Chapter 20: Medicine – Set B

1. A patient mangled his left hand in machinery requiring amputation at the wrist. The
wound has healed and the patient is fitted with an artificial hand. The device has a
molded socket, flexible elbow hinges and triceps pad. A total of 30 minutes was spent
training the patient to use the prosthesis. What codes are reported for the prosthesis,
training and diagnosis?
a. 97761 x 2, L6050, Z44.8, Z89.112 c. L6055, S68.422A
b. 97761, Z89.112 d. 97763 x 2, S68.422A, Z89.112
2. A patient who has psoriasis vulgaris on his back has not responded to topical
applications. He is treated with laser therapy on a total area of 260 sq. cm
a. 17108, L44.0 c. 96921, L40.0
b. 17108, L20.0 d. 96921, L20.0
3. A patient with chronic myeloid leukemia (CML), BCR/ABL-positive has an implanted
access port for delivery of chemotherapy. The device needs to be irrigated before
receiving treatment. What ICD-10-CM and CPT® codes are reported for the irrigation?
a. 96523, C92.10 c. 96521, C95.10
b. 96522, C92.11 d. 96522, C95.10
4. A post-MI (myocardial infarction) patient has been receiving cardiac rehabilitation. At
this session, the physician evaluates the patient, determines he shows satisfactory
progress and may increase his normal daily activities. Continuous EKG is not used at this
session. What CPT® code is reported?
a. 93798 c. 93797
b. 99213 d. 93799
5. A 54 year-old female with uncontrolled type 1 insulin dependent diabetes and related
peripheral vascular disease presents with a deep diabetic ulceration on the bottom of her
right foot. The wound reaches into the fascia and appears to be draining. She
acknowledges going barefoot frequently and is not certain how or when the wound
occurred. After the provider discusses the seriousness of her condition he debrides the
wound, using a water jet and surgical scissors. Size of wound is 70 sq. cm. He applied
topical ointment and a sterile dressing. He counseled the patient about the need to wear
shoes at all times and inspect her feet daily. He advised the patient to wear a water
protective covering on her lower leg when taking a shower and to change the dressing
daily, using ointment provided. A surgical shoe was provided. Patient is to return weekly
until the wound heals and continue her insulin regime. If satisfactory progress does not
occur, a graft may be considered. What codes are reported?
a. 97602, L3260, E10.51, L97.502, Z79.4
b. 97597, 97598 x 3, L3260, E10.621, E10.51, L97.513
c. 97597 x 4, L3260, E10.621, L97.313
d. 97598 x 4, L3265, E10.52, L97.502, Z79.4
6. A young child received a mumps, measles, rubella and varicella (MMRV) injection at a
neighborhood clinic with physician counseling. What CPT® code(s) are reported?
a. 90707, 90716, 90471, 90472 x 3 c. 90710, 90460
b. 90707, 90716, 90460, 90461 x 3 d. 90710, 90460, 90461 x 3
7. 32-year-old ETOH dependent female is in a partial hospitalization program and has been
seeing an addictive disease specialist (psychotherapist) in a chemical dependency
 program. Her employer is aware of her problem. She was referred to the group through
their Employee Assistance Program. As long as she is in compliance, they will support
her efforts. Recently, she has arrived late at the meetings. The physician met with the
patient and discussed the importance of her treatment, compliance with the program and
avoidance of situations in which she may use alcohol. She denies contacts with her
previous associates and assures the physician she has had no alcohol intake since
beginning the substance abuse treatment program. They will continue to reinforce her
progress and successful sobriety. Time of the session was 45 minutes. What CPT® and
ICD-10-CM codes are reported?
a. 90832, F10.220 c. 90832, F10.20
b. 90834, F10.20 d. 90834, F10.220
8. A 50 year-old male is coming in for an eye examination for iritis. His last visit to the
office was two years ago. The ophthalmologist performs a review of history, external
ocular and adnexal examination, routine ophthalmoscopy and a biomicroscopy. Iritis is
not found. The eye examination is completely normal. What CPT® and ICD-10-CM
codes are reported?
