*Week 4: Urinary Male/Female

If The Dr Didn't Say It Didn't Happen

100

2. What are the filtering units of the kidney called? a. Glomerulus b. Tubules c. Calyx d. Nephrons

D

200

4. Left ureteral stent placement and ESWL (Extracorporeal Shock Wave Therapy or Lithotripsy) of the left kidney are performed. What CPT® code(s) is/are reported for this service? a. 52332-LT b. 52353-LT c. 50590-LT d. 50590-LT, 52332-51-LT

D

300

6. 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? a. 50561 b. 50580 c. 50130 d. 50060

A

400

8. The urologist is called into the operating room to repair a kidney laceration status post MVA. The urologist examines the kidney and repairs a small 2 cm laceration of the kidney. What CPT® code is reported for this service? a. 50520 b. 50500 c. 50526 d. 50525

B

500

10. Transurethral resection of a medium-size (3.0cm) bladder tumor was performed in an outpatient setting. What CPT® code is reported for this service? a. 52234 b. 52224 c. 52240 d. 52235

D

Code What You See

100

12. Transurethral resection of bladder neck and nodular prostatic regrowth. What CPT® code is reported for this service? a. 55801 b. 52630 c. 52640 d. 52500

B

200

14. Cryosurgical ablation of the prostate is performed for prostate cancer. What CPT® and ICD-10-CM codes are reported for this service? a. 55873, C61 b. 55873, C79.82 c. 55873, D07.5 d. 55875, C61

A

300

16. 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? a. 51550 b. 51555 c. 51555-22 d. 51550-22

B

400

18. A 63-year-old gentleman comes into the ED complaining of the urge to urinate but has been unable to empty his bladder. The physician 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? a. 51701, R33.8, N40.1 b. 51702, N40.1, R33.8 c. 51702, R33.9, N40.1 d. 51701, N40.1, R33.9

B

500

20. 63-year-old male presents for the insertion of an artificial inflatable urinary sphincter for urinary incontinence. A 4.5cm cuff, 22ml balloon, 61-70 mmHg artificial inflatable urinary sphincter was inserted. What CPT® code is reported for this service? a. 53446 b. 53447 c. 53448 d. 53445

D

Study Smarter Not Harder

100

22. The patient has a 3.6 cm tumor in the lower pole of the right kidney. A percutaneous right renal cryosurgical ablation is performed. What CPT® code is reported for this service? a. 50250-RT b. 50593-RT c. 50542-RT d. 50541-RT

B

200

24. Vasectomy reversal is performed, bilaterally, using the operating microscope. Choose the procedure code(s). a. 55250 b. 55400 c. 55400-50, 69990 d. 55450-50, 69990

C

300

Female 26. A pregnant patient presents to the hospital in active labor. The obstetrician providing her prenatal care is contacted to perform the delivery. The provider delivers twins. The obstetrician will also provide the postnatal care. What CPT® code(s) describe this procedure? a. 59430 b. 59400, 59409-51 c. 59510 x 2 d. 59409 x 2

B

400

Female 28. If a physician obtains a Pap smear specimen from a non-Medicare patient and incurs the cost for it to be transferred to an outside laboratory, how is this coded? a. Q0091 b. 99000 c. 88164 d. This service cannot be billed separately.

B

500

Female 30. What modifier is appropriate for a separately billable antenatal service during the global OB package period? a. 24 b. 25 c. 57 d. No modifier is needed

D

Keep It Simple

100

Female 32. A 56-year-old woman with biopsy-proven carcinoma of the vulva with metastasis to the lymph nodes has complete removal of the skin and deep subcutaneous tissues of the vulva in addition to removal of her inguinofemoral, iliac and pelvic lymph nodes bilaterally. The diagnosis of carcinoma of the vulva with 7 of the nodes also positive for carcinoma is confirmed on pathologic review. What are the CPT® and ICD-10-CM codes reported for this procedure? a. 56637, C51.9, C79.89 b. 56640-50, C51.9, C77.4 c. 56632-50, D07.1 d. 56633, 38765-50, C51.9, C77.4

B

200

Female 34. An 88-year-old widow with uterine prolapse and multiple comorbid conditions has been unsuccessful in the use of a pessary for treatment elects to receive colpocleisis (LeFort type) to prevent further prolapse and avoid more significant surgery like hysterectomy. The treatment is successful. What are the CPT® and ICD-10-CM codes reported for this procedure? a. 59320, N81.3 b. 57130, N88.3 c. 57120, N81.4 d. 57020, N81.2

