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AAPC CPC chapter 10
Chapter 10-Cardio
| Question | Answer |
|---|---|
| Left and right sides of heart separated by ______. Coronary sinus: large vein, drains blood from heart walls into right _____. | septum, atrium |
| Tricuspid: 3 cusps (flaps). "lub dub" sound: Lub is tricuspid and _____ valves closing and dub is aortic and _____ valves closing. | mitral, pulmonary |
| Bundle of His: (AV bundle) and purkinje ______- "pacemaker" cells. Natural pacemaker of heart: _____ node. | fibers, SA |
| 5 systems relating to circulation: systemic, _____, pulmonary, portal and lymphatic. | coronary |
| On average ____ liters of blood circulating blood throughout the body. | 5 |
| Sytemic, pulmonary and coronary carry blood ____ the body. Systemic supplies blood to _____ except heart and lungs. | throughout, tissues |
| Semilunar valves: pulmonary and ______. | aortic |
| Acute Rheumatic fever: strep throat with group A sreptococci that's left _____. Major sequeala is heart ____ that lead to chronic rheumatic heart diseases. | untreated, lesions |
| HTN disease with HF: add on code to specify _____ of HF. Hypertensive CVD: code the CV condition 1st followed by _____ code. | type, hypertension |
| Hypertensive Retinopathy: 2 codes needed- hypertensive retinopathy with code to indicate type of _____ | hypertension |
| Secondary hypertension: 2 codes needed. Code for ____ cause and 2nd code to indicate type of hypertension. | underlying |
| Report hypertension: controlled or _____ | uncontrolled |
| STEMI: also called _____ MI | transmural |
| Arteriosclerosis: code selection indicates whether artherosclerosis is of a native artery, _____ artery or transplanted heart. | bypassed |
| I25.10: when pt has had CABG and doctor didn't _____ where the CAD is being treated and whether in native _____ or not. | specify, vessel |
| I25.82: "Chronic total occlusion of coronary artery" _____% occlusion | 100 |
| I24.0: debris caused an acute ____ of coronary artery not resulting in MI | blockage |
| Artherosclerosis/coronary: report if known presence of ____ or spasms | angina |
| Endocarditis: infectious organism or underlying _____ | disease |
| PAD/PVD: if only _____ is given, report I73.9- "unspecified." If d/t _____ use combination codes. | diagnosis, diabetes |
| Valve disorders: code for which valve affected and whether it's ____ or aquired. | congenital |
| Pericardiectomy: removal of the fibrous ____ (pericardium) surrounding the heart. | sac |
| Document if procedure/surgery required _____ use. Cardiac tumors may be inside or ____ of the heart. | bypass, out |
| TMR: Transmyocardial _____ revascularization surgery to treat severe angina. | laser |
| CPT coding for pacemaker/defibrillator need to know: The type of system, whether placement is _____ or permanent, whether device is single ____ or multiple leads or leadless, placement of _____, what components of device is being inserted, etc. | temporary, dual, electrodes |
| Pacemakers: different codes for _____ or dual chambers. May need more than 1 code for procedure. When looking for pacemakers/implantable defibrillators (CPT) look up cardiac _____ devices. | single, assist |
| ILR: implantable ___ recorder (cardiac rhythm monitor). | loop |
| Hemodynamic monitoring: implantable rhythym monitor. Implantation of ______ pressure sensor used for this, Code 33289. | wireless |
| Valves: when coding, need to know which valve is diseased or replaced, and what _____ of replacement valve. Replacement can be mechanical or _____ valve. | type, biological |
| Most open aortic valve surgery done with pt in cardiopulmonary ______ since heart cannot pump blood during surgery. | bypass |
| Transcather aortic valve replacement (TAVR): with a _____ valve, through various approaches (femoral artery, axillary artery, etc.) | prosthetic |
| Transcatheter aortic valve replacement: require 2 _____ and all components of procedure reported with modifier 62. There's 2 separate codes for various approaches with use of cardiopulmonary _____. | surgeons, bypass |
| Infundibulum: also known as the outflow _____, extends to the pulmonary artery (valves). | tract |
| Commissurotomy: surgery, opening or division of fibrous _____ for valves. | ring |
| 5 major coronary arteries: left circumflex, left and right anterior ______, Ramus intermedius. | decending |
| Takeuchi procedure: holes are made in the aorta and pulmonary arteries where the vessels ____ each other. The holes sewn together to create direct aortopulmonary opening. A _____ of pulmonary artery wall is created as a tunnel and blood diverted to this. | touch, flap |
| CABG: need to know: how many ____, how many arterial or venous and which veins/arteries? How were grafts _____, open or endoscopic? Did pt have _____ CABG? | grafts, harvested, previous |
