Practice Exam

60000 SERIES
Question 1
A patient with conductive sensorineural hearing loss in the right ear has tried multiple
medical therapies without recovery of her hearing. Patient has consented to have an
electromagnetic bone conduction hearing device implanted. What CPT and ICD-9-CM
codes describe this procedure?
A. 69710-RT, 389.05
B. 69714-RT, 389.20
C. 69710-RT, 389.21
D. 69930-RT, 389.06
Question 2
A 26-year-old female with a one-year history of a left tympanic membrane perforation
has consented to have it repaired. A postauricular incision was made under general
anesthesia. Dissection was carried down to the temporalis fascia and a 3 x 3 cm segment
of fascia was harvested and satisfactorily desiccated. The tympanic membrane was
excised. Using a high-speed drill a canaloplasty was performed until the entire annulus
could be seen. The ossicular chain was examined, it was found to be freely mobile. The
previously harvested skin was trimmed and placed in the anterior canal angle with a
slight overlapping over the temporalis fascia. Packing is placed in the ear canal, external
incisions are closed, and dressings are applied. What code should be used for this
procedure?
A. 69436-LT
B. 69631-LT
C. 69632-LT
D. 69641-LT
Question 3
A 70-year-old female has a drooping left eyelid obstructing her vision and has consented
to having the blepharoptosis repaired. A skin marking pencil was used to outline the
external proposed skin incision on the left upper lid. The lower edge of the incision was
placed in the prominent lid crease. The skin was excised to the levator aponeurosis. An
attenuated area of levator aponeurosis was dehisced from the lower strip. Three 6-0 silk
sutures were then placed in mattress fashion, attaching this attenuated tissue superiorly to
the intact tissue inferiorly. This provided moderate elevation of the lid. The correct CPT
code is:
A. 67904-E1
B. 67903-E1
C. 67901-E1
D. 67911-E1

Question 4
A patient has aphakia and anisometropia in the right eye underwent surgery to implant a
lens. An incision is made in the corneal-scleral juncture and a scleral tunnel was made. A
partial vitrectomy was performed and the physician guides the intraocular implant into
the eye pulling it into position by Prolene sutures. What CPT code should be reported?
A. 66982-RT
B. 66983-RT
C. 66984-RT
D. 66985-RT
Question 5
A 35-year-old had neuroplasty performed in the wrist for carpal tunnel syndrome. The
palm was opened through a curved incision, and further skin flaps were developed. The
ulnar origin of the transverse carpal ligament was divided, decompressing the carpal
tunnel. Tension of the nerve is released and the incision is sutured in layers. What CPT
describes this procedure?
A. 64721
B. 64719
C. 64708
D. 64704
Question 6
A 37-year-old has multilevel lumbar degenerative disc disease and is coming in for an
epidural injection. Localizing the skin over the area of L5-S1, the physician uses the
transforaminal approach under fluoroscopy guidance for needle position. The spinal
needle is inserted, and the patient experienced paresthesias into her left lower extremities.
The anesthetic drug is injected into the epidural space. What are the codes for this
procedure?
A. 64483, 64484, 77003-26
B. 64493, 77003-26
C. 64483, 77003-26
D. 64493, 64494, 77003-26
Question 7
A 30-year-old male has displacement of the lumbar intervertebral disc. The affected nerve
in the facet joints of the lumbar region was destroyed by a neurolytic agent in the right
segmental medial branches of L3, L4, and L5. Select the procedure codes.
A. 64493, 64494, 64495
B. 64622, 64623 x 2
C. 64483, 64484-51 x 2
D. 64620, 64623-50

