Chapter 12 Test Review
Question 1_4 out of 4 points
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?
Selected Answer: d.
50590-LT, 52332-51-LT
Correct Answer: d.
50590-LT, 52332-51-LT
Response Rationale: Two procedures are performed. CPT® 52353 describes laser lithotripsy and does not
Feedback: include ESWL. CPT® 52332 describes the stent placement, but does not include the ESWL. CPT®
50590 describes the ESWL but not the placement of the stent. CPT® 50590 and 52332 describe
both procedures performed. Modifier LT is appended to 50590 to indicate the lithotripsy was
performed on the left kidney. Modifiers 51 and LT are appended to code 52332 to indicate more
than one procedure was performed on the left side. Look in the CPT® Index for
Lithotripsy/Kidney and Insertion/Stent/Ureteral.
Question 2_4 out of 4 points
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?
Selected Answer: a.
53661
Correct Answer: a.
53661
Response Rationale: In the CPT® Index look for Urethra/Dilation/Suppository and/or Instillation. CPT®
Feedback: 53660 is for the initial dilation. CPT® 53605 and 53665 are reported when general or spinal
anesthesia is provided. No type of anesthesia is indicated in the note. This is a repeat
procedure and the subsequent CPT® code 53661 is reported.
Question 3_4 out of 4 points
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?
Selected Answer: c.
52235
Correct Answer: c.
52235
Response Rationale: Transurethral resection of bladder tumors are coded by the size of the tumor; less
, Feedback: than 0.5 cm (52224), 0.5 cm- up to 2.0 cm (52234), 2.0 cm up to 5.0 cm (52235), 5.0 cm or
larger (52240). In the CPT® Index see Resection/Tumor/Bladder or Tumor/Bladder.
Question 4_0 out of 4 points
A patient comes in for removal of a calculus from the renal pelvis via renal endoscopy through an established
nephrostomy. What CPT® code is reported?
Selected Answer: a.
50060
Correct Answer: b.
50561
Response Rationale: Renal endoscopy codes are divided into two code sets: 50551-50562 and 50570-
Feedback: 50580. The difference between the two is whether the procedure is performed through an
established nephrostomy or pyelostomy or a new nephrostomy. For this scenario, the procedure
is performed through an established nephrostomy. In the CPT® Index locate
Endoscopy/Kidney/Removal/Calculus. Code 50561 is reported.
Question 5_4 out of 4 points
Preoperative diagnosis: Hematuria. Postoperative diagnosis: Right renal calculi and bladder calculus. What
ICD-10-CM code(s) is/are reported for this service?
Selected Answer: c.
N20.0, N21.0
Correct Answer: c.
N20.0, N21.0
Response Rationale: The preoperative diagnosis indicates the reason why the patient is having surgery.
Feedback: The postoperative diagnosis indicates what was found during the surgery. Hematuria is a
symptom of renal calculi and bladder calculus, and not coded separately. Refer to ICD-10-CM
guideline 1.B. 4. Look in the ICD-10-CM Alphabetic Index for Calculus, calculi, calculous/kidney
which directs you to code N20.0 and Calculus, calculi, calculous /bladder which directs you to
code N21.0. Verify code selection in the Tabular List.
Question 6_0 out of 4 points
A clamp circumcision is performed without dorsal block on a newborn baby boy. What CPT® code is reported
for this service?
Selected Answer: c.
54160-52
Correct Answer: b.
54150-52
Response Rationale: The circumcision used a clamp as described in CPT® 54150. Code 54160 describes a
Feedback: surgical excision other than clamp. The parenthetical beneath 54150 says to report the code
with modifier 52 when the circumcision is performed without a penile or ring block. In the CPT®
, Index look for Circumcision/Surgical Excision/Neonate.
Question 7_4 out of 4 points
A 63 year-old gentleman comes into the ED complaining of the urge to urinate but has been unable to empty
his bladder. The provider decides to place a Foley catheter to relieve the urine retention due to prostate
hypertrophy. What is the code selection for the procedure and diagnosis codes?
