MOCK-1 Past Paper PDF

**MOCK-1** **Date: 17^th^ Jan 2023 MOCK -1 ** **Name: ** **Date: ** **Time: 4 hours ** **1. The patient is here to follow-up for a keloid excised from his neck in November of last year. He believes it's coming back. He does have a recurrence of the keloid on the superior portion of the scar. Si...

**MOCK-1** **Date: 17^th^ Jan 2023 MOCK -1 ** **Name: ** **Date: ** **Time: 4 hours ** **1. The patient is here to follow-up for a keloid excised from his neck in November of last year. He believes it's coming back. He does have a recurrence of the keloid on the superior portion of the scar. Since the keloid is still small, options of an injection or radiation to the area were discussed. It was agreed our next course should be a Kenalog injection. Risks associated with the procedure were discussed with the patient. Informed consent was obtained. The area was infiltrated with 1.5 cc of medication. This was a mixture of 1 cc of Kenalog-40 and 0.5 cc of 1% lidocaine with epinephrine. He tolerated the procedure well. What CPT® andICD-10-CM code(s) are reported? ** **a. 11900, 11901 x 7, J3301, L73.0 ** **b. 11900, J3301, L91.0 ** **c. 11901, J3301, L91.0 ** **d. 11901 x 8, J3301, D48.5 ** ** 11900 Injection, intralesional; up to and including 7 lesions ** ** 11901 Injection, intralesional; more than 7 lesions ** **J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg ** **Brand name(s): Clinicort, Kenalog, Tri-Kort, Trilog ** **2. A 15-year-old female with hypertrophic breasts is experiencing breast pain. She was seen with her parents requesting surgical treatment for this problem. A few weeks later she received a reduction of breast treatment in removing breast tissue to correct this problem. What are the correct CPT and ICD 10 CM codes for this scenario? ** **a. 19318, N62, N64.4 ** **b. 19301, N64.4, N62 ** **c. 19306, N62 ** **d. 19316, N64.4 ** **N64.4 Mastodynia ** ** 19316 Mastopexy ** ** 19318 Breast reduction ** ** 19300 Mastectomy for gynecomastia ** ** 19301 Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy) 19302 Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy ** ** 19303 Mastectomy, simple, complete ** ** 19305 Mastectomy, radical, including pectoral muscles, axillary lymph nodes** **Page 1 ** **Date: 17^th^ Jan 2023 MOCK -1 ** ** 19306 Mastectomy, radical, including pectoral muscles, axillary and internal mammary lymph nodes (Urban type operation) ** ** 19307 Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle ** **3. Indications: 15-year-old boy was burned in a fire and assessed to have received burns to 75 percent of his total body surface area. He was transferred to a burn center for definitive treatment. Once stable, he was brought to the OR. ** **Procedure: Due to extent of the patient's burns and lack of sufficient donor sites, his full thickness burns will be excised and covered with xenograft (skin substitute graft), and a split thickness skin biopsy will be harvested for preparation of autologous grafts to be applied in the coming weeks, when available. After induction of anesthesia, extensive debridement of the full thickness burns was undertaken. Attention was first directed to the patient's [face, neck, and] [scalp. A total of 500 sq cm] in this area received full-thickness burns. The eschar involving this area was excised down to viable tissue. Hemostasis was achieved using electrocautery. Attention was then turned to the [trunk. A total of 950 sq cm] in this area received full-thickness burns. The eschar involving this area was excised down to viable tissue.Hemostasis was achieved. Attention was then turned to the arms and [legs. A total of 725 sq] cm received full thickness burns. The eschar involving this area was excised down to viable tissue. Hemostasis was achieved. Attention was then turned to the [hands and feet. A total of 300 sq cm] in this area received full-thickness burns. The eschar involving this area was exciseddown to viable tissue. All involved areas were then covered with xenograft. Finally, a split thickness skin graft of 0.015 inches in depth was harvested using a dermatome from a separate donor site. A total of 85 sq cm was recovered. What procedures codes would be reported service? ** **a. 15200, 15201 x 123, 15004, 15005, 15002, 15003 ** **b. 15275, 15276 x 31, 15271, 15272 x 66, 15004, 15005 x 16, 15002, 15003 x 7 c. [15277, 15278 x 7, 15273, 15274 x 16,] 15004, 15005 x 7, 15002, 15003 x 16, 15040 d. 15130, 15131 x 7, 15135, 15136 x 16, 15004, 15005 x 7, 15002, 15003 x 16 ** **950+725= 1675 Sq cm: 15273, 15274 x 16 ** **500+300= 800 Sq cm: 15277, 15278 x 7 ** **4. A 59-year-old female has non-palpable right breast mass. An ultrasound exam shows that the mass is not a simple cyst. Fine needle aspiration (FNA) biopsy of the mass is performed [under ultrasonic guidance.] The report for the ultrasound is within the report of the procedure which confirms breast cancer. What procedure and diagnosis code(s) will be reported? FNA ** **a. 19083, C50.921 ** **b. 19083, 76942, C50.912 ** **c. 19100, 76942, C50.911** **Page 2 ** **Date: 17^th^ Jan 2023 MOCK -1 ** **d. 10005, C50.911 ** ** 10005 Fine needle aspiration biopsy, including ultrasound guidance; first lesion ** **5. A 36-year-old male presents to have multiple lesions destroyed. Three benign lesions on his face are destroyed and five actinic keratoses on his left arm are destroyed. Codes for the procedures are: ** **a. 17000, 17003 ** **b. 17000, 17003 x 4, 17110 ** **c. 17110 ** **d. 17260 x 5, 17110 x 3 ** **6. The left breast was prepped and draped in a sterile fashion. An incision from the 3 aroundto the 9 o'clock position on the areolar border on its inferior aspect was made in the skin and extended to the subcutaneous tissue. The breast mass was excised by sharp dissection. The mass was found to be approximately 1.5 - 2 cm in maximum dimension. Hemostasis was made adequate using electrocautery and the Argon beam coagulator. After this was accomplished, the skin margins were reapproximated with running inverted 3-0 Vicryl subcuticular suture. Select the procedure and diagnosis codes. ** **a. 19120, N63.23 ** **b. 19301, D49.3 ** **c. 19125, N60.82 ** **d. 19101, N64.51 ** **19120 Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions ** **19125 Excision of breast lesion identified by preoperative placement o[f] r[a]diological marker, open; single lesion + 19126 Excision of breast lesion identified by preoperative placement of radiological marker, open; each additional lesion separately identified by a preoperative radiological marker (List separately in addition to code forprimary procedure) ** **7. A patient is seen in the hospital's outpatient surgical area with a diagnosis of a displaced comminuted fracture of the lateral condyle, right elbow (Closed Fracture). An ORIF (open reduction) procedure was performed and included the following techniques: An incision was made in the area of the lateral epicondyle. This was carried through subcutaneous tissue, andthe fracture site was easily exposed. Inspection revealed the fragment to be rotated in two places about 90 degrees. It was possible to manually reduce this quite easily, and the manipulation resulted in an almost anatomic reduction. This was fixed with two pins driven across the humerus. The pins were cut off below skin level. The wound was closed with plain catgut subcutaneously and 5-0 nylon for the skin. Dressings and a long arm cast were applied. What CPT® andICD-10-CM codesare reported?