question

What 7 items are included in the surgical package?

answer

procedures, local anesthesia, one related E/M encounter prior, immediate post op care, order prep, evaluation of patient in recovery, typical post op follow up care

question

What six items are included in the Medicare surgical package for major surgeries?

answer

procedure, pre op services prior, post op follow up, complications, post surgical pain management, insignificant surgical procedures not done in operating room

question

What three items are included in Medicare surgical package for minor surgeries?

answer

procedure, pre op services prior, post op follow up

question

For major surgeries, Medicare allows post op follow up care for up to _____.

answer

90 days

question

For minor surgeries, Medicare allows post up follow up care for up to _____.

answer

10 days

question

True or False. Treatment for any complications that occur during the post op period are included in the surgical package.

answer

False

question

NCCI stands for

answer

National Correct Coding Initiative

question

Who developed NCCI?

answer

CMS

question

The NCCI was created to promote ______ nationwide and prevent ________.

answer

correct coding, inappropriate unbundling

question

Coding edits that pertain to HCPCS that should not be used together

answer

comprehensive component edits

question

Coding edits that apply to improbable or impossible combinations of codes

answer

mutually exclusive edits

question

Body parts that are included in the integumentary subsection

answer

skin, nails, breasts

question

What information must be known to accurately code excision of lesions (4)?

answer

type of lesion, site, size, type of closure

question

When taking into account the size of an excised lesion, you should always include ______.

answer

margins

question

The surgeon records that he excised a 5cm lesion with 2 cm margins. How big was the total excision?

answer

9cm

question

The adjacent tissue transfer codes include the _______ or ______ and _____.

answer

tissue transfer, rearrangement, excision

question

This type of wound repair primarily involves the epidermis, dermis or subcutaneous tissues without involvement of deeper structures.

answer

simple

question

This type of wound repair requires the suturing of only one layer.

answer

simple

question

This type of would repair involves one or more of the deeper layers of subcutaneous tissue and superficial fascia and skin.

answer

intermediate

question

This type of wound repair is closed in layers.

answer

intermediate

question

If a wound requires closure of the subcutaneous tissue or more than one layer beneath the dermis, it is considered an ______ repair.

answer

intermediate

question

A one layer wound that is heavily contaminated and requires extensive cleaning would be an _____ repair.

answer

intermediate

question

This type of wound repair goes beyond layered closure and requires scar revision, debridement, undermining, stents, or retention sutures.

answer

complex

question

What information is needed to code wound closures (4)?

answer

type of repair, site, extent of wound, length of repair

question

Debridement can be reported separately from wound repair when it requires _____, _____ of considerable amounts of _______, or if it is carried out _____.

answer

prolonged cleansing, removal, tissue, separately

question

When coding repairs of multiple wounds you add together the lengths of wound in the _____ from the _______.

answer

same classification, same anatomic groups

question

When sequencing codes for multiple wound repairs the most ______ is reported first.

answer

complicated

question

Are superficial wounds closed only with Steri strips and bandages reported with simple repair codes?

answer

no

question

This involves treating damaged or lost skin in which a piece is taken from another area and transplanted to damaged or missing section.

answer

skin grafting

question

This type of skin grafting involves making an incision above, through, and below scar or defect.

answer

z plasty

question

This type of skin grafting is used to reposition a scar so it more closely conforms to the natural lines and creases of the skin.

answer

z plasty

question

This type of skin grafting involves a series of triangular flaps; two are removed and then the other two are moved together and sutured into place.

answer

w plasty

question

This type of skin grafting involves a v shaped incision with advancement and stretching of the skin. The defect is then covered and forms a Y when sutured.

answer

v y plasty

question

This type of skin grafting involves a curved or semicircular incision of the skin and subcutaneous tissues.

answer

rotational flap

question

This type of skin grafting involves the sliding of a pedicle graft into the new position.

answer

advancement

question

The physician records 3cm, 4cm, and 6cm simple wound repairs of the elbow and forearm. He also records a 5 cm intermediate wound repair of the arm. What is the total length of the simple would repair to be coded? What is the total length of the intermediate wound repair?

answer

13cm, 5cm

question

This type of skin grafting involves grafted tissue that remains connected to the vascular bed.

answer

pedicle graft

question

This type of skin grafting is obtained from a genetically dissimilar individual.

answer

allograft

question

This type of skin grafting is obtained from a different species.

answer

xenograft

question

This type of skin grafting involves a piece of skin taken from a donor and place on the damaged area.

answer

free skin graft

question

This type of skin grafting involves the removal of skin leaving one end still attached; the skin is then folded over the damaged area.

answer

pedicle flap graft

question

This type of skin grafting involves applying biomaterial engineered tissue to substitute for skin autograft or allograft.

answer

skin substitute

question

This is a piece of skin cut away near site and transferred with the base attached.

answer

flap

question

Used for skin cancer, this treatment involves excising the tissue all the way down until no cancer is found; involves several stages with histologic exam of 100% of the surgical margins.

