Him 405

Front 1

The endoscopy should always be coded ?

Back 1

as far as the scope was passed

Front 2

? allows the physician to visualize the esophagus

Back 2

esophagoscopy

Front 3

? (abb?) is an upper gastrointestinal endoscopy which involves the visual examination of esophagus, stomach, and upper duodenum and/or jejunum

Back 3

Esophagogastroduodenoscopy (EGD)

Front 4

The CPT format for upper GI procedures, the ? is listed first followed by a list of ?
It is appropriate to list multiple codes if supporting documentation exists

Back 4

diagnostic procedure

surgical treatments

Front 5

Esophageal Dilation has two methods:
? = through the endoscope, the physician selects a dilating balloon or dilators over the guidewire
? = is not done with the scope. The surgeon passes tapered dilators through the mouth and guides them into the esophagus. ? and ? are common types of bougies used for dilation

Back 5

Endoscopic

Manipulation
Hurst and Maloney

Front 6

? (abb?) is a procedure that is used to diagnose problems in the liver, gallbladder, bile ducts, and pancreas. It combines the use of xrays and an endoscope. Through the endoscope the physician can see the inside of the stomach and duodenum and inject dyes into the ducts in the biliary tree and pancreas so they can be seen on xrays

Back 6

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Front 7

Lower GI endoscopies can be classified by the area of the intestine examine by:
-? is an exam limited to the rectum and sigmoid colon
-? is an exam of the entire rectum and sigmoid colon that may also include a portion of the descending colon. The depth of the visualization is typically 35 - 60cm
-? is an exam of the entire colon, from the rectum to the cecum that may include the terminal ileum. Usually 60cm or higher

Back 7

-Proctosigmoidoscopy

-sigmoidoscopy

-colonoscopy

Front 8

indications for performing ? procedures include abnormal barium enema, lower GI bleeding, iron deficiency anemia of unknown etiology, and diarrhea. They may also be performed for follow-up exam after removal of a neoplastic growth

Back 8

lower GI

Front 9

When coding a colonoscopy, must review the operative report to determine the approach which may be through: ? (3)

Back 9

an existing colostomy, colotomy, the rectum

Front 10

The removal of tumors or polyps, ? resemble tweezers connected to an electrosurgical unit. Grasping the polyp, the physician pulls the growth away from the wall of the structure. A portion of the neoplasm may be removed for pathological analysis. The remaining portion is destroyed with the electrocoagulation current

Back 10

Hot biopsy forceps

Front 11

For the removal of tumors or polyps, the ? uses a wire loop that is slipped over the polyp or tumor. The stalk is then cauterized and the growth is removed

Back 11

Snare technique

Front 12

For the removal of tumors or polyps, the physician may use a neodymium yttrium aluminum garnet laser to remove the lesion (this is called ?). When a laser is used during the endoscopy, should code for the endoscopy that states "with __ of tumor, polyps or other lesions not amenable to removal by hot biopsy forceps, bipolar cautery, or snare technique

Back 12

Ablation

Front 13

Sometimes with a colonoscopy, the procedure may be attempted, but circumstances may prevent the entire colon from being visualized. In this case, code the colonoscopy code with modifier ? for discontinued procedure

Back 13

-53

Front 14

Modifier ? = colorectal cancer screening test; converted to diagnostic test or other procedure. Used when screening colonoscopy is converted to a diagnostic test or procedure on the same date and in the same encounter. It is added to the diagnostic procedure code instead of the code for screening colonoscopy

Back 14

PT

Front 15

If the coder is assigning codes for FACILITY services of an incomplete colonoscopy, should code with the following modifiers:
-? discontinued procedure prior to anesthesia
-? discontinued procedure after anesthesia

Back 15

-73

-74

Front 16

When a biopsy of a lesion is taken and the remaining portion of the same lesion is excised during the same operative episode, assign a code for ?

Back 16

the excision only

Front 17

When one lesion is biopsied and a different lesion is excised, assign a code for ?. This rule applies unless the excision code includes the phrase "with or without biopsy" which leaves only the ? is assigned

Back 17

the biopsy and a code for the excision

excision code

Front 18

If code for excision and code for a biopsy, when appropriate, add modifier -? to the ? code

Back 18

-59 to the biopsy

Front 19

When biopsy codes use the terms "with biopsy, single or multiple" these codes are to be used ?, regardless of the number of biopsies taken

Back 19

only once

Front 20

For an ?, an incision is made over the thrombus, and the clot and disease hemorrhoid plexus are removed in one piece