| CPT divides codes by venous, arterial and _____ arterial- venous. | combination |
| Procurement of most arteries and the saphenous vein are ______. (grafts) | bundled |
| Sequential graft: sometimes used for CABG's. _____ each anastomosis (contact point) | Count |
| Whether pt has had previous CABG important for: ICD coding my be ____ if the pt has artherosclerosis of native coronary arteries vs previous bypass grafts. | different |
| Whether pt has had previous CABG important for: Add-on codes 33530 for additional reimbursement for _____ on CABG or valve procedures performed more than one ____ after original procedure. | reoperation, month |
| Most common septal defect: Ostium secundum (second opening). Normal for developing ____, but closes at birth. | fetus |
| Tetrology of Fallot: congenital heart condition, 4 anomalies: Stenosis of infundibulum, ventricular ____ defect, abnormally positioned aorta, hypertrophy of right _____. | septal, ventricle |
| Transposition of the great vessels: total reversal of the origin of the ____ and pulmonary artery. | aorta |
| Truncus arteriosis: common arterial trunk ____ out of both ventricles in the heart while the ____ is in stages of early development. | opening, fetus |
| Endovascular repair of abdominal aorta/or iliac arteries (EVAR): codes selected based on vessel involved and type of graft and if vessel _____. | ruptured |
| Endarterectomy: reported in separate code. Excision of _____ layers of artery. | diseased |
| Reporting total or partial excision of an _____ artery and the replacemnt with a graft- see codes under "Repair blood vessel other than for fistula with or without patch angioplasty" | occluded |
| Aneurysm coding guidelines for _____. | repairs |
| Code 35301 reported with add-on code 35390 when 2nd thromboendarterectomy is done more than 1 ____ after original operation involving _____ artery. | month, carotid |
| In situ graft: vein is left in it's ____ place while the arterial flow of blood is bypassed from artery to vein to artery to circumvent a ____ and create new circulatory pathway. | native, blockage |
| Any additional procedures (bypass) done to _____ blood flow toward or away from graft site as well as intraoperative angiograms are considered inherent in these codes and should not be ____ out for billing | improve, separated |
| If a vein and synthetic graft (bypass) are used in combination (composite graft) 35681 is reported, doesn't require modifier ___ | 51 |
| When reporting a bypass graft: when device used- report type of ____ or device. | graft |
| Note the point-to-point intersection/anastomosis of the _____ (bypass). | graft |
| Harvesting of saphenous vein graft if included in the description of work codes 35501-35587 and should ____ be reported separately. | not |
| Vascular injection procedures are in "Interventional ______" | radiology |
| Central venous access device: (CVAD) May be tunneled or non-tunneled and may be accessed via exposed ____ or a sub q port or pump. | catheter |
| CPT separates dialysis circut into 2 segments peripheral and ____. | central |
| Dialysis: coding based on progressive hierarchies, each ____ intensive service includes the procedures from less intensive procedures. Therefore only ____ code reported. | more, 1 |
| Ultrasound guidance for punture of dialysis circut usually not performed and not _____ in 36901-36906. | included |
| Transcatheter procedures: angioplasty perfromed for placing stent is ___ in the stent placement and not coded separately. | included |
| Interventional cardiology/ radiology (IVR): diagnose and ____ diseases using minimally invasive techniques under _____ guidance. | treat, imaging |
| Digital subtraction angiography: using electronic circuitry to subtract the background of bone and soft tissue to provide a useful ___ of arteries injected with a contrast. | image |
| Vascular injections: look at CPT Guidlines for to ___. | code |
| Non selective catheterization: catheter into the blood vessel, no ____ needed. | manipulation |
| Selective catheterization: the needle or catheter must be manipulated into other ____ of the vascular family. | branches |
| 5 vascular procedures for different systems are coded separately: systemic, pulmonary, coronary, ____ and lymphatic. | portal |
| Arterial system coding: surgical component coded separately from _____ component, there may not be a one-to-one corrospondence between the two procedures. | radiologic |
| Code complex procedures: first describe ____ procedural service without regard to the type and # of images provided. Then report the exact ____ service. | exact, imaging |
| Arterial selective Catheterizations: determin begining point (puncture site) and ____ point ( injection site/highest order catheter position) | end |
