GUIDELINES

1. Which punctuation is used in the ICD-10-CM Alphabetic index to enclose supplementary words that
may be present or absent in the statement of a disease or procedure without affecting the code number
to which it is assigned?

A Brackets

B.Semicolon

C.Parentheses

D.Colons

2. According to CPT coding guidelines for obstetrical ultrasounds, which CPT code includes a detailed
anatomic evaluation of the fetal brain, face, heart, chest, abdominal organs, limbs, umbilical cord, and
placenta?

A.76810

B.76805

C.76811

D.76816

3. According to the ICD-10-C Guidelines, for hypertensive cerebrovascular disease, what is the
sequencing of codes?

A.Assign the appropriate hypertension code, followed by the appropriate code from categories 160-169.

B.Assign the appropriate code from categories 160 169, followed by the appropriate hypertension code.

C.Assign a code from category 116, Hypertensive crisis, followed by the appropriate hypertension code

D.Assign a code from category 127, Other pulmonary heart diseases, followed by the appropriate
hypertension code.

5 Which statement is FALSE in reporting a personal history ICD-10-CM code?

A.A personal history code is acceptable on any medical record regardless of the reason of the visit

B.A personal history code is reported when the patient's condition is no longer present or being treated

C.A personal history code can be reported as a first-listed code when the reason for encounter is for a
screening

D.A personal history code can be reported with follow-up codes

6. Which statement is NOT true regarding the ICD-10-CM coding guidelines for bums?

A Necrosis of burned skin should be coded as a non-healed bum

B.If the patient has burns of varying degrees in the same anatomic site, assign separate codes for each
degree bum

C.The burns codes are also for burns resulting from electricity and radiation.

D.Sequence first the code that reflects the highest degree of burn when more than one burn is present

7. In the ICD-10-CM code book, which of the following is NOT true about the abbreviation NOS?

A.It signifies that the record lacks information for assigning a more specific code

B.It signifies that even though the medical record is specific, the condition is not elsewhere classifiable

C.It is the abbreviation for "not otherwise specifted"

D It is the equivalent of unspecified

ICD 10
1 A 58-year-old with type 1 Diabetes Mellitus comes in for comprehensive eye examination. She is
diagnosed with proliferative diabetic retinopathy with macular edema in the right eye. What ICD-10-CM
coding is reported?

A.E10.3511

B.E10.3519

C.E10.3211

D .E10.311

2. A few days after a bad coughing spell, the patient developed dyspnea that is occurring episodically
throughout the day and night. The physician suspects he has viral pneumonia and orders a chest X-ray.

What is the ICD-10-CM coding is reported?

A.R06.00

B.J12.9. R06.00

C .J18.9

D.J129
3. Which diagnosis codes are reported for a patient who has hypertension and acute renal failure

A .I12.9.N18.9

B.I10 N17.9

C.I12.9. N17.9

D.I10, N19

4. A 38-year-old female presents to her primary care physician due to passing frequent, small amounts
of urine. The physician diagnosed her with urinary tract infection and prescribed ciprofloxacin 500 mg
po q12h for 10 days. Two weeks later she presents to the physician with symptoms and testing showed
she still has a urinary tract infection. On questioning, this patient only took the Cipro once a day and was
saving pills for the next time she needed an antibiotic, due to financial problems. She was given implicit
instructions on how important it to take what is prescribed.

Report the correct diagnosis coding for this office visit.

A.N39.0.T36.8X6A. z91.120

B..Z91.120, T36.8X60

C.N39.0.Z91.120

D.T36.8X6D, N39.0

5.A patient is diagnosed with sepsis and associated acute respiratory failure.

What ICD-10-CM code selection is reported?

A.A41.9. R65.21, J96.00

B. A41.9

C.A41.9, J96.00

D.A41.9, R65.20, J96.00

Integumentary chapter questions :

1. A surgeon performed Mohs micrographic surgery on a lesion on the right arm. This required two
stages. Stage one had six tissue blocks and stage two had three tissue blocks.

What CPT codes are reported for the Mohs surgery?

A.17311,17315

B.17313, 17314, 17315

C.17313,17315

D.17311, 17312, 17315

2. A physician performed as debridement of partial thickness (second degree) burns on the right
forearm totaling 8% of the total body surface area.

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

A.16030, T22.211A, T31.0

B.16030, T22.611A T31.0

C.16025, T22.211A T31.0

D.01952.T22.611A, T31.0

3.A physician used electrosurgery to destroy 14 actinic keratosis on the temples and cheeks. He also
removed 10 skin tags from the neck.

What CPT® codes are reported?

