(The correct answer has been verified, selected and highlighted in yellow for all of the questions below.

)
1 What form is used to submit a provider’s charge to the insurance carrier?

a. ABN
b. UB-04
c. CMS-1500
d. Provider reimbursement form
2 AAPC credentialed coders have proven mastery of what information?
a. Code sets
b. Evaluation and management principles
c. Documentation guidelines
d. All of the above
3 When coding an operative report, what action would NOT be recommended?

a. Coding from the header without reading the body of the report.
b. Reading the body of the report.
c. Highlighting unfamiliar words.
d. Starting with the procedure listed.
4 When are providers responsible for obtaining an ABN for a service NOT considered
medically necessary?

a. During a procedure or service.

b. After a denial has been received from Medicare.
c. After providing a service or item to a beneficiary.
d. Prior to providing a service or item to a beneficiary.
5 Evaluation and management services are often provided in a standard format such as
SOAP notes. What does the acronym SOAP stand for?

a. Subjective, Objective, Assessment, Plan

b. Standard, Objective, Activity, Period

c. Source, Opinion, Advice, Provider

d. Scope, Observation, Action, Plan
6 What is a myocardial infarction?

a. Malfunction in one of the valves in the heart, disrupting blood flow

b. Lack of oxygen to the heart tissue, resulting in tissue death
 c. Abnormal heart beats causing pain, nausea and discomfort
d. Overgrowth of muscle tissue, affecting the heart’s ability to pump
7 Which of the following is true about the function of the cochlea?

a. It helps with balance only

b. It helps with balance and sound transmission
c. Its function is to excrete cerumen (wax) to help keep the ear clean
d. It transmits sound only
8 Which of the following best describes psoriasis?

a. An inflammatory condition characterized by redness pustular and vesicular lesions,

crusts, and scales.
b. An allergic reaction characterized by wheals and generally accompanied by pruritus.
c. A chronic condition characterized by red, dry, elevated lesions, covered by silvery
scales.
d. A contagious infection of skin generally caused by staphylococcus bacterium.
9 A thin membrane lining the chambers of the heart and valves is called the:

a. Epicardium
b. Endocardium
c. Pericardium
d. Myocardium
10 The dome-shaped muscle under the lungs flattening during inspiration is the:

a. Diaphragm
b. Pleura
c. Mediastinum
d. Bronchus
11 When a patient has a condition that is both acute and chronic and there are separate
entries for both, how is it reported?

a. Code only the chronic code

b. Code only the acute code
c. Code both sequencing the acute first
d. Code both sequencing the chronic first
12 Which diagnosis code(s) below reports pain in the left and right ears?

a. H92.09
b. H92.03
 c. H93.8X3
d. H92.01, H92.02
13 What is the ICD-10-CM code for nausea?

a. T75.3XXA
b. R11.0
c. R11.11
d. R11.2
14 A patient presents to the Emergency Department with nausea and vomiting, abdominal
pain and fever. The provider suspects appendicitis. The test results are pending. What ICD-
10-CM code(s) is/are reported?

a. R11.2, R10.9, R50.9, K37

b. R11.2, R10.9, R50.9
c. K37
d. R11.0, R11.10, R10.9, R50.9
15 A 10 month-old comes into the pediatrician’s office for a harsh, bark-like cough. She is
diagnosed with croup. The mother also wants the pediatrician to look at a rash that has
developed on her leg. The pediatrician prescribes over the counter medication of
acetaminophen for the croup and hydrocortisone cream for the rash on the leg. She is to
follow up in five days or return earlier if the conditions worsen. What ICD-10-CM code(s)
should be reported for this visit?

a. J05.0, R21
b. J05.0
c. J05.0, R05, R21
d. R21
16 What does MRSA stand for?

a. Methicillin Resistant Streptococcus Aureus

b. Moderate Resistance Susceptible Aureus
c. Methicillin Resistant Staphylococcus Aureus
d. Mild Resistance Streptococcus Aureus
17 A 32 year-old patient with hyperthyroidism has an ultrasound to determine why her neck
is enlarged. The results of the ultrasound reveal a uninodular goiter. What ICD-10-CM code is
reported?

a. E04.1
b. E05.10
 c. E05.11
d. E05.20
18 A 45 year-old patient is scheduled to have an INFUSAID pump installed. He has primary
liver cancer and the pump is being inserted for continuous administration of 5-FU. A pocket
is created just under the skin and the pump is placed in the pocket. A catheter is attached to
the pump and to the subclavian vein. The pump is filled with a chemotherapy agent
provided by the hospital and the patient is observed for adverse reaction and discharged to
home. What ICD-10-CM codes are reported?

a. Z51.11, C22.9
b. C22.9, Z51.12
c. Z51.11, C22.8
d. C22.8, Z51.11
19 A patient with type 2 diabetes presents with diabetic macular edema and proliferative
diabetic retinopathy in the right eye. What ICD-10-CM code(s) is/are reported?

a. E11.3511
b. E11.311, E11.3519
c. E11.3519
d. E11.9, E11.311, E11.3519
20 A patient is coming in for follow up of his essential hypertension and cardiomegaly. Both
conditions are stable and he is told to continue with his medications. The two conditions are
unrelated. What ICD-10-CM code(s) is/are reported?

