COC 2020 Final Exam Study Questions - Set 3 (Complete Solutions, Answered)

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COC 2020 Final Exam Study Questions - Set 3 (Complete Solutions, Answered) A patient is diagnosed with pressure ulcers on each heel. Each heel displays bone involvement with evidence of necrosis and... is identified as stage 4. Select the diagnosis code(s): L89.614,L89.624 A patient is given Xylocaine, a local anesthetic, by injection in the thigh above the site to be biopsied. A small bore needle is then introduced into the muscle, about 3 inches deep, and a muscle biopsy is taken. What CPT code is reported for this service? 20206 A patient is having a decompression of the nerve root involving two segments of the lumbar spine via transpedicular approach. Report the CPT® code(s). 63056, 63057 A patient is having phacoemulsification ofan age-related nuclear cataract of the left eye. What ICD-10-CM code is reported? H25.12 A patient is having surgery to repair a recurrent left inguinal hernia without obstruction. What ICD-10-CM code is reported? K40.91 A patient is in outpatient surgery for a laparoscopic oophorectomy for a right ovarian cyst. After admission, the anesthesiologist discovered the patient had an upper respiratory infection and the surgery was cancelled. Applying the coding concept from ICD-10-CM guideline IV.A.I, what is the appropriate ICD-10-CM code selection? N83.201, J06.9, Z53.09 A patient is in the hospital for a hysterosalpingogram due to her infertility for 10 years. She has no history of pelvic infection or surgery. A 5-F hysterosalpingogram catheter was used. The catheter balloon was inflated in the lower uterine segment. Contrast was administered through the catheter and multiple images were taken. Findings were possible right cornual contour abnormality manifested by focal extravasation and minimal intravasation of undetermined etiology. Recommend endovaginal ultrasound for further evaluation. What are the CPT ® and ICD-10-CM codes reported? 58340, 74740, N97.9 A patient is in the outpatient radiology department of the hospital for an MRI of the brain to rule out stroke. His symptoms are slurred speech and headache. The ventricles and sulci are seen within the brain. There is no evidence of space-occupying lesion or intracranial hemorrhage. No abnormal extra-axial cerebral fluid collections are identified. Diffusion weighting imaging shows no abnormality. Impression is negative. What CPT ® and ICD-10-CM codes are reported by the facility? 70551, R47.81, R51 A patient is receiving pain management treatment for chronic cervical pain caused by a motor vehicle accident. Report the ICD-10-CM code(s). G89.21, M54.2, V49.9XXA A patient is referred to the hospital radiology clinic for numbness and tingling in the arms. The radiologist performs a Doppler analog waveform analysis, a volume plethysmography and a flow velocity signal of the arteries of both arms. What procedure and diagnosis codes are reported for the facility services? 93922, R20.0, R20.2 A patient is respirator dependent and has a tracheostomy in need of revision due to redundant scar tissue formation surrounding the site. Under general anesthesia and establishing the airway to maintain ventilation, the scar tissue is resected and then repair is accomplished using a layered closure. What CPT ® and ICD-10-CM codes are reported? 31830, L90.5, Z43.0, Z99.11 A patient is scheduled for closure of a cystostomy. The patient has a personal history of bladder carcinoma. After removing the sutures that secured the cystostomy tube to the skin and bladder, the surgeon removed the cystostomy tube and sutured the bladder musculature to repair the opening. The physician placed a drain tube, brought it out through a separate stab incision in the skin, and performed a layered closure. What CPT ® and ICD-10-CM codes are reported? 51880, Z43.5, Z85.51 A patient is seen in the outpatient clinic for pain and the physician gives a series of 6 injections for the following muscles on the right side of the back: the rhomboid (1), trapezius (3), and latissimus dorsi (2). Report the CPT® code(s) for the trigger point injections. 20553 A patient is seen in the emergency department to treat a second-degree burn to his right arm (9 percent) and third-degree burns on his chest and left arm (25 percent). Select the diagnosis codes. T21.31XA, T22.30XA, T22.20XA, T31.32 A patient is seen in the hospital outpatient surgery department for anal fistula repair. The surgeon first explores the anal canal and identifies the location of the fistula. The fistula tract is then excised. The perianal skin is incised and a wedge of skin and subcutaneous tissue is mobilized and advanced into the defect that was created by the excision of the fistula. The incisions are closed with sutures. What are the correct procedure and diagnosis codes for this encounter? 46288, K60.3 A patient is seen in the hospital outpatient surgery department for anorectal fistula repair. The surgeon first explores the anal canal and identifies the location of the fistula. The fistula tract is then thoroughly irrigated. A fistula plug was introduced through the fistula tract ensuring that the plug completely occludes the internal fistula opening. The plug was trimmed to insure a flush fit with the mucosal wall and absorbable sutures were used to secure the plug into place. What CPT® code is reported for the procedure? 46707 A patient is seen in the outpatient clinic for follow-up on hypertension. He also has CKD stage 3. The Pts blood pressure is stable at 138/88. The doctor instructs the Pt to continue with the same doses of Vorvasc. He also writes a script for blood work to be drawn at lab:CBC, BMP. I12.9, N18.3 A patient is seen in the outpatient GI lab of the hospital for a screening colonoscopy. A colonoscopy revealed three polyps in the transverse colon. The polyps were removed by snare technique. What are the procedure and diagnosis codes for this procedure? 45385, Z12.11, D12.3 A patient is sent to the hospital for a bone marrow needle biopsy. The specimen is sent to the lab in the hospital for interpretation. The diagnosis is thrombocytopenia. What CPT ® and ICD-10-CM codes are reported by the facility? 38221, 88305, D69.6 A patient presented to outpatient radiology with a 90% lesion of the right iliac, and 85% lesion in the right popliteal artery. From a right femoral artery access, atherectomy was performed in the iliac artery, and angioplasty followed by stent placement was performed in the popliteal artery. What CPT ® codes are reported? 