3 - Series - Ans 2022

30,000 series
1.a - Physician report the creation of the pocket (Skin pocket is included). This
procedure is included with insertion of the pacemaker.
2.b - (52- Reduced services) A colonoscopy is the examination of the entire colon,
from the rectum to the cecum, and may include the examination of the terminal
ileum. You can find this description in the surgery section of the CPT Professional
Edition under digestive endoscopy procedures.
3.c - Reports a single temporary transvenous pacing (33210).
4.c - Bilateral diagnostic nasal endoscopy (31237-50). The guidelines for codes
31231–31294 report unilateral procedures unless otherwise stated.
5.d – Esophagoscopy
6.c - Catheter placements into the aorta from a femoral, brachial or axillary
approach are defined by code 36200.
7.b - TLA (translumbar aortogram) catheter placement is defined by code 36160.
8.c - Typical global periods (in days) are 0, 10 and 90.
9.c - Repair to a coronary arteriovenous chamber fistula. The fistula did not
require cardiopulmonary bypass (33501)
10.b - thoracentesis aspiration with image guidance (32555).
11.a - The drainage of fluid from the pleural cavity was performed via needle
(percutaneous) with insertion of a catheter, eliminating multiple choice answers B
and D. The procedure was performed under ultrasound guidance, eliminating
multiple choice answer C.
12.c – 38505 (axillary) A needle was used to obtain the biopsies, eliminating
multiple choice answers B and D. An aspiration (drawing fluid out) was not
performed, eliminating multiple choice answer A. Imaging guidance (ultrasound)
was performed, correctly reporting 76942 from the parenthetical note.
13.a - The key term for this scenario is temporal artery biopsy, which is found in the
code descriptive for multiple choice answer A.
14.d -For this procedure the thoracic surgeon is performing a Thoracostomy

(32551), which is the puncturing of the chest between the ribs to remove fluid
and/or air from the chest cavity. This eliminates the codes that have
thoracentesis, i.e B, C which a needle is used to puncture the chest and also A.
The final clue is tube thoracostomy which leads to the code 32551.
15.b - A surgical endoscopy is being performed since there is a removal of tissue

from the sphenoid sinus (31288). No biopsies were performed or just a look-see
(diagnostic endoscopy) for that area of the sinus.
16.b - Code 39000 is a cervical approach, code 39010 reports a transthoracic

approach.
17.d - A surgical thorascopy always includes a diagnostic thorascopy. You can find
this note in the CPT Professional Edition under the Endoscopy heading.
18.c - The code 33530 and 35572 are add-on codes and should not have modifier
51 appended. Review modifier -51 in Appendix A of the CPT Professional Edition
for this note.
19.a - The code 33210 reports a temporary transvenous single chamber

pacemaker. There is not enough information in the question to code for the
placement of the permanent system.
20.d - When coding for this procedure, it is necessary to code for the removal
(33235) and then replacement of the leads (33217). Modifier -51 indicates
multiple procedures in the same anatomic site.
21.d - Transcatheter aortic valve performed via an open femoral approach

(33362), Cardio-Pulmonary, bypass via open peripheral arterial and venous
cannulations (33368).
22.c - Transcatheter retrieval (removal), percutaneous, of intravascular foreign

body/ broken catheter (eg, fractured venous or arterial catheter).
23.b - arterial thrombolysis (initial date of treatment - 37211) procedure is started
Monday and finished on Tuesday (cessation - 37214) (these codes should be used
once per date of treatment).
24.c - selective common carotid catheter placements (36223) eliminating A and B.

Bilateral cervical and cerebral carotid imaging (50). The vertebral is imaged with a
selective catheter placement in the innominate (NOT in the vertebral itself);
therefore, (36225) Selective catheter placement, subclavian or innominate artery,
unilateral, with angiography of the ipsilateral vertebral circulation and all
associated radiological supervision and interpretation, includes angiography of
the cervicocerebral arch, when performed applies here.
25.a – The word selection is not mentioned by default it is a Non-selective

catheter placement (36221); includes both unilateral or bilateral son need of
modifier 50. Code 36221 should not be reported with 36222-36226.
26.d - procedure with the help of catheter into innominate subclavian artery, by
neck incision (34001).
27.b - Endovascular graft for abdominal aortic aneurysm repair (34800-34826).
28.c- 3 venous grafts (+33519) from left lower limb and 1 arterial graft (33533)
from left radial artery (35600). Under guidelines of combined artery-venous
grafting for coronary bypass, when an upper extremity artery eg: radial artery was
procured. To report harvesting of an upper extremity artery, use 35600 in
addition to bypass procedure.
29.c - 2 physicians operating as primary surgeons therefore modifier 62 should be

appended. Revision of skin pocket is included in 33206-33249.Insertion and
placement of the electrode i.e 33208. Surgeon A 33208-62, Surgeon B 33208-62.
30.a - removal of 2 lobes (bilobectomy - 32482), with bronchoplasty (32501

