Exam 27: Coding and Surgical Procedures

A 45-year-old female with chronic bladder and kidney infections undergoes an IVP. This abbreviation stands for

A patient with a significant past medical history consisting of coronary artery disease and hypertension was found to have a tumor in the chest wall. Resection of left chest wall tumor was performed, including transection of three ribs and partial resection of left diaphragm, left lower lobe lung wedge resection, and left chest wall reconstruction with Gore-Tex mesh. The pathology report indicated mesothelioma in the chest wall and lung. Select the appropriate CPT and ICD-10-CM codes.

CT Scan of the Chest and Adrenals History: Left pulmonary nodule on chest x-ray Technique: Helical transaxial images, 7 mm, of the chest were obtained after the administration of oral and intravenous contrast. Findings: The patient's chest x-rays from February 24 and 25 were reviewed. There is an ill-defined opacity suggested in the left midlung zones on those studies, including oblique views. Within the left lower lobe laterally, there is an approximately 2-cm area of parenchymal density that has the appearance of interstitial changes without findings of a significant nodule or mass. This finding can relate to scarring. There is no other nodule, mass, or effusion. Within the mediastinum, there is no evidence of adenopathy seen. The heart and great vessels are normal in appearance. There is a suggestion of minimal pericardial thickening anteriorly that is not specific. Osseous structures show degenerative changes with osteophyte formation at multiple levels in the thoracic spine. Visualized upper abdominal structures, including liver, spleen, kidneys, pancreas, aorta, and para-aortic retroperitoneum, show no specific finding. The adrenal glands are not enlarged. Impression: There is a small focal area of increased parenchymal density that has an interstitial pattern. There is no significant nodule or mass. This is suggestive of scarring. There is no nodule, mass, effusion, or adenopathy seen. Consider chest x-ray follow-up of this lesion to assess stability. Select the appropriate ICD-10-CM and CPT code(s):

A 60-year-old patient was experiencing chest pain in the emergency department and went into cardiac arrest. CPR was performed on the patient by the ER physician, and the patient was resuscitated. The patient was then admitted to the telemetry unit for further monitoring by the cardiologist on-call. The cardiologist performed a comprehensive history, a detailed examination, and medical decision making of moderate complexity. Select the appropriate CPT and ICD-10-CM codes for cardiologist.

Procedures: Craniotomy for a patient with benign clinoidal meningioma. The surgeon carried out a stereotactic osteoplastic craniotomy along with resection of clinoidal/sphenoid wing mass. For the microdissection an intraoperative microscope was used. Prior to decompressing the superior orbital fissure, the tumor was extirpated through the opticocarotid, carotid oculomotor, as well as prechiasmatic spaces. Select the appropriate CPT and ICD-10-CM codes.

Sally was seen today for repair of four lacerations following a fall on some broken glass. The physician evaluated and performed simple repair on the following: a 6-cm laceration on the right forearm, a 2.5-cm laceration on the right forearm, a 0.5-cm laceration on the left hand, and a 20-cm laceration on the left upper arm. Select the appropriate ICD-10-CM and CPT code(s):

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.

An established patient presents to the office with an acute, deep cough, along with wheezing. The patient has a history of allergies along with chronic rhinitis. After an expanded problem-focused exam, the physician learns that the patient's home has just been found to have mold in the walls. The physician has spent an additional 15 minutes providing resources and counseling with the patient regarding the effects of mold and treatment of his URI. The physician has also recommended lab tests and x-rays. Select the appropriate CPT and ICD-10-CM codes.

Which of the following designates a waiver needed for any service that does not meet the coverage criteria established in an LCD?

John, a nine-year-old boy, is being seen today for persistent allergic sinusitis. Today he will undergo percutaneous sequential and incremental allergy testing with biological allergens with 15 various allergens being applied followed by interpretation and report. Select the appropriate CPT and ICD-10-CM codes.

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.

Joey, age 5, is taken to the OR today for removal of a small foreign body from his right nares. General anesthesia was required due to the significant level of anxiety displayed by the child, as well as the location of the small object. Select the appropriate CPT and ICD-10-CM codes.

A 67-year-old female patient with stage 5 chronic kidney disease presents today for ongoing dialysis. Choose the appropriate ICD-10-CM codes:

Tom Smith, who is 45 years old, was recently diagnosed with a liver mass. The family physician ordered a liver biopsy to be performed. At the outpatient surgery area the patient was treated by Dr. Jane, who performed a percutaneous liver biopsy. Select the appropriate CPT and ICD-10-CM codes for the anesthesia for this procedure.

Sam, a welder, was seen today by the ophthalmologist for removal of a welding flash from his left eye. The flash had caused a nonperforating tear in the cornea. The ophthalmologist removed the flash and repaired the cornea. Select the appropriate ICD-10-CM and CPT code(s):

Jones was brought to the OR for open reduction by posterior approach of fractures to vertebrae at L4 and L5 as a result of a car accident. Select the appropriate ICD-10-CM and CPT code(s):

A patient with intractable pain from the left lower extremity due to varicose veins elected for ligation and stripping. The left greater saphenous vein was stripped to the level of the knee, and multiple left lower extremity varicose veins were also stripped. Select the appropriate CPT and ICD-10-CM codes.

A 2-year-old with osteogenesis imperfecta was brought to the OR for application of a halo with placement of seven pins. Select the appropriate ICD-10-CM and CPT code(s):

Dr. Mathis has been called to the ICU to provide care for a 37-year-old male patient who has received second-degree burns over 50% of his body. Dr. Mathis provides support from 1 p.m. to 3 p.m. After leaving the unit to do his rounds, Dr. Mathis is called back around 5 p.m., and he provides critical care support to the patient until 6 p.m. Select the appropriate CPT codes.

A 62-year-old female patient with metastatic lung cancer reports to the infusion center for chemotherapy. She receives a subarachnoid injection consisting of doxorubicin, cyclophosphamide, and etoposide via a subcutaneous reservoir. Select the appropriate CPT and ICD-10-CM codes.