Deck 14: Integumentary System

Question 1

When reporting a staged procedure what modifier is added to the CPT code?

A)-25
B)-51
C)-58
D)-76

Answer 1

-58

Question 2

The correct code for repairing the following lacerations: 4.2 simple repair of the trunk, 1.3 simple repair of the arm, and 2.8 intermediate repair of the scalp:

A)12032, 12001-59, 12002-59
B)12004
C)12034
D)12032, 12002-59

Answer 2

12032, 12002-59

Question 3

To properly code lesion excision, you must know the behavior and the narrowest margin about the lesion, in addition to the following:

A)site, number
B)site, number, diameter
C)status, diameter
D)status, site, number

Answer 3

site, number, diameter

Question 4

Wound closure requiring the use of adhesive strips as the sole repair material should be coded with:

A)99024
B)repair code
C)99499
D)an E/M code

Question 5

What two items are needed to correctly code for local treatment of burns?

A)length and width of burn
B)width and depth of burn
C)percentage of body surface and depth of burn
D)percentage of body surface and width of burn

Question 6

Incision and drainage codes are divided into subcategories according to the:

A)size of the lesion
B)condition for which the procedure is performed
C)depth of the incision
D)amount of drainage

Question 7

The repaired wound should be measured or converted to:

A)millimeters
B)centimeters
C)inches
D)all of the above

Question 8

Excision defined as full thickness would be through the:

A)epidermis
B)dermis
C)subcutaneous tissue
D)muscle

Question 9

Which modifier indicates a significant, separately identifiable E/M service?

A)-25
B)-51
C)-50
D)-47

Question 10

An excision of the left great toe nail and matrix, complete for permanent removal:

A)11740-TA
B)11730-TA
C)11720-TA
D)11750-TA

Question 11

When an excision is being performed, the "margins" refer to the ____ required to adequately excise the lesion based on the physician's judgment.

A)widest diameter
B)narrowest margin
C)square centimeters
D)length

Question 12

Using the "Rule of Nines," one adult leg is what percentage of the human body?

A)12%
B)14%
C)16%
D)18%

Question 13

A physician performs an operative procedure that has a 90-day surgical package.On day 40, the same physician performs an unrelated procedure on the same patient.What modifier would you attach to the CPT code when reporting the second procedure?

A)-24
B)-25
C)-58
D)-79

Question 14

Mohs micrographic surgery requires a single physician to act in two integrated but separate and distinct capabilities of a surgeon and a(n):

A)radiologist
B)pathologist
C)assistant surgeon
D)none of these

Question 15

The removal of a lesion by transverse incision that did not require sutured closure is reported using codes from which subsection?

A)Removal of Skin Tags
B)Biopsy
C)Paring or Cutting
D)Shaving of Epidermal or Dermal Lesions

Question 16

There is no tissue remaining for pathological examination after this method has been used.

A)ablation
B)Mohs
C)excision
D)destruction

Question 17

When coding 3 punch biopsies of the skin, performed at the same visit, the reporting would be:

A)11104 x 3
B)11104 x 2 and 11105 x 1
C)11104, 11105 x 2
D)none of the above

Question 18

The method used by the physician to obtain a lesion biopsy depends on which set of factors?

A)size and location
B)location and type
C)malignant/benign status
D)size and type

Question 19

Single-layered closure of heavily contaminated wounds that require extensive cleaning or removal of particulate matter constitutes what type of repair?

A)simple
B)intermediate
C)complex
D)none of the above

Question 20

An excision of a benign lesion from the neck measuring 1.8 cm:

A)11422
B)11200
C)11307
D)11622

Question 21

Excision of benign lesions on chest, 0.4 cm, with simple closure.
CPT Code: ____________________

Question 22

The patient is brought back to the operating room for a staged procedure to a procedure that was performed 5 days previously.
LOCATION: Inpatient, Hospital
PATIENT: Soren Gademore
SURGEON: Gary Sanchez, M.D.
DIAGNOSIS: Status post open wound, right lower extremity.
SURGICAL PROCEDURE: Split thickness skin graft, right thigh to right lower extremity.
DESCRIPTION OF PROCEDURE: The patient's right leg was prepped with Betadine scrub and solution and draped in the routine sterile fashion.A skin graft was taken from the right thigh on its anterolateral aspect, meshed with a 1:1.5 ratio mesher, and applied to the 66 sq cm defect on the right leg with staples.Dressing consisted of Xeroform, Kerlix fluffs, Kerlix roll, Kling, Sof-Rol, and a short leg fiberglass cast.Scarlet Red and ABD pads were applied to the donor site.The patient tolerated the procedure well and left the area in good condition.
Pathology Report Later Indicated: Benign tissue
CPT Code: ____________________

