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| Section | Objectives |
|---|---|
| Topic 1: HCPCS Level II Coding | - Durable medical equipment and supplies - Medicare coding procedures |
| Topic 2: CPT Coding | - Surgical, diagnostic, and procedural coding - CPT guidelines and conventions |
| Topic 3: Compliance and Regulatory Guidelines | - Fraud and abuse regulations - HIPAA and medical ethics |
| Topic 4: ICD-10-CM Diagnosis Coding | - ICD-10-CM guidelines - Diagnosis code selection and sequencing |
| Topic 5: Medical Terminology and Anatomy | - Human anatomy basics - Medical terminology structure |
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NEW QUESTION # 237
(Preoperative diagnoses:Bradycardia.
Postoperative diagnosis:Bradycardia.
Procedure performed:Dual-chamber pacemaker implantation.
Brief history:77-year-old female with recurrent syncope; evaluation revealed first-degree AV block, sinus bradycardia, bundle-branch block; bradyarrhythmia suspected; after discussion with her sister, dual-chamber pacemaker recommended; risks explained; consent obtained.
Procedure details:Taken to cardiac catheterization lab; positioned on cath table; prepped/draped standard; procedure challenging due to agitation despite adequate sedation; left infraclavicular area anesthetized with
0.5 cc Xylocaine; pacemaker pocket created; hemostasis with cautery; 9-French peel-away sheath used to introduce an atrial and a ventricular lead; leads positioned with excellent thresholds; secured with O-silk sutures over sleeves; pulse generator connected; pocket flushed with antibiotic solution; pacemaker/leads placed in pocket; incision closed in two layers; performed under fluoroscopic guidance.
Complication:None.
Plan:Return to recovery; discharge later this evening to nursing home with routine post-pacemaker care.
Question:What CPT coding is reported for this procedure?)
Answer: B
Explanation:
This operative report documents anew permanent dual-chamber pacemaker implantation: creation of a subcutaneouspocket, placement oftwo transvenous leads(oneatrialand oneventricular) via a peel-away sheath, confirmation of thresholds, and connection/insertion of thepulse generatorinto the pocket with layered closure.
CPT pacemaker insertion coding is determined by thenumber of chambers/leads placedduring the session.
33208is the correct code for insertion of adual-chamberpermanent pacemaker system (atrial and ventricular leads with generator).33206is for asingle-chamber ventricularsystem and33207is for asingle-chamber atrialsystem, so neither matches a dual-lead implantation. Reporting 33206 and 33207 together is not correct because CPT provides the single comprehensive dual-chamber code when both leads are placed. The fluoroscopic guidance and catheterization lab setting support how the leads were placed but do not change the CPT selection, and "challenging due to agitation" does not by itself create a separate reportable service.
Therefore, report33208.
NEW QUESTION # 238 
Refer to the supplemental information when answering this question:
View MR 004813
What CPTand ICD-10-CM codes are reported?
Answer: C
Explanation:
CPT Code 43246: Esophagogastroduodenoscopy, with transoral insertion of intra-abdominal tube (e.g., gastrostomy or jejunostomy) This code describes the attempted PEG tube placement.
Modifier -52: Reduced services. This modifier is appended because the procedure was aborted and the PEG tube was not successfully placed.
ICD-10-CM Code K94.29: Other specified disorders of digestive system
This code captures the patient ' s chronic feeding requirement, which is the reason for the attempted PEG tube placement.
ICD-10-CM Code K44.9: Diaphragmatic hernia without obstruction or gangrene This code reports the small hiatal hernia that was found during the procedure.
References:
CPT Code 43246: Esophagogastroduodenoscopy, with transoral insertion of intra-abdominal tube (e.g., gastrostomy or jejunostomy) Modifier 52: Reduced services ICD-10-CM Code K94.29: Other specified disorders of digestive system ICD-10-CM Code K44.9: Diaphragmatic hernia without obstruction or gangrene AAPC Coder ' s Desk Reference: This resource provides detailed information on coding guidelines and procedures.
NEW QUESTION # 239
A patient with jaundice was seen by the physician to obtain liver biopsies. A needle biopsy was taken using CT guidance for needle placement. The physician obtained two core biopsies, which were then sent to pathology. What CPTcodes are reported?
Answer: A
Explanation:
1. Procedure and CPTCode Selection:
The patient underwent a needle biopsy of the liver using CT guidance to obtain two core biopsy samples.
CPTCode 47000 is for a percutaneous needle biopsy of the liver, which covers the liver biopsy procedure.
CPTCode 77012 is the correct code for CT guidance for needle placement in soft tissue, which includes the guidance required to obtain accurate liver biopsy samples.
2. Rationale for Excluding Other Options:
Code 47001 in option A is an add-on code for a liver biopsy performed during another procedure (such as a laparoscopic or open procedure) and is not applicable in this case, as 47000 is sufficient for a percutaneous approach.
Code 76942 (in option A) represents ultrasound guidance, not CT guidance, and thus is incorrect.
Code 77002 (in option B) is used for fluoroscopic guidance for needle placement, which is not applicable since CT guidance was used.
Option C incorrectly includes 47001, which is not needed as 47000 fully covers the percutaneous needle biopsy.
3. AAPC and CPTCoding Guidelines:
According to AAPC guidelines, 47000 is used for percutaneous liver biopsies, and 77012 should be reported for CT guidance for needle placement in the liver.
Therefore, the correct answer is D. 47000, 77012.
NEW QUESTION # 240
What is the muscular ring around a lumen that contracts to control flow through that lumen called?
Answer: C
Explanation:
A sphincter is a muscular ring that encircles a lumen (or passage) and contracts to control the flow of substances through it. Sphincters are found throughout the body in areas such as the gastrointestinal tract (e.g., the lower esophageal sphincter, pyloric sphincter, anal sphincter) and the urinary system (e.g., urethral sphincter), where they regulate the passage of food, waste, and other materials.
A: Stricture refers to an abnormal narrowing of a passage or duct in the body, often due to scarring or disease, not a muscular ring.
B: Snare is a surgical instrument, not a structure within the body.
D: Sinus refers to a cavity or channel within bone or tissue, unrelated to muscle control of flow.
Therefore, the correct answer is C. Sphincter.
NEW QUESTION # 241
Which one of the following is an example of a case in which a diabetes-related problem exists and the code for diabetes is never sequenced first?
Answer: D
NEW QUESTION # 242
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