Deck 14: Surgery Section: Female Reproductive System and Maternity Care and Delivery

Question 1

The three layers of the uterus are:

A) endocervical canal, portio vaginalis, and external os
B) labia majora, labia minora, and clitoris
C) endometrium, myometrium, and perimetrium
D) pudendum, labia, and endocervical

Answer 1

endometrium, myometrium, and perimetrium

Question 2

Which of the following statements is true regarding diabetes mellitus and gestational diabetes in a pregnant patient?

A) diabetes mellitus may resolve itself following the pregnancy
B) gestational diabetes is developed during pregnancy and may or may not resolve itself following the pregnancy
C) neither gestational diabetes nor diabetes mellitus should be managed with insulin while a patient is pregnant
D) code Z79.4 should only be used to describe pregnant patients with type I diabetes

Answer 2

gestational diabetes is developed during pregnancy and may or may not resolve itself following the pregnancy

Question 3

Select the correct flow of the female reproductive system (path of the oocyte):

A) vulva - ovaries - uterus - vagina
B) ovaries - fallopian tubes - uterus - vagina - vulva
C) vagina - ovaries - fallopian tubes - vulva
D) fallopian tubes - ovaries - vagina - uterus

Answer 3

ovaries - fallopian tubes - uterus - vagina - vulva

Question 4

The period of pregnancy that begins with conception and ends at the time of delivery is:

A) postpartum
B) peripartum
C) puerperium
D) antepartum

Question 5

What is the third stage of menopause?

A) premenopause
B) menopause
C) postmenopause
D) perimenopause

Question 6

When a return to the operating room for debridement of an incision site infection during the postoperative period of a related procedure by the same physician occurs, modifier _____ is appropriate to append:

A) 52
B) 58
C) 78
D) 79

Question 7

Salpingitis is:

A) fibrouslike tumors in the smooth muscles of the uterus
B) growth or presence of tissue outside the uterus that normally grows inside the uterus
C) difficult or painful labor
D) inflammation of one or both fallopian tubes

Question 8

An x-ray of the uterus and fallopian tubes is:

A) cephalic tomography
B) hysterosalpingography
C) colpography
D) D&C

Question 9

Patient presents for a scheduled initial resection of a primary peritoneal malignancy. The surgeon is prepared to also perform a bilateral salpingo-oophorectomy and omentectomy to ensure complete removal of the malignant growth. During the procedure, the surgeon determines that only the left fallopian tube and ovary needs to be removed. CPT code 58950, Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy, should be reported:

A) 58950-50
B) 58950
C) 58950-52
D) 58950-51

Question 10

Which of the following is true about Chapter 15 codes?

A) They are not to be used when the patient is in the postpartum period
B) They are used as first-listed diagnoses regardless of the reason for treatment
C) They take sequencing priority over codes from all other chapters
D) They may not be used if the patient is not in active labor

Question 11

Patient presents for supervision of normal first pregnancy in her 22^nd week. What would be the appropriate ICD-10-CM code for this encounter?

A) Z33.1
B) Z34.00
C) Z34.02
D) Z34.80

Question 12

The subheading "Noninflammatory Disease of Female Genital Tract" (code range N80-N98) contains the following conditions except:

A) Endometriosis of uterus
B) Acute salpingitis and oophoritis
C) Female genital prolapse
D) Menstruation disorders

Question 13

Cephalic version is:

A) a procedure used to turn a fetus from a breech position
B) surgical puncture into the amniotic sac
C) suturing of the opening of the cervix
D) visualization of the vagina and cervical tissue by means of a scope

Question 14

What is the definition of a missed abortion?

A) when infection of the endometrium and uterus is present
B) when the fetus remains in the uterus for up to 8 weeks after intrauterine death
C) when products of conception are retained for up to 4 weeks and surgical removal is necessary
D) when an abortion must be induced

Question 15

The portion of the cervix uteri that projects into the vagina is called:

A) portio vaginalis
B) external os
C) labia minora
D) endocervical canal

Question 16

The normal global delivery package includes all of the following except:

A) monthly visits to 28 weeks
B) biweekly visits to 36 weeks
C) bimonthly visits to 32 weeks
D) weekly visits until delivery

Question 17

The Bartholin's glands:

A) function as a lining in the uterus
B) contain sweat- and oil-secreting glands
C) produce mucous secretions
D) contain the vaginal and urethral openings

Question 18

The peripartum period is the period that:

A) begins with the delivery of the placenta and extends through 6 weeks after delivery
B) begins 30 days prior to delivery and extends to 5 months after delivery
C) begins with conception and ends at the time of delivery
D) lasts 6 weeks following delivery

Question 19

An obstetric surgeon performs bilateral, open drainage of ovarian abscesses using a vaginal approach. Code 58820, Drainage of ovarian abscess; vaginal approach, open, should be reported in the following way to accurately report this service:

A) 58820, 58820-59
B) 58820 X 2
C) 58820, 58820-51
D) 58820 -50

Question 20

The opening in the portio vaginalis that dilates during labor is the:

A) external os
B) pudendum
C) cervix
D) vagina

Question 21

Which structure of the female genital system's primary function is it to nourish and protect a developing fetus?