Question 23

Location: Hospital
PREOPERATIVE DIAGNOSIS: Pilonidal cyst.
POSTOPERATIVE DIAGNOSIS: Same.
PROCEDURE PERFORMED: Excision of pilonidal cyst, simple.
ANESTHESIA: General endotracheal anesthesia with 30 cc of local infiltrated directly into the wound.
PROCEDURE IN DETAIL: After good general endotracheal anesthesia, the patient was carefully placed in the prone position.Care was taken to pad dependent areas.The area around the pilonidal cyst was shaved, prepped, and draped sterilely.After this, a total of 30 cc of Marcaine was injected into the area around the pilonidal sinus and a small elliptical incision was made to include the two sinuses.Wide dissection was carried down to the coccyx to include all inflamed tissue.After this, the wound was irrigated.Hemostasis was obtained with electrocautery.The wound was packed with Vaseline gauze and dressed.The patient tolerated the procedure well and was returned to the recovery room in good condition.
CPT Code: ____________________

Question 24

Mastopexy.
CPT Code: ____________________

Question 25

Dermabrasion of the segmental face:

A)15780
B)15781
C)15782
D)15783

Question 26

To report an excision of a malignant lesion, the correct range of codes to use would be:

A)11600-11646
B)11400-11471
C)11200-11201
D)11102-11107

Question 27

Excision of three malignant lesions: a 2.4-cm lesion of the leg, a 3.2-cm lesion of the back, and a 1.6-cm lesion of the lip:

A)11606, 11642
B)11604, 11603, 11642
C)11606, 11624, 11642
D)11603, 11624, 11642

Question 28

Mastectomy that is done for gynecomastia:

A)19300
B)19301
C)19303
D)19305

Question 29

Suction lipectomy, lower right leg.
CPT Code: ____________________

Question 30

An established patient has a simple removal of sutures performed by the nurse.The physician did NOT perform the initial repair.
CPT Code: ____________________

Question 31

Simple repair of a superficial wound of the nose measuring 5.2 cm.
CPT Code: ____________________

Question 32

Patient presents for an excision of a sacral pressure ulcer with ostectomy, with primary suture.
CPT Code: ____________________

Question 33

Full-thickness graft, free, to the axillae, including direct closure of donor site, 12 sq.cm.:

A)15240
B)15200
C)15260
D)15261

Question 34

INDICATIONS: The patient had a YV advancement flap and advancement of the hamstring muscles about 3 weeks ago, but the wound separated and the muscles retracted over the area of the bone.She has had moderate separation of the wound but not complete separation, and we plan to minimally debride this area and resuture the wound with tension sutures.
DIAGNOSIS: Wound dehiscence, left ischial area, partial.
SURGICAL FINDINGS: A 6 cm long by about 4 cm deep wound dehiscence.
PROCEDURE PERFORMED: Debridement of ischial wound by curettage with secondary wound closure.
PROCEDURE: The patient was intubated and turned in the prone position.The area was prepped with Betadine scrub and solution and draped in routine sterile fashion.The area was curettaged and a piece of the tissue was placed in a culture tube.This was curettaged down to bleeding granulation tissue.I was reluctant to restart by complete debridement of all these areas, because there are factors operative in this wound that are probably beyond our control.We nevertheless completed debridement of the granulation down to bleeding tissue and put far/near, near/far tension type sutures in the wound using #2 Ethibond.I then put some Xeroform underneath the sutures that were holding the wound together and put three boxes of Kerlix Fluffs on top of this to cover some of the open areas on the thigh.The thigh sutures were also removed.I then taped the three boxes of Kerlix Fluffs to the ischial area with Elastoplast and taped around the leg to hold this in place, placing an ABD pad over the open areas where the sutures had been present.I then taped the buttock and leg up on the lumbar area with Elastoplast in such a manner as to support the ischial closure.A home health care nurse was in attendance at this time and she was advised as to how to retape and dress this on a daily basis.The patient had two open areas of the thigh and right lower leg, one of which was a donor site, the other of which was an old skin graft with open areas.We applied Scarlet Red and ABD pads to this area.Estimated blood loss 50 cc.Otherwise, the patient tolerated the procedure well and left the area in good condition.
CPT Code: ____________________