A.11200 x 10, 17000-59, 17003

B.11200, 17004-59

C. 11200, 17000-59, 17003 x 13

D.11200 x 10, 17000-59, 17003 x 13

4. A patient presents with keratosis lesions on her left cheek, above the left eyebrow, and on the chin
area. The dermatologist treats those areas by lightly sanding the surface of a total of 5 lesions.

What CPT® coding is reported?

A.15786 x 5

B.15786, 15787

C.15787 x 5

D.15786,15787x4

5. A patient with multiple atypical lesions on the face and trunk is in the office to perform a biopsy. A
punch tool was used to obtain a full-thickness tissue sample for a lesion on the trunk. Partial-thickness
tissue samples were taken from one lesion on the forehead and one lesion on the cheek using a curette
What CPT® coding is reported?

A.11104, 11102x2

B.11104x2, 11102

C.11104, 11103

D.11104, 11103x2

Musculoskeletal system
1.A patient is diagnosed with compression fractures of the T2, T3, and T4 vertebrae and needs vertebral
augmentation. The patient agrees to have a kyphoplasty. A cavity is created, a balloon catheter is
inserted in the vertebrae, and inflated restoring the height of the vertebra. Bone cement is injected in
the vertebral space until each of the two whole vertebral body is filled. The procedure is performed
bilaterally.

What CPT coding is reported?

A.22513-50.22515-50 x2

B.22513.22515x2

C.22514-50,22515-50

D.22514.22515

2. A patient had surgery a year ago to repair one flexor tendon in his wrist. He is in surgery for a
secondary repair for the tendon without a free graft.

What CPT® coding is reported?

A.25263 x2

B.25270

C.25272 ×2

D.25263

3. A patient with scoliosis has posterior arthrodesis performed on three cervical vertebral segments.

What CPT&Coding is reported?

A.22630, 22632 x 2
B.22808

C. 22600, 22614 x2

D.22800

4. A 35-year-old is coming in for trigger point injections for right-sided thoracic spine pain. Three points
are injected with Depo Medrol 40 mg/mL on the rhomboid major muscle under fluoroscopic guidance.

Which CPT coding is reported for the injections?

A.20553

B.20553 x 3, 77002

C.20552,77002

D.20552 x 3,77002

5. Ten-year-old boy has a painful felon abscess of the deep tissues of the palmar surface of his right
thumb. The provider makes an incision on one side of the nail and then across the fingertip parallel to
the end of the nail. He identifies the area of abscess and drains it. A drainage tube is inserted.

What CPT8 and ICD-10-CM is reported?

A.26011-F5, L03.011

B.26010-F5. L02. 511

C.10140-F5 L02.511

D.10061-F5 L03.011

6. What CPT® code is used for incision and drainage (I&D) of superficial hematoma of the elbow?

A.23931

B.10140

C.10160

D.23930

Cardio respiratory chapter questions :

2 A mother brings her 2-year-old daughter to the Emergency Department because she stuck a large
bead up her right nostril. The 2-year-old is fussy and the provider along with the mother's consent will
use general anesthesia to remove the bead. The child is placed under general anesthesia, incises the
mucosa, and removes the bead from the nostril with nasal forceps.

A.30300-22

B.30300

C.30320

D.30310

3. A 65-year-old with lymphoma is having an insertion of a tunneled central venous catheter placement
via right subclavian vein. Under fluoroscopic visualization, the catheter tip is inserted into the superior
vena cava above the right atrium. The catheter is tied up and the incision site closed.

What central venous access procedure code is reported?

A. 36556

B.36561

C.36569

D.36558

4. An air bag deployed whenja driver lost control of the car and crashed into a guardrail on the side of
the highway. The driver suffers partial impact resulting in a skull fracture of the anterior cranial base.
The fracture is diagnosed using the MRI scanner and cerebrospinal fluid is noted dripping via the
sphenoid sinus into the right nasal passage. The patient requires a surgical nasal sinus endoscopy 10
assess and repair the injury.

What is the correct procedure and diagnosis coding combination to report this service?

A.31291, 31231-59, S02.109A, V47.5XXA, Y92.411

B.31287, S02.19XA, V47.5XXA, Y92.411

C.31291, S02.19XA V47.5XXA, Y92.411

D.31235, S02.91XA, V47.5XXA, Y92.411

5.A 63-year-old patient requires extracorporeal membrane oxygenation (ECMO) for acute respiratory
syndrome. The cannulla insertion is through an open approach via surgical incision in the chest What
CPT codes are reported?

A.33954,32100
B.33954

C.33956

D.33956, 32100

6.A 62-year-old with heart block needs a reimplantation of a dual chamber pacemaker. The entire
system with transvenous atrial and ventricular leads was removed. A completely new system with
transvenous atrial and ventricular leads were inserted.

