AAPC CPC Chapter 9 – Flashcards

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

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

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

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

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

A patient with adenocarcinoma of the larynx has developed cervical adenopathy 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

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

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

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

A thoracotomy procedure was performed for repair of hemorrhage and lung tear. What CPT® code is reported? A) 32100 B) 32110 C) 32120 D) 32420

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

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

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

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

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

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

CASE 1 Preoperative Diagnosis: Recurrent pleural effusion, stage IV right lung cancer. Postoperative Diagnosis: Recurrent pleural effusion, stage IV right lung cancer.(Report this diagnosis if no further findings are found in the notes.) Procedure Performed: Video-assisted thoracoscopy,(Indication the procedure is being performed by Video Assisted Thoracic Surgery (VATS).) lysis of adhesions, talc pleurodesis Procedure: Patient was brought to the operating room and placed in supine position. IV sedation and general anesthesia were administered, per the anesthesia department. A double-lumen endotracheal tube was placed, per anesthesia. The position was confirmed by bronchoscopy. The patient was placed in the decubitus position with the right side up. The chest was prepped in the standard fashion with ChloraPrep, sterile towels, sheets, and drapes. A small incision is made between two ribs and a standard port placement was utilized to gain access to the tho-racic cavity. The endoscope is inserted into the chest cavity. We had excellent isolation of the lung; however, we had poor exposure because there were a number of fibrous adhesions, a few were actually very dense. We immediately evacuated approximately 700 ml of fluid;(Indicating of pleural effusion(fluid around the lung, in the pleural space).) however, once we entered the chest we encountered a number of loculated areas. We did not break down the adhesions. We gained enough exposure to do a complete talc pleurodesis. After lysing of adhesions,(Removal of the adhesions to get to the thoracic cavity was necessary to perform the pleurodesis, it is not reported separately.) we were confident that we had access to the entire thoracic cavity. Eight grams of talc were introduced into the right thoracic cavity and strategically placed under direct vision.(Pleurodesis.) The chest tubes were then placed. The wounds were closed in layers. The patient tolerated the procedure well and was taken to the recovery room in stable condition. What are the CPT® and ICD-10-CM codes reported? CPT code: ICD-10-CM codes (2):

CASE 2 Preoperative diagnosis: malignant neoplasm glottis Postoperative diagnosis: malignant neoplasm glottis(Diagnosis to report for the procedure.) Procedure: An incision is made low in the neck. The trachea is identified in the middle and an opening is created to allow for the new breathing passage. A tracheostomy(This is the performed procedure.) tube is inserted and secured with sutures. The patient tolerated the procedure well and was sent to recovery without complications. What are the CPT® and ICD-10-CM codes reported? CPT® code: ICD-10-CM code:

CASE 3 Preoperative Diagnosis: Pedestrian in a MVA involving a car, left pneumothorax. Postoperative Diagnosis: Pedestrian in a MVA involved a car, left pneumothorax.(Report the post-operative diagnosis and verify from the operative note.) Procedure: Bronchoscopy, left VATS,(Statement of two procedures performed, must be verified in the body of the operative note.) wedge resection. Procedure: Patient was brought into the operating room and placed in supine position. IV sedation and general anesthesia was administered, per the anesthesia department. A single lumen endotrachial tube was placed for bronchoscopy, per anesthesia. Due to the nature of the trauma,(Traumatic pneumothorax.) we were interested in ruling out a bronchial tear. The bronchoscope was introduced in the mouth and passed into the throat without difficulty. There was no evidence of sanguineous drainage or bronchial trauma noted to the left mainstem. There were copious amounts of secretions noted and removed without difficulty. The right mainstem was also cannulated and found to be free of unexpected trauma. The bronchoscopy was terminated at that time.(Diagnostic bronchoscopy.) A double lumen endotracheal tube was placed, per anesthesia. The position was confirmed by bronchoscopy. The patient was placed in the decubitus position with the left side up. The chest was prepped in standard fashion with Betadine, sterile towels, sheets, and drapes. A small incision is made along the upper boarder of the fourth rib just below the intercostal space and a standard port placement was utilized to gain access to the thoracic cavity. An endoscope was inserted into the chest cavity. Initially we had excellent exposure with good isolation of the lung.(Thoracoscope was used.) We identified a large bleb at the apex of the lower lobe of the left lung, which was likely to be the source of the chronic air leak. We removed the area of the large bleb at the apex with a wedge resection using thoracoscopic green load for therapeutic correction of the patient's pneumothorax.(Wedge resection.) The wounds were closed in layers. Chest tubes were placed. The patient tolerated the procedure well and was taken to the recovery room. What are the CPT® and ICD-10-CM codes reported? CPT® codes: ICD-10-CM codes:

CASE 4 Preoperative diagnosis: 1. Chronic hyperplastic rhinosinusitis 2. Allergies 3. Status post-prior polypectomy and sinus surgery Postoperative diagnosis: 1. Intranasal and sinus polyps (Report the diagnoses if no further positive findings are found in the operative note.) 2. Chronic hyperplastic rhinosinusitis (Report the diagnosis if no further positive findings are found in the operative note.) Operative procedure: Left sinusotomy (three or more sinuses) including: • Nasal and sinus endoscopy • Endoscopic intranasal polypectomy • Endoscopic total sinus ethmoidectomy • Endoscopic sphenoidotomy • Endoscopic nasal antral windows, middle meatus, and inferior meatus • Endoscopic removal of left maxillary sinus contents Right sinusotomy (three or more sinuses) including: • Nasal and sinus endoscopy • Endoscopic intranasal polypectomy(Indication the surgery will be performed through an endoscope.) • Endoscopic total sinus ethmoidectomy • Endoscopic sphenoidotomy • Endoscopic nasal antral windows, middle meatus, and inferior meatus • Endoscopic removal of right maxillary sinus contents Specimens sent to pathology: 1. Left ethmoid and sphenoid contents for routine and fungal cultures 2. Right maxillary contents for routine and fungal cultures 3. Left intranasal ethmoid, sphenoid, and maxillary specimens for pathology 4. Right ethmoid, sphenoid, maxillary, and right intranasal contents for pathology Findings: Complete nasal obstruction by polyps(Report this diagnosis for the intranasal polyps.) obscuring of all of the normal landmarks. The right middle turbinate was found and preserved. The residual body of the left middle turbinate was found and preserved. There was thickened hyperplastic mucosa throughout the sinuses with some polyps in the sinuses,(Documentation supports the presence of sinus polyps.) and the majority of the sinus cavities were filled with glue-like mucopurulent debris. At the end of the case there were no visible polyps, the airway was clear, and the debris had been removed. Procedure: The patient was taken to the operating room, placed in the supine position, and general endotracheal anesthesia was obtained adequately. A pharyngeal pack was placed. The nose was infiltrated with Xylocaine with epinephrine, and cottonoids soaked in 4% cocaine were placed. The procedure was performed in a similar manner bilaterally. The cottonoids were removed. The 30-degree, wide-angle sinus telescope with Endo-scrub and the Stryker Hummer device were used to remove the polyps starting anteriorly and working posteriorly. This led to visualization of the middle turbinates.(Endoscope was used for the surgical excision of nasal polyps obstructing normal anatomical landmarks. A total excision was performed with the operative note indicating the removal was performed anteriorly and posteriorly(front to back).) The middle meati disease was removed. The area of the uncinate process and infundibulum was shaved away and forceps were used to remove portions of bone particle. Using blunt dissection, the agger nasi cells, ethmoid and sphenoid sinuses were entered and the contents removed with forceps and suction.(Diseased tissue removed in the ethmoid and sphenoid sinuses.) The inferior turbinates were infractured; a mosquito clamp was placed through the lateral nasal wall into the maxillary sinuses through the inferior meatus. That opening was opened with forward and backward biting forceps,(Maxillary antrostomy.) sinus endoscopy was performed, and inspissated mucus and debris cleaned out of the sinuses.(Diseased tissue removed in the maxillary sinus.) In a similar manner the sinuses were opened from the middle meatus and the sinuses cleaned.(Indication this is a bilateral procedure.) Like before, the ethmoid, sphenoid, and maxillary sinuses were cleaned of debris, and inspissated mucus was suctioned from the frontal recesses. The patient was then suctioned free of secretions, with adequate hemostasis noted. Gelfilm was soaked, rolled, and placed in the middle meati. Telfa gauze was infused with Bacitracin, folded and placed in the nose. Vaseline gauze was placed between the folds of Telfa. The pharyngeal pack was removed. He was suctioned free of secretions, with adequate hemostasis noted, and the procedure terminated. He tolerated it well and left the operating room in satisfactory condition. What are the CPT® and ICD-10-CM codes to report? CPT® codes (2): ICD-10-CM codes (3):

