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Tuesday, October 1, 2019

RESPIRATORY SYSTEM SAMPLE QUESTIONS - 001


1. A surgeon started with a diagnostic thoracoscopy. During the same surgical session she completed a surgical thoracoscopy to control a hemorrhage. How would you report this procedure?
a. 32601
b. 32601, 32654-59
c. 32505
d. 32654

2. A patient is brought from an MVA to the ER with multiple fractured ribs, labored breathing, and complaints of chest pain and palpitations. In the ER the thoracic surgeon performs a tube thoracostomy with some relief of the patient’s most severe symptoms. Several tests are run and radiographs taken. What is the correct code?
A. 32100
B. 32555
C. 32554
D. 32551

3. A sinus endoscopy with tissue removal from the sphenoid sinus was performed. The correct CPT® code is:
A. 31287
B. 31288
C. 31235
D. 31050

4. Surgeon performed radical maxillary sinusotomy with removal of antrochoanal polyps, bilaterally. The correct CPT code is,
a) 31020-50
b) 31030-50
c) 31032-50
d) 31050-58

5. Patient with congenital cleft palate underwent rhinoplasty with columellar lengthening, including the septum and tip.
a) 30410
b) 30462-50
c) 30462
d) 30460-50

6. A patient with diagnosis of larynx fracture. The physician did operative laryngoscopy with removal of chicken bone fragment with the help of operating microscope.
a) 31531
b) 31531, 69990
c) 31531-22
d) 31530, 69990

7. A patient underwent single-lung transplant with cardiopulmonary bypass employed during the procedure.
a) 32852
b) 32854
c) 32853
d) 32851

8. Select the codes for exploration with a flexible fiberoptic bronchoscope with transbronchial lung biopsy and washing from a LUL mass and bronchial brushings from a RLL mass.
a) 31622, 31623-50, 31628-51
b) 31628, 31623-51
c) 31625
d) 31625-50

9. What is the CPT code(s) for a segmentectomy of the right lung and a wedge resection of the left lung due to bacterial infection?
a) 32484-50
b) 32505-LT, 32484-RT
c) 32440-RT, 32484-LT
d) 32486-RT, 32505-LT

10. A patient suffering from chronic inflammation of the maxillary sinus underwent a surgical endoscopic transnasal balloon dilation procedure to restore normal sinus function. During this procedure, maxillary antrostomy with removal of tissue was completed. How should you report these procedures?
a) 31295
b) 31267, 31295-59
c) 31295, 31256-59, 31267-59
d) 31297

11. Dr. Walters performed a subsequent thoracocentesis of the pleural cavity for aspiration with needle fluoroscopic guidance. Which codes should Dr. Walters report for his professional services?
a) 32554
b) 32555
c) 32556
d) 32557

12. Alicia is 20 months old and suffering from chronic inflammation of the trachea, which is causing difficulty in breathing. Dr. Marion inserted a planned incisional tracheal trachea for Alicia. This procedure was completed under general endotracheal anesthesia. The patient tolerated the procedure well and was returned to the recovery room in stable condition. How should Dr. Marion report this procedure?
a) 31610
b) 31601
c) 31830
d) 31615

13. A patient underwent a recurrent destruction of the laryngeal nerve for therapeutic purposes. How would you report this procedure?
a) 31595
b) 31599
c) 31595, 64681-59
d) 64642, 31599-59

14. A patient underwent anterior and posterior ethmoidectomy and sphenoidotomy with removal of polyp.
a) 31254, 31287
b) 31255, 31287
c) 31254, 31288
d) 31255, 31288

15. What would you report for anterior and posterior ethmoidectomy and sphenoidotomy with removal of polyps, with frontal sinus exploration and antrostomy?
a) 31255, 31256, 31287
b) 31255, 31256, 31288, 31276
c) 31254, 31256, 31287, 31276
d) 31255, 31256, 31276

16. The surgeon performs a high thoracotomy with resection of a single lung segment on a 57-year-old heavy smoker who had presented with a six-month history of right shoulder pain. An apical lung biopsy confirmed lung cancer. Code the encounter for surgery. 
a) 32100
b) 32484
c) 32503
d) 19271, 32551


