CS-7638 Midterm Actual Exam Newest
With Complete Questions And Correct
Detailed Answers| Brand New Version!
Since the laceration was specified as intermediate, a code from repair/closure,
intermediate is assigned based on location (leg) and size 6.0 cm. CPT code 12032
covers intermediate repairs/closures of the leg 2.5-7.0 cm. The remaining selections
represent simple repairs or repairs to anatomical areas or sizes that are not represented
in this scenario.
Left and right mammogram for benign fibrocystic breast disease
a. 77047
b. 77046-RT-LT
c. 77066
d. 77065
c. 77066
Diagnostic mammogram code 77066 is already bilateral, therefore, there is no need for
modifier -50. The remaining selections are for unilateral diagnostic mammogram or an
MRI of the breast and, therefore, are not correct in this instance.
Topical tetracaine was applied along with YAG capsulotomy lens for left cataract
extraction. Good visualization of posterior capsular opacification was obtained and a
total of 41 shots at 2 millijoules were utilized to open the posterior capsule.
a. 66820-LT
b. 66821-LT
c. 66982-LT
d. 66984-LT
b. 66821-LT
YAG laser is utilized to treat cataract (posterior capsular opacification), which codes to
66821-LT. There was no mention that an intraocular lens was implanted at the time of
the cataract extraction, therefore, codes for cataract extraction with intraocular lens are
not appropriate. The remaining selection is for cataract extraction, however, by stab
incision which was not the case in this instance.
Triglycerides
a. 84478
1
,b. 84481
c. 84450
d. 84480
a. 84478
Triglycerides are assigned code 84478. Two (2) of the remaining selections are for
thyroid testing, and SGOT, neither of which were performed in this instance.
Treatment of molluscum contagiosum by cryotherapy. Patient was given light sedation
and the two lesions were exposed. Curettage was attempted, but the lesions were not
easily removed; therefore, cryotherapy was used to treat each of the lesions through
two freeze/thaw cycles.
a. 17111
b. 17110
c. 17003
d. 17000, 17003
b. 17110
Two (2) lesions were involved, both molluscum contagiosum, which according to the
CPT is assigned 17110 for destruction benign lesions other than skin tags or cutaneous
vascular proliferative lesions, up to 14 lesions. The remaining selections are for
destruction of premalignant lesions, or benign lesions other than skin tags or cutaneous
vascular proliferative lesions 15 and over.
Upper GI with barium contrast for abdominal pain, nausea. There is mild esophageal
dysmotility, followed by multiple contractions in the distal esophagus. Esophageal
mucosa appears normal. No evidence of esophagitis, stomach is negative. No ulcer
seen.
a. 74248
b. 74250
c. 74246
d. 74240
d. 74240
Assign CPT code 74240 for upper gastrointestinal study with barium contrast from
diagnostic X-ray, gastrointestinal tract. The remaining selections are for swallowing
studies, small intestine follows through upper GI, however, performed with double
contrast, which is not documented in this scenario.
This Physician Self-Referral Law prohibits a physician from making referrals for certain
designated health services payable by Medicare to an entity with which he or she (or an
immediate family member) has a financial ownership interest or compensation
arrangement, unless an exception applies:
a. Stark Law.
b. Zone Program Integrity Contractor (ZPIC).
2
,c. Medicare False Claim Program.
d. Medicare Integrity Program.
a. Stark Law.
Under the Stark Law, physicians are prohibited from making referrals to entities in which
they have a financial ownership. The Medicare False Claims Program was enacted for
the purpose of identifying potential fraud and abuse practices. The Medicare Integrity
Program safeguards the Medicare Program against fraud, abuse and waste. The Zone
Program Integrity Contractor (ZPIC) was established by CMS to combat fraud, waste
and abuse.
The patient is a 42-year-old female who was discovered to have breast cancer on the
right side. She was treated with mastectomy followed by chemotherapy and radiation
therapy. She now elects to proceed with reconstruction by single pediculate
myocutaneous TRAM flap, which is performed uneventfully.
a. 19364-RT
b. 19361-RT
c. 19367-RT
d. 19316-RT
c. 19367-RT
The reconstruction/repair was performed by TRAM flap, and therefore, only CPT code
19367-RT is appropriate. Two of the remaining selections are also for breast
reconstruction, however involve different approaches or techniques, and, therefore are
incorrect. The remaining selection is for a mastectomy, which was not performed during
this session, and, therefore is also incorrect.
A 27-year-old female has menorrhagia and wants permanent sterilization. The patient
was placed in Allen stirrups in the operating room. Under anesthesia the cervix was
dilated and the hysteroscope was advanced to the endometrium into the uterine cavity.
