Deck 15: Surgery Section: Nervous System

Question 1

When hemilaminectomies are performed at both the right and left laminae of an interspace, which modifier is reported?

A) 51
B) 59
C) 58
D) 50

Answer 1

50

Question 2

In what code range will a coder locate codes to describe Episodic and Paroxysmal Disorders in ICD-10-CM?

A) G40-G47
B) G00-G09
C) G35-G37
D) G80-G83

Answer 2

G40-G47

Question 3

What is a syringomyelia?

A) cyst of the spinal cord and brainstem area
B) degeneration of the anterior horn cells
C) Werdnig-Hoffmann disease
D) cyst of the spinal cord

Answer 3

cyst of the spinal cord

Question 4

All of the following are common diseases affecting the peripheral nervous system except:

A) mononeuropathy
B) Parkinson's disease
C) carpal tunnel syndrome
D) Guillain-Barre syndrome

Question 5

Which larger component of the nervous system are the sympathetic and parasympathetic nervous systems a part of?

A) peripheral nervous system
B) somatic nervous system
C) autonomic nervous system
D) central nervous system

Question 6

Category G47, Sleep Disorders, in ICD-10-CM contain codes to describe sleep disorders that are a result of all of the following except:

A) physiologic abnormalities
B) disease process
C) anatomical anomalies
D) behavioral disorders

Question 7

Which disease is due to the degeneration of nigral neurons, which are responsible for creating dopamine?

A) Addison's disease
B) Alzheimer's disease
C) hydrocephalus
D) Parkinson's disease

Question 8

What is an electroencephalography?

A) removal of a small amount of cerebrospinal fluid
B) recording that measures brain and body activity during sleep
C) radiographic study of the intracranial structures
D) recording and analysis of the electrical activity in the brain

Question 9

Codes in the Injection, Drainage, or Aspiration subheading of the Spine and Spinal Cord subheading are further divided by all of the following except:

A) age of the patient
B) nature of the procedure
C) condition
D) number of days on which the procedure is performed

Question 10

Select the question that is not a typical question needed to determine the correct coding of procedures performed on the Nervous System:

A) What was the approach?
B) Was the procedure primary or a reexploration of a surgical site?
C) Was the treatment for a traumatic injury or a medical condition?
D) Were grafts and/or patches used during repair?

Question 11

Which of the following is not a primary function of the ventricles?

A) production of cerebrospinal fluid
B) filtration of cerebrospinal fluid
C) transport of cerebrospinal fluid
D) regulation of cerebrospinal fluid pressure

Question 12

What is hemiparesis?

A) periodic muscle spasms experienced on one side of the body
B) weakness on one side of the body
C) loss of sensation on one side of the body
D) loss of the ability to move one side of the body

Question 13

Select the structure that is not part of the meninges:

A) Pia mater
B) Arachnoid mater
C) Hippocampus
D) Dura mater

Question 14

How are the general headings of codes in the Nervous System subsection categorized in CPT?

A) approach
B) anatomic site
C) type of procedure
D) age of patient

Question 15

What is an incision into the cranium in which a bone flap is removed and then returned either immediately or at a later time to the original site?

A) laminotomy
B) foraminotomy
C) neurorrhaphy
D) craniotomy

Question 16

What is a laminectomy?

A) the removal of the facet or bony overgrowth on the facet that leads to compression of the nerve root
B) removal of the superior or inferior half of the lamina
C) the enlargement of the foramen through which the nerve root exits the spinal canal
D) removal of the lamina of a vertebral segment

Question 17

What is a repair of transected nerves by suturing?

A) anastomosis
B) neuroplasty
C) denervation
D) neurorrhaphy

Question 18

A radiographic study of the intracranial structures of the brain is:

A) echoencephalography
B) polysomnogram
C) electroencephalography
D) cerebrospinal fluid analysis

Question 19

What are anterior horn cell diseases?

A) cognitive deficits
B) a group of conditions that affect the anterior nerve root
C) primary, persistent unilateral headaches
D) lack of muscle coordination in the execution of voluntary movements

Question 20

Select the type of headache that is not listed under Other Headache Syndromes (G44) in ICD-10-CM:

A) post-traumatic
B) migraine
C) tension
D) cluster

Question 21

What is the primary function of the nervous system?

