Sample/Practice/Free Urology (Genitourinary) Coding Questions
1.
Please supply the appropriate ICD9 code
for Calculus of ureter ___________
The
following scenario is applicable to questions 2-3:
Pt
is scheduled to have sonographically guided transrectal prostate biopsies,
cystoscopy
with fulguration of minor lesions in the bladder, and insertion of a left
double
J stent. Pre and post op DX – prostate nodule and small bladder lesions.
2.
How should this scenario be coded?
a.
52224, 52332, 55700, 76942
b.
52214, 55700, 76872,
c.
55700, 52000, 76942
3.
What modifier would be appended to show that a physician performed the
supervision
and interpretation of the procedure? ____________
4.
Cystitis is inflammation of the_____________.
a.
Kidneys
b.
Prostate
c.
bladder
5.
What is ureteral calculi?
a.
stone in the kidney
b.
stone in the ureter
c.
stone in the urethra
d.
stone in the bladder
6.
Which of the following terms describes the area located at the base of the
bladder?
a.
Renal pelvis
b.
Calyx
c.
Trigone
d.
Dome
7.
Code the urologist’s services:
PREOPERATIVE
DIAGNOSIS: Advanced carcinoma of the right ureter, morbid
Obesity
POSTOPERATIVE
DIAGNOSIS: Same
DESCRIPTION
OF PROCEDURE PERFORMED: Open nephrostomy with drainage catheter Patient was
placed in a lateral position and after adequate general anesthesia, a right flank
incision was made to gain access to the retroperitoneal space. Gerota's fascia
at the lower pole of the kidney was then incised using a deep knife. The ureter
was identified and isolated using Metzenbaum scissors and a small Penrose drain
was used to retract the ureter. Additional blunt dissection exposed the renal
pelvis where a small incision was made, Kelly forceps were used to tunnel a
passageway for the nephrostomy tube. A clamp was used to pull the catheter
through the tunnel until the tip was drawn into the renal pelvis. A separate
flank incision was made in the skin and the end of the catheter was brought
out. A large Penrose drain was placed near
the
kidney and secured to the skin using silk sutures and the incision used for the
surgical
approach was closed.
a.
52334
b.
50125
c.
50392
d.
50040
8.
When two surgeons perform procedures described by one CPT code and both
surgeons
document their part of the procedure, append a 80 modifier.
a.
True
b.
False
9.
Removal of a kidney is called a ______________________________.
10.
Code the urologist’s services:
PREOPERATIVE
DIAGNOSIS: Urinary calculi
POSTOPERATIVE
DIAGNOSIS: Same
DESCRIPTION
OF PROCEDURE PERFORMED: Percutaneous nephrostolithotomy Patient was placed in a
lateral position on their left side and 5 mL of lidocaine was injected for
local anesthesia. Using fluoroscopy, a suitable posterior calyx of the right kidney
was identified and a puncture was made below the 12th rib where a nephrostomy
needle was passed into the collecting system. The needle was withdrawn and 3 mL
of contrast was used to check for proper placement. Next a 0,035 guidewire (eg,
0.035 in) was passed into the collecting system and the needle was removed. A
fascial incising needle was used to cut the lumbodorsal fascia and the tract
was dilated by passing dilating catheters over the guidewire (6F, 8F, and 10F catheters).
A 14F nephrostomy catheter was positioned over the guide wire and sutured to
the skin. Next a nephroscope was passed through the tube until a single stone
measuring approximately 1.5 X 1.5 cm was visualized. It was removed with some
difficulty using graspers. Another 3 mL of contrast was used to confirm that no
additional stones or other obstruction remained, the scope was withdrawn and
the patient was returned to recovery room in good condition.
a.
50580, 5004551, 76000
b.
50580. 76000
c.
50080, 50395
d.
50081
11.
Which of the following medical terms describes an abnormal opening between the bladder
and vagina that permits passage of fecal material into the vagina?
a.
Vesicovaginal fistula
b.
Rectovaginal fistula
c.
Rectocele
d.
None of the above
12.
Code the urologist’s services…
PREOPERATIVE
DIAGNOSIS: Phimosis
POSTOPERATIVE
DIAGNOSIS: Same
PROCEDURE:
Excision of phimotic foreskin
This
male patient has been experiencing increasing symptoms associated with
phimosis
such as pain during intercourse and difficult hygiene. After considering his options,
he has elected to undergo surgical treatment. After adequate general
anesthesia,
with the patient in the supine position, several Kelly hemostats were
placed
at the edge of the prepuce. Next, fine dissecting scissors were used to make a longitudinal
incision to the prepuce. This was extended in a circular fashion until it was
possible to excise it completely and submit it for pathologic examination. Multiple
small bleeders encountered were controlled using electrocautery and the skin edges
were reapproximated using sutures. After adequate dressing, the patient was returned
to the recovery room in good condition. The foreskin was submitted to pathology.
a.
54100
b.
54161
c.
54304, 54100
d.
None of the above
13.
According to the National Correct Coding Initiative, if a double Jstent is
inserted at the same time as another cystourethroscopy or ureteroscopy
procedure, each may be reported separately if adequately documented and
medically necessary. In order to receive reimbursement for each code, a 59
modifier
should be appended to the 52332.
a.
True
b.
False
Answers:
1. 592.1
2. a
3. 26
4. c
5.
b
6. c
7. d
8. False
9. Nephrectomy
10. c
11. a
12. b
13.
True
Double J stent and Ureteral Stent used in removing tumors either from ureter or the kidney. Manish Medi is a leading manufacturers of Double J stent and Ureteral Stent with high quality technology
ReplyDeleteinteresting piece of information, i have read atleast eight posts of yours by now, and let me tell you, your blog gives the best and the most interesting information. This is just the kind of information that i had been looking for, i'm already your rss reader now and i would regularly watch out for the new posts,Regards guidewire training in hyderabad
ReplyDeleteNice information on urology. Questions are very selective. Visit Best Urologist to find top specialist.
ReplyDelete