MEDICON

20,000 series Questions:

1. Which types of joints are considered synovial?

A. Suture joint, medial joint, and articulation joint

2. A physician applied a cast and also provided all of the subsequent fracture care. The same
physician may report the application of the cast separately from the fracture care.

A. True
B. False

3. A physician designed and prepared prosthesis for palatal lift prosthesis. How should you
report the physician’s professional service for this process?

A. 21083
B. 21083-26
C. L9900
D. L8699-26

4. The patient presented for medial meniscal tear left knee. Arthroscopy with partial medial
menisectomy left knee and arthroscopic picking (drilling pick holes) of the lateral femoral
condyle left knee was performed. Code the procedure and diagnosis codes.

A.29880-LT, 29879-51-LT, S89.212A

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C.29882-LT, 29885-51-LT, S89.219A

5. Patient complains of chronic/acute arm and shoulder pain following bilateral carpal tunnel
surgery. Patient is followed by pain management for over a year. Physician finally diagnoses
patient with reflex dystrophy syndrome (RSD). Physician performs six trigger point injections
into four muscle groups. Code the procedure(s).

A.20552
B.20553 x 6
C.20551 x 6
D.20553

6. Dr. Roy completed a deep transfer of the anterior tibial and flexor digitorum tendons. Which
codes should be used to report this procedure?

A.27658*2

B.27690, 27692-51

C.27691, 27692

D.27691, 27692*2

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7. Which codes would you report for an aspiration and injection of ganglion cyst to the bone of the
left great toe?

A.20600

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B.20612

C.20615

D.20600, 20612-59

8. Roy is a 25 years old patient who underwent a subcutaneous excision of an 8-cm spongy tumor
on her upper abdominal wall. How should you report this procedure?

A.22902

B.22903

C.22900

D.22905

9. A patient presents for a steroid injection into the bilateral SI joint under fluoroscopic guidance.
How should you report this?

A.27096, 77003-26
B.27096-50
C.27096-50, 77003-26
D.27096

10. A patient presents for injection of steroid into the right SI joint, as well as trigger points in the
trapezius, iliopsoas, and quadriceps muscles. How will you report this?

A.20553
B.20553, 20552-59
C.20553, 27096
D.20553, 27096-RT

11. A 56-year-old female undergoes bilateral SI joint injection with ultrasonic guidance. How should
you report this?

A.20552, 76942
B.20552-50
C.27096
D.27096, 76942

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12. Posterior placement of pedicle screws and rods at L2-S1 is reported using which instrumentation
code?

A.+22840
B.+22842
C.+22843
D.+22845

13. A patient suffered a fracture of the femur head. He had an open treatment of the femoral head
with a replacement using a Medicon alloy femoral head and methyl methacrylate cement. How
would you report this procedure?

A. 27236

B. 27235

C. 27238

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D. 27275, 27236-59

14. What modifier should you report when the same physician provided a re-reduction of a
fracture?

A. 76

B. 59

C. 77

D. 54

15. This is a 32-year-old female who presents today with sacroiliitis. On the physical exam there was

pain on palpation of the left sacroiliac joint and fluoroscopic guidance was done for the needle
positioning. Then 80 mg of Depo-Medrol and 1 mL of bupivacaine at 0.5% was injected into the left
sacroiliac joint with a 22 gauge needle. The patient was able to walk from the exam room without
difficulty. Follow up will be as needed. The correct CPT® code is:

A.20610-LT, 77003-26
B.27096-LT, 77003-26
C.27096-LT
D.20551

16. A 61-year-old gentleman with a history of a fall while intoxicated suffered a blow to the
forehead and imaging revealed a posteriorly displaced odontoid fracture. The patient was taken
into the Operating Room, and placed supine on the operating room table. Under mild sedation, the
patient was placed in Gardner-Wells tongs and gentle axial traction under fluoroscopy was
performed to gently try to reduce the fracture. It did reduce partially without any change in the
neurologic examination. More manipulation would be necessary and it was decided to intubate and
use fiber optic technique. The anterior neck was prepped and draped and an incision was made in a
skin crease overlying the C 4-C5 area. Using hand-held retractors, the ventral aspect of the spine

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was identified and the C2-C3 disk space was identified using lateral fluoroscopy. Using some
pressure upon the ventral aspect of the C2 body, we were able to achieve a satisfactory reduction
of the fracture. Under direct AP and lateral fluoroscopic guidance, a Kirschner wire was advanced
into the C2 body through the fracture line and into the odontoid process. This was then drilled, and
a 42 millimeter cannulated lag screw was advanced through the C2 body into the odontoid process.
What procedure code should be used?

