BC3030X: Billing and Coding Applications with Simulations (1-032017) Section 01 exam elaborations

Review Test Submission: Week 5 - Certification Test Course BC3030X: Billing and Coding Applications with Simulations (1-) Section 01 • Question 1 0.6 out of 0.6 points A patient who may have a stricture of the artery is undergoing an aortogram in which the left femoral artery was cannulated with a catheter advanced in to the infrarenal abdominal aorta. Contrast medium was injected and films taken by serialography showing the aortoiliac inflow vessels are widely patent. The bilateral common femorals appear normal. What CPT® codes are reported for the professional component? Selected Answer: 36200, 75630-26 Correct Answer: 36200, 75630-26 • Question 2 0 out of 0.6 points 82-year-old female with a right leg medial malleolar non-healing ulcer elected to proceed with peripheral angiography. Using a RIM catheter, from a left femoral artery access, the contralateral right iliac artery was accessed and the catheter was gradually advanced to the right common femoral artery. The right lower extremity angiography was performed with both C02 injection and subsequently localized pictures of femoral distal bypass grafts were performed using contrast injections. This revealed the right superficial femoral artery is 100% occluded at its origin. Decision for angioplasty was made and intervention was performed through this area with a 7 mm x 20 mm balloon inflated up to 7 atmospheres. The gradual inflation resulted in enlarging the artery to a more normal flow of blood. What CPT® codes is/are reported? Selected Answer: 37220, -59 Correct Answer: 37224, 75710- 26-59 Response Feedback : The second order selective catheterization (36246) for the diagnostic angiography will not be reported as an additional code, because the catheterization was performed through the same access site as the interventional angioplasty, code 37224. The diagnostic angiography is reported with . Because the decision to perform the angioplasty was made after reading the films for the diagnostic angiography, modifier 59 is appended to show that it is not bundled with code 37224.This information is found in the Vascular Procedures Guidelines of the Radiology Section in the CPT® codebook. In the CPT® Index, look for Angioplasty/Femoral Artery/Intraoperative direction you to 37224. Look for Angiography/Leg Artery directing you to 73706, 75635, . • Question 3 0 out of 0.6 points 65-year-old female has a 2.5 cm by 2.0 cm non-small cell lung cancer in her right upper lobe. The tumor is inoperable due to severe respiratory conditions. She will be receiving stereotactic body radiation therapy under image guidance. Beams arranged in 8 fields will deliver 25 Grays per fraction for 4 fractions. What CPT® and ICD-10-CM codes are reported? Selected Answer: 77371, C34.91 Correct Answer: 77373, Z51.0, C34.11 Response Feedback : Patient is having stereotactic radiation therapy technique delivered, not managed, in a large radiation dose to tumor sites in the upper right lobe of the lung. In the CPT® index look for Radiation Therapy/Stereotactic/Body. Codes do not need modifier TC or 26, because they are facility only codes. According to ICD-10-CM guidelines Section I.C.2.a. “If a patient admission/encounter is solely for the administration of chemotherapy, immunotherapy or radiation therapy, assign the appropriate Z51.-code as the first-listed or principal diagnosis, and the diagnosis or problem for which the service is being performed as a secondary diagnosis. In the Table of Neoplasms look for Neoplasm, neoplastic/lung/upper lobe/Malignant Primary column referring you to C34.1-. Verification in the Tabular List indicates a fourth character is needed, report 1 for the right lung. Correct code is C34.11. • Question 4 0 out of 0.6 points 37-year-old has multilevel lumbar degenerative disc disease and is coming in for an epidural injection. Localizing the skin over the area of L5-S1, the physician uses the transforaminal approach under fluoroscopy guidance for needle positioning. The spinal needle is inserted, and the patient experienced paresthesias into her left lower extremity. The anesthetic drug is injected into the epidural space. What CPT® code(s) is/are reported? Selected [None Answer: Given] Correct Answer: 64483 Response Feedback : In the CPT® Index, look for Nerves/Injection/Anesthetic. You are referred to or . You can also find this under Epidural/Injection/Transforaminal. Review the codes to choose appropriate service. Code 64483 is the correct code, because the anesthetic was injected into the epidural space in one single level (L5-S1) using the transforaminal approach. Imaging guidance is included in the procedure and not reported separately. • Question 5 0 out of 0.6 points A parent brings her child to the ED. She thinks she swallowed a small toy figure. A radiology exam from the nose to the rectum is performed. The foreign body is not located. What CPT® code(s) is/are reported for the radiology services? Selected Answer: [None Given] Correct Answer: 76010 Response Feedback: The radiology exam is performed to locate a foreign body, yet no foreign body is found. In the CPT® Index, look for X-ray/Nose to Rectum/Foreign Body. The correct code is 76010.