Medical Coding and Billing Unit 10 Questions

1. This 60-year-old patient was admitted with emphysematous nodules. A thoracoscopic wedge resection was performed in the left lung to remove the lung nodules. A resection was done in the upper and lower lobes. Which of the following answers is correct? (Points : 2)

J98.4, 32666, 32667 J43.9, 32666 J98.4, 32505 J43.9, 32666, 32667

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Question 2. 2. A neonatal patient is brought to the operating room for repair of complete transposition of the great arteries under cardiopulmonary bypass. The infant is in critical condition and may not survive. Assign the correct diagnosis codes and CPT codes to report the administration of anesthesia, including physical status, Level I and II modifiers, and qualifying conditions for this procedure. (Points : 2)

Q20.3, 00562–AA–23, 99100 Q20.1, 00561–AD–P5, 99140 Q20.3, 00561–AA–P5 Q20.3, 00563–AA–P5, 99100, 99140

Question 3. 3. A 69-year-old patient was hit by a car, causing intra-thoracic trauma and hemorrhage. The patient was taken directly from the Emergency Department to the operative suite where the chest was opened and hemorrhage was controlled, but the patient’s heart stopped. Open heart massage was performed but the patient expired before the patient could be admitted. Assign the appropriate CPT code(s) and any required modifier(s) to report this service. (Points : 2)

32110-CA 32110, 32160 32160-CA 32110-CA, 32160-CA

Question 4. 4. A non-Medicare patient with carcinoma of the oral cavity and lower lip is receiving daily intramuscular injections of the interferon alfa-2a (3 million units) in the outpatient cancer center. Which of the following will be reported for this service? The payer does accept HCPCS Level II codes for drugs. (Points : 2)

Z51.12, I49.8, 96401, J9213 C14.8, 96372, J9213 C06.9, C00.2, 96372 Z51.12, 96549

Question 5. 5. An elderly patient has an abscess formation around a pacemaker pocket on his chest wall that requires that the device be removed and the pocket reformed in another location. Which of the following code sets is appropriate for this outpatient surgical service? (Points : 2)

T82.7XXA, L02.219, 33222 L02.219, 33222 T82.7XXA, 33223 T82.857A, L02.219, 33999

Question 6. 6. Assign the appropriate ICD-10-CM diagnosis code for aspiration pneumonia due to inhalation of food. (Points : 2)

J15.9 J69.0 J18.9 J69.1

Question 7. 7. A hospital-based pediatric clinic is treating a newborn with talipes equinovarus by manipulation and short leg casting. Which of the following code sets is reported for a visit where the condition is evaluated with a -problem-focused history and examination and parents’ questions are answered, followed by foot and ankle manipulation and replacement of the plaster cast? (Points : 2)

Q66.6, 29450 M21.549, 29405 Q66.0, 29405 Q66.0, 99212–25, 29450

Question 8. 8. A 32-year old female has recently had surgery for melanoma of the right lower leg, Clark level IV> She had no other signs of metastasis or adenopathy. Under general anesthesia, a sentinel node biopsy of the deep axillary nodes was performed with a gamma counter probe. An injection of isosulfan blue dye was performed and the nodes followed carefully to the single-bright-blue node. This node was excised and sent for frozen section, which proved to be negative for melanoma. Before the procedure, the radiologist performed a lymphoscintigraphy. Which of the following code sets would the surgeon report. (Points : 2)

C44.691, 38525 C4A.71, 38525, 38792 C4A.71, 38525, 38792–51, 78195 C43.9, 38525, 38790–51

Question 9. 9. What code(s) is/are assigned for a patient receiving home care after a kidney transplant? (Points : 2)

Z48.29 Z48.298, Z94.0 N18.6 Z94.0

Question 10. 10. What would be the appropriate ICD-10-CM code for lumbar stenosis? (Points : 2)

M48.00 M48.06 M48.07 M48.26

Question 11. 11. Dr. Smith sent a patient to observation care at the local hospital following his visit to the nursing facility. The patient was admitted for observation to rule out stoke due to a change in mental status. The next morning, Dr. Smith left town, and his partner, Dr., Johnson, admitted the patient to inpatient care because of sudden worsening symptoms. The patient expired later the same day. Assuming documentation guidelines were met, how would E/M services for these two physician be coded? (Points : 5)

Dr. Smith: 99315; 99219; Dr. Johnson: 99236 Dr. Smith: 99219; Dr. Johnson: 99217, 99236 Dr. Smith: 99219; Dr. Johnson: 99236 Dr. Smith: 99315; 99222; Dr. Johnson: 99238