A.22505
B.22305
C.22315
D.22318

17. PREOPERATIVE DIAGNOSIS: Right scaphoid fracture. TYPE OF PROCEDURE: Open reduction and
internal fixation of right scaphoid fracture. DESCRIPTION OF PROCEDURE: The patient was brought
to the operating room, anesthesia having been administered. The right upper extremity was
prepped and draped in a sterile manner. The limb was elevated, exsanguinated, and a pneumatic
arm tourniquet was elevated. An incision was made over the dorsal radial aspect of the right wrist.
Skin flaps were elevated. Cutaneous nerve branches were identified and very gently retracted. The
interval between the second and third dorsal compartment tendons was identified and entered.
The respective tendons were retracted. A dorsal capsulotomy incision was made, and the fracture
was visualized. There did not appear to be any type of significant defect at the fracture site. A 0.045
Kirschner wire was then used as a guidewire, extending from the proximal pole of the scaphoid
distalward. The guidewire was positioned appropriately and then measured. A 25-mm Acutrak drill
bit was drilled to 25 mm. A 22.5-mm screw was selected and inserted and rigid internal fixation was
accomplished in this fashion. This was visualized under the OEC imaging device in multiple
projections. The wound was irrigated and closed in layers. Sterile dressings were then applied. The
patient tolerated the procedure well and left the operating room in stable condition. What code
should be used for this procedure?

A.25628-RT
B.25624-RT
C.25645-RT
D.25651-RT

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18. The surgeon performs a diagnostic endoscopy on a Medicare patient, followed by a surgical
endoscopy in the same family. How should you code?

A. Report only the diagnostic endoscopy

19. Per 2016 CPT® guidelines, which code(s) includes conscious sedation, when performed?

A.+22522
B.44705
C.67810
D.95907-95913

20. Which procedure would be reported when a patient had all five toes on a single foot
amputated at the metatarsals during the same operative session?

A.28800
B.28805
C.27888
D.28820

21. Which of the following is a method to treat fractures where a fixation, such as a rod or nail,
is placed across the fracture?

A.Open
B.Closed
C.Endoscopy
D.Percutaneous

22. A 28-year-old football player fell to his knees upon being tackled. The impact was so severe
that he suffered a broken left tibia. A medic was called onto the field and the man was
transported to the nearest ER. Two days later, an orthopedic surgeon repaired the fracture by
placing four screws into the injured area under ultrasonic guidance. The correct CPT® code for
this procedure is:

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A.27750-LT
B.27752-LT
C.27756-LT
D.27758-LT

23. Which CPT® code should you report when a physician performs an endoscopic
gastrocnemius recession?

A.27687
B.29999
C.27687-52
D.29893

24. Which CPT® code should you report when a physician performs manipulation of spine
requiring anesthesia, lumbar region?

A.22305
B.22326-52
C.22505
D.29893

25. Renny suffered with dislocation of right fourth metacarpal. Dr. Ross completed a closed
manipulation under anesthesia and repaired Renny’s injury. What code should Dr. Ross report
for her service?

A.26605
B.26641
C.26670
D.26675

26. Assign code for surgical endoscopy of TMJ joint.

A. 29800
B. 29804
C. 21010
D. 29806

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27. Assign code for injection into the subacromial bursa under ultrasound guidance?

A. 20610, 76942

B. 20611, 76942

C. 20611

D. 20612

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28. This is 59-year-old came for pain management. 30 mg of injection is given in the rhomboid
major, rhomboid minor, and pectoralis major muscles under ultrasonic guidance. Assign CPT
codes?

A. 20552, 76942

B. 20553, 76942

C. 20552

D. 20553

29. Anterior arthrodesis for spinal deformity from T1 to T6 and a cast is also applied Assign CPT
Codes?

A. 22810X6

B. 22810

C. 22810, 29035

D. 22802

30. The term arthrodesis refers to…..

A. Surgical fixation of testis

B. Surgical removal of joint

C. Surgical fixation of a joint.

D. Surgical fixation of breast.

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MEDICON
4th Floor, Nagasai Nivas Prime Hospital Lane, Telangana 500016
Phone number : 9848665333. Mail: [email protected]