10000 Series (10Q) - Try Free Quiz
1. Dr. David, a dermatologist, opened and drained multiple complicated acne pustules and comedones on a 19-year-old patient with severe acne. For one of the more complicated acne pustules, Dr. Brown incised, drained, and marsupial zed the acne cyst by suturing the right and left sides, leaving the cyst open for drainage. What is the correct code for the procedure?
A. 10060
B. 10061, 10040
C. 10040
D. 10061
2. Dr Joesph a dermatologist, is seeing a patient for an acne surgery follow-up that was performed eight months ago. The surgery was successful and the patient’s skin condition has rapidly improved due to a strict hygiene regimen and acne medications. Today the patient stated that he would like to reduce acne scarring by having dermabrasion on his entire face. Although the patient requested the entire face, the dermatologist only performed the dermabrasion on the areas on the patient’s face that were not currently prone to acne breakouts (his forehead and brow area). What is the correct code for this procedure?
A. 15781 B. 15780 C. 15786 D. 15788
3. A physician biopsied the skin on a 30-year-old woman’s upper eyelid, with a possible fungal infection. Three sites were biopsied. How should the physician code for this procedure?
A. 11100, 11101 (X2) B. 11100 (X3) C. 11100, 67810 D. 67810
4. The physician performed the excision of two 1.5 cm malignant lesions on a patient’s upper back. During the surgery, the physician noted four additional lesions, which looked to be pre-malignant. These lesion excisions were 0.3, 0.7, 1.0, and 1.45 cm, respectively. The suspect lesions were sent to pathology lab, where they were determined to be benign. What are the appropriate codes for the service?
A. 11400 (X4), 11602 (X2)
B. 11400, 11401 (X2), 11402
C. 11404, 11603
D. 11400, 11401 (X2), 11402, 11602 (X2)
5. A 22-year-old woman with excessive skin of her upper eyelid presented to her physician’s office for the revision of her right eyelid. Her physician decided that she would perform a blepharoplasty of the right eyelid, during which she would remove the excessive skin weighing down the lid. When the physician performs this procedure, what code should she report?
A. 15822 B. 15823 C. 15823-50 D. 15820
6. Two weeks ago, a 32-year-old male suffered a thumb injury at work. He was using a belt grinder on a small piece of steel when the belt caught the tip of his left thumb in the grinder. His thumb was ground down to the tip, his thumb nail was removed and a small piece of his anterior phalange bone was broken off. The patient has an appointment scheduled today to see if his nail bed on his left thumb can be reconstructed using a graft from his left great toe. What is code for this procedure?
A. 11760-LT B. 11765 C. 11762-LT D. 11730, 11732
7. A 10-year-old boy was running through his house and ran into a sliding glass door, breaking the glass and suffering severe lacerations on his trunk and arms and minor lacerations on his face and legs. The emergency department physician performed the simple closure of one 2 cm laceration on the boy’s cheek and two 2.3 cm lacerations on the boy’s left leg. The physician performed the simple closure of one 4 cm laceration on the right arm and the layered closure of two lacerations on the left arm, which were 1.5 and 3 cm, respectively. The physician treated the 5 cm laceration on the boy’s chest, which required the removal of particulate glass and a single layer closure. What are the correct codes for the wound repair performed by the emergency department physician?
A. 12001, 12002 (X2), 12032 (X2)
B. 12005, 12011-51, 12032-51
C. 12004, 12011-51, 12032 (X2)
D. 12004, 12011-51, 12034-51
8. A 32-year old woman with severe gynecomastia and a prevalent family history of breast cancer elected to have a complete bilateral mastectomy with immediate insertion of breast prosthesis implants. What is/are the correct code(s) for the procedure?
A. 19300-50, 19340-50
B. 19300-50, 19340-50
C. 19303, 19357
D. 19300-50, 19357-50
9. A 56-year-old male presents to a podiatry office with complaints of recurrent problems with an ingrown toenail on his right great toe. He has been treated multiple times with antibiotics, but the pain and swelling is causing him difficulty wearing his work boots. He currently does not have an infection, although the ingrown toenail is present and painful. The doctor performs a wedge excision of the skin of the nail fold to his right great toe. Which of the following codes should you use?