No polyps or fibroids were seen. The NovaSure was used for endometrial ablation. A
knife was then used to make an incision in the right lower quadrant and left lower
quadrant with 5 mm trocars inserted under direct visualization with no injury to any
abdominal contents. Laparoscopic findings revealed the uterus, ovaries, and fallopian
tubes to be normal. The appendix was normal as were the upper quadrants. Because of
the patient's history of breast cancer and desire for no further children, it was decided to
take out both the tubes and ovaries.
a. 58661, 58563-51
b. 58660, 58353
c. 58661, 58558
d. 58662, 58563-51
a. 58661, 58563-51
Hysteroscopic ablation was performed, which is assigned 58563. In addition, removal of
tube(s), ovary(ies), is assigned 58661. As 58661 is most significant, assign first,
followed by 58563 with modifier -51 to indicate multiple procedures same approach.
3
, A dysrhythmia refers to
a. vascular inflammatory disorder.
b. heart abnormality present at birth.
c. abnormal variation in the heart rhythm.
d. obstruction of an artery of the heart.
c. abnormal variation in the heart rhythm.
The prefix "dys" refers to abnormal or irregular. Therefore, an abnormal heart rhythm
would be "dys" rhythmia. Since the prefix "dys" refers to difficult, painful or irregular, only
the abnormality present at birth or abnormal variation of heart rhythm could be correct.
Since "rhythmia" refers to rhythm, the choice "abnormal variation of heart rhythm" is
correct. The heart abnormality present at birth is referred to as a "congenital anomaly."
A patient is brought from an MVA to the ER with multiple fractured ribs, labored
breathing, and complaints of chest pain and palpitations. In the ER, the thoracic
surgeon performs a tube thoracostomy with water seal with some relief of the patient's
most severe symptoms.
a. 32555
b. 32551
c. 32556
d. 32100
b. 32551
When tube thoracostomy is performed, locate code 32551 in the Introduction/Removal
of Procedures on Lungs/Pleura.
Two of the remaining selections are the thoracentesis, not tube thoracostomy, and,
therefore are incorrect in this instance. The remaining selection is a thoracotomy which
is also incorrect in this instance.
OB ultrasound, sizes and dates. Single intrauterine pregnancy with fetus in cephalic
position. Fetal cardiac motion observed, estimated ultrasound due date is 4/15/xx.
a. 76818
b. 76816
c. 76815
d. 76817
c. 76815
Assign CPT code 76815 for OB ultrasound limited, as no maternal evaluation and only
limited OB evaluation. The remaining selections are also ultrasounds, however, for
follow-up evaluation, or fetal biophysical profile, or performed transvaginally.
Procedure performed: Direct Laryngoscopy with excision of laryngeal lesion.
Laryngoscope was advanced into the larynx. There was a yellow cystic lesion along the
left false vocal cord. The scope was advanced just superior to the lesion. Lesion was
grasped, and by using straight and upbiting scissors, the entire capsule was excised.
4
With Complete Questions And Correct
Detailed Answers| Brand New Version!
Since the laceration was specified as intermediate, a code from repair/closure,
intermediate is assigned based on location (leg) and size 6.0 cm. CPT code 12032
covers intermediate repairs/closures of the leg 2.5-7.0 cm. The remaining selections
represent simple repairs or repairs to anatomical areas or sizes that are not represented
in this scenario.
Left and right mammogram for benign fibrocystic breast disease
a. 77047
b. 77046-RT-LT
c. 77066
d. 77065
c. 77066
Diagnostic mammogram code 77066 is already bilateral, therefore, there is no need for
modifier -50. The remaining selections are for unilateral diagnostic mammogram or an
MRI of the breast and, therefore, are not correct in this instance.
Topical tetracaine was applied along with YAG capsulotomy lens for left cataract
extraction. Good visualization of posterior capsular opacification was obtained and a
total of 41 shots at 2 millijoules were utilized to open the posterior capsule.
a. 66820-LT
b. 66821-LT
c. 66982-LT
d. 66984-LT
b. 66821-LT
YAG laser is utilized to treat cataract (posterior capsular opacification), which codes to
66821-LT. There was no mention that an intraocular lens was implanted at the time of
the cataract extraction, therefore, codes for cataract extraction with intraocular lens are
not appropriate. The remaining selection is for cataract extraction, however, by stab
incision which was not the case in this instance.
Triglycerides
a. 84478
1
,b. 84481
c. 84450
d. 84480
a. 84478
Triglycerides are assigned code 84478. Two (2) of the remaining selections are for
thyroid testing, and SGOT, neither of which were performed in this instance.
Treatment of molluscum contagiosum by cryotherapy. Patient was given light sedation
and the two lesions were exposed. Curettage was attempted, but the lesions were not
easily removed; therefore, cryotherapy was used to treat each of the lesions through
two freeze/thaw cycles.
a. 17111
b. 17110
c. 17003
d. 17000, 17003
b. 17110
Two (2) lesions were involved, both molluscum contagiosum, which according to the
CPT is assigned 17110 for destruction benign lesions other than skin tags or cutaneous
vascular proliferative lesions, up to 14 lesions. The remaining selections are for
destruction of premalignant lesions, or benign lesions other than skin tags or cutaneous
vascular proliferative lesions 15 and over.
