Question 1

Dr. Helter, a gastroenterologist, is placing a feeding tube for a patient with gastroparesis in the outpatient surgery department of Community General Hospital. After the long gastrointestinal tube feeding tube was inserted, a KUB was done to verify the position in the duodenum. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code for placing a feeding tube without imaging guidance is 43752, and the correct ICD-10-CM code for gastroparesis is K31.84. However, the scenario specifies the use of a KUB (Kidneys, Ureters, and Bladder X-ray) to verify the position, which is coded as 74018 for a single view abdominal X-ray. Therefore, the correct combination of codes is not listed in the options provided, indicating a mistake in the question or answer choices. Given the options, A) is the closest match, but it inaccurately combines codes from different procedures and conditions.

Question 2

George, a 73-year-old male, is hospitalized for epileptic seizure disorder. He experiences anoxic brain damage, and anesthesia was called to insert the endotracheal tube in order to put the patient on the ventilator. Select the appropriate CPT and ICD-10-CM codes for the anesthesiologist.

Accepted Answer

The correct CPT code for endotracheal intubation is 31500. The ICD-10-CM codes for anoxic brain damage and unspecified epilepsy are G93.1 and G40.909, respectively.

Question 3

Sam, a 26-year-old male with Down syndrome, undergoes lithotripsy with a water bath for lodged ureteral stones. The procedure was supervised by the anesthesiologist under general anesthesia due to the patient's Down syndrome and associated anxiety. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code for lithotripsy with a water bath is 00872, and the modifier P3 is used for a patient with severe systemic disease (which can be applicable for a patient with Down syndrome undergoing anesthesia). The ICD-10-CM code for ureteral stones is N20.1, and the code for Down syndrome is Q90.9.

Question 4

Georgette, a 57-year-old female, experiences polyneuropathy in the right arm due to a spur located at C4-C5. She presents today in the pain clinic for epidural injection by the anesthesiologist of an anesthetic agent for the purpose of pain control. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code for an epidural injection in the cervical or thoracic spine is 62320, which includes injection of diagnostic or therapeutic substances. The ICD-10-CM code D16.6, which refers to a benign neoplasm of the vertebral column, is appropriate here as it aligns with the description of a spur causing polyneuropathy, assuming the spur is benign.

Question 5

A 39-year-old female patient is seen at the ambulatory surgery center for excision for 6 uterine fibroid tumors. The tumors weighed a total of 268 grams. The OB-GYN used an abdominal approach. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code for the excision of multiple uterine fibroids with a total weight of 268 grams using an abdominal approach is 58146. The appropriate ICD-10-CM code for uterine fibroids without specification is D25.9.

Question 6

A 26-year-old female patient with uterine polyps is sent for a hysterosalpingography. Under contrast the full uterus and fallopian tubes are visualized. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code for hysterosalpingography is 58340, the ICD-10-CM code for uterine polyps is N84.0, and 74740 is the code for radiological supervision and interpretation.

Question 7

A 34-year-old infertility patient with a history of repeated miscarriages and dysmenorrhea is being seen today to evaluate the patency of her fallopian tubes. The physician suspects that there might be occlusions that are preventing the egg from implanting or preventing sperm from moving through. A transcervical catheter is used to view the fallopian tubes for patency, and a hysterosalpingography is also performed. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT codes are 58345 for the transcervical catheter procedure and 74742 for the hysterosalpingography. The ICD-10-CM codes are N97.0 for female infertility, N96 for recurrent pregnancy loss, and Z87.49 for a personal history of other diseases of the female genital tract.

Question 8

Dr. Smith is performing a vaginal hysterectomy, with removal of tubes and ovaries, for a 59 year old patient. Her diagnoses include menorrhagia and ovarian endometriosis. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The answer of Dr. Smith is performing a vaginal hysterectomy,...

Question 9

A colposcopy is performed on patient, age 42, for cervical dysplasia. The pathology report later showed the specimen was negative for carcinoma. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

57455 is the CPT code for colposcopy of the cervix including upper/adjacent vagina; when performed, with biopsy(s) of the cervix. N87.9 is the ICD-10-CM code for cervical dysplasia, unspecified, which matches the patient's condition as described.

Question 10

Tina, age 31, gravida 2, Para 1, is pregnant with twins and has been seeing Dr. Smidley. At 41 weeks she experiences labor and is taken directly to the hospital by her husband. After 14 hours of extremely hard labor the first twin is born; it is a male weighing 6lbs 3ozs. Dr. Petrowski, the attending OB-GYN, orders a cesarean section because the second twin is large for dates, causing cephalopelvic disproportion. The second twin, a female weighing 9lbs 2ozs, was delivered via C-section. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct coding involves 59514 for the cesarean delivery of the second twin, 59409 for the vaginal delivery of the first twin, O30.003 for twin pregnancy, O33.5xx2 for maternal care due to disproportion of fetus and pelvic size, and Z37.2 for twins, both liveborn. This combination accurately reflects the procedures performed and the conditions encountered during the delivery.