a. I11.0, I51.3
b. I51.7
c. I11.9, I51.7
d. I10, I51.7
21 What would be considered an adverse effect?

a. Rash developing when taking penicillin.

b. Hemorrhaging after a vaginal delivery.
c. Shortness of breath when running.
d. Wound infection after surgery.
22 An X-ray is performed for pain in the left little finger. This is the initial encounter for this
visit. The X-ray report shows a fractured distal phalanx that is dislocated. What ICD-10-CM
code(s) is/are reported?

a. S62.637A, S63.257A
 b. S62.637B,
S63.257B c.
S62.637A d.
23 A S62.635A
6 month-old patient is seen at the clinic for a routine well-child visit and vaccinations.
During the examination the provider finds that the child has a fever and a diagnosis of acute
otitis media in the right ear is documented. Vaccinations are not given at this time. What
ICD-10-CM code(s) is/are reported?

a. H66.90, Z00.01
b. Z00.121
c. Z00.121, H66.91, Z28.01
d. Z00.121, H66.90, Z23
24 A 14 year-old male patient was injured while skateboarding. The injuries included a
displaced transverse fracture of the right femur shaft with multiple significant abrasions of
the right thigh. What ICD-10-CM codes are reported?

a. S72.321A, V00.138A, Y93.51

b. S72.321A, S70.311A, V00.138A, Y93.51
c. S72.91XA, S70.311A, V00.138A
d. S72.91XA, S70.311A, Y93.51
25 The patient is admitted for radiation therapy for metastatic bone cancer, unknown
primary. She developed severe vomiting secondary to the radiation. What ICD-10-CM code(s)
is/are reported?

a. Z51.0, C79.51, C80.1, R11.10

b. C79.51, C80.1
c. R11.10
d. C79.51, C80.1, R11.10, Z51.0
26 CPT® Category III codes reimburse at what level?

a. Reimbursement, if any, is determined by the payer

b. 10 percent
c. 85 percent
d. 100 percent
27 When procedures are “mandated” by third party payers, what modifier would you use?

a. 52
b. 32
 c. 76
d. 26
28 What is the correct code for the application of a short arm cast?

a. 29075
b. 29065
c. 29280
d. 29125
29 What codes are voluntarily reported to payers, provide evidence-based performance-
measure data?

a. CPT® Category III codes

b. CPT® Category I codes
c. CPT® Category II codes
d. HCPCS Level II codes
30 What chapter in the HCPCS Level II codebook lists the code for Wheelchairs?

a. Durable Medical Equipment (E0100-E8002)

b. Orthotic Procedures and Services (L0112-L4631)
c. Prosthetic Procedures (L5000-L9900)
d. Transportation Services including Ambulance (A0021-A0999)
31 Which statement is TRUE regarding the Table of Neoplasms in ICD-10-CM?

a. The Table of Neoplasms is found by looking for Neoplasm in the ICD-10-CM Alphabetic
Index.
b. There are six columns in the Table of Neoplasms; Malignant Primary, Malignant
Secondary, Ca in situ, Benign, Uncertain Behavior and Unspecified Behavior.
c. The Table of Neoplasms is found in the Tabular List.
d. There is not a Table of Neoplasms in ICD-10-CM.
32 The patient is here to see us about some skin tags on her neck and both underarms. She
has had these lesions for some time; they are irritated by her clothing, itch, and at times
have a burning sensation to them. We discussed treatment options along with risks.
Informed consent was obtained and we proceeded. We removed 16 skin tags from the right
axilla, 16 skin tags from the left axilla, 10 from the right side of the neck and 17 from the left
side of the neck. What CPT® and ICD-10-CM codes are reported?

a. 11200, 11201 x 4, 11201-52, L91.8

b. 11200, 11201 x 5, L91.8
c. 11057, D23.5, D23.4
d. 11200, 11201-51 x 5, D23.5, D23.4
33 Joe has a terrible problem with ingrown toenails. He goes to the podiatrist to have a nail
permanently removed along with the nail matrix. What CPT® code is reported?

a. 11765
b. 11720
c. 11730
d. 11750
34 PREOPERATIVE & POSTOPERATIVE DIAGNOSES:
1. Macromastia.
2. Back pain.
3. Neck pain.
4. Shoulder pain.
5. Shoulder grooving.
6. Intertrigo.

NAME OF PROCEDURE:
1. Right breast reduction of 1950 g.
2. Right free-nipple graft.
3. Left breast reduction of 1915 g.
4. Left free-nipple graft.

INDICATIONS FOR SURGERY: The patient is a 43 year-old female with macromastia and
associated back pain, neck pain, shoulder pain, shoulder grooving and intertrigo. She
desired a breast reduction. Because of the extreme ptotic nature of her breasts, we felt she
would need a free-nipple graft technique. In the preoperative holding area, we marked her
for this free-nipple graft technique of breast reduction. The patient observed these markings
so she could understand the surgery and agree on the location, and we proceeded. The
patient also was morbidly obese with a body mass index of 54. Because of this, we felt she
met the criteria for DVT prophylaxis, which included Lovenox injection. The patient
understood this would increase her risk of bleeding. She also made it known she is a
Jehovah's Witness and refused blood products, but she did understand her risk of bleeding
would significantly increase and we proceeded.

