Question 1

A 76-year-old female had a recent mammographic and ultrasound abnormality in the 6 o’clock position of the left breast. She underwent core biopsies which showed the presence of a papilloma. The plan now is for needle localization with excisional biopsy to rule out occult malignancy. After undergoing preoperative needle localization with hook wire needle injection with methylene blue, the patient was brought to the operating room and was placed on the operating room table in the supine position where she underwent laryngeal mask airway (LMA) anesthesia. The left breast was prepped and draped in a sterile fashion. A radial incision was then made in the 6 o’clock position of the left breast corresponding to the tip of the needle localizing wire. Using blunt and sharp dissection, we performed a generous excisional biopsy around the needle localizing wire including all of the methylene blue-stained tissues. The specimen was then submitted for radiologic confirmation followed by permanent section pathology. Once hemostasis was assured, digital palpation of the depths of the wound field failed to reveal any other palpable abnormalities. At this point, the wound was closed in 2 layers with 3-0 Vicryl and 5-0 Monocryl. Steri-Strips were applied. Local anesthetic was infiltrated for postoperative analgesia.

What CPT® and ICD-10-CM codes describe this procedure?

A. 19100, N63.20

B. 19285, C50.912

C. 19120, R92.8

D. 19125, D24.2

Question 2

A 53-year-old male is in the dermatologist’s office for removal of 2 lesions located on his lower lip and nose. Lesions were identified and marked. The lower lip lesion of 4 mm in size was shaved to the level of the superficial dermis. Utilizing a 3-mm punch, a biopsy was taken of the left supratip nasal area. What are the CPT® codes for these procedures?

A. 40490, 11104-59

B. 11310, 11104-59

C. 17000, 17003

D. 11440, 11105-59

Question 3

A 76-year-old has dermatochalasis on bilateral upper eyelids. The condition does not interfere with the function of the eyelids. The patient agrees to surgery. The patient is here for a bilateral blepharoplasty. A lower incision line was marked at approximately 5 mm above the lid margin along the crease. Then using a pinch test with forceps the amount of skin to be resected was determined and marked. An elliptical incision was performed on the left eyelid and the skin was excised. In a similar fashion the same procedure was performed on the right eye. The wounds were closed with sutures. What CPT® coding is reported?

A. 15822, 15823-51

B. 15823-50

C. 15822-50

D. 15820-LT, 15820-RT

Question 4

A 42-year-old male has a frozen left shoulder. An arthroscope was inserted in the posterior portal in the glenohumeral joint. The articular cartilage was normal except for some minimal grade III-IV changes, about 5% of the humerus just adjacent to the rotator cuff insertion of the supraspinatus. The biceps was inflamed, not torn at all. The superior labrum was not torn at all, the labrum was completely intact. The rotator cuff was completely intact. An anterior portal was established high in the rotator interval. The rotator interval was very thick and contracted. Adhesions were destroyed with electrocautery and the Bovie. The superior glenohumeral ligament, the middle glenohumeral ligament and the tendinous portion of the subscapularis were released. The arthroscope was placed anteriorly, adhesions were destroyed and the shaver was used to debride some of the posterior capsule and the posterior capsule was released in its posterosuperior and then posteroinferior aspect.  What CPT® code(s) is (are) reported?

A. 23450-LT

B. 23466-LT

C. 29805-LT, 29806-51-LT

D. 29825-LT

Question 5

After adequate anesthesia was obtained the patient was turned prone in a kneeling position on the spinal table. A lower midline lumbar incision was made and the soft tissues divided down to the spinous processes. The soft tissues were stripped away from the lamina down to the facets and discectomies and laminectomies were then carried out at L3-4, L4-5 and L5-S1. Interbody fusions were set up for the lower three levels using the Danek allografts and augmented with structural autogenous bone from the iliac crest. The posterior instrumentation of a 5.5 mm diameter titanium rod was then cut to the appropriate length and bent to confirm to the normal lordotic curve. It was then slid immediately onto the bone screws and at each level compression was carried out as each of the two bolts were tightened so that the interbody fusions would be snug and as tight as possible. Select the appropriate CPT® codes for this visit?

