Chapter 11: Digestive System
How many lobes are in the liver? A.4 lobes B.3 lobes C.2 lobes D.5 lobes
Answer: A. 4 lobes Rationale: The human liver has four lobes: the right lobe and left lobe, which may be seen in an anterior view, plus the quadrate lobe and caudate lobe.
What is the function of the gallbladder? A.It plays a role in maintaining glucose levels in the blood. B.It conveys and stores bile. C.It breaks down and stores waste products. D.It produces acidic juices for digestion.
Answer: B. It conveys and stores bile. Rationale: The gallbladder is a sac-shaped organ located under the liver. It stores bile that is produced by the liver.
Medical Terminology
Abdomin/o - abdomen, abdominal An/o - anus Appendic/o - appendix -ase - enzyme Bil/i - bile Bucc/o - cheek Cec/o - cecum Celi/o - abdomen -cele - hernia Cheil/o - lip -chezia - defecation Chol/e, chol/o - bile, gall Choledoch/o - common bile duct Cholecyst/o - gallbladder Cirrh/o - orange/yellow Col/o, colon/o - large intestine, colon Dent/i, dent/o, odont/o - teeth Dia- through, throughout, completely Duoden/o - duodenum -ectasia, -ectasis - dilation, expansion, distension emesis - vomiting End/o, ent/o - within, inner, containing Enter/o - intestine Esophag/o - esophagus Gastr/o - stomach Gingiv/o - gingivae, gums of the mouth Gloss/o - tongue Hepat/o - liver Herni/o - rupture, protrusion of part of a structure through the tissues containing it Ile/o - ileum Jejun/o - jejunum Labi/o - lips Lapar/o - abdominal wall Lingu/o - tongue Lith - calculus, stone -lysis - separation, loosening, dissolving, destruction Or/o - mouth -ostomy, -stomy - artificial or surgical creation of an opening Pancreat/o - pancreas -pepsia - digestion Peritone/o - peritoneum -phagia - eating, swallowing -plasty - plastic repair, plastic surgery, reconstruction Proct/o - rectum Rect/o - rectum -rrhea - flow, discharge -scope, -scopy - action involving the use of an instrument for viewing Sial/o - saliva, salivary gland, salivary duct Sialaden/o - salivary gland Sigmoid/o - sigmoid colon Splen/o - spleen Stomat/o - mouth -tomy - incision into, cutting Uvul/o - uvula Viscer/o - internal organs
What CPT® code is reported for an intraoral incision and drainage of a hematoma of the tongue, submandibular space? A.41008 B.41009 C.41015 D.41017
Answer: A. 41008 Rationale: CPT® code 41008 is specifically for Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submandibular space. Look in the CPT® Index for Drainage/Hematoma/Mouth/Submandibular Space. The code selection is made because it is intraoral, not extraoral.
A 43-year-old male has a chronic posterior anal fissure. The posterior anal fissure was excised down to the internal sphincter muscle. Which CPT® code is reported? A.46200 B.46261 C.46270 D.46275
Answer: A. 46200 Rationale: In the CPT® Index, look for Anus/Fissure/Excision. You are referred to 46200. This is the correct code. There was a removal (excision) of a fissure, not fistula, without a sphincterotomy or hemorrhoidectomy
What CPT® code is reported for a proximal subtotal pancreatectomy, with total duodenectomy, partial gastrectomy, choledochoenterostomy, and gastrojejunostomy, with pancreatojejunostomy? A.48150 B.48152 C.48153 D.48154
Answer: A. 48150 Rationale: The CPT® code 48150 is specifically for pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy, and gastrojejunostomy (Whipple-type procedure); with pancreatojejunostomy. Look in the CPT® Index for Pancreas/Excision/Partial.
What are the two processes of digestion? A.Mechanical and chemical B.Chewing and absorption C.Ingestion and defecation D.Secretion and propulsion
Answer: A. Mechanical and chemical Rationale: Digestion consists of two processes, mechanical and chemical. Mechanical digestion is chewing (or mastication) of the food, then your stomach churning the food, and finally the small intestine (duodenum) absorbing the food. Chemical digestion is the work the stomach acids, bile, and enzymes do by breaking large carbohydrate, lipid, protein, and nucleic acid molecules into their subcomponents of nutrients.