CASE 5 Preoperative Diagnoses 1. Sarcoid of lymph nodes(Diagnosis if no further positive findings are found in the operative note.) 2. New onset paratracheal adenopathy(Diagnosis if no further positive findings are found in the operative note.) Postoperative Diagnoses 1. Sarcoid of lymph nodes 2. New onset paratracheal adenopathy Procedure Performed: Mediastinotomy(Indication of what procedure is being performed.) Description of Procedure: The patient was brought to the operating room and placed in supine position. IV sedation and general anesthesia was administered by the anesthesia department. The neck was prepped in standard fashion with betadine scrub, sterile towels and drapes. A standard linear incision was made over the trachea.(Procedure performed with the anterior cervical approach.) We were able to dissect down the pretracheal fascia into the mediastinum without difficulty. The extensive adenopathy was immediately apparent just below the innominate artery on the right paratracheal side. One exceedingly large lymph node was identified and biopsied extensively.(Biopsy performed.) The specimen was sent to pathology. Hemostasis was obtained without difficulty. The region was infused with a marcaine, lidocaine, and epinepherine mixture. The wound was closed in layers. The skin was closed with subcutaneous stitches and covered with Dermabond. The patient tolerated the procedure well and was taken to the recovery room in stable condition. What are the CPT® and ICD-10-CM codes reported? CPT® code: ICD-10-CM codes (2):

CASE 6 Preoperative Diagnosis 1. Loculated left pleural effusion, chronic Postoperative Diagnosis 1. Loculated left pleural effusion, chronic Procedure Performed: Attempted, ultrasound guided thoracentesis Description of Procedure: The patient was prepped and draped in the sitting position. Using ultrasound guidance and 1% lidocaine, the thoracic catheter was introduced into the pleural space where we encountered very thick fibrous type pleura. The catheter was advanced, and we were unable to aspirate fluid. The catheter was removed. Sterile dressings were applied. Chest x-ray will be obtained for follow-up. Patient tolerated the procedure well. What are the CPT® and ICD-10-CM codes for this procedure? CPT® code: ICD-10-CM code:

CASE 8 Preoperative Diagnosis: 1. Mass, right upper lobe. Postoperative Diagnosis: 1. Carcinoma, right upper lobe. Procedure Performed: VATS, right superior lobectomy. Description of Procedure: Under general anesthesia, after a double-lumen tube intubation, the right lung was collapsed and the right side up is oriented so the patient is in the left lateral decubitus position. We prepped and draped the patient in the usual manner and gave antibiotics. Then two 1 cm incisions were made along the posterior and mid axillary line at the ninth and seventh intercostal spaces. The lung was deflated and a camera was inserted. A longer (6 cm) incision was made along the fourth intercostal space anteriorly. We then freed up some adhesions at the top of the lung, both in the superior area away from the tumor and in the anterior mediastinal area. The tumor seemed to be in the right upper lobe. The dissection began by ligating the superior pulmonary vein and its branches, and the upper lobe was freed up. The small fissure was incomplete, and I proceeded with the lobectomy. The pulmonary artery branches were then ligated. The bronchus was ligated, as well. The superior branches to the upper lobe were ligated with Endo GIA. The lobe was freed up and sent to pathology. The wound was then closed in layers. A chest tube was placed to suction, and the patient was sent to recovery in stable condition. Pathology confirmed carcinoma. What are the procedure and diagnosis codes for this procedure? CPT® code: ICD-10-CM code:

CASE 9 Preoperative Diagnosis: 1. Grade 3 squamous cell carcinoma of penis with inguinal lymphatic metastasis Postoperative Diagnosis 1. Grade 3 squamous cell carcinoma of penis with inguinal lymphatic metastasis Procedure Performed: Laparoscopic bilateral pelvic lymphadenectomy Description of Procedure: The patient is placed in supine position with thigh abduction. A 1.5 cm incision was made 2 cm distally of the lower vertex of the femoral triangle. The second incision was made 2 cm proximally and 6 cm medially. Two 10 mm Hasson trocars were inserted in these incisions. The last trocar was placed 2 cm proximally and 6 cm laterally from the first port. Radical endoscopic bilateral pelvic lymphadenectomy was performed.The main landmarks-adductor longus muscle medially, the sartorius muscle laterally and the inguinal ligament superiorly, were well visualized. The retrograde dissection using a harmonic scalpel was started distally near the vertex of the femoral triangle towards the fossa ovalis, where the saphena vein was identified, clipped, and divided, towards the femoral artery laterally. After the procedure, one can identify the skeletonized femoral vessels and the empty femoral channel, showing that the lymphatic tissue in this region was completely resected. The surgical specimen was removed through the first port incision. A suction drain was placed to prevent lymphocele, and were kept until the drainage reached 50 ml or less in 24 hours. Patient tolerated the procedure well and was transferred to recovery in stable condition. What CPT® and ICD-10-CM codes are reported? CPT® code: ICD-10-CM codes (2):

