Weekly Chapter Exercise 6

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Question #1

What is the appropriate code to report for this case study?

A 6-year old male presents to the office with a history of snoring, mouth breathing, restless sleeping at night, and waking during the night. His parents describe periods of observed apnea for several seconds. He has some dysphagia for solid food and is often tired or cranky during the day. A tape recording of his breathing at night has been made. On physical examination, the child has 4+ enlarged tonsils, and enlarged tonsils and adenoids are confirmed on lateral neck radiograph. A tonsillectomy and adenoidectomy are performed under general anesthesia in an outpatient facility. Postoperatively, the family contacts the surgeon’s office on several occasions with questions regarding postoperative fears, poor oral intake, possible dehydration, and a stiff neck. These symptoms resolve over the next 7 to 10 days.

Description of Procedure: Intraservice includes reassuring and comforting the child during induction of anesthesia; monitoring for sudden airway obstruction during induction of anesthesia; positioning patient; placing a mouth gag; removing tonsils and adenoids; obtaining hemostasis with electrocautery; and placing a gastric tube in the stomach to remove secretions and blood.

A 42820

B 42800

C 42825

D 42804

Question #2

Code 43273 differs from code 43260 for endoscopic retrograde cholangiopancreatography (ERCP), which involves fluoroscopic images of the papilla and common bile ducts and is performed in the interventional endoscopy or radiology suite.

A FALSE

B TRUE

Question #3

Separate codes within the Pharynx, Adenoids, and Tonsils subsection are used to report control of hemorrhage after tonsillectomy and adenoidectomy procedures.

A TRUE

B FALSE

Question #4

The Digestive System subsection contains guidelines associated with reporting common procedures such as tonsillectomy and adenoidectomy, enterectomy, appendectomy, various gastrointestinal endoscopy and laparoscopy procedures, lysis of adhesions, intraperitoneal catheter placement, hernia repair, and procedures of the tongue and esophagus.

A TRUE

B FALSE

Question #5

Mesh or other prostheses are often used to repair all types of hernias and should be reported separately.

A TRUE

B FALSE

Question #6

What is the appropriate code to report for this case study?

A 45-year-old male presents with complaints of a nonhealing lesion on the left lateral border of the anterior two thirds of the tongue. He notes that it has gradually enlarged over the past two months. The lesion is biopsied.

Description of Procedure: Intraservice includes identification of the lesion and area of lesion to be biopsied; application of appropriate local anesthetic agent; surgical removal of the biopsy specimen; hemostasis by appropriate means; and closure as

A 41100

B 41108

C 41115

D 41112

Question #7

What is the difference between primary and secondary tonsillectomy or adenoidectomy?

A Primary procedures are performed to remove residual or regrowth of tonsil or adenoid tissue, while secondary procedures are performed when no prior tonsillectomy or adenoidectomy has been performed

B There is no difference between primary and secondary tonsillectomy or adenoidectomy

C Primary procedures are performed on patients younger than 12, while secondary procedures are performed on patients older than 12

D Primary procedures are performed when no prior tonsillectomy or adenoidectomy has been performed, while secondary procedures are performed to remove residual or regrowth of tonsil or adenoid tissue

Question #8

What are codes 43279-43283 used for?

A Repair of paraesophageal hernia using the laparoscopic approach

B Endoscopic procedures of the esophagus

C Laparoscopic procedures of the esophagus

D Control of nasopharyngeal hemorrhage

Question #9

How is bleeding control reported during an endoscopic procedure?

A By appending modifier 79 to the endoscopic procedure code

B Separately from the endoscopic procedure

C Included in the endoscopic procedure

D By appending modifier 78 to the endoscopic procedure code