Question 35

Destruction of 7 actinic keratoses:

A)17004
B)17000 x 7 units
C)17000, 17003 x 7 units
D)17000, 17003 x 6 units

Question 36

Suture of superficial wounds of cheek: one 1-cm laceration, one 3-cm laceration, and one 2-cm laceration.
CPT Code: ____________________

Question 37

Removal of 37 skin tags by electrosurgical destruction:

A)11200, 11201 x 3 units
B)11201 x 4 units
C)11200 x 4 units
D)none of the above

Question 38

Removal with reinsertion of an implantable contraceptive capsule:

A)11980
B)11976, 11981
C)11981, 11982
D)11983

Question 39

Fine-needle aspiration biopsy of the breast without imaging:

A)19000
B)19100
C)10021
D)19030

Question 40

Excision of a pilonidal cyst that was a complicated procedure:

A)11770
B)11771
C)11772
D)10081

Question 41

Match the following common procedures and suffixes with the correct definition.
-rrhaphy

A)to remedy, replace, or heal
B)suffix for molding or surgically forming
C)free flow or withdrawal of fluids from a wound or cavity
D)cutting or taking away
E)to unite parts by stitching them together
F)inspection of body organs or cavities by the use of a lighted scope that may be placed through an existing opening or through a small incision
G)scraping of a cavity using a spoon-shaped instrument
H)forcing a fluid into a vessel or cavity
I)suffix for suturing
J)suffix for puncture of a cavity
K)suffix for removal of part or all of an organ of the body
L)removal of a small piece of living tissue for diagnostic examination
M)surgically cutting into
N)binding or tying off, as in constricting blood flow of a vessel or binding fallopian tubes for sterilization
O)suffix for incision into

Question 42

Match the following common procedures and suffixes with the correct definition.
-ectomy

A)to remedy, replace, or heal
B)suffix for molding or surgically forming
C)free flow or withdrawal of fluids from a wound or cavity
D)cutting or taking away
E)to unite parts by stitching them together
F)inspection of body organs or cavities by the use of a lighted scope that may be placed through an existing opening or through a small incision
G)scraping of a cavity using a spoon-shaped instrument
H)forcing a fluid into a vessel or cavity
I)suffix for suturing
J)suffix for puncture of a cavity
K)suffix for removal of part or all of an organ of the body
L)removal of a small piece of living tissue for diagnostic examination
M)surgically cutting into
N)binding or tying off, as in constricting blood flow of a vessel or binding fallopian tubes for sterilization
O)suffix for incision into

Question 43

Match the following common procedures and suffixes with the correct definition.
excision

A)to remedy, replace, or heal
B)suffix for molding or surgically forming
C)free flow or withdrawal of fluids from a wound or cavity
D)cutting or taking away
E)to unite parts by stitching them together
F)inspection of body organs or cavities by the use of a lighted scope that may be placed through an existing opening or through a small incision
G)scraping of a cavity using a spoon-shaped instrument
H)forcing a fluid into a vessel or cavity
I)suffix for suturing
J)suffix for puncture of a cavity
K)suffix for removal of part or all of an organ of the body
L)removal of a small piece of living tissue for diagnostic examination
M)surgically cutting into
N)binding or tying off, as in constricting blood flow of a vessel or binding fallopian tubes for sterilization
O)suffix for incision into

Question 44

Do not use this modifier with skin tag codes because skin tag codes are based on the number of lesions removed.(Make sure to include a dash in front of your modifier answer.-XX) ____________________

Question 45

Match the following common procedures and suffixes with the correct definition.
injection

A)to remedy, replace, or heal
B)suffix for molding or surgically forming
C)free flow or withdrawal of fluids from a wound or cavity
D)cutting or taking away
E)to unite parts by stitching them together
F)inspection of body organs or cavities by the use of a lighted scope that may be placed through an existing opening or through a small incision
G)scraping of a cavity using a spoon-shaped instrument
H)forcing a fluid into a vessel or cavity
I)suffix for suturing
J)suffix for puncture of a cavity
K)suffix for removal of part or all of an organ of the body
L)removal of a small piece of living tissue for diagnostic examination
M)surgically cutting into
N)binding or tying off, as in constricting blood flow of a vessel or binding fallopian tubes for sterilization
O)suffix for incision into

Question 46

Match the following common procedures and suffixes with the correct definition.
endoscopy

