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[rusts Sot, , Mock Test No. 1, , 150 questions, Answers, , 202, Ameer estate, beside CLGl Bank, SR Naga 500038, PH: 9959602447, 9985277066
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9959602447 www.transc com 9985277066, , Integumentary System (10000 Series), , 1. OPERATIVE REPORT, , OPERATIVE PROCEDURE: Excision of back lesion., INDICATIONS FOR SURGERY: The patient has an enlarging lesion on the upper, midback,, , FINDINGS AT SURGERY: There was a 5-cm, upper midback lesion., OPERATIVE PROCEDURE: With the patient prone, the back was prepped ai, draped in the usual sterile fashion. The skin and underlying tissues were a, with 30 mL of 1% lidocaine with epinephrine. Through a 5-cm transve!, the lesion was excised. Hemostasis was ensured. The incision, , Vicryl for the deep layers and running 3-0 Prolene subcuticular —, , , , , the skin. The patient was returned to the same-day, postoperative condition. All sponge, needle, and instru, Estimated blood loss is 0 mL. >, PATHOLOGY REPORT LATER INDICATED: Folica, back., , A. 11406, 12002 O, B. 11424, , C. 11406, 12032, , D. 11606 &, , CORRECT ANSWER:, C. 11406 identifies the excisioi ign lesion more than 4 cm; the deep, , layers were closed, whic id or intermediate closure reported in, addition to the lesion ova 12032., iON e:, , is were correct., , dibular type, skin of, , RATIONALE:, A. 11406 is correct for, xcision of a benign lesion larger than 4 cm; 12002, is a simple closure, eye closure is included in the excision code, so 11406, and 12002 would orted together. Further, the report describes a deep, layer closure t arintermediate closure, which should be reported with 12032., B. 11424 is of a benign lesion but of the scalp, neck, hands, feet, or, italia, back or trunk as indicated in the operative report, and thereis, ep the intermediate closure (12032)., is @xcision of the correct size and site of a lesion but for a malignant lesion,, not a benign lesion as specified in the report. Also, the code for the intermediate, closure is missing in this choice., , , , 2. EMERGENCY DEPARTMENT REPORT, , CHIEF COMPLAINT: Nasal bridge laceration., , SUBJECTIVE: The patient is a 74-year-old male who presents to the emergency, department with a laceration to the bridge of his nose. He fell in the bathroom tonight., He recalls the incident. He just sort of lost his balance. He denies any vertigo. He, denies any chest pain or shortness of breath. He denies any head pain or neck pain., , 202, A-Block, Ameer Estate, Beside ICICI Bank,SR Nagar, Hyderabad-500038
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9959602447 www.transc com 9985277066, , There was no loss of consciousness. He slipped on a wet floor in the bathroom and, lost his balance; that is how it happened. He has not had any blood from the nose or, mouth., , PAST MEDICAL HISTORY:, , 1. Parkinson's, , 2. Back pain, , 3. Constipation, , MEDICATIONS: See the patient record for a complete list of medications., ALLERGIES: NKDA., , REVIEW OF SYSTEMS: Per HPI. Otherwise, negative. ®&, PHYSICAL EXAMINATION: The exam showed a 74-year-old male in no, , distress. Examination of the HEAD showed no obvious trauma other th ge of, the nose, where there is approximately a 1.5- to 2-cm laceration. He ny, tenderness under this. Pupils were equal, round, and reactive. OSE:, OROPHARYNX was unremarkable. NECK was soft and supple. was regular., LUNGS were clear but slightly diminished in the bases., PROCEDURE: The wound was draped in a sterile fashil, Xylocaine with sodium bicarbonate. It was cleansed wi, repaired using interrupted 6-0 Ethilon sutures (Dr. Ba, assisted with the suturing)., , ASSESSMENT: Nasal bridge laceration, stat I., , Plan: Keep clean. Sutures out in 5 to 7 days. Wat signs of infection., A. 12051, S01.20XA, , B. 12011, S01.20XA &, C. 12011, S01.23KA fe), , , , , , r, first-year resident,, , D. 12011, 11000, S01.23XA, , CORRECT ANSWER: QO, , B. 12011 identifies the repair, le 2.5 cm or less. S01.20XA is the diagnosis for, the open wound of the ., , 3. SAME-DAY SU, DIAGNOSIS: Invert ple with mammary duct ectasia, left., , OPERATIO! jon of mass deep to left nipple., With the # general anesthesia, a circumareolar incision was made with, , , , i ind carried down into the breast tissue. The nipple complex was, , a small retractor. We gently dissected underneath to free up the nipple, entirely "Once this was done, we had the nipple fully unfolded, and there was some, evident mammary duct ectasis. An area 3 X 4 cm was excised using electrocautery., Hemostasis was maintained with the electrocautery, and then the breast tissue deep, to the nipple was reconstructed using sutures of 3-0 chromic. Subcutaneous tissue, was closed using 3-0 chromic, and then the skin was closed using 4-0 Vicryl. SteriStrips were applied. The patient tolerated the procedure well and was returned to the, recovery area in stable condition. At the end of the procedure, all sponges and, instruments were accounted for., , A. 19120-RT, N60.49, , 202, A-Block, Ameer Estate, Beside ICICI Bank,SR Nagar, Hyderabad-500038