** **Page 3 ** **Date: 17^th^ Jan 2023 MOCK -1 ** **a. 24579-RT, 29065-51-RT, S42.453B ** **b. 24577-RT, S42.451A ** **c. 24579-RT, S42.451A ** **d. 24575-RT, S42.453B ** **Fracture Type: Closed Fracture( ICD 7^th^ place: A) Vs Open fracture(ICD 7^th^ place: B) Treatment Type: ** **a) Open Treatment ** **b) Percutaneoustreatment ** **c) Closed treatment ** ** 24577 Closed treatment of humeral condylar fracture, medial or lateral; with manipulation 24575 Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation, when performed ** ** 24579 Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation, when performed ** **8. A Grade I, high velocity type 1 open right femur shaft fracture was incurred when a 15- year-old female pedestrian was hit by a car. She was taken to the operating room within four hoursof her injury for thorough irrigation and debridement, including excision of devitalized bone. The patient was then re- prepped, re-draped, and repositioned. Intramedullary rodding ** **was then carried out with proximal and distal locking screws. What are the correct codes for this diagnosis and procedure? ** **a. 27506, 11044-51, S72.301B, V03.90XXA, Y93.01 ** **b. 27506, 11012-51, S72.301B, V03.90XXA, Y93.01 ** **c. 27507, 11012-51, S72.301A, V03.90XXA, Y93.01 ** **d. 27507, 11044-51, S72.91XA, V03.90XXA, Y93.01 ** ** 27506 Open treatment of femoral shaft fracture, with or without external fixation, with insertion of intramedullary implant, with or without cerclage and/or locking screws ** ** 27507 Open treatment of femoral shaft fracture with plate/screws, with or without cerclage ** **9. Sally suffered a burst [fracture to her lumbar spine] during a skiing accident. Dr. Phyllis performed a partial corpectomy to L2 by a transperitoneal approach followed by anterior arthrodesis of L1-L3. She also positioned anterior instrumentation and placed a structuralallograft to L1-L3. How would Dr. Phyllis report this procedure? ** **a. 63090, 22558-51, 22585, 22845, 20931 ** **b. 63085, 22533, 22585-51, 22808-59 ** **c. 22612 x 2, 22808, 22840-51, 20931 ** **d. 22558, 22858-51, 22845-51, 20931-59** **Page 4 ** **Date: 17^th^ Jan 2023 MOCK -1 ** **10. A 35-year-old is coming in for trigger point injections for right sided thoracic spine pain. Four trigger points are injected with Depo Medrol 40 mg/mg. on the [rhomboid major and] [rhomboid minor] under Fluro guidance. ** **a. 20553, 77002, J1030 ** **b. 20552, 77002, J1030 ** **c. 20605X2, 77002, J1020 ** **d. 20552X2, 77002, J1020 ** ** 20552 Injection(s); single or multiple trigger point(s), 1or 2 muscle(s) ** ** 20553 Injection(s); single or multiple trigger point(s), 3 or more muscles ** **J1030 Injection, methylprednisolone acetate, 40 mg ** **Brand name(s): Depa-Medlone, Depoject, Depo-Medrol ** **11. 70-year-old male has [compression fractures of the C3 and C5 due to osteoporosis.] Vertebroplasty is performed by using bone filler devices advanced into the vertebral body anteriorly near the midline and deposit a total of 1.75 ml of radiopaque bone cement on rightand left sides of the fractures. ** **a. 22510, 22512-51, S12.200A, S12.400A ** **b. 22510-50, 22512-50-51, S12.200A, S12.400A ** **c. 22513, 22515, S12.200A, S12.400A ** **d. 22510, 22512, S12.200A, S12.400A ** **22510 Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic ** **22513 Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic ** **12. PREOPERATIVE DIAGNOSIS: [Rightscaphoid fracture.]- ** **POST-OP DIAGNOSIS: [Right scaphoid fracture] Closed & Displaced\_ 7^th^ Place- A TYPE OF PROCEDURE: Open reduction and internal fixation of right scaphoid fracture. DESCRIPTION OF PROCEDURE: The patient was brought to the operating room, anesthesia having been administered. The right upper extremity was prepped and draped in a sterile manner. The limb was elevated, exsanguinated, and a pneumatic arm tourniquet was elevated.An incision was made over the dorsal radial aspect of the right wrist. Skin flaps were elevated. Cutaneous nerve branches were identified and very gently retracted. The interval between the second and third dorsal compartment tendons was identified and entered. The respective tendons were retracted. A dorsal capsulotomy incision was made, and the fracture was visualized. There did not appear to be any type of significant defect at the fracture site. A ** **0.045 Kirschner wire was then used as a guidewire, extending from the proximal pole of the** **Page 5 ** **Date: 17^th^ Jan 2023 MOCK -1 ** **scaphoid distalward. The guidewire was positioned appropriately and then measured. A 25-mm Acutrak drill bit was drilled to 25 mm. A 22.5-mm screw was selected and inserted and rigid internal fixation was accomplished in this fashion. This was visualized under the OEC imaging device in multiple projections. The wound was irrigated and closed in layers. Steriledressings were then applied. The patient tolerated the procedure well and left the operatingroom in stable condition. What code should be used for this procedure? ** **a. 25628-RT, S62.91XA ** **b. 25624-RT, S62.91XD ** **c. 25645-RT, S62.91XS ** **d. 25651-RT, S62.91XB ** ** 25624 Closed treatment of carpal scaphoid (navicular) fracture; with manipulation 25628 Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed ** **13. 