Chapter 10 Review UPDATED ACTUAL QUESTIONS AND CORRECT ANSWERS
What part of the cardiovascular system is responsible for Heart valves
the one-way flow of blood through the chambers of the Rationale: Heart valves are made of flaps (cusps/leaflets) opening and closing like
heart? one way swinging doors, preventing blood from flowing back.
A physician places a centrally inserted, tunneled central 36563
venous access device with a subcutaneous pump in a 7 Rationale: Look in the CPT® Index for Venous Access Device/Insertion/Central
year-old patient. which directs the coder to 36560-36566. The code for insertion of a tunneled
central venous access device with a subcutaneous pump is 36563.
A patient suffering from an abdominal aortic aneurysm 34842
involving a renal artery undergoes endovascular repair Rationale: Look in the CPT® Index for Repair/Aorta/Visceral/Endovascular
deploying a fenestrated visceral autograft using two directing you to code 34841-34848. Code 34842 is correct to report because two
visceral artery endoprostheses. Radiological supervision visceral artery endoprostheses were used.
and interpretation were performed. Select the CPT® code
for this procedure.
How many layers of tissue does an artery have? Three
Rationale: An artery has three layers: an outer layer of tissue, a muscular middle
and an inner layer of epithelial cells.
____ is a term standing for enlargement of the heart. Cardiomegaly
Rationale: Cardio = heart, megaly = enlargement
, Physician replaces a single chamber permanent 33214
pacemaker with a dual chamber permanent pacemaker. Rationale: Code 33214 is used for the conversion of a single chamber system to a
What CPT® code(s) is/are reported? dual chamber system which includes removal of the previously placed pulse
generator, testing of existing lead, insertion of new lead, and insertion of new
pulse generator. Look in the CPT® Index for Cardiac Assist Device/Pacemaker
System/Upgrade which refers you to code 33214.
Intracoronary stents are placed percutaneously in the 92928-RC, 92928-LD, 92920-LC
right coronary and left anterior descending arteries for a Rationale: Only one base intervention is reported for each major coronary artery.
patient with stenosis. Percutaneous transluminal balloon The hierarchy from highest to lowest is as follows: atherectomy, stent placement,
angioplasty is performed on the left circumflex coronary followed by angioplasty. The base intervention code 92928 is reported for the
artery. Choose the correct CPT® codes for this stent placement in the right coronary (92928-RC) and the left anterior descending
procedure. arteries (92928-LD). Each is reported with the corresponding coronary artery
modifiers. Look in the CPT® Index for Coronary Artery/Angioplasty/with Stent
Placement and you are directed to 92928-92929. To locate the angioplasty code,
look in the CPT® Index for Coronary Artery/Angioplasty which directs you to
92920-92921. The base code 92920-LC is reported for the angioplasty of the left
circumflex.
A physician states he performed a comprehensive EP 93600-26, 93602-26, 93610-26, 93618-26
study with induction of arrhythmia in the hospital. The Rationale: Although the physician stated a comprehensive EP study was
report shows bundle of His recording, pacing and performed, the right ventricular pacing and recording, and left atrial pacing and
recording of the right atrium, and induction of arrhythmia recording from the coronary sinus or left atrium were not done. The components
by electrical pacing. What CPT® codeing is reported? must be billed separately. Look in the CPT® Index for Electrophysiology
Procedure directing you to 93600-93660. The procedure was performed in the
hospital; therefore, modifier 26 is appended to all the codes to report the
professional service.
A patient in the ED was found to have a ruptured 35103
abdominal aortic aneurysm. He was taken to emergency Rationale: You must read the question carefully because this is a ruptured aortic
surgery; a physician performed a direct repair. The aneurysm involving the common iliac not a ruptured aneurysm of the common
physician documented that the aneurysm involved the iliac. Look in the CPT® Index for Aneurysm Repair/Abdominal Aorta which directs
common iliac. Select the proper CPT® code for this you to multiple codes. On review of the code ranges, code 35103 is correct. Code
procedure. 35102 is a repair of an aneurysm not ruptured.
An arterial catheterization is performed by cutdown for 36625
transfusion. What CPT® code is reported? Rationale: The answer is found in the CPT® Index by referencing
Catheterization/Arterial System/Cutdown directing you to 36625.
A physician performs a four-vessel autogenous (one 33535, 33517, 33530, 35600
venous, three arterial) coronary bypass on a patient who Rationale: Because this is a combo graft, codes 33517-33523 must be coded for
had a previous CABG two years ago, utilizing the the venous portion of the graft. Also, this is a redo more than one month after the
saphenous vein, radial artery and the left and right original surgery, so the add-on code 33530 is appropriate. Look in the CPT® Index
internal mammary arteries. Select the CPT® codes for this for Coronary Artery Bypass Graft (CABG)/Arterial-Venous Bypass which directs
procedure. you to 33517-33519, 33521-33523, 33531, and Arterial Bypass which directs you to
33533-33536. In this CPT® Index look for CABG is Harvest/Upper Extremity Artery
which directs you to 35600. Look for the codes in the numeric section and you
see all additional codes are add-on codes; therefore, no modifiers are required.
To code for the reoperation look in the CPT® Index for Reoperation/Coronary
Artery Bypass/Valve procedure which directs you to 33530.
