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| Section | Weight | Objectives |
|---|---|---|
| HCPCS Level II | 5-10% | - Modifiers - Supplies and Equipment |
| Anatomy & Physiology | 10-15% | - Medical Terminology - Body Systems |
| Radiology | 5-10% | - Diagnostic Imaging |
| ICD-10-CM (Diagnosis Coding) | 10-15% | - Conventions and Guidelines - Code Selection |
| Surgery Coding | 40-50% | - Nervous System - Musculoskeletal System - Cardiovascular System - Genitourinary System - Respiratory System - Integumentary System - Digestive System |
| E/M (Evaluation and Management) | 10-15% | - Emergency Department - Office/Outpatient Visits |
| Medicine | 5-10% | - Specialty Coding |
| Laboratory / Pathology | 5-10% | - Organ and Disease Panels |
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NEW QUESTION # 200
A CRNA independently administers MAC anesthesia for ICD replacement.
What CPT and ICD-10-CM codes are reported?
Answer: A
Explanation:
00534 = Anesthesia for pacemaker/defibrillator procedures
QZ = CRNA without medical direction
QS = MAC anesthesia
I49.01 = Ventricular fibrillation
NEW QUESTION # 201
View MR 002395
MR 002395
Operative Report
Pre-operative Diagnosis: Acute rotator cuff tear
Post-operative Diagnosis: Acute rotator cuff tear, synovitis
Procedures:
1) Rotator cuff repair
2) Biceps Tenodesis
3) Claviculectomy
4) Coracoacromial ligament release
Indication: Rotator cuff injury of a 32-year-old male, sustained while playing soccer.
Findings: Complete tear of the right rotator cuff, synovitis, impingement.
Procedure: The patient was prepared for surgery and placed in left lateral decubitus position. Standard posterior arthroscopy portals were made followed by an anterior-superior portal. Diagnostic arthroscopy was performed. Significant synovitis was carefully debrided. There was a full-thickness upper 3rd subscapularis tear, which was repaired. The lesser tuberosity was debrided back to bleeding healthy bone and a Mitek 4.5 mm helix anchor was placed in the lesser tuberosity. Sutures were passed through the subcapulans in a combination of horizontal mattress and simple interrupted fashion and then tied. There was a partial-thickness tearing of the long head of the biceps. The biceps were released and then anchored in the intertubercular groove with a screw. There was a large anterior acromial spur with subacromial impingement. A CA ligament was released and acromioplasty was performed. Attention was then directed to the supraspinatus tendon tear. The tear was V-shaped and measured approximately 2.5 cm from anterior to posterior. Two Smith & Nephew PEEK anchors were used for the medial row utilizing Healicoil anchors.
Side-to-side stitches were placed. One set of suture tape from each of the medial anchors was then placed through a laterally placed Mitek helix PEEK knotless anchor which was fully inserted after tensioning the tapes. A solid repair was obtained. Next there were severe degenerative changes at the AC joint of approximately 8 to 10 mm. The distal clavicle was resected taking care to preserve the superior AC joint capsule. The shoulder was thoroughly lavaged. The instruments were removed and the incisions were closed in routine fashion. Sterile dressing was applied. The patient was transferred to recovery in stable condition.
What CPT coding is reported for this case?
Answer: D
Explanation:
* 29827: Arthroscopic rotator cuff repair is correctly coded as 29827.
* 29828: Arthroscopic biceps tenodesis is an additional procedure and should be coded as 29828 with modifier -51 (Multiple Procedures).
* 29824: Arthroscopic claviculectomy (partial resection of the distal clavicle) is coded as 29824 with modifier -51.
* 29826: Arthroscopic subacromial decompression, including coracoacromial ligament release, is coded as 29826.
* All these procedures were performed arthroscopically and documented in the operative report, justifying the use of these codes and the use of modifier -51 for multiple procedures.
References:
* CPT Professional Edition, AMA
NEW QUESTION # 202
A woman at 36-weeks gestation goes into labor with twins. Fetus 1 is an oblique position, and the decision is made to perform a cesarean section to deliver the twins. The obstetrician who delivered the twins, provided the antepartum care, and will provide the postpartum care.
What CPT coding is reported for the twin delivery?
Answer: C
Explanation:
* Cesarean Delivery with Antepartum and Postpartum Care: The procedure involved the cesarean section delivery of twins, including antepartum and postpartum care.
* CPT Code 59510: This code is used for routine obstetric care including antepartum care, cesarean delivery, and postpartum care. The code is not reported per fetus but per delivery, even when delivering multiples.
References:
* AMA's CPT Professional Edition (current year)
NEW QUESTION # 203
Preoperative diagnosis: Right thigh benign congenital hairy nevus. *1
Postoperative diagnosis: Right thigh benign congenital hairy 0 nevus.
Operation performed: Excision of right thigh benign congenital>1
nevus, excision size with margins 4.5 cm and closure size 5 cm.
Anesthesia: General.0
Intraoperative antibiotics: Ancef.0
Indications: The patient is a 5-year-old girl who presented with her parents for evaluation of her right thigh congenital nevus. It has been followed by pediatrics and thought to have changed over the past year. Family requested excision. They understood the risks involved, which included but were not limited to risks of general anesthesia, infection, bleeding, wound dehiscence, and poor scar formation. They understood the scar would likely widen as the child grows because of the location of it and because of the age of the patient. They consented to proceed.
Description of procedure: The patient was seen preoperatively in > I the holding area, identified, and then brought to the operating room. Once adequate general anesthesia had been induced, the patient's right thigh was prepped and draped in standard surgical fashion. An elliptical excision measuring 6 x 1.8 cm had been marked. This was injected with Lidocaine with epinephrine, total of 6 cc of 1% with 1:100,000. After an adequate amount of time, a #15 blade was used to sharply excise this full thickness.
This was passed to pathology for review. The wound required limited undermining in the deep subcutaneous plane on both sides for approximately 1.5 cm in order to allow mobilization of the skin for closure. The skin was then closed in a layered fashion using 3-0 Vicryl on the dermis and then 4-0 Monocryl running subcuticular in the skin, the wound was cleaned and dressed with Dermabond and Steri-Strips.
The patient was then cleaned and turned over to anesthesia for S extubation.
She was extubated successfully in the operating room and taken S to the recovery room in stable condition. There were no complications.
What E/M code is reported for this encounter?
Answer: A
Explanation:
Established patient with moderate MDM
99214 aligns with CPC exam standards
NEW QUESTION # 204
Patient is diagnosed with dacryocystitis, which is the inflammation of?
Answer: D
Explanation:
Dacryocystitis is the inflammation of the lacrimal sac, which is part of the tear drainage system located in the inner corner of the eye. The lacrimal sac is connected to the nasolacrimal duct, which drains tears into the nasal cavity. Inflammation in this area can cause pain, redness, and swelling near the inner corner of the eye.References: ICD-10-CM, medical dictionaries
NEW QUESTION # 205
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