Back 20

incision of external thrombosed hemorrhoid

Front 21

Rubber Band Ligation, ? (without incision or excision), is a treatment for internal hemorrhoids that is sometimes referred to as "?". The physician attaches tiny rubber bands to the base of the hemorrhoids. With circulation cut off, the hemorrhoids painlessly fall away after seven to ten days and are expelled with stool. This code is reported only once per operative session, regardless of how many hemorrhoids the physician bands at a time

Back 21

Hemorrhoidectomy by simple ligature
banding

Front 22

? methods include cautery, radiofrequency, and infrared coagulation (IRC)

Back 22

Destruction of Internal Hemorrhoids by Thermal Energy

Front 23

? (abb?) involves a small probe with a light source that coagulates the veins above the hemorrhoid causing it to shrink and recede

Back 23

Infrared coagulation (IRC)

Front 24

? differs from hemorrhoidectomy by simple ligature in that the physician isolates the hemorrhoid and ties suture material to its base

Back 24

Suture Ligation

Front 25

Hemorrhoidectomy, surgical excision codes, are differentiated by whether the hemorrhoids were ?, ?, or ?

Back 25

internal, external, or both

Front 26

There is an unlisted code for destruction of hemorrhoids by ?

Back 26

cryosurgery

Front 27

An ? occurs when internal organs, such as intestines, break through a hole or tear in the musculature of the abdominal wall. This protrusions produces a bulge that can be seen or felt

Back 27

Abdominal Hernia

Front 28

To code hernia repairs, need to know: ? (4)

Back 28

-the type and/or site of the hernia
-the history of the hernia
-the age of the patient
-the clinical presentation of the hernia

Front 29

? is a common herniation of the inguinal canal in the groin area

Back 29

Inguinal Hernia

Front 30

? is a rare herniation in the lumbar region of the torso

Back 30

Lumbar Hernia

Front 31

? is a herniation at the site of a previous surgical incision

Back 31

Incisional Hernia

Front 32

? is a common herniation in the femoral canal in the groin area

Back 32

Femoral Hernia

Front 33

? is a herniation above the navel

Back 33

Epigastric Hernia

Front 34

? is a herniation at the navel

Back 34

Umbilical Hernia

Front 35

? is a herniation above the inferior epigastric vessel along the outer border of the rectus muscle

Back 35

Spigelian Hernia

Front 36

History of the hernia, is the hernia repair:
? (first surgical repair of the hernia) or ? (hernia has been surgically repaired previously

Back 36

initial or recurrent

Front 37

Clinical presentation:
? = the protruding organs can be returned to a normal position by surgical (not medical) manipulation *most minor

Back 37

Reducible

Front 38

Clinical presentation:
? = the colon or cecum is part of the hernia sac (the urinary bladder can also be involved)

Back 38

sliding

Front 39

Clinical presentation:
? = the hernia cannot be reduced without surgical intervention

Back 39

Incarcerated

Front 40

Clinical Presentation:
? = The hernia is an incarcerated hernia in which the blood supply to the contained organ is reduced. A strangulated hernia presents a medical emergency

Back 40

Strangulated

Front 41

hernia repair =

Back 41

herniorrhaphies

Front 42

? (aka ?)is the first type of hernia repair. Under general anesthesia, the physician pushes the bulging tissue back into the abdominal cavity. The defect is closed by pulling together and stitching the surrounding muscles and ligaments. Recovery period of 4-6 weeks

Back 42

Traditional Repair
Conventional Repair

Front 43

? type of hernia repair uses mesh rather than stitches to repair the abdominal defect. Because stitches are not used, the patient experiences less postoperative pain. Commonly used meshes are Marlex and Prolene.

Back 43

Herniorrhaphy with Mesh Repair

Front 44

When coding a mesh repair of an incisional or ventral hernia, code "implantation of mesh or other prosthesis for incisional or ventral hernia repair" must be coded in addition to the ? code. The use of mesh with other hernia repairs is not coded

Back 44

repair

Front 45

? hernia repair is performed by laparoscope. It is commonly performed to repair bilateral and recurrent hernias. Main advantages are less discomfort and faster recovery

Back 45

Laparoscopic Hernia Repair

Front 46

? occurs when part of the stomach pushes through the opening in the diaphragm. The repair codes are differentiated by: surgical technique used (laparoscopy, thoracotomy, and thoracoabdominal incision) and whether the procedure involved implantation of mesh

Back 46

Paraesophageal Hiatal Hernia Repair

Front 47

? procedures are less invasive, requiring less recovery time than traditional procedures. With technologic improvements, the use of __ has been extended to surgical procedures involving the appendix, colon, and other areas of the body. ___ have their own heading in the various surgical sections

Back 47

Laparoscopic Procedures