14 year-old status post injury over one year ago to her left wrist presented with recurrent wrist
pain. The patient was taken to the operating room and placed under general anesthesia. She was
placed in wrist traction. The radiocarpal joint was entered endoscopically through sharp skin
incisions and blunt dissection into the joint. There was found to be mild synovitis in the dorsal
ulnar aspect of the wrist. This was debrided arthroscopically with a shaver. There was a peripheral
tear of the triangular fibrocartilage. This area was shaved to promote healing. Using outside in
technique, a PDS suture was placed across the TFCC and into the capsule. There was synovitis
within the midcarpal joint, but there was no articular injury. All instruments were removed and
the wounds were closed with interrupted nylon sutures. What CPT ® code is reported? -
answer29846-LT
44-year-old male with biplanar deformity, acquired limb length discrepancies and tibial nonunion
has undergone deformity correction. He now requires exchange of an external fixation strut 45
days postoperatively. The intraoperative mounting parameters, deformity parameters, and initial
strut settings are inserted into the computer prior to Jim's discharge and a daily schedule is
generated for him to perform the gradual deformity correction necessary. What CPT® code(s)
should be reported? - answer20697
56 year-old pro golfer is having Mohs micrographic surgery for skin cancer on his forehead. The
surgeon takes him back for two stages. The first stage has 4 tissue blocks and the second stage has
6 tissue blocks. What is the best way to code for both stages? - answer17311, 17312, 17315
66 year-old male with a history of anemia presents for a liver core biopsy to evaluate for possible
cirrhosis. The patient was brought to the CAT scan suite in which limited CT images of the upper
abdomen were performed for biopsy needle placement. The appropriate site for the liver core
biopsy was chosen. The patient's skin was then marked with the computer coordinates. An
18-gauge needle was advanced into the appropriate site and a sample was obtained. What CPT ®
codes are reported for the facility? - answer47000, 77012
A must include cholesterol, serum total (82465), Lipoprotein, direct measurement, high density
cholesterol (HDL cholesterol) (83718), and Triglycerides (84478) - answerLipid Panel (80061)
A patient presents to the hospital-based outpatient surgery department for a left knee medial
meniscus repair. She had recurrent locking, swelling and catching of the knee. A diagnostic
arthroscopy was performed. Under direct visualization, a medial portal was established and
debridement of the posterior horn of the medial meniscus was performed. A shaver was then
introduced to trim the meniscus back to a stable rim. The remainder of the knee was probed. The
scope was then withdrawn and the wound was closed with #4-0 Vicryl. The discharge diagnosis
was a bucket-handle tear of the medial meniscus. The patient tolerated the procedure well. What
are the correct procedure and diagnosis codes for this encounter? - answer29881, S83.212A
A 12 year-old child presents to the ED with an acute exacerbation of asthma. The patient is
wheezing and is having difficulty breathing. She is not responding to the therapy. The physician
documents as the final diagnosis asthma with status asthmaticus. What ICD-10-CM code(s) is/are
reported? - answerJ45.902
A 12 year-old's diabetes mellitus is well controlled with oral antidiabetic medications . The patient
has no complications. Applying the coding concept from ICD-10-CM guidelines I.C.4.a.l, I.C.4.a.2,
and I.C.4.a.3, what ICD-10-CM code(s) is/are reported? - answerE11.9, Z79.84
A 13 year-old is seen in the emergency department with a sudden onset of nausea, fever and
diarrhea. A stool culture indicated Salmonella bacterium. The patient stated that she had been at a
family reunion and recalls eating some salad, ice-cream and chicken. Diagnosis made was
salmonella gastroenteritis. Report the diagnosis code(s) for the visit. - answerA02.0
A 14-year-old male is brought to the ER by his parents after hitting his left knee on the base when
sliding into base at a baseball game in a public park. After X-rays were obtained, it revealed a
sprain to the knee. The patient was instructed to keep his leg elevated and keep weight off of it as
much as possible for the next two weeks. What diagnosis codes are reported for this encounter? -
answerS83.92XA, W21.89XA, Y92.830, Y93.64
A 15 year old female undergoing treatment for Hodgkin's lymphoma presents to the behavioral
health clinic to be evaluated for increasing acute panic attacks during her cancer treatments. The
psychologist spent 1 hour and 15 minutes face-to-face with the patient. The patient was diagnosed
with adjustment disorder with anxiety and a treatment plan was initiated. She will be seen for a
reassessment in 30 days. What are the correct CPT ® and ICD-10-CM codes to report this service? -
answer96150 x 5, F43.22, C81.90
A 15 year-old has been taken to surgery for crushing his index and middle fingers, injuring his
digital nerves of the left hand. The physician located the damaged nerves in both fingers and
sutures them to restore sensory function. What CPT® and ICD-10-CM codes are reported? -
answer64831-LT, 64832-LT, S64.491A, S64.493A
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