Upper GI with barium contrast for abdominal pain, nausea. There is mild esophageal
dysmotility, followed by multiple contractions in the distal esophagus. Esophageal
mucosa appears normal. No evidence of esophagitis, stomach is negative. No ulcer
seen.
a. 74248
b. 74250
c. 74246
d. 74240
d. 74240
Assign CPT code 74240 for upper gastrointestinal study with barium contrast from
diagnostic X-ray, gastrointestinal tract. The remaining selections are for swallowing
studies, small intestine follows through upper GI, however, performed with double
contrast, which is not documented in this scenario.
This Physician Self-Referral Law prohibits a physician from making referrals for certain
designated health services payable by Medicare to an entity with which he or she (or an
immediate family member) has a financial ownership interest or compensation
arrangement, unless an exception applies:
a. Stark Law.
b. Zone Program Integrity Contractor (ZPIC).
2
,c. Medicare False Claim Program.
d. Medicare Integrity Program.
a. Stark Law.
Under the Stark Law, physicians are prohibited from making referrals to entities in which
they have a financial ownership. The Medicare False Claims Program was enacted for
the purpose of identifying potential fraud and abuse practices. The Medicare Integrity
Program safeguards the Medicare Program against fraud, abuse and waste. The Zone
Program Integrity Contractor (ZPIC) was established by CMS to combat fraud, waste
and abuse.
The patient is a 42-year-old female who was discovered to have breast cancer on the
right side. She was treated with mastectomy followed by chemotherapy and radiation
therapy. She now elects to proceed with reconstruction by single pediculate
myocutaneous TRAM flap, which is performed uneventfully.
a. 19364-RT
b. 19361-RT
c. 19367-RT
d. 19316-RT
c. 19367-RT
The reconstruction/repair was performed by TRAM flap, and therefore, only CPT code
19367-RT is appropriate. Two of the remaining selections are also for breast
reconstruction, however involve different approaches or techniques, and, therefore are
incorrect. The remaining selection is for a mastectomy, which was not performed during
this session, and, therefore is also incorrect.
A 27-year-old female has menorrhagia and wants permanent sterilization. The patient
was placed in Allen stirrups in the operating room. Under anesthesia the cervix was
dilated and the hysteroscope was advanced to the endometrium into the uterine cavity.
No polyps or fibroids were seen. The NovaSure was used for endometrial ablation. A
knife was then used to make an incision in the right lower quadrant and left lower
quadrant with 5 mm trocars inserted under direct visualization with no injury to any
abdominal contents. Laparoscopic findings revealed the uterus, ovaries, and fallopian
tubes to be normal. The appendix was normal as were the upper quadrants. Because of
the patient's history of breast cancer and desire for no further children, it was decided to
take out both the tubes and ovaries.
a. 58661, 58563-51
b. 58660, 58353
c. 58661, 58558
d. 58662, 58563-51
a. 58661, 58563-51
Hysteroscopic ablation was performed, which is assigned 58563. In addition, removal of
tube(s), ovary(ies), is assigned 58661. As 58661 is most significant, assign first,
followed by 58563 with modifier -51 to indicate multiple procedures same approach.
3
, A dysrhythmia refers to
a. vascular inflammatory disorder.
b. heart abnormality present at birth.
c. abnormal variation in the heart rhythm.
d. obstruction of an artery of the heart.
c. abnormal variation in the heart rhythm.
The prefix "dys" refers to abnormal or irregular. Therefore, an abnormal heart rhythm
would be "dys" rhythmia. Since the prefix "dys" refers to difficult, painful or irregular, only
the abnormality present at birth or abnormal variation of heart rhythm could be correct.
Since "rhythmia" refers to rhythm, the choice "abnormal variation of heart rhythm" is
correct. The heart abnormality present at birth is referred to as a "congenital anomaly."
A patient is brought from an MVA to the ER with multiple fractured ribs, labored
breathing, and complaints of chest pain and palpitations. In the ER, the thoracic
surgeon performs a tube thoracostomy with water seal with some relief of the patient's
most severe symptoms.
a. 32555
b. 32551
c. 32556
d. 32100
b. 32551
When tube thoracostomy is performed, locate code 32551 in the Introduction/Removal
of Procedures on Lungs/Pleura.
Two of the remaining selections are the thoracentesis, not tube thoracostomy, and,
therefore are incorrect in this instance. The remaining selection is a thoracotomy which
is also incorrect in this instance.
OB ultrasound, sizes and dates. Single intrauterine pregnancy with fetus in cephalic
position. Fetal cardiac motion observed, estimated ultrasound due date is 4/15/xx.
a. 76818
b. 76816
c. 76815
d. 76817
c. 76815
Assign CPT code 76815 for OB ultrasound limited, as no maternal evaluation and only
limited OB evaluation. The remaining selections are also ultrasounds, however, for
follow-up evaluation, or fetal biophysical profile, or performed transvaginally.
Procedure performed: Direct Laryngoscopy with excision of laryngeal lesion.
Laryngoscope was advanced into the larynx. There was a yellow cystic lesion along the
left false vocal cord. The scope was advanced just superior to the lesion. Lesion was
grasped, and by using straight and upbiting scissors, the entire capsule was excised.
4