78-year-old patient with bilateral, lower lobe lung cancer has been in the hospital for seven days with a tunneled chest tube in place to drain fluid from the pleural space. The chest tubecurrently is inserted between the 4th and 5th intercostal space on the left side. There is a verybad infection at the insertion site. The physician removes this chest tube and inserts another chest tube between the 5th and 6th intercostal space on the left side to continue fluid drainage. The tube placed today is just the same as the one removed, only sterile. What CPT® andICD 10-CM codes are reported? ** **a. 32560, 32552-51, T81.89XA, C34.90 ** **b. 32550, 32552-51, T85.79XA, C34.30 ** **c. 32551, 32552-51, T85.79XA, C78.00 ** **d. 32561, 32552-51, T81.89XA, C34.90 ** ** 32550 Insertion of indwelling tunneled pleural catheter with cuff ** ** 32551 Tube thoracostomy, includes connection to drainage system (eg, water seal), when performed, open (separate procedure) ** ** 32560 Instillation, via chest tube/catheter, agent for pleurodesis (eg, talc for recurrent or persistent pneumothorax) ** ** 32561 Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); initial day** **All Rights Reserved, Copyright © 2020 metiz, Bangalore. Page 6 Info ** **Date: 17^th^ Jan 2023 MOCK -1 ** **14. Dr. Sacra performed a CABG surgery on Fred five months ago. Today, Dr. Sacra completed another coronary artery bypass using three venous grafts with harvesting of a femoropopliteal vein segment (35572). How would Dr. Sacra report her work for the current surgery? ** **a. 33512, 33530-51, 35572-51 ** **b. 33535, 35500-51, 33519 ** **c. 33512, 33530, 35572 ** **d. 33535, 33519, 33530-51, 35500 ** **15. Mr. Azeri, a 68-year-old patient, has a [dual-chamber pacemaker.] The leads in this system were recalled. The leads were extracted via transvenoustechnique, the generator was left in place, and new leads were inserted via transvenous technique. How would you report this procedure? ** **a. 33214, 33215-51, 33208-51, 33218-51 ** **b. 33215, 33210-51, 33216-51 ** **c. 33208, 33235-51, 33217-51 ** **d. 33235, 33217-51 ** **Removal of Leads( Two leads)- ** **33235Placement Leads(Two leads)- ** **33217 ** **16. The patient is a 67 -year-old gentleman with metastatic colon cancer recently operated on for a brain metastasis, now for placement of an Infuse-A-Port for continued chemotherapy. The left subclavian vein was located with a needle and a guide wire placed. This was confirmedto be in the proper position fluoroscopically. A transverse incision was made just inferior to this and a subcutaneous pocket created just inferior to this. After tunneling, the introducer was placed over the guide wire and the [power port line was placed] with the introducer and the introducer was peeled away. The tip was placed in the appropriate position under fluoroscopic guidance and the catheter trimmed to the appropriate length and secured to the power port device. The locking mechanism was fully engaged. The port was placed in the subcutaneous pocket and everything sat very nicely fluoroscopically. It was secured to the underlying soft tissue with 2-0 silk stitch. What code should be used for this procedure? ** **A. 36556, 77001-26 B. 36558 ** **C. 36561, 77001-26 D. 36571 ** **17. A catheter is placed in the left common femoral artery in retrograde fashion which was directed into the right iliac system advancing it to the external iliac. Dye was injected and a select right lower extremity angiogram was performed which revealed patency of the common femoral and profunda femoris. The catheter was then manipulated into the femoral** **Page 7 ** **Date: 17^th^ Jan 2023 MOCK -1 ** **artery in which a select lower extremity angiogram was performed which revealed occlusion from the popliteal to the peroneal artery. What are the procedure codes that describe this procedure? ** **A. 36217, 75736-26, 75774-26 B. 36247, 75716-26 ** **C. 36217, 75658-26 D. 36247, 75710-26 ** **18. 79-year-old male with [symptomatic bradycardia and syncope] is taken to the Operating Suite where an [insertion of a DDD pacemaker will be performed.] A left subclavian venipuncture was carried out. A guide wire was passed through the needle, and the needle was withdrawn. A second subclavian venipuncture was performed, a second guide wire was passed and the second needle was withdrawn. An oblique incision in the deltopectoral area incorporating the wire exit sites. A subcutaneous pocket was created with the cautery on the pectoralis fascia. An introducer dilator was passed over the first wire and the wire and dilator were withdrawn. A ventricular lead was passed through the introducer, and the introducer was broken away in the routine fashion. A second introducer dilator was passed over the second guide wire and the wire and dilator were withdrawn. An atrial lead was passed throughthe introducer and the introducer was broken away in the routine fashion. Each of the leads were sutured down to the chest wall with two 2-0 silk sutures each, connected the leads to the generator, curled the leads, and the generator was placed in the pocket. We assured hemostasis. We assured good position with the fluoroscopy. What code should be used for this procedure? ** **A. 33208 ** **B. 33212, 33217-51 ** **C. 33208, 76000-26 ** **D. 33235, 76000-26 ** **To report fluoroscopic guidance for diagnostic lead evaluation without lead insertion, replacement, or revision procedures, use 76000. ** **19. 56-year-old patient complains of occasional rectal bleeding. His physician decides to perform a rigid proctosigmoidoscopy. During the procedure, two [polyps] are found in the rectum. The polyps are removed by a snare. What CPT® andICD-10-CM codesarereported? ** **a. 45320, K62.1 ** **b. 45383, D12.6 ** **c. 45309, 45309, D12.6 ** **d. 45315, K62.1** ** 45309 Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique ** **Page 8 ** **Date: 17^th^ Jan 2023 MOCK -1 ** ** 45315 Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique ** **20. 42-year-old patient is brought to the operating room for an anterior abdominal repair of a 2.5 cm incarcerated incisional recurrent hernia using mesh. What CPT® andICD-10-CM codes are reported? ** **a. 49561, K40.91 ** **b. 49566, K43.2 ** **c. 49614, K43.2 ** **d. 49561, 49568, K43.2 ** **49613 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible. ** **49614 less than 3 cm incarcerated or strangulated. ** **49615 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible. ** **49616 3 cm to 10 cm, incarcerated or strangulated. ** **49617 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible. ** **49618 greater than 10 cm, incarcerated or strangulated. ** **49621Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial orrecurrent, including implantation of mesh or other prosthesis, when performed; reducible. ** **49622 incarcerated or strangulated. ** **+ 49623 Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach(ie, open, laparoscopic, robotic) (List separately in addition to code for primary procedure)** **Page 9 ** **Date: 17^th^ Jan 2023 MOCK -1 ** **21. A 28-year-old female that had symptoms of RLQ abdominal pain, fever, and vomiting was diagnosed with acute appendicitis. The surgeon makes an abdominal incision to remove the appendix. [The appendix was not ruptured.] The incision is closed. What are the correct CPT® and ICD-10-CM codes for this encounter? ** **a. 44950, K35.80 ** **b. 44970, K35.80 ** **c. 