The documentation states:
He was then sterilely prepped and draped along the flank and abdomen in the usual sterile fashion. I
first made a skin incision off the tip of the twelfth rib, extending medially along the banger’s lines of
the skin. This was approximately 3.5 cm in length. Once this incision was carried sharply,
electrocautery was used to gain access through the external oblique, internal oblique, and transverse
abdominis musculature and fascia.
What surgical approach was used for this procedure?
D
Explanation:
The documentation describes making a skin incision off the tip of the twelfth rib and extending
medially along the banger’s lines of the skin. The use of electrocautery to gain access through
multiple layers of musculature and fascia indicates an open surgical approach. Open surgery involves
making a large incision to expose and directly view the surgical site. This is distinct from
percutaneous (which involves needles or catheters), laparoscopic (which uses small incisions and a
camera), and other minimally invasive techniques.
Reference: AMA's CPT® Professional Edition, ICD-10-CM, and HCPCS Level II (current year)
The mediastinum is:
A
Explanation:
The mediastinum is an anatomical region located in the thoracic cavity. It is bounded by the sternum
in front, the vertebral column at the back, and is situated between the lungs. It contains the heart,
trachea, esophagus, thymus, and other structures, but it is not itself an organ. Therefore, the correct
answer is that it is a location in the chest.
Reference: ICD-10-CM, Medical Anatomy and Physiology textbooks
Patient is diagnosed with dacryocystitis, which is the inflammation of?
D
Explanation:
Dacryocystitis is the inflammation of the lacrimal sac, which is part of the tear drainage system
located in the inner corner of the eye. The lacrimal sac is connected to the nasolacrimal duct, which
drains tears into the nasal cavity. Inflammation in this area can cause pain, redness, and swelling
near the inner corner of the eye.
Reference: ICD-10-CM, medical dictionaries
In rhinoplasty:
A
Explanation:
Rhinoplasty is a surgical procedure performed to reconstruct or reshape the nose. It can be done for
cosmetic reasons or to improve breathing function. The term "rhino" refers to the nose, and "plasty"
refers to the surgical molding or forming of a part of the body.
Reference: AMA's CPT® Professional Edition, medical dictionaries
Where is a Warthin's tumor found?
C
Explanation:
Warthin's tumor, also known as papillary cystadenoma lymphomatosum, is a benign tumor of the
salivary glands, most commonly affecting the parotid gland. It typically presents as a painless, slow-
growing mass near the angle of the jaw.
Reference: ICD-10-CM, medical dictionaries, and oncology textbooks
When a patient has ESRD, which system is affected?
D
Explanation:
End-Stage Renal Disease (ESRD) is a condition in which the kidneys fail to work effectively to remove
waste products and excess fluids from the blood. This primarily affects the genitourinary system,
which includes the kidneys, ureters, bladder, and urethra. Patients with ESRD often require dialysis or
a kidney transplant.
Reference: ICD-10-CM (current year), Chapter 14: Diseases of the Genitourinary System (N00-N99).
The human shoulder is made of which three bones?
D
Explanation:
The human shoulder is composed of three main bones: the clavicle (collarbone), scapula (shoulder
blade), and humerus (upper arm bone). These bones form the shoulder joint, which is one of the
most flexible and mobile joints in the human body, allowing for a wide range of motion.
Reference: AMA's CPT® Professional Edition (current year), Musculoskeletal System section.
The outermost protective layer of skin is called the:
A
Explanation:
The outermost protective layer of the skin is called the epidermis. It serves as a barrier to protect the
body against environmental elements, pathogens, and helps to retain moisture. The epidermis itself
is composed of several sub-layers, with the stratum corneum being the outermost layer.
Reference: ICD-10-CM (current year), Chapter 12: Diseases of the Skin and Subcutaneous Tissue (L00-
L99).
Which one of the following is a commercial or private payer?
A
Explanation:
Blue Cross Blue Shield is a commercial or private payer, which means it is an insurance company that
provides health insurance plans to individuals and groups. In contrast, Medicare and Medicaid are
government programs, and the Veterans Health Administration (VHA) is a federal healthcare system
for military veterans.
Reference: AMA's CPT® Professional Edition (current year), Appendix B: Payers and Reimbursement.
Which place of service code is submitted on the claim for a service that is performed in an outpatient
surgical floor?
C
Explanation:
The place of service code 22 is used for services performed in an outpatient hospital setting,
including outpatient surgical floors. This code indicates that the procedure was done in a hospital but
not requiring an inpatient admission.
Reference: AMA's CPT® Professional Edition (current year), Place of Service Codes.
Which entity offers compliance program guidance to form the basis of a voluntary compliance
program for a provider practice?
C
Explanation:
The Office of Inspector General (OIG) provides compliance program guidance to form the basis of a
voluntary compliance program for provider practices. This guidance is intended to help healthcare
providers develop effective internal controls to monitor adherence to applicable statutes,
regulations, and program requirements of Federal healthcare programs. The OIG issues various
compliance guidelines and resources to assist organizations in establishing comprehensive
compliance programs to prevent fraud, waste, and abuse.
Reference: OIG Compliance Program Guidance, AMA's CPT® Professional Edition, and healthcare
compliance resources.
A cardiologist attempted to perform a percutaneous transluminal coronary angioplasty of a totally
occluded blood vessel. The surgeon stopped the procedure because of an anatomical problem
creating risk for the patient and preventing performance of the catheterization.
What modifier is appended to the procedure code?
B
Explanation:
Modifier 53 is used to report a discontinued procedure. It indicates that a procedure was started but
terminated due to the patient's well-being being at risk. In this scenario, the percutaneous
transluminal coronary angioplasty was attempted but stopped because of an anatomical problem
that created a risk for the patient, preventing the completion of the procedure.
Reference: AMA's CPT® Professional Edition, coding guidelines on the use of modifiers.
According to the Repair (Closure) CPT® guidelines, what type of repair is reported when a single layer
closure includes copious irrigation and extensive cleaning to remove particulate matter?
C
Explanation:
According to the CPT® guidelines for Repair (Closure), an intermediate repair includes the closure of
a wound with one or more layers of subcutaneous tissue and superficial fascia in addition to the skin
(epidermal and dermal) closure. It also involves extensive cleaning of the wound, which includes
copious irrigation and the removal of particulate matter. This description fits the scenario provided in
the question.
Reference: AMA's CPT® Professional Edition, Repair (Closure) guidelines.
The CPT® code book provides full descriptions of medical procedures, although some descriptions
require the use of a semicolon (;) to distinguish among closely related procedures.
What is the full description of CPT® code 69644?
A
Explanation:
CPT® code 69644 refers to a tympanoplasty with mastoidectomy, which includes canalplasty, middle
ear surgery, and tympanic membrane repair. The specific procedure described by this code is
performed with an intact or reconstructed canal wall and includes ossicular chain reconstruction. The
use of a semicolon in the CPT® description helps distinguish between different variations of the
procedure.
Reference: AMA's CPT® Professional Edition, specific code descriptions and guidelines.
Which statement regarding lesion excision is TRUE?
A
Explanation:
Lesion excision codes in the CPT® codebook include the removal of the lesion along with the
necessary margins and a simple (nonlayered) closure when performed. These codes do not cover
intermediate or complex closures, which are reported separately if performed. The measurement for
selecting the appropriate lesion excision code includes the lesion and the margins required for
complete excision.
Reference: AMA's CPT® Professional Edition, lesion excision guidelines.