A. 22612, 22614 x 2, 22842, 20938, 20930

B. 22533, 22534 x 2, 22842

C. 22630, 22632 x 2, 22842, 20938, 20930

D. 22554, 22632 x 2, 22842

Question 6

Patient has lung cancer in his upper right and middle lobes. Patient is in the operating suite to have a video-assisted thoracoscopy surgery (VATS). A 10-mm-zero-degree thoracoscope is inserted in the right pleural cavity through a port site placed in the ninth and seventh intercostal spaces. Lung was deflated. The tumor is in the right pleural. Both lobes were removed thoracoscopically. Port site closed. A chest tube was placed to suction and patient was sent to recovery in stable condition. Which CPT® code is reported for this procedure? 

 

A. 32482

B. 32484

C. 32670

D. 32671

Question 7

The patient is a 58-year-old white male, one month status post pneumonectomy. He had a post pneumonectomy empyema treated with a tunneled cuffed pleural catheter which has been draining the cavity for one month with clear drainage. He has had no evidence of a block or pleural fistula. Therefore a planned return to surgery results in the removal of the catheter. The correct CPT® code is:

A. 32440-78

B. 32035-58

C. 32036-79

D. 32552-58

Question 8

This 67-year-old man presented with a history of progressive shortness of breath. He has had a diagnosis of a secundum atrioseptal defect for several years, and has had atrial fibrillation intermittently over this period of time. He was in atrial fibrillation when he came to the operating room, and with the patient cannulated and on bypass, the right atrium was then opened. A large 3 x 5 cm defect was noted at fossa ovalis, and this also included a second hole in the same general area. Both of these holes were closed with a single pericardial patch. What CPT® and ICD-10-CM codes are reported?

A. 33675, Q21.0

B. 33647, Q21.1, R06.02

C. 33645, Q21.2, R06.02

D. 33641, Q21.1

Question 9

An 82-year-old female had a CAT scan which revealed evidence of a proximal small bowel obstruction. She was taken to the Operating Room where an elliptical abdominal incision was made, excising the skin and subcutaneous tissue. There were extensive adhesions along the entire length of the small bowel. The omentum and bowel were stuck up to the anterior abdominal wall. Time consuming, tedious and spending an extra hour to lysis the adhesions to free up the entire length of the gastrointestinal tract from the ligament to Treitz to the ileocolic anastomosis. The correct CPT® code is:

A. 44005

B. 44180-22

C. 44005-22

D. 44180-59

Question 10

55-year-old patient was admitted with massive gastric dilation. The endoscope was inserted with a catheter placement. The endoscope is passed through the cricopharyngeal muscle area without difficulty. Esophagus is normal, some chronic reflux changes at the esophagogastric junction noted. Stomach significant distention with what appears to be multiple encapsulated tablets in the stomach at least 20 to 30 of these are noted. Some of these are partially dissolved. Endoscope could not be engaged due to high grade narrowing in the pyloric channel, the duodenum was not examined. It seems to be a high grade outlet obstruction with a superimposed volvulus. A repeat examination is not planned at this time. What code should be used for this procedure?

A. 43246-52

B. 43241-52

C. 43235

D. 43191

Question 11

The patient is a 78-year-old white female with morbid obesity that presented with small bowel obstruction. She had surgery approximately one week ago and underwent exploration, which required a small bowel resection of the terminal ileum and anastomosis leaving her with a large inferior ventral hernia. Two days ago she started having drainage from her wound which has become more serious. She is now being taken back to the operating room. Reopening the original incision with a scalpel, the intestine was examined and the anastomosis was reopened , excised at both ends, and further excision of intestine. The fresh ends were created to perform another end- to-end anastomosis. The correct procedure code is:

A. 44120-78

B. 44126-79

C. 44120-76

D. 44202-58

Question 12

A 5-year-old male with a history of prematurity was found to have a chordee due to congenital hypospadias. He presents for surgical management for a plastic repair in straightening the abnormal curvature. Under general anesthesia, bands were placed around the base of the penis and incisions were made degloving the penis circumferentially. The foreskin was divided in Byers flaps and the penile skin was reapproximated at the 12 o’clock position. Two Byers flaps were reapproximated, recreating a mucosal collar which was then criss- crossed and trimmed in the midline in order to accommodate median raphe reconstruction. This was reconstructed with use of a horizontal mattress suture. The shaft skin was then approximated to the mucosal collar with sutures correcting the defect. Which CPT® code should be used?