A) to send and receive messages via nerve pathways made up of neurons
B) to control internal and external bodily functions
C) to regulate voluntary functions, including speech and movement
D) to regulate involuntary functions, including breathing, metabolism and digestion

Question 22

The autonomic and the somatic nervous systems are subdivisions of which component of the nervous system?

A) sensory neuron
B) central nervous system
C) nerve roots
D) peripheral nervous system

Question 23

Select the correct definition for hypersomnolence:

A) difficulty falling asleep or staying asleep
B) excessive sleepiness
C) sleep apnea due to obesity
D) circadian rhythm disruption

Question 24

What is hemiplegia?

A) weakness on one side of the body
B) periodic muscle spasms experienced on one side of the body
C) loss of sensation on one side of the body
D) loss of the ability to move one side of the body

Question 25

Which of the following is the system that consists of nerves only and connects the brain and spinal cord to the body?

A) somatic nervous system
B) peripheral nervous system
C) central nervous system
D) cerebellum

Question 26

What is a movement disorder that results in clenching of the jaw or grinding of the teeth?

A) circadian rhythm disorder
B) bruxism
C) organic insomnia
D) hypersomnolence

Question 27

What is an excision of the cranium in which a bone flap is removed and not returned to the original site?

A) corpectomy
B) foraminotomy
C) craniectomy
D) facetectomy

Question 28

Select the correct flow of the nervous system:

A) nerve root - nerve pathway - sensory neuron - motor neuron - muscle or organ
B) sensory neuron - nerve pathway - nerve root - brain or spinal cord - nerve root - motor neuron - muscle or organ
C) muscle or organ - nerve pathway - nerve root - motor neuron - sensory neuron - brain or spinal cord
D) brain or spinal cord - sensory neuron - nerve root - nerve pathway - motor neuron - muscle or organ

Question 29

Where are Nerve, Nerve Root, and Plexus Disorders found in ICD-10-CM?

A) G50-G59
B) G35-G37
C) G89-G99
D) G60-G65

Question 30

Codes in the Endovascular Therapy (61623-61642) subheading are divided into:

A) Dilation, Insertion, Repair, Closure
B) Occlusion/remobilization, Angioplasty/stent placement, Dilation
C) Angioplasty/stent placement, Dilation, Closure
D) Occlusion/remobilization, Dilation, Repair

Question 31

What is the primary difference between encephalitis and meningitis?

A) meningitis is synonymous with myelitis
B) encephalitis requires inflammation in the brain tissue or spinal cord, while meningitis requires inflammation in the meninges of the brain or spinal cord
C) encephalitis requires inflammation to be present in both the meninges of the brain and the spinal cord while meningitis requires inflammation to be present in either the meninges of the brain or the spinal cord
D) encephalitis is always caused by a spinal or cranial abscess while meningitis can be caused by several underlying conditions

Question 32

Which structure plays a key role in the formation of long-term memory?

A) Hippocampus
B) arachnoid mater
C) dura mater
D) pons

Question 33

Which of the following is not an available approach for selection in the Neurostimulators subheading in CPT?

A) burr hole
B) craniectomy
C) craniotomy
D) twist drill

Question 34

Which lobes are responsible for knowledge of numbers and their relations?

A) parietal
B) occipital
C) temporal
D) frontal

Question 35

What is meningitis?

A) abscess within the spine or cranium
B) inflammation of the brain tissue and spinal cord
C) inflammation of alveoli causing sleep disruption
D) inflammation of the meninges of the brain and/or spinal cord

Question 36

The amygdala is part of the:

A) brainstem
B) brain
C) cerebrum
D) cerebellum

Question 37

What is a temporary loss of consciousness due to the sudden decline of blood flow to the brain?

A) dementia
B) ataxia
C) anterior horn cell disease
D) syncope

Question 38

Katie steps off the train into Grand Central Station and scans the crowd for her father, who is waiting to pick her up. After looking through a large crowd of faces, she recognizes her father and she smiles. Which lobes of the brain is Katie currently using to recognize her father's face?

A) parietal
B) occipital
C) frontal
D) temporal

Question 39

In Category G00-G09, "Inflammatory Diseases of the Central Nervous System" which condition does not require the use of an additional code to identify the organism?

A) pneumococcal meningitis
B) other bacterial meningitis
C) staphylococcal meningitis
D) streptococcal meningitis

Question 40

Which of the following is not a type of hydrocephalus included in Chapter 6 of ICD-9-CM?

