AAPC - Chapter 12 Review Exam with the best Grades (A+)

What ICD-10 -CM code is reported for carcinoma of the bladder dome? - C67.1 What is the correct CPT® code for a percutaneous pyelostolithotomy with dilation and basket extraction measuring 1 cm? - 50080 Patient is a 40 year-old female presenting for repeat urethral dilation for urethral stricture using the instillation of a saline solution. What CPT® code is reported for this service? - 53661 Left ureteral stent placement and Extracorporeal Shock Wave Therapy or Lithotripsy (ESWL) of the left kidney are performed. What CPT® code(s) is/are reported for this service? - 50590-LT, 52332-51-LT Transurethral resection of a medium-size (3.0 cm) bladder tumor was performed in an outpatient setting. What CPT® code is reported for this service? - 52235 A partial cystectomy is performed due to the prior administration of radiation. It is complicated due to extensive adhesions and required and additional 2 hours beyond the usual cystectomy procedure. What CPT® code is reported for this service? - 51555 When a cystectomy is performed, there are various means of diverting the urine. One method is to create a neobladder which allows the patient to void through his or her urethra. Which code describes this procedure? - 51596 The urologist performs a cystourethroscopy with ureteroscopy to fulgurate a ureteral lesion. - 52354 Patient presents to the emergency room with complaints of an erection lasting longer than two hours. Saline solution is used to irrigate the corpora cavernosa. What CPT® code is reported for this service? - 54220 Cryosurgical ablation of the prostate is performed for prostate cancer. What CPT® and ICD-10-CM codes are reported for this service? - 55873, C61 GreenLight laser vaporization of the prostate is performed. What CPT® code is reported for this service? - 52648 Transurethral resection of bladder neck and nodular prostatic regrowth. What CPT® code is reported for this service? - 52630 In ICD-10-CM when both CKD and ESRD are reported what code(s) is/are reported? - N18.6 Vasectomy reversal is performed, bilaterally, using the operating microscope. Choose the procedure code(s). - 55400-50, 69990 Patient is admitted for acute bilateral pyelonephritis. What is the appropriate ICD-10-CM code? - N10 A 67 year-old gentleman with localized prostate cancer will be receiving brachytherapy treatment. Following calculation of the planned transrectal ultrasound, guidance was provided for percutaneous perineal placement of 1-125 seeds into the prostate tissue. What CPT® code is reported for needle placement to insert the radioactive seeds into the prostate? - 55875 The patient has significant morbid obesity and her pannus has been retracted to help with dissection. The planned procedure is to place a catheter/tube to drain the bladder. It is apparent she has quite a bit of scarring from her previous surgeries and also appears to have an old sinus tract just above the symphysis. A midline incision is made following her old scar from just above the symphysis for a length of about 4-6cm. The sinus tract was excised, as this was also in the midline, and carefully dissected down to the level of the fascia. It does not appear to be an actual hernia, as there are no ventral contents within it. Again, there is quite a bit of distortion from previous scarring because of the obesity, but staying in the midline, the fascia is incised just above the symphysis of a length of about 2cm. The fat and scar is incised above the fascia more superiorly and with palpation, mesh from a previous hernia repair is felt. This was not palpable prior to the incision because of her body habitus. The mesh was not exposed or entered, it comes down quite close to the symphysis and certainly is too close to place a suprapubic (SP) tube. There is concern the mesh may become infected with an SP tube tract right there. Therefore, decision to abort the procedure is made. What CPT® code and modifier are reported for this service? - 51040-53 Dr. Smith is treating a 72 year-old female with ureteral obstruction caused by a postoperative stricture and post radiation scarring following treatment for transitional cell cancer. The patient requires removal and replacement of an internal indwelling ureteral stent. Dr. Smith advances a diagnostic catheter under conscious sedation into the bladder and injects contrast to opacity the bladder. A guide wire is advanced into the bladder and the diagnostic catheter is exchanged for a larger catheter to allow the use of a snare device. Under the fluoroscopic guidance the snare device is negotiated into the bladder through the sheath and used to grasp the pigtail portion of the double-J ureteral stent tube within the bladder and the indwelling stent tube is pulled out of the bladder and urethra far enough to allow retrograde introduction of a guide wire through the stent, directed into the renal pelvis. Using fluoroscopic guidance to negotiate the wire through the inner lumen of the ureteral stent tube rather than through side holes, a diagnostic catheter is positioned over the wire into the renal pelvis, allowing opacification and visualization of the renal pelvis. The guide wire is repositioned into the renal pelvis and the diagnostic catheter removed. A new double-J ureteral stent tube is introduced and positioned. The guide, sheath and safety wire are removed after appropriate position is confirmed with fluoroscopy and a permanent image is obtained for the medical record. What code is used to describe the exchange? - 50385 Benign prostatic hypertrophy with outlet obstruction and hematuria. Operation: TURP Anesthesia: Spinal Description of procedure: The patient was placed on the operating room table in sitting position and spinal anesthesia induced. He was placed in the lithotomy position, prepped and draped appropriately. Resection was begun at the posterior bladder neck and extended to the verumontanum (a crest near the wall of the urethra). Posterior tissue was resected first from the left lateral lobe, then right lateral lobe, then anterior. Depth of resection was carried to the level of the circular fibers. Bleeding vessels were electrocauterized as encountered. Care was taken to not resect distal to the verumontanum, thus protecting the external sphincter. At the end of the procedure, prostatic chips were evacuated from the bladder. Final inspection showed good hemostasis and intact verumontanum. The instruments were removed, Foley catheter inserted and the patient returned to the recovery area in satisfactory condition. What CPT® code is reported for this service? - 52601 A 58 year-old man with an enlarging right hydrocele is here for surgical repair. He is taken to the operating room where the hydrocele was enucleated from the skin in dartos fashion and delivered into the wound. It was skeletonized at the equator and then was opened and drained. Excess hydrocele sac tissue was excised with electrocautery. It was then wrapped backward around the spermatic cord and sewn there so it would not reform. There were a few pockets also opened up and skeletonized. The testicle was replaced in the scrotum. What CPT® code is reported for this service? 55040-RT Patient is status post left extracorporeal shock wave therapy (ESWL) performed three weeks ago; there is no global time for this procedure. He returns today for scheduled left ureteroscopy with basket extraction of ureteral calculi. What CPT® code is reported for this service? - 52352 Patient is a 67 year-old male with chronic orchialgia following a right inguinal hernia repair. He is admitted for scrotal exploration and simple orchiectomy. The patient is brought to the operating room and placed supine on the operating table in. After adequate anesthesia was accomplished, he was prepped and draped in the usual sterile fashion; 0.25% Marcaine plain was infused in the skin along his median rhaphe and a 4cm median rhaphe incision was made. We disse