DESCRIPTION OF PROCEDURE: The patient was given 40 mg of subcutaneous Lovenox in the

preoperative holding area. She was then taken to the operating room. Bilateral thigh-high
TED hose, in addition to bilateral pneumatic compression stockings were used throughout
the procedure. IV Ancef 1 g was given. Anesthesia was induced. Both arms were secured on
padded arm boards using Kerlix rolls. A similar body Bair Hugger was placed. The chest and
abdomen were prepped and draped in sterile fashion. I began by circumscribing around each
nipple-areolar complex using a 42-mm areolar marker. On each side the free-nipple grafts
were harvested. They were marked to be side specific and were stored on the back table in
moistened lap sponges. Meticulous hemostasis was achieved using Bovie cautery. The tail of
the apex of each breast was de-epithelialized using the scalpel. I amputated the inferior
portion of the breast from the right side. Again, meticulous hemostasis was achieved using
the Bovie cautery. There were also large feeder vessels divided and ligated using either a
medium Ligaclip or 3-0 silk tie sutures. I then moved to the left and again amputated the
inferior portion of the breast. Meticulous hemostasis was achieved using the Bovie cautery. Each of these
wounds were temporarily closed using the skin stapler. The patient was then sat up. I felt we had
achieved a very symmetrical result. The new positions for the nipple- areolar complexes were marked
with a 42-mm areolar marker and methylene blue. The patient was then placed in the supine position and
the new positions for the nipple-areolar complexes were de-epithelialized using the scalpel. Meticulous
hemostasis was then achieved again using the Bovie cautery. The free-nipple grafts were then retrieved
from the back table. They were each defatted using scissors and were placed in an on-lay fashion on the
appropriate side, and each was inset using 5-0 plain sutures. Vents were made in the skin graft to allow
for the egress of fluid on each side. A vertical mattress suture was used, tied over a piece of Xeroform in
critical areas of each of the nipple-areolar complexes. A Xeroform bolster wrapped over a mineral oil-
moistened sponge was affixed to each of the nipple-areolar complexes using 5-0 nylon suture. The
vertical and transverse incisions were closed using 3-0 Monocryl, both interrupted and running suture,
and 5-0 Prolene. The patient tolerated the procedure well. Again, meticulous hemostasis was achieved
using the Bovie cautery. She was given another 1 g of Ancef at the 2-hour mark by our anesthesiologist,
and was taken to the recovery room in good condition. What CPT® code is reported?

a. 19325-50
b. 19324-50
c. 19318-50
d. 19366-50
35 The patient is coming in for removal of fatty tissue of the posterior iliac crest, abdomen,
and the medial and lateral thighs. Suction-assisted lipectomy was undertaken in the left
posterior iliac crest area and was continued on the right and the lateral trochanteric and
posterior aspect of the medial thighs. The medial right and left thighs were suctioned
followed by the abdomen. The total amount infused was 2300 cc and the total amount
removed was 2400 cc. The incisions were closed and a compression garment was applied.
What CPT® codes are reported?

a. 15830, 15832-50-51
b. 15877, 15878-50-51
c. 15877, 15879-50-51
d. 15830, 15839-50-51, 15847
36 Hallux rigidus is a condition affecting what part of the body?

a. Foot
b. Knee
c. Spine
d. Ankle
37 A 49 year-old presents with an abscess of the right thumb. The physician incises the
abscess and purulent sanguineous fluid is drained. The wound is packed with iodoform packing.
What CPT® code is reported?

a.
26011-F5

b.
10061-F5

c.
10060-F5

d.
26010-F5

38 This 45 year-old male presents to the operating room with a painful mass of the right
upper arm. Upon deep dissection a large mass in the soft tissue of the patient's shoulder
was noted. The mass appeared to be benign in nature. With deep blunt dissection and
electrocautery, the mass was removed and sent to pathology. What CPT® code is reported?

a. 23075-RT
b. 23030-RT
c. 23066-RT
d. 23076-RT
39 Under general anesthesia, a 45 year-old patient was sterilely prepped. The wrist joint was
injected with Marcaine and epinephrine. Three arthroscopic portals were created. The
articulating surface between the scaphoid and the lunate clearly showed disruption of the
ligamentous structures. We could see soft tissue pouching out into the joint; this was
debrided. There was abnormal motion noted within the scapholunate articulation. At this
point the C-arm was brought in. Arthroscopic instruments were placed in the joint and
confirmed the location of the shaver as a probe in the scapholunate ligament. There was a
significant gap between the capitate and lunate. K-wire was utilized from the dorsal surface
into the lunate, restoring the space. Further examination revealed gross instability between
the capitate and lunate. With the wrist in neutral position, a K-wire was passed through the
scaphoid, through the capitate and into the hamate. This provided stabilization of the wrist
joint. Stitches were placed, and a thumb spica cast was applied. What CPT® code(s) is/are
reported?

