Chapter 11 Review Questions and Answers Graded A+
A patient is seen to have an esophageal motility
procedure with acid perfusion study performed. When reporting an encounter for screening of
What CPT® code(s) is/are reported? - malignant neoplasms of the intestinal tract, what
ANSWER -91010, 91013 does the 5th character indicate? -
Rationale: This is a diagnostic gastrointestinal ANSWER -Anatomic location being
procedure. Look in the CPT® Index for screened in the intestinal tract.
Gastroenterology, Diagnostic/Esophagus Rationale: Subcategory Z12.1 identifies
Tests/Motility Study which directs you to codes screening for malignant neoplasms of the
91010, 91013. 91010 best describes the motility intestinal tract. The 5th character identifies the
study with add-on code 91013 used to identify anatomic location in the intestinal tract.
the acid profusion study. Parenthetical note
under add-on code 91013 indicates it is reported
with code 91010. What is the eponym for a
pancreatoduodenectomy? - ANSWER -
Whipple procedure
What ICD-10-CM code is reported for a patient Rationale: A Whipple procedure is also known as
with a family history of colon cancer? - a pancreatoduodenectomy. Look in the CPT®
ANSWER -Z80.0 Index for Whipple Procedure; it refers you to
Rationale: Family history of a disease/condition code 48150. The code description verifies that
is represented by Z codes. Look in the ICD-10- this procedure involves a pancreatectomy and
CM Alphabetic Index for History/family duodenectomy. The other eponyms can be found
(of)/malignant neoplasm (of) in the CPT® Index and do not involve the
NOS/gastrointestinal tract which refers you to removal of the pancreas and duodenum.
code Z80.0. The Tabular List verifies code Z80.0
is reported for a family history of malignant
neoplasm of digestive organs. If a perianal abscess is identified, incised and
drained during the course of performing an
internal and external hemorrhoidectomy, what
What CPT® and ICD-10-CM codes are reported CPT® codes are reported? - ANSWER -
for a hemicolectomy performed on a patient with 46255, 46050-51
colon cancer? - ANSWER -44140, C18.9 Rationale: The hemorrhoidectomy is indexed in
Rationale: For the CPT® code, hemi- means half CPT® under Hemorrhoidectomy/Simple which
or partial and colectomy is the removal of the directs you to code 46255. When you read all the
colon. Look in the CPT® Index for code descriptions for hemorrhoidectomies, code
Colectomy/Partial which directs you to code 46255 is correct to report for the procedure since
44140.Next, look in the ICD-10-CM Alphabetic internal and external hemorrhoids were removed.
Index for Carcinoma, which directs you to see The I&D code for the perianal abscess is indexed
also, Neoplasm, by site, malignant. Go to the under Incision and Drainage/Abscess/Anal
Table of Neoplasms and look for Neoplasm, referring you to codes 46045-46050. Reviewing
neoplastic/colon which directs you to see also the descriptions of the codes directs you to code
Neoplasm/intestine/large and report code C18.9 46050 for Incision and drainage of the perianal
under the Malignant Primary column. There is no abscess. Modifier 51 is appended to indicate
documentation the cancer is secondary or had multiple procedures during the same operative
metastasized from another site, it is considered session.
primary. Verify the code in the Tabular List.
, Chapter 11 Review Questions and Answers Graded A+
What is the correct CPT® coding for a partial
distal gastrectomy with Roux-en-Y reconstruction
with vagotomy? - ANSWER -43633, 43635 A 12 year-old patient had an adenoidectomy in
Rationale: In CPT® Index, look for 2013 and a second adenoidectomy this year.
Gastrectomy/Partial, which directs us to several What CPT® code(s) is/are reported for the
codes including 43631-43635. When reviewing second adenoidectomy performed this year? -
these codes in the main section of CPT®, code ANSWER -42836
43633 code descriptor represents a partial Rationale: Sometimes adenoid tissue, even after
gastrectomy with Roux-en-Y reconstruction. it has been removed, will grow back when a few
Next, look for Vagotomy/with Partial Distal cells are left behind. For the removal of the
Gastrectomy in the CPT® Index. Code 43635 secondary adenoid tissue, report code 42836
represents the vagotomy. Modifier 51 is not used which represents the secondary adenoidectomy.
