This is second post of my next CPC Practice Questions 2017 series post. I will publish more questions in coming days. Do check these. Practice more and more these questions and find answers in the next post.
For previous post, see this :
- A 56 year old male patient had coronary artery bypass two months ag. He now presents for a re-operation for coronary bypass. Cardiopulmonary bypass machine will be used during this procedure and the patient will be placed under general anesthesia
- A male patient passes out while jogging in the park. Upon examination at the hospital he is found to have a wide complex tachycardia and undergoes and electrophysiologic study and radiofrequency ablation
- A 64 year old fell in the kitchen while mopping the floor and could not get up. The fall resulted in a broken hip. Upon examination of the break, the physician decides a hip replacement is needed. The patient is taken to the operating room where anesthesia is administered for the surgery of a total hip replacement
- A patient presents to the labor delivery department in the first stages of labor. The baby is in breech position so the physician decides to perform an external cephalic version to manipulate the fetus for a head presentation. The patient is taken to the operating room where she received anesthesia for this procedure.
C. 01967, 01968
- A 67 year old female in good physical health is having a cholecystectomy. The anesthesiologist begins to prepare this patient for surgery at 1000. The surgery begins at 10:15 and ends at 11:30. The anesthesiologist releases the patient to the PACU nurses at 11:45.
A. 1 hr 30mins, 00840
B. 1 hr 45mins, 00790
C. 1 hr 15mins, 00790
D. 2hrs 15mins, 00840
- Using ultrasound guidance an anesthesiologist injects an analegesic and a steroid mixture into the parsvertebral facet joint on both the right and left sides at L1-L2 and L2-L3. The procedure is done for pain management for the patient’s persistent pain secondary to spondylosis with myelopathy.
A. 64493, 64494, 77003-26
B. 0216T-50, 0217T-50
C. 64483-50, 64484-50, 77003-26 x2
D. 64493-50, 64494-50
- Patient is coming into surgery for total knee replacement due to worn down cartilage in the knee joint. When patient was taken to the recovery room, he still continued to have postoperative pain during recovery. The anesthesiologist came in and performed a left femoral block, which provided significant post-operative pain relief.
A. 01402, 64448, 01996
B. 01400, 64447
C. 01402, 64447
- A 15 year old male was seen this morning in his pediatrician’s office for controlling a nosebleed with cauterization. He returns to the office in the afternoon with a nosebleed continuing after initial cautery. This time the pediatrician uses Surgifoam and extensive cautery anteriorly in the left nose
- Preoperative Diagnosis: Acute MI, severe left main arteriosclerotic coronary artery disease
Postoperative Diagnosis: Acute MI, severe left main arteriosclerotic coronary artery disease
Procedure performed: Placement of an LABP right common femoral artery
Description of procedure: Patient’s right groin was prepped and draped in the usual sterile fashion. Access was obtained through the groin via opening the femoral artery. The tip of the balloon catheter was placed and then intra-aortic balloon pump was placed after the right common femoral artery had been dilated with the small dilator. The ballon pump had good waveform. The balloon pump catheter was secured to his skin after local anesthesia of 2cc of 1% Xylocaine was used to numb the area. 0 silk suture was used to secured the balloon pump. The patient had sterile dressing placed. The patient tolerated the procedure there were no complication.
- The cardiothoracic surgeon takes a patient to the operating room to perform an open balloon angioplasty of femoral pepriteal artery. During the same operative session, the surgeon performs an open transluminal peripheral atherectomy of the visceral artery.
A. 37224, 75964-26
B. 37224, 0235T
C. 37228, 37220
D. 37228, 0238T
- A lymphanglogram is performed on a patient with early onset of cervical cancer. Code the condition as well as the injection procedure with radiological imaging on one side.
A. 38790-50, 75807, 180.0.. can be this
B. 38792-50, 78195, 180.8
C. 38790, 75805, 180.9,
D. 38792, 76942, 180.0
- An eight year old male presents with multiple Ventrical Septai Defects (VSDs) and is in current heart failure. Under general anesthesia, the skin incision is made via median sternotomy. Cardiopulmonary bypass is initiated. Under epicardial guidance the muscular VSD is located. The guidewire is placed transmyocardially through the VSD. A new technology device is then delivered over guidance to close the VSD, after successful closure the guidewire is removed and the site is repaired. A chest tube is placed in the sternum.
- An oncologist performs a bone marrow aspiration and a bone marrow biopsy on the right posterior iliac spine. The procedures were performed during the same encounter. Select the appropriate code(s) for a Medicare patient.
A. 38221, 38220
C. 38221, G0364
D. 38220, G0364
- A catheter is placed into aortic arch from a right femoral arterial approach. The catheter is then guided into the right common carotid. Dye is injected and imaging of the ipsilateral extracranial carotid and bilateral external carotid is performed.
- Patient is a 26 year old female new to our group practice. She has symptoms indicative of gastritis with increasing abdominal bloating I have been contracted as a locum tenes to substitute for Dr. Allen while he is on vacation for two weeks.
- Patient is a 26 year old female in for one month follow up to our group practice for asthma. My partner Dr. Jones is unavailable today and this patient is new to me. She has no new complaint and no recurrence of dyspnea (see previous note). Blood pressure 120/84, RRR, NBS, lungs clear to auscultation. All question answered. No scheduled f/u. Return PRN. The MDM was straightforward.
- A patient presents to the oncology office for her scheduled chemotherapy. Uring the encounter she receives IV chemo medicationn for two hours and 16 minutes.
A 96413, 96415
B. 99211-25, 96413, 96417
C. 99211, 96413, 96411 X 2
D. 96413, 96365
- A 10 year old child that has regrowth of tonsil tissue is taken to the operating room for a tonsillectomy.
- A 34year old male is taken back to the OR for a takedown of his colostomy and reversal of his small intestines after six months of bowel rest for his colitis. The patient supine on the operating table and general endotracheal anesthesia is administered. His abdomen is prepped and draped in the usual sterile manner. The colostomy stoma was incised and dissected sharply from the abdominal wall. After the stoma was mobilized and taken down from the abdominal wall, it was closed with 0-0 chronic and 5-0 prolene. The abdominal incisions were closed in the usual fashion.
- A patient undergoes a laparoscopic partial colostomy of the transverse colon, including low pelvic anastomosis, due to cancer of the colon and rectum.
Please do all these questions and ask your queries in the comments section.