A. 54304

B. 54340

C. 54400

D. 54440

Question 13

A 22-year-old is 14 weeks pregnant and wants to terminate the pregnancy. She has consented for a D&E. She was brought to the operating room where MAC anesthesia was given. She was then placed in the dorsal lithotomy position and a weighted speculum was placed into her posterior vaginal vault. Cervix was identified and dilated. A 6.5-cm suction catheter hooked up to a suction evacuator was placed and products of conception were evacuated. A medium size curette was then used to curette her endometrium. There was noted to be a small amount of remaining products of conception in her left cornua. Once again the suction evacuator was placed and the remaining products of conception were evacuated. At this point she had a good endometrial curetting with no further products of conception noted. Which CPT® code should be used?

A. 59840

B. 59841

C. 59812

D. 59851

Question 14

A 37-year-old female has menorrhagia and wants permanent sterilization. The patient was placed in Allen stirrups in the operating room. Under anesthesia the cervix was dilated and the hysteroscope was advanced to the endometrium into the uterine cavity. No polyps or fibroids were seen. The Novasure was used for endometrial ablation. A knife was then used to make an incision in the right lower quadrant and left lower quadrant with 5-mm trocars inserted under direct visualization with no injury to any abdominal contents. Laparoscopic findings revealed the uterus, ovaries and fallopian tubes to be normal. The appendix was normal as were the upper quadrants. Because of the patient’s history of breast cancer and desire for no further children, it was decided to take out both the tubes and ovaries. This had been discussed with the patient prior to surgery. What are the codes for these procedures?

A. 58660, 58353-51

B. 58661, 58563-51

C. 58661, 58558-51

D. 58662, 58563-51

Question 15

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 removal of a tissue overgrowth around the foramen. Which CPT® code(s) is (are) used for this procedure?

A. 63045-50, 63048-50

B. 63020-50, 63035-50, 63035-50

C. 63015-50

D. 63045, 63048 x 2

Question 16

An extracapsular cataract removal is performed on the right eye by manually using an iris expansion device to expand the pupil. A phacoemulsification unit was used to remove the nucleus and irrigation and aspiration was used to remove the residual cortex allowing the insertion of the intraocular lens. What CPT® code is reported?

A. 66985

B. 66984

C. 66982

D. 66983

Question 17

An infant who has chronic otitis media in the right and left ears was placed under general anesthesia and a radial incision was made in the posterior quadrant of the left and right tympanic membranes. 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 are reported?

A. 69436-50, H65.33

B. 69436-50, H66.43

C. 69433-50, H65.113

D.69421-50, H65.33

Question 18

A 50-year-old patient is coming to see her primary care physician for hypertension.  The patient also discusses with her physician that the OBGYN office had just told her that her Pap smear came back with an abnormal reading and is worried because her aunt had passed away with cervical cancer. The physician documents she spent 55 minutes face-to-face counseling on the awareness, other screening procedures and treatment if it turns out to be cervical cancer. What E/M code(s) is (are) reported for this visit?

A. 99215, 99417

B. 99213, 99358

C. 99214, 99354

D. 99213

Question 19

A patient was admitted yesterday to the hospital for possible gallstones. The following day the physician who admitted the patient performed a detailed history, a detailed exam and a medical decision making of low complexity. The physician tells her the test results have come back positive for gallstones and is recommending having a cholecystectomy. What code is reported for this evaluation and management service for the following day?

A. 99253

B. 99221

C. 99231

D. 99234

Question 20

A patient came into the ER with wheezing and a rapid heart rate. The ER physician documents a comprehensive history, comprehensive exam and medical decision of moderate complexity. The patient has been given three nebulizer treatments. The ER physician has decided to place him in observation care for the acute asthma exacerbation. The ER physician will continue examining the patient and will order additional treatments until the wheezing subsides. Select the appropriate code(s) for this visit.

A. 99284, 99219

B. 99219

C. 99284

D. 99235

Question 21

A 6-month-old patient is administered general anesthesia to repair a cleft palate. What anesthesia code(s) is (are) reported for this procedure?

A. 00170, 99100

B. 00172

C. 00172, 99100

D. 00176

Question 22

A 50-year-old female had a left subcutaneous mastectomy for cancer. She now returns for reconstruction which is done with a single TRAM flap. Right mastopexy is done for asymmetry. Select the anesthesia code for this procedure.