Question 8
A patient has spinal stenosis and disk displacement in the L3-L4 and L4-L5 and
underwent a removal of the posterior arch of a vertebra to provide additional space for
the nerves and widen the spinal canal. The back was prepped and an incision was made
down to the deep fascia and the spinous processes of L5, L4 and L3 were identified
performing the laminectomy of L4 up to L3 and a resection of the flavum ligament. There
was resection of the facet and decompression was carried out laterally to the level of the
medial border of the pedicle. Foraminotomies of L3-4 and L4-5 were performed with the
Kerrison punch and there was plenty of room for the nerve roots to exit in these regions
with no further stenosis above or below this area. What procedure code(s) should be
used?
A. 63047, 63048
B. 63042, 63044
C. 63017
D. 63005
Question 9
A six-week-old infant has hydrocephalus and the parents have consented to have surgery
to drain the cerebrospinal fluid. The infants scalp is incised, then a burr hole was drilled.
A periumbilical incision was made dissecting through until the peritoneum was identified
and incised. The shunt was tunneled, passing over from the belly up to the cranial
incision with a small counter incision in the neck. The shunt tubing was passed through
and then cut and attached to the strata valve. Free flow of cerebrospinal fluid was
obtained from the distal shunt tubing and was placed into the peritoneum. What code
should be used for this procedure?
A. 61070
B. 61210
C. 62192
D. 62223
Question 10
A 43-year-old female patient diagnosed with papillary carcinoma of the thyroid
underwent a total thyroidectomy. The neck and anterior chest were prepped and the
incision was made two fingerbreadths above the sternal notch and was deepened down
through the platysma muscle where flaps were created both superior and inferior to the
incision. The left side of the interior, inferior, and superior poles vessels were serially
clamped, cut, and ligated, on the thyroid side dividing the isthmus on the right lobe side
of the midline removing the left lobe and several enlarged lymph nodes. Then dissection
was done on the right side removing the right lobe from the trachea. Which CPT code
should be used?
A. 60240
B. 60252
C. 60260
D. 60220

Question 11
A 55-year-old man presents with uncontrolled tremors that have become quite severe and
is now disabling. A trial of a deep brain stimulator electrode is recommended. The patient
is placed in the head-holder adapter for the frame. Scalp is incised exposing the skull
using a perforator to make a single burr hole 2.5 cm from the midline at the level of the
coronal suture exposing the dura and punctured for access. Microelectrode recording
(MER) and stimulation is done to target and reposition the electrodes to determine the
best placement for the neurostimulator electrode. The neurostimulator electrode array is
placed in the thalamus and fastened into position with radiographic imaging monitoring
its placement. The lead is coiled in a pocket under the galea, which is sutured closed,
followed by skin closure. What code should be used for this procedure?
A. 61850
B. 61863
C. 61867
D. 61870
Question 12
A 41-year-old female has carpal tunnel syndrome in her left hand. The patient underwent
release of the carpal ligament with internal neurolysis. An incision was made directly
over the carpal ligament through the skin down to the carpal ligament. Under direct
vision the carpal ligament was divided and under microscopic vision internal neurolysis
was performed with a nerve block on the median nerve. The correct CPT code is:
A. 64704
B. 64719
C. 64721
D. 64722
Question 13
A patient that has a cyst-like mass on his left external auditory canal was visualized under
the microscope and a microcup forceps was used to obtain a biopsy of tissue along the
posterior superior canal wall. Which CPT code should be used?
A. 69100-RT
B. 69105-LT
C. 69140-RT
D. 61945-LT
Question 14
A 26-year-old patient presents with headache, neck pain, and fever and is concerned that
he may have meningitis. The patient was placed in the sitting position and given 0.5 mg
Ativan IV. His back was prepped and a 20-gauge needle punctured the spine between L4
and L5 with the return of clear fluid. The cerebral spinal fluid was reviewed and showed
no sign of meningitis. What procedure code should be used?
A. 62270
B. 62272
C. 62282
D. 62319

Question 15
A 65-year-old male with a history of chronic glaucoma has progressive optic nerve
damage and elevated intraocular pressure. A clear corneal incision is made and
viscoelastic material is injected into the anterior chamber over the lens to increase and
maintain anterior chamber depth. The endoscope is inserted through the temporal incision
to view the nasal ciliary processes which is coagulated with the endpoint of shrinkage and
whitening. The endoscope is moved in an arc, allowing treatment of the processes over an
arc of 180 and a second corneal incision is made 90 away and 180 of ciliary processes
are destroyed with laser therapy. The surgeon has completed coagulation of 270 of
angle. The eye is reformed with balanced salt solution. Wounds are checked for leakage
and sutures are placed to seal the wound What CPT code describes this procedure?
A. 66680
B. 66700
C. 66710
D. 66711
Question 16
A 53-year-old woman with scarring of the right cornea has significant corneal thinning
with a high risk of perforation and underwent reconstruction of the ocular surface. The
eye is incised and an operating microscope is used with sponges and forceps to debride
necrotic corneal epithelium. Preserved human amniotic membrane is first removed from
the storage medium and transplanted by trimming the membrane to fit the thinning area
of the cornea and sutured. This process was repeated three times until the area of thinning
is flushed with surrounding normal-thickness cornea. All of the knots are buried and a
bandage contact lens is placed with topical antibiotic-steroid ointment. What procedure
code should be used?
A. 65780
B. 65781
C. 65710
D. 65435
Question 17
A 60-year-old female with uncontrolled intraocular pressure and early cataracts has been
coming in for laser trabeculoplasty. This is her third and last session within the last week
for her treatment series. She will be examined over the next three months to ensure the
normal inflammations subside. What code(s) should be used for this procedure?
A. 65850
B. 65855
C. 65855 x 3
D. 67145 x 3