The suffix meaning artificial or surgical opening: A.-ectasis B.-stomy C.-cele D.-lysis
Answer: B. -stomy Rationale: -ectasis means dilation, -cele means hernia, -lysis means release.
What CPT® coding is reported for a peritoneoscopy with laparoscopic partial colectomy and anastomosis? A.44140 B.44204 C.49320, 44140 D.49320, 44204
Answer: B. 44204 Rationale: A peritoneoscopy is a separate procedure and is not separately reportable when it is performed with a more extensive procedure. It is incidental to the laparoscopic partial colectomy and anastomosis. Look in the CPT® Index for Colectomy/Partial/with Anastomosis/Laparoscopic. The code is selected based on whether additional procedures, such as a coloproctostomy, are performed. There are no additional procedures in this case making 44204 the correct code choice.
A 55-year-old patient underwent a repair of an initial left inguinal hernia. An incision was made at the groin. A hernia sac was readily identified and cleared from the surrounding tissue, inverted into the preperitoneal space, and plugged. Mesh was tacked to the surrounding muscle layers and then placed over the entire floor. What CPT® code(s) is/are reported? A.49500-LT B.49505-LT C.49505-LT, 49568 D.49650-LT, 49568
Answer: B. 49505-LT Rationale: In the CPT® Index, look for Hernia Repair/Inguinal/Initial, Child 5 years or older. You are referred to 49505 and 49507. Review the codes to choose the appropriate service. 49505 is the correct code. The repair was through an incision (not by laparoscopy) on an initial inguinal hernia on a patient over five years of age and the hernia was not incarcerated or strangulated. According to CPT® guidelines, "With the exception of the incisional hernia repairs (49560-49566), the use of mesh or other prosthesis is not separately reported." It is inappropriate to code the mesh in this scenario. Modifier LT is appended to indicate the hernia is on the left side
A patient was seen in the outpatient GI lab of the hospital for rectal bleeding. A colonoscopy revealed three polyps in the transverse colon. The polyps were removed by snare technique and determined to be benign. What is the correct diagnosis code for this procedure? A.K63.5 B.D12.3 C.K92.1 D.K62.5
Answer: B. D12.3 Rationale: The definitive diagnosis is polyps and identified as benign. Rectal bleeding is a sign of polyps in the colon and not coded. In the ICD-10-CM Alphabetic Index, look for Polyp, polypus/colon/transverse directing you to D12.3. You can also use the Table of Neoplasms and look for Neoplasm, neoplastic/Intestine, intestinal/large/transverse; the Benign column indicates D12.3.
What are the three categories of teeth? A.Enamel, Root, Crown B.Incisors, Cuspids, Molars C.Baby teeth, Adolescent teeth, Wisdom teeth D.There are not three categories of teeth
Answer: B. Incisors, Cuspids, Molars Rationale: There are three categories of teeth: l The Incisors—The teeth in the front of the mouth. They are shaped like chisels and are useful in biting off large pieces of food. Each person has eight of these (four on the top, four on the bottom). l The Cuspids—The pointy teeth immediately behind the incisors. Also called the canines, these teeth are used for grasping or tearing food. Each person has four of these (two on the top and two on the bottom). l The Molars—The flattened teeth used for grinding food. They are the furthest back in the mouth, and their number can vary among people.
A 42-year-old patient visits his doctor for chest pain and a dry cough lasting for two months. After evaluating the patient, the physician states the patient has GERD. What is/are the correct diagnosis code(s)? A.K21.00 B.K21.9 C.K63.9, R05 D.R07.9, R05
Answer: B. K21.9 Rationale: GERD is the definitive diagnosis. Chest pain and a dry cough are both symptoms of GERD and are not reported separately. GERD is an acronym for Gastroesophageal Reflux Disease. In the ICD-10-CM Alphabetic Index, look for Disease, diseased/gastroesophageal reflux (GERD) or look for GERD, and you are guided to K21.9. There is no indication the patient has esophagitis.
What is the name of the portion of the large intestine that runs horizontally across the abdomen? A.Sigmoid colon B.Transverse colon C.Descending colon D.Ascending colon
Answer: B. The transverse colon Rationale: The name of the large intestine that runs horizontally across the abdomen is the transverse colon.