a. 29847
b. 29847, 29840-51
c. 29846
d. 29840
40 A 45 year-old presents to the operating room with a right index trigger finger and left
shoulder bursitis. The left shoulder was injected with 1 cc of Xylocaine, 1 cc of Celestone and
1 cc of Marcaine. An approximately 1-inch incision was made over the A1 pulley in the distal
transverse palmar crease. This incision was taken through skin and subcutaneous tissue.
The A1 pulley was identified and released in its entirety. The wound was irrigated with
antibiotic saline solution. The subcutaneous tissue was injected with Marcaine without
epinephrine. The skin was closed with 4-0 Ethilon suture. Clean dressing was applied. What
CPT® codes are reported?

a. 20552-F6, 20605-52-LT
b. 20553-F6, 20610-51-LT
c. 26055-F6, 20610-51-LT
d. 26055-F6, 20610-76-LT
41 What CPT® code is reported for open decortication and parietal pleurectomy?

a. 32652
b. 32320
c. 32220
d. 32225
42 Which statement is TRUE regarding coding COPD with asthma in ICD-10-CM?

a. Only the COPD is reported.

b. The type of asthma is reported along with the COPD.
c. Only the asthma is reported.
d. COPD with bronchitis is reported for COPD with asthma.
43 What ICD-10-CM code is reported for pyopneumothorax with fistula?

a. J86.0
b. J86.9
c. J93.9
d. J95.811
44 The pulmonologist in a multispecialty group refers a patient to the otolaryngologist
because he thinks that the shortness of breath that the patient is experiencing may be due
to sinusitis and laryngopharyngeal reflux (LPR). The otolaryngologist decides to perform a
rigid bilateral nasal endoscopy to get a better look at what is going on in the sinuses and a
flexible laryngoscopy to determine if (LPR) is contributing to the problems because he could
not get adequate visualization on manual exam. First the bilateral nasal endoscopy is
performed and the otolaryngologist diagnosis chronic pansinusitis. Next a flexible fiberoptic
laryngoscope is introduced nasally and the larynx and trachea are inspected. The diagnosis
is chronic laryngitis/tracheitis and LPR. He prescribes Singulair and Nexium and proposes
endoscopic surgery will be considered in the future if the current treatment does not fully
take care of the problems experienced by the patient. What CPT® and ICD-10-CM codes are
reported for the procedure?

a. 31575, 31231-59, J32.4, J37.1

b. 31576, 31231-51, J32.4, J02.9, J41.8
c. 31576, 31237-50-59, J32.4, J37.0, J41.8
d. 31575, 31231-50-59, J32.4, J37.1
45 A patient with a diagnosis of chronic sphenoidal sinusitis undergoes a bilateral
sinusotomy. While the provider examines the diseased sphenoid sinus, she takes a biopsy of
the sphenoidal masses and removes the mucosa with several polyps. Transseptal sutures are
placed and the intraoral incision is closed in a single layer. The nose is packed and external
nasal dressings are placed. What CPT® and ICD-10-CM codes are reported?

a. 31090, 30115-50-51, J32.9

b. 31288-50, J32.9
c. 31237-50, J32.3
d. 31051-50, J32.3, J33.8
46 Which main coronary artery bifurcates into two smaller ones?

a. Left
b. Inverted
c. Right
d. Superficial
47 A patient presents to the outpatient surgery department for revision to his autogenous
radiocephalic fistula so he can continue his hemodialysis. What is the correct CPT® code?

a. 36832
b. 36904
c. 36825
d. 36831
48 Physician replaces a single chamber permanent pacemaker with a dual chamber
permanent pacemaker. What CPT® code(s) is/are reported?

a. 33212, 33233-51
b. 33213, 33233-51, 33235-51
c. 33213, 33233-51
d. 33214
49 CLINICAL SUMMARY: The patient is a 41 year-old female with known coronary disease and
recent recurrent chest pain, cardiac catheterization demonstrated subtotal occlusion of the
diagonal artery at its takeoff from the left anterior descending artery.

PROCEDURE: With informed consent obtained, the patient was prepped and draped in the
usual sterile fashion. With the right groin area infiltrated with 2% Xylocaine, the patient was
given 2 mg of Versed and 50 mcg Fentanyl intravenously for conscious sedation and pain
control. The right femoral artery was cannulated with a modified Seldinger technique and a
6 French catheter sheath placed. A 6 French JL3.5 catheter with no side holes was utilized as
a guiding catheter. After the initial guiding picture had been obtained, the patient was given
Angiomax per protocol, and a short Cross-it 100 wire was advanced to the LAD and then into
the diagonal vessel. A 2.0. 15-mm-long Maverick balloon was used for dilatation of the
diagonal artery ostium with inflation pressure up to 8 atmospheres applied. Final
angiographic documentation was carried out after the patient received 200 mcg of
intracoronary nitroglycerine. The guiding catheter was then pulled, the sheath secured in
place. The patient is now being transferred to telemetry for post coronary intervention
observation and care.

RESULTS: The initial guiding picture of the left coronary system demonstrates the high-grade
ostial stenosis of the diagonal artery taking off within the LAD. Following the coronary
intervention with balloon angioplasty there is complete resolution of the stenosis with less
than 10 percent residual narrowing observed, no evidence for intimal disruption, no
intraluminal filling defect, and good antegrade TIMI III flow preserved.