A)to remedy, replace, or heal
B)suffix for molding or surgically forming
C)free flow or withdrawal of fluids from a wound or cavity
D)cutting or taking away
E)to unite parts by stitching them together
F)inspection of body organs or cavities by the use of a lighted scope that may be placed through an existing opening or through a small incision
G)scraping of a cavity using a spoon-shaped instrument
H)forcing a fluid into a vessel or cavity
I)suffix for suturing
J)suffix for puncture of a cavity
K)suffix for removal of part or all of an organ of the body
L)removal of a small piece of living tissue for diagnostic examination
M)surgically cutting into
N)binding or tying off, as in constricting blood flow of a vessel or binding fallopian tubes for sterilization
O)suffix for incision into

Question 47

Match the following common procedures and suffixes with the correct definition.
drainage

A)to remedy, replace, or heal
B)suffix for molding or surgically forming
C)free flow or withdrawal of fluids from a wound or cavity
D)cutting or taking away
E)to unite parts by stitching them together
F)inspection of body organs or cavities by the use of a lighted scope that may be placed through an existing opening or through a small incision
G)scraping of a cavity using a spoon-shaped instrument
H)forcing a fluid into a vessel or cavity
I)suffix for suturing
J)suffix for puncture of a cavity
K)suffix for removal of part or all of an organ of the body
L)removal of a small piece of living tissue for diagnostic examination
M)surgically cutting into
N)binding or tying off, as in constricting blood flow of a vessel or binding fallopian tubes for sterilization
O)suffix for incision into

Question 48

Match the following common procedures and suffixes with the correct definition.
ligation

A)to remedy, replace, or heal
B)suffix for molding or surgically forming
C)free flow or withdrawal of fluids from a wound or cavity
D)cutting or taking away
E)to unite parts by stitching them together
F)inspection of body organs or cavities by the use of a lighted scope that may be placed through an existing opening or through a small incision
G)scraping of a cavity using a spoon-shaped instrument
H)forcing a fluid into a vessel or cavity
I)suffix for suturing
J)suffix for puncture of a cavity
K)suffix for removal of part or all of an organ of the body
L)removal of a small piece of living tissue for diagnostic examination
M)surgically cutting into
N)binding or tying off, as in constricting blood flow of a vessel or binding fallopian tubes for sterilization
O)suffix for incision into

Question 49

Match the following common procedures and suffixes with the correct definition.
-plasty

A)to remedy, replace, or heal
B)suffix for molding or surgically forming
C)free flow or withdrawal of fluids from a wound or cavity
D)cutting or taking away
E)to unite parts by stitching them together
F)inspection of body organs or cavities by the use of a lighted scope that may be placed through an existing opening or through a small incision
G)scraping of a cavity using a spoon-shaped instrument
H)forcing a fluid into a vessel or cavity
I)suffix for suturing
J)suffix for puncture of a cavity
K)suffix for removal of part or all of an organ of the body
L)removal of a small piece of living tissue for diagnostic examination
M)surgically cutting into
N)binding or tying off, as in constricting blood flow of a vessel or binding fallopian tubes for sterilization
O)suffix for incision into

Question 50

Match the following common procedures and suffixes with the correct definition.
suture

A)to remedy, replace, or heal
B)suffix for molding or surgically forming
C)free flow or withdrawal of fluids from a wound or cavity
D)cutting or taking away
E)to unite parts by stitching them together
F)inspection of body organs or cavities by the use of a lighted scope that may be placed through an existing opening or through a small incision
G)scraping of a cavity using a spoon-shaped instrument
H)forcing a fluid into a vessel or cavity
I)suffix for suturing
J)suffix for puncture of a cavity
K)suffix for removal of part or all of an organ of the body
L)removal of a small piece of living tissue for diagnostic examination
M)surgically cutting into
N)binding or tying off, as in constricting blood flow of a vessel or binding fallopian tubes for sterilization
O)suffix for incision into

Question 51

Match the following common procedures and suffixes with the correct definition.
-otomy

A)to remedy, replace, or heal
B)suffix for molding or surgically forming
C)free flow or withdrawal of fluids from a wound or cavity
D)cutting or taking away
E)to unite parts by stitching them together
F)inspection of body organs or cavities by the use of a lighted scope that may be placed through an existing opening or through a small incision
G)scraping of a cavity using a spoon-shaped instrument
H)forcing a fluid into a vessel or cavity
I)suffix for suturing
J)suffix for puncture of a cavity
K)suffix for removal of part or all of an organ of the body
L)removal of a small piece of living tissue for diagnostic examination
M)surgically cutting into
N)binding or tying off, as in constricting blood flow of a vessel or binding fallopian tubes for sterilization
O)suffix for incision into