44950, R10.31, R50.9, R11.10, K35.80 ** **d. 44960, H60.541 ** **22. A colonoscopy is performed on a 50-year-old patient with a [family history of colon cancer.] Found during the procedure were multiple polyps. Two polyps in the [transverse colon] were removed with hot forceps cautery. Three polyps in the [ascending colon] were removed via snare. Portions of all polyp tissues were to be sent to pathology. What are the correct CPT® and ICD-10-CM codes for this patient encounter? ** **a. 45384 x2, 45385 x3, D12.3 ** **b. 45384, 45385-59, D12.3, D12.2, [Z80.0] ** **c. 45384, 45385-59, D12.6, Z80.0 ** **d. 45384 x2, 45385 x3, D12.3 ** **D12.0 Benign neoplasm of cecum ** **D12.1Benign neoplasm of appendix ** **D12.2Benign neoplasm of ascending colon ** **D12.3Benign neoplasm of transverse ** **cDo1l2o.n4Benign neoplasm of descending colon ** **D12.5 Benign neoplasm of sigmoid colon ** **D12.6Benign neoplasm of colon, unspecified ** **D12.7Benign neoplasm of rectosigmoid junction ** **D12.8 Benign neoplasm of rectum ** **D12.9Benign neoplasm of anus and anal canal ** **23. Postoperative Diagnosis: [calculi of the] ** **[gallbladderp]rocedure: removal of gallbladder ** **indications: the patient is a 40 year old woman who has a six month history of RUQ pain, which ultrasound revealed to be multiple gallstones. She presents for removal of her gallbladder. Procedure: the patient was bought to the OR and prepped and draped in a normalsterile fashion. After adequate general endotracheal anesthesia was obtained, a trocar was placed and CO2 was insufflated into the abdomen until an adequate pneumoperitoneum was achieved. A camera was placed at the umbilicus and the gallbladder and liver bed were visualized. The gallbladder was enlarged and thickened, and there was evidence of chronic inflammatory changes. Two additional ports were placed, and graspers were used to free the gallbladder from the liver bed with a combination of sharp dissection and electrocautery.** **Page 10 ** **Date: 17^th^ Jan 2023 MOCK -1 ** **Several attempts were made before it was decided that additional exposure was needed, and I converted to an open approach. The trocars were removed, and a midline incision was made. At this time, it was clear that there were multiple adhesions in the area, and once these were carefully taken down, we were able to grasp the gallbladder. The cystic duct was carefully ligated and the gallbladder carefully removed from the field. The area was copiously irrigated, and a needle biopsy of the liver was taken. Then the skin was reapproximated in layers. Sponges and needle counts were correct, and the patient was taken to the recovery room ingood condition. ** **a. 47600-22 ** **b. 47600-22, 47001 ** **c. 47562, 47600-22, 47001 ** **d. 47562-22, 47000 ** **24. Per-operative diagnosis: lower left inguinal pain ** **Postoperative diagnosis: inguinal hernia ** **Procedure: this 30-year-old patient presented with lower left inguinal pain and no examination was found to have a left inguinal hernia. The decision to perform a left inguinal hernia repair was made. The procedure was performed in the outpatient hospital surgery center. Risks and benefits of the surgery were discussed with the patient and the patient decided to proceed with the surgery. A skin incision was placed at the umbilicus where the leftrectusfascia was incised anteriorly. The rectus muscle wasretracted laterally. Balloon dissectorwas passed below the muscle and above the peritoneum. Insufflation and de insufflation weredone with the balloon removed. The structural balloon was placed in the preperitoneal space and insufflated to 10 mm Hg carbon dioxide. The other trocars were placed in the lower midline times two. The hernia sac was easily identified and was well-defined. It wasdissected off the cord anteromedially. It was an indirect sac. It was taken back down and [reduced into the peritoneal] [cavity.] Mesh was then tailored and placed overlying the defect, covering the femoral, indirect, and direct spaces, tacked into place. After this was completed, there was good hemostasis. The cord, structures, and vas were left intact. The trocars were removed. The wounds were closed with 0 Vicryl for the fascia, 4-0 for the skin. Steri-strips - were applied. The patient was awakened and carried to the recovery room in good condition, having tolerated the procedure well. What are the correct procedure and diagnostic codes? ** **a. 49505-LT, K40.90 c.49507-LT, K40.20 ** **b. 49505-LT,49568,K40.90 d.49501-LT,49568,K40.20 ** **25. A 26-year-old gravida2 para1 female has been spotting and has been on bed rest. She awoke this morning with severe cramping and bleeding. Her husband brought her to the hospital. After examination, it was determined she has an incomplete early spontaneous abortion. She is in the 12th week of her pregnancy. She was taken to the OR and a dilation and curettage (D&C) was performed. There were no complications from the procedure. She will follow-up with me in the office. She has had four antepartum visits during her pregnancy.** **Page 11 ** **Date: 17^th^ Jan 2023 MOCK -1 ** **a. 59812, O03.4 ** **b. 59812, 59425, O03.4 ** **c. 58120, O03.4 ** **d. 58120, 59425, O03.9 ** **(For surgical treatment of spontaneous abortion, use 59812) ** **(For medical treatment of spontaneous complete abortion, any trimester, use E/M codes 99202-99233) dilation and curettage (D&C) was performed- Surgical ** **Treatment59425- Delivery occur, then report to indicate ** **Antepartum care. ** **26. The patient is a 25-year-old G2P1 female at 13 weeks with a molar pregnancy. She has had irregular bleeding for one week. Ultrasound was performed yesterday and the physician confirms a 16 week size uterus with hydatidiform molar pregnancy. She is admitted today for an evacuation and curettage. What are the CPT® andICD-10-CM codes? ** **A. 59870, O01.9 ** **B. 59812, O02.89 ** **C. 57505, O02.0 ** **D. 59160, O01.9 ** ** Uterine evacuation and curettage for hydatidiform mole ** ** 59812 Treatment of incomplete abortion, any trimester, completed surgically ** **27. A pregnant patient delivers twins at 30 weeks gestation. The first baby is delivered vaginally, but during this delivery, the second baby has turned into the transverse position during labor. The decision is made to perform a [caesarean to deliver the second baby.] The OB physician who performed the delivery also performed the prenatal care and will be performingthe postpartum care. The standard coding for this is: ** **a.59514, 59409-51 b.59510, 59409-51 ** **c. 59510-22 d.59510, 59400-51 ** ** 59510 Routine obstetric care including antepartum care, cesarean delivery, and postpartum care ** ** 59514 Cesarean delivery only ** ** 59515 Cesarean delivery