answer

mohs micrographic surgery

question

This type of breast biopsy removes the entire lesion.

answer

excisional

question

This type of breast biopsy removes only a portion of the lesion.

answer

incisional

question

How are procedures performed on both breasts indicated?

answer

modifier 50

question

This involves fixing a fracture by exposing the site via surgical incision.

answer

open treatment

question

This involves fixing a fracture without surgical excision.

answer

closed treatment

question

When a fracture is treated with reduction or restoration it is _________.

answer

manipulated

question

Additional codes for casts and strapping would apply for ________ or to afford ______.

answer

replacement casts, pain relief

question

Additional codes for casts and strapping would apply for initial casts without __________, when __________ does not perform ______, when ______ provides or will provide _______.

answer

restorative treatment, same physician, treatment, another physician, treatment

question

If a patient had both diagnostic and surgical arthroscopy, which procedure would be coded?

answer

surgical

question

_______ endoscopic procedures are automatically included as part of the code when the patient has a surgical endoscopic procedures.

answer

diagnostic

question

When a diagnostic and surgical endoscopy is performed during the same operative episode which procedure(s) do you report?

answer

surgical

question

If a procedure from 31231-31294 (nasal sinus endoscopy) is reported as bilateral, you will need ______ because these codes are assumed ______.

answer

modifier 50, unilateral

question

This type of laryngoscopy uses a small mirror to visualize the vocal chords.

answer

indirect

question

This type of laryngoscopy uses a scope to visualize the vocal chords.

answer

direct

question

Would the use of an operating microscope affect your code choice when coding laryngoscopy?

answer

yes

question

When an operating microscope is used during a laryngoscopy, a _______ is used.

answer

separate code

question

______ requires that the catheter be removed, manipulated, or guided into a part of the arterial system other than aorta or the vessel punctured.

answer

selective arterial catheterization

question

______ involves the placement of a catheter or needle directly into an artery or it is negotiated only into the thoracic or abdominal aorta from any approach.

answer

nonselective arterial catheterization

question

_________ includes catheter placement in those veins that rise directly from the vena cava or the vein punctured directly (primary) and any subsequent (secondary) branches of the primary venous branches.

answer

selective venous catheterization

question

______ involves direct puncture of peripheral veins and the vena cava; or placement of the catheter in the inferior or superior vena cava by any route.

answer

non selective venous catheterization

question

What are the two components of a pacemaker?

answer

leads, generator

question

How many codes need to be assigned to fully code arterial-venous bypass grafting?

answer

two

question

When a small, flexible tube is placed in large veins for frequent access, it is called a ______.

answer

central insertion

question

When a tube is placed in the arm and advanced into the larger subclavian vein, it is called a ______.

answer

peripheral insertion

question

________ catheters are fixed in place at the site of insertion, with the catheter and attachments protruding directly.

answer

non tunneled

question

______ catheters are passed under the skin from the insertion site to a separate exit site, where the catheter and its attachments emerge from underneath the skin.

answer

tunneled

question

This is a passageway between an artery to a vein which is surgically created for hemodialysis treatments.

answer

av fistula

question

This is the surgical removal of a clot.

answer

Thrombectomy

question

Is a CPT code assigned if the nurse inserts the catheter?

answer

no

question

Is a CPT code assigned if removal of a catheter involves pulling it out at the bedside?

answer

no

question

This is a scope of the upper gastrointestinal region including the esophagus, stomach and upper duodenum.

answer

EGD

question

This is a scope of the rectum and sigmoid colon.

answer

proctosigmoidoscopy

question

This is a scope of the rectum, sigmoid, and portion of descending colon.

answer

sigmoidoscopy

question

This is a scope of the entire colon, from the rectum to cecum.

answer

colonoscopy

question

What modifier is assigned if a patient is prepped for a colonoscopy, but the procedure was incomplete?

answer

53

question

What information is needed in order to assign CPT codes for hernia repairs(5)?

answer

type or site, initial or recurrent, age, clinical presentation, surgical treatment

question

What methodology is used to categorize genitourinary endoscopies(2)?

answer

body part, procedure

question

How many codes would be assigned for a procedure involving a hysteroscopic biopsy and dilation and curettage of the uterus?

answer

one

question

What is commonly performed with a hysteroscopic biopsy?

answer

dilation and curettage

question

To code spinal injections, coders need to determine what two things?

answer

site, substance

question

To code spinal surgery, coders need to determine what three things?

answer

surgical approach, location, procedure

question

How many codes are used for cataract extraction with the insertion of intraocular lens prosthesis during the same operative episode?

answer

one

question

Type of cataract extraction where the lens with capsule are removed.

answer

intracapsular

question

Type of cataract extraction where the lens is removed without the capsule.

answer

extracapsular

question

What term should you use if a physician performed a myringotomy for the insertion of a ventilating tube?

answer

tympanostomy

question

This phrase, which is in parentheses after code description, allows you to code a procedure if it is not an integral part of another procedure.

answer

separate procedure

question

The national correct coding initiative applies to _____ and _____.

