AAPC CPC Chapter 11. Answers and Questions. All rated A+. Latest update 2022

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A ??A patient with hypertension is scheduled for same day surgery for removal of her gallbladder due to chronic gallstones. She is examined preoperatively by her cardiologist to be cleared for surger... y. What ICD-10-CM codes are reported by the cardiologist? A) Z01.810, K80.20, I10 B) I10, Z01.818, K80.20 C) K80.20, I10, Z01.810 D) K80.21, Z01.89, I10 D ??A patient is admitted for a simple primary examination of the gastrointestinal system to rule out GI cancer. An Esophagogastroduodenoscopy (EGD) is performed, which includes examination of the esophagus, stomach and portions of the small intestine. During the examination, a stricture of the esophagus is identified and subsequently dilated via balloon dilation (20 mm). What CPT® and ICD-10-CM codes are reported? A) 43235, K22.2 B) 43235, C15.9 C) 43248, Q39.3 D) 43249, K22.2 D ??A screening colonoscopy is performed on a 50 year-old patient with a family history of colon cancer. Multiple polyps were found during the procedure. Two polyps in the transverse colon were removed with hot forceps cautery. Three polyps in the ascending colon were removed via snare. Portions of all polyp tissues were to be sent to pathology. What are the correct CPT® and ICD-10-CM codes for this patient encounter? A) 48584 x2, 45385 x3, K63.5 B) 45384, 45385-59, K63.5, Z12.11, Z80.0 C) 45384 x2, 45385 x3, Z80.0, K63.5, Z12.11 D) 45384, 45385-59, Z12.11, D12.3, D12.2, Z80.0 B ??A 33 year-old male patient presents to the endoscopy suite to determine if he has an ulcer. The physician performs a diagnostic scope through the esophagus, stomach and into the duodenum and jejunum. During the scope the patient has a severe drop in blood pressure and the physician discontinues the procedure, but not before observing and diagnosing a bleeding ulcer on the stomach lining as well a perforated ulcer in the jejunum. A repeat examination is planned. What CPT® and ICD-10-CM codes are reported? A) 43235-52, K25.4, K28.5 B) 43235-53, K25.4, K28.5 C) 43200-52, K25.5, K28.5 D) 43235-53, K25.4, K28.1 A ??A patient presents for esophageal dilation. The physician begins dilation by using a bougie. This attempt was unsuccessful. The physician then dilates the esophagus transendoscopically using a balloon (25mm). What CPT® code(s) is/are reported? A) 43220 B) 43450-53, 43220 C) 43450, 43220 D) 43220, 43450-52 D ??How do you report a screening colonoscopy performed on a 65 year-old Medicare patient with a family history of colon cancer? The physician was able to pass the scope to the cecum. What CPT® and ICD-10-CM codes are reported? A) 45330, Z13.818, Z80.0 B) 45378, Z12.11, Z85.038 C) G0104, Z13.818, Z85.038 D) G0105, Z12.11, Z80.0 A ??A patient presents with a 2 cm benign lip lesion. The provider decides to remove the lesion along with a portion of the lip by performing a wedge excision. Single-layer suture repair is performed. What CPT® code(s) is/are reported for this service? A) 40510 B) 11442, 12011-51 C) 40510, 12011-51 D) 11442, 40510 A ??What is the correct ICD-10-CM code for a patient with IBS? A) K58.9 B) K59.2 C) K58.0 D) K59.8 A ??What is the correct CPT® coding for a partial distal gastrectomy with Roux-en-Y reconstruction with vagotomy? A) 43633, 43635 B) 43634, 43635 C) 43621, 43635 D) 43633, 43640-51 D ??What CPT® and ICD-10-CM codes are reported for diagnosis of a recurrent unilateral reducible femoral hernia repair? A) 49550, K41.91 B) 49555, K41.21 C) 49505, K41.31 D) 49555, K41.91 D ??In ICD-10-CM, how is Crohn's disease of the small intestine with intestinal obstruction reported? A) Crohn's disease of the small intestine is reported first with intestinal obstruction reported as a secondary diagnosis. B) Intestinal obstruction is reported first with Crohn's disease of the small intestine is reported as a secondary. C) One combination code is reported to indicate Crohn's disease of the small intestine with intestinal obstruction. D) Crohn's disease of the small intestine is reported as regional enteritis of the small intestines. C ??A patient is seen in the gastroenterologist's