only; including postpartum care ** ** 59400 Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care ** ** 59409 Vaginal delivery only (with or without episiotomy and/or forceps) ** ** 59410 Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care ** **28. A 30-year-old disabled Medicare patient is scheduled for surgery due to the discovery of what looks like an [ovarian mass on the right ovary.] On entering the abdomen, the surgeon finds an enlarged [ovarian cyst on the right,] but the ovary is otherwise normal. The left ovary is** **Page 12 ** **Date: 17^th^ Jan 2023 ** **MOCK ** **-1 ** **necrotic looking. The decision is made, based on the patient's age, to remove the cyst fromthe right ovary, and also perform a left salpingo-oophorectomy. Code this encounter. ** **A.58720-50 b.58925-RT, 58720-51-LT ** **C.58925-50, 58720-51-LT d.58925-50 ** **Salpingo-oophorectomy: Removal of fallopian tube and ovaries ** ** 58720 Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure) 58925 Ovarian cystectomy, unilateral or bilateral ** **29. A 55-year-old man with complaints of an [elevated PSA] of 6.5 presents to the outpatient surgical facility for prostate biopsies. The patient is placed in the lateral position. Some calcifications were found in the right lobe, with no obvious hypo echogenic abnormality. The base of the prostate was infiltrated and random needle biopsies were performed under ultrasonic guidance? ** **a.10022 b.55706 c.55700, 76942-26 d.55705, 76942-26 ** ** 55700 Biopsy, prostate; needle or punch, single or multiple, any approach- Percutaneous (If imaging guidance is performed, see 76942, 77002, 77012, 77021) ** ** 55705 Biopsy, prostate; incisional, any approach- Open ** ** 55706 Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance- Percutaneous ** **30. Newborn male is scheduled for a circumcision. He is sterilely prepped and draped; a penile nerve block is performed. The circumcision is performed by a ring device( Clamp). Hemostasisis achieved. Vaseline Gauze dressing applied. Patient tolerated the procedure well. How would this encounter be coded? ** **a.54160 b.54150 c.54161, 64450 d.54150, 64450** ** 64450 Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch ** **31. The patient is a 64-year-old female who is undergoing a REMOVAL of a previously implanted Medtronic pain pump and catheter due to a possible infection. The back was incised; dissection was carried down to the previously placed catheter. There was evidence of infection with some fat necrosis in which cultures were taken. The intrathecal portion of the \ ** **All Rights Reserved, Copyright © 2020Infometiz, ** **Page 13 \ ** **Bangalore. ** **MOCK -1 ** **catheter was removed. Next the pump pocket was opened with evidence of seroma. The pump was dissected from the anterior fascia. A 7-mm Blake drain was placed in the pump pocket through a stab incision and secured to the skin with interrupted Prolene. The pump pocket was copiously irrigated with saline and closed in two layers. What are the CPT and ICD-10-CM codes for this procedure? ** **A. 62365, 62350-51, T85.890A, Z45.49 B. 62360, 62355, T81.4XXA C. 62365, 62355-51, T85.79XA D. 36590, T85.890A, T88.8XXA ** ** 62355 Removal of previously implanted intrathecal or epidural catheter ** ** 62365 Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion ** **32. The patient is a 73-year-old gentleman who was noted to have progressive gait instability over the past several months. Magnetic resonance imaging demonstrated a ventriculomegaly.It was recommended that the patient proceed forward with right frontal ventriculoperitoneal shunt placement with Codman programmable valve. What is the correct code for this surgery? ** **A. 62220 B. 62223 C. 62190 D. 62192 ** ** 62220 Creation of shunt; ventriculo-atrial, -jugular, -auricular ** ** 62223 Creation of shunt; ventriculo-peritoneal, -pleural, other terminus ** ** 62190 Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular ** ** 62192 Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus Creation/ Insertion/ placement ** **33. MRI reveals patient has cervical stenosis. It was determined he should undergo bilateral cervical laminectomy at C3 through C6 and fusion. The edges of the laminectomy were then cleaned up with a Kerrison and foraminotomies were done at C4, C5, and C6. The stenosis is ** **central: a facetectomy is performed by using a burr. Nerve root canals were freed by additional resection of the facet, and compression of the spinal cord was relieved by removalof a tissue overgrowth around the foramen. Which CPT codes should be used for this procedure? ** **A. 63045-50, 63048-50 ** **B. 63020-50, 63035-50, 63035-50 ** **C. 63015-50 ** **D. 63045, 63048 x 3 ** ** 63045 Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root\[s\], \[eg, spinal or lateral recess stenosis\]), single vertebral segment; cervical** **Page 14 ** **MOCK -1 ** **Nerve root canals were freed- Decompression ** **34. An infant who has chronic otitis media was placed under general anesthesia and a radial incision was made in the posterior quadrant of the left tympanic membrane. A large amount of mucoid effusion was suctioned and then a ventilating tube was placed in both ears. What CPT and ICD-10-CM codes should be reported? ** **A. 69436-50, H65.30 ** **B. 69436-50, H65.90 ** **C. 69433-50, H65.119 ** **D. 69421-50, H65.30 ** ** 69420 Myringotomy including aspiration and/or eustachian tube inflation ** ** 69421 Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia 69424 Ventilating tube removal requiring general anesthesia ** ** 69433 Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia ** **  ** **69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia** **H65.30Chronic mucoid otitis media, unspecified ear ** **H65.31 Chronic mucoid otitis media, right ear H65.32 ** **Chronic mucoid otitis media, left ear ** **H65.33Chronic mucoid otitis media, bilateral ** **35. A 65-year-old patient presented with [ectropion] of the right lower eyelid. Repair with tarsal wedge excision is performed for correction. Attention was then directed to the left eye. The patient also had an ectropion of the left lower lid which was repaired by suture repair. Code this procedure. ** **A. 67916-50, H02.132, H02.135 B. 67916-E4, 67914-E2, H02.132, H02.135 C. 67914-50, H02.135 D. 67923-E4, 67921-E2, H02.132 ** ** 67914 Repair of ectropion; suture ** ** 67915 Repair of ectropion; thermocauterization ** ** 67916 Repair of ectropion; excision tarsal wedge ** ** 67917 Repair of ectropion; extensive (eg, tarsal strip operations) ** ** 67921 Repair of entropion; suture ** ** 67922 Repair of entropion; thermocauterization ** ** 67923 Repair of entropion; excision tarsal wedge ** ** 67924 Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation) ** **Page 15 ** **MOCK -1 ** **36. PROCEDURE: Bilateral lumbar medial branch block under fluoroscopy for the L3, L4, L5 medial branches for the L4-L5, L5-S1 facets for diagnostic and therapeutic purposes. PROCEDURE: The patient was placed in the prone position on the fluoroscopy table and automated blood pressure cuff and pulse oximeter applied. The skin entry points for approaching the anatomic target points of the bilateral segmental medial branches or dorsal ramus of L3, L4, L5 were identified with a 22.5 degree from perpendicular lateral oblique fluoroscopy view and marked. Following thorough Chloraprep preparation of the skin and draping and 1% lidocaine infiltration of the skin entry points and subcutaneous tissues, a 22 gauge 6\" spinal needle was placed under fluoroscopic guidance down on the target point for each respective segmental medial branch or dorsal ramus. At each point 1 mL consisting of 0.5% bupivacaine and Depo-Medrol was injected. A total of 80 mg of Depo-Medrol was divided between all four spots. Code the procedure(s). ** **A. 64483, 64484, 77003-26 B. 64493-50, 64494-50, 64495-50 C. 64493, 64494, 63395 x 4, 77003-26 D. 64493-50, 64494 X 2 ** **37. A patient is positioned on the scanning table headfirst with arms at the side for an MRI of the thoracic spine and spinal canal. A contrast agent is used to improve the quality of the images. The scan confirms the size and depth of a previously biopsied leiomyosarcoma metastasized to the thoracic spinal cord. What CPT® andICD-10-CM codesarereported? ** **a. 72255, D49.7 ** **b. 72157, D43.2 ** **c. 72070, C79.31 ** **d. 72147, C72.0 ** ** 72146 Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material 72147 Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) ** **38. A 78-year-old with lower back pain and leg pain is scheduled for a MRI of lumbar spine without contrast. Following the MRI, the patient is diagnosed with spinal stenosis of the lumbar region. What are the procedure and diagnosis codes? ** **A. 72020-26, M54.5, M79.606, M48.06 ** **B. 72149-26, M48.06 ** **C. 72148-26, M48.06 ** **D. 72158-26, M48.07, M54.5, M79.606** **Page 16 ** **MOCK -1 ** **39. The physician orders an ultrasound on a patient 25 weeks pregnant with twins to access fetal heart rate and fetal position. Select the code(s). ** **a. 76805, 76810 ** **b. 76811, 76812 ** **c. 76812 x 2 ** **d. 76815 \ ** ** 76815 Ultrasound, pregnant uterus, real time with image documentation, ** **limited (eg, fetal heart beat, placental \ ** **location, fetal position and/or qualitative amniotic fluid volume) ** **, 1 or more fetuses \ ** **40. A patient with colon cancer receives seven radiation treatments. During the course of the treatments, the physician views the port films, reviews the treatment parameters, and assesses the patient's response to the treatment. Code for the radiation treatment management. ** **a. 77427 ** **b. 77431 x 4 ** **c. 77427 x 2 ** **d. 77427, 77431 ** ** 77427 Radiation treatment management, 5 treatments ** **(77431 is not to be used to fill in the last week of a long course of therapy) ** **Total 7 treatments: 5 treatment (77427) + 2 Treatments (77431) ** **Total 8 treatments: 5 +3 = 77427 X 2 **  **41. This gentleman has localized prostate cancer and has chosen to have completed transrectal ultrasonography performed for dosimetry purposes. Following calculation of the planned transrectal ultrasound, guidance was provided for percutaneous placement of 25 seeds. Select the appropriate codes for this procedure.** **Page 17 ** **MOCK -1 ** **a. 55860, 76942-26 ** **b. 55875, 76965-26 ** **c. 55860, 76873-26 ** **d. 55875, 77778-26, 76965-26 ** ** 55875 Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy ** **Placement of 25 seeds- Radioelement ** ** (For interstitial radioelement application, see 77770, 77771, 77772, 77778) ** ** (For ultrasonic guidance for interstitial radioelement application, use 76965) ** **42. On the same date of service (DOS), if an AP chest x-ray is performed at 7:00 am and read by Dr. A and at 10:30am another AP chest x-ray is performed and read by Dr. A, the correct modifier(s) to be assigned to these codes to describe the physicians reading of these studies ina hospital-based setting are (is): ** **a. 71045-26 and 71045-26 ** **b. 71045- 76 and 71045-76 ** **c. 71045-26 and 71045-26,76 ** **d. 71045-26 and 71045-26,-77 ** **43. A patient has partial removal of his lung-88309. The surgeon also biopsies several lymph nodes-88305 in the patient's chest which are examined intraoperatively by frozen section- 88331 and sent with the lung tissue for Pathologic examination. The pathologist also performsa trichome stain-88313. What CPT® codesarereportedfor the labtestsperformed? ** **a. 88309 x 2, 88313 c. 88307, 88305x2, 88332 ** **b. 88309, 88305, 88313, 88331 d. 88309, 88307, 88313 ** **44. A 58-year-old male patient with abdominal pain and episodes of bright red blood in his stool reports to his physician's office for a check-up. His physician performs a digital rectal exam and tests for occult blood. Dr. Smith documents this blood occult test was done for purposes other than colorectal cancer screening. How would you report the occult blood test? ** **a. 82270 b. 82274 ** **c. 82271 d. 82272 ** **45. Patient is coming in for a pathological examination for ischemia in the left leg. The first specimen is 1.5 cm of a single portion of arterial plaque taken from the left common femoral artery. The second specimen is 8.5 x 2.7 cm across x 1.5 cm in thickness of a cutaneous** **Page 18 ** **MOCK -1 ** **ulceration with fibropurulent material on the left leg. What surgical pathology codes should be reported for the pathologist? ** **A. 88302, 88304 B. 88304-26, 88305-26 ** **C. 88305-26, 88307-26 D. 88307, 88309 ** **46. Physician orders a comprehensive metabolic panel but also wants blood work on calcium ions and also orders a basic metabolic panel. Select the code(s) on how this is reported. ** **A. 80053, 80047 B. 80053 C. 80047, 82040, 82247, 82310, 84075, 84155, 84460, 84450 D. 80053, 82330 ** **47. 