as code 43635 is an add-on code and is modifier Look in the CPT® Index for Adenoids/Excision
51 exempt. with a code range of 42830-42836. In this case,
the patient is over 12 years of age upon
presentation for the secondary adenoidectomy,
A 45 year-old woman underwent a laparoscopic further supporting the criteria for 42836.
cholecystectomy. The procedure was performed
for recurrent bouts of acute cholecystitis. What
CPT® and ICD-10-CM codes are reported? - What is the correct ICD-10-CM coding for
ANSWER -47562, K81.0 diverticulosis of the small intestine which has
Rationale: In the CPT® Index, look for been present since birth? - ANSWER -
Cholecystectomy/Laparoscopic which directs you Q43.8
to 47562-47564. 47600 and 47605 are open Rationale: If a condition has been present since
cholecystectomy codes. By turning to the birth, it is considered congenital. Look in the ICD-
numeric section of CPT and reviewing the code 10-CM Alphabetic Index for Diverticulosis/small
descriptions, you can verify that 47562 is the intestine which refers you to K57.10. Verification
appropriate code for a laparoscopic in the Tabular list has an Excludes1 note under
cholecystectomy with no additional procedures category code K57 for a congenital diverticulum
performed.Acute cholecystitis is indexed in ICD- of intestine and directs you to code Q43.8.
10-CM Alphabetic Index under Congenital diverticulum is in the list of congenital
Cholecystitis/acute for code K81.0. Verify code malformations beneath code Q43.8.
selection in the Tabular List.
Bile empties into the duodenum through what
In ICD-10-CM, how is Crohn's disease of the structure? - ANSWER -Common bile duct
small intestine with intestinal obstruction Rationale: The liver produces bile which passes
reported? - ANSWER -One combination from the bile duct of the liver and finds its way
code is reported to indicate Crohn's disease of into the small intestine by way of common bile
the small intestine with intestinal obstruction. duct.
Rationale: In ICD-10-CM there are combination
codes to include the anatomic site (i.e., small
intestine, large intestine) as well as the What CPT® and ICD-10-CM codes represent the
associated complications of Crohn's disease. creation of an opening into the stomach to insert
Example: K50.012 Crohn's disease of small a temporary feeding tube for nutritional support in
intestine with intestinal obstruction. an adult patient with proximal esophageal
A patient is seen to have an esophageal motility
procedure with acid perfusion study performed. When reporting an encounter for screening of
What CPT® code(s) is/are reported? - malignant neoplasms of the intestinal tract, what
ANSWER -91010, 91013 does the 5th character indicate? -
Rationale: This is a diagnostic gastrointestinal ANSWER -Anatomic location being
procedure. Look in the CPT® Index for screened in the intestinal tract.
Gastroenterology, Diagnostic/Esophagus Rationale: Subcategory Z12.1 identifies
Tests/Motility Study which directs you to codes screening for malignant neoplasms of the
91010, 91013. 91010 best describes the motility intestinal tract. The 5th character identifies the
study with add-on code 91013 used to identify anatomic location in the intestinal tract.
the acid profusion study. Parenthetical note
under add-on code 91013 indicates it is reported
with code 91010. What is the eponym for a
pancreatoduodenectomy? - ANSWER -
Whipple procedure
What ICD-10-CM code is reported for a patient Rationale: A Whipple procedure is also known as
with a family history of colon cancer? - a pancreatoduodenectomy. Look in the CPT®
ANSWER -Z80.0 Index for Whipple Procedure; it refers you to
Rationale: Family history of a disease/condition code 48150. The code description verifies that
is represented by Z codes. Look in the ICD-10- this procedure involves a pancreatectomy and
CM Alphabetic Index for History/family duodenectomy. The other eponyms can be found
(of)/malignant neoplasm (of) in the CPT® Index and do not involve the
NOS/gastrointestinal tract which refers you to removal of the pancreas and duodenum.
code Z80.0. The Tabular List verifies code Z80.0
is reported for a family history of malignant
neoplasm of digestive organs. If a perianal abscess is identified, incised and
drained during the course of performing an
internal and external hemorrhoidectomy, what
What CPT® and ICD-10-CM codes are reported CPT® codes are reported? - ANSWER -
for a hemicolectomy performed on a patient with 46255, 46050-51
colon cancer? - ANSWER -44140, C18.9 Rationale: The hemorrhoidectomy is indexed in
Rationale: For the CPT® code, hemi- means half CPT® under Hemorrhoidectomy/Simple which
or partial and colectomy is the removal of the directs you to code 46255. When you read all the
colon. Look in the CPT® Index for code descriptions for hemorrhoidectomies, code
Colectomy/Partial which directs you to code 46255 is correct to report for the procedure since
44140.Next, look in the ICD-10-CM Alphabetic internal and external hemorrhoids were removed.