C

300

Female 36. A woman with abdominal pain and bleeding has a diagnosis of multiple fibroid tumors and undergoes laparoscopic resection without hysterectomy. After the abdomen is entered and inspected it is found she has 5 separate intramural fibroid tumors to be removed. The fibroid tumors are suc cessfully removed, with a total weight of 300 grams. Pathology confirms leiomyoma (myomas or fibroids). What are the CPT® and ICD-10-CM codes reported for this service? a. 58146, D25.9 b. 58546, D25.1 c. 58545, D25.1 d. 58140, D25.9

B

400

Female 38. A woman presents for hysterectomy after ECC (endocervical curettage) and EMB (endometrial biopsy) indicates endometrial cancer. Transabdominal approach (incision) is chosen for exposure of all structures possibly affected. The abdomen is thoroughly inspected with no gross disease outside the enlarged uterus but several lymph nodes are enlarged and the decision is made to perform a hysterectomy with bilateral removal of tubes and ovaries and bilateral pelvic lymphadenectomy with periaortic lymph node sampling. Specimens sent to pathology confirm endometrial cancer but find normal tissue in the lymph nodes. What are the CPT® and ICD-10-CM codes reported for this service? a. 58548, C54.1 b. 58200, C55, C77.5 c. 58210, C54.1 d. 58150, 38770-51, C54.1, C77.5

C

500

Female 40. Patient with ovarian cancer of both ovaries. She has removal of her ovaries with peritoneal washings and assessment of the abdomen for any metastases, including inspection of omentum, diaphragm, and multiple biopsies. Lymph nodes in the pelvic and peri-aortic areas were also biopsied. She has previously had a hysterectomy. What are the CPT® and ICD-10-CM codes reported for this service? a. 58950, 49255, C79.61, C79.62 b. 58943, C56.1, C56.2 c. 58720, 38770, C56.1, C79.62 d. 58940, C56.1, C56.2

B

Overthinking Is Not Ok

100

Female 42. 27-year-old woman delivers twins by her regular obstetrician by cesarean delivery. Both are delivered without complications. Patient will have postpartum care in two weeks. What is/are the CPT® code(s) reported for this service? a. 59510 b. 59510, 59514-51 c. 59400 d. 59510, 59510-51

A

200

Female 44. A pregnant patient presents to labor and delivery with the baby in a breech presentation. During the delivery the doctor attempts to turn the baby (version of the breech presentation) while it is still in the uterus. The baby turns but then immediately resumes his previous breech position. Can this service (the version of the breech) be billed? If so, what is the code? a. No, because the doctor was unable to successfully turn the baby. b. No, this procedure is included in the obstetrical global package c. Yes, because the doctor did the work, even though the outcome was unsuccessful. Report this procedure with code 59412 d. Yes, only billing it with postpartum care 59515

C

300

Female 46. What is the code for ultrasound evaluation of a fetus and mother, usually done early in pregnancy (first trimester), to confirm fetal age, set an anticipated delivery date, for qualitative assessment of amniotic fluid volume/gestational sac shape and examination of the maternal uterus and adnexa? a. 59025 b. 76819 c. 76801 d. 76815

C

400

Female 48. Mrs. Smith is visiting her mother and is 150 miles away from home. She is in the 26th week of pregnancy. In the late afternoon she suddenly feels a gush of fluids followed by strong uterine contractions. She is rushed to the hospital but the baby is born before they arrive. In the ED she and the baby are examined and the retained placenta is delivered. The baby is in the neonatal nursery doing okay. Mrs. Smith has a 2nd degree perineal laceration secondary to precipitous delivery, which was repaired by the ED physician. She will return home for her postpartum care. What codes does the ED physician report (CPT® and ICD-10-CM codes)? a. 59409, O80, Z3A.26, Z37.0 b. 59409, 59414-51, 59300-51, O62.3, O70.1, Z3A.26, Z37.0 c. 59414, 59300-51, O62.3, O70.9, Z3A.26, Z37.0 d. 59414, 59300-51, O73.0, O70.1, Z3A.26, Z37.0

D

500

52. What ICD-10-CM codes are reported for an encounter for full-term uncomplicated delivery of a single live birth? a. O80, Z37.0 b. O80, Z37.1 c. O82, Z37.0 d. O82, Z37.1

A