Question 18
Parents of a three-year-old male who has been having chronic serous otitis media in the
right ear have consented to surgery. Patient is placed under general anesthesia and the
physician makes an incision in the tympanic membrane. Fluid is suctioned out from the
middle ear and a ventilating tube is placed in the ear to provide a drainage route to help
reduce middle ear infections. What CPT and ICD-9-CM codes should be reported?
A. 69420-RT, 69433-51-RT, 381.10
B. 69421-RT, 69436-50, 381.4
C. 69421-RT, 69436-51-RT, 381.10
D. 69420-RT, 69433-RT, 381.01
Question 19
Biochemical and imaging evaluations reveals a 3.0 cm pheochromocytoma of the left
adrenal gland on a 25-year-old female consenting to have it removed. The physician uses
a sharp instrument to puncture the proximal area of the back to the retroperitoneal space
superior to the kidney, adjacent to the adrenal gland. Then a laparoscope was used in
excising the adrenal gland. The correct CPT code is:
A. 60500
B. 60520
C. 60540
D. 60650
Question 20
A 15-year-old has been taken to surgery for crushing his index and middle finger, injuring
his digital nerves. The physician locates the damaged nerves in both fingers and they are
sutured to restore sensory function. What CPT code should be reported?
A. 64831, 64872
B. 64834, 64837-51
C. 64831, 64837-51
D. 64831, 64832

ANSWERS
Question 1
A patient with conductive sensorineural hearing loss in the right ear has tried multiple medical
therapies without recovery of her hearing. Patient has consented to have an electromagnetic
bone conduction hearing device implanted. What CPT and ICD-9-CM codes describe this
procedure?
A. 69710-RT, 389.05
B. 69714-RT, 389.20
C. 69710-RT, 389.21
D. 69930-RT, 389.06
View Rationale
Question 2
A 26-year-old female with a one-year history of a left tympanic membrane perforation has
consented to have it repaired. A postauricular incision was made under general anesthesia.
Dissection was carried down to the temporalis fascia and a 3 x 3 cm segment of fascia was
harvested and satisfactorily desiccated. The tympanic membrane was excised. Using a highspeed drill a canaloplasty was performed until the entire annulus could be seen. The ossicular
chain was examined, it was found to be freely mobile. The previously harvested skin was trimmed
and placed in the anterior canal angle with a slight overlapping over the temporalis fascia.
Packing is placed in the ear canal, external incisions are closed, and dressings are applied. What
code should be used for this procedure?
A. 69436-LT
B. 69631-LT
C. 69632-LT
D. 69641-LT
View Rationale
Question 3
A 70-year-old female has a drooping left eyelid obstructing her vision and has consented to
having the blepharoptosis repaired. A skin marking pencil was used to outline the external
proposed skin incision on the left upper lid. The lower edge of the incision was placed in the
prominent lid crease. The skin was excised to the levator aponeurosis. An attenuated area of
levator aponeurosis was dehisced from the lower strip. Three 6-0 silk sutures were then placed in
mattress fashion, attaching this attenuated tissue superiorly to the intact tissue inferiorly. This
provided moderate elevation of the lid. The correct CPT code is:
A. 67904-E1
B. 67903-E1
C. 67901-E1
D. 67911-E1
View Rationale
Question 4

