Deck 11: Surgery Section: Cardiovascular and Lymphatic Systems

Question 1

In which code range can a coder find Chapter 9 codes in ICD-10-CM?

A) J00-J99
B) I00-I99-
C) E00-E89
D) L00-L99

Answer 1

I00-I99-

Question 2

All of the following are common problems patients present with concerning the cardiovascular system except:

A) hypertension
B) congestive heart failure
C) bursitis
D) edema

Answer 2

bursitis

Question 3

Which structure in the lymphatic system produces T cells?

A) lymph nodes
B) thymus
C) lymph vessels
D) spleen

Answer 3

thymus

Question 4

The pulmonary valve:

A) prevents the flow of blood back into the right ventricle and opens to allow deoxygenated blood to flow through the pulmonary artery into the lungs
B) opens to allow blood to exit the left ventricle and flow into the aorta when the pressure in the left ventricle rises above the pressure in the aorta
C) stops the backflow of blood between the right atrium and right ventricle
D) allows blood to flow from the left atrium into the left ventricle

Question 5

Which of the following conditions is characterized by fluid build-up in the stomach, enlarged spleen, and severe esophageal hemorrhaging?

A) embolus
B) hypertension
C) sick sinus syndrome
D) portal vein thrombosis

Question 6

A central venous access device is used for all of the following except:

A) blood transfusions
B) multiple blood draws
C) administration of chemotherapy
D) administration of oral antibiotics

Question 7

The ______ circulation system transports oxygenated blood away from the heart, to the rest of the body, and returns oxygen-depleted blood back to the heart:

A) pulmonary
B) peripheral
C) systemic
D) cardiovascular

Question 8

A coder will no longer document subsequent care of an acute myocardial infarction using codes from the category "Acute Myocardial Infarction" (I21) after what time period?

A) 7 weeks
B) 4 weeks
C) 3 weeks
D) 8 weeks

Question 9

A disturbance in the electrical impulse of the heart is:

A) conduction disorder
B) dysrhythmia
C) systolic heart failure
D) congestive heart failure

Question 10

Which of the following is true regarding selective placement of a catheter in subsection Vascular Injection Procedures, (36000-36522)?

A) the catheter is not advanced beyond the aorta
B) the catheter is left in the access vessel
C) the catheter is placed into the first, second, or third order of the vascular family
D) the catheter is placed into the third, fourth, or fifth order of the vascular family

Question 11

The heart's natural pacemaker, where the electrical impulses begin, is called the:

A) Purkinje fibers
B) Sinoatrial (SA) node
C) Atrioventricular (AV) node
D) Bundle of His

Question 12

Which of the following is not a further subdivision of the subcategory "Rheumatic fever with heart involvement"?

A) acute rheumatic pericarditis
B) acute rheumatic endocarditis
C) acute rheumatic angiocarditis
D) acute rheumatic myocarditis

Question 13

A patient presents for bilateral lymphangiography to determine presence or absence of neoplasms in the lymph nodes. CPT code 38790, Injection procedure, lymphangiography, is available for use. What modifier should be appended to describe this procedure?

A) 51
B) 59
C) 50
D) 79

Question 14

When coding for the cardiovascular system, coders may need to select codes from all of the following sections:

A) Evaluation and Management; Surgery
B) Surgery; Radiology; Pathology and Laboratory
C) Surgery; Medicine; Pathology and Laboratory
D) Surgery; Evaluation and Management; Radiology; Medicine

Question 15

When de-oxygenated blood is returned to the heart, the blood is brought into the center of the cardiovascular system by the ____________ .

A) SA node
B) bundle of HIS
C) inferior vena cava
D) pulmonary valve

Question 16

Blood is pumped away from the heart by the pulmonary artery to the lungs via the _____ system:

A) systemic
B) cardiovascular
C) pulmonary
D) peripheral

Question 17

Veins that are located close to the arteries are called:

A) deep veins
B) capillaries
C) superficial veins
D) arterioles

Question 18

A right internal carotid angiography and a left vertebral angiography were performed on the same patient during the same session. Which modifier is appropriate to accurately report these services?