answer

physicians, hospitals

question

NCCI updates _______.

answer

quarterly

question

For debridement, coding decisions are based on _____ and _____.

answer

deepest level, size

question

For debridement, the surface area of multiple wounds can be added if they are the same _____.

answer

depth

question

Destruction of lesions include what four methods?

answer

electrosurgery, cryosurgery, laser, chemical treatment

question

Skin grafts are measured in _____.

answer

square centimeters

question

For fractures, do you code for the initial cast?

answer

no

question

Type of pacemaker with a pulse generator and one electrode inserted in either the atrium or ventricle.

answer

single chamber

question

Type of pacemaker with a pulse generator and electrodes inserted into both the atrium and ventricle.

answer

dual chamber

question

When coding central venous access procedures, what are four things that must be considered?

answer

type of procedure, central or peripheral, tunneled, age

question

Procedures designed to improve blood supply to an area.

answer

endovascular revascularization

question

Endovascular revascularization is differentiated by which three territories?

answer

iliac, femoropopliteal, tibial/peroneal

question

This type of endoscopy is used to visualize the liver, gallbladder, bile ducts, and pancreas.

answer

Endoscopic retrograde cholangiopancreatography

question

Mesh code may only be used as an add on code if used for _____ or _____ hernia repair.

answer

incisional, ventral

question

When physician uses cystoscopy, look under _____.

answer

cystourethroscopy

question

When a catheter is placed into (not at or near the origin) a branch off the aorta or the access vessel. Each of these vessels arising from the aorta or access vessel represents different vascular families.

answer

selective catheterization

question

Refers to a catheter that remains in the accessed vessel or that has made it into the aorta.

answer

nonselective catheterization

question

Surgical method in which a patient's dead, damaged, or infected tissue is removed to assist in the healing process.

answer

debridement

question

Skin lesions can include which five types?

answer

moles, cysts, keloids, warts, skin tags

question

Lesion removal can be done with which four methods?

answer

shaving, paring, excising, laser

question

For excisions, if a lipoma extends into the dermis, use code for ______. If a lipoma extends into the soft tissue, use a code from the _______ section.

answer

excision of skin lesion, musculoskeletal

question

Repairs with tissue adhesives like Dermabond are reported using the appropriate code from the ______ category.

answer

repair

question

Type of biopsy that involves the insertion of a hollow needle to remove a biopsy specimen of breast tissue.

answer

percutaneous

question

Type of mastectomy that refers to the partial removal of part of the breast tissue, leaving the breast almost intact.

answer

partial

question

A partial mastectomy is also called a ______ or _____.

answer

lumpectomy, lobectomy

question

Type of mastectomy for the excision of all the breast tissue, with the lymph nodes and muscles left intact.

answer

simple complete

question

Type of mastectomy used for excision of breast tissue with the skin and nipple intact

answer

subcutaneous

question

Type of mastectomy referring to the excision of breast tissue including pectoral muscles and axillary lymph nodes.

answer

radical

question

Type of mastectomy used for the excision of breast tissue including axillary lymph nodes with or without pectoralis minor muscles, but pectoralis major muscles are left intact.

answer

modified radical

question

When coding for a pacemaker, you should consider what three elements?

answer

location of electrode, type of procedure, type of approach

question

Three types of procedures to consider when coding for a pacemaker.

answer

inserting, replacing, repositioning

question

Two approaches for placing electrodes for a pacemaker.

answer

epicardial, transvenous

question

With regard to lesions in the colon, when doing a biopsy on a lesion and then excising it, you should code for _____ only.

answer

excision

question

With regard to lesions of the colon, when doing a biopsy on one lesion and excising a another, assign a ______ code for the first lesion and a _____ code for the second lesion.

answer

biopsy, excision

question

Surgical incision codes for hemorrhoidectomy is differentiated by whether hemorrhoids were _____, _____, or _____ and the number of ______.

answer

internal, external, both, columns/groups

question

Type of hernia above the navel

answer

epigastric

question

Type of hernia at the navel

answer

umbilical

question

Herniation usually above the inferior epigastric vessel along the outer border of the rectus muscle.

answer

spigelian

question

Protruding organs can be returned to normal position by surgical manipulation.

answer

reducible

question

The colon or cecum is part of the hernia sac.

answer

sliding

question

Hernia cannot be reduced without surgical intervention.

answer

incarcerated

question

The hernia is an incarcerated hernia in which the blood supply to the contained organ is reduced - medical emergency.

answer

strangulated

question

Modifier _____ should be reported when multiple procedures are performed on urinary tract.

answer

51

question

Codes for removal of lesions of the penis is located in the ______ subsection.

answer

male genital system

question

Prostatectomy involving the use of a scope inserted through the urethra to remove prostate tissue piece by piece.

answer

turp

question

Prostatectomy involving an incision between the back of the scrotum and anus.

answer

perineal

question

Prostatectomy involving an incision in the front wall of the abdomen above the pubic bone to reach the prostate.

answer

retropubic

CPT Medical Coding: Surgery – Ch 4 – Flashcards

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