a. 92012, Z01.00 c. 92014, 92225, Z01.00
b. 92012, 92225, Z01.01 d. 92002, Z01.110
9. A patient with carcinoma of the descending colon presents for chemotherapy
administration at the infusion center. The infusion was started with 1000 cc of normal
saline. Heparin, 1000 units was added and then Fluorouracil, 800 mg was added and
infused over 2 hours. Dexamethasone, 20 mg was administered, IV push. At the end of
the 2 hours, the IV was disconnected and the patient was discharged. What codes are
reported?
a. 96413, 96415, 96375, J9190 x 2, J1100 x 20, J1644, Z51.11, C18.6
b. 96413, 96375, J9190 x 2, J1100 x 20, Z51.12, C18.8
c. 96413, J9190, J1100, J1642, Z51.11, C18.6
d. 96415, 96375, J9190, J1100, J1644, Z51.0, C18.9
10. A female patient reports repeated falls. She has no known head trauma or other injuries.
She noticed some slight stiffness in her joints and weakness in her lower extremity
muscles, with slight stiffness in her arm joints. The provider decided to test for possible
multiple sclerosis (MS). She was sent to a clinic providing somatosensory studies. The
testing included upper and lower limbs. What CPT® and ICD-10-CM codes are
reported?
a. 95938, M62.81, M25.60, R29.6 c. 95926, M62.81, M25.60, R29.6
b. 95925, 95926, G35 d. 95926, G35
11. A 64-year-old patient came to the emergency department complaining of chest pressure.
The physician evaluated the patient and ordered a 12 lead EKG. Findings included signs
of acute cardiac damage. Appropriate initial management was continued by the ED
physician who contacted the cardiologist on call in the hospital. Admission to the cardiac
unit was ordered. No beds were available in the cardiac unit and the patient was held in
the ED. The cardiologist left the ED after completing the evaluation of the patient.
 Several hours passed and the patient was still in the ED. During an 80- minute period, the
patient experienced acute breathing difficulty, increased chest pain, arrhythmias, and
cardiac arrest. The patient was managed by the ED physician during this 80-minute
period. Included in the physician management were a new 12 lead EKG, endotracheal
intubation and efforts to restore the patient’s breathing and circulation for 20 minutes.
CPR was unsuccessful, the patient was pronounced dead after a total of 44 minutes
critical care time, exclusive of other separately billable services. What CPT® codes are
reported by the physician?
a. 99285-25, 31500, 92950
b. 99291
c. 99291-25, 99292-25, 31500
d. 99291-25, 31500, 92950
12. A patient with Sickle cell anemia with painful sickle crisis received normal saline IV, 100
cc per hour to run over 5 hours for hydration in the physician?s office. She will be given
Morphine & Phenergan, prn (as needed). What codes are reported?
a. 96360, 96361 x 4, J7050 x 2, D57.00 c. 96360, 96361 x 3, J7030, D57.00
b. 96360 x 5, J7050, D57.1 d. 96360, J7030, D57.819
13. 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. V5140, H90.3, Z46.1 c. V5140, H90.6
b. V5261, Z46.1, H90.3 d. V5261, Z01.110, H90.3
14. A 5-year-old is brought in to see an allergist for generalized urticaria. The family just
recently visited a family member that had a cat and dog. The mother wants to know if her
son is allergic to cats and dogs. The child’s skin was scratched with two different
allergens. The physician waited 15 minutes to check the results. There was a flare up
reaction to the cat allergen, but there was no flare up to the dog allergen. The physician
included the test interpretation and report in the record.
a. 95024 x 2 c. 95004 x 2
b. 95027 x 2 d. 95018 x 2
15. A 42-year-old patient presented to the urgent care center with complaints of slight
dizziness. He had received services at the clinic about 2 years ago. The patient related
this episode happened once previously and his 51-year-old brother has a pacemaker. A
chest X-ray with 2 views and an EKG with rhythm strip were ordered (equipment owned
by the urgent care center). The physician detected no obvious abnormalities, but the
patient was advised to see a cardiologist within the next 2 - 3 days. The physician
interpreted and provided a report for the rhythm strip and Chest X-ray. What CPT® and
ICD-10-CM codes are reported for the physician employed by the urgent care center who
performed a Level 3 office visit in addition to the ancillary services?
a. 99213-25, 71046, 93040, R42 c. 99283-25, 71045-26, 93010, R41.842
b. 99213-25, 71046-26, 93042, R42 d. 99203-25, 71045, 93000, R41.89
16. A 55 year-old male has had several episodes of tightness in the chest. His provider
ordered a PTCA (percutaneous transluminal coronary angioplasty) of the left anterior
descending coronary artery. The procedure revealed atherosclerosis in the native vessel.