A. 10060
B. 11760
C. 11765, 11765
D. 11750
10. A 10-year-old girl comes to her pediatrician’s office after smashing the nail of her right 2nd digit in the car door the previous night. This morning, the tip of her finger is edematous, there is a large amount of ecchymosis present, and the pain is worse than when the injury initially occurred. The pediatrician uses a disposable Bovie high-temperature cautery pen to cauterize a hole in the nail to allow the subungual hematoma to drain. A small amount of serosanguineous fluid is removed and pain rapidly decreased. Which of the following codes should you use?
A. 11720
B. 11730
C. 11740
D. 11750
A. 10060
B. 10061, 10040
C. 10040
D. 10061
10,000 SERIES (20 QUESTIONS) – ANSWER KEY & RATIONALE
1. Answer: C - The correct code for the procedure is 10040 (Acne Surgery). This is the only code necessary, as it includes the opening of acne comedones, cysts, and pustules. It also includes the marsupialization of the acne cysts. Codes: 10060 and 10061 are used for the incision and drainage of unspecified abscesses or cysts, rather than acne cysts.
2. Answer: A - The correct code for this procedure is 15781(Dermabrasion; Segmental, Face). Code 15780 is not appropriate because it refers to the total face, which in this case, did not apply because the dermatologist only performed the procedure on certain parts of the patient’s face. Code 15786 is inappropriate because it refers to an abrasion of a lesion, rather than dermabrasion. Code 15788 is also inappropriate because it refers to a chemical peel, not dermabrasion.
3. Answer: A - The physician should code for this procedure using codes: 11000 (Biopsy of Skin, Subcutaneous Tissue and/or Mucous Membrane) and 11001 (X2) (Each Additional Lesion).The physician biopsied three sites, therefore three biopsy codes should be listed on the claim. Code 67810 (Incisional Biopsy of the Eyelid Skin including Lid Margin) is not the correct code because the biopsy is for the skin of the eyelid, instead of an incisional biopsy of the eyelid.
4. Answer: D - The appropriate codes for the service are: 11400, for the excision of the 0.3 cm benign lesion, 11401 (X2) for the excision of both 0.7 and 1.0 benign lesions, 11402 for the excision of the 1.45 cm benign lesion, and 11602 (X2) for the excision of both of the 1.5 cm malignant lesions. CPT coding guidelines state that each malignant/benign lesion excised needs to be reported separately; therefore each lesion removal needs to be
coded separately.
5. Answer: B - When the physician performs this procedure, she should report code 15823 (Blepharoplasty, Upper Eyelid; with Excessive Skin weighting Down Lid). Modifier -50 is inappropriate because the procedure is only going to be performed on the right side not bilaterally. Code 15820 is inappropriate because it refers to a blepharoplasty of the lower eyelid.
6. Answer: C - The appropriate code for this procedure is 11762-LT (Reconstruction of the Nail Bed with Graft). The physician is planning on using a graft of the nail bed from the left great toe, therefore the code 11760-LT would not be correct because it only applies to the unspecified repair of the nail bed not a repair performed with a graft.
7. Answer: D - The correct codes for the wound repair performed by the emergency department physician are 12004, for the simple repair of the 4.6 cm and 4 cm lacerations of the left leg and right arm; 12011 for the simple repair of the 2 cm laceration of the cheek; and 12034 for the intermediate repair of the 4.5cm and 5cm lacerations of the left arm and chest. According to CPT guidelines, when multiple wounds are repaired, the coder must “add together the lengths of those in the same classification and from all anatomic sites that are grouped together into the same code descriptor.” The repair of the chest laceration is an intermediate repair because it required the removal of particulate matter (glass).
8. Answer: A - The correct codes for the procedure are 19300 (Mastectomy for Gynecomastia) and 19340 (Immediate Insertion of Breast Prosthesis following Mastopexy, Mastectomy or in Reconstruction). Both codes need to be appended with modifier -50 to indicate that they were performed bilaterally. Code 19303 is not appropriate, in this case, because the mastectomy was performed due to gynecomastia.
9. Answer: C - 11765 is correct because it is the only code that is specific to wedge excision of the skin of nail fold. Code 10060 is incorrect because the ingrown toenail was not infected and did not require drainage. Code 11760 is incorrect because there was no repair done to the nail bed and 11750 is incorrect because the wedge excision was performed to the skin, not the nail itself, and the nail was not removed.
10. Answer: C - 11740 is correct because the subungual hematoma was able to be evacuated by using a disposable Bovie cautery pen in the office. Code 11720 is incorrect because there was no debridement done of the nail. Code 11730 is incorrect because there was no avulsion and 11750 is incorrect because there was no excision of the nail for permanent removal.