A patient with a large prolapsed hemorrhoid arrives at the Emergency Department. After multiple attempts, the provider is unable to reduce it. The physician applies granulated sugar to the hemorrhoid and is then able to reduce the hemorrhoid. What is the correct diagnosis code? A.K64.4 B.K64.0 C.K64.8 D.K64.5
Answer: C. K64.8 Rationale: Hemorrhoids are dilated or enlarged varicose veins which occur in and around the anus and rectum. The condition can be complicated by thrombosis, strangulation, prolapse, and ulceration. To find hemorrhoids in the ICD-10-CM Alphabetic Index, locate Hemorrhoids/prolapsed directing you to K64.8. Verify code selection in the Tabular List.
What organ in the human body has the capability to regenerate? A.Pancreas B.Kidney C.Liver D.Intestine
Answer: C. Liver Rationale: The liver is the only organ in the human body that can self-regenerate, which is why an adult can donate a portion of a liver to a child and that transplanted portion will regenerate, usually within six weeks of the procedure.
The prefix meaning lip: A.an/o B.cec/o C.cheil/o D.col/o
Answer: C. cheil/o Rationale: An/o means anus, cec/o means cecum, col/o means colon.
Approximately how long is the large intestine in normal anatomy? A.6 ft. long B.9 ft. long C.3 ft. long D.5 ft. long
Answer: D. 5 ft. long Rationale: The large intestine is about 5 ft. long
Name the three sections of the small intestine. A.Sigmoid, rectum, ilium B.Jejunum, duodenum, ilium C.Cecum, jejunum, ileum D.Duodenum, jejunum, ileum
Answer: D. Duodenum, jejunum, ileum Rationale: The three sections of the small intestine are the duodenum, jejunum, and the ileum. The ilium (note spelling) is one of the bones located in the pelvis. The sigmoid, rectum, and cecum are parts of the large intestine.
The patient is a 65-year-old female with type 2 diabetes. She is seen today by her primary care physician for extreme abdominal bloating and discomfort after eating. The patient also complains of constant heartburn. This occurs frequently and is not relieved by anything the patient has tried. The patient recorded her blood sugar this morning as 178. Her A1C taken in the office was 8.2. The physician diagnoses gastroparesis due to the patient's diabetes. Code the ICD-10-CM diagnosis(es). A.E10.43 B.K31.84 C.E11.43 D.E11.43, K31.84
Answer: D. E11.43, K31.84 Rationale: Gastroparesis is also called delayed gastric emptying. Gastroparesis may occur when the vagus nerve is damaged and the muscles of the stomach and intestines do not work normally. Food then moves slowly or stops moving through the digestive tract. The most common cause of gastroparesis is diabetes. In this case, the physician did link the gastroparesis to the patient's diabetes, so we will use a diabetic complication code. In ICD-10-CM Alphabetic Index look for Diabetes, diabetic/type 2/with/gastroparesis which directs you to E11.43. Even if the provider had not linked the gastroparesis with diabetes, because it is listed under 'with' in the Alphabetic Index, there is a presumed causal relationship. In the Tabular List, there is an instructional note for code K31.84 that indicates to Code first underlying disease, if known and code E11.43 is listed. There is also an Excludes2 note under category code K31 which indicates that code E11.43 can be reported with codes in category K31.
A 28-year-old female has constant abdominal pain and diarrhea. The provider runs blood tests and takes a stool sample. A colonoscopy with biopsy is performed to rule out ulcerative colitis. The provider determines the patient has IBS. What is/are the correct diagnosis code(s)? A.K22.0 B.K58.0, R10.9, R19.7 C.K51.90, K58.0 D.K58.0
Answer: D. K58.0 Rationale: IBS is an acronym for Irritable Bowel Syndrome and can cause the intestinal tract to contract stronger and longer than normal. This may cause symptoms such as abdominal pain, constipation or diarrhea, and/or flatulence. To find IBS in the ICD-10-CM, look in the ICD-10-CM Alphabetic Index for Syndrome/irritable/bowel/with/diarrhea leading you to code K58.0. Abdominal pain and diarrhea are symptoms of IBS, and not coded separately. Ulcerative colitis is a rule-out diagnosis and is not coded.