Index for Carcinoma, which directs you to see The I&D code for the perianal abscess is indexed
also, Neoplasm, by site, malignant. Go to the under Incision and Drainage/Abscess/Anal
Table of Neoplasms and look for Neoplasm, referring you to codes 46045-46050. Reviewing
neoplastic/colon which directs you to see also the descriptions of the codes directs you to code
Neoplasm/intestine/large and report code C18.9 46050 for Incision and drainage of the perianal
under the Malignant Primary column. There is no abscess. Modifier 51 is appended to indicate
documentation the cancer is secondary or had multiple procedures during the same operative
metastasized from another site, it is considered session.
primary. Verify the code in the Tabular List.
, Chapter 11 Review Questions and Answers Graded A+
What is the correct CPT® coding for a partial
distal gastrectomy with Roux-en-Y reconstruction
with vagotomy? - ANSWER -43633, 43635 A 12 year-old patient had an adenoidectomy in
Rationale: In CPT® Index, look for 2013 and a second adenoidectomy this year.
Gastrectomy/Partial, which directs us to several What CPT® code(s) is/are reported for the
codes including 43631-43635. When reviewing second adenoidectomy performed this year? -
these codes in the main section of CPT®, code ANSWER -42836
43633 code descriptor represents a partial Rationale: Sometimes adenoid tissue, even after
gastrectomy with Roux-en-Y reconstruction. it has been removed, will grow back when a few
Next, look for Vagotomy/with Partial Distal cells are left behind. For the removal of the
Gastrectomy in the CPT® Index. Code 43635 secondary adenoid tissue, report code 42836
represents the vagotomy. Modifier 51 is not used which represents the secondary adenoidectomy.
as code 43635 is an add-on code and is modifier Look in the CPT® Index for Adenoids/Excision
51 exempt. with a code range of 42830-42836. In this case,
the patient is over 12 years of age upon
presentation for the secondary adenoidectomy,
A 45 year-old woman underwent a laparoscopic further supporting the criteria for 42836.
cholecystectomy. The procedure was performed
for recurrent bouts of acute cholecystitis. What
CPT® and ICD-10-CM codes are reported? - What is the correct ICD-10-CM coding for
ANSWER -47562, K81.0 diverticulosis of the small intestine which has
Rationale: In the CPT® Index, look for been present since birth? - ANSWER -
Cholecystectomy/Laparoscopic which directs you Q43.8
to 47562-47564. 47600 and 47605 are open Rationale: If a condition has been present since
cholecystectomy codes. By turning to the birth, it is considered congenital. Look in the ICD-
numeric section of CPT and reviewing the code 10-CM Alphabetic Index for Diverticulosis/small
descriptions, you can verify that 47562 is the intestine which refers you to K57.10. Verification
appropriate code for a laparoscopic in the Tabular list has an Excludes1 note under
cholecystectomy with no additional procedures category code K57 for a congenital diverticulum
performed.Acute cholecystitis is indexed in ICD- of intestine and directs you to code Q43.8.
10-CM Alphabetic Index under Congenital diverticulum is in the list of congenital
Cholecystitis/acute for code K81.0. Verify code malformations beneath code Q43.8.
selection in the Tabular List.
Bile empties into the duodenum through what
In ICD-10-CM, how is Crohn's disease of the structure? - ANSWER -Common bile duct
small intestine with intestinal obstruction Rationale: The liver produces bile which passes
reported? - ANSWER -One combination from the bile duct of the liver and finds its way
code is reported to indicate Crohn's disease of into the small intestine by way of common bile
the small intestine with intestinal obstruction. duct.
Rationale: In ICD-10-CM there are combination
codes to include the anatomic site (i.e., small
intestine, large intestine) as well as the What CPT® and ICD-10-CM codes represent the
associated complications of Crohn's disease. creation of an opening into the stomach to insert
Example: K50.012 Crohn's disease of small a temporary feeding tube for nutritional support in
intestine with intestinal obstruction. an adult patient with proximal esophageal