A patient has aphakia and anisometropia in the right eye underwent surgery to implant a lens. An
incision is made in the corneal-scleral juncture and a scleral tunnel was made. A partial vitrectomy
was performed and the physician guides the intraocular implant into the eye pulling it into position
by Prolene sutures. What CPT code should be reported?
A. 66982-RT
B. 66983-RT
C. 66984-RT
D. 66985-RT
View Rationale
Question 5
A 35-year-old had neuroplasty performed in the wrist for carpal tunnel syndrome. The palm was
opened through a curved incision, and further skin flaps were developed. The ulnar origin of the
transverse carpal ligament was divided, decompressing the carpal tunnel. Tension of the nerve is
released and the incision is sutured in layers. What CPT describes this procedure?
A. 64721
B. 64719
C. 64708
D. 64704
View Rationale
Question 6
A 37-year-old has multilevel lumbar degenerative disc disease and is coming in for an epidural
injection. Localizing the skin over the area of L5-S1, the physician uses the transforaminal
approach under fluoroscopy guidance for needle position. The spinal needle is inserted, and the
patient experienced paresthesias into her left lower extremities. The anesthetic drug is injected
into the epidural space. What are the codes for this procedure?
A. 64483, 64484, 77003-26
B. 64493, 77003-26
C. 64483, 77003-26
D. 64493, 64494, 77003-26
View Rationale
Question 7
A 30-year-old male has displacement of the lumbar intervertebral disc. The affected nerve in the
facet joints of the lumbar region was destroyed by a neurolytic agent in the right segmental
medial branches of L3, L4, and L5. Select the procedure codes.
A. 64493, 64494, 64495
B. 64622, 64623 x 2
C. 64483, 64484-51 x 2
D. 64620, 64623-50

View Rationale
Question 8
A patient has spinal stenosis and disk displacement in the L3-L4 and L4-L5 and underwent a
removal of the posterior arch of a vertebra to provide additional space for the nerves and widen
the spinal canal. The back was prepped and an incision was made down to the deep fascia and
the spinous processes of L5, L4 and L3 were identified performing the laminectomy of L4 up to L3
and a resection of the flavum ligament. There was resection of the facet and decompression was
carried out laterally to the level of the medial border of the pedicle. Foraminotomies of L3-4 and
L4-5 were performed with the Kerrison punch and there was plenty of room for the nerve roots to
exit in these regions with no further stenosis above or below this area. What procedure code(s)
should be used?
A. 63047, 63048
B. 63042, 63044
C. 63017
D. 63005
View Rationale
Question 9
A six-week-old infant has hydrocephalus and the parents have consented to have surgery to drain
the cerebrospinal fluid. The infants scalp is incised, then a burr hole was drilled. A periumbilical
incision was made dissecting through until the peritoneum was identified and incised. The shunt
was tunneled, passing over from the belly up to the cranial incision with a small counter incision in
the neck. The shunt tubing was passed through and then cut and attached to the strata valve.
Free flow of cerebrospinal fluid was obtained from the distal shunt tubing and was placed into the
peritoneum. What code should be used for this procedure?
A. 61070
B. 61210
C. 62192
D. 62223
View Rationale
Question 10
A 43-year-old female patient diagnosed with papillary carcinoma of the thyroid underwent a total
thyroidectomy. The neck and anterior chest were prepped and the incision was made two
fingerbreadths above the sternal notch and was deepened down through the platysma muscle
where flaps were created both superior and inferior to the incision. The left side of the interior,
inferior, and superior poles vessels were serially clamped, cut, and ligated, on the thyroid side
dividing the isthmus on the right lobe side of the midline removing the left lobe and several
enlarged lymph nodes. Then dissection was done on the right side removing the right lobe from
the trachea. Which CPT code should be used?
A. 60240
B. 60252
C. 60260
D. 60220

