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Assign code(s) for the following diagnosis: Congestive heart failure due to
hypertension.
I10Essential (primary) hypertension
I11.0Hypertensive heart disease with heart failure
I50.9Heart failure, unspecified
I50.23Acute on chronic systolic (congestive) heart failure
a. I10, I50.9
b. I11.0
c. I50.23, I10
d. I11.0, I50.9 - 🧠ANSWER ✔✔Correct Answer: D
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,Heart failure is assigned a combination code when a causal relationship is
stated (due to hypertension) or implied (hypertensive). Use an additional
code to identify the type of heart failure in those patients with heart failure
(CMS 2020a, Section I.C.9.a.1, 46-47).
A patient is seen for evaluation of a right orbital roof fracture. How should
this be coded?
S02.121AFracture of orbital roof, right side, initial encounter for closed
fracture
S02.31XAFracture of orbital floor, right side, initial encounter for closed
fracture
S02.92XAUnspecified fracture of facial bones, initial encounter for closed
fracture
S02.91XAUnspecified fracture of skull, initial encounter for closed fracture
a. S02.121A
b. S02.31XA
c. S02.92XA
d. S02.91XA - 🧠ANSWER ✔✔Correct Answer: A
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,Alphabetic Index for fracture, traumatic; orbit, orbital; roof guides the coder
to S02.12. Evaluation of a fracture is an example of active treatment which
is reported with 7th character "A" (Schraffenberger and Palkie 2020, 580-
584).
Patient presents in the ER with thrombosis of a loop PTFE hemodialysis
fistula without mechanical complications. The physician performed a
percutaneous thrombectomy of the left brachial vein. Assign a facility code
for this outpatient procedure.
05CA3ZZExtirpation of matter from left brachial vein, percutaneous
approach
36904Percutaneous transluminal mechanical thrombectomy and/or infusion
for thrombolysis, dialysis circuit, any method, including all imaging and
radiological supervision and interpretation, diagnostic angiography,
fluoroscopic guidance, catheter placement(s), and intraprocedural
pharmacological thrombolytic injection(s)
36832Revision, open, arteriovenous fistula; without thrombectomy,
autogenous or nonautogenous dialysis graft (separate procedure)
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, 37184Primary percutaneous transluminal mechanical thrombectomy,
noncoronary, arterial or arterial bypass graft, including fluoroscopic
guidance and intrapro - 🧠ANSWER ✔✔Correct Answer: B
This episode of care occurs in the ER which is an outpatient setting,
therefore, a CPT code should be used. CPT code 36904 correctly identifies
the thrombectomy procedure because it specifies the site of the
thrombectomy as "dialysis circuit." 36904 includes imaging guidance,
diagnostic angiography, catheter placement, and intraprocedural
pharmacological thrombolytic injections" (Kirchoff 2009, 203).
Patient admitted for laparoscopic repair of right diaphragmatic hernia.
Assign the ICD-10-PCS procedure code for this surgery.
0BQT4ZZRepair diaphragm, percutaneous endoscopic approach
0BQT3ZZRepair diaphragm, percutaneous approach
0WQF4ZZRepair abdominal wall, percutaneous endoscopic approach
0BQT0ZZRepair diaphragm, open approach
a. 0BQT4ZZ
b. 0BQT3ZZ
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