AAPC Chapter 17 Practical Applications
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Questions and Answers

What was percutaneously accessed in the described procedure?

The right common femoral artery

What type of catheter was advanced to the upper abdominal aorta?

Omni Flush catheter

The common iliac vessels were found to have stenosis.

False

What catheter was used to selectively catheterize the superior mesenteric artery?

<p>Cobra 2 catheter</p> Signup and view all the answers

The inferior mesenteric artery was successfully catheterized on the first attempt.

<p>False</p> Signup and view all the answers

Which catheter achieved selective catheterization of the inferior mesenteric artery?

<p>Simmons 2 catheter</p> Signup and view all the answers

What was the impression after the angiogram of the abdominal aorta and mesenteric arteries?

<p>Normal abdominal aortic angiogram</p> Signup and view all the answers

What closure device was used for hemostasis in the right groin?

<p>Angio-Seal closure device</p> Signup and view all the answers

What are the CPT® and ICD-10-CM codes reported for this service?

<p>36245, 36245-59, 75726-26, K55.9</p> Signup and view all the answers

What are the CPT® and ICD-10-CM codes reported for CASE 1?

<p>74177-26, 71260-26, C34.12, I25.10</p> Signup and view all the answers

What are the CPT® and ICD-10-CM codes reported for CASE 2?

<p>70470, C34.90, I67.2, G93.9, G23.8</p> Signup and view all the answers

What are the CPT® and ICD-10-CM codes reported for CASE 3?

<p>77067, Z12.31, Z80.3</p> Signup and view all the answers

What are the CPT® and ICD-10-CM codes reported for CASE 4?

<p>73552-LT, M79.605</p> Signup and view all the answers

What are the CPT® and ICD-10-CM codes reported for CASE 5?

<p>76770-26, Z48.816, N13.70, N28.81, N27.0</p> Signup and view all the answers

What are the CPT® and ICD-10-CM codes reported for CASE 6?

<p>74177-26, 74340-26, 44500, 99152, 99153 x 3, R10.9, R19.7, R63.4</p> Signup and view all the answers

What are the CPT® and ICD-10-CM codes reported for CASE 7?

<p>58340, 74740-26, N97.9</p> Signup and view all the answers

What are the CPT® and ICD-10-CM codes reported for CASE 8?

<p>93976-26, 76770-26-59, I70.1</p> Signup and view all the answers

What are the CPT® and ICD-10-CM codes reported for CASE 9?

<p>72148-26, M48.56XA, M51.26, M51.36</p> Signup and view all the answers

What are the CPT® and ICD-10-CM codes reported for CASE 10?

<p>Not provided.</p> Signup and view all the answers

Study Notes

Case 1: CT Scans with Contrast

  • Location: Regional Hospital with coding for professional component.
  • Three separate CT scans performed: Thorax, Abdomen, and Pelvis with Low Osmolar Contrast.
  • History includes non-small-cell lung cancer.
  • Findings indicate a centrally necrotic pulmonary mass in the left upper lobe measuring 83 x 64 mm, stable compared to prior measurements.
  • Additional findings include scarring in the right lower lobe and coronary arteriosclerotic calcification.
  • CPT® codes: 74177-26, 71260-26; ICD-10-CM codes: C34.12, I25.10.

Case 2: CT Head with Contrast

  • Location: Independent Diagnostic Testing Facility with the IDTF billing for the global component.
  • Procedure includes CT of the Head with/without contrast.
  • History: Non-small-cell lung cancer without specified location.
  • Findings report an intact calvarium, minimal mucosal thickening, and probable anterior communicating artery aneurysm measuring 6 x 5 mm.
  • No signs of metastatic disease detected.
  • CPT® code: 70470; ICD-10-CM codes: C34.90, I67.2, G93.9, G23.8.

Case 3: Bilateral Mammogram Screening

  • Location: Imaging center, radiologist employed, reporting the global component.
  • Study: Bilateral digital mammogram using computer-aided detection (CAD).
  • No previous mammograms for comparison; clinical history indicates positive family history of breast cancer.
  • Findings normal with BIRADS 1 - Negative result.
  • CPT® code: 77067; ICD-10-CM codes: Z12.31, Z80.3.

Case 4: Femur X-Ray

  • Location: Imaging center, radiologist employed for global component reporting.
  • Study: X-ray of the left femur (AP and lateral views).
  • Indication: Left leg pain, but findings show no fractures or dislocations.
  • Normal appearance of the femoral head and acetabulum.
  • CPT® code: 73552-LT; ICD-10-CM code: M79.605.

Case 5: Ultrasound of the Urinary Tract

  • Location: Regional hospital, coding for the professional component.
  • Purpose: Evaluate status post-ureteral reimplantation for vesicoureteral reflux.
  • Key findings indicate changes in kidney size and scarring without hydronephrosis.
  • Impressions suggest right renal enlargement and stable small left renal size.
  • CPT® code: 76770-26; ICD-10-CM codes: Z48.816, N13.70, N28.81, N27.0.

Case 6: CT Enteroclysis

  • Location: Regional Hospital, focus on unexplained abdominal pain.
  • Procedure: CT enteroclysis with fluoroscopic guidance and IV contrast.
  • Findings reveal no transmural inflammatory disease; mild prominence of vasa recta.
  • Recommendations made for possible microscopic colitis evaluation.
  • CPT® codes: 74177-26, 74340-26; ICD-10-CM codes: 44500, 99152, 99153 x 3, R10.9, R19.7, R63.4.

Case 7: Hysterosalpingogram

  • Location: Regional Hospital, performed for infertility assessment.
  • Indication: 15-year history of infertility with prior childbirth.
  • Findings suggest a possible contour abnormality of the right cornua without evidence of tube patency.
  • Recommendations include endovaginal ultrasound for further evaluation.
  • CPT® codes: 58340, 74740-26; ICD-10-CM code: N97.9.

Case 8: Renal and Bladder Ultrasound

  • Location: Regional Hospital, performed for renal artery stenosis evaluation.
  • Findings show normal kidneys with bilateral cysts; right kidney measures 10.1 cm and left kidney 10.4 cm.
  • Doppler study findings indicate moderate stenosis of the right renal artery origin.
  • CPT® codes: 93976-26, 76770-26-59; ICD-10-CM code: I70.1.

Case 9: MRI of the Lumbar Spine

  • Location: Regional Hospital, evaluation for low back pain.
  • Technique: 1.5 Tesla magnet used for lumbar imaging.
  • Findings include mild anterior wedging at L3 and a moderate size right paracentral disc protrusion at L4-5.
  • Impression: Multilevel degenerative disc disease.
  • CPT® code: 72148-26; ICD-10-CM codes: M48.56XA, M51.26, M51.36.

Case 10: Angiogram Procedures

  • Location: Regional Hospital, focused on mesenteric ischemia.
  • Procedures: Abdominal aortic and mesenteric artery angiograms performed under fluoroscopy.
  • Findings indicate normal aortic and mesenteric circulation with no stenosis.
  • CPT® codes: 36245, 36245-59 (x3), 75726-26 (x3); ICD-10-CM code: K55.9.

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This quiz consists of flashcards related to practical applications in Chapter 17 of the AAPC coding curriculum. It covers coding for CT scans performed at a regional hospital, including details about the exams and contrast used. Test your knowledge on radiological coding practices and professional components.

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