17. Code a diagnostic bronchoscopy and a repeat therapeutic bronchoscopy with aspiration of tracheobronchial tree.
a) 31622, 31646-51
b) 31645
c) 31622, 31629-51
d) 31645, 31622-51

18. A 43-year-old female was seen in the emergency room with severe epistaxis. She said this is a common occurrence for her during the really cold dry months of winter. Extensive bilateral anterior cautery and packing is required to control the hemorrhage.
What code is reported for the procedure (do not code the E/M).
a) 30901-22
b) 30903-50
c) 30905
d) 30903

19. Patient’s nose was hit with a baseball during a high school baseball game. At that time reconstruction was performed, with local grafts. Patient returns now as an adult, discontent with bony prominence along the bony pyramid and flat look of the tip of the nose. Patient underwent major repair with osteotomies and nasal tip work. Choose the correct CPT code(s) to report the procedure(s) performed.
a) 30410
b) 30435
c) 30450
d) 30462

20. Patient underwent bilateral nasal/sinus diagnostic endoscopy. Finding the airway obstructed the physician fractures the middle turbinates and performs surgical endoscopy with the total ethmoidectomy and bilateral nasal septoplasty.Choose the correct CPT code(s) to report the
 procedure(s) performed.
a) 30930, 31255, 30520-51
b) 31255-50, 30520-50-51
c) 31231, 30130, 31255-50
d) 31255, 30520

21. A patient with recurrent pneumothoraces presents for chemopleurodesis. A thoracoscope is inserted between the ribs and into the pleural space between the parietal and pleural viscera 5g of sterile asbestos free talc was inserted. What is the correct code for this service?
a) 32650
b) 32560
c) 32601, 32560
d) 32650, 32560

22. Procedure codes related to the ethmoid sinus would be found under which of these CPT ranges?
a) 30000-30999
b) 31000 – 31299
c) 31300 – 31599
d) 31600 – 31899

23. Patient is 40-year-old male who was involved in a motor vehicle crash. He is having some pulmonary insufficiency. Procedure: Bronchoscope was inserted through the accessory point on the end of the ET tube and was then advanced through the ET tube. The ET tube came pretty close down to the carina. We selectively intubated the right, main stem bronchus with the bronchoscope. There were some secretions here, and these were aspirated. We then advances this selectively into first the lower and then the middle and upper lobes. Secretions were present, more so in the middle and lower lobes. No mucous plug was identified. We then went into the left main stem and looked at the upper and lowerlobes.There was really not much in the way of secretions present. We did inject some saline and aspirated this out. We then removed the bronchoscope and put the patient back on the supplemental O2, we waited a few minutes. The oxygen level actually stayed pretty good during this time. We then reinserted the bronchoscope and went down to the right side again. We aspirated out all secretions and made sure everything was clear. We then removed the bronchoscope and pulled back on the ET tube about 1.5 cm. We then again placed the patient on supplemental oxygenation. Findings: No mucous plug was identified. Secretions were found mainly in the right lung and were aspirated. The left side looked pretty clear.
a) 31645, J98, V87.7XXA
b) 32654, J98.4, V87.7XXA
c) 31645, J98.4, V89.2XXA
d) 31646, J98, V89.2XXA

24. Performed: Fiberoptic bronchoscopy with brushings and cell washings.Procedure: The patient was already sedated, on a ventilator, and intubated; so his bronchoscopy was done through the ET tube. It was passed easily down to the carina. About 2 to 2.5 cm above the carina, we could see the trachea, which appeared good, as was the carina. In the right lung, however, had petechial ecchymotic areas scattered throughout the airways. The tissue was friable and swollen, but no mucous plugs were noted & all the airways were open ,just somewhat swollen .No abnormal secretions were noted
at all. Brushings were taken as well as washings including some with mucomyst to see whether we could get some distal mucous plug ,but nothing was returned. The specimens were sent to appropriate cytological & bacteriological studies.
a) 31622,31623-51
b) 31622
c) 31623
d) 31624


25. Roger had a rhinoplasty to correct damage caused by a broken nose. One year later he had a secondary rhinoplasty with major revisions. At the end of the second surgery the incisions were closed with a single layer technique. How would you report the second procedure?
a. 30450
b. 30450-78
c. 30420, 12014
d. 30430, 12014-59







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