CONCLUSION: Successful coronary intervention with balloon angioplasty to the

ostial/proximal segment of the second diagonal vessel.

a. 92937-LD
b. 92921-LD
c. 92924-LD
d. 92920-LD
50 In the cardiac suite, an electrophysiologist performs an EP study. With programmed
electrical stimulation, the heart is stimulated to induce arrhythmia. Observed is right atrial
and ventricular pacing, recording of the bundle of His, right atrial and ventricular recording
and left atrial and ventricular pacing and recording from the left atrium.

a. 93620, 93618, 93621

b. 93600, 93602, 93603, 93610, 93612, 93618, 93621, 93622
c. 93620, 93621, 93622
d. 93619, 93621
51 What ICD-10-CM code is reported for internal hemorrhoids?

a. K64.9
b. K64.8
c. K64.4
 d. K64.0
52 What is the correct ICD-10-CM code for a patient with IBS?

a. K58.9
b. K59.2
c. K59.8
d. K58.0
53 A 45 year-old woman underwent a cholecystectomy performed laparoscopically. The
procedure was performed for recurrent bouts of acute cholecystitis. What CPT® and ICD-10-
CM codes are reported?

a. 47600, K81.0
b. 47562, K81.0
c. 47605, K81.2
d. 47570, K81.9
54 Margaret has a cholecystoenterostomy with a Roux-en-Y. Five hours later, she has an
enormous amount of pain, abdominal swelling and a spike in her temperature. She is
returned to the OR for an exploratory laparotomy and subsequent removal of a sponge that
remained behind from surgery earlier that day. The area had become inflamed and was
demonstrating early signs of peritonitis. What is the correct coding for the subsequent
services on this date of service? The same surgeon took her back to the OR as the one who
performed the original operation.
What CPT® code is reported?

a. 49402-78
b. 49000-58
c. 49000-77
d. 49402-77
55 Operative Report
Indications: This is a third follow-up EGD dilation on this 40 year-old patient for a pyloric
channel ulcer which has been slow to heal with resulting pyloric stricture. This is a repeat
evaluation and dilation.
Medications: Intravenous Versed 2 mg. Posterior pharyngeal Cetacaine spray.
Procedure: With the patient in the left lateral decubitus position, the Olympus GIFXQ10 was
inserted into the proximal esophagus and advanced to the Z-line. The esophageal mucosa
was unremarkable. Stomach was entered revealing normal gastric mucosa. Mild erythema
was seen in the antrum. The pyloric channel was again widened. The ulcer, as previously
seen, was well healed with a scar. The pyloric stricture was still present. With some probing,
the 11 mm endoscope could be introduced into the second portion of the duodenum,
revealing normal mucosa. Marked deformity and scarring was seen in the proximal bulb.
Following the diagnostic exam, a 15 mm balloon was placed across the stricture, dilated to
maximum pressure, and withdrawn. There was minimal bleeding post-op. Much easier
access into the duodenum was accomplished after the dilation. Follow-up biopsies were also
taken to evaluate Helicobacter noted on a previous exam. The patient tolerated the
procedure well.

Impressions: Pyloric stricture secondary to healed pyloric channel ulcer, dilated.

Plan: Check on biopsy, continue Prilosec for at least another 30 days. At that time, a repeat
endoscopy and final dilation will be accomplished. He will almost certainly need chronic H2
blocker therapy to avoid recurrence of this divesting complicated ulcer.

What CPT® and ICD-10-CM codes are reported?

a. 43245, 43239-51, K31.1, Z87.11

b. 43236, 43239-59, K31.1, Z87.11
c. 43235, 43239-51, K31.4, Z87.19
d. 43248, 43239-59, K31.5, Z87.19
56 What is the correct CPT® code for a percutaneous pyelostolithotomy with dilation and
basket extraction measuring 1 cm?

a. 50080
b. 50081
c. 50040
d. 50130
57 Vasectomy reversal is performed, bilaterally, using the operating microscope. Choose the
procedure code(s).

a. 55400-50, 69990
b. 55250
c. 55450-50, 69990
d. 55400
58 When a cystectomy is performed, there are various means of diverting the urine. One
method is to create a neobladder which allows the patient to void through his or her urethra.
Which code describes this procedure?

a. 51595
b. 51596
c. 51590
d. 51580
59 Patient comes in today to the provider’s office for routine monthly Foley catheter change.
A two way Foley catheter is replaced in the usual sterile fashion. An abdominal urinary
drainage bag and bedside bag are given to the patient. What is/are the correct code(s)?
 a. 51701, A4338, A4357, A4358
b. 51100
c. 51102
d. 51702, A4338, A4357, A4358
60 Dr. Smith is treating a 72 year-old female with a ureteral obstruction caused by a
postoperative stricture and post radiation scarring following treatment for transitional cell
cancer. The patient requires removal and replacement of an internal indwelling ureteral
stent. Dr. Smith advances a diagnostic catheter under conscious sedation into the bladder
and injects contrast to opacity the bladder. A guide wire is advanced into the bladder and
the diagnostic catheter is exchanged for a larger catheter to allow the use of a snare device.
Under the fluoroscopic guidance the snare device is negotiated into the bladder through the
sheath and used to grasp the pigtail portion of the double-J ureteral stent tube within the
bladder and the indwelling stent tube is pulled out of the bladder and urethra far enough to
allow retrograde introduction of a guide wire through the stent, directed into the renal pelvis.
Using fluoroscopic guidance to negotiate the wire through the inner lumen of the ureteral
stent tube rather than through side holes, a diagnostic catheter is positioned over the wire
into the renal pelvis, allowing opacification and visualization of the renal pelvis. The guide
wire is repositioned into the renal pelvis and the diagnostic catheter removed. A new double-
J ureteral stent tube is introduced and positioned. The guide, sheath and safety wire are
removed after appropriate position is confirmed with fluoroscopy and a permanent image is
obtained for the medical record.
What code is used to describe the exchange?