Selected Answer: b.
51702, N40.1, R33.8
Correct Answer: b.
51702, N40.1, R33.8
Response Rationale: In the CPT® Index look for Catheter/Bladder referring you to codes 51701-51703.
Feedback: CPT® code 51702 is correct to report for this scenario since an indwelling catheter (for example
a Foley catheter) is left in the bladder and urine is drained. Code 51701 is used when a non-
indwelling catheter is inserted to determine post void residual urine; this is sometimes called a
straight cath. The patient is diagnosed with urine retention and prostate hypertrophy. In the
ICD-10-CM Alphabetic Index look for Enlargement, enlarged/prostate/with lower urinary
retention guiding you to code N40.1. In the Tabular List locate N40.1 and you are directed to use
additional code for associated symptoms. Code R33.8 is used to describe urinary retention.
Verify code selection in the Tabular List.
Question 8_4 out of 4 points
In ICD-10-CM when both CKD and ESRD are reported what code(s) is/are reported?
Selected Answer: c.
N18.6
Correct Answer: c.
N18.6
Response Rationale: Kidney or renal failure can be acute N17 or chronic N18. Chronic kidney disease
Feedback: (CKD) is classified in ICD-10-CM by severity (N18). The severity of CKD is designated by stages 1-
5 (N18.1-N18.5). Code N18.6 for End stage renal disease (ESRD) is reported when
documentation supports ESRD. If both CKD and ESRD are supported by the documentation, only
N18.6 is reported as supported by the Excludes1 note under N18.5. Look in the ICD-10-CM
Alphabetic Index for Disease/end stage renal which directs you to N18.6. Verify code selection in
the Tabular List.
Question 9_4 out of 4 points
What CPT® code is reported for removal of ureteral stones via laparoscopy?
Selected Answer: d.
50945
Correct Answer: d.
50945
Question 1_4 out of 4 points
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?
Selected Answer: d.
50590-LT, 52332-51-LT
Correct Answer: d.
50590-LT, 52332-51-LT
Response Rationale: Two procedures are performed. CPT® 52353 describes laser lithotripsy and does not
Feedback: include ESWL. CPT® 52332 describes the stent placement, but does not include the ESWL. CPT®
50590 describes the ESWL but not the placement of the stent. CPT® 50590 and 52332 describe
both procedures performed. Modifier LT is appended to 50590 to indicate the lithotripsy was
performed on the left kidney. Modifiers 51 and LT are appended to code 52332 to indicate more
than one procedure was performed on the left side. Look in the CPT® Index for
Lithotripsy/Kidney and Insertion/Stent/Ureteral.
Question 2_4 out of 4 points
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?
Selected Answer: a.
53661
Correct Answer: a.
53661
Response Rationale: In the CPT® Index look for Urethra/Dilation/Suppository and/or Instillation. CPT®
Feedback: 53660 is for the initial dilation. CPT® 53605 and 53665 are reported when general or spinal
anesthesia is provided. No type of anesthesia is indicated in the note. This is a repeat
procedure and the subsequent CPT® code 53661 is reported.
Question 3_4 out of 4 points
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?
Selected Answer: c.
52235
Correct Answer: c.
52235
Response Rationale: Transurethral resection of bladder tumors are coded by the size of the tumor; less
, Feedback: than 0.5 cm (52224), 0.5 cm- up to 2.0 cm (52234), 2.0 cm up to 5.0 cm (52235), 5.0 cm or
larger (52240). In the CPT® Index see Resection/Tumor/Bladder or Tumor/Bladder.
Question 4_0 out of 4 points
A patient comes in for removal of a calculus from the renal pelvis via renal endoscopy through an established
nephrostomy. What CPT® code is reported?
Selected Answer: a.
50060
Correct Answer: b.
