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| Section | Objectives |
|---|---|
| ICD-10-CM Diagnosis Coding | - ICD-10-CM guidelines - Diagnosis code selection and sequencing |
| Compliance and Regulatory Guidelines | - HIPAA and medical ethics - Fraud and abuse regulations |
| CPT Coding | - CPT guidelines and conventions - Surgical, diagnostic, and procedural coding |
| Medical Terminology and Anatomy | - Human anatomy basics - Medical terminology structure |
| HCPCS Level II Coding | - Durable medical equipment and supplies - Medicare coding procedures |
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NEW QUESTION # 44
A patient arrives for a PEG placement. The patient requires tube feeds for nutrition but frequently pulls out the dobhoffs tube. An EGD was performed. Several attempts were made to place the PEG tube without success so the procedure was aborted. During the withdraw of the scope, a small hiatal hernia was noted in the stomach. The scope was removed the the patient transferred to recovery.
What CPT and ICD-10-CM coding is reported?
Answer: B
NEW QUESTION # 45
A 60-year-old male has three-vessel disease and supraventricular tachycardia which has been refractory to other management. He previously had pacemaker placement and stenting of LAD coronary artery stenosis, which has failed to solve the problem. He will undergo CABG with autologous saphenous vein and an extensive modified MAZE procedure to treat the tachycardia.
He is brought to the cardiac OR and placed in the supine position on the OR table. He is prepped and draped, and adequate endotracheal anesthesia is assured. A median sternotomy incision is made and cardiopulmonary bypass is initiated. The endoscope is used to harvest an adequate length of saphenous vein from his left leg.
This is uneventful and bleeding is easily controlled. The vein graft is prepared and cut to the appropriate lengths for anastomosis. Two bypasses are performed: one to the circumflex and another to the obtuse marginal. The left internal mammary is then freed up and it is anastomosed to the ramus, the first diagonal, and the LAD. An extensive maze procedure is then performed and the patient is weaned from bypass. At this point, the sternum is closed with wires and the skin is reapproximated with staples. The patient tolerated the procedure without difficulty and was taken to the PACU.
Choose the procedure codes for this surgery.
Answer: D
Explanation:
The CABG procedure involved multiple bypasses, with the use of autologous saphenous vein grafts and the left internal mammary artery, along with an extensive modified MAZE procedure. CPTcode 33535 describes a coronary artery bypass using arterial grafts, including at least three coronary artery bypasses.
CPTcode 33259-51 is for the MAZE procedure for supraventricular tachycardia, with the -51 modifier indicating multiple procedures. CPTcode 33519-51 is for an additional vein graft, and CPTcode 33508-
51 describes the endoscopic harvesting of the vein.
References:
* AMA's CPTProfessional Edition (current year), Codes 33535, 33259-51, 33519-51, 33508-51
NEW QUESTION # 46
Refer to the supplemental information when answering this question:
View MR 000281
What anesthesia and diagnosis codes are reported for this case?
Answer: D
Explanation:
CPT Code 00811: Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to the splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing This code is reported for anesthesia services provided during a colonoscopy that is diagnostic in nature.
ICD-10-CM Code D62: Acute posthemorrhagic anemia
This is the most accurate postoperative diagnosis. The operative report states "Anemia due to acute blood loss." ICD-10-CM Code N18.6: End stage renal disease This code captures the patient's documented history of ESRD.
ICD-10-CM Code Z99.2: Dependence on renal dialysis
This code is necessary to report the patient's dialysis status, as it affects the overall risk of the procedure.
Why other options are incorrect:
00812: This code is for therapeutic colonoscopies, not diagnostic.
D64.9: This code is for anemia, unspecified. D62 is more specific to the patient's condition.
K62.5: This code is for lower gastrointestinal bleeding, but the anemia is the primary diagnosis in this case.
References:
CPT Code 00811: Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to the splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing ICD-10-CM Code D62: Acute posthemorrhagic anemia ICD-10-CM Code N18.6: End stage renal disease ICD-10-CM Code Z99.2: Dependence on renal dialysis AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.
NEW QUESTION # 47
A patient in a radiology facility has an X-ray examination of her lumbosacral spine due to pain while playing golf. The radiologist takes a complete 7-view of the lumbosacral spine, including bending views.
What CPTcode is reported?
Answer: C
Explanation:
1. Procedure and CPTCode Selection:
The patient underwent a 7-view X-ray of the lumbosacral spine, which included bending views. A complete set of views is captured.
CPTCode 72114 is appropriate for a complete lumbosacral spine X-ray with a minimum of six views. This code includes comprehensive imaging, such as bending and other specialized views, which were taken in this scenario.
2. Rationale for Excluding Other Options:
Code 72020 is for a single-view X-ray of the spine, which is not adequate to describe a 7-view series.
Code 72080 is for a two- or three-view X-ray of the thoracolumbar spine, which does not cover the full set of seven views described in this scenario.
Code 72084 represents a complete thoracic spine study with multiple views but does not specifically cover the lumbosacral spine, which is the focus of this X-ray examination.
3. AAPC and CPTCoding Guidelines:
According to AAPC and CPTguidelines, 72114 is the correct choice for a complete lumbosacral spine study involving multiple views, including specialized views like bending.
Therefore, the correct answer is C. 72114.
NEW QUESTION # 48
During a laparoscopic hemicolectomy, the left kidney is accidentally perforated. A nephrologist performs open repair of the kidney laceration and places a JP drain.
What CPT and ICD-10-CM coding is reported by the nephrologist?
Answer: A
Explanation:
50500 = Repair of kidney laceration
N99.72 = Accidental puncture/laceration of genitourinary system during a procedure S37.062A (traumatic kidney injury) is not used for intraoperative complications The nephrologist does not report the colectomy, nor modifier -80
NEW QUESTION # 49
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