Question 11

Patient undergoes a uterine evacuation and curettage for a hydatidiform mole and severe vaginal bleeding, which is complicated by a urinary tract infection caused by E. coli. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct codes are 59870, O01.9, N93.9, N39.0, and B96.2. 59870 is the CPT code for uterine evacuation and curettage for a hydatidiform mole. O01.9 is the ICD-10-CM code for hydatidiform mole. N93.9 is the ICD-10-CM code for severe vaginal bleeding. N39.0 is the ICD-10-CM code for urinary tract infection caused by E. coli. B96.2 is the ICD-10-CM code for other specified complications of pregnancy.

Question 12

A 43 year old patient has an in situ malignant neoplasm of the left kidney. He is scheduled for a left nephrectomy with partial ureterectomy by open approach. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The procedure described is a left nephrectomy with partial ureterectomy, which corresponds to CPT code 50220. The ICD-10-CM code D09.19 is used for an in situ neoplasm of the kidney.

Question 13

A 54-year-old patient presented to the emergency room with a gunshot wound in the back exiting through the front. A CT scan shows some renal damage to the right kidney and a renal exploration is ordered. The surgeon has been called in and the patient is taken to surgery to examine the renal structure. Making an incision over the gunshot wound, the surgeon examines both the blood vessels and the kidney. The trauma has caused a hematoma to the kidney, which has not spread, so the surgeon closes and the patient is sent to the floor for observation. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

50010 is the correct CPT code for renal exploration not requiring repair, which matches the scenario described. S31.001A and S37.091A are the correct ICD-10-CM codes for an open wound of the front wall of the abdomen and injury to the right kidney, respectively. W34.00xA is the correct code for an accidental gunshot wound.

Question 14

Marc will be having a kidney transplant due to end stage renal disease caused by malignant hypertension. The donor is his cousin Sidney. Under general anesthesia, Sidney undergoes a radical nephrectomy; the surgeon then does his backbench work to dissect and remove any fat and prepares the ureters, veins, and arteries. Next the surgeon performs a renal nephrectomy and allo-transplantation on Will. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The answer of Marc will be having a kidney transplant...

Question 15

The patient undergoes repair of the renal pelvis to treat an ureteropelvic junction obstruction the patient has had since birth. An incision is made and an excision is performed on the (right) congenital kidney abnormality; a secondary pyeloplasty, solitary kidney or calycoplasty is performed on the left kidney. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT codes for the procedures described are 50400 for the repair of the renal pelvis (pyeloplasty) on the right side, indicating a right-sided procedure, and 50405 for the secondary pyeloplasty on the left side, indicating a left-sided procedure. The correct ICD-10-CM code is Q62.11, which specifies congenital ureteropelvic junction obstruction, matching the description of the patient's condition since birth.

Question 16

ESWL was performed on Mrs. Wilson's left kidney 1 week ago; now ESWL is being performed on her right kidney. She has 4 stones being removed today: 2 in the renal pelvis and 2 in the calyx. Under local anesthesia, the ESWL is performed and all 4 stones are successfully destroyed. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

50590 is the CPT code for extracorporeal shock wave lithotripsy (ESWL) of the kidney. The modifier RT indicates the right side. Modifier 58 is used for a staged or related procedure by the same physician during the postoperative period. N20.0 is the ICD-10-CM code for kidney stones.

Question 17

A 59-year-old male patient is scheduled for a 2^nd stage TURP due to BPH with urinary obstruction and LUTS. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code is 52601-58 for a staged procedure, and the ICD-10-CM codes are N40.1 for BPH with LUTS and N13.8 for urinary obstruction.

Question 18

Procedure: Debridement of 2nd degree burn, 200cm of right hand and wrist, excisional debridement of 3rd degree burns to 10% of the abdomen and 13% of the back.
General anesthesia was achieved and the patient was placed in the right lateral decubitus position. The left hip and lower back as well as the abdomen and right upper extremity were prepped and draped with Betadine. The 2nd degree blisters were completely debrided off all of the fingers and the hand. The area was then scrubbed thoroughly with a scrub brush, bleeding was controlled with a saline epinephrine soak, and the hand was thoroughly dried. A large biobrane glove was stretched over the hand and held in place at the wrist with staples. The ellipsis was drawn around the skin transversely at both the lower back as well as the abdomen. These areas were then excised with a number 10 blade. The burns were scrubbed and dressed with biobrane.
Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT code is 16030 for excisional debridement of burns. The ICD-10-CM codes T21.34xA and T21.32xA are for 3rd degree burns of the abdomen and back, and T23.291A is for 2nd degree burns of the hand.

Question 19

Jim went to the doctor for removal of his skin tags. The physician noted 32 skin tags on his back. Using a scalpel the physician removed all of the skin tags and gave Mr. Evans an antibiotic cream prescription to use for the next 7-10 days. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The correct CPT codes for the removal of up to 15 skin tags is 11200, and for each additional 10 skin tags (or part thereof), the code is 11201, which needs to be used twice in this case because the physician removed 32 skin tags in total. The ICD-10-CM code L91.8 is appropriate for skin tags.

Question 20

The patient presented in the emergency room with a sudden outbreak of lesions on the face, bilaterally on arms and legs, and groin after taking her prescribed sulfa drugs. Several of the lesions had to be shaved: 2 on the leg, one 1.4cm on the groin, and 3 close to the ear. The physician concluded that this was dermatitis. Select the appropriate CPT and ICD-10-CM codes.

Accepted Answer

The answer of The patient presented in the emergency room...

Quiz 27: Coding and Surgical Procedures