CASE 10 Preoperative Diagnosis: Carcinoma, right lung and bronchus intermedius. Procedure Performed: Bronchoscopy. DESCRIPTION OF PROCEDURE: Two liters of oxygen were supplied nasally. The right nostril was anesthetized with two applications of 4% lidocaine and two applications of lidocaine jelly. The posterior pharynx was anesthetized with two applications of Cetacaine spray. The Olympus PF fiberoptic bronchoscope was introduced into the patient's right nostril. The posterior pharynx, epiglottis, and vocal cords were normal. The trachea and main carina were normal. The entire tracheobronchial tree was then visually examined and the major airways. No abnormalities were noted on the left side. There was, however, extrinsic compression of the posterior segment of the right upper lobe. There also appeared to be a submucosal tumor involving the bronchus intermedius between the right upper lobe and right middle lobe. Multiple washings, brushings, and biopsies were taken from the right upper lobe bronchus and bronchus intermedius. The specimens were sent for cytology and routine pathology. The patient tolerated this without complications. The CPT® and ICD-10-CM codes to report are: CPT® codes (2): ICD-10-CM code:

What ICD-10-CM code is reported for a patient that has RSV (respiratory syncytial virus) pneumonia? A) J18.9 B) B97.4 C) J21.0 D) J12.1

In ICD-10-CM, codes for Factors Influencing Health Status and Contact with Health Services begin with which letter? A) A B) Z C) V D) E

What CPT® code is reported for an emergency endotracheal intubation to save the patient's life? A) 31600 B) 31500 C) 31603 D) 31502

Johnny has a penny removed from his left nostril in the provider's office. What CPT® code is reported? A) 30300 B) 30320 C) 30160 D) 30100

What CPT® code is reported for a major thoracotomy for post-op hemorrhage following an endoscopic upper lobectomy? A) 32310 B) 32110 C) 32100 D) 32120

A 43 year-old female is seen in the emergency room with severe epistaxis. She said this is a common occurrence for her during the cold dry months of winter and this is why she is here for the third time this week. Extensive bilateral posterior cautery and packing is again required to control the hemorrhage. What CPT® code is reported for the procedure? (Note: Do not code the E/M) A) 30906-50 B) 30905-50 C) 30903-50 D) 30905-22

Most nasal passages have how many turbinates present on the lateral wall of each nasal cavity? A) 5 B) 2 C) 6 D) 3

An operative report lists excisional bilateral biopsies of deep cervical nodes and biopsy of right deep axillary nodes as the procedures performed. The pathology report comes back confirming lymphadenitis. What CPT® codes are reported? A) 38520-50, 38525-51-RT B) 38520-50, 38505-59, 38740-59-RT C) 38510-50, 38525-51-RT D) 38510, 38525-51-RT

What CPT® codes are reported for an extrapleural pneumonectomy as well as empyemectomy performed during the same surgical session? A) 32440, 32540-51 B) 32445, 32540-51 C) 32440, 32036-51 D) 32445, 32036-51

A 20 year-old patient is seen for 5 transbronchial lung biopsies of 2 separate lobes. One biopsy is taken in one lobe and 4 biopsies in another lobe. What CPT® code(s) is/are reported? A) 31628 B) 31628, 31632 x 4 C) 31628, 31632 D) 31629, 31632

