DIGESTIVE SYSTEM
1. An 81 year old woman underwent a radical right hemicolectomy for carcinoma of the ascending
colon. She returns at this time as advised for a follow up colonoscopy. The physician inserts the
video colonoscope into the anus and starts to advance the scope through the colon past the splenic
flexure when the patient’s blood pressure drops. The physician elects to terminate the procedure
and the scope is withdrawn. The correct CPT code and modifiers are.
a. 45378-53
b. 45391-22
c. 44360-52
d. 45399-59
2. If an endoscopy (i.e 49320) is performed prior to standalone open lysis of adhesions (44005), is it
separately reportable?
a. Yes
b. No
c. Sometimes
d. It depends
3. A 79 year old male has acute cholecyctitis and abnormal liver function test. He has elected to go in
for surgery. A laparoscope is placed through an epigastric incision with the insertion of two lateral
5mm ports. The gallbladder is elevated and the cystic duct is located and dissected out. In the
process of transecting the duct, the gallbladder tears and several gallstones were released. These
are removed with a gallstone retriever along with removal of the gallbladder. The cystic duct stump
is tied off and the common bile duct is incised. A large stone is seen and removed. The common bile
duct is closed over a t-tube catheter which brought out through the abdominal wall and connected
to a drainage bag.
a. 47564
b. 47480, 47564-51
c. 47420, 47562-51
d. 47480, 47562-51
, 4. An elderly gentleman presents with a high grade small bowel obstruction. A midline abdominal
incision is performed encountering fairly dense adhesions. Using a combination of sharp dissection
and elctrocautery, a full adhesionlysis is performed on several adhesions up to the anterior
abdominal wall, which appears to be the culprits for this patient’s small bowel obstruction. In
dissecting out this mat of adhesions, an enterotomy is made and a limited small bowel resection and
a double stapled anastomosis are performed.
a. 44120, 44005 -51
b. 44125
c. 44120
d. 44130, 44005 - 51
5. Midred was seen by the surgeon for a right parotid mass measuring 1.7 x 1.1cm. She complained
of pain and did not get relief from antibiotics. A right lateral lobe parotidectomy, with dissection and
preservation of the facial nerve was completed.
a. 42410-RT
b. 42415 – RT
c. 42420
d. 42330
6. Patient presents with complaints of blood per rectum for the past three months. He has not been
experiencing significant abdominal pain, but his bowels have been alternating between constipation
and diarrhoea. The blood is ribbon like in appearance. Abdominal exam reveals mild tenderness
throughout all quadrants. Proctoscopy is performed with 8 cm of interference. Multiple biopsies are
taken unable to pass regular scope, stricture size scope was advanced past the lesion and visualized
the distal rectal mucosa. Digital exam reveals internal haemorrhoids prolapsing. Biopsies sent to lab.
Patient scheduled for follow up visit pending pathology report. What CPT and ICD codes are
reported
a. 46608, K64.1
b. 46611, K64.8, K62.5
c. 46606, K64.8
d. 46606, 46600, K64.4
7. A 43 year old male has a chronic posterior and fissure. The posterior anal fissure was excised
down to the internal sphincter muscle.
a. 46200
b. 46261
c. 46270
d. 46275
1. An 81 year old woman underwent a radical right hemicolectomy for carcinoma of the ascending
colon. She returns at this time as advised for a follow up colonoscopy. The physician inserts the
video colonoscope into the anus and starts to advance the scope through the colon past the splenic
flexure when the patient’s blood pressure drops. The physician elects to terminate the procedure
and the scope is withdrawn. The correct CPT code and modifiers are.
a. 45378-53
b. 45391-22
c. 44360-52
d. 45399-59
2. If an endoscopy (i.e 49320) is performed prior to standalone open lysis of adhesions (44005), is it
separately reportable?
a. Yes
b. No
c. Sometimes
d. It depends
3. A 79 year old male has acute cholecyctitis and abnormal liver function test. He has elected to go in
for surgery. A laparoscope is placed through an epigastric incision with the insertion of two lateral
5mm ports. The gallbladder is elevated and the cystic duct is located and dissected out. In the
process of transecting the duct, the gallbladder tears and several gallstones were released. These
are removed with a gallstone retriever along with removal of the gallbladder. The cystic duct stump
is tied off and the common bile duct is incised. A large stone is seen and removed. The common bile
duct is closed over a t-tube catheter which brought out through the abdominal wall and connected
to a drainage bag.
a. 47564
b. 47480, 47564-51
c. 47420, 47562-51
d. 47480, 47562-51
, 4. An elderly gentleman presents with a high grade small bowel obstruction. A midline abdominal
incision is performed encountering fairly dense adhesions. Using a combination of sharp dissection
and elctrocautery, a full adhesionlysis is performed on several adhesions up to the anterior
abdominal wall, which appears to be the culprits for this patient’s small bowel obstruction. In
dissecting out this mat of adhesions, an enterotomy is made and a limited small bowel resection and
a double stapled anastomosis are performed.
a. 44120, 44005 -51
b. 44125
c. 44120
d. 44130, 44005 - 51
5. Midred was seen by the surgeon for a right parotid mass measuring 1.7 x 1.1cm. She complained
of pain and did not get relief from antibiotics. A right lateral lobe parotidectomy, with dissection and
preservation of the facial nerve was completed.
a. 42410-RT
b. 42415 – RT
c. 42420
d. 42330
6. Patient presents with complaints of blood per rectum for the past three months. He has not been
experiencing significant abdominal pain, but his bowels have been alternating between constipation
and diarrhoea. The blood is ribbon like in appearance. Abdominal exam reveals mild tenderness
throughout all quadrants. Proctoscopy is performed with 8 cm of interference. Multiple biopsies are
taken unable to pass regular scope, stricture size scope was advanced past the lesion and visualized
the distal rectal mucosa. Digital exam reveals internal haemorrhoids prolapsing. Biopsies sent to lab.
Patient scheduled for follow up visit pending pathology report. What CPT and ICD codes are
reported
a. 46608, K64.1
b. 46611, K64.8, K62.5
c. 46606, K64.8
d. 46606, 46600, K64.4
7. A 43 year old male has a chronic posterior and fissure. The posterior anal fissure was excised
down to the internal sphincter muscle.
a. 46200
b. 46261
c. 46270
d. 46275