View Rationale
Question 11
A 55-year-old man presents with uncontrolled tremors that have become quite severe and is now
disabling. A trial of a deep brain stimulator electrode is recommended. The patient is placed in the
head-holder adapter for the frame. Scalp is incised exposing the skull using a perforator to make
a single burr hole 2.5 cm from the midline at the level of the coronal suture exposing the dura and
punctured for access. Microelectrode recording (MER) and stimulation is done to target and
reposition the electrodes to determine the best placement for the neurostimulator electrode. The
neurostimulator electrode array is placed in the thalamus and fastened into position with
radiographic imaging monitoring its placement. The lead is coiled in a pocket under the galea,
which is sutured closed, followed by skin closure. What code should be used for this procedure?
A. 61850
B. 61863
C. 61867
D. 61870
View Rationale
Question 12
A 41-year-old female has carpal tunnel syndrome in her left hand. The patient underwent release
of the carpal ligament with internal neurolysis. An incision was made directly over the carpal
ligament through the skin down to the carpal ligament. Under direct vision the carpal ligament
was divided and under microscopic vision internal neurolysis was performed with a nerve block
on the median nerve. The correct CPT code is:
A. 64704
B. 64719
C. 64721
D. 64722
View Rationale
Question 13
A patient that has a cyst-like mass on his left external auditory canal was visualized under the
microscope and a microcup forceps was used to obtain a biopsy of tissue along the posterior
superior canal wall. Which CPT code should be used?
A. 69100-RT
B. 69105-LT
C. 69140-RT
D. 61945-LT
View Rationale
Question 14
A 26-year-old patient presents with headache, neck pain, and fever and is concerned that he may
have meningitis. The patient was placed in the sitting position and given 0.5 mg Ativan IV. His
back was prepped and a 20-gauge needle punctured the spine between L4 and L5 with the return
of clear fluid. The cerebral spinal fluid was reviewed and showed no sign of meningitis. What
procedure code should be used?

A. 62270
B. 62272
C. 62282
D. 62319
View Rationale
Question 15
A 65-year-old male with a history of chronic glaucoma has progressive optic nerve damage and
elevated intraocular pressure. A clear corneal incision is made and viscoelastic material is
injected into the anterior chamber over the lens to increase and maintain anterior chamber depth.
The endoscope is inserted through the temporal incision to view the nasal ciliary processes which
is coagulated with the endpoint of shrinkage and whitening. The endoscope is moved in an arc,
allowing treatment of the processes over an arc of 180 and a second corneal incision is made
90 away and 180 of ciliary processes are destroyed with laser therapy. The surgeon has
completed coagulation of 270 of angle. The eye is reformed with balanced salt solution. Wounds
are checked for leakage and sutures are placed to seal the wound What CPT code describes
this procedure?
A. 66680
B. 66700
C. 66710
D. 66711
View Rationale
Question 16
A 53-year-old woman with scarring of the right cornea has significant corneal thinning with a high
risk of perforation and underwent reconstruction of the ocular surface. The eye is incised and an
operating microscope is used with sponges and forceps to debride necrotic corneal epithelium.
Preserved human amniotic membrane is first removed from the storage medium and transplanted
by trimming the membrane to fit the thinning area of the cornea and sutured. This process was
repeated three times until the area of thinning is flushed with surrounding normal-thickness
cornea. All of the knots are buried and a bandage contact lens is placed with topical antibioticsteroid ointment. What procedure code should be used?
A. 65780
B. 65781
C. 65710
D. 65435
View Rationale
Question 17
A 60-year-old female with uncontrolled intraocular pressure and early cataracts has been coming
in for laser trabeculoplasty. This is her third and last session within the last week for her treatment
series. She will be examined over the next three months to ensure the normal inflammations
subside. What code(s) should be used for this procedure?
A. 65850

B. 65855
C. 65855 x 3
D. 67145 x 3
View Rationale
Question 18
Parents of a three-year-old male who has been having chronic serous otitis media in the right ear
have consented to surgery. Patient is placed under general anesthesia and the physician makes
an incision in the tympanic membrane. Fluid is suctioned out from the middle ear and a ventilating
tube is placed in the ear to provide a drainage route to help reduce middle ear infections. What
CPT and ICD-9-CM codes should be reported?
A. 69420-RT, 69433-51-RT, 381.10
B. 69421-RT, 69436-50, 381.4
C. 69421-RT, 69436-51-RT, 381.10
D. 69420-RT, 69433-RT, 381.01
View Rationale
Question 19
Biochemical and imaging evaluations reveals a 3.0 cm pheochromocytoma of the left adrenal
gland on a 25-year-old female consenting to have it removed. The physician uses a sharp
instrument to puncture the proximal area of the back to the retroperitoneal space superior to the
kidney, adjacent to the adrenal gland. Then a laparoscope was used in excising the adrenal
gland. The correct CPT code is:
A. 60500
B. 60520
C. 60540
D. 60650
View Rationale
Question 20
A 15-year-old has been taken to surgery for crushing his index and middle finger, injuring his
digital nerves. The physician locates the damaged nerves in both fingers and they are sutured to
restore sensory function. What CPT code should be reported?
A. 64831, 64872
B. 64834, 64837-51
C. 64831, 64837-51
D. 64831, 64832