to a cardiac facility for acute hypertensive heart failure with pulmonary edema. Report the facility ED services and the ICD-10-CM code(s). 99291-25, 31500, 93005, 71045, 82803, I11.0, I50.1, 146.2 A 75 year-old male who is five days post-coronary bypass grafting, presents today to the Emergency Department with an acute MI. He has no prior history of MIs. In the hospital's cardiac catheterization unit, a cardiac catheterization reveals a fresh thrombus in the saphenous vein graft. PTCA is performed in addition to removal of the thrombus by aspiration. What are the correct CPT ® and ICD-10-CM codes for the procedure? 92941, T82.868A, I21.3, Z95.1 A 75 year-old Medicare patient with type I diabetes was admitted to the ED in a diabetic coma from a pump breakdown, in which he received too much insulin. He was treated in the ED and critical care time for the facility was 70 minutes. The patient was transferred to Observation for 8 hours prior to discharge. Report the facility charge and the diagnoses. 99291, G0378 x 8, T85.614A, T38.3X1A, E10.641 A 78 year-old female patient suffering from rheumatic arthritis and myopathy presents to the clinic's physical therapy department for 30 minutes of ultrasound treatments to the right hand with the physical therapist in continual attendance. What CPT ® and ICD-10-CM codes are reported for this service? 97035 x 2, M05.441 A benign lesion of the trunk measures 1.0 cm and the margin required to adequately excise the lesion includes 0.2 cm on both sides for a total margin of 0.4 cm. Provide the correct CPT® code(s). 11402 A cardiologist performed a transluminal atherectomy on the right femoral artery and the right popliteal vessel by percutaneous approach from the left femoral artery. Report the CPT code(s). 37225-RT A character's position can be understood as which type of classification that allows different specific values to be inserted into that space, and whose physical position remains stable? Semi-independent A child is seen in a hospital-based pediatric clinic for treatment of a first- and second-degree burn to the calf area of the right leg. What are the correct diagnosis codes for this patient encounter? T24.231A, T31.0 A child was admitted for an obstructed airway. The physician scheduled a flexible laryngoscopy. Finding nothing, he progressed to the trachea, then to the bronchial tubes. A biopsy was taken for an abnormal bronchial lesion and a lodged tiny Lego toy was found and removed. What CPT ® and ICD-10-CM codes are reported? 31635, 31625, T17.908A, J98.09 A child was seen in the hospital's pediatric clinic for an 18-month examination and immunization injections. An examination revealed an ear infection; therefore, no immunizations were given at that time. One month later, the child returned for a Hib, PRP-T vaccine. No other services were rendered. The nurse practitioner in the clinic counseled the parents on side effects and provided an information sheet on the vaccine. What CPT ® and ICD-10-CM codes are reported by the facility? 90471, 90648, Z23 A choledochal cyst is a cyst originating from which structure? Common bile duct A code from categories Q00-Q99 can be used until the patient reaches what age? Refer to ICD-10-CM guideline I.C.17. • They can be used throughout the life of the patient unless it has been corrected. A colonoscopy is performed on a Medicare patient for guaiac positive stools. An area of ulceration is noted in the igmoid region and the physician performs a biopsy. The excision of tissue causes bleeding which was controlled endoscop1cally with bipolar cautery. What CPT code is reported? 45380 A condition where the thyroid is overactive is called: Thyrotoxicosis A construction worker who was welding without goggles had a piece of metal embedded in the right eye. The patient was rushed to the emergency department where the ER physician examined the patient and provided a midlevel evaluation and management service. The ER E/M service was determined to be 99282. The ophthalmologist on call examined the patient and determined the foreign body would need to be removed surgically. Because the metal shaving was imbedded, the physician using a slit lamp, made a V shaped incision to penetrate the conjunctiva. The metal shaving was removed and the physician applied an antibiotic to the eye with a pressure patch over the lid. The patient was advised to visit the ophthalmology clinic the next day. Provide the facility CPT ® codes for the surgical service. 99282-25, 65210-RT A couple with inability to conceive has fertility testing. The semen specimen is tested for volume, count motility and a differential is calculated. The findings indicate infertility due to oligospermia. What CPT® and ICD-10-CM codes are reported by the facility? 89320, N46.11 A critical access hospital is: Answer: A facility in a rural area used for hospital inpatient stays, inpatient rehabilitation and psychiatric services, which also offers emergency services Rationale: Medicare beneficiaries in rural areas can receive services from critical access hospitals. CAHs offer 24-hour emergency services seven days a week, hospital inpatient stays, inpatient rehabilitation, and psychiatric services. A CT of the cervical spine C1-C4 was performed in the outpatient department of the hospital using contrast. What CPT® code is reported for the facility? 72126 [Show More]

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