A) communicating
B) idiopathic normal pressure
C) degenerative
D) obstructive

Question 41

The autonomic nervous system controls muscles of which type of organs?

A) internal
B) sympathetic
C) parasympathetic
D) major

Question 42

An ambidextrous patient suffers a left side flaccid hemiplegia. Select the correct ICD-10-CM diagnosis code for this condition:
G81.00 Flaccid hemiplegia affecting unspecified side
G81.02 Flaccid hemiplegia affecting dominant side
G81.03 Flaccid hemiplegia affecting nondominant side

A) G81.00
B) G81.03
C) G81.02
D) G81.02, G81.03

Question 43

What is the removal or resection of the anterior portion of the vertebra?

A) foraminotomy
B) facetectomy
C) craniectomy
D) corpectomy

Question 44

The category Other Disorders of the Central Nervous System (G89-G99) in ICD-10-CM contains codes for all of the following conditions except:

A) Generalized pain
B) Pain, not elsewhere classified
C) Cerebrospinal fluid leak
D) Disorders of autonomic nervous system

Question 45

All of the following are components of the cerebrum except:

A) occipital lobes
B) frontal lobes
C) temporal lobes
D) parietal lobes

Question 46

At what level(s) of the spine may a lateral extracavitary for extradural exploration/decompression be performed?

A) thoracic or lumbar
B) lumbar
C) cervical, thoracic, or lumbar
D) cervical

Question 47

Select the true statement regarding coding in the Cerebrospinal Fluid (CSF) Shunt subheading:

A) procedures in this subheading include initial programming
B) the codes for replacement/revision or removal are based on the location of the distal end of the shunt
C) the codes for CSF removals are divided as to with or without contrast material
D) codes for insertions include one replacement/revision service per shunt

Question 48

Which system is responsible for relaxation, bringing all systems back to normal after a fight-or-flight response?

A) somatic nervous system
B) peripheral nervous system
C) parasympathetic nervous system
D) sympathetic nervous system

Question 49

What is the corpus callosum?

A) involved in auditory perception
B) largest lobe of the brain sitting just inside the front of the skull
C) structure that divides the left and right hemispheres of the cerebrum
D) integrates sensory information from various parts of the body

Question 50

At what anatomic site is an intracranial procedure performed?

A) cerebellum
B) cerebrum
C) brain
D) skull

Question 51

Approximately how many neurons does the human body have?

A) 1000 billion
B) 100 billion
C) 100 million
D) 1 trillion

Question 52

At what anatomic site is an intracerebral procedure performed?

A) brain
B) cranium
C) cerebellum
D) cerebrum

Question 53

Why are multiple surgeons typically used to perform surgeries of the skull base?

A) the surgery is typically long and surgeons need to be available to give one another reprieves
B) reimbursement is provided for several elements of the procedure
C) reconstruction may not be performed by the same surgeon as the approach
D) the nature and complexity of the procedure

Question 54

When two related procedures are performed via separate incisions at two connecting interspaces, which modifier is appropriate to append to the code for the second procedure?

A) 51
B) 50
C) 59
D) 58

Question 55

Which structure is responsible for communication and coordination between the two hemispheres of the brain?

A) Hippocampus
B) pons
C) arachnoid mater
D) dura mater

Question 56

In which chapter of the ICD-10-CM manual will a coder find Diseases of the Central Nervous System and Sense Organs?

A) 9
B) 5
C) 6
D) 8

Question 57

To what category will a coder code conditions related to Sleep Disorders in ICD-10-CM?

A) G31
B) G47
C) G51
D) G25

Question 58

Select the condition that is not a common disease affecting the central nervous system:

A) hydrocephalus
B) multiple sclerosis
C) cystic fibrosis
D) meningitis

Question 59

What is the nonbony area between two vertebral segments?

A) cartilaginous end plate
B) nucleus pulposus
C) annulus fibrosus
D) vertebral interspace

Question 60

What is the function of the amygdala?

A) receive and process visual information such as color and motion
B) processing and memory of emotions
C) auditory perception, processing of semantics in both speech and vision
D) planning, organizing, problem solving, memory, impulse control, speech, and language

Question 61

Codes for what condition are found in category G89 in ICD-10-CM?

