Chapter 9 - Section Review Quizzes

What is the ICD-10-CM code for primary malignant thymoma? A.C37 B.C73 C.D15.0 D.D09.8

Answer: A. C37 Rationale: Primary malignancy of the thymus is coded with C37. Look in the ICD-10-CM Alphabetic Index for Thymoma/malignant.

A 4-month-old infant presents to the physician with cold-like symptoms, coughing, and wheezing. The infant is diagnosed with bronchiolitis due to RSV. How is this condition coded? A.J21.0 B.J21.8 C.J21.0, B97.4 D.R05, B97.4

Answer: A. J21.0 Rationale: RSV is a common cause for bronchiolitis. Look in the ICD-10-CM Alphabetic Index for Bronchiolitis/due to/respiratory syncytial virus. Code J21.0 is a combination code used to describe a diagnosis with an associated secondary process (manifestation) or a diagnosis with an associated complication. A secondary code is not required

What portion of the thoracic cavity lies between the lungs and contains the heart? A.Mediastinum B.Diaphragm C.Lymphatic channels D.Bone marrow

Answer: A. Mediastinum Rationale: The mediastinum contains the heart and great vessels and lies between the lungs in the thoracic cavity

Can a diagnostic thoracoscopy be billed with video-assisted thoracoscopic surgery (VATS) under certain circumstances? A.No: A diagnostic thoracoscopy is always included in the surgical VATS. B.No: A surgical VATS is always included in the diagnostic VATS. C.Yes: Anytime a diagnostic VATS and surgical VATS are performed together. D.Yes: When a diagnostic biopsy is performed and submitted for pathologic evaluation, resulting in a surgical VATS.

Answer: A. No: A diagnostic VATS is always included in the surgical VATS. Rationale: Diagnostic thoracoscopy is bundled into surgical VATS and cannot be billed separately during the same surgical session, per CPT® instruction

A thoracotomy procedure was performed for repair of hemorrhage and lung tear. What CPT® code is reported? A.32100 B.32110 C.32120 D.32151

Answer: B. 32110 Rationale: Thoracotomy main code is 32100; control of the hemorrhage and lung tear would be code 32110. In the CPT® Index, look for Thoracotomy/Hemorrhage

A patient with adenocarcinoma of the larynx has developed cervical adenopathy and is undergoing an excisional biopsy of the right cervical node. An incision is made above the clavicle and dissection taken down into the muscle. Blunt dissection was used to work the way down to the node, which was firm and white. The entire node was taken, and the wound was closed. What CPT® code is reported? A.38500 B.38510 C.38520 D.38542

Answer: B. 38510 Rationale: The patient had a deep cervical node excisional biopsy. It is considered deep because the node was below the muscle. Look in the CPT® Index for Biopsy/Lymph Nodes/Open and you are directed to 38500, 38510-38530. There is no mention of excision of the scalene fat pad. 38510 is for a biopsy of the deep cervical node(s)

What is the major muscle used during respiration? A.Intercostal muscles of the ribs B.Diaphragm C.Abdominal muscles D.Chest wall or pectoral muscles

Answer: B. Diaphragm Rationale: The diaphragm separates the thoracic cavity from the abdominal cavity and is the primary muscle used during respiration. The diaphragm contracts during inspiration and relaxes during exhalation.

What is the ICD-10-CM code for acquired lymphedema? A.I88.1 B.I89.0 C.Q82.0 D.I88.8

Answer: B. I89.0 Rationale: Acquired lymphedema typically occurs after major surgery or cancer treatment such as radiation therapy. It is more common than congenital lymphedema. Look in the ICD-10-CM Alphabetic Index for Lymphedema (acquired) (see also Elephantiasis). Locate Elephantiasis (nonfilarial) referring you to I89.0.

What is the ICD-10-CM code for a child with an acute exacerbation of hay fever asthma? A.J45.22 B.J45.901 C.J45.32 D.J45.902

Answer: B. J45.901 Rationale: Look in the ICD-10-CM Alphabetic Index for Asthma/with/Hay Fever which points to see Asthma, allergic extrinsic. Locate Asthma/allergic extrinsic/with/exacerbation (acute) referring you to J45.901. In ICD-10-CM asthma codes are specific to severity - mild, moderate, severe as well as intermittent or persistent. In this case the indexing leads to an unspecified code.