50561
Response Rationale: Renal endoscopy codes are divided into two code sets: 50551-50562 and 50570-
Feedback: 50580. The difference between the two is whether the procedure is performed through an
established nephrostomy or pyelostomy or a new nephrostomy. For this scenario, the procedure
is performed through an established nephrostomy. In the CPT® Index locate
Endoscopy/Kidney/Removal/Calculus. Code 50561 is reported.
Question 5_4 out of 4 points
Preoperative diagnosis: Hematuria. Postoperative diagnosis: Right renal calculi and bladder calculus. What
ICD-10-CM code(s) is/are reported for this service?
Selected Answer: c.
N20.0, N21.0
Correct Answer: c.
N20.0, N21.0
Response Rationale: The preoperative diagnosis indicates the reason why the patient is having surgery.
Feedback: The postoperative diagnosis indicates what was found during the surgery. Hematuria is a
symptom of renal calculi and bladder calculus, and not coded separately. Refer to ICD-10-CM
guideline 1.B. 4. Look in the ICD-10-CM Alphabetic Index for Calculus, calculi, calculous/kidney
which directs you to code N20.0 and Calculus, calculi, calculous /bladder which directs you to
code N21.0. Verify code selection in the Tabular List.
Question 6_0 out of 4 points
A clamp circumcision is performed without dorsal block on a newborn baby boy. What CPT® code is reported
for this service?
Selected Answer: c.
54160-52
Correct Answer: b.
54150-52
Response Rationale: The circumcision used a clamp as described in CPT® 54150. Code 54160 describes a
Feedback: surgical excision other than clamp. The parenthetical beneath 54150 says to report the code
with modifier 52 when the circumcision is performed without a penile or ring block. In the CPT®
, Index look for Circumcision/Surgical Excision/Neonate.
Question 7_4 out of 4 points
A 63 year-old gentleman comes into the ED complaining of the urge to urinate but has been unable to empty
his bladder. The provider decides to place a Foley catheter to relieve the urine retention due to prostate
hypertrophy. What is the code selection for the procedure and diagnosis codes?
Selected Answer: b.
51702, N40.1, R33.8
Correct Answer: b.
51702, N40.1, R33.8
Response Rationale: In the CPT® Index look for Catheter/Bladder referring you to codes 51701-51703.
Feedback: CPT® code 51702 is correct to report for this scenario since an indwelling catheter (for example
a Foley catheter) is left in the bladder and urine is drained. Code 51701 is used when a non-
indwelling catheter is inserted to determine post void residual urine; this is sometimes called a
straight cath. The patient is diagnosed with urine retention and prostate hypertrophy. In the
ICD-10-CM Alphabetic Index look for Enlargement, enlarged/prostate/with lower urinary
retention guiding you to code N40.1. In the Tabular List locate N40.1 and you are directed to use
additional code for associated symptoms. Code R33.8 is used to describe urinary retention.
Verify code selection in the Tabular List.
Question 8_4 out of 4 points
In ICD-10-CM when both CKD and ESRD are reported what code(s) is/are reported?
Selected Answer: c.
N18.6
Correct Answer: c.
N18.6
Response Rationale: Kidney or renal failure can be acute N17 or chronic N18. Chronic kidney disease
Feedback: (CKD) is classified in ICD-10-CM by severity (N18). The severity of CKD is designated by stages 1-
5 (N18.1-N18.5). Code N18.6 for End stage renal disease (ESRD) is reported when
documentation supports ESRD. If both CKD and ESRD are supported by the documentation, only
N18.6 is reported as supported by the Excludes1 note under N18.5. Look in the ICD-10-CM
Alphabetic Index for Disease/end stage renal which directs you to N18.6. Verify code selection in
the Tabular List.
Question 9_4 out of 4 points
What CPT® code is reported for removal of ureteral stones via laparoscopy?
Selected Answer: d.
50945
Correct Answer: d.
50945