A. 00404

B. 00402

C. 00406

D. 00400

Question 23

A patient is having knee replacement surgery. The surgeon requests that in addition to the general anesthesia for the procedure that the anesthesiologist also insert a continuous lumbar epidural infusion for postoperative pain management. The anesthesiologist performs postoperative management for two postoperative days.

A. 01400-AA, 62326, 01996 x 2

B. 01402-AA, 62327, 01966 x 2

C. 01402-AA, 62326, 01996 x 2

D. 01404-AA, 62327

Question 24

A 35-year-old male sees his primary care physician complaining of fever with chills, cough and congestion. The physician performs a chest X-ray taking lateral and AP views in his office. The physician interprets the X-ray views and the patient is diagnosed with walking pneumonia. Which CPT® code is reported for the chest X-rays performed in the office and interpreted by the physician?

A. 71046-26

B. 71047-26

C. 71046

D. 71045-26-TC

Question 25

This gentleman has localized prostate cancer and has chosen to have complete transrectal ultrasonography performed for dosimetry purposes. Following calculation of the planned transrectal ultrasound, guidance was provided for percutaneous placement of 1-125 seeds. Select the appropriate codes for this procedure.

A. 55920, 76965-26

B. 55876, 76942-26

C. 55860, 76873-26

D. 55875, 76965-26

Question 26

A 76-year-old female had a ground level fall when she tripped over her dog earlier this evening in her apartment. The Emergency Department took X-rays of the left wrist in oblique and lateral views which revealed a displaced distal radius fracture, type I open left wrist. What radiological service and ICD-10-CM codes are reported?

A. 73100-26, S52.502B, W18.31XA, Y92.039

B. 73110-26, S52.602A, W18.31XA, Y92.039

C. 73115-26, S52.502A, W18.31XA, Y92.039

D. 73100-26, S52.602B, W18.31XA, Y92.039

Question 27

An 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 single drug class using an immunoassay in a random access chemistry analyzer. Presence of antidepressants is found and a drug confirmation is performed to identify the particular antidepressant. What correct CPT® codes are reported?

A. 80307, 80338

B. 80305, 80338

C. 80306 x 3, 80332

D. 80307 x 3, 80333

Question 28

A patient uses Topiramate to control his seizures. He comes in every two months to have a therapeutic drug testing performed to assess serum plasma levels of this medication. What lab code(s) is (are) reported for this testing?

A. 80305

B. 80375

C. 80201

D. 80306, 80375

Question 29

Patient that is a borderline diabetic has been sent to the laboratory to have an oral glucose tolerance test. Patient drank the glucose and five blood specimens were taken every 30 to 60 minutes up to three hours to determine how quickly the glucose is cleared from the blood. What code(s) is (are) reported for this test?

A. 82947 x 5

B. 82946

C. 80422

D. 82951, 82952 x 2

Question 30

A patient with severe asthma exacerbation has been admitted. The admitting physician orders a blood gas for oxygen saturation only. The admitting physician performs the arterial puncture drawing blood for a blood gas reading on oxygen saturation only. The physician draws it again in an hour to measure how much oxygen the blood is carrying. Select the codes for the blood gas testing. 

A. 82805, 82805-51

B. 82810, 82810-91

C. 82803, 82803-51

D. 82805, 82805-90

Question 31

A new patient is having a cardiovascular stress test done in his cardiologist’s office. Before the test is started the physician documents a medically appropriate history, examination, and moderate complexity medical decision making. The physician will be supervising and interpreting the stress on the patient’s heart during the test. What procedure codes are reported for this encounter?

A. 93015-26, 99204-25

B. 93016, 93018, 99204-25

C. 93015, 99204-25

D. 93018-26, 99204-25

Question 32

A cancer patient is coming in to have a chemotherapy infusion. The physician notes the patient is dehydrated and will first administer a hydration infusion. The infusion time was 1 hour and 30 minutes. Select the code(s) that is (are) reported for this encounter?

A. 96360

B. 96360, 96361

C. 96365, 96366

D. 96422

Question 33

A patient that has multiple sclerosis has been seeing a therapist for four visits. Today’s visit the therapist will be performing a comprehensive reevaluation to determine the extent of progress. There was a revised plan assessing the changes in the patient’s functional status. Initial profile was updated to reflect changes that affect future goals along with a revised plan of care. A total care of 30 minutes were spent in this re-evaluation. What CPT® and ICD-10-CM codes should be reported?