18-year-old female with a history of depression comes into the ER in a coma. The ER physician orders a drug screen on antidepressants, phenothiazines, and benzodiazepines. The lab performs a screening for each single drug class using an immunoassay in a random-access analyzer. Presence of antidepressants is found, and a drug confirmation is performed to identify the particular antidepressant. What correct CPT® codesare reported? ** **A. 80305 X 3, 80332 ** **B. 80306X3 ** **C. 80307 ** **D. 80307, 80338 ** **Confirmation: Definitive Drug Test ** ** 80332 Antidepressants, serotonergic class; 1 or 2 ** ** 80333 Antidepressants, serotonergic class; 3-5 ** ** 80334 Antidepressants, serotonergic class; 6 or more ** ** 80335 Antidepressants, tricyclic and other cyclicals; 1 or 2 ** ** 80336Antidepressants, tricyclic and other cyclicals; 3-5 ** ** 80337 Antidepressants, tricyclic and other cyclicals; 6 or more ** ** 80338 Antidepressants, not otherwise specified ** **48. A patient presents to the ED with crushing chest pain radiating down the left arm and up under the chin. There are elevated S-T segments on EKG. The cardiologist sees and admits the patient to CCU. He orders three serial CPK enzymes levels with [instructions that the tests are] [also to be done with isoenzymes] if the initial tests are elevated for that date of service. The [CPK enzyme levels were elevated,] the lab codes would be: ** **A. 82550, 82552, 82550-76 x 2, 82552-76 x 2 B. 82550, 82552, 82552-91 x 2 C. 82550, 82550-91 x 2, 82552, 82552-91 x 2 D. 82550 x 3, 82554 x 3 ** ** 82550 Creatine kinase (CK), (CPK); total ** ** 82552 Creatine kinase (CK), (CPK); isoenzymes ** ** 82553 Creatine kinase (CK), (CPK); MB fraction only ** ** 82554 Creatine kinase (CK), (CPK); isoforms** **Page 19 ** **MOCK -1 ** **49. 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® andICD-10-CM codesarereported? ** **a. 90384, 96372, O36.0120 ** **b. 90386, 96372, O36.0120 ** **c. 90384, 90471, P55.0 ** **d. 90386, 90471, P55.0 ** **50. A patient with hypertensive end stage renal failure, stage V and secondary hyperparathyroidism is evaluated by the physician and receives peritoneal dialysis. The physician evaluates the patient once before dialysis begins. What CPT® andICD-10-CM codesare reported? ** **a. 90945, I12.0, N18.6, N25.81 c. 90945, I12.9, N18.5, N25.81 b. 90947, I10, N18.6, N25.81 d. 90947, I12.0, N18.6, N25.81 ** **I12.0 Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stagerenal disease ** **I12.9 Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease,or unspecified chronic kidney disease ** **51. A patient with congestive heart failure and chronic respiratory failure is placed on homeoxygen. 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® codesare reported? ** **a. 99503, I50.9, J96.10 c. 99504, I50.9, J96.0 ** **b. 99503, I50.9 d. 99503, I50.9, J96.0 ** **52. The patient is admitted to the hospital for a EEG to determine the focus of her cerebral seizures. The test also consists of video recording and interpretation. The EEG is performed in 12 hours. Select the appropriate coding. ** **a. 95719 ** **b. 95718-52 ** **c. 95717 ** **d. 95718 ** **53. A patient presents to her oncologist's office for schedule chemotherapy. The patient is severely dehydrated. The physician decides to schedule the chemotherapy for another day and** **Page 20 ** **MOCK -1 ** **orders hydration therapy to be performed today instead of the chemotherapy. The therapy isordered and administered for one hour and 10minutes. Select the code(s). ** **a. 96413-53, 96360 ** **b. 96360 ** **c. 96360, 96361 ** **d. 96413, 96361 ** **54. 69-year-oldfemale has been having chest tightness. Cardiologist orders percutaneous transluminal coronary angioplasty (PCTA) of the right coronary artery(RC) and left anterior descending coronary artery(LD). The procedure revealed atherosclerosis in the native vessel of the left anterior descending coronary artery and right coronary artery. Stents were insertedin both arteries to keep the arteries opened. Patient was placed under moderate conscious sedation during the procedure for a total of 30 minutes. What CPT®codes should be reportedfor this procedure? ** **a. 92920-LT, 92921-RT, 99152, 99153 ** **b. 92928-LD, 92928-RC, 99152, 99153 ** **c. 92920-LD, 92921-RC, 99152, 99153 ** **d. 92928-LD, 92929-RC, 99152,99153X 2 ** **55. An established 47-year-old patient presents to the physician's office after falling last night at her home when she slipped in water on the kitchen floor. She is complaining of back pain and no tingling or numbness. Physician documents that she has full range motion of the spine,with discomfort. Her gait is within normal limits. Straight leg rising is negative. She requested no medication. It is recommended to use heat, such as a hot water bottle. (Risk: Low) Doctor's Assessment: Back Strain. What E/M and ICD-10-CM codes are reported for this service? a. 99212, S39.012D ** **b. 99212, S39.012A ** **c. 99213, S39.012A ** **d. 99203, S39.012A ** **MDM: Low ** **Problem: Low (Back Strain) ** **Data: NA ** **Risk: Low (Physical therapy)** **Page 21 ** **MOCK -1 \ ** **Level ** **of ** **MDM ** **Straightfo rward ** **Low ** **complexity ** **Moderate complexity ** **High ** **complexity ** **Keys ** **Minimal Problem: [no interventions required,] No OTC, No Lab & Radio test(s) ** **OTC, Physical Therapy, Minor Surgery without risk, ** **Test(s) ordered or performed \Dissection was carried down through the fascia to the bone. The fracture site was seen, and traction was applied and a bone clamp achieving anatomic reduction. Two 3.5 screws were placed and countersunk near anatomic alignment. A 10-hole locking large fragment plate from synthesisplaced on the anterolateral aspect of the humerus. Multiple locking and standard screw fixation both proximally and distally for a stable construct. Multiplaner C arm Wound was irrigated thoroughly and closed in layered fashion over a drain, Sterile dressing applied. Patient taken to the recovery room in stable condition. No operative complications. Estimated blood loss was 300 cc and all counts were correct. ** **A. 24545-LT B.24575-LT C.24546-LT D. 24577-LT ** ** 24545 Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; without intercondylar extension ** ** 24546 Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, \ ** **when performed; with ** **intercondylar extension \ ** **94. Pre and post operative diagnosis: Right tibial plateau fracture. Right midshaft tibia fracture Technique: The patient was taken to the operating room and placed supine on the operating table where successful general anesthetic was performed. The right leg was prepped and draped in the usual sterile fashion. Appropriate preoperative antibiotics were given. Medial [Incision] [was made over the tibial plateau, through skin and subcutaneous tissue below.] A small fragment T plate was placed up along the medial tibial plateau, along the periosteum, which was not stripped. The plate was secured in a butters fashion supporting the medial tibialplateau. An Anterior lateral incision was made through the skin and subcutaneous tissue below. The fascia had been ruptured near the fracture site. The anterior compartment musculature was elevated off the tibia. This was held with a clamp and was placed along the lateral border of the tibia. This