a. 50386-26
b. 50384
c. 50385-26
d. 50385
61 If a woman is hospitalized with severe pre-eclampsia in the 30th week of her pregnancy
what is the diagnosis code for her daily visits?

a. O14.10, Z3A.00
b. O14.13, Z3A.30
c. O14.03, Z3A.30
d. O14.13
62 Patient wishes permanent sterilization and elects laparoscopic tubal ligation with Falope
ring. What is the CPT® code reported for this service?

a. 58600
b. 58671
c. 58615
d. 58670
63 What ICD-10-CM code is reported for an incomplete uterine prolapse?

a. N81.3
b. N81.85
c. N81.4
d. N81.2
64 A patient with a long history of endometriosis has an exploratory laparotomy for an
enlarged right ovary seen on ultrasound with other possible masses on the uterus and in the
peritoneum. Exploration reveals these masses to be endometriosis including a chocolate
cyst (endometrioma) of the right ovary, right fallopian tube and peritoneum. The
endometriomas are all small, less than 5 cm, and laser is used to ablate them, except the
ovarian cyst, which is excised. During the procedure the patient also has a tubal ligation.
What are the CPT® and ICD-10-CM codes reported for this service?

a. 49000, 58662-51, 58925-51, 58671-51, N80.1, N80.2, N80.3, Z30.2

b. 58662, 58600-51, N80.1, N80.2, N80.3, Z30.2
c. 49203, 58671-51, N80.8
d. 49203, 58611, N80.1, N80.2, N80.3, Z30.2
65 What is the code for ultrasound evaluation of a fetus and mother, usually performed early
in pregnancy (first trimester), to confirm fetal age, set an anticipated delivery date, for
qualitative assessment of amniotic fluid volume/gestational sac shape and examination of
the maternal uterus and adnexa?

a. 76801
b. 76815
c. 76819
d. 59025
66 Looking in the CPT® manual the Nervous System is divided into what subheadings?

a. Skull, Meninges, and Brain; Spine and Spinal Cord; Extracranial Nerves, Peripheral
Nerves, and Autonomic Nervous System.
b. Brain, Central Nervous System, Autonomic Nervous System
c. Skull, Spine, Peripheral Nervous System, Central Nervous System
d. Central Nervous System and Peripheral Nervous System
67 A 50 year-old male is diagnosed with a tumor of the skull base just below the occipital
tonsils. The neurosurgeon performs a transpetrosal approach to the posterior cranial fossa.
He then performs an intradural removal of the tumor of the posterior cranial fossa at the
base of the skull. Dural repair is done and the area is closed with Neurolon. What CPT®
code(s) is/are reported?

a. 61521
 b. 61597, 61616-
51 c. 61598,
61616-51 d.
61524
68 What CPT® code is used to report neurorrhaphy with autogenous vein graft for one
nerve?

a. 64910
b. 64885
c. 64911
d. 64892
69 A 41 year-old female has carpal tunnel syndrome in her left hand. The patient underwent
release of the carpal ligament with internal neurolysis. An incision was made directly over
the carpal ligament through the skin to the carpal ligament. Under direct vision the carpal
ligament was divided then internal neurolysis of the median nerve was performed using a
magnifying loupes. What CPT® code is reported?

a. 64722
b. 64719
c. 64721
d. 64704
70 A patient recently experienced muscle atrophy and noticed she did not have pain when
she cut herself on a piece of glass. The provider decides to obtain a needle biopsy of the
spinal cord under ultrasound guidance in the outpatient setting. The biopsy results come
back as syringomyelia. What CPT® and ICD-10-CM codes are reported for the biopsy
procedure?

a. 62270, 76942-26, G95.0

b. 62269, G12.9
c. 62270, G12.9
d. 62269, 76942-26, G95.0
71 What is exophthalmos?

a. Enlargement of the thyroid gland.

b. Excess sugar in the urine.
c. Protrusion of the eyeballs.
d. A condition resulting from an excess of hormones from the adrenal cortex.
72 To code for the operating microscope, what verbiage are you looking for in the medical
record?
 a. Microdissection may be necessary.
b. The operating microscope was sterilely draped and brought into the surgical field.
c. “Due to the intricate dissection under magnification…”
d. Loupes were donned for magnification.
73 A 65 year-old patient presents with an ectropion of the right lower eyelid. Repair with
tarsal wedge excision is performed for correction. Attention was then directed to the left eye.
The patient also has an ectropion of the left lower eyelid which is repaired by suture repair.
What CPT® code(s) is/are reported?