A. 97168, Z51.89, G35

B. 97164, Z56.89, G35

C.97167, G35

D. 97163, Z56.9, G35

Question 34

What is the term used for inflammation of the bone and bone marrow?

A. Chondromatosis

B. Osteochondritis

C. Costochondritis

D. Osteomyelitis

Question 35

The root word trich/o means:

A. Hair

B. Sebum

C. Eyelid

D. Trachea

Question 36

Complete this series: Frontal lobe, Parietal lobe, Temporal lobe, ____________.

A. Medulla lobe

B. Occipital lobe

C. Middle lobe

D. Inferior lobe

Question 37

A patient is having pyeloplasty performed to treat an uretero-pelvic junction obstruction. What is being performed?

A. Surgical repair of the bladder

B. Removal of the kidney

C. Cutting into the ureter

D. Surgical reconstruction of the renal pelvis

Question 38

A 27-year-old was frying chicken when an explosion of the oil had occurred and she sustained second-degree burns on her face (5%), third degree burns on both hands (5%). There was a total of 10 percent of the body surface that was burned. Select which ICD-10-CM codes are reported.

A. T20.20XA, T23.301A, T23.302A, T31.10, X10.2XXA, Y93.G3

B. T23.301A, T23.302A, T20.20XA, T31.11, X10.2XXA, Y93.G3

C. T23.301A, T23.302A, T20.20XA, T31.10, X10.2XXA, Y93.G3

D. T23.601A, T23.602A, T20.60XA, T31.10, X10.2XXA, Y93.G3

Question 39

A patient that has cirrhosis of the liver just had an endoscopy performed showing hemorrhagic esophageal varices. The ICD-10-CM codes are reported:

A. I85.01, K74.69

B. I85.11, K74.60

C. K74.60, I85.11

D. I85.00, K74.69

Question 40

A 55-year-old-patient had a fracture of his left knee cap six months ago. The fracture has healed but he still has staggering gait in which he will be going to physical therapy. What ICD-10-CM codes are reported?

A. S82.002A, R26.81

B. R26.0, S82.002A

C. S82.092S, R26.0

D. R26.0, S82.002S

Question 41

Which statement is TRUE about Z codes:

A. Z codes are never reported as a primary code.

B. Z codes are only reported with injury codes.

C. Z codes may be used either as a primary code or a secondary code.

D. Z codes are always reported as a secondary code.

Question 42

Patient with corneal degeneration is having a cornea transplant. The donor cornea had been previously prepared by punching a central corneal button with a guillotine punch. This had been stored in Optisol GS. It was gently rinsed with BSS Plus solution and was then transferred to the patient’s eye on a Paton spatula and sutured with 12 interrupted 10-0 nylon sutures. Select the HCPCS Level II code for the corneal tissue.

A. V2790

B. V2785

C. V2628

D.V2799

Question 43

The patient presents to the office for an injection. Joint prepped using sterile technique. Muscle group location: gluteus maximus. Sterilely injected with 40 mg of Kenalog-10, 2 cc Marcaine and 2 cc lidocaine 2%. Sterile bandage applied. Choose the HCPCS Level II code for this treatment.

A. J3301 x 4

B. J3301

C. J3300 x 40

D. J3300

Question 44

Which health plan does NOT fall under HIPAA?

A. Medicaid

B. Medicare

C. Workers’ compensation

D. Private plans

Question 45

Which statement is an example in which a diabetes-related problem exists and the code for diabetes is NEVER sequenced first?

A. If the patient has an underdose of insulin due to an insulin pump malfunction.

B. If the patient is being treated for secondary diabetes.

C. If the patient is being treated for Type 2 diabetes and uses insulin.

D. If the patient is diabetic with an associated condition.

Question 46

Which of the following is an example of electronic data?

A. A digital X-ray

B. An explanation of benefits

C. An advance beneficiary notice

D. A written prescription

Question 47

Guidelines from which of the following code sets are included as part of the code set requirements under HIPAA?

A. CPT® Category III codes

B. ICD-10-CM

C. HCPCS Level II

D. ADA Dental Codes

Question 48

PREOPERATIVE DIAGNOSIS: Displaced impacted Colles fracture, left distal radius and ulna. 