A) 51
B) 78
C) 59
D) 50

Question 19

Dr. Sellers actively assists in the identification of an optimal bone marrow donor for his patient. Cells from the donor are acquired and proper procedure is followed to transfer these cells to the patient. However, after receiving the first donation, it is evident the patient requires a second donation and transplant in another operative session on the same date of service. Dr. Sellers returns to the original donor and harvests an additional donation of cells. Select the appropriate code(s) to report Dr. Sellers' second set of harvesting services:

A) None - the second set of harvesting services is included in the first reporting of 38204
B) 38204-51, Management of recipient hematopoietic progenitor cell donor search and cell acquisition, Multiple Procedures
C) 38204-78, Management of recipient hematopoietic progenitor cell donor search and cell acquisition, Unplanned return to the operating/procedure room by the same physician or another qualified health care professional following the initial procedure for a related procedure during the postoperative period
D) 38204, Management of recipient hematopoietic progenitor cell donor search and cell acquisition

Question 20

The largest vein that carries de-oxygenated blood from the back, abdomen, and pelvis, and lower extremities of the body back to heart is the:

A) inferior vena cava
B) deep vein
C) superior vena cava
D) tunica externa

Question 21

All of the following are potential questions a coder would ask himself/herself when selecting a code in subheading "Pacemaker or Implantable Defibrillator" in the CPT manual except:

A) Was the approach transvenous or epicardial?
B) Has the patient suffered an acute myocardial infarction prior to placement?
C) Was the device permanent or temporary?
D) Was this an initial insertion, a replacement, or a repositioning?

Question 22

What is a collection of excess fluid in the lymph tissue?

A) sick sinus syndrome
B) rheumatic chorea
C) hypertension
D) lymphedema

Question 23

Subsection Cardiac Assist, (33967-33997) include all of the following procedures except:

A) transthoracic insertion of a ventricular assist device
B) replacement of a ventricular assist device
C) percutaneous insertion of a ventricular assist device
D) abdominal insertion of a ventricular assist device

Question 24

Lymph vessels:

A) are collections of tissue located along the lymph vessels
B) transport lymph fluids and merge into lymphatic ducts
C) produce T cells
D) contain nutrients, fats, electrolytes, and cellular waste

Question 25

All of the following are components of malignant hypertension except:

A) arterial pressure that is mildly elevated
B) possible hemorrhage of vessels
C) possible necrosis of organs such as eyes, heart, and kidneys
D) severely elevated arterial pressure

Question 26

Select the true statement regarding correct coding of Coronary Artery Bypass Grafting:

A) Codes 33533-33548, Arterial grafting for coronary bypass, require use of modifier -51 when used with combined codes for arterial-venus grafting
B) Codes 33510-33516, Venous grafting only for coronary artery, are to be used as primary procedure codes any time a combined arterial and venous grafting procedure is performed
C) Combined codes for arterial-venus grafting are always sequenced first when this procedure is performed
D) Codes 33517-33530, Combined arterial-venus grafting for coronary bypass, are add-on codes and may not be used alone or as a primary procedure

Question 27

What is a common medical abbreviation for the condition "heart attack"?

A) AMI
B) BMI
C) ITA
D) CVA

Question 28

What is valve insufficiency?

A) narrowing of the valve
B) rupture of the valve
C) contracture of the valve
D) improper closure or functioning of the valve

Question 29

An x-ray exam of the arteries or veins is a(n):

A) percutaneous transluminal coronary angioplasty
B) endartectomy
C) cardioversion
D) angiography

Question 30

Select the indication for which removal of the spleen is not typically performed:

A) enlargement that becomes destructive to platelets
B) means of diagnosing certain conditions
C) dialysis
D) spontaneous rupture

Question 31

The aortic valve:

A) opens to allow blood to exit the left ventricle and flow into the aorta when the pressure in the left ventricle rises above the pressure in the aorta
B) allows blood to flow from the left atrium into the left ventricle
C) stops the backflow of blood between the right atrium and right ventricle
D) prevents the flow of blood back into the right ventricle and opens to allow deoxygenated blood to flow through the pulmonary artery into the lungs

Question 32

Where can a coder find the correct codes for the diagnosis ischemic heart disease?

A) Chapter 9, ICD-10-CM
B) Chapter 4, CPT
C) Chapter 3, CPT
D) Chapter 6, ICD-10-CM

Question 33

Which of the following is not true regarding rheumatic fever?

A) it commonly occurs after a throat infection
B) if left untreated, it can lead to complications such as liver failure
C) it commonly occurs after suffering an infection from group A streptococci
D) if not treated properly, it can lead to complications including inflammation of the heart

Question 34

Select the middle layer of the artery wall:

A) capillaries
B) tunica externa
C) tunica media
D) tunica intima

Question 35

Which of the following structures is not a main part of the cardiovascular system?

A) blood
B) marrow
C) heart
D) blood vessels

Question 36

When a coder sees the terminology "Sydenham's" or "St. Vitus' dance," to what condition is the provider referring?

A) rheumatic chorea
B) sick sinus syndrome
C) lymphedema
D) hypertension

Question 37

What is an electrical device inserted into the body to shock the heart into regular rhythm?

A) shunt
B) defibrillator
C) catheter
D) lead

Question 38

What is deep vein thrombosis?