clinic for a diagnostic colonoscopy. When performing the service, the physician notes suspicious looking polyps and removes three using a snare technique to send to pathology for further testing. What is/are the correct CPT® code(s) to report? A) 45378, 45385-51 B) 45380 C) 45385 D) 45378, 45380-51 C ??What ICD-10-CM code(s) is reported for ulcerative colitis with rectal bleeding? A) K51.511 B) K52.9, K62.5 C) K51.911 D) K51.90 D ??What is the CPT® code for removal of a foreign body from the esophagus via the thoracic area? A) 43215 B) 43020 C) 43500 D) 43045 B ??Where is the vermilion border located? A) Underneath the tongue B) Upper and lower lips C) Stomach lining D) In the esophagus C ??What ICD-10-CM code is reported for internal hemorrhoids? A) K64.4 B) K64.9 C) K64.8 D) K64.0 C ??A 56 year-old patient complains of occasional rectal bleeding. His physician decides to perform a rigid proctosigmoidoscopy. During the procedure, two polyps are found in the rectum. The polyps are removed by a snare. What CPT® and ICD-10-CM codes are reported? A) 45309, 45309, K63.5 B) 45385, K63.5 C) 45315, K62.1 D) 45320, K62.1 D ??Margaret has a cholecystoenterostomy with a Roux-en-Y. Five hours later, she has an enormous amount of pain, abdominal swelling and a spike in her temperature. She is returned to the OR for an exploratory laparotomy and subsequent removal of a sponge that remained behind from surgery earlier that day. The area had become inflamed and was demonstrating early signs of peritonitis. What is the correct coding for the subsequent services on this date of service? The same surgeon took her back to the OR as the one who performed the original operation. What CPT® code is reported? A) 49000-58 B) 49000-77 C) 49402-77 D) 49402-78 B ??An 11 year-old patient is seen in the OR for a secondary palatoplasty for complete unilateral cleft palate. Shortly after general anesthesia is administered, the patient begins to seize. The surgeon quickly terminates the surgery in order to stabilize the patient. What CPT® and ICD-10-CM codes are reported for the surgeon? A) 42220-52, Q35.7, R56.9 B) 42220-53, Q35.9, R56.9 C) 42215-76, Q35.7, R56.9 D) 42215-53, Q35.9, R56.9 C ??A 28 year-old female had symptoms of RLQ abdominal pain, fever and vomiting. She was diagnosed with acute appendicitis. The surgeon makes an abdominal incision to remove the appendix. The appendix was not ruptured. The incision is closed. What are the correct CPT® and ICD-10-CM codes for this encounter? A) 44950, R10.31, R50.9, R11.10, K35.80 B) 44970, K35.80 C) 44950, K35.80 D) 44970, K37 C ??A 20 year-old patient presented to the hospital for a sigmoidoscopy due to a history of bloody stools for three weeks' duration. The patient was prepped for the sigmoidoscopy and the sigmoidoscope was passed without difficulty to about 40 cm. The entire mucosal lining was erythematosus. There was no friability of the overlying mucosa and no bleeding noted. No pseudo polyps were identified. Biopsies were taken at about 30 cm; these were thought to be representative of the mucosa in general. The scope was retracted; no other abnormalities were seen. What CPT® and ICD-10-CM codes are reported? A) 45330, 45331, K62.5 B) 45333, Z12.11, K62.5 C) 45331, K92.1 D) 45305, K92.1 A ??A 45 year-old patient with liver cancer is scheduled for a liver transplant. The patient's brother is a perfect match and will be donating a portion of his liver for a graft. Segments II and III will be taken from the brother and then the backbench reconstruction of the graft will be performed, both a venous and arterial anastomosis. The orthotopic allotransplantation will then be performed on the patient. What CPT® codes are reported? A) 47140, 47146, 47147, 47135 B) 47141, 47146, 47135 C) 47140, 47147, 47146, 47399 D) 47141, 47146, 47399 A ??Operative Report Indications: This is a third follow-up EGD dilation on this 40 year-old patient for a pyloric channel ulcer which has been slow to heal with resulting pyloric stricture. This is a repeat evaluation and dilation. Medications: Intravenous Versed 2 mg. Posterior pharyngeal Cetacaine spray. Procedure: With the patient in the left lateral decubitus