A) corpus uteri
B) external os
C) cervix uteri
D) portio vaginalis

Question 22

Growth or presence of tissue outside the uterus that normally grows inside the uterus is called:

A) uterine fibroids
B) dystocia
C) uterine prolapse
D) endometriosis

Question 23

Code Z39.0 is reported when

A) normal delivery
B) delivery occurs prior to admission and the mother is admitted for postpartum care without complication
C) the episode of care for pregnancy during an admission does not end in delivery
D) a complication of the pregnancy was addressed and resolved during an episode of care prior to the episode of care for delivery

Question 24

"Early pregnancy" is defined as:

A) first to 28 weeks
B) first 3 months
C) less than 22 weeks' gestation
D) Days 1 - 30

Question 25

Select the choice that is not a common type of nonobstetrical repair of the uterus, as listed in the CPT manual?

A) suspension
B) plastic
C) sling
D) suturing

Question 26

Dystocia is another term for:

A) prolonged labor
B) retained placenta
C) rupture of uterus during labor
D) hemorrhage after delivery

Question 27

All of the following are criteria for use of code O80, Encounter for full-term uncomplicated delivery, except:

A) breech presentation
B) full term
C) single, live-born infant
D) spontaneous labor and delivery

Question 28

An incision on the perineum and posterior vaginal wall during labor is:

A) cerclage
B) colposcopy
C) episiotomy
D) conization

Question 29

Which of the following is not included in a typical antepartum visit?

A) initial and subsequent history and exam
B) routine glucose blood work
C) fetal heart tones
D) routine chemical urinalysis

Question 30

The layer of the uterus that prevents adhesions between the opposite walls of the uterus is:

A) perimetrium
B) myometrium
C) pudendum
D) endometrium

Question 31

A premature separation of the placenta from the uterus is:

A) conception
B) abruption placentae
C) dystocia
D) hydatidiform mole

Question 32

The suturing of the opening of the cervix is known as:

A) episiotomy
B) perineotomy
C) cerclage
D) colposcopy

Question 33

Which of the following is not a primary function of the female genital system?

A) production of female egg cells
B) reproduction
C) enable sperm to enter the body for reproduction
D) production of estrogen and progesterone

Question 34

In Vitro Fertilization procedures are found in which code range in CPT?

A) 58600-58770
B) 58970-58976
C) 58800-58960
D) 58100-58791

Question 35

Fingerlike structures at the end of each fallopian tube that capture and sweep the egg into the tube are called:

A) endometrium
B) fimbriae
C) myometrium
D) cilia

Question 36

All of the following are subheadings in the "Vulva, Perineum, and Introitus" subheading of CPT except:

A) Incision
B) Destruction
C) Revision
D) Excision

Question 37

The endometrium is the:

A) passageway between the uterine cavity and external os
B) outermost layer of the uterus
C) usual location of conception
D) lining of the uterus

Question 38

Ectopic pregnancy sites may be all of the following except:

A) ovarian
B) endocervical canal
C) fallopian tube
D) peritoneal cavity

Question 39

The Female Reproductive subsection is found in Chapter ___ of the ICD-10-CM manual:

A) Ten
B) Fifteen
C) Nine
D) Fourteen

Question 40

All of the following are internal organs and tissue of the female genital system except:

A) vagina
B) uterus
C) vulva
D) fallopian tubes

Question 41

Peritoneal adhesions and intrauterine infections are categorized as which of the following in ICD-10-CM?

A) Other Maternal and Fetal Complications
B) Complications Mainly Related to Pregnancy
C) Inflammatory Disease of Female Pelvic Organs
D) Complications of the Puerperium

Question 42

Select the correct listing of external structures of the female genital system:

A) vulva, labia majora, labia minora, Bartholin's glands, and vagina
B) vulva, labia majora, labia minora, Bartholin's glands, and clitoris
C) vagina, labia majora, labia minora, and clitoris
D) vulva, Bartholin's glands, uterus, and ovaries

Question 43

Cilia are:

A) hair like projections within each fallopian tube that aid in the movement of the egg through the tube
B) small oval-shaped glands
C) small glands next to the vaginal opening that produce mucous secretions
D) fingerlike structures at the end of each fallopian tube that capture and sweep the egg into the tube

Question 44

Removal of a segment of the cervix, diagnostic or therapeutic is:

A) amniocentesis
B) conization
C) episiotomy
D) cephalic version

Question 45

Encounter for full-term uncomplicated delivery is reported using which code in ICD-10-CM ?