What CPT codes are reported?

A.33235 33217-51. 33233-51

B.33235 33213-51 33208-51

C.33228 33208-51

D 33235 33208-51 33233-51

Digestive chapter questions :

1. Patient has a liver mass and presents for a percutaneous needle biopsy of the liver with CT guidance.
The surgeon took four core specimens from the liver mass. Pathology report indicates the patient has a
benign hepatic adenoma.

What CPT and ICD-10-CM code are reported?

A.47000, 77012, D13.4 R16.0

B.47000, 77012, D13.4

C.47000, 10009, D13.4 A16.0

D.47100, R16.0

3. A patient arrives for a PEG placement. The patient requires tube feeds for nutrition but frequently
pulls out the dobhoffs tube. An EGD was performed. Several attempts were made to place the PEG tube
without success so the procedure was aborted. During the withdraw of the scope, a small hiatal hernia
was noted in the stomach. The scope was removed the the patient transferred to recovery.
What CPT and ICD-10-CM coding is reported?

A.43246, K94.29, 293.1

B.49450-53, K94.29, K44.9

C .43830-52, Z43.1

D.43246-53, K94.29, K44.9

4. A patient is seen at the doctor's office for nausea, vomiting, and sharp right lower abdominal pain. CT
scan of the abdomen is ordered. Labs come back indicating an increased WBC count with review of the
abdominal CT scan. The physician determines the patient has acute appendicitis. The physician
schedules an appendectomy and takes the patient to the operating room. The appendix is severed from
the intestines and removed via open surgery. What CPT and diagnosis codes are reported?

A.44950, K35.890

B.44950, K35.80

C.44950, K35.80, R11.2, R10.31

D.44970, K35.80

5. A 63-year-old male presents to the operating room for open surgery on a recurrent incarcerated,
incisional hernia repair with insertion of a prosthetic mesh. The size of the hernia is 12 cm.

Whet CPT and ICD-10-CM codes are reported?

A.49596, K43.2

B.49596, 15778, K43.0

C.49618, 15778, K43.2

D.49618, K43.0

6. An 18-year-old female's adenoids has grown back after the primary procedure performed three years
ago.

What CPT® code is reporte

A.42836

B.42831

C.42826
D.42821

Urinary chapter questions :

1. Mr. Jones was recently seen by his provider for severe pain in his left testes. After further testing, the
provider diagnosed him with testicular cander. A radical inguinal left orchiectomy via inguinal approach
is performed to eliminate the possible spread of the cancer.

What CPT code is reported for this procedure?

A.54520-LT

B.54522-LT

C.54530-LT

2. 56-year-old female is postmenopausal with abnormal vaginal bleeding. Ob-gyn provider performs a
hysteroscopy and biopsies the lining of the uterus.

What CPT code is reported?

A.58579

B.58555

C.58578

D.58558

3.A 42-year-old male is diagnosed with a left renal mass. A laparoscope is inserted and advanced to the
operative site. The left kidney is removed, along with the entire left ureter. What CPT code is reported
for this procedure?

A.50220

B.50546

C.50543

D.50548

4. A patient presents to the hospital-based clinic in her 12th week of pregnancy. After a series of
examinations, the provider discovered that the fetus would have many abnormalities if the pregnancy
continues. The patient decides to terminate the pregnancy. The physician dilates the cervix. A cannula is
inserted in the uterine cavity and mechanically evacuates the fetus and products of conception.

What CPT code is reported?

A. 59651

B.59856

C.59841

5.A patient that delivered her second child vaginally has a history of having a previous cesarean delivery
for the first child.

What CPT code is reported for the delivery of the second child with antepartum care and postpartum
care with the same provider?

A.59614

B 59610

C 59410

D.59400

Nervous system chapter questions :

1. A patient has a perforation in the right ear. The otolaryngologist performed a tympanoplasty
removing a portion of the mastoid, along with reconstruction of the external auditory canal and
tympanic membrane repair without reconstruction of the ossicular chain.

What CPT code is reported for this surgery

A.69645

B.69641

C.69643

D.69646

2.Ms. C is diagnosed with an infratentorial intracerebellar hematoma, and the neurologist performs a
craniectomy to access the hematoma. The hematoma is accessed, and a suction device is used to
remove it.

What CPT code is reported?

A .61108
B 61154

C.61312

D.61315

3. The provider uses a nerve tissue graft, harvested from a living donor, for nerve repair on the first
strand of the median nerve in the forearm.

What CPT® code is reported?

