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NEW QUESTION # 82
Multiple laceration repairs were performed:
Simple: cheek (2.5 cm), nose (3 cm)
Intermediate: left leg (9 cm), right leg (11.5 cm)
Complex: left upper arm (4 cm)
What CPT codes are reported?
Answer: B
Explanation:
Complex (arm, 4 cm) → 13121
Intermediate legs total = 20.5 cm → 12036
Simple face closures coded separately:
12013 (cheek)
12011 (nose)
Modifiers allow separate anatomical reporting.
Correct answer: A
NEW QUESTION # 83
A 55-year-old patient was recently diagnosed with an enlarged goiter. It has been two years since her last visit to the endocrinologist. A new doctor in the exact same specialty group will be examining her. The physician performs a medically appropriate history and exam. The provider reviewed the TSH results and ultrasound.
The provider orders a fine needle aspiration biopsy which is a minor procedure.
What E/M code is reported?
Answer: C
Explanation:
The patient is seeing a new doctor in the same specialty group for an enlarged goiter and is undergoing a medically appropriate history and exam, along with a fine needle aspiration biopsy.
* Procedure Description:
* Medically appropriate history and exam.
* Review of TSH results and ultrasound.
* Ordering of fine needle aspiration biopsy.
* CPT Coding:
* 99202: Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making.
Since it has been two years since the last visit and the patient is being seen by a new doctor in the same specialty group, the encounter is considered a new patient visit.
References:
* AMA's CPT Professional Edition (current year).
* CPT Assistant for detailed coding guidelines on evaluation and management services.
NEW QUESTION # 84
According to the ICD-10-CM Guidelines, what code is reported as an additional code when the blood pressure of a patient with hypertension remains above goal in spite of the use of antihypertensive medications?
Answer: C
Explanation:
According to ICD-10-CM Guidelines, I11A.0 (Resistant hypertension) is used to indicate hypertension that remains uncontrolled despite the use of multiple antihypertensive medications. Resistant hypertension is coded to highlight the severity of the patient's condition and the difficulty in managing their blood pressure.
This code is added as a secondary code to reflect the persistent elevation of blood pressure despite medication.
A: I10 (Essential hypertension) is a general code for primary hypertension but does not specify resistance to treatment.
B: A code from category I27 is related to pulmonary heart diseases, not directly related to hypertension management issues.
D: A code from category I16 (Hypertensive crisis) is used for hypertensive emergencies or urgencies, which are acute episodes, not persistent uncontrolled hypertension despite treatment.
Thus, the correct answer is C. I11A.0, Resistant hypertension.
NEW QUESTION # 85
(Full Case:Preoperative diagnosis:Recurrent dysphagia.Postoperative diagnosis:Hiatal hernia with obstruction.
Procedure:EGD with dilation.Consent:PAR conference; informed consent signed; premedication given.
Position/monitoring:left lateral decubitus; monitored with BP cuff and pulse oximeter throughout.Topical:
Hurricaine spray to posterior pharynx.Scope passage:flexible endoscope passed under direct visualization through cricopharyngeus into esophagus; advanced with identification of EG junction into stomach; rugal folds visualized; advanced to antrum/pylorus; pylorus cannulated; duodenal bulb and second portion visualized; retroflexed views of cardia/fundus/lesser curvature.Dilation technique:guidewire placed in antrum; scope removed; wire positioned by markings;#14 French dilatorpassed into stomach area;esophageal dilation performed over guidewire.Findings:tortuous/shortened esophagus; large sliding hiatal hernia; EG junction
~30 cm; stomach abnormal with very large sliding hiatal hernia; duodenum normal.Question:What CPT coding is reported?)
Answer: C
Explanation:
The documented service is an upper GI endoscopy (EGD) withesophageal dilationperformed using aguidewireand a passed dilator ("dilation performed over the guidewire"). In CPT, when a therapeutic endoscopic service is performed, you report thetherapeutic EGD code, not the separate diagnostic EGD code, because diagnostic visualization is inherent in performing the therapeutic procedure. Therefore,43235 (diagnostic EGD) is not additionally reported. The key distinction between the dilation codes offered is the method:43248describes EGD withesophageal dilation using a guidewire technique(bougie/dilator passed over a guidewire), which matches the narrative: guidewire placed in the antrum, scope removed, and a dilator passedover the guidewireinto the stomach area. Code43249generally reflects balloon dilation of the esophagus performed endoscopically; the note does not describe balloon inflation, diameter, or balloon equipment. The hiatal hernia findings and dysphagia indication support medical necessity but do not change code selection. Thus, the correct CPT code is43248alone.
NEW QUESTION # 86
View MR 001394
MR 001394
Operative Report
Procedure: Excision of 11 cm back lesion with rotation flap repair.
Preoperative Diagnosis: Basal cell carcinoma
Postoperative Diagnosis: Same
Anesthesia: 1% Xylocaine solution with epinephrine warmed and buffered and injected slowly through a 30-gauge needle for the patient's comfort.
Location: Back
Size of Excision: 11 cm
Estimated Blood Loss: Minimal
Complications: None
Specimen: Sent to the lab in saline for frozen section margin control.
Procedure: The patient was taken to our surgical suite, placed in a comfortable position, prepped and draped, and locally anesthetized in the usual sterile fashion. A #15 scalpel blade was used to excise the basal cell carcinoma plus a margin of normal skin in a circular fashion in the natural relaxed skin tension lines as much as possible The lesion was removed full thickness including epidermis, dermis, and partial thickness subcutaneous tissues. The wound was then spot electro desiccated for hemorrhage control. The specimen was sent to the lab on saline for frozen section.
Rotation flap repair of defect created by foil thickness frozen section excision of basal cell carcinoma of the back. We were able to devise a 12 sq cm flap and advance it using rotation flap closure technique. This will prevent infection, dehiscence, and help reconstruct the area to approximate the situation as it was prior to surgical excision diminishing the risk of significant pain and distortion of the anatomy in the area. This was advanced medially to close the defect with 5 0 Vicryl and 6-0 Prolene stitches.
What CPT coding is reported for this case?
Answer: B
NEW QUESTION # 87
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