A) raised, painful veins, typically in the upper back leg
B) an acute condition characterized by arterial swelling and embolism
C) hemorrhage following rupture of a vein
D) inflammation of a vein with development of a clot in a deep vein

Question 39

What is the start of the His-Purkinje system?

A) Sinoatrial (SA) node
B) Atrioventricular (AV) node
C) Purkinje fibers
D) Bundle of His

Question 40

An endartectomy is:

A) a procedure used to improve blood flow to the heart by bypassing a blockage of a vessel with a grafted vessel
B) the surgical connection of two vessels
C) a device used to hold open a blood vessel
D) surgical removal of plaque from within a blocked or occluded artery

Question 41

Symptoms including bradycardia, fatigue, syncope, shortness of breath, confusion, and palpitations are all indications of what cardiac condition?

A) thrombus
B) hypertension
C) sick sinus syndrome
D) arrhythmia

Question 42

All of the following are components of the electrical system of the heart except:

A) aorta
B) AV node
C) His-Purkinje system
D) SA node

Question 43

The subheading "Heart (Including Valves) and Great Vessels" (33300-33340) includes all of the following procedures except:

A) exploratory cardiotomy
B) percutaneous transluminal balloon angioplasty
C) insertion of graft aorta or great vessels
D) suture repair of aorta or great vessels

Question 44

Select the procedure that means to surgically connect two vessels:

A) lymphadenectomy
B) anastomosis
C) percutaneous transluminal coronary angioplasty
D) endartectomy

Question 45

In systolic heart failure:

A) contraction of the heart muscle does not pump blood adequately
B) the heart does not relax properly after contraction, resulting in decreased blood flow through the heart
C) the left side of the heart fails
D) the heart is unable to pump blood to the extremities and lungs, resulting in edema of these areas

Question 46

This valve allows blood to flow from the left atrium into the left ventricle:

A) mitral
B) pulmonary
C) tricuspid
D) aortic

Question 47

Select the correct definition of diastolic heart failure:

A) contraction of the heart muscle does not pump blood adequately
B) the heart is unable to pump blood to the extremities and lungs, resulting in edema of these areas
C) the left side of the heart fails
D) the heart does not relax properly after contraction, resulting in decreased blood flow through the heart

Question 48

A patient presents with a hyperactive thymus. A coder will select a code from range:

A) E32, diseases of thymus
B) E34, other endocrine disorders
C) E23, hypofunction and other disorders of the pituitary gland
D) I10, essential hypertension

Question 49

Where could a coder locate codes for acute rheumatic fever in the ICD-10-CM manual?

A) Chapter 9
B) Chapter 10
C) Chapter 8
D) Chapter 7

Question 50

What is the primary difference between codes from Category I11, I15, and I16 in ICD-10-CM?

A) They each represent different categories of CKD
B) Each category represents a different specificity of hypertension and Category I11 represents hypertensive heart disease; I15 represents secondary hypertension; and I16 represents hypertensive crisis
C) Each category represents a different specificity of hypertension
D) Category I11 represents hypertensive heart disease; I15 represents secondary hypertension; and I16 represents hypertensive crisis

Question 51

Through what means does ablation assist in the treatment of abnormal heart arrhythmia?

A) ablation destroys cardiac tissue, preventing abnormal electrical signals from traveling through the heart, stopping an arrhythmia
B) ablation promotes inflammation in the epicardial tissue, preventing abnormal electrical signals from traveling through the heart, stopping an arrhythmia
C) ablation provides a "jump start" of new electrical conduction from the Bundle of His, stopping the previous rhythm and enabling the heart to begin a new, consistent rhythm
D) ablation destroys the Purkinje fibers that are sending an abnormal electrical impulse, allowing the His-Purkinje system to effectively reset and begin a new, consistent rhythm

Question 52

How many chambers does the heart contain?

A) four
B) two
C) three
D) five

Question 53

In the category Chronic Rheumatic Heart Disease (I05-I09) which of the following is not a true statement?

A) There is a subvision for mitral and aortic valve involvement
B) There is not a subdivision for rheumatic disorders of both aortic and tricuspid valves
C) There is a subvision for tricuspid valve only
D) There is a subvision for mitral valve only

Question 54

Select the correct description for code I10 in ICD-10-CM:

A) benign hypertension
B) unspecified hypertension
C) essential primary hypertension
D) malignant hypertension

Question 55

What is the medical term for bleeding within the brain?

A) cerebrovascular disease
B) subarachnoid hemorrhage
C) intracranial hemorrhage
D) transient ischemic attack

Question 56

What is the inflammation of large blood vessels?