A 55 year-old patient has history of lung cancer of the right lower lobe. He is complaining of difficulty breathing and mild chest pain. Patient is scheduled for a diagnostic VATS (Video-assisted thoracoscopic surgery). Under general anesthesia he was placed in left lateral decubitus position and a thoracoscope was inserted through a port site. The VATS exploration immediately revealed a mass of the left upper lobe. A biopsy was performed and sent to pathology. Results from pathology revealed small cell carcinoma. Decision was made to remove the upper lobe of his left lung by performing an open procedure. The thoracoscope is withdrawn and the surgeon opens the chest cavity and rib spreaders are inserted to separate the ribs to gain access to the lung. The upper lobe of the left lung is identified, isolated and removed. The instruments are removed and the chest incision is closed in layers. What CPT® codes are reported? A) 32440 B) 32480-58, 32608-51 C) 32663 D) 32663, 32601-51

An 18 month-old patient is seen in the ED unable to breathe due to a toy he swallowed which had lodged in his throat. Soon brain death will occur if an airway is not established immediately. The ED provider performs an emergency transtracheal tracheostomy. What CPT® and ICD-10-CM codes are reported? A) 31603, T17.290A B) 31601, 31603, T17.228A C) 31601, J34.9, T17.298A D) 31603, T17.220A

A patient is seen in the OR for removal of a hepatic adenoma which has invaded the diaphragm. The resection of the diaphragm portion of the mass was repaired with primary sutures. What CPT® code is reported for the diaphragmatic mass resection? A) 39540 B) 39560 C) 39545 D) 39561

Provide the correct ICD-10-CM code(s) for acute RSV bronchiolitis. A) J21.8, B97.4 B) J20.9 C) J21.8 D) J21.0

A patient with AML (Acute Myelogenous Leukemia) has just learned his sister is an HLA (Human Leukocyte Antigen) match for him. Stem cells taken from the donor (the patient's sister) will be transplanted into the patient to help with his treatment. What CPT® code is used to report the harvesting of the stem cells from the donor (his sister)? A) 38206 B) 38204 C) 38205 D) 38207

A patient underwent bilateral nasal/sinus diagnostic endoscopy. Finding the airway obstructed the provider fractures the middle turbinates to perform the surgical endoscopy with total bilateral ethmoidectomy and nasal septoplasty. What CPT® codes are reported? A) 31231, 30130-51, 31255-50 B) 30930, 30520-51, 31255-51 C) 30520, 31255-51 D) 30520, 31255-50-51

A patient presents to the emergency department (ED) with a sucking chest wound. The ED provider on duty performs an immediate tube thoracostomy in order to restore normal breathing to the patient before rushing him to surgery for another provider to address other injuries. What CPT® code is reported by the ED provider? A) It is not coded, as it will be bundled with any procedures performed during surgery. B) 31500 C) 31603 D) 32551

A returning 2 year-old child is seen in the pediatrician's office with stridor and a bark like cough. The pediatrician examines the child quickly and determines the child has stridulous croup. The child is given a nebulizer breathing treatment in the office to improve PO2 levels. Medication used is breathable Epinephrine. What CPT® and ICD-10-CM codes are reported? A) 94644, R06.1, R05 B) 94640, J38.5 C) 94644, J04.2 D) 94642, J38.5, R05, R06.1

A patient with recurrent pneumothoraces presents for chemopleurodesis. Under local anesthesia a small incision is made between the ribs. A catheter is inserted into the pleural space between the parietal and pleural viscera. Subsequently, 5g of sterile asbestos free talc was introduced into the pleural space via the catheter. What CPT® and ICD-10-CM codes are reported? A) 32601, 32560, J95.811 B) 32650, 32560, J93.11 C) 32560, J93.81 D) 32650, J95.811

The surgeon makes an incision in the neck near the cricothyroid membrane for an emergency tracheostomy for a patient who arrives in the emergency room with tracheal crushing injuries suffered in a car accident in which the patient was riding as the passenger. What CPT® and ICD-10-CM codes are reported? A) 31605, S17.0XXA, V49.9XXA B) 31603, S11.10XA, V49.9XXA C) 31612, S21.309A, V86.19XA D) 31600, S21.309A, V86.19XA

A 45 year-old presents with acute pericarditis. The surgeon makes a small incision between two ribs and enters the thoracic cavity. An endoscope is introduced and the pericardial sac is examined by direct visualization. Using an instrument introduced through the endoscope, the surgeon creates an opening in the pericardial sac for drainage purposes. What CPT® code is reported? A) 32662 B) 32658 C) 32659 D) 32661

