Deck 4: Pathology and Laboratory
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Deck 4: Pathology and Laboratory
1

T4-2B:
SERVICE CODE(S): ___________________________________________________
ICD-10-CM DX CODE(S): ______________________________________________
80076 (Organ or Disease-Oriented Panel, Hepatic Function Panel)
ICD-10-CM DX: P59.9 (Jaundice, newborn)
PTS: 1
ICD-10-CM DX: P59.9 (Jaundice, newborn)
PTS: 1
2
T4-1D LABORATORY WORKUP
Patient with pernicious anemia in for check of his B12 level. Also complaining of fatigue. The patient presents to the lab for vitamin B12, TSH (thyroid stimulating hormone), and hemoglobin.
T4-1D:
SERVICE CODE(S): ___________________________________________________
ICD-10-CM DX CODE(S): ______________________________________________
Patient with pernicious anemia in for check of his B12 level. Also complaining of fatigue. The patient presents to the lab for vitamin B12, TSH (thyroid stimulating hormone), and hemoglobin.
T4-1D:
SERVICE CODE(S): ___________________________________________________
ICD-10-CM DX CODE(S): ______________________________________________
82607 (Vitamin, B12), 84443 (Thyroid Stimulating Hormone, [TSH]), 85018 (Blood Cell Count, Hemoglobin)
ICD-10-CM DX: D51.0 (Anemia, pernicious), R53.83 (Fatigue)
ICD-10-CM DX: D51.0 (Anemia, pernicious), R53.83 (Fatigue)
3
T4-2D LABORATORY WORKUP
Uric serum acid laboratory tests for a 63-year-old patient with gout.
T4-2D:
SERVICE CODE(S): ___________________________________________________
ICD-10-CM DX CODE(S): ______________________________________________
Uric serum acid laboratory tests for a 63-year-old patient with gout.
T4-2D:
SERVICE CODE(S): ___________________________________________________
ICD-10-CM DX CODE(S): ______________________________________________
84550 (Uric Acid, Blood)
ICD-10-CM DX: M10.9 (Gout/gouty)
PTS: 1
ICD-10-CM DX: M10.9 (Gout/gouty)
PTS: 1
4
T4-2C PREGNANCY
A 27-year-old female presents for her initial obstetrical laboratory tests during her first pregnancy, which included:
ABO (three main blood types) blood typing
RhD blood typing
Rubella antibody
Hemogram with manual WBC (white blood count) and CBC (complete blood count)
Hepatitis B
Qualitative VDRL
RBC (red blood cell) antibody screen
T4-2C:
SERVICE CODE(S): ___________________________________________________
ICD-10-CM DX CODE(S): ______________________________________________
A 27-year-old female presents for her initial obstetrical laboratory tests during her first pregnancy, which included:
ABO (three main blood types) blood typing
RhD blood typing
Rubella antibody
Hemogram with manual WBC (white blood count) and CBC (complete blood count)
Hepatitis B
Qualitative VDRL
RBC (red blood cell) antibody screen
T4-2C:
SERVICE CODE(S): ___________________________________________________
ICD-10-CM DX CODE(S): ______________________________________________
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5
AUDIT REPORT T4.1 ANATOMIC PATHOLOGY
1. Forensic examination is performed on a white female, approximate age 25, who sustained multiple gunshot wounds.
SERVICE CODE(S): 88045___________________________________________
2. An autopsy is performed on a 53-year-old male who appears to have died from liver disease. Gross and microscopic to liver only.
T4.1:
SERVICE CODE(S): 88027____________________________________________
INCORRECT/MISSING CODE(S): _____________________________________
1. Forensic examination is performed on a white female, approximate age 25, who sustained multiple gunshot wounds.
SERVICE CODE(S): 88045___________________________________________
2. An autopsy is performed on a 53-year-old male who appears to have died from liver disease. Gross and microscopic to liver only.
T4.1:
SERVICE CODE(S): 88027____________________________________________
INCORRECT/MISSING CODE(S): _____________________________________
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6
T4-1C SCREENING
A 66-year-old male for lab screening PSA (prostate specific antigen), and patient complained of lower leg edema. Diagnosis indicates benign prostatic hyperplasia without urinary obstruction. Patient presented to the lab for a total PSA, sodium, and UA (urine analysis) (automated).
T4-1C:
SERVICE CODE(S): ___________________________________________________
ICD-10-CM DX CODE(S): ______________________________________________
A 66-year-old male for lab screening PSA (prostate specific antigen), and patient complained of lower leg edema. Diagnosis indicates benign prostatic hyperplasia without urinary obstruction. Patient presented to the lab for a total PSA, sodium, and UA (urine analysis) (automated).
T4-1C:
SERVICE CODE(S): ___________________________________________________
ICD-10-CM DX CODE(S): ______________________________________________
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7

T4-2A:
SERVICE CODE(S): ___________________________________________________
ICD-10-CM DX CODE(S): ______________________________________________
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8

T4-1A:
SERVICE CODE(S): ___________________________________________________
ICD-10-CM DX CODE(S): ______________________________________________
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9

T4-1B:
SERVICE CODE(S): ___________________________________________________
ICD-10-CM DX CODE(S): ______________________________________________
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10
AUDIT REPORT T4.2 CYTOPATHOLOGY AND CYTOGENIC
STUDIES
1. A laboratory technician performs screening by automated system of a cervical smear, under physician supervision.
SERVICE CODE(S): 88141____________________________________________
2. An amniotic fluid sample is received in the laboratory for a suspected nonneoplastic disorder. A tissue culture chromosome analysis was performed.
T4.2:
SERVICE CODE(S): 88267__________________________________________
INCORRECT/MISSING CODE(S): ___________________________________
STUDIES
1. A laboratory technician performs screening by automated system of a cervical smear, under physician supervision.
SERVICE CODE(S): 88141____________________________________________
2. An amniotic fluid sample is received in the laboratory for a suspected nonneoplastic disorder. A tissue culture chromosome analysis was performed.
T4.2:
SERVICE CODE(S): 88267__________________________________________
INCORRECT/MISSING CODE(S): ___________________________________
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