CPC Chapter 8-Musculoskeletal System Review Questions Flashcards
A Colles’ fracture is a fracture of what part of the body?
A. Elbow
B. Wrist
C. Knee
D. Ankle
B. Wrist
Rationale: A Colles’ fracture is a fracture of the distal radius and sometimes involves the ulna. These areas of the forearm bones are part of the wrist joint.
In the CPT® code book, 25000 and 25001 are for incisions in the tendon sheath on the wrist. Code 25000 is for the extensor tendon and 25001 is for the flexor tendon sheath. What is the difference between extension and flexion?
A. Extension causes bending of the wrist; flexion causes straightening of the wrist.
B. Extension causes straightening of the wrist; flexion causes bending of the wrist.
C. Extension causes the wrist to move forward by rotating; flexion causes the wrist to move backward by rotating.
D. Extension causes the wrist to move backward by rotating; flexion causes the wrist to move forward by rotating.
B. Extension causes straightening of the wrist; flexion causes bending of the wrist.
Rationale: When muscles are named for their action, words like flexor and extensor are often included in the name. Flexion is bending of a limb or body part and extension is straightening of a limb or body part.
In the CPT® code book, 28400 and 28405 are used when coding a calcaneal fracture. What is the difference between these two codes?
A. One includes internal fixation and one does not.
B. One is for a foot fracture and one is for an ankle fracture.
C. One includes manipulation and one does not.
D. One requires surgery and one does not.
C. One includes manipulation and one does not.
Rationale: Both codes are used when coding a closed treatment of a calcaneal fracture. “Closed” treatment means there is not an incision made over the fracture site. Code 28400 is “without manipulation” and code 28405 is “with manipulation.” Internal fixation is not a closed treatment procedure.
This type of connective tissue attaches a muscle to a bone:
A. Ligament
B. Vein
C. Vertebra
D. Tendon
D. Tendon
Rationale: Tendons attach muscles to bone, and ligaments attach bones to other bones.
Which type of muscles help control movement of the body, maintain posture, and help produce heat?
A. Striated or skeletal
B. Smooth or visceral
C. Cardiac
D. Involuntary
A. Striated or skeletal
Rationale: Striated or skeletal muscles are often attached to bones and help move the body. They are considered voluntary muscles, meaning we have control over their movement.
What is the correct 7th character in ICD-10-CM for a healing comminuted fracture of the right fibula, open, type 1?
A. B
B. D
C. H
D. E
D. E
Rationale: Look up Fracture/fibula/comminuted S82.45-. Verification in the Tabular List indicates the correct 6th character is 1 for the right side. The correct 7th character is E, for subsequent encounter, open fracture Type 1. See the list of 7th digits under category S82. Per chapter 19 guidelines, “A fracture not indicated whether displaced or not displaced should be coded as displaced.”
What is the correct ICD-10-CM code for a new patient seen for a left-sided nursemaid’s elbow?
A. S53.492A
B. S53.032S
C. S50.02XA
D. S53.032A
D. S53.032A
Rationale: Look up nursemaid’s elbow, S53.03-. Verification in Tabular List verifies code choice S53.032A, for left elbow, initial encounter.
How would compartment syndrome of the lower extremity caused by an auto accident be listed in the ICD-10-CM Alphabetic Index?
A. Syndrome/compartment/lower extremity
B. Compartment syndrome/leg
C. Syndrome/compartment/non-traumatic/leg
D. Syndrome/compartment
A. Syndrome/compartment/lower extremity
Rationale: Compartment syndrome is listed under Syndrome in ICD-10-CM. Traumatic is considered the default unless specifically stated as nontraumatic. An auto accident is considered a traumatic injury.
How would you code a new pathological fracture of the right femur due to postmenopausal osteoporosis?
A. M81.0
B. M80.851A
C. M80.051A
D. M84.551A
C. M80.051A
Rationale: Code M80.051A describes a pathological fracture of the right femur. In the ICD-10-CM Alphabetic Index look up Fracture, pathological/due to/osteoporosis/postmenopausal — see Osteoporosis/postmenopausal/with pathologic fracture. You’re directed to M80.00-. In the Alphabetic Index, there is no listing for femur. Review the subcategories for M80.0 in the Tabular List. Subcategory M80.05 is used to identify current pathological fracture of femur. 6th character 1 is used for the right femur and 7th character A is used for the initial encounter.
What is the code for a traumatic fracture of the fifth metacarpal shaft on the right hand with delayed healing?
A. S62.306G
B. S62.326G
C. S62.327D
D. S62.316G
B. S62.326G
Rationale: In the ICD-10-CM Alphabetic Index, look for Fracture, traumatic/metacarpal/fifth/shaft (displaced), which directs you to S62.32-. In the Tabular List, subcategory S62.32 requires a 6th character for laterality and a 7th character for type of encounter. S62.326G is the correct code. ICD-10-CM guidelines I.19.c states, “A fracture not indicated as open or closed should be coded to closed. A fracture not indicated whether displaced or not displaced should be coded to displaced.”
The physician performs arthroscopic meniscus repair with partial medial and lateral repairs. What procedure code is reported?
A. 29883
B. 29880
C. 29882
D. 27332
A. 29883
Rationale: Code 29883 is for an arthroscopy, knee, surgical; with meniscus repair (medial AND lateral). Look in the CPT® Index for Arthroscopy/Surgical/Knee, which gives a range of codes for procedures on the knee that can be done with an arthroscope.
How should you code an arthroscopic abrasion chondroplasty of the medial femoral condyle?
A. 29884
B. 29862
C. 29879
D. 29860
C. 29879
Rationale: The medial femoral condyle is part of the knee. Look in the CPT® Index for Arthroscopy/Surgical/Knee 29871–29889. In the code section, review the indentations until you arrive at 29879 Abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture. Note that the code is in the arthroscopy section so it’s not an open procedure.
The patient came to the office for a therapeutic injection, left shoulder subacromial space. What procedure code is reported?
A. 20612
B. 20610
C. 20552
D. 20550
B. 20610
Rationale: Code 20610 Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee, subacromial bursa), without ultrasound guidance indicates that the arthrocentesis is for aspiration and/or injection. The drug used in the injection (usually a steroid) is coded separately. Look in the CPT® Index for Arthrocentesis/Large Joint.
Joe was in a motorcycle accident and fractured his right femur. The surgeon placed an intramedullary locking implant (nail) through a buttock incision. What procedure code is reported?
A. 27503-RT
B. 27508-RT
C. 27510-RT
D. 27506-RT
D. 27506-RT
Rationale: The surgery is an open treatment of a closed femoral shaft fracture with internal fixation (intramedullary implant) and is reported 27506-RT. Look in the CPT® Index for Fracture/Femur/Peritrochanteric/Intramedullary Implant Shaft. Report modifier RT to indicate right femur.
Jeff was skateboarding and crushed the long arm cast (without further injury to the arm) that was placed for a fractured left radius and ulna. Another physician replaces the cast with a short-arm fiberglass cast. What procedure code is reported for the replacement cast?
A. 29085
B. 29065
C. 29075
D. 29125
C. 29075
Rationale: The first cast or splint is included as part of the initial fracture treatment; because this was a replacement cast, it can be coded. For the short arm cast look in the CPT® Index for Cast/Elbow to Finger.
