Question 1

Young child presents with cleft lip and cleft palate. This is the first attempt of repair, which includes major revision of the cleft palate and unilateral cleft lip repair.

Accepted Answer

The correct codes for the procedures are 42215 for the major revision of the cleft palate and 40700 for the unilateral cleft lip repair.

Question 2

Patient comes to the hospital with a history of right flank pain. Urine tests are negative. Radiology examination reveals that the patient has renal cysts. Patient is now admitted for laparoscopic ablation of the cysts.

Accepted Answer

The correct code for laparoscopic ablation of renal cysts is 50541, which specifically refers to laparoscopic procedures on the kidney, including cyst ablation.

Question 3

Patient has extensive bladder cancer. She underwent a complete cystectomy with bilateral pelvic lymphadenectomy and creation of ureteroileal conduit.

Accepted Answer

The procedure described is a complete cystectomy with creation of a ureteroileal conduit, which is best represented by code 51595.

Question 4

Patient has been on the bone marrow transplant recipient list for 3 months. A perfect match was made and the patient came in and received peripheral stem cell transplant.

Accepted Answer

The answer of Patient has been on the bone marrow...

Question 5

Laparoscopic gastric banding

Accepted Answer

The answer of Laparoscopic gastric banding
...

Question 6

Patient presents to the emergency room with right lower abdominal pains. Emergency room physician suspects possible appendicitis. Patient was taken to the operating room where a laparoscopic appendectomy was performed. Pathology report was negative for appendicitis.

Accepted Answer

The laparoscopic appendectomy (44970) is the code that should be used since the surgeon performed the surgery even though the pathology report was negative for appendicitis. Code 44950 would not be appropriate since the pathology report showed negative results. Code 44901 would not apply since the procedure was performed laparoscopically. Code 49320 is used when the surgeon performs a diagnostic laparoscopy and converts to an open procedure.

Question 7

Female with 6 months of stress incontinence. Outpatient therapies are not working and the patient decides to have the problem fixed. Laparoscopic urethral suspension was completed.

Accepted Answer

Code 51992 is specifically for laparoscopic sling procedures, while code 51840 is for open retropubic urethropexy. Code 51845 is for laparoscopic retropubic urethropexy, which is not the procedure performed in this case. Code 51990 is the closest option, as it is for laparoscopic bladder neck suspension. However, it is not as specific to the urethra as 51992, which is specifically for laparoscopic suspension of the urethra. Therefore, the best choice is B, code 51990.

Question 8

Morbidly obese patient comes in for vertical banding of the stomach.

Accepted Answer

The correct code for vertical banding of the stomach is 43842, which is an open or laparoscopic approach for placement of a silastic adjustable gastric band. Codes 43848 and 43999 are not appropriate as they are for different procedures. Code 43659 is for an unlisted laparoscopic procedure, and while it may be used for vertical banding in certain circumstances, the more specific code 43842 should be used when it is available.

Question 9

Nephrectomy with resection of ½ of the ureter.

Accepted Answer

The correct code for nephrectomy with resection of ½ of the ureter is 50220, which describes a nephrectomy with partial ureterectomy.

Question 10

Patient has a history of chronic alcohol abuse with portal hypertension. Patient has been vomiting blood for the past 3 days and presented to his physician's office. Patient was sent to the hospital for evaluation and an EGD was performed. Biopsy findings showed gastritis, esophagitis and bleeding esophageal varices, which were injected with sclerosing solution.

Accepted Answer

The answer of Patient has a history of chronic alcohol...

Question 11

Injection snoreplasty for treatment of palatal snoring.

Accepted Answer

Injection snoreplasty is a procedure that involves injecting a sclerosing agent into the soft palate to reduce its size and stiffen it. This can help to reduce snoring by reducing the amount of vibration in the soft palate. The correct code for injection snoreplasty is 42299.

Question 12

Excision of 2.5 cm bladder tumor with cystoscopy.

Accepted Answer

The correct code for excision of bladder tumor with cystoscopy is 52235, which specifies removal of a tumor or tumors measuring 2.5 cm or less. Code 51550 (cystourethroscopy with fulguration [including cryosurgery or laser surgery] and/or resection of; small bladder tumor[s] [0.5 to 2.0 cm]) is incorrect because the tumor size is larger than 2.0 cm. Code 51530 (cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder [separate procedure]) is also incorrect as it does not specify tumor removal. Code 51060 (cystourethroscopy, with biopsy[s], single or multiple) is incorrect because it does not include tumor excision.

Question 13

Patient presents to the hospital with right ureteral calculus. Patient is taken to the operating room where a cystoscopy with ureteroscopy is performed to remove the calculus.

Accepted Answer

The answer of Patient presents to the hospital with right...

Question 14

Patient underwent anoscopy followed by colonoscopy. The physician examined to colon to 60 cm.

Accepted Answer

The answer of Patient underwent anoscopy followed by colonoscopy. The...

Question 15

Male patient has been diagnosed with benign prostatic hypertrophy and undergoes a transurethral destruction of the prostate by radiofrequency thermotherapy.

Accepted Answer

The correct code for transurethral destruction of the prostate by radiofrequency thermotherapy is 53852.

Question 16

Patient presents with a history of upper abdominal pain. Cholangiogram was negative and patient was sent to the hospital for ERCP. During the procedure the sphincter was incised and a stent was placed for drainage.

Accepted Answer

The procedure described involves an ERCP with sphincterotomy (43262) and the placement of a stent (43268).

Question 17

Patient arrives to the hospital and has a Nissen fundoplasty done endoscopically.

Accepted Answer

The procedure described is an endoscopic Nissen fundoplication, which is coded as 43280.

Question 18

Patient has ovarian vein syndrome and has ureterolysis performed.

Accepted Answer

CPT code 50722 is used for ureterolysis, which is the surgical procedure performed for ovarian vein syndrome.

Question 19

Male with urinary incontinence. Sling procedure was performed 6 months ago and now the patient has returned for a revision of the sling procedure.

Accepted Answer

The appropriate code for a revision of sling procedure is 53442. The other codes listed are not appropriate for this particular scenario.

Question 20

Patient is admitted for contact laser vaporization of the prostate. The physician performed a TURP and transurethral resection of the bladder neck at the same time.

Accepted Answer

The answer of Patient is admitted for contact laser vaporization...

Exam 1: Registered Health Information Administrator