CPC

14 Aug 2020

Cardiovascular Surgery Quiz


      1.     A 66 yrs old male patient is brought to the operating room for pacemaker placement. The Cardiologist inserted two leads via a subclavian vein and the electrodes are placed in the right atrial and another one in the right ventricle. Both the leads are connected with the generator. he created a skin pocket in the right side of chest below the clavicle to keep the pulse generator. Finally closed all the area with sterile technique. The patient tolerated the procedure well and transferred to the designated area in stable condition, Assign the appropriate CPT codes for this procedure?

A.    33208,  33202 - 51

B.    33206

C.     33208

D.    33213,  33217 - 51

 

      2.     73 yrs old male patient is brought to the operating room for a CABG procedure. Following general anesthesia a median Sternotomy incision is made and cardiopulmonary bypass is initiated. The saphenous vein is harvested from his right leg. The two vein graft was prepared. Two bypasses are performed using the vein graft (one to the right posterior descending and one for the marginal artery). Proximal and distal anastomoses are looking good. A branch of the subclavian artery is brought down to the left circumflex and anastomosed. The patient was warmed and weaned from the cardiopulmonary bypass and the incision site was closed in layers in the usual fashion. The leg incision site was closed as well. Sterile dressings were applied and the patient is transferred to the Coronary intensive care unit in stable condition.  Assign the appropriate CPT codes for this service?

A.    33511

B.    33533,  33518

C.     33533,  33511

D.    33533,  33518,  35500

 

      3.     A 58 yrs old patient is brought to the operating room for Angiography procedure, Access: The right femoral artery, Catheter advanced into aorta images were taken following dye, Images reveals normal anatomy, Catheter was manipulated into the celiac trunk and dye was injected and an angiogram was performed images shows patent artery, then catheter moved to common hepatic artery, the dye was injected and images were taken it shows 40% stenosis of the vessel. Assign the appropriate CPT codes for this service?

A.    36246, 75726 – 26, 75774 - 26

B.    36246,  75726 – 26

C.     36246,  36248,  75726 – 26

D.    36245,  36246,  75726 – 26, 75774 – 26

 

      4.     A 55 yrs female patient with h/o breast cancer requires a port-A-cath for the administration of anti-neoplastic drugs for long term treatment schedule. At the patient’s bedside in the hospital, using ultrasound guidance right Subclavian vein was located and a needle and a guidewire placed. A transverse incision was made just inferior to this and a subcutaneous pocket was created. After tunnelling, the introducer was placed over the guidewire and the power port line was placed with the introducer and the introducer was peeled away. The tip of the catheter was placed in the right atrium under fluoroscopic guidance and the catheter connected to the power port device. The locking mechanism was fully engaged. The port was placed in the subcutaneous pocket. It was secured to the underlying soft tissue with 2-0 silk stitch. What is the appropriate CPT codes for the procedure performed?

A.    36571,  76937 - 26,  77001 – 26

B.    36571,  76937,  77001

C.     36560,  76942 - 26,  77001 – 26

D.    36561,  76937 - 26,  77001 – 26

 

      5.     A male (67 yrs ) patient is brought to the operation room for Re-vascular procedure. The patient is suffering from a severe atherosclerotic plague in his right anterior tibial and posterior tibial artery the physician is planned to place two stent in the vessels to restore the vascular flow.  A catheter is advanced from right femoral artery to the right anterior tibial artery and an angiography confirms the stenosis, pre-dilation with a balloon is performed followed by placement of a bare-metal stent post angiography images show excellent results the same thing repeated in the posterior tibial artery. What are the appropriate CPT codes for the procedure performed?

A.    37230

B.    37230,  37234

C.     37231,   37234

D.    37230,   37232,  37234

 

      6.     A 71 yrs patient is brought to the operating room for Re-vascular procedure. The patient is suffering from severe stenosis in his left femoral and popliteal artery. A catheter is advanced from the right side of the femoral artery in retrograde fashion advanced into the left iliac system and moved to the left femoral artery, angiography confirms the stenosis and Pre-dilation with a balloon is performed followed by placement of a stent in the femoral artery. Post angiography images show excellent results following that catheter is advanced to the popliteal artery crossing the stenosis a stent was deployed, post images show good results. What are the appropriate CPT codes for the procedure performed?

A.    37230,  37234

B.    37226,  37226 – 59

C.     37226,  37224 – 59

D.    37226

 

      7.     A patient with severe occlusive disease in the inferior mesenteric artery was brought to the operating room to undergo percutaneous transluminal Thrombectomy and stent placement, a catheter is advanced from right femoral artery to aorta, aortography images show patent vessel and the catheter is moved into inferior mesenteric artery at the site of occlusion the short segment of embolus was removed followed by placement of a stent is performed successfully. Post images show excellent results.  What are the appropriate CPT codes for the procedure performed?

A.    37238,  37184

B.    37236,  37184

C.     37236,  37286

D.    37221,  37286

 

      8.     A female patient with vaginal bleed due to rupture of the aneurysm is here for vascular embolization procedure. via the right femoral artery, the catheter is advanced into the internal iliac artery and further advanced into its branches and embolization coils are placed in the distal, beyond third-order branch of the iliac vascular family, follow up images shows cessation of the bleeding and occlusion of the vessel. What are the appropriate CPT codes for the procedure performed?

A.    37244

B.    37242

C.     37244, 37244 – 59

D.    37242, 37244 – 59

 

      9.     A 69 yrs Female patient with bilateral leg swelling is admitted in the hospital, after sterile prep and drape the physician inject dye into the webbing between the first and second toes on each foot. The physician selects one of the larger lymphatic channels and numb the area. He made a small incision and then inserts a tube into the channel; this process was repeated on the other foot. Once both tubes are in place more contrast was slowly injected. Fluoroscopic images were taken and it shows stenosis on either side. How would you report the physician’s service?

A.    38790 – 50, 75803 – 26

B.    38790,  75803 – 26

C.     38790 – 50,  75803

D.    38790,  75801 – 26

  

     10.    47yrs male patient is suffering from prostate cancer is here to undergo a biopsy of axillary lymph nodes due to abnormal enlargement of right axillary lymph nodes. After sterile prep and drape following local anesthesia the physician insert 16 gauge needles under CT guidance to take 3 samples from three axillary lymph nodes and sent all samples to pathology. How would you report the physician’s service?

A.    38525

B.    38525 x 3

C.     38505,  77012 – 26

D.    38505 x 3,  77012 – 26

 

 _________________________________________________________

Answers: 

1.    C

2.    B

3.    A

4.    D

5.    B

6.    D

7.    C

8.    A

9.    A

10.  C