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9959602447 www.transc com 9985277066, , B. 11404-LT, N60.39, C. 19112, N60.49, D. 19120-LT, N60.49, , CORRECT ANSWER:, D. 19120-LT identifies the excision of a single duct lesion of the left breast., N60.49 is the diagnosis code for a mammary duct ectasia., , 4. This patient returns today for palliative care to her feet. Her toenails have, elongated and thickened, and she is unable to trim them on her own. She stat, she has had no problems and no acute signs of any infection or oes, , She returns today strictly for nail debridement to her feet., , EXAMINATION: Her pedal pulses are palpable bilaterally. The nails Ae} 1, through 4 on the left, and 1 through 3 on the nght., , ASSESSMENT: Onychomycosis, 1 through 4 on the left and 1 Wd on the right., PLAN: Mild debridement of mycotic nails X7. This patient is to ici clinic in 3, to 4 months for follow-up palliative care., , A. 11721 X7, B48.8, B. 99212, 11721, B35.1, C. 11719, B35.1, , D. 11721, B35.1, , CORRECT ANSWER:, D. 11721 identifies the debrideme: nat or more, by any method, and the, report indicated that 7 nails were Cos 35.1 is the diagnosis code for, onychomycosis of the nail, which jal infection and is stated in the, assessment section of the re, , §. OPERATIVE REPOR’, , With the patient having a wife localization performed by radiology, she was taken, to the operating roo! er local anesthesia of the left breast, was prepped and, draped in a sterile tA breast line incision was made through the entry point of, , , , , the wire, and a ue surrounding the wire (approximately 1, , The patient t the procedure well and was discharged from the operating room, in stable it the end of the procedure, all sponges and instruments were, acco}, , A.11 T, D24.1, B. 11400-LT, D24.2, C. 19125-LT, D24.2, D. 19125-LT, D24.1, , 202, A-Block, Ameer Estate, Beside ICICI Bank,SR Nagar, Hyderabad-500038
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9959602447 www.transcodecpc.com 9985277066, , CORRECT ANSWER:, , C. 19125-LT identifies the excision of a single breast lesion, on the left of which, radiology performs placement of the marker, in this case a wire. As with, , most surgery cases, many different codes should be reviewed before, deciding on the correct code assignment. In the process of doing so, the, coder would determine that this procedure is not a breast biopsy (19101), because the report does not indicate the tissue is being removed for, diagnostic reasons. Nor is it a lumpectomy (19301) because the report does, not indicate specific attention to surgical margins. This procedure descri, , a breast lesion excision without specific attention to surgical margins, eo, therefore 19125 is the correct code. See the guidelines preceding c, , for more information in this regard. D24.2 is the diagnosis code fo nign, lesion of the LEFT breast., , ®, 6. What code(s) would be used to code a split-thickness skin aa Bop highs to the, , abdomen, measuring 45 X 21 cm? ay, A. 18100 X 2, , B. 15100, 15101 X 9 \, C. 15100, 15101 X 9-51 m, , D. 15100, 15101 X 8, , CORRECT ANSWER:, , B. 15100 is the correct code for t sq cm and 15101, , “or part thereof.” Therefore the ad 5 sq cm is reported with 9 units, of 15101 (8 units accounts for an 0 sq cm. An additional unit of 1 is, added to account for the rem q cm). 15101 is an add-on code,, therefore the -51 modi n essary., , 7. What code would be uSed to feport a massive debridement of an open abdominal, wound, including sub tissue and muscle?, , A. 11000, , B. 11010, C. 11042, D. 11043, WER:, , Cc CTAN., cain itifies the debridement of the skin, subcutaneous tissue, and, muscle., , RATIONALE:, , A. 11000 reports only debridement of skin, not the subcutaneous tissue or muscle., Furthermore, this code is for extensive eczematous or infected skin which was not, stated in this case., , 202, A-Block, Ameer Estate, Beside ICICI Bank,SR Nagar, Hyderabad-500038
