THE CARDIOVASCULAR SYSTEM FINAL ASSESSMENT
EXAM WITH WELL PERFECTED ANSWERS
Where is the hypertension table located in ICD-10-CM? - CORRECT ANSWER >>>Correct
Answer: c.
There is no hypertension table in ICD-10-CM.
Response Feedback: Rationale: Hypertension is found in the ICD-10-CM Alphabetic Index by
looking for Hypertension. Unlike ICD-9-CM, ICD-10-CM does not have a hypertension table.
A physician places a centrally inserted, tunneled central venous access device with a
subcutaneous pump in a 7 year-old patient. - CORRECT ANSWER >>>36563
Rationale: Look in the CPT® Index for Venous Access Device/Insertion/Central which directs the
coder to 36560-36566. The code for insertion of a tunneled central venous access device with a
subcutaneous pump is 36563.
How many layers of tissue does an artery have? - CORRECT ANSWER >>>Three
Rationale: An artery has three layers: an outer layer of tissue, a muscular middle and an inner
layer of epithelial cells
What is the term for the divider between the heart chamber walls? - CORRECT ANSWER
>>>Septum
Which main coronary artery bifurcates into two smaller ones? - CORRECT ANSWER >>>Left
Rationale: The left main coronary artery branches into two slightly smaller arteries: the left
anterior descending coronary artery and the left circumflex coronary artery.
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, Physician changes the old battery to a new one on a patient's dual chamber permanent
pacemaker. What CPT® code(s) is/are reported? - CORRECT ANSWER >>>33228
Rationale: CPT® guidelines state "When the battery of a pacemaker is changed, it is actually the
pulse generator that is changed." It is reported with one code. In the CPT® Index look for
Pacemaker, Heart/Replacement/Pulse Generator and you are referred to 33227-33229. Code
33228 is reported for dual chamber (dual lead system).
Procedure: Right femoral angiography, percutaneous transluminal tibioperoneal angioplasty and
stenting.
Description of Procedure: The patient was premedicated and brought to the cardiovascular
laboratory. The right inguinal region is prepped and draped in the usual sterile fashion. Local
cutaneous anesthesia was obtained with 1% Lidocaine. A 6 French sheath was inserted
antegrade into the right femoral artery. It was kinked and was replaced with a 6 French Arrow
sheath.
Findings: Selective injections into the right femoral artery revealed diffuse irregularities of the
superficial femoral artery with a 95 percent mid to distal stenosis and a 60 percent distal
stenosis. The distal popliteal artery had an eccentric 60 percent stenosis. The tibial peroneal
trunk was diffusely diseased with sequential 95 percent stenosis present. The anterior tibial and
posterior tibial arteries are both occluded. We gave intravenous hep - CORRECT ANSWER
>>>37130, 37225-51
Rationale: Treatment of lesions in the femoral popliteal artery and stenosis in the tibial peroneal
trunk to restore blood supply (revascularization) using angioplasty with placement of a stent in
the tibial peroneal trunk is being performed. 37224 is coded for the angioplasty in the
femoralpopliteal artery. Look in the CPT® Index for Revascularization/Artery/Femoral-Popliteal,
3722437227. Angioplasty was performed in the femoral artery and in the popliteal artery;
therefore, the correct code is 37224. Look in the CPT® Index for
Revascularization/Artery/Tibial/Peroneal which directs the coder to 37228-37235. Angioplasty
and stent placement were performed; therefore, the correct code is 37230. Modifier 51 denotes
additional procedures performed during the same session.
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EXAM WITH WELL PERFECTED ANSWERS
Where is the hypertension table located in ICD-10-CM? - CORRECT ANSWER >>>Correct
Answer: c.
There is no hypertension table in ICD-10-CM.
Response Feedback: Rationale: Hypertension is found in the ICD-10-CM Alphabetic Index by
looking for Hypertension. Unlike ICD-9-CM, ICD-10-CM does not have a hypertension table.
A physician places a centrally inserted, tunneled central venous access device with a
subcutaneous pump in a 7 year-old patient. - CORRECT ANSWER >>>36563
Rationale: Look in the CPT® Index for Venous Access Device/Insertion/Central which directs the
coder to 36560-36566. The code for insertion of a tunneled central venous access device with a
subcutaneous pump is 36563.
How many layers of tissue does an artery have? - CORRECT ANSWER >>>Three
Rationale: An artery has three layers: an outer layer of tissue, a muscular middle and an inner
layer of epithelial cells
What is the term for the divider between the heart chamber walls? - CORRECT ANSWER
>>>Septum
Which main coronary artery bifurcates into two smaller ones? - CORRECT ANSWER >>>Left
Rationale: The left main coronary artery branches into two slightly smaller arteries: the left
anterior descending coronary artery and the left circumflex coronary artery.
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, Physician changes the old battery to a new one on a patient's dual chamber permanent
pacemaker. What CPT® code(s) is/are reported? - CORRECT ANSWER >>>33228
Rationale: CPT® guidelines state "When the battery of a pacemaker is changed, it is actually the
pulse generator that is changed." It is reported with one code. In the CPT® Index look for
Pacemaker, Heart/Replacement/Pulse Generator and you are referred to 33227-33229. Code
33228 is reported for dual chamber (dual lead system).
Procedure: Right femoral angiography, percutaneous transluminal tibioperoneal angioplasty and
stenting.
Description of Procedure: The patient was premedicated and brought to the cardiovascular
laboratory. The right inguinal region is prepped and draped in the usual sterile fashion. Local
cutaneous anesthesia was obtained with 1% Lidocaine. A 6 French sheath was inserted
antegrade into the right femoral artery. It was kinked and was replaced with a 6 French Arrow
sheath.
Findings: Selective injections into the right femoral artery revealed diffuse irregularities of the
superficial femoral artery with a 95 percent mid to distal stenosis and a 60 percent distal
stenosis. The distal popliteal artery had an eccentric 60 percent stenosis. The tibial peroneal
trunk was diffusely diseased with sequential 95 percent stenosis present. The anterior tibial and
posterior tibial arteries are both occluded. We gave intravenous hep - CORRECT ANSWER
>>>37130, 37225-51
Rationale: Treatment of lesions in the femoral popliteal artery and stenosis in the tibial peroneal
trunk to restore blood supply (revascularization) using angioplasty with placement of a stent in
the tibial peroneal trunk is being performed. 37224 is coded for the angioplasty in the
femoralpopliteal artery. Look in the CPT® Index for Revascularization/Artery/Femoral-Popliteal,
3722437227. Angioplasty was performed in the femoral artery and in the popliteal artery;
therefore, the correct code is 37224. Look in the CPT® Index for
Revascularization/Artery/Tibial/Peroneal which directs the coder to 37228-37235. Angioplasty
and stent placement were performed; therefore, the correct code is 37230. Modifier 51 denotes
additional procedures performed during the same session.
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