 It was determined a stent would be required to keep the artery open. The stent was
inserted during the procedure.
a. 92928-LD, I25.10 c. 92920-LD, 92928, I25.811, I25.750
b. 92920-LD, 92929-59, I25.811 d. 92920-LD, 92928-59, I25.10
17. A pregnant female is Rh negative and at 28 weeks gestation. The child?s father is Rh
positive. The mother is given an injection of a high-titer Rho (D) immune globulin, 300
mcg, IM. What CPT®? and ICD-10-CM codes are reported?
a. 90384, 96372, O36.0130, Z3A.28 c. 90384, 90471, P55.0, Z3A.00
b. 90386, 96372, O36.0130, Z3A.28 d. 90386, 90471, P55.0, Z3A.00
18. A patient with hypertensive end stage renal failure, stage 5, and secondary
hyperparathyroidism is evaluated by the provider and receives peritoneal dialysis. The
provider evaluates the patient once before dialysis begins. What CPT® and ICD-10-CM
codes are reported?
a. 90945, I10, N18.5, Z99.2, N25.81 c. 90945, I12.0, N18.6, Z99.2, N25.81
b. 90947, I12.0, N25.81 d. 90947, I12.0, N18.5, Z99.2
19. A patient with congestive heart failure and chronic respiratory failure with hypoxia is
placed on home oxygen. Prescribed treatment is 2 L nasal cannula oxygen at all times. A
home care nurse visited the patient to assist with his oxygen management. What CPT®
and ICD-10-CM codes are reported?
a. 99503, I50.9, J96.11 c. 99504, I50.1, J96.11
b. 99503, I50.9, J80 d. 99503, J50.1, J80
20. A therapist in a residential care facility works with a nonverbal autistic child, age 4. In
this session the therapist uses drawing paper and washable markers. The therapist sat with
the child and began to draw on a sheet of paper. She gave paper and markers to the child
and encouraged the child to draw. The psychotherapy session lasted 30 minutes.
a. 90832, 90785, F84.0 c. 90882, F84.0
b. 90785, F84.0 d. 90791, 90785, F84.9
21. A patient had several panic attacks at work disturbing her coworkers. She had been
unable to explain any particular reason for her behavior. Her employer requested she be
referred for counseling. After several sessions, her psychiatrist provided reports for her
primary care provider and her insurer about her status and prognosis. What CPT® and
ICD-10-CM codes are reported for the preparation of the report?
a. 90889, F41.0 c. 90885, F41.0
b. 90887, F41.9 d. 90889, F41.1
22. A 55-year-old patient had several episodes of fecal incontinence. A colonoscopy had
been performed one year ago with normal results. Anorectal manometry was performed
to determine the pressure on the sphincter muscles. The test indicated a mild relaxation of
the sphincter. Biofeedback training was prescribed. What CPT® and ICD-10-CM codes
are reported?
a. 90901, R10.0, R15.0 c. 91122, 90911, R10.0
b. 91122, 90911, K62.0 d. 91122, K62.89 , R15.9
23. A 49 year old patient had several episodes of esophageal reflux and underwent a
gastroesophageal reflux test to measure the pH balance (a measure of the degree of
 acidity or alkalinity). The test was performed with a mucosal attached capsule. The
physician provided an interpretation and report. The physician stated the diagnosis as
gastroesophageal reflux. What CPT® and ICD-10-CM codes are reported?
a. 91034, K21.9 c. 91037, R12
b. 91034, K21.0 d. 91035, K21.9
24. 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 c. 96040 x 2, Q99.8
b. 96040, Q99.2 d. 96040 x 2, Q99.2
25. Mrs. Salas had angina decubitus that lasted for 30 minutes and was admitted to the
Coronary Care Unit with a diagnosis of R/O MI. The cardiologist (private practice based)
takes her to the cardiac catheterization suite at the local hospital for a left heart
catheterization. Injection procedures for selective coronary angiography and left
ventriculography were performed and imaging supervision and interpretation for the
selective coronary angiography and left ventriculography was provided. What CPT®
code(s) is/are reported for the services?
a. 93452- 26 c. 93453- 26
b. 93458- 26 d. 93453- 26, 93462