Chapter 15: Eye and Ocular Auditory – Set B

1. A patient with 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. What CPT® code is reported?
a. 69100-RT c. 69140-RT
b. 69105-LT d. 69145-LT
2. What CPT® code is reported for a tympanoplasty with mastoidotomy and with ossicular
chain reconstruction in the right ear?
a. 69644-RT c. 69646-RT
b. 69636-RT d. 69632-RT
3. A patient with right and left prominent ears presents for an otoplasty. What CPT® and
ICD-10-CM codes are reported?
a. 69300, Q17.5 c. 69310, H61.113
b. 69300-50, Q17.5 d. 69320, H61.113
4. A 2 year-old with bilateral chronic serous otitis media has ventilation tubes placed in her
right and left ears using general anesthesia. What CPT® and ICD-10-CM codes are
reported?
a. 69433, H65.03 c. 69433-50, H65.23
b. 69436, H65.03 d. 69436-50, H65.23
5. The provider makes an incision in the patient's left tympanic membrane in order to inflate
eustachian tubes and aspirate fluid in a patient with acute eustachian salpingitis. The
procedure is completed without anesthesia. What CPT® and ICD-10-CM codes are
reported?
a. 69421, H68.012 c. 69420, H68.012
b. 69421, H68.022 d. 69420, H68.022
6. Operative Report
PREOPERATIVE DIAGNOSIS: Prolapsed vitreous in anterior chamber with corneal
edema POSTOPERATIVE DIAGNOSIS Same
OPERATION PERFORMED Anterior vitrectomy

The patient is a 72 year-old woman who approximately 10 months ago underwent

cataract surgery with a YAG laser capsulotomy, developed corneal edema and required a
corneal transplant. The patient has done well. Over the last few weeks, she developed
posterior vitreous detachment with vitreous prolapse to the opening in the posterior
capsule with vitreous into the anterior chamber with corneal touch and adhesion to the
graft host junction and early corneal edema. The patient is admitted for anterior
vitrectomy.

