50000 Series (10Q) - Try Free Quiz
1. A physician endoscopically removed a 0.3 cm calculus from patient’s right kidney under general anesthesia. Access was gained through an established nephrostomy. What is the correct code for this procedure?
A. 50060 -RT
B. 50075 -RT
C. 50561 -RT
D. 50580 -RT
2. A 25-year-old female patient with ESRD received a dual renal transplant without nephrectomy. What is the correct code for this transplant?
A. 50360 -50 B. 50360 C. 50365 D. 50365 -50
3. A physician performed a cystoscopy with ureteral stent removal. What is the appropriate CPT code?
A. 52000, 52310 B. 52310 C. 52000 D. 52315
4. The patient presents to the gynecologist’s office complaining of stress incontinence. The GYN decides to perform a sling operation using synthetic materials to reinforce the patient’s muscles and allow for additional urinary control. This procedure is performed laparoscopically in order to be less invasive. What is the correct code for this procedure?
A. 57288 B. 57287 C. 51990 D. 51992
5. A 38-year-old female patient with severe endometriosis and urethral malignancy received pelvic exenteration with removal of bladder and ureteral transplantations. The patient also received a full hysterectomy. What is the correct code for this service?
A. 58240 B. 51597, 58285 C. 51597 D. 58240, 58285
6. An 87-year-old male patient in a rehab hospital status-post hip transplant is having trouble voiding. After his last voiding, the physician measured his bladder capacity using a non-imaging ultrasound device. How should you code for this procedure?
A. 51741 B. 51798 C. 51798 -50 D. 51792
7. A physician performed an endoscopic resection of a 2.3 cm bladder tumor. What is the correct CPT code?
A. 52235 B. 52234 C. 52240 D. 52224
8. PROGRESS NOTE PATIENT: Davis, Levi DATE: 09/08/2014 MEDICAL NOTE:
The patient is actively being treated for bladder cancer. The patient presented to the office today for bladder instillation treatment. The patient was catheterized and his bladder was emptied of all contents. An anticarcinogenic agent was introduced into the bladder at 0100 hours. The patient was instructed to lie in supine position for 45 minutes. The physician returned at 0145 hours and emptied the bladder of the anticarcinogenic agent. The patient tolerated the procedure well. The patient was instructed to return to office in one week for the next treatment and a follow-up examination. What is the correct code for the instillation treatment only?
A. 51715 B. 51701 C. 51702 D. 51720
9. A physician performed a cystourethroscopy with an ejaculatory duct catheterization and irrigation. Duct radiography was also performed to visualize ejaculatory duct system. What CPT codes should be reported?
A. 52000, 52010
B. 52000, 52010, 74440
C. 52010, 74440
D. 52010
10. A physician performed an incision and drainage on a complicated deep penile abscess. What is the appropriate code for this procedure?
A. 10061 B. 10081 C. 54015 D. 54105
Answer
1. Answer: C - The correct code for this procedure is 50561(Renal Endoscopy through Established Nephrostomy or Pyelostomy, with or without Irrigation, Instillation, or Ureteropyelography, Exclusive of Radiologic Service; with Removal or Foreign Body or Calculus). Codes 50060 and 50075 are incorrect because they are used for the removal of the calculus via an open incision, or nephrolithotomy. Code 50580 is incorrect because it is used for an endoscopic removal of a calculus through a nephrotomy; while in this case, access for the procedure was gained through a nephrostomy.
2. Answer: A - The correct code for this transplant is 50360 (Renal Allotransplantation, Implantation of Graft; without Recipient Nephrectomy) and modifier -50. Modifier -50 must be included on the claim to indicate that the service was bilateral (it was performed dually). Code 50365 is incorrect because it is used for a renal transplantation with nephrectomy, meaning that the patient’s kidneys were removed before the transplants were implanted. This was not the case.
3. Answer: B - The appropriate CPT code is 52310 (Cystourethroscopy, with Removal of Foreign Body, Calculus, or Ureteral Stent From Urethra or Bladder; Simple). Code 52000, for cystourethroscopy should not be reported separately as the term “separate procedure” is within the code description. In other words, you do not need to report it unless it was the only procedure performed. In this case, it is included within the code for the primary procedure, 52310. Code 52315 is also incorrect because there is no mention of the procedure being complicated.
4. Answer: D - Code 51992 (Laparoscopy, Surgical; Sling Operation for Stress Incontinence) is the appropriate code for this procedure. Codes 57288 and 57287 are used for open procedures and although code 51990 is also used for laparoscopic stress incontinence, this code refers to urethral suspension not a sling.
5. Answer: C - The correct code for this service is 51597 (Pelvic Exenteration, Complete, for Vesical, Prostatic, or Urethral Malignancy, with Removal of Bladder and Ureteral Transplantations, with or without Hysterectomy and/or Abdominoperineal Resection of Rectum and Colon and Colostomy, or any Combination Thereof). Code 58285, for radical hysterectomy, should not be reported separately, as code 51597 already includes hysterectomy. Code 58240 is incorrect because it is used for a pelvic exenteration performed due to a gynecologic malignancy. In this case, the patient had a urethral malignancy, not gynecologic malignancy.
6. Answer: B - You should code for this procedure with 51798 (Measurement of Post-Voiding Residual Urine and/or Bladder Capacity by Ultrasound, Non-Imaging). Modifier -50 should not be used for a bilateral procedure. In this case, the procedure cannot be done bilaterally.
7. Answer: A - The correct CPT code is 52235 (Cystourethroscopy, with Fulguration and/or Resection of; MEDIUM Bladder Tumor(s) (2.0 to 5.0 cm)). The procedure description states that the bladder tumor was 2.3 cm, so it fits within the medium size category for bladder tumors. Code 52234 is used for small (0.5 up to 2.0 cm) tumors and code 52240 is used for large (over 5.0 cm) tumors.
8. Answer: D - The correct code for the instillation procedure is 51720 (Bladder Instillation of Anticarcinogenic Agent (Including Retention Time)). In this procedure, an anticarcinogenic agent for the treatment of cancer was instilled into the bladder and held for a certain amount of time in order to kill cancer cells. This is a common treatment for bladder cancer.
9. Answer: C - The CPT codes that should be reported are 52010 (Cystourethroscopy, with Ejaculatory Duct Catheterization, with or without Irrigation, Instillation, or Duct Radiography, Exclusive of Radiologic Service) and 74440 (Vasography, Vesiculography, or Epidemiography, Radiological Supervision and Interpretation) Duct radiography was performed, therefore the radiological S&I also needs to be reported. In parenthesis under code 52010, it directs the coder to code 74440, the appropriate radiological S&I code.
10. Answer: C - The appropriate code for this procedure is 54015 (Incision and Drainage of Penis, Deep). Codes 10061 and 10081 are incorrect because they are integumentary codes that refer to the incision and drainage of deep abscesses of the skin. In this case, the abscess is not in the skin of the penis, it is in the deep tissue of the penis, therefore integumentary codes are inappropriate.