was held with a clamp. then 4.5 mm screws were placed acrossthe tibia plateau. The patient's bone quality was extremely poor. There was significant amount of osteoporosis making it difficult for good bites with the screws. We were able to interlock the lateral screws with the medial plate using a combination of bolts and washers. This method provided a very stable proximal construct. The plate was then secured distally using a combination of interfragmentary screws and screwed through the plate using more 4.5 mm screws. Stable construct was identified. The wound was irrigated. C-arm images were satisfactory. The wound was closed with a combination of 2.0 Vicryl and 3.0 Nylon running suture. Note that the fascia was not closed entirely laterally to allow for some compartment release. ** **A. 27535-RT,27758-RT B.27759-RT** **Page 36 ** **MOCK -1 ** **C. 27535-RT, 27759-RT-51 D. 27540-RT, 27756-RT-51 ** ** 27535 Open treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed ** ** 27758 Open treatment of tibial shaft fracture (with or without fibular fracture), with plate/screws, with or without cerclage \ ** ** 27759 Treatment of tibial shaft fracture (with or without fibular fracture) by or without interlocking screws and/or cerclage ** **intramedullary implant ** **, with \ ** **95. Operative Report Preoperative Diagnosis: Incarcerated left inguinal hernia in 38-year-old male. ** **Postoperative Diagnosis: As above ** **Findings: Huge in Incarcerated left inguinal hernia containing bowel and ascetic fluid Technique The patient was placed on the operating room table in the supine position IV sedation was administered without complications. Oxygen and monitoring were in place a perprotocol. Left groin and scrotum were prepped with Betadine and draped in a sterile fashion. Local anesthesia was infiltrated in the subcutaneous tissue in a field block using a mixture of lidocaine, Marcaine, Saline.The patient was placed general Trendelenburg position. The incision was made over the inguinal ligament and dissection was carried down sharply to the external oblique a aponeurosis which was opened along the course of its fibers. Hernia and spermatic cord was encircled with a Penrose drain at the public tubercle. The ilioinguinal nervewas identified and carefully preserved, retracted superiorly. The incarcerated hernia sac was Gendy dissected away from the vas and the testicular vessels with careful preservation of the vessels. The hernia was then reduced, and the defect closed with an extra large Marlex mesh plug which was sutured in place at various points using 2-0 Vicryl suture. The mesh onlay patch was then placed as reinforcement. The ilioinguinal nerve was placed back in the canal. ** **The onlay patch was sutured together lateral to the internal ring. External oblique was closed with running 2-0 Vicryl suture. Scarpus was closed with interrupted 2-0 Vicryl suture. Skin was closed with staples. Antibiotic ointment and sterile dressing were placed over the incision. All sponge, instrument and needle counts were correct. The patient tolerated the procedure well.He was taken back to the recovery room in stable condition. ** **A. 49507 B.49521,49568 C. 49525 D. 49507,49568 ** **96. Pre-op and Post Op Dx: Chronic Otitis Media ** **Procedure: After the patient was properly identified, he has brought into the operating roomand placed in supine position. The patient was prepped and draped in the usual fashion. General anesthesia was administered via inhalation mask, and after adequate sedation was achieved, a medium size speculum was placed in the ear and cerumen was removed aromatically using instruments with operative microscope. An incision was, made in the anterior inferior quadrant of the tympanum and thick mucoid fluid was suctioned. An Armstrong grommet ventilating tube was placed without difficulty followed by antibiotic drops in cotton balls and a similar procedure was performed on the left side.** **Page 37 ** **MOCK -1 ** **Also, serous fluid was noted. The patient was awakened after having tolerated the procedure well and taken to the recovery room in stable condition. ** **A. 69436-50 B.69421-50 C. 69433-50 D. 69420-50 ** **97. Which statement is false regarding the instruction for use of the CPT codebook? ** **A. Special report should accompany the use of an unlisted procedure code. B.Main body of category I section consists of six sections with each section divided into subsection and subcategories. ** **C.Instruction listed in parenthetical notes typically indicates that a code should not be reported with other code(s) and will prevent errors of highest probability but are not all inclusive. ** **D.Guidelines provide explanations for specific section application. ** **98. The patient's managed care plan requires that physician report patient management codes for pregnant patients. Which of the following pieces of information must be documented in the medical record in order to report 0501F? ** **A. Blood pressure, Weight, Uterine size, fetal heart tones, urine protein and LMP B.Blood pressure, Weight, uterine size, fetal heart tones, urine protein, EDD, DOS and LMP C.Blood pressure, Weight, Uterine size, fetal heart tones, urine protein, LMP D.Blood pressure, Weight urine protein, uterine size, fetal heart tones, EDD and DOS ** ** 0501F Prenatal flow sheet documented in medical record by first prenatal visit (documentation includes at minimum blood pressure, weight, urine protein, uterine size, fetal heart tones, and estimated date of delivery). Report also: date of visit and, in a separate field, the date of the last menstrual period \[LMP\] (Note: If reporting 0501F Prenatal flow sheet, it is not necessary to report 0500F Initial prenatal care visit) (Prenatal) ** **99. The CPT manual provides full description of medical although some description requires use of a semicolon (;) to distinguish among closely related procedures. What is the full description of CPT code 35840? ** **A.Exploration for postoperative hemorrhage, thrombosis, or infection; abdomen B.Exploration for postoperative hemorrhage, thrombosis, or infection; excluding abdomen ** **C.Exploration for postoperative hemorrhage, thrombosis, or infection; neck and or abdomen ** **D.Exploration for postoperative hemorrhage, thrombosis, or infection; neck, chest abdomen, and or extremity** **Page 38 ** **MOCK -1 ** **100. Coding guidelines for assigning ICD10CM codes for neoplasm, states that if document ed which of the following should be referenced first to locate the correct code. ** **A.The neoplasm table in the Alphabetic index ** **B.The tabular list ** **C.The histological term in the Alphabetic Index ** **D.The histological term in the tabular list** **Page 39 **