An ICU diabetic patient who has been in a coma for weeks as the result of a head injury becomes conscious and begins to improve. The provider performs a tracheostomy closure and since the scar tissue is minimal, the plastic surgeon is not needed. What CPT® and ICD-10-CM codes are reported for this procedure? A) 31825, Z43.0, E11.641, S06.9X9D B) 31820, Z43.0, S06.9X9D, E11.9 C) 31820, E11.641, Z93.0 D) 31825, Z43.0, E11.9, S06.9X9D

A 27 year-old girl has been on the lung transplant list for months and today she will be receiving a LT and RT lung from an individual involved in an MVA. This person was DOA at the hospital and is an organ donor. The donor pneumonectomy was performed by physician A, the backbench work by physician B and the transplant of both lungs into the prepped and waiting patient by physician C. What is the correct coding for the removal (physician A), preparation (physician B) and insertion (physician C) of the lungs? A) 32850, 32856, 32851 x 2 B) 32850, 32855, 32851 C) 32850, 32856, 32853 D) 32850, 32855 x 2, 32850-50

A patient with partial vocal cord paralysis requires bilateral removal of the arytenoids cartilage to improve breathing. The laryngoscope with operating microscope is inserted. Adequate visualization is established and the arytenoid cartilage is exposed by excision of the mucosa overlying it. What diagnosis and procedure codes are reported for this procedure? A) 31560, J38.00 B) 31561, 69990, J38.02 C) 31561, J38.02 D) 31560, 69990, J38.02C

A 14 year-old boy presents at the Emergency Department experiencing an uncontrolled epistaxis. Through the nares, the ED provider packs his entire nose via an anterior approach with extensive packing of medicated gauze. In approximately 15 minutes the nosebleed stops. What CPT® and ICD-10-CM codes are reported? A) 30901-50, R04.0 B) 30903-50, R04.0 C) 30901, I78.0 D) 30905, R04.0

What ICD-10-CM code is reported for spontaneous pneumothorax? A) S27.0XXA B) J93.83 C) J95.811 D) S27.2XXA

What CPT® code is reported for a frontal sinusotomy, nonobliterative, with osteoplastic flap, brow incision? A) 31080 B) 31086 C) 31084 D) 31087

What ICD-10-CM code is reported for pyopneumothorax with fistula? A) J86.0 B) J95.811 C) J93.9 D) J86.9

A surgeon performed a transthoracic median sternotomy for exploration of the space around the lung sacs and for drainage of fluid, caused by pneumonia. What is/are the appropriate code(s) for this scenario? A) 39010 B) 39220, 32554-51 C) 39000, 32554-51 D) 39401

What anatomical cavity or compartment contains all of the thoracic viscera except the lungs? A) Mediastinum B) Peritoneum C) Mesentery D) Thoracic

Where in the respiratory system is the carina located? A) Inferior turbinate B) Sphenoid sinus C) Tracheal bifurcation D) Left bronchus

Which statement is TRUE regarding coding COPD with asthma in ICD-10-CM? A) Only the asthma is reported. B) COPD with bronchitis is reported for COPD with asthma. C) The type of asthma is reported along with the COPD. D) Only the COPD is reported.

A patient's nose was hit with a baseball during a high school baseball game. At that time reconstruction was performed with local grafts. Patient returns now as an adult, discontent with the bony prominence along the bony pyramid and flat look of the tip of the nose. He underwent major repair with osteotomies and nasal tip work. What CPT® code is reported? A) 30462 B) 30410 C) 30435 D) 30450

A 25 year-old male presents with a deviated nasal septum. The patient undergoes a nasal septum repair and submucous resection. Cartilage from the bony septum was detached and the nasoseptum was realigned and removed in a piecemeal fashion. Thereafter, 4-0 chronic was used to approximate mucous membranes. Next, submucous resection of the turbinates was handled in the usual fashion by removing the anterior third of the bony turbinate and lateral mucosa followed by bipolar cauterization. What CPT® codes are reported? A) 30620, 30999-51 B) 30520, 30140-51 C) 30420, 30140-51 D) 30450, 30999-51

A 20 year-old female who returned from spring break in Mexico six days ago, presents to the ED with a high fever for three days, a sore throat, general aches and a miserable cough. The ED provider suspects flu and orders a rapid flu test. What ICD-10-CM code(s) is reported? A) R50.9, J02.9, R52, R05 B) J11.1, R50.9, J02.9, R05 C) J11.1 D) J09.X9

How are multiple moderate lacerations of the spleen, initial encounter coded in ICD-10-CM? A) S36.030A B) S36.039A C) S36.031A D) S36.032A