A) O77.9
B) O72.8
C) O82
D) O80

Question 46

When an incision is made in the posterior wall of the vagina behind the cervix to enter the posterior pelvic cavity, this is called a:

A) colpotomy
B) loop electrode conization
C) vaginectomy
D) curettage of the cervix

Question 47

The early beginning of menopause, marked by shorter or longer periods is:

A) perimenopause
B) premenopause
C) menopause
D) postmenopause

Question 48

Which of the following is not a common approach for hysterectomies, as listed in the CPT manual?

A) ventral
B) abdominal
C) laparoscopic
D) vaginal

Question 49

An abnormality during the early stages of pregnancy in which tissue around a fertilized egg develops into an abnormal cluster of grapelike cells instead of a normal embryo is called:

A) amenorrhea
B) hydatidiform mole
C) abruption placentae
D) uterine fibroids

Question 50

Many of the codes within Chapter 15, Pregnancy, Childbirth and the Puerperium are further defined as to the trimester. There is an instructional note at the beginning of ICD-10-CM Chapter 15 instructing the use of which additional code?

A) 7^th character to identify fetus
B) Category O08 to identify any associated complication
C) Category B95-B97 to identify infectious agent
D) Category Z3A, weeks of gestation to identify specific week of the pregnancy

Question 51

Which of the following is not a subheading in the Maternity Care and Delivery subheading of CPT?

A) Normal Delivery
B) Ante partum and Fetal Invasive Services
C) Cesarean Delivery
D) Delivery after Previous Cesarean Delivery

Question 52

Pregnant patient in her 19^th week of gestation presents to the office with excessive vomiting due to the pregnancy. Which ICD-10-CM code(s) would be appropriate?

A) O21.2
B) O21.8
C) O21.0, Z3A.19
D) O21.0

Question 53

A surgical puncture into the amniotic sac to remove fluid is:

A) dilation and curettage (D&C)
B) amenorrhea
C) amniocentesis
D) conization

Question 54

All of the following are included in gynecologic procedures except:

A) induction of labor when indicated
B) diagnostic pelvic examinations
C) diagnostic scopes in surgical scope procedures
D) vaginal or cervical dilation for procedures done by vaginal approach

Question 55

In ICD-10-CM, the subcategory Z3A represents:

A) Episode of care
B) Weeks of gestation
C) Outcome of delivery
D) Specific trimester

Question 56

Ovarian cysts are reported with codes from category N83, Noninflammatory disorders of ovary, fallopian tube and broad ligament. The codes for ovarian cysts are further defined by:

A) type, acuity, and laterality
B) type, acquired or congential
C) laterality
D) type and laterality

Question 57

Dilation and curettage (D&C) is:

A) incision on the perineum and posterior vaginal wall during labor
B) an x-ray of the uterus and fallopian tubes
C) widening and surgical removal of part of the lining of the uterus
D) visualization of the vagina and cervical tissue by means of a scope

Question 58

A 25-year-old female patient presents to the orthopedic urgent care with a probable right ankle fracture. The patient is 12 weeks pregnant. Upon examination and ultrasound, the physician diagnoses the patient with a closed fracture of the right lateral malleolus. The patient's ankle is wrapped, she is given crutches and self-care instructions, and is sent home. Select the appropriate ICD-10-CM codes and sequence for this patient's visit:

A) S82.61XD
B) S82.61XA
C) O9A.211
D) O9A.211, S82.61XA

Question 59

Procedures performed on the bulb of the vestibule and the vestibule of the vagina are located in which subheading of CPT?

A) Cervix Uteri
B) Corpus Uteri
C) Vagina
D) Vulva, Perineum, and Introitus

Question 60

When a coder sees the phrase "without menses" in the provider's documentation, the following condition is being identified:

A) uterine fibroids
B) salpingitis
C) endometriosis
D) amenorrhea

Question 61

When a hernia repair is performed at a different site than another genitourinary service performed on the same day, which modifier would be appended to the hernia repair code?

A) 50
B) 58
C) 52
D) 59

Question 62

Select the correct subheadings found in the Cervix Uteri subheading of the Female Genital System subsection of CPT:

A) Excision, Introduction, Repair, and Surgical Laparoscopy/Hysteroscopy
B) Incision, Destruction, Excision, Introduction, Repair, Manipulation, and Endoscopy/Laparoscopy
C) Endoscopy, Excision, Repair, and Manipulation
D) Incision, Excision

Question 63

Which structure of the female reproductive system is primarily responsible for transportation of the oocyte?