31.a. You can locate this procedure in the index of CPT® Professional Edition under
TAVR/ TAVI (see Artery/Femoral/Approach/Transcatheter Aortic Valve
Replacement). Review the guidelines with these codes for reporting criteria,
including modifiers -62 and -59. Modi-fier -62 is required for the two physicians on
all components of the TAVR/TAVI procedures.Diagnostic coronary angiography
performed at the time of TAVR/TAVI can be reported under certain circumstances.
In this case, the initial cardiac catheterization was completed for diagnostic
purposes on the same day as the TAVR/TAVI. Therefore, modifier -59 is required for
reporting the separate study.
32.c. Review the reporting criteria in the guidelines for central venous access
procedures. The Central Venous Access Procedures Table in CPT® Professional
Edition is helpful for reporting procedures. Find the header Repair/Device in the left
column of the table, then follow the row across to the column entitled “Any Age”
for the code suggestion. Follow the same steps and locate “Repositioning of
Catheter Any Age” for the code suggestion. Once you have found the codes, review
them for additional parenthetical notes.
33. a. This procedure was an insertion of a dual pacemaker with radiological

evaluation for trans-venous lead placement and function of the pacemaker. The
radiological service, evaluation of pacemaker, moderate sedation, and creation of
the skin pocket are included in the insertion of the pacemaker. Review the
guidelines under Pacemaker or Pacing Cardioverter-Defibrillator for guidance in
reporting these procedures.
34. d. selecting the correct answer can be tackled two ways.

(1) A third order selective catheter placement in the brachiocephalic system was
not performed, eliminating multiple choice answers A and C. Bilateral angiography
of the lower extremities was not performed, eliminating multiple choice answer B.
Arterial access was the left common femoral artery and the catheter was directed
into the right common iliac (36245 – first order) into right external iliac (36246-
second order). The catheter was then directed to the common femoral into the
superficial femoral artery (36247-third order). Report only the highest level of
catheter placement 36247. Angiography for the right extremity is 75710. Modifier
26 denotes the professional service.
(2) A right lower extremity angiogram was performed. Code 75736 is eliminated
because that is for the pelvis. Code 75716 is eliminated because this for an a
bilateral angiogram. Code 75756 is eliminated because that is for the internal
mammary. Code 75710 is the correct angiography code.
35. A. This procedure is represented with a new code for 2011. Review of the
parenthetical notes with this code in the CPT® Professional Edition will assist with
correct conjunctive coding.
36. Answer: D. 36200, 75716-26, 75625-26, Rationale: The catheter was placed at
the level of the renals or renal arteries, not in the renal arteries, so this is a
nonselective catheterization. Nonselective catheter placement in the aorta is
reported with 36200, which is found in the CPT® Index under
Aorta/Catheterization/Catheter or Catheterization/Aorta. Because the catheter was
repositioned and separate studies were performed, both the aortography and the
extremity angiography are reported. In the CPT® Index, Look for
Aorta/Aortography; you are referred to 75600–75630. Angiography of the lower
extremities is found under Angiography/Leg Artery; you are referred to 73706,
75635, 75710–75716. Modifier 26 reports the professional service.
37. B. To narrow down your choices, you can start with coding the diagnosis first.
The patient is having the procedure done due to a lung mass. A specimen was sent
to pathology and came back indicating that the lung mass is cancerous. In
the ICD-9-CM index, look up in the Neoplasm Table
lung/malignant/primary column. You are referred to code 162.9, eliminating
multiple choice answers A and D. You would not code 31622 since this is a separate
procedure. A diagnostic procedure is not coded if performed at the same session as
a surgical procedure in the same area. A surgical procedure (biopsy) was performed
with the bronchoscopy.
38. D. The patient had a secundum atrial septal (atrioseptal) defect, eliminating
multiple choice answers A and C. The surgery was only performed on the atrial
septum, eliminating multiple choice answer B.
39. A. The key term for this scenario is “temporal artery biopsy”, which is found in
the code descriptive for multiple choice answer A.
40. C. A needle was used to obtain the biopsies, eliminating multiple choice answers
B and D. An aspiration (drawing fluid out) was not performed, eliminating multiple
choice answer A. There is a parenthetical note under code 38505 that indicates see
imaging guidance, when performed 76942, 77012, 77021. Imaging guidance
(ultrasound) was performed, correctly reporting 76942.

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30,000 series

3.c - Reports a single temporary transvenous pacing (33210).

7.b - TLA (translumbar aortogram) catheter placement is defined by code 36160.

8.c - Typical global periods (in days) are 0, 10 and 90.

10.b - thoracentesis aspiration with image guidance (32555).

14.d -For this procedure the thoracic surgeon is performing a Thoracostomy

15.b - A surgical endoscopy is being performed since there is a removal of tissue

16.b - Code 39000 is a cervical approach, code 39010 reports a transthoracic

19.a - The code 33210 reports a temporary transvenous single chamber

21.d - Transcatheter aortic valve performed via an open femoral approach

22.c - Transcatheter retrieval (removal), percutaneous, of intravascular foreign

24.c - selective common carotid catheter placements (36223) eliminating A and B.

25.a – The word selection is not mentioned by default it is a Non-selective

27.b - Endovascular graft for abdominal aortic aneurysm repair (34800-34826).

29.c - 2 physicians operating as primary surgeons therefore modifier 62 should be

30.a - removal of 2 lobes (bilobectomy - 32482), with bronchoplasty (32501

33. a. This procedure was an insertion of a dual pacemaker with radiological

34. d. selecting the correct answer can be tackled two ways.

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