PROCEDURE: The patient was prepped, and draped in the usual manner after first
undergoing retrobulbar anesthetic. A lid speculum was inserted. An incision was made at
approximately the 10 o’clock meridian 3 mm in length, 2 mm posterior to the limbus, and
grooved forward into clear cornea with a 3.2 mm anterior chamber. An anterior
vitrectomy was carried out, placing a visco-elastic substance in the anterior chamber to
 maintain it. A Sinskey hook was used to sweep vitreous away from the corneal wound
and this was removed with the disposable vitrectomy instrument. The patient’s pupil is
noted to be round. There was no vitreous to the wound. The wound self-sealed without
aqueous leak. Cautery was used to close the conjunctiva. Subconjunctival Decadron and
Gentamicin was given. The patient tolerated the procedure well and was discharged to the
recovery room in good condition. What CPT® code(s) is/are reported?
a. 67015, 67028, 65810, 67025 c. 67005
b. 65810 d. 67010
7. A patient presents to the emergency room with a severely damaged eye. The injury was
sustained when the patient was a passenger in a multi-car accident on the public highway.
The patient sustained a large open lacerated wound to the left eye. The posterior chamber
was ruptured and significant vitreous and some intraocular tissue was lost. The eyeball
was not repairable and was removed, en masse. A permanent implant was inserted but not
attached to the extraocular muscles. The patient was released with an occlusive eye patch.
What CPT® and ICD-10-CM codes are reported?
a. 65091-LT, S05.22XS, V49.59XS, Y92.411
b. 65103-LT, S05.22XA, V49.59XA, Y92.411
c. 65093-LT, S05.22XA, V43.92XA, Y92.411
d. 65101-LT, S05.22XD, V89.2XXD, Y92.488
8. Xenon laser photocoagulation for prophylaxis of a recent right eye retinal detachment
with a giant tear is performed for an accidental injury sustained from a baseball to the eye
at fastball practice. What are the procedure and diagnosis codes for this service?
a. 67145, H33.031, W21.03XA c. 67105, H33.001, T15.01XA
b. 67141, H33.8, W50.0XXA d. 67108, H33.051, W50.0XXA
9. Preoperative Diagnosis: Left orbital cyst, hemangioma versus lymphangioma
Postoperative Diagnosis: Left orbital cyst, hemangioma versus lymphangioma
Procedures Performed: Aspiration of left orbital cyst with injection of Kenalog
Anesthesia: General
Complications: None
Estimated Blood Loss: Minimal
Indications for Procedure: The patient presents with a small cyst of the superior medial
left orbit felt to be suggestive for hemangioma versus lymphangioma. Risks, benefits, and
alternatives of steroid injection to inactivate the cyst were reviewed. These risks included
failure to work and significant visual loss. After discussion, they elected to proceed.
Description of Procedure: After informed operative consent was obtained, the patient was
brought to the operating room and laid in the supine position. General anesthetic was
administered per the anesthesiologist. A 25-gauge needle on a 5 cc syringe was placed
within the mass and aspirated. Approximately 0.5 cc of blood was recovered, but the
blood was of normal bright red color. Kenalog 40 mg (1 cc) was then injected where the
mass was aspirated without difficulty. Operative area was clean and dry. The patient was
then awakened and taken to the recovery room. Pupil reactions were brisk and equal with
2 mm pupils noted in the recovery room. There were no operative complications. What
are the procedure and diagnosis codes?
 a. 67415-LT, H05.812 c. 67405-LT, D18.1
b. 67500-LT, D18.09 d. 67515-LT, H05.812
10. A patient with mixed conductive and 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-10-
CM codes are reported?
a. 69710-RT, H90.11 c. 69710-RT,
H90.71
b. 69714-RT, H90.8 d. 69930-RT, H90.0
11. 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 CPT® code is reported?
a. 69436-LT c. 69632-LT
b. 69631-LT d. 69641-LT
12. 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 eyelid. The lower edge of the incision
was placed in the prominent eyelid 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
eyelid. What CPT® code is reported?
a. 67904-E1 c. 67901-E1
b. 67903-E1 d. 67911-E1
13. 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 then sutured. This process was repeated three times until the area of
thinning is flush with surrounding normal thickness cornea. All of the knots are buried
and a bandage contact lens is placed with topical antibiotic steroid ointment. What CPT®
code is reported?
a. 65780 c. 65710
b. 65781 d. 65435
14. A 60-year-old female with uncontrolled intraocular pressure and early cataracts has been
coming in for laser trabeculoplasty. This is her first treatment application. She will be
 examined over the next three months to ensure the normal inflammations subside. What
CPT® code is reported?
a. 65850 c. 65855
b. 66170 d. 66172
15. Parents of a 3 year-old male who has chronic serous otitis media in the right ear have
consented to surgery. Patient is placed under general anesthesia and the provider 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-10-CM codes are reported?
a. 69421-RT, H65.21 c. 69436-RT,
H65.21
b. 69436-50, H65.91 d. 69433-RT,
H65.01
16. A provider uses cryotherapy for removal trichiasis of the right upper eyelid. What CPT®
and ICD-10-CM codes are reported?
a. 67820-E3, H02.059 c. 67830-E3, H02.051
b. 67825-E3, H02.051 d. 67840-E3, B79
17. A patient receives chemodenervation with Botulinum toxin injections to stop
blepharospasms of the right eye. What are the procedure and diagnosis codes?
a. 64650, R61 c. 64612-RT, G24.5
b. 67345-RT, G24.5 d. 64616-RT, R29.891
18. The surgeon performed an insertion of an intraocular lens prosthesis. Treatment plan was
established and discussed with the patient six weeks earlier when the cataract was
removed (by the same surgeon). What CPT® code is reported?
a. 66985-58 c. 66984
b. 66983-58 d. 66985
19. The provider performs an iridotomy using laser on both eyes for chronic angle closure
glaucoma that is moderate; procedure includes local anesthesia. What CPT® and ICD-
10-CM codes are reported?
a. 66710-50, H40.2212, H40.2222 c. 66762-50, 66990, H40.2432
b. 66625, H40.2290 d. 66761-50, H40.2232
20. A provider extracts a tumor, using a frontal approach, from the lacrimal gland of a 14
year-old patient. What CPT® and ICD-10-CM codes are reported?
a. 68500, C69.50 c. 68520, D31.50
b. 68505, C69.51 d. 68540, D49.89
21. 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 is reported?
a. 66680 c. 66710
b. 66700 d. 66711
22. The ENT surgeon performs an anterior skull base LeFort I osteotomy approach for the
intradural removal of a meningioma by a neurosurgeon. What CPT® code is reported by
the ENT surgeon?
a. 61580-62 c. 61586
b. 61586-62 d. 61584
23. Under general anesthesia, a provider excises one chalazion from each upper eyelid. What
are the procedure and diagnosis codes for the service?
a. 67840-E1, 67808-E3, H00.11, H00.14
b. 67808-E1-E3, H00.11, H00.14
c. 67805, H02.821, H02.824
d. 67801-E2-E3, H00.12, H00.15
24. The provider creates an opening in the opaque posterior lens capsule of the patient’s right
eye by cutting an inverted U shape in the tissue. The cut is made using a YAG laser. The
tissue within the inverted U falls down, and out of the patient’s field of vision. The
procedure is done to improve the vision of a patient with a secondary cataract. What
CPT® code is reported?
a. 66999-50 c. 66821-RT
b. 66830-50 d. 66762-RT
25. A 26 year-old female with a one-year history of a left tympanic membrane perforation.
She has extensive tympanosclerosis with a nonhealing perforation. Her options, including
observation with water precautions or surgery, were discussed. The patient wished to
proceed with surgery. With use of the operating microscope, the surgeon performs a left
lateral graft tympanoplasty. What CPT® code is reported?
a. 69632-LT c. 69631-LT
b. 69641-LT d. 69642-LT