a. 67916-E4, 67914-E2
b. 67916-50
c. 67914-50
d. 67923-E4, 67921-E2
74 What ICD-10-CM code is reported for bilateral chronic otitis media with effusion?

a. H65.93
b. H65.499
c. H65.493
d. H65.33
75 A 26 year-old female with a one-year history of a left tympanic membrane perforation.
She has extensive tympanosclerosis with a nonhealing perforation. Her options, including
observation with water precautions or surgery, were discussed. The patient wished to
proceed with surgery. With use of the operating microscope, the surgeon performs a left
lateral graft tympanoplasty. What CPT® code is reported?

a. 69631-LT
b. 69641-LT
c. 69642-LT
d. 69632-LT
76 Report the appropriate anesthesia code for an obstetric patient who had a planned
general anesthesia for cesarean hysterectomy.

a. 01969
b. 01963
c. 01962
d. 01967
77 The patient had surgery to remove and replace an existing Hickman catheter. The
anesthesiologist reported a postoperative diagnosis of a catheter related bloodstream
infection (CRBSI). What ICD-10-CM code(s) is/are reported?
 a. Z45.2 b. Z45.2,
T80.219A c.
T80.219A d.
T80.211A
78 The patient is receiving a cast change for a compound left trimalleolar fracture (ankle).
What ICD-10-CM code is reported?

a. S82.892D
b. S82.851S
c. S89.302S
d. S82.852D
79 Anesthesia start time is reported as 7:14 am, and the surgery began at 7:26 am. The
surgery finished at 8:18 am and the patient was turned over to PACU at 8:29 am, which was
reported as the ending anesthesia time. What is the anesthesia time reported?

a. 7:26 am to 8:29 am (63 minutes)

b. 7:26 am to 8:18 am (52 minutes)
c. 7:14 am to 8:18 am (64 minutes)
d. 7:14 am to 8:29 am (75 minutes)
80 A 72 year-old patient is undergoing a corneal transplant. An anesthesiologist is personally
performing monitored anesthesia care. What CPT® code and modifier(s) are reported for
anesthesia?

a. 00144, 99100
b. 00144-AA-QS, 99100
c. 00144-QK-QS, 99100
d. 00144-AA, 99100
81 Which anatomic position has the patient lying at an angle instead of lying flat or directly
on their side?

a. Supine
b. Lateral
c. Prone
d. Oblique
82 A 25 year-old female in her last trimester of her pregnancy comes into her obstetrician’s
office for a fetal biophysical profile (BPP). An ultrasound is used to first monitor the fetus’
movements showing three movements of the legs and arms (normal). There are two
breathing movements lasting 30 seconds (normal). Non-stress test (NST) of 30 minutes
showed the heartbeat at 120 beats per minute that increased with movement (normal or
reactive). Arms and legs were flexed with fetus’ head on its chest, opening and closing of a
hand. Two pockets of amniotic fluid at 3cm were seen in the uterine cavity (normal).
Biophysical profile scored 9 out of 10 points (normal or reassuring). What CPT® code is
reported by the obstetrician?

a. 76819
b. 76815
c. 59025, 76818
d. 76818
83 A patient with prostate cancer has his first dose of radiation treatment of a single area
that requires a single port and an energy level of 7 milli-electron volts (MeV). What CPT®
code is reported?

a. 77373
b. 77412
c. 77402
d. 77407
84 Magnetic resonance imaging of the chest is first done without contrast medium
enhancement and then is performed with an injection of contrast. What CPT® code(s) is/are
reported for the radiological services?

a. 71275
b. 71552
c. 71555
d. 71550, 71551
85 A young child is taken to the OR to reduce a meconium plug bowel obstruction. A
therapeutic enema is performed with fluoroscopy. The patient is in position and barium is
instilled into the colon through the anus for the reduction. What CPT® code is reported by
the independent radiologist for the radiological service?

a. 74280-26
b. 74270-26
c. 74283-26
d. 74246-26
86 What is the code for gross and microscopic examination (surgical pathology) of breast
tissue from a simple mastectomy?

a. 88307
b. 88300
c. 88309
 d. 88305
87 A patient has a traumatic head injury and some cerebrospinal fluid (CSF) is removed to
limit potential damage from swelling of the brain. The CSF is sent to pathology for
examination and the results show unusual cytological counts, although no specific findings.
The patient has had no previous symptoms known to his family members. What is the ICD-
10-CM code for this examination of CSF?

a. A39.0
b. S06.1X0A
c. Z00.01
d. R83.6
88 A physician orders a General Health Panel, all tests except a creatinine, including CBC
with automated differential. What CPT® code(s) is/are reported?

a. 85025, 84443, 82040, 82247, 82310, 82374, 82435, 82947, 84075, 84132, 84155,
84295, 84460, 84450, 84520
b. 80050-22
c. 80050-52
d. 80050
89 Esther Glass has a primary cancer located in the intra-hepatic biliary tract and had a
cholecystectomy and biopsy of the duodenum done. Two separate specimens (gall bladder,
biopsy of duodenum) were sent to the pathologist working at a hospital laboratory. The
technician prepared the slides and the pathologist (self-employed) read them. Select the
best code or codes for the pathologist’s services.