0238T-RT, 37226-RT A patient presented to the ED with an apparent acute MI. He is immediately taken to the cardiac cath lab where diagnostic coronary angiography with left ventriculography was performed. There was an acute total occlusion of the first diagonal of the LAD, and 80% stenosis of the left main coronary artery and 75% stenosis of the proximal left anterior descending coronary artery. The decision was made to stent the left main coronary artery, and the proximal LD. Aspiration thrombectomy was performed in the first diagonal of the LD and a stent was placed. IVUS was used in the diagonal to confirm adequate stent expansion. What CPT ® codes are reported? 93458-59, 92941-LD, 92928-LM, 92978 A patient presented to the emergency department with complaint of left wrist pain due to an imbedded foreign body (thorn entered while trimming bushes, at home, in his backyard). The provider incises the area and dissects the tissue to locate the thorn. The thorn was located deep in the tissues of the wrist. The emergency department physician proceeded to remove the thorn without complication and performs a layered closure. Code this scenario. 25248, S61.542A, W45.8XXA, Y92.017, Y93.H2 A patient presented to the emergency department with second degree burns to both forearms, which makes up 9 percent TBSA (Total Body Surface Area). She is three months pregnant, 12 weeks. The burns are not affecting the pregnancy. Select the diagnosis codes. T22.212A, T22.211A, T31.0, Z33.1 A patient presented to the hospital outpatient facility for chemotherapy for breast cancer. Report only the infusion services. Do not report the drugs. (Hydratione per protocol/500cc/10:00AM-11:00AM; Taxol 35 mg/11:00AM-12:45PM;Decadron 10 mg;10:45-11:15 IV drip concurrent; Aloxi 250 mcg/10:45-11:15 mixed w/Decadron in concurrent IV drip) 96413, 96415, 96368, 96361-59 A patient presented to the hospital outpatient pulmonary clinic for asthma follow-up. During the encounter, the physician performed an expanded problem focused history and exam with moderate decision making for this established patient. The documentation supported a low-level E/M for the facility. Later in the evening, the patient suffered an acute asthma attack and went to the ER in the same hospital for treatment. What modifier is used to indicate multiple E/M services occurred on the same date? 27 A patient presented with a right ankle fracture. After induction of general anesthesia, the right leg was elevated and draped in the usual manner for surgery. A longitudinal incision was made parallel and posterior to the fibula. It was curved anteriorly to its distal end. The skin flap was developed and retracted anteriorly. The distal fibula fracture was then reduced and held with reduction forceps. A lag screw was inserted from anterior to posterior across the fracture. A 5-hole 1/3 tubular plate was then applied to the lateral contours of the fibula with cortical and cancellous bone screws. Final radiographs showed restoration of the fibula. The wound was irrigated and closed with suture and staples on the skin. Sterile dressing was applied followed by a posterior splint. What CPT code is reported? 27792-RT A patient presents for a liver transplant. The provider documents the patient has Laennec's cirrhosis associated with long term alcohol dependent use. What are the diagnosis codes for this encounter? K70.30, FI0.20 A patient presents to the hospital-based ambulatory surgery center for skin grafts due to previous third-degree burns on the abdomen. Burn eschar is removed from the abdomen and the defect size at that time measured 10 cm x 10 cm. An acellular dermal allograft from a donor bank was placed on the defect and sewn into place. What are the correct procedure codes for this service? 15002, 15273 A patient presents to her physician and tells him she drinks each night when she gets home from work. She asks her physician to recommend an alcohol treatment center because her life has become unmanageable and she wishes to quit drinking. The patient is diagnosed with uncomplicated alcohol dependence. Select the diagnosis code. F10.20 A patient presents to outpatient surgery department for freeing of intestinal adhesions to correct an internal hernia. Documentation states that under anesthesia, the surgeon placed a trocar at the umbilicus into the abdominal cavity and insufflated the area. A laparoscope was placed through the umbilical incision and additional trocars were placed. Intestinal adhesions were identified tangled with a loop of small bowel. Dissection and gentle removal of the adhesions were performed releasing the small internal hernia showing viable pink bowel. The trocars were removed and the incision was closed with sutures. What CPT® code is reported for the procedure? 44180 A patient presents to the ambulatory surgery center at the local hospital with a diagnosis of left ureteral stones. After being prepped and draped, the surgeon examines the urinary collecting system with a cystourethroscope that was passed through the urethra and into bladder. The surgeon inserts a special instrument through the cystourethroscope to manipulate the calculi found in the ureter. The stones are not removed. The surgeon then inserts a ureteral stent and removes the cystourethroscope. No complications were noted. What CPT ® and ICD-10-CM codes are reported? 52330-LT, 52332-LT, N20.1 A patient presents to the ASC for a scheduled dilation of the esophagus. After being prepped and draped, anesthesia was administered. An unguided dilator is used. The surgeon passes the dilator into the patient's throat down into the esophagus until the end of the dilator passes the stricture. The dilator is withdrawn after it passes the stricture. As the surgeon prepares to insert the dilator again, the patient begins to seize on the operating table. The procedure is terminated and the patient stabilized before being sent to recovery in stable condition. What are the correct procedure and diagnosis codes for this encounter? 43450-74, K22.2, R56.9 A patient presents to the ED with puncture wounds on the right forearm from a dog bite. The dog was not wearing a collar. The ED physician cleans the wound, gives a rabies vaccination in the deltoid region (IM), and administers human rabies immunoglobulin (RIg) IM. The ED visit is a mid-level visit. What CPT® and ICD-10-CM codes are reported by the facility? [Show More]

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