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Patient with coronary arteriosclerosis disease (CAD) sees his cardiologist to discuss a coronary artery bypass graft (CABG). This will be the patient’s first CABG. What ICD-10-CM code is reported?

In the hospital setting a patient undergoes transcatheter placement of an extracranial vertebral artery stent in the right vertebral artery. Which CPT® code is reported by the physician providing only the radiologic supervision and interpretation?

Dr. Smith is treating a 72-year-old female with ureteral obstruction caused by a postoperative stricture and post radiation scarring following treatment for transitional cell cancer. The patient requires removal and replacement of an internal indwelling ureteral stent. Dr. Smith advances a diagnostic catheter under conscious sedation into the bladder and injects contrast to opacity the bladder. A guide wire is advanced into the bladder and the diagnostic catheter is exchanged for a larger catheter to allow the use of