| Arterial selective Catheterizations: how many branches of each _____ family did the catheter go in? Only code highest order catheter selection within each family. | vascular |
| Arterial selective Catheterizations: anamolies: if 2 ____ required, each access point coded independently. | punctures |
| Venous system coding: like arterial selective catheterization except there are no codes for each additional 2nd or 3rd or _____ order catheterization. Instead CPT dictates use of code 36012. | higher |
| Venipunture procedures coding: what is the ____, is it direct percutaneous or cut-down procedure (incision to expose the vessel), did a _____ perform the procedure? | site, physician |
| Sclerotherapy: obliterating veins through a reaction caused by _____ solution injected into the vein. | chemical |
| Endovascular Revitilization: lower extremity services for _____ disease. Diagnostic angiography reported separately with modifier ____ when done prior to the intervention. | occlusive, 59 |
| Femoral popliteal territory: all interventions performed in the common ____, profunda, superficial femoral and popliteal arteris are reported with 1 code. | femoral |
| Tibial/peroneal territory: report 1 code based on the more work ___ procedure and add-on codes for additional procedures on vessels in this territory. | intense |
| Dianostic angiography radiologic supervision and interpretation (S&I): codes should not be used with _____ procedures for: contract injection, angiography, road mapping or flouroscopic guidance, vessel ____, post angiography (stent)/angioplsty. | interventional, measurement |
| CPT: radiology: when code descriptor states "selective" the catheter must be placed in the ____ to report the code. | vessel |
| SPECT scans: radioactive substance into vein and ____ to view the heart. | camera |
| Cardiac blood pool imaging: radioactive substance into blood stream, monitored as it ____ through heart. | travels |
| PCI: percutaneous coronary intervention- only one base procedure can be performed in a ____ coronary artery. Add-on codes for additional procedures in branches. Coded per ____. | major, vessel |
| Only 3 major coronary arteries have recognized branches and PCI can only be reported for up to ____ branches. | 2 |
| The 3 coronary arteries and branches recognized are: the left anterior decending, Left ____, right coronary. | circumflex |
| Modifiers: LC- left ____, LD- left decending, LM- Left main coronary, RC- Right _____, RI- Ramus intermedius. | decending, coronary |
| EKG: codes are differentiated by which ____ of the procedure the physician is reporting. | part |
| Cardio stress test: if doctor monitors the test only 93016. If doctor interperets it and writes official ____- 93018. If doctor does both 93016 and 93018 | report |
| Cardiac catheterization: global codes, meaning they are considered to have both a ____ and professional component. | technical |
| Cardiac catheterization: technical component- modifier TC is the provision of ____ personell, equipment, supplies and cost from performing procedure. | technical |
| Cardiac catheterization: professional component- modifier ____ is for the doctor's work providing the service such as interpreting a test or performing a procedure and ____ a fromal report. | 26, writing |
| Non congenital catheterization codes include: intraprocedural injections for _____, Imaging supervision, _____ and interpretation. | angiography, report |
| HCPCS codes may include drugs ____ for testing/procedures. | injected |
| Modifier 22: "increased procedural services" for when the service is ____ than usually required for listed procedure. | greater |
| Modifier 51: "_______ procedures" (non E/M) | multiple |
| Modifier 58: "staged or related procedure by same physician during post- op period" if procedure was: planned at the time of ____ procedure, more ____ than original procedure, for therapy following a dianostic surg proc. | original, exstensive |
| Modifier ____: when going beyond the work provided by initial procedure. | 58 |
| Modifier 59: "Distinct procedural service" procedures not ____ reported together. Don't use for E/M codes. | normally |
| Modifier 59: when provider sees pt during different session, treats a _____ site or organ system, makes a separate incision/excision, tends to a different ____, treats a separate injury. | different, lesion |
| Modifier ____: "Repeat procedure or service by same physician" Modifier 77: "Repeat procedure or service by ____ physician." | 76, another |
| Modifier 78: "Unplanned return to OR/Procedure room by same physician following ___ procedure for related procedure during post-op period." | initial |
| Modifier ___: "Unrelated procedure or service by same physician" | 79 |
Created by:
mlovest
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