D025 COMPREHENSIVE STUDY GUIDE
COMPLETE QUESTIONS AND CORRECT
ANSWERS
●● Where is urine formed?
Answer: Kidneys
Rationale: Urine is formed in the renal tubules and empties into the
calyces, then into the renal pelvis of the kidney. It then travels through
the ureters to the bladder.
●● A 65-year-old woman diagnosed with a right renal tumor is status
post hand-assisted laparoscopic nephrectomy. Pathology report reveals a
definitive diagnosis of renal oncocytoma. What is the ICD-10-CM code?
Answer: D30.01
RATIONALE: Look in the ICD-10-CM Alphabetic Index for
Oncocytoma, which directs you to see Neoplasm, by site, benign. Look
in the Table of Neoplasms for Neoplasm, neoplastic/renal/Benign
column D30.0-. In the Tabular List report 5th character 1 for right
kidney. Correct code choice is D30.01.
●● Mr. Brown presents today with a sudden onset of chills and fever
with dull pain in the flank over the kidneys, which are tender when
palpated. He has urgency and frequency of urination. Diagnosis is acute
pyelonephritis. What is the ICD-10-CM code?
,Answer: N10
RATIONALE: Acute pyelonephritis is coded N10, unless mention of a
lesion of renal medullary necrosis is documented. Do not use chronic
pyelone-phritis because the documentation clearly states "acute." Look
in the ICD-10-CM Alphabetic Index for Pylonephritis/acute N10. Verify
code selection in the Tabular List.
●● A Urologist examines the urinary collecting system with a
cystourethroscope and removes four bladder tumors by fulguration. Two
tumors measured 1.5 cm and the other two tumors measured 2.5 cm and
3.0 cm. What code(s) should be reported?
Answer: 52235
RATIONALE: Look in the CPT® Index for
Fulguration/Cystourethroscopy with/Tumor. You are referred to 52234-
52235, 52240, 52250. When different size bladder tumors are removed
in one surgical session, the code selection is based on the largest tumor
size. In this example, the largest tumor removed is 3.0 cm. Only one
code is reported regardless of the number of tumors removed.
●● Excision of urachal cyst and an incarcerated umbilical hernia repair
were performed on a six-year-old male. Code the procedure:
Answer: 51500
RATIONALE: Umbilical hernia repair codes are reported using CPT®
49580-49587 and are differentiated by the age of the patient and whether
or not the hernia is reducible, incarcerated or strangulated. A reducible
hernia is one that can be reduced to a normal position. An incarcerated
or strangulated hernia is one that cannot be reduced to a normal position
, without surgical intervention. The description of CPT® 51500 Excision
of urachal cyst or sinus, with or without umbilical hernia repair includes
the umbilical hernia repair. Hernia repair is not reported separately;
therefore, CPT® 51500 is the correct answer. Look in the CPT® Index
for Cyst/Urachal/Bladder/Excision 51500.
●● Patient presents for treatment of multiple condyloma on the penis.
The excised diameter is 0.8cm. Code the procedure.
Answer: 54060
RATIONALE: Surgical excision of condyloma(s) of the penis is
reported using CPT® 54060. Report this procedure only once because
the description includes multiple condyloma excision during a
single/same surgical setting. CPT® 11420 describes excision of a benign
lesion of the genitalia, but is not specific to condyloma and the diameter
of the lesion excision is stated as 0.5 cm or less. CPT® 11421 describes
a benign lesion excised from the genitalia 0.6 cm to 1.0 cm, and would
be appropriate had there not been a clear and concise code for
condyloma excision. CPT® 11621 describes a malignant lesion excision
and is not reported because there is no documentation of a malignant
lesion excision. Tip: When determining the specific code to report, the
body system or organ should be accessed first, before using the
integumentary codes. Look in the CPT® Index for Condyloma/Penis for
the range of codes.
●● A circumcision was performed on a newborn using a dorsal penile
nerve block for anesthesia. The provider used a Plastibell for this
circumcision. What CPT® code is reported?