A.64912

B.64910

C .64890

D.64897

4 A 45-year-old female had a closed fracture of the L2-L4 vertebrae 15 years ago and now has
displacement of the lumbar intervertebral disc between L3 and L4. The surgeon will decompress the
spinal cord, involving one segment of the lumbar spine. The surgeon performs the surgery by going
through the pedicle on the side of the disc's bulge to reach the herniated disc. The lamina and facet joint
are removed, along with disc fragments.

What is the correct CPT® coding for the procedure?

A.63056, 63057

B.63101,63103

C.63056

D.63101

5.The evisceration of ocular contents was performed using a surgical microscope for enhanced
visualization. The procedure was performed on the left eye and an implant was not placed in the ocular
cavity.

What CPT coding is reported?

A.65091-LT

B.65091-LT, 69990-51

C.65093-LT. 69990

D.65093-LT
6. A patient is brought to the operating room having left-sided aural vertigo and meningitis. The
provider inserts a speculum in the left external ear canal and inserts a right-angle pick into the oval
window. Using an operating microscope, the provider destroys the semicircular canals, the utticle, and
saccule completely removing the diseased labyrinth structures. The provider confirms the excision of the
labyrinth and places a drain the left inner ear canal.

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

A.69910, H81.312, G00.9

B.69910, 69990, H81.392, G03.9

C.69801, H81.392. G03.9

D.69905,69990, H81.312, G03.9

Radiology chapter questions :

1. A patient has swelling in both arms and lymphangitis is suspected. She is in the outpatient radiology
department for a lymphangiography of both arms.

What CPT coding is correct?

A.75801-50

B.75801,75803

C 75803-50

D. 75803

2. A patient with a history of chronic venous embolism in the superior vena cava has a radiographic
study to visualize any abnormalities. In outpatient surgery the physician accesses the subclavian vein
and the catheter is advanced to the superior vena cava for injection and imaging. The supervision and
interpretation of the images is performed by the physician. What codes are reported for this procedure?
A.36000, 75827-26

B.36010, 75825-26

C.36010,75827-26

D.36000, 75825-26

3. A patient in a radiology facility has an X-ray examination of her entire spine after falling down the
stairs and experiencing peripheral paresthesia. A radiologist takes a total of 8 views of the lumbar spine,
thoracic spine, the cervical spine (including atlas and axis) and base of the skull.

What is the CPT code is reported

A.72020

B.72114

C. 72081x8

D.72084

4. A patient is seen in the ER after falling 35 feet out of a tree onto his back. Patient cannot move any of
his extremities and has loss of sensation in all extremities, abdomen, and chest. Both an orthopedic
surgeon and a neurologist are concerned about spinal fractures. Both agree to order the following
radiology tests: CT scans of the cervical spine, thoracic spine, and lumbar spine; each without contrast,
then followed by with contrast and further sections.

What CPT codes for this service?

A.72125.72126, 72128, 72129, 72131,72132

B.72126,72129, 72132

C.72125, 72128, 72131

D.72127 ,72130, 72133

5. A 45-year-old male, with no prior history of heart disease, has been diagnosed having atherosclerotic
heart disease with unstable angina. He is in the cardiologist's office for a cardiac MRI test to determine
the morphology and function of his heart under stress. First images obtained are without contrast and
then contrast is administered for the next set of images. Then the physician injects medicine to increase
the heart rate and checks the coronary arteries for narrowing or blockage. Physician interprets the test
and the results and images are in the medical record.

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

A.75563-26, I25.118

B.75557,75559, I25.110

C.75563,I25.110

D. 75559-26 I25.118

6. A patient is having X-ray imaging of his abdomen following a traumatic episode. A decubitus, supine,
and erect views are performed on the abdomen.

What CPT® is reported?

A.74018-26

B.74022 -26

C.74021-26

D.74019-26

Lab and path chapter questions :

1. The provider orders a bile test for a patient to aid in the determination of inborn errors of bile
metabolism. Lab analyst measures the level of cholylglycine using radioimmunoassay. What CPT code is
reported for the test?

A.82239

B.82247

C.82240

D 82248

2.A 27-year-old male dies of a gunshot wound. A forensic autopsy is performed to gain evidence for the
police investigation and any subsequent trial.

What CPT8 code is reported?

A.88045

B.88025

C 88040

D.88005
3. A patient underwent a colonoscopy, where the gastroenterologist biopsied two polyps from the
colon. Each polyp was sent to pathology as separately identified specimens. The gastroenterologist was
requesting a pathology consult while the patient was still on the table. Tissue blocks and frozen sections
were then prepared and examined as follows:

Specimen 1: First Tissue Block-Three Frozen Sections

Second Tissue Black-One Frozen Section

Specimen 2: First Tissue Block-Two Frozen Sections

Second Tissue Block-One Frozen Section

What CPT coding is reported?