position, the Olympus GIFXQ10 was inserted into the proximal esophagus and advanced to the Z-line. The esophageal mucosa was unremarkable. Stomach was entered revealing normal gastric mucosa. Mild erythema was seen in the antrum. The pyloric channel was again widened. The ulcer, as previously seen, was well healed with a scar. The pyloric stricture was still present. With some probing, the 11 mm endoscope could be introduced into the second portion of the duodenum, revealing normal mucosa. Marked deformity and scarring was seen in the proximal bulb. Following the diagnostic exam, a 15 mm balloon was placed across the stricture, dilated to maximum pressure, and withdrawn. There was minimal bleeding post-op. Much easier access into the duodenum was accomplished after the dilation. Follow-up biopsies were also taken to evaluate Helicobacter noted on a previous exam. The patient tolerated the procedure well. Impressions: Pyloric stricture secondary to healed pyloric channel ulcer, dilated. Plan: Check on biopsy, continue Prilosec for at least another 30 days. At that time, a repeat endoscopy and final dilation will be accomplished. He will almost certainly need chronic H2 blocker therapy to avoid recurrence of this divesting complicated ulcer. What CPT® and ICD-10-CM codes are reported? A) 43245, 43239-51, K31.1, Z87.11 B) 43235, 43239-51, K31.4, Z87.19 C) 43248, 43239-59, K31.5, Z87.19 D) 43236, 43239-59, K31.1, Z87.11 B ??A 57 year-old patient with chronic pancreatitis presents to the operating room for a pancreatic duct-jejunum anastomosis by the Puestow-type operation. What are the correct CPT® and ICD-10-CM codes for the encounter? A) 48520, K85.80 B) 48548, K86.1 C) 48520, K86.1 D) 48548, K85.90 D ??Procedure: Colectomy with a take-down of splenic flexure. The patient was taken to the operating room, placed in the dorsal lithotomy position, and then prepped and draped in the usual sterile fashion. A vertical paramedian incision was made along the left side of the umbilicus from the symphysis and taken up to above the umbilicus. This incision was carried down to the rectus muscles, which were separated in the midline. The peritoneal cavity was entered with findings as described. The ascitic fluid was removed and hand-held retractors were used to assist in surgical exposure. The malignant intra-abdominal tumor was resected from the hepatic flexure into the mid transverse colon. The resection was extended into the left upper quadrant and the attachments were also clamped, cut and suture ligated with 2-0 silk sutures in a stepwise fashion until mobilization of the tumor mass could be brought medial and hemostasis was obtained. Attempts to find a dissection plane between the malignant tumor mass and the transverse colon were unsuccessful as it appeared the tumor mass was invading into the wall of the bowel with extrinsic compression and distortion of the bowel lumen. Given the mass could not be resected without removal of bowel, attention was directed to mobilization of the splenic flexure. Retroperitoneal dissection was started in the pelvis and continued along the left paracolic gutter. The ligamentous and peritoneal attachments were taken down with Bovie cautery in a stepwise fashion around the splenic flexure of the colon until the entire left colon was mobilized medially. Similar steps were then carried on the right side as the right colon and hepatic flexure were mobilized. The peritoneal and ligamentous attachments were taken down with Bovie cautery. Vascular attachments were clamped, cut, and suture ligated with 2-0 silk until the right colon was mobilized satisfactorily. The GIA stapler was introduced and fired at both ends to dissect the tumorous bowel free. The bowel was delivered off the operative field. Attention was then directed towards re-anastomosis of the colon. Linen-shod clamps were used to gently clamp the proximal and distal segments of the large bowel. The staple line was removed with Metzenbaum scissors and the colon lumen was irrigated. The silk sutures were used to divide the circumference of the bowel into equal thirds, and the proximal [Show More]

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