Question 1

Which of the following is not a part of the digestive system?

Accepted Answer

The thymus gland is part of the immune system, not the digestive system. The gallbladder, salivary glands, and esophagus are all parts of the digestive system.

Question 2

Codes for biopsy and excision of the tongue and floor of the mouth are defined by anatomical site. Select the correct division of the tongue and floor of mouth:

Accepted Answer

The tongue and floor of the mouth are anatomically divided into the anterior two-thirds of the tongue, the posterior one-third of the tongue, and the floor of the mouth for the purpose of coding biopsies and excisions, reflecting the distinct clinical management and treatment approaches for these areas.

Question 3

The upper part of the stomach is called the:

Accepted Answer

The upper part of the stomach is called the fundus. It is the portion of the stomach that is above the level of the opening of the esophagus into the stomach.

Question 4

A condition in which stones form in the biliary duct and gallbladder is:

Accepted Answer

Choledocholithiasis specifically refers to the condition where stones form in the bile ducts, which can include the common bile duct and the gallbladder.

Question 5

Where does a peptic ulcer occur?

Accepted Answer

The answer of Where does a peptic ulcer occur?
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Question 6

A coder sees the following statement in the documentation: "performed surgical removal of a gall stone through an incision into the gall bladder." Which procedure is this statement describing?

Accepted Answer

The statement describes a cholelithotomy, which is the surgical removal of a gallstone (cholelith) through an incision into the gallbladder.

Question 7

When selecting a code to describe an ulcer in the digestive system, a coder must identify if the ulcer is:

Accepted Answer

The correct choice is A) acute or chronic, hemorrhaging, perforated, or obstructed. This is because in medical coding, especially for ulcers in the digestive system, it is crucial to specify the nature and complications of the ulcer for accurate diagnosis and treatment coding. These details help in determining the severity, potential complications, and the appropriate medical interventions required.

Question 8

A provider performs a surgical endoscopy beyond the second portion of the duodenum with placement of a percutaneous jejunostomy tube. While visualizing this placement, the surgeon notes unusual bleeding and performs bipolar cautery to control it. A biopsy is performed of a probable polyp and the surgeon completes the procedure.
Select the appropriate CPT code(s) listed below that describe this procedure:
44360 Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) 44361 with biopsy, single or multiple
44363 with removal of foreign body
44364 with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
44365 with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery
44366 with control of bleeding (e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)
44372 with placement of percutaneous jejunostomy tube

Accepted Answer

The correct codes are 44372 for the placement of a percutaneous jejunostomy tube, 44366 for the control of bleeding using bipolar cautery, and 44361 for the biopsy of a probable polyp. These codes collectively describe the procedures performed.

Question 9

Select the part of the digestive system in which peristaltic action occurs after food is chewed and swallowed:

Accepted Answer

Peristaltic action occurs in the esophagus as it helps move chewed food from the throat down into the stomach.

Question 10

Gastroesophageal reflux disease may be indicated in provider documentation by stating:

Accepted Answer

Severe heartburn is a common symptom of gastroesophageal reflux disease (GERD), where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus).

Question 11

The subsection "Diseases of Oral Cavity, Salivary Glands, and Jaws" contains codes to describe all of the following conditions except:

Accepted Answer

The subsection "Diseases of Oral Cavity, Salivary Glands, and Jaws" in medical coding systems like ICD-10 typically includes conditions related to the structure and diseases of the teeth, oral cavity, and salivary glands, such as abnormalities of size and form of teeth (A), ankylosis of teeth (B), and hereditary disturbances in tooth structure (D). However, a broken tooth due to trauma (C) is usually classified under a different category related to injuries or trauma rather than diseases.

Question 12

The pancreas is considered to be a(n) _____________ of the digestive system.

Accepted Answer

The pancreas is considered an accessory organ of the digestive system because it aids in digestion by secreting enzymes that help break down food in the small intestine, but food does not pass through it.

Question 13

What does the abbreviation ERCP stand for?

Accepted Answer

ERCP stands for endoscopic retrograde cholangiopancreatography, a procedure used to diagnose and treat conditions of the bile ducts and pancreatic duct.

Question 14

Terms such as cryo, chemical, or thermal in the documentation indicate coding ____________ instead of excision of a lesion.

Accepted Answer

Terms like cryo, chemical, or thermal in medical documentation typically indicate a destruction process rather than an excision or removal. These terms are associated with methods used to destroy tissue, such as freezing (cryo), using chemicals, or applying heat (thermal), rather than cutting it out or repairing it.

Question 15

Select the correct list of decisions needed to accurately code for a repair of the mouth procedure:

Accepted Answer

The correct coding for a repair of the mouth procedure often requires detailed information including the size of the area being repaired, the specific site of the repair, whether the procedure is on the anterior or posterior part of the mouth, the laterality (left or right side), if the repair involves the entire dental arch, and the complexity of the procedure. These details ensure accurate coding and billing for the procedure performed.

Question 16

When an endoscopy is performed to determine the need for a more extensive open procedure, modifier ________ is appended to describe that the scope procedure was planned and a more extensive procedure was planned for a future date.

Accepted Answer

Modifier 58 is used to indicate that a procedure or service was planned or anticipated at the time of the original procedure, such as when an endoscopy is performed to determine the need for a more extensive procedure at a future date.

Question 17

The function of the soft palate is to:

Accepted Answer

The soft palate rises during swallowing to close off the nasal passages, preventing food from entering the nasal cavity.

Question 18

When performing an endoscopy on a patient who is scheduled and prepped for a total colonoscopy, if the physician is unable to advance the scope beyond the splenic flexure due to unforeseen circumstances, modifier _______ is appended to the colonoscopy code.

Accepted Answer

Modifier 53 is used to indicate a procedure that is discontinued after anesthesia is administered but before completion due to extenuating circumstances or those that threaten the well-being of the patient. In this case, if the scope cannot be advanced beyond the splenic flexure, the procedure is considered incomplete, and modifier 53 is appropriate.

Question 19

An increase in blood pressure in the veins between the GI tract and the liver, causing enlargement of the veins, is:

Accepted Answer

Portal hypertension is the correct answer because it specifically refers to an increase in blood pressure within the portal venous system, which includes veins coming from the stomach, pancreas, spleen, and intestines that merge into the portal vein supplying the liver. This condition can lead to complications such as esophageal varices, but the term itself directly describes the increase in blood pressure.

Question 20

There are three distinct components of physician work for a liver allotransplantation. They are:

Accepted Answer

The three distinct components of physician work for a liver allotransplantation include preparing the cadaver or living donor, backbench work (which involves preparing the liver graft for transplantation once it has been removed from the donor), and the actual recipient liver allotransplantation surgery. These steps encompass the comprehensive process from donor preparation to the surgical transplantation into the recipient.

Quiz 12: Surgery Section: Digestive System