A.88331,88332

B.88331×4 88332 x 3

C.88331x2 88332 x 2

D.88331 x 3 88332 × 2

4. A physician orders an obstetric panel that includes syphilis screening using the non-treponemal
antibody approach, an automated CBC with manual differential WBC count, HBSAg rubella antibody, a
serum antibody screen, and ABO and Rh blood typing

What CPT® coding is reported?

A.80031,86780

B.80055, 85027, 85007, 87340, 86762, 86780, 86850, 86900, 86901

C.85027,85007, 87340, 86762.86780, 86850, 86900, 86901

D.80055

5. A patient had a vaginal hysterectomy for endometrial hyperplasia. This condition is not a cancer or a
prolapse. Specimens from the uterus were sent to pathology for gross and microscopic examination. The
results of the pathology were sent to the surgeon.

Which CPT® code is reported for the surgical pathology?

A.88302

B.88309
C.88305

D.88307

6. A provider orders liquid chromatography mass spectrometry (LC-MS) definitive drug test for a patient
suspected of acetaminophen (analgesic) overdose. What CPT code is reported for the test?

A.80329

B.80299

C.80143

D.80324

Evaluation and management chapter questions :

1.Dr. Burns sees newborn baby James at the birthing center on the same day after the cesarean delivery.
Dr. Burns examined baby James, the maternal and newborn history, ordered appropriate blood test
tests and hearing screening. He met with the family at the end of the exam.

How would Dr. Burns report his services?

A.99460

B.99462

C.99463

D.99461

2.A 13-year-old is seen by his, primary care physician for an annual exam. His last exam with the primary
care physician was two years ago. He has no complaints.

What CPT code is reported?

A.99383

B.99382

C.90393
D.99394

3 .A patient presents to the physiciani's office for the first time with coughing and shortness of breath.
The patient has a history of asthma and esophageal reflux. The physician performs a medically
appropriate history and exam. The physician assesses the patient with moderate persistent asthma with
acute exacerbation and esophageal reflux. The patient was told to take Turns for the reflux.

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

A.99203, J45.41, K21.9

B.99202 J45.901. K21.00

C.99205. J45.41 K21.9

D.99204, J45.991, K21.00

5. A 16-year-old female just moved to the area and is living in a campground with her parents. She has
several medical conditions and the parents are unable to take her to a physician's office. A physician
sees the patient in the campground and documents a medical decision making of moderate complexity.
After the visit, the physician spends an additional 25 minutes in a prolonged discussion with the
patient's parents; he reviews complex and detailed medical records from her previous physicians and
complètes a comprehensive treatment plan. A care plan with the local health agency and a dietician is
initiated.

What E/M coding is reported for this visit?

A.99349

B.99344, 99417

C.99204, 99417

D.99344

6. Ms. M is a type 2 diabetic who was recently diagnosed with significant coronary artery disease after
being admitted to the hospital with chest pain. She saw a cardiologist after discharge who developed a
care plan that includes monitoring, medication adjustment and communication with her
endocrinologist. The cardiologist spent a total time of 40 minutes of personal management time during
the first month.

How would the cardiologist report this service?

A.99424,99425

B.99426
C.99424

D 99426, 99427

HCPCS questions
1. What is the correct HCPCS Level II code for a standard wheelchair?

K0010

K0001

K0002

E1130

2 According to CPT® coding guidelines for obstetrical ultrasounds, which CPT code includes a detailed
anatomic evaluation of the fetal brain, face, heart, chest, abdominal organs, limbs, umbilical cord, and
placenta?

76810

76805

76811

76816

3. According to the ICD-10-C Guidelines, for hypertensive cerebrovascular disease, what is the
sequencing of codes?

A.Assign the appropriate hypertension code, followed by the appropriate code from categories I60-I69.

B.Assign the appropriate code from categones I60-I69, followed by the appropriate frypertension code

C.Assign a code from category I16.

Hypertensive crisis, followed by the appropriate hypertension code.

D.Assign a code from category I27, Other pulmonary heart diseases, followed by the appropriate
hypertension code.

5. Which statement is FALSE in reporting a personal history ICD- 10-CM code?

A.A personal history code is acceptable on any medical record regardless of the reason of the visit.

B.A personal history code is reported when the patient's condition is no longet present or being treated.
C.A personal history code can be reported as a first-listed code when the reason for encounter is for a
screening.

D.A personal history code can be reported with follow-up codes.