What is the term for removal of part of the lymph system? A.Lymphoma B.Lymphadenectomy C.Lymphadenitis D.Lymphedema

Answer: B. Lymphadenectomy Rationale: The suffix "ectomy" means removal, so lymphadenectomy is the correct answer

An indirect endoscopic procedure of the larynx means the larynx is viewed: A.Directly with a scope B.With mirrors C.Through an open incision D.Through an open mouth

Answer: B. With mirrors Rationale: Indirect endoscope of the larynx is performed by viewing the larynx with the use of mirrors. A direct laryngos-copy is the use of an endoscope to look directly at the larynx.

Can bronchoscopy codes be coded together by a physician, and if yes, how? Are multiple procedures reported with modifier 51? A.No. B.Yes: Report multiple procedures with modifier 51 (if required by the payer). C.Yes: Report distinct procedures with modifier 59. D.Yes: Report multiple bronchoscopy codes together because no modifier is required.

Answer: B. Yes: Report multiple procedures with a modifier 51 (if required by the payer). Rationale: Yes, bronchoscopy codes are billed as multiple procedures with a modifier 51. List the highest RVU valued code first and then all other codes with a modifier 51.

A patient with right arm and shoulder pain, and a droopy eyelid is referred to a pulmonologist after the discovery of an abnormality in the right upper lobe on a recent chest X-ray. The pulmonologist orders a CT scan and determines the patient has a Pancoast tumor. What ICD-10-CM code is used to report this? A.C34.10 B.C34.12 C.C34.11 D.C34.91

Answer: C . C34.11 Rationale: A Pancoast tumor is typically a fast growing, non-small cell tumor in the upper part of the lung. Look in the ICD-10-CM Alphabetic Index for Pancoast's syndrome or tumor, C34.1-. A 5th character is needed to identify laterality. C34.11 identifies a malignant neoplasm of the upper lobe of the right lung

Patient is a mouth-breather. He is diagnosed with inflamed inferior turbinates and a superficial ablation is performed. What CPT® code is reported? A.30802 B.30140 C.30801 D.30802-52

Answer: C. 30801 Rationale: Code 30801 is superficial ablation of the turbinates, as compared to 30802, which is intramural ablation of the turbinates. Code 30140 is a submucous resection of the inferior turbinate, not an ablation. In the CPT® Index, look for Ablation/Turbinate Mucosa which directs you to 30801-30802

What is the ICD-10-CM code selection for a patient with whooping cough who presents with pneumonia? A.J12.9 B.A37.01 C.A37.91 D.J18.9

Answer: C. A37.91 Rationale: This condition is coded with a combination code. A combination code is a single code used to describe a diag-nosis with an associated secondary process (manifestation) or a diagnosis with an associated complication. A secondary code is not required. In the ICD-10-CM Alphabetic Index locate Pneumonia/In (due to)/whooping cough.

Where does the exchange of oxygen and carbon dioxide take place within the lungs? A.Bronchioles B.Larynx C.Alveoli D.Windpipe

Answer: C. Alveoli Rationale: The alveoli or air sacs are where the exchange of oxygen from the lungs and carbon dioxide from the capillaries of the circulatory system takes place. High partial pressure of oxygen in the alveoli diffuses into the low partial pressure of oxygen in the capillaries and high partial pressure of carbon dioxide in the capillaries diffuses to the low partial pressure of carbon dioxide in the alveoli.

Where is the mediastinum located? A.Left upper abdominal quadrant B.Muscle that separates the abdominal and thoracic cavities C.In between the two lungs D.Below the diaphragm

Answer: C. In between the two lungs Rationale: The mediastinum is the part of the thoracic cavity between the lungs that contains the heart, aorta, esophagus, trachea, and thymus gland, as well as blood vessels and nerves. The Diaphragm is the muscle separating the thoracic and abdominal cavities and plays a significant role in respiration

What is the ICD-10-CM code for a patient who presents with enlarged tonsils and adenoids for the fourth time in a year? A.J35.03 B.J35.9 C.J35.3 D.J03.90

Answer: C. J35.3 Rationale: Repetitive enlargement of the tonsils and adenoids in a year is a chronic condition. Look in the ICD-10-CM Alphabetic Index for Enlargement, enlarged (see also Hypertrophy)/adenoids/with tonsils

What is also referred to as the "windpipe?" A.Bronchus B.Larynx C.Trachea D.Glottis

Answer: C. Trachea Rationale: The trachea carries air from the mouth and throat down to the lungs and is often referred to as the windpipe.