A) temporal arteritis
B) portal vein thrombosis
C) bruits
D) thrombus

Question 57

An atrial septal defect occurs when:

A) there is a hole in the septum between the two lower chambers of the heart
B) there is a hole in the aorta
C) there is a hole in the inferior vena cava
D) there is a hole in the septum between the two upper chambers of the heart

Question 58

Modifier 53 signifies:

A) Decision for Surgery
B) Discontinued Procedure
C) Bilateral Procedure
D) Distinct Procedural Service

Question 59

All of the following are main functions of the lymphatic system except:

A) defend the body against disease
B) maintain body temperature
C) absorb and transport liquids from blood vessels
D) maintain fluid balance

Question 60

Of the following, select the answer that is not a known section of the heart that can be involved in an acute myocardial infarction:

A) subendocardial wall
B) supralateral wall
C) inferoposterior wall
D) anterolateral wall

Question 61

This contains nutrients, fats, electrolytes, and cellular waste:

A) lymph vessels
B) lymph nodes
C) lymph fluid
D) lymph waste

Question 62

A central venous access device is used for all of the following except:

A) multiple blood draws
B) administration of oral antibiotics
C) blood transfusions
D) administration of chemotherapy

Question 63

What is a common medical abbreviation for the condition "heart attack"?

A) ITA
B) BMI
C) AMI
D) CVA

Question 64

Select the procedure that means to surgically connect two vessels:

A) percutaneous transluminal coronary angioplasty
B) lymphadenectomy
C) endartectomy
D) anastomosis

Question 65

A patient presents with a hyperactive thymus. A coder will select a code from range:

A) I10, essential hypertension
B) E32, diseases of thymus
C) E34, other endocrine disorders
D) E23, hypofunction and other disorders of the pituitary gland

Question 66

What is the bridge between the atria and the ventricles that allows the electrical signals to pass to the bundle of His?

A) Bundle of His
B) Sinoatrial (SA) node
C) Purkinje fibers
D) Atrioventricular (AV) node

Question 67

All of the following are components of the electrical system of the heart except:

A) SA node
B) aorta
C) His-Purkinje system
D) AV node

Question 68

When a coder sees the terminology "Sydenham's" or "St. Vitus' dance," to what condition is the provider referring?

A) sick sinus syndrome
B) lymphedema
C) rheumatic chorea
D) hypertension

Question 69

Of the following, select the answer that is not a known section of the heart that can be involved in an acute myocardial infarction:

A) inferoposterior wall
B) supralateral wall
C) anterolateral wall
D) subendocardial wall

Question 70

The largest vein that carries de-oxygenated blood from the back, abdomen, and pelvis, and lower extremities of the body back to heart is the:

A) superior vena cava
B) deep vein
C) tunica externa
D) inferior vena cava

Question 71

A patient presents for bilateral lymphangiography to determine presence or absence of neoplasms in the lymph nodes. CPT code 38790, Injection procedure, lymphangiography, is available for use. What modifier should be appended to describe this procedure?

A) 51
B) 59
C) 79
D) 50

Question 72

What is an electrical device inserted into the body to shock the heart into regular rhythm?

A) defibrillator
B) shunt
C) catheter
D) lead

Question 73

Which of the following is the wall dividing the right and left sides of the heart?

A) epicardium
B) endocardium
C) aorta
D) septum

Question 74

What is the primary difference between codes from Category I11, I15, and I16 in ICD-10-CM?

A) Each category represents a different specificity of hypertension and Category I11 represents hypertensive heart disease; I15 represents secondary hypertension; and I16 represents hypertensive crisis
B) Category I11 represents hypertensive heart disease; I15 represents secondary hypertension; and I16 represents hypertensive crisis
C) They each represent different categories of CKD
D) Each category represents a different specificity of hypertension

Question 75

The heart's natural pacemaker, where the electrical impulses begin, is called the:

A) Sinoatrial (SA) node
B) Purkinje fibers
C) Atrioventricular (AV) node
D) Bundle of His

Question 76

A right internal carotid angiography and a left vertebral angiography were performed on the same patient during the same session. Which modifier is appropriate to accurately report these services?

A) 50
B) 59
C) 78
D) 51

Question 77

All of the following are components of malignant hypertension except:

A) possible necrosis of organs such as eyes, heart, and kidneys
B) severely elevated arterial pressure
C) possible hemorrhage of vessels
D) arterial pressure that is mildly elevated

Question 78

Select the correct description for code I10 in ICD-10-CM:

A) malignant hypertension
B) benign hypertension
C) essential primary hypertension
D) unspecified hypertension

Question 79

All of the following are primary functions of the cardiovascular system except:

A) removing carbon dioxide from cells
B) transporting nutrients and oxygen to cells
C) assisting the digestive system in removing waste products from the body
D) removing waste products from cells

Question 80

Select the indication for which removal of the spleen is not typically performed:

A) spontaneous rupture
B) dialysis
C) enlargement that becomes destructive to platelets
D) means of diagnosing certain conditions