Cardiovascular System Quiz

Conduction System Components

• The conduction system consists of pacemaker cells, nodes, the bundle of His, and Purkinje fibers.

Cardiomegaly

• Enlargement of the heart is referred to as cardiomegaly.

Artery Structure

• Arteries are composed of three layers of tissue.

Coronary Vessel Repair

• Angioplasty is the procedure for repairing coronary vessels.

Abdominal Aortic Aneurysm

• For a ruptured abdominal aortic aneurysm involving the common iliac, CPT® code 35103 applies.

Dual Chamber Implantable Defibrillator Replacement

• Replace a dual chamber defibrillator system with a multi-lead system, using codes: 33244, 33202-51, 33264-51, and 33223-59.

Coding Hypertensive Retinopathy

• To accurately code hypertensive retinopathy in ICD-10-CM, specify the affected eye(s).

PICC Line Placement

• For PICC line placement with a port under fluoroscopic guidance in a 45-year-old patient, report codes 36571 and 77001-26.

Angiography and Catheterization

• Aortography and bilateral extremity angiography are reported with CPT® codes 36200, 75625-26, and 75716-26.

Tunneled Central Venous Access Device

• Insertion of a tunneled central venous access device with a subcutaneous pump in a 7-year-old is coded as 36563.

Heart Failure Coding

• For acute systolic heart failure due to hypertension with CKD stage 4, use ICD-10-CM codes I13.0, I50.21, and N18.4.

Electrophysiology Study

• In a comprehensive electrophysiology study, report codes 93600-26, 93602-26, 93610-26, and 93618-26.

Hemodialysis Fistula Revision

• For revision of an autogenous radiocephalic fistula, the correct CPT® code is 36832.

Angioplasty Procedure

• For right femoral angiography and percutaneous transluminal tibioperoneal angioplasty with stenting, use codes 37230 and 37224-51.

Pseudoaneurysm and Left Ventricular Failure Codes

• The ICD-10-CM codes for pseudoaneurysm, cardiac tamponade, and left ventricular failure are I72.9, I31.4, and I50.1.

PTA for Hemodialysis AV Graft

• Report percutaneous transluminal angioplasty for obstructed hemodialysis AV graft with CPT® code 36902.

Pacemaker Replacement Coding

• Reimplantation of a dual chamber pacemaker is reported using codes 33235, 33208-51, and 33233-51.

Coronary Artery Bypass Grafting

• For CABG involving one arterial and one vein graft, report codes 33533, 33517, and 35600.

Vascular Injection Procedures

• Included in vascular injection procedures are local anesthesia, catheter introduction, contrast media injection, and related care.

Extremity Venous Study

• For complete noninvasive physiologic studies of both lower extremities, use CPT® code 93970.

MAZE Procedure for Atrial Fibrillation

• MAZE procedure for atrial fibrillation performed on cardiopulmonary bypass is coded as 33256.

Complete TTE for Mitral Valve Prolapse

• For a complete TTE assessing mitral valve prolapse, the correct CPT® code is 93303.### General Coding Guidelines
• Global service reported indicates no modifier is necessary for procedures performed in the physician’s clinic.
• Echocardiography for congenital cardiac anomalies can be reported using codes 93303-93304 from the CPT® Index.

Procedure Overview for Card 23

• Patient underwent right femoral artery access for catheter placement in abdominal aorta, involving a 5 French pigtail catheter.
• A total of 80cc contrast injected, followed by oblique DSA images of iliac circulation.
• Findings show the lower abdominal aorta with mild atheromatous changes and two eccentric plaques above the iliac bifurcation.
• High-grade stenosis noted in both proximal iliacs, more severe on the right.
• Normal results for multiple arteries including right superficial femoral, profunda femoral, and popliteal arteries.
• Stenosis of approximately 40-50% present in the left common femoral artery.

Reporting Codes for Card 23

• Use code 36200 for nonselective catheter placement in the aorta.
• Code 75630-26 for the abdominal aortogram with bilateral iliofemoral lower extremity angiography, indicating professional service.

Clinical Summary for Card 24

• Patient: 55-year-old female with known coronary disease and recurrent chest pain.
• Previous treatment included intervention to left anterior descending and diagonal arteries.
• Cardiac catheterization showed patency of the stented segment but significant stenosis in the right coronary artery.

Procedure Details for Card 24

• Sterile prep with conscious sedation using 2mg Versed and 50mcg fentanyl.
• Exchange of diagnostic catheter sheath was performed, followed by IVUS interrogation.
• Significant stenosis confirmed, requiring deployment of a 3.0 x 16 mm Taxus stent under high inflation pressure.
• Post-procedure angiography shows improved artery size with no complications.

Reporting Codes for Card 24

• Stent placement is reported with code 92928-RC, indicating the right coronary artery.
• IVUS procedure reported with add-on code 92978.

Procedure Overview for Card 25

• Catheter advanced into left renal artery via right common femoral puncture for selective catheterization.
• Angiographic films taken; a 6.0 x 18 mm balloon expandable Racer stent was deployed.
• Procedure yielded excellent results with no residual stenosis.

Reporting Codes for Card 25

• Selective catheterization of the left renal artery coded as 36245-LT.
• Stent deployment in the left renal artery is reported with code 37236, which covers radiologic supervision and interpretation.

Test your knowledge of the cardiovascular system with this quiz. It includes questions about the conduction system, heart enlargement, and the structure of arteries. Perfect for students in anatomy or physiology courses.