A) Pain
B) Other Headache Syndromes
C) Hereditary and Degenerative Diseases of the Central Nervous System
D) Disorders of the Peripheral Nervous System

Question 62

All of the following are separate components of a skull base procedure in CPT except:

A) Repair and/or reconstruction
B) Initial diagnostic procedures
C) Definitive procedures
D) Approach procedures

Question 63

Robbie is helping his mother break spaghetti in half to put it in a large pot of boiling water for cooking. Robbie decides to throw a handful of spaghetti into the pot and boiling water splashes up onto Robbie's arm. Which lobes of the brain are telling Robbie that the water is very hot?

A) occipital
B) frontal
C) parietal
D) temporal

Question 64

What is a polysomnogram?

A) recording that measures brain and body activity during sleep
B) radiographic study of the intracranial structures
C) removal of a small amount of cerebrospinal fluid
D) recording and analysis of the electrical activity in the brain

Question 65

To perform an anterior discectomy for decompression, it is common for a thoracic surgeon to perform the approach component of the procedure and a neurosurgeon to perform the decompression procedure. Because this procedure is reportable only by one CPT code, which modifier will each surgeon append to the code to report his/her portion of the service?

A) 66
B) 63
C) 62
D) 64

Question 66

CPT codes for injection, drainage, or aspiration in the Skull, Meninges, and Brain general heading are divided first by anatomical site, then by:

A) age of the patient and initial or subsequent
B) initial or subsequent and whether a substance was injected
C) body area and age of the patient
D) body area and whether a substance was injected

Question 67

What is a medical imaging technique that creates a 3-D image of a specific anatomical site for therapeutic surgical or diagnostic interventions or localization of a tumor?

A) stereotactic
B) magnetic resonance imaging
C) angiography
D) CT scan

Question 68

Another term for memory impairment is:

A) ataxia
B) syncope
C) anterior horn cell disease
D) dementia

Question 69

How are codes for peripheral neurostimulators categorized?

A) level of intensity of shock delivered
B) simple or complex procedure
C) primary or revision procedure
D) method of electrode placement

Question 70

What is the system that includes the brain and spinal cord and is responsible for coordination and communication within the entire body?

A) somatic nervous system
B) cerebellum
C) peripheral nervous system
D) central nervous system

Question 71

What is the name for a syringomyelia that has extended into the brainstem area?

A) status migrainous
B) hemiparesis
C) syringobulbia
D) encephalitis

Question 72

What is the enlargement of the foramen through which the nerve root exits the spinal canal?

A) corpectomy
B) foraminotomy
C) facetectomy
D) craniectomy

Question 73

What are the primary functions of the frontal lobes?

A) receive and process visual information such as color and motion
B) planning, organizing, problem solving, memory, impulse control, speech, and language
C) integrate sensory information from various parts of the body and map objects perceived visually into body coordinate positions
D) auditory perception, processing of semantics in both speech and vision

Question 74

In what code range will a coder find procedures performed on the Skull, Meninges, and Brain in CPT?

A) 62263-63746
B) 60000-60099
C) 64000-64999
D) 61000-62258

Question 75

Which of the following is a disorder of the ventricle and/or cerebrospinal fluid that leads to increased intracranial pressure?

A) Addison's disease
B) Parkinson's disease
C) Alzheimer's disease
D) hydrocephalus

Question 76

Select the disease that is caused by destruction of subcortical white matter of the brain:

A) Alzheimer's disease
B) hydrocephalus
C) Parkinson's disease
D) Addison's disease

Question 77

How are codes for peripheral neurostimulators categorized?

A) simple or complex procedure
B) method of electrode placement
C) primary or revision procedure
D) level of intensity of shock delivered

Question 78

Select the correct function of the thalamus:

A) contains cerebrospinal fluid and protects the central nervous system
B) carries sensory information from the peripheral nerves to the brain and from the brain to the peripheral nerves
C) acts as a central relay for incoming message to the nervous system
D) is the control center for many autonomic functions of the peripheral nervous system and sleep-wake cycles

Question 79

Select the structure that is not part of the meninges:

A) Dura mater
B) Arachnoid mater
C) Pia mater
D) Hippocampus

Question 80

Which lobes are responsible for knowledge of numbers and their relations?

A) occipital
B) parietal
C) frontal
D) temporal