What is another name for the larynx? A.Windpipe B.Trachea C.Voice box D.Epiglottisv

Answer: C. Voice box Rationale: The larynx is responsible for speech and is known as the voice box.

Which code(s) describe(s) bilateral endoscopic nasal procedure to diagnose breathing problems? A.31231-50 B.31230-RT, 31230-LT C.31233 D.31231

Answer: D. 31231 Rationale: Code 31231 is a diagnostic nasal endoscopy, unilateral or bilateral. No modifier is necessary. In the CPT® Index, look for Endoscopy/Nose/Diagnostic which directs you to 31231-31235

Which CPT® code(s) describes VATS therapeutic wedge resection of the left upper lobe followed by left upper lobectomy? A.32480 B.32505, 32480 C.32663, 32666 D.32663

Answer: D. 32663 Rationale: CPT® subsection guidelines for Lungs and Pleura indicate therapeutic wedge resection is bundled into the lobec-tomy when it is the same lobe. The wedge resection can only be coded separately if it was performed on a different lobe or contralateral lung.

A patient has a mass in her left axilla that is a suspected recurrence of lymphoma. She has a left axillary node excisional biopsy. The lymph node biopsied is under the pectoralis minor. What CPT® code is reported? A.38500 B.38562 C.38745 D.38525

Answer: D. 38525 Rationale: The patient has an excisional biopsy of the left axillary node. Because the lymph node biopsied is under the pectoralis minor muscle, it is considered a deep lymph node. Look in the CPT® Index for Biopsy/Lymph Nodes/Open and you are directed to 38500, 38510-38530. 38525 is for biopsy of the deep axillary nodes

How many lobes are in both lungs combined? A.6 B.3 C.2 D.5

Answer: D. 5 Rationale: There are five lobes total, three in the right and two in the left.

Which of the following is not one of the four organs of the lymph system? A.Spleen B.Thymus gland C.Tonsils D.Bone Marrow

Answer: D. Bone Marrow Rationale: Bone marrow is not an organ of the lymphatic system; rather, it is included in the hemic system.

What protects the trachea from food or liquids entering? A.Larynx B.Glottis C.Voice box D.Epiglottis

Answer: D. Epiglottis Rationale: The epiglottis is the lid that covers the larynx during swallowing to prevent food or liquid from entering the trachea, which can lead to choking

A patient presents to the physician with persistent stuffiness and facial pain. The physician documents a diagnosis of nasal polyps. What ICD-10-CM code is reported? A.J33.0 B.J33.8 C.J33.1 D.J33.9

Answer: D. J33.9 Rationale: Look in the ICD-10-CM Alphabetic Index for Polyp, polypus/nasal, J33.9. This is the correct code for an unspecified nasal polyp

What is the ICD-10-CM code selection for a patient with COPD presenting with an acute bronchitis? A.J44.0 B.J21.8 C.J44.9 D.J44.0, J20.9

Answer: D. J44.0, J20.9 Rationale: Acute bronchitis with COPD should be coded as COPD with a lower respiratory tract infection. An instruc-tional note states to code also for the infection. In this case - we know bronchitis is the infection, but the infectious agent is not specified. Look in the ICD-10-CM Alphabetic Index for Disease/pulmonary/chronic obstructive with lower respiratory infection referring you to J44.0. Look for Bronchitis/acute or subacute referring you to J20.9.

A 20-year-old male presents to the emergency department (ED) with chest pain and shortness of breath. Chest X-ray reveals a pneumothorax. The patient gives a history of no recent trauma; patient smokes two packs of cigarettes a day. The ED physician documents a diagnosis of spontaneous tension pneumothorax. What is the ICD-10-CM code selection? A.S27.0XXA B.S27.0XXA, Z77.22 C.J93.0 D.J93.0, F17.210

Answer: D. J93.0, F17.210 Rationale: Spontaneous tension pneumothorax is reported with J93.0. Look in the ICD-10-CM Alphabetic Index for Pneu-mothorax NOS/tension (spontaneous). Nicotine dependence is reported as it could be significant to the patient's condition. Look in the ICD-10-CM Alphabetic Index for Dependence/drug/nicotine/cigarettes

Which CPT® code describes a pneumonectomy? A.32442 B.32440 C.32440-50 D.32445

nswer: B. 32440 Rationale: A pneumonectomy is removal of a lung. In the CPT® Index, look for Pneumonectomy 32440-32445. Read the code descriptors to select the correct code