POSTOPERATIVE DIAGNOSIS: Displaced impacted Colles fracture, left distal radius and ulna. 

 

PROCEDURE: Reduction with application of an external fixation system, left wrist fracture 

 

INDICATIONS: The patient is a 46 year-old right-hand-dominant female who fell off stairs 4 to 5 days ago sustaining an impacted distal radius fracture with possible intraarticular component and an associated ulnar styloid fracture. Today in surgery, fracture was reduced anatomically and an external fixation system was applied. 

 

PROCEDURE DESCRIPTION: Under satisfactory general anesthesia, the fracture was manipulated and C-arm images were checked. The left upper extremity was prepped and draped in the usual sterile orthopedic fashion. Two small incisions were made over the second metacarpal and after removing soft tissues including tendinous structures out of the way, drawing was carried out and blunt-tipped pins were placed for the EBI external fixator. The frame was next placed and the site for the proximal pins was chosen. Small incision was made. Subcutaneous tissues were carried out of the way. The pin guide was placed and 2 holes were drilled and blunt-tipped pins placed. Fixator was assembled. C-arm images were checked. Fracture reduction appeared to be anatomic. Suturing was carried out where needed with 4-0 Vicryl interrupted subcutaneous and 4-0 nylon interrupted sutures. Sterile dressings were applied. Vascular supply was noted to be satisfactory. Final frame tightening was carried out. 

 

What CPT® coding is reported?

A. 25600-LT, 20692-51

B. 25605- LT, 20690-51

C. 25606-LT

D. 25607-LT

Question 49

Preoperative Diagnosis: Syncope. Symptomatic Bradycardia. 

Postoperative Diagnosis: Bradycardia

 

Procedure: Insertion DDD Pacemaker

 

Anesthesia: Moderate Sedation

 

Procedure Description: 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 through the 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 CPT® coding is reported?

A. 33208

B. 33212

C. 33226

D. 33235

Question 50

PREOPERATIVE DIAGNOSIS: Diverticulitis, perforated diverticula 

POST OPERATIVE DIAGNOSIS: Diverticulitis, perforated diverticula 

 

PROCEDURE: Hartmann procedure, which is a sigmoid resection with Hartmann pouch and colostomy. 

 

DESCRIPTION OF THE PROCEDURE: Patient was prepped and draped in the supine position under general anesthesia. Prior to surgery patient was given 4.5 grams of Zosyn and Rocephin IV piggyback. A lower midline incision was made, abdomen was entered. Upon entry into the abdomen, there was an inflammatory mass in the pelvis and there was a large abscessed cavity, but no feces. The abscess cavity was drained and irrigated out. The left colon was immobilized, taken down the lateral perineal attachments. The sigmoid colon was mobilized. 

 

There was an inflammatory mass right at the area of the sigmoid colon consistent with a diverticulitis or perforation with infection. Proximal to this in the distal left colon, the colon was divided using a GIA stapler with 3.5 mm staples. The sigmoid colon was then mobilized using blunt dissection. The proximal rectum just distal to the inflammatory mass was divided using a GIA stapler with 3.5 mm staples. The mesentery of the sigmoid colon was then taken down and tied using two 0 Vicryl ties. Irrigation was again performed and the sigmoid colon was removed with inflammatory mass. 

 

The wall of the abscessed cavity that was next to the sigmoid colon where the inflammatory mass was, showed no leakage of stool, no gross perforation, most likely there is a small perforation in one of the diverticula in this region. Irrigation was again performed throughout the abdomen until totally clear. All excess fluid was removed. The distal descending colon was then brought out through a separate incision in the lower left quadrant area and a large 10 mm 10 French JP drain was placed into the abscessed cavity. The sigmoid colon or the colostomy site was sutured on the inside using interrupted 3-0 Vicryl to the peritoneum and then two sheets of film were placed into the intra- abdominal cavity. The fascia was closed using a running #1 double loop PDS suture and intermittently a #2 nylon retention suture was placed. The colostomy was matured using interrupted 3-0 chromic sutures. I palpated the colostomy; it was completely patent with no obstructions. Dressings were applied. Colostomy bag was applied. 

 

Which CPT® code is reported?

A. 44140

B. 44143

C. 44160

D. 44208