Question 52

Match the following common procedures and suffixes with the correct definition.
-centesis

A)to remedy, replace, or heal
B)suffix for molding or surgically forming
C)free flow or withdrawal of fluids from a wound or cavity
D)cutting or taking away
E)to unite parts by stitching them together
F)inspection of body organs or cavities by the use of a lighted scope that may be placed through an existing opening or through a small incision
G)scraping of a cavity using a spoon-shaped instrument
H)forcing a fluid into a vessel or cavity
I)suffix for suturing
J)suffix for puncture of a cavity
K)suffix for removal of part or all of an organ of the body
L)removal of a small piece of living tissue for diagnostic examination
M)surgically cutting into
N)binding or tying off, as in constricting blood flow of a vessel or binding fallopian tubes for sterilization
O)suffix for incision into

Question 53

To correctly code lesion excision, you must know the behavior (benign/malignant) as well as the site, ____________________, and number of the lesion(s).

Question 54

Match the following common procedures and suffixes with the correct definition.
biopsy

A)to remedy, replace, or heal
B)suffix for molding or surgically forming
C)free flow or withdrawal of fluids from a wound or cavity
D)cutting or taking away
E)to unite parts by stitching them together
F)inspection of body organs or cavities by the use of a lighted scope that may be placed through an existing opening or through a small incision
G)scraping of a cavity using a spoon-shaped instrument
H)forcing a fluid into a vessel or cavity
I)suffix for suturing
J)suffix for puncture of a cavity
K)suffix for removal of part or all of an organ of the body
L)removal of a small piece of living tissue for diagnostic examination
M)surgically cutting into
N)binding or tying off, as in constricting blood flow of a vessel or binding fallopian tubes for sterilization
O)suffix for incision into

Question 55

Match the following common procedures and suffixes with the correct definition.
curettage

A)to remedy, replace, or heal
B)suffix for molding or surgically forming
C)free flow or withdrawal of fluids from a wound or cavity
D)cutting or taking away
E)to unite parts by stitching them together
F)inspection of body organs or cavities by the use of a lighted scope that may be placed through an existing opening or through a small incision
G)scraping of a cavity using a spoon-shaped instrument
H)forcing a fluid into a vessel or cavity
I)suffix for suturing
J)suffix for puncture of a cavity
K)suffix for removal of part or all of an organ of the body
L)removal of a small piece of living tissue for diagnostic examination
M)surgically cutting into
N)binding or tying off, as in constricting blood flow of a vessel or binding fallopian tubes for sterilization
O)suffix for incision into

Question 56

Match the following common procedures and suffixes with the correct definition.
repair

A)to remedy, replace, or heal
B)suffix for molding or surgically forming
C)free flow or withdrawal of fluids from a wound or cavity
D)cutting or taking away
E)to unite parts by stitching them together
F)inspection of body organs or cavities by the use of a lighted scope that may be placed through an existing opening or through a small incision
G)scraping of a cavity using a spoon-shaped instrument
H)forcing a fluid into a vessel or cavity
I)suffix for suturing
J)suffix for puncture of a cavity
K)suffix for removal of part or all of an organ of the body
L)removal of a small piece of living tissue for diagnostic examination
M)surgically cutting into
N)binding or tying off, as in constricting blood flow of a vessel or binding fallopian tubes for sterilization
O)suffix for incision into

Question 57

Match the following common procedures and suffixes with the correct definition.
incision

A)to remedy, replace, or heal
B)suffix for molding or surgically forming
C)free flow or withdrawal of fluids from a wound or cavity
D)cutting or taking away
E)to unite parts by stitching them together
F)inspection of body organs or cavities by the use of a lighted scope that may be placed through an existing opening or through a small incision
G)scraping of a cavity using a spoon-shaped instrument
H)forcing a fluid into a vessel or cavity
I)suffix for suturing
J)suffix for puncture of a cavity
K)suffix for removal of part or all of an organ of the body
L)removal of a small piece of living tissue for diagnostic examination
M)surgically cutting into
N)binding or tying off, as in constricting blood flow of a vessel or binding fallopian tubes for sterilization
O)suffix for incision into