A) Bartholin's glands
B) vulva
C) fallopian tubes
D) ovaries

Question 64

A small oval-shaped gland(s) that produces the oocyte, ovum, and female hormones is/are:

A) fallopian tubes
B) cervix uteri
C) uterus
D) ovaries

Question 65

Select the procedure type that is not located in the Vagina, Repair subheading of the Female Genital System subsection of CPT:

A) fitting of radiation ovoids
B) plastic repair of a rectocele
C) suturing of nonobstetrical injuries
D) repairs of the urethral sphincter

Question 66

An excision of a tumor from the uterus is:

A) colpectomy
B) hysterectomy
C) trachelectomy
D) myomectomy

Question 67

Code range O00 - O9A in the ICD-10-CM manual contains the chapter:

A) Pregnancy, Childbirth and the Puerperium
B) Diseases of The Female Reproductive System
C) Congenital Anomalies
D) Diseases of The Male Reproductive System

Question 68

The puerperium is the period that:

A) begins 30 days prior to delivery and extends to 5 months after delivery
B) begins with the delivery of the placenta and extends through 6 weeks after delivery
C) begins with conception and ends at the time of delivery
D) lasts 6 weeks following delivery

Question 69

Admission services and episiotomy are included services in which global package?

A) Delivery
B) Routine follow up care
C) Postpartum care
D) Antepartum care

Question 70

When a coder sees the phrase "scope examination of vagina" in the provider's documentation, which procedure is the provider referring to?

A) colposcopy
B) conization
C) hysterosalpingography
D) laparoscopy

Question 71

When using the code O94, "sequelae of complications of pregnancy, childbirth, and puerperium," the coder should:

A) assign this code when it is inferred that a current condition is a direct result of a complication arising during pregnancy, childbirth, or the puerperium
B) always sequence the code from the O94 category first
C) assign this code for any complications occurring immediately following delivery, during the same hospital admission
D) look for documentation clearly stating the current condition is a direct result of a complication arising during pregnancy, childbirth, or the puerperium

Question 72

The Maternity Care and Delivery subsection of CPT is formatted based on:

A) normal vs. high-risk pregnancy
B) episode and type of care or delivery
C) frequency of care
D) delivery

Question 73

The main body of the uterus is called the:

A) external os
B) portio vaginalis
C) corpus uteri
D) cervix uteri

Question 74

Select the true statement regarding Categories O35 and O36 in ICD-10-CM:

A) a code from the perinatal chapter may be used on the mother's record if it provides more specificity than codes from categories O35 and O36
B) a code from these categories should be used to describe the fetus' condition regardless of whether the fetal condition is affecting the management of the pregnancy
C) a condition corrected via in utero surgery does not need to be reported using a code from these categories
D) a code from these categories should be used if further diagnostic tests or studies are required

Question 75

The code ranges for "Pregnancy, Childbirth, and the Puerperium"can be found in Chapter ____ of the ICD-10-CM manual:

A) Nine
B) Six
C) Eleven
D) Fifteen

Question 76

Select the true statement regarding Categories O35 and O36 in ICD-10-CM:

A) a code from these categories should be used to describe the fetus' condition regardless of whether the fetal condition is affecting the management of the pregnancy
B) a code from these categories should be used if further diagnostic tests or studies are required
C) a code from the perinatal chapter may be used on the mother's record if it provides more specificity than codes from categories O35 and O36
D) a condition corrected via in utero surgery does not need to be reported using a code from these categories

Question 77

Which of the following is not a common approach for hysterectomies, as listed in the CPT manual?

A) abdominal
B) ventral
C) laparoscopic
D) vaginal

Question 78

A 25-year-old female patient presents to the orthopedic urgent care with a probable right ankle fracture. The patient is 12 weeks pregnant. Upon examination and ultrasound, the physician diagnoses the patient with a closed fracture of the right lateral malleolus. The patient's ankle is wrapped, she is given crutches and self-care instructions, and is sent home. Select the appropriate ICD-10-CM codes and sequence for this patient's visit:

A) S82.61XA
B) S82.61XD
C) O9A.211
D) O9A.211, S82.61XA

Question 79

All of the following are criteria for use of code O80, Encounter for full-term uncomplicated delivery, except:

A) spontaneous labor and delivery
B) full term
C) breech presentation
D) single, live-born infant

Question 80

When a hernia repair is performed at a different site than another genitourinary service performed on the same day, which modifier would be appended to the hernia repair code?

A) 59
B) 52
C) 58
D) 50