a. 88304-26 x2
b. 88305-26 x2
c. 88304-26, 88305-26
d. 88304, 88305
90 A patient has partial removal of his lung which is sent in for gross and microscopic
examination. The pathologist also did gross and microscopic exam on biopsies for several
lymph nodes in the patient’s chest which are placed in one container. A consultation is
performed on a tissue block of a single specimen intraoperatively by frozen section. The
pathologist also performs a trichrome stain. What CPT® codes are reported for the lab tests
performed?

a. 88307, 88305 x 2, 88332

b. 88309, 88305, 88313, 88331
c. 88309 x 2, 88307 x 2, 88313, 88331, 88332
d. 88309 x 2, 88313, 88329
91 If the pain is sharp, stabbing or dull, what is the component of the History of Present
Illness (HPI)?

a. Quality
b. Modifying Factor
c. Timing
d. Duration
92 Dr. Howitzer sees Mrs. Jones in Clinic Eight for sudden loss of consciousness while
watching the Olympic Torch go by. He is a new provider to the neurology department. Dr.
Drake Rinaldi, a prominent member of the neurology faculty at the university saw Mrs. Jones
last month. Dr. Howitzer performs a history including 3 HPI elements and 2 ROS, a detailed
exam and has medical decision making of high complexity. The final diagnosis given is
transient loss of consciousness. The patient makes a follow-up appointment to see Dr.
Rinaldi in one week. What is the appropriate diagnosis and E/M code for this visit?

a. 99203, R55
b. 99202, R40.1
c. 99214, R55
d. 99215, R40.1
93 After moving across country, Ms. Robbins took her 2 year-old daughter to a new pediatric
clinic for an annual physical. The provider completed an age / gender appropriate history,
exam, and provided anticipatory guidance. He ordered no additional tests or immunizations.
What CPT® code is reported?

a. 99392
b. 99391
c. 99381
d. 99382
94 The physician was called to the hospital floor for the medical management of a 56 year-
old patient admitted one day ago with aspiration pneumonia and COPD. No chest pain at
present, but still SOB and some swelling in his lower extremities. Patient was tachypneic
yesterday; lungs reveal course crackles in both bases, right worse than left. The physician
writes instructions to continue with intravenous antibiotic treatment and respiratory support
with ventilator management. He reviewed chest X-ray and labs. Patient is improving and a
pulmonary consultation has been requested. What CPT® code is reported?

a. 99232
b. 99231
c. 99218
d. 99221
95 An established 47 year-old patient presents to the provider’s office after falling last night
in her apartment when she slipped in water on the kitchen floor. She is complaining of low
back pain and no tingling or numbness. Provider documents that she has full range motion
of the spine, with discomfort. Her gait is within normal limits. Straight leg raising is negative.
She requested no medication. It is recommended to use heat, such as a hot water bottle.
Provider’s Assessment: Lower Back Muscle Strain. What E/M and ICD-10-CM codes are
reported for this service?

a. 99213, S39.012A, W01.0XXA, Y92.030

b. 99212, S39.012A, W18.30XA, Y92.030
c. 99213, S33.9XXA, W18.40XD, Y92.030
d. 99212, S39.012A, W19.XXXD, Y92.030
96 A new patient with cystic fibrosis underwent evaluation of lung function, including
percussion, vibration and cupping to the chest wall to facilitate his lung function. What CPT®
code(s) is/are reported for this service?

a. 99201-25, 94668
b. 94667
c. 94664
d. 94662
97 A patient with hypertensive cardiovascular disease is admitted by his primary care
provider. What is/are the correct ICD-10-CM code(s) for this encounter?

a. I11.9
b. I11.0
c. I10, I25.10
d. I11.9, I25.10
98 A 30 year-old male cut his right hand on a nail repairing the gutter on his house. Six days
later it became infected. He went to the intermediate care center in his neighborhood, his
first visit there. The wound was very red and warm with purulent material present. The
wound was irrigated extensively with sterile water and covered with a clean sterile dressing.
An injection of Bicillin CR, 1,200,000 units was given. The patient was instructed to return in
three to four days. The provider diagnosed open wound of the hand with cellulitis. A
problem focused history and examination with a low MDM were performed. What are the
codes?

a. 96372, S61.411A, L03.114, W45.0XXA, Y93.H9

b. 99201, 96372, J0558 x 12, S61.411A, L03.113, W45.0XXA, Y93.H9
c. 99284, S41.009A, L03.113
d. 99201, J0558 x 4, S52.009A, W31.81XA
 99 A qualified genetics counselor is working with a child who has been diagnosed with fragile
X syndrome. After extensive research about the condition, she meets with the parents to
discuss the features of the disease and the child’s prognosis. The session lasted 45 minutes.
What CPT® and ICD-10-CM codes are reported?

a. 96040, Q99.9
b. 96040, Q99.2
c. 96040 x 2, Q99.2
d. 96040 x 2, Q99.8
100 A patient with bilateral sensory hearing loss is fitted with a digital, binaural, behind the
ear hearing aid. What HCPCS Level II and ICD-10-CM codes are reported?

a. V5261, Z46.1, H90.3

b. V5261, Z01.110, H90.3
c. V5140, H90.6
d. V5140, H90.3, Z46.1

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