What part of the cardiovascular system is responsible for Heart valves
the one-way flow of blood through the chambers of the Rationale: Heart valves are made of flaps (cusps/leaflets) opening and closing like
heart? one way swinging doors, preventing blood from flowing back.
A physician places a centrally inserted, tunneled central 36563
venous access device with a subcutaneous pump in a 7 Rationale: Look in the CPT® Index for Venous Access Device/Insertion/Central
year-old patient. which directs the coder to 36560-36566. The code for insertion of a tunneled
central venous access device with a subcutaneous pump is 36563.
A patient suffering from an abdominal aortic aneurysm 34842
involving a renal artery undergoes endovascular repair Rationale: Look in the CPT® Index for Repair/Aorta/Visceral/Endovascular
deploying a fenestrated visceral autograft using two directing you to code 34841-34848. Code 34842 is correct to report because two
visceral artery endoprostheses. Radiological supervision visceral artery endoprostheses were used.
and interpretation were performed. Select the CPT® code
for this procedure.
How many layers of tissue does an artery have? Three
Rationale: An artery has three layers: an outer layer of tissue, a muscular middle
and an inner layer of epithelial cells.
____ is a term standing for enlargement of the heart. Cardiomegaly
Rationale: Cardio = heart, megaly = enlargement
, Physician replaces a single chamber permanent 33214
pacemaker with a dual chamber permanent pacemaker. Rationale: Code 33214 is used for the conversion of a single chamber system to a
What CPT® code(s) is/are reported? dual chamber system which includes removal of the previously placed pulse
generator, testing of existing lead, insertion of new lead, and insertion of new
pulse generator. Look in the CPT® Index for Cardiac Assist Device/Pacemaker
System/Upgrade which refers you to code 33214.
Intracoronary stents are placed percutaneously in the 92928-RC, 92928-LD, 92920-LC
right coronary and left anterior descending arteries for a Rationale: Only one base intervention is reported for each major coronary artery.
patient with stenosis. Percutaneous transluminal balloon The hierarchy from highest to lowest is as follows: atherectomy, stent placement,
angioplasty is performed on the left circumflex coronary followed by angioplasty. The base intervention code 92928 is reported for the
artery. Choose the correct CPT® codes for this stent placement in the right coronary (92928-RC) and the left anterior descending
procedure. arteries (92928-LD). Each is reported with the corresponding coronary artery
modifiers. Look in the CPT® Index for Coronary Artery/Angioplasty/with Stent
Placement and you are directed to 92928-92929. To locate the angioplasty code,
look in the CPT® Index for Coronary Artery/Angioplasty which directs you to
92920-92921. The base code 92920-LC is reported for the angioplasty of the left
circumflex.
A physician states he performed a comprehensive EP 93600-26, 93602-26, 93610-26, 93618-26
study with induction of arrhythmia in the hospital. The Rationale: Although the physician stated a comprehensive EP study was
report shows bundle of His recording, pacing and performed, the right ventricular pacing and recording, and left atrial pacing and
recording of the right atrium, and induction of arrhythmia recording from the coronary sinus or left atrium were not done. The components
by electrical pacing. What CPT® codeing is reported? must be billed separately. Look in the CPT® Index for Electrophysiology
Procedure directing you to 93600-93660. The procedure was performed in the
hospital; therefore, modifier 26 is appended to all the codes to report the
professional service.
A patient in the ED was found to have a ruptured 35103
abdominal aortic aneurysm. He was taken to emergency Rationale: You must read the question carefully because this is a ruptured aortic
surgery; a physician performed a direct repair. The aneurysm involving the common iliac not a ruptured aneurysm of the common
physician documented that the aneurysm involved the iliac. Look in the CPT® Index for Aneurysm Repair/Abdominal Aorta which directs
common iliac. Select the proper CPT® code for this you to multiple codes. On review of the code ranges, code 35103 is correct. Code
procedure. 35102 is a repair of an aneurysm not ruptured.
An arterial catheterization is performed by cutdown for 36625
transfusion. What CPT® code is reported? Rationale: The answer is found in the CPT® Index by referencing
Catheterization/Arterial System/Cutdown directing you to 36625.
A physician performs a four-vessel autogenous (one 33535, 33517, 33530, 35600
venous, three arterial) coronary bypass on a patient who Rationale: Because this is a combo graft, codes 33517-33523 must be coded for
had a previous CABG two years ago, utilizing the the venous portion of the graft. Also, this is a redo more than one month after the
saphenous vein, radial artery and the left and right original surgery, so the add-on code 33530 is appropriate. Look in the CPT® Index
internal mammary arteries. Select the CPT® codes for this for Coronary Artery Bypass Graft (CABG)/Arterial-Venous Bypass which directs
procedure. you to 33517-33519, 33521-33523, 33531, and Arterial Bypass which directs you to
33533-33536. In this CPT® Index look for CABG is Harvest/Upper Extremity Artery
which directs you to 35600. Look for the codes in the numeric section and you
see all additional codes are add-on codes; therefore, no modifiers are required.
To code for the reoperation look in the CPT® Index for Reoperation/Coronary
Artery Bypass/Valve procedure which directs you to 33530.
