Exam 4 Cardiovascular and Hemic Lymph Paper Version

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Oct 30, 2023

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55 Points 1. ____ Cardiology is entering the body to make a correction or for examination. Invasive Electrophysiology Noninvasive Angiography 2. An example of a noninvasive cardiology procedure/service is: placement of a temporary pacemaker placement of an intra-aortic balloon assist device cardiovascular stress test angioplasty 3. A ________ is an x-ray of the portal and circulatory vessels of the spleen. Splenoportography Splenotomy Splenectomy Splenostomy 4. The device that can be inserted into the body to electrically shock the heart into regular rhythm. epicardial rhythm enhancer ventricle insertion cardioverter-defibrillator transverse marker 5. What is the name of the electrodes that are placed into the atrium and/or ventricle of the heart when a pacemaker is inserted? guidewires leads catheters threads 6. Within the cardiovascular system, what is compared to the branches of a tree? veins vascular families arteries coronary vessels 7. In which type of catheter placement is the catheter moved, manipulated, or guided into a part of the arterial system other than the vessel punctured? localized infiltrated infused selective 8. The number of postoperative days usually assigned for the global period following implantation of a pacemaker is: 10 62 12 90 9. A (n) ____ is a mass of undissolved matter that is present in blood and is transported by the blood. thrombus false aneurysm aneurysm embolus pg. 1 EXAM 4 CARDIOLOGY AND HEMIC/LYMPH

10. If the clinic physician performs the catheterization procedure at the hospital, which modifier would you append to the catheterization code? -51 -TC -26 no modifier needed 11. What is bundled into a cardiac catheterization? introduction recording of pressures taking of blood samples all of the above 12. If a clinic owns its own x-ray equipment, what modifier would be used when coding for the supervision and interpretation of a cardiac catheterization? -26 -51 -TC no modifier 13. If catheterization is performed on the coronary arteries, in which section would you find the codes? Surgery Medicine Radiology All of the above 14. The pulse generator of a pacemaker is also referred to as: the lead the battery the electrode cardioverter 15. Placement of a dual-chamber pacemaker. Using a standard technique, the left infraclavicular subcutaneous pacemaker pocket was created with sharp and blunt dissection. The 2 j-tipped guidewires were advanced through a left subclavian vein using standard left subclavian venotomy under fluoroscopic guidance. The peel-away sheaths and introducers were advanced over the guidewires, and the guidewires were removed. The pacemaker leads were advanced under fluoroscopic guidance into the right ventricular apex and right atrial appendage. The pacemaker leads were seen to function adequately in vivo and were sutured in place with 0 silk. The leads were connected to the pulse generator, which was delivered into the wound in the usual fashion; 2-0 Vicryl suture was used to close the deep tissue layer and a 4-0 running subcuticular suture was used to close the skin. There were no complications of the procedure. Code the pacemaker placement only. 33207-RT 16. The implantation of a patient-activated cardiac event recorder. 33285 17. Coronary artery bypass using one venous graft. 33533 +33517 18. Five-vessel coronary artery bypass using two arteries and three venous grafts. pg. 2 EXAM 4 CARDIOLOGY AND HEMIC/LYMPH

33534 +33519 19. Pericardial drainage with insertion of indwelling catheter, percutaneous, including CT guidance 33019 20. Abdominal aortogram in an outpatient facility. The right groin was prepped and draped in the usual fashion. Seldinger technique was used to enter the femoral artery. A 6-French sheath was placed. A pigtail catheter was introduced in the upper abdominal aorta, and an AP aortogram was done using the DSA cut film technique using 20 cc of Omnipaque. Results: The abdominal aorta appears mildly irregular above and below the renal arteries, with no significant stenosis. Report physician services only. (What mod is needed for the radiology code?) (2 codes) 36200 75625-26 21. A patient presents to the physician’s office to have blood drawn for various lab tests. The venous blood is drawn by the medical assistant and sent to the lab with an order from the physician. Code only the drawing of the blood. 36415 22. What is the code for a tunneled centrally inserted central venous catheter, without pump or port, in a 72-year-old patient? 36558 23. Cardioversion. Reason for procedure: Atrial fibrillation. Elective, external 175 J of synchronous cardioversion was undertaken very easily, with complete resolution of atrial fibrillation to normal sinus rhythm. 92960 24. PTCA of left anterior descending coronary artery. A 6-French JL4 guiding catheter was used, and a 014 extra-support wire was passed through the LAD obstruction and “entered” the distal vessel. This was first dilated with a 3-mm 20 CrossSail balloon, subsequently with a 3.5 10 cutting balloon (arteriectasis). With the cutting balloon, there were four inflations at 6-7 atmospheres and up to 1-minute inflation times. The balloon was withdrawn, and angiography showed the vessel to be wide open with mild irregularities and less than 15% narrowing remaining. There was no distal embolism. There was no dissection noted. There was normal TIMI flow. The case was then terminated at this point and balloons, catheters, and wires were removed, and the patient was sent to her room in good condition. ( What mod is needed to indicate the artery?) 92920-LD 25. Echocardiogram, transthoracic—complete study with color-flow Doppler and echocardiography. 93306 pg. 3 EXAM 4 CARDIOLOGY AND HEMIC/LYMPH

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