COMPLETE QUESTIONS AND CORRECT
ANSWERS
●● Where is urine formed?
Answer: Kidneys
Rationale: Urine is formed in the renal tubules and empties into the
calyces, then into the renal pelvis of the kidney. It then travels through
the ureters to the bladder.
●● A 65-year-old woman diagnosed with a right renal tumor is status
post hand-assisted laparoscopic nephrectomy. Pathology report reveals a
definitive diagnosis of renal oncocytoma. What is the ICD-10-CM code?
Answer: D30.01
RATIONALE: Look in the ICD-10-CM Alphabetic Index for
Oncocytoma, which directs you to see Neoplasm, by site, benign. Look
in the Table of Neoplasms for Neoplasm, neoplastic/renal/Benign
column D30.0-. In the Tabular List report 5th character 1 for right
kidney. Correct code choice is D30.01.
●● Mr. Brown presents today with a sudden onset of chills and fever
with dull pain in the flank over the kidneys, which are tender when
palpated. He has urgency and frequency of urination. Diagnosis is acute
pyelonephritis. What is the ICD-10-CM code?
,Answer: N10
RATIONALE: Acute pyelonephritis is coded N10, unless mention of a
lesion of renal medullary necrosis is documented. Do not use chronic
pyelone-phritis because the documentation clearly states "acute." Look
in the ICD-10-CM Alphabetic Index for Pylonephritis/acute N10. Verify
code selection in the Tabular List.
●● A Urologist examines the urinary collecting system with a
cystourethroscope and removes four bladder tumors by fulguration. Two
tumors measured 1.5 cm and the other two tumors measured 2.5 cm and
3.0 cm. What code(s) should be reported?
Answer: 52235
RATIONALE: Look in the CPT® Index for
Fulguration/Cystourethroscopy with/Tumor. You are referred to 52234-
52235, 52240, 52250. When different size bladder tumors are removed
in one surgical session, the code selection is based on the largest tumor
size. In this example, the largest tumor removed is 3.0 cm. Only one
code is reported regardless of the number of tumors removed.
●● Excision of urachal cyst and an incarcerated umbilical hernia repair
were performed on a six-year-old male. Code the procedure:
Answer: 51500
RATIONALE: Umbilical hernia repair codes are reported using CPT®
49580-49587 and are differentiated by the age of the patient and whether
or not the hernia is reducible, incarcerated or strangulated. A reducible
hernia is one that can be reduced to a normal position. An incarcerated
or strangulated hernia is one that cannot be reduced to a normal position
, without surgical intervention. The description of CPT® 51500 Excision
of urachal cyst or sinus, with or without umbilical hernia repair includes
the umbilical hernia repair. Hernia repair is not reported separately;
therefore, CPT® 51500 is the correct answer. Look in the CPT® Index
for Cyst/Urachal/Bladder/Excision 51500.
●● Patient presents for treatment of multiple condyloma on the penis.
The excised diameter is 0.8cm. Code the procedure.
Answer: 54060
RATIONALE: Surgical excision of condyloma(s) of the penis is
reported using CPT® 54060. Report this procedure only once because
the description includes multiple condyloma excision during a
single/same surgical setting. CPT® 11420 describes excision of a benign
lesion of the genitalia, but is not specific to condyloma and the diameter
of the lesion excision is stated as 0.5 cm or less. CPT® 11421 describes
a benign lesion excised from the genitalia 0.6 cm to 1.0 cm, and would
be appropriate had there not been a clear and concise code for
condyloma excision. CPT® 11621 describes a malignant lesion excision
and is not reported because there is no documentation of a malignant
lesion excision. Tip: When determining the specific code to report, the
body system or organ should be accessed first, before using the
integumentary codes. Look in the CPT® Index for Condyloma/Penis for
the range of codes.
●● A circumcision was performed on a newborn using a dorsal penile
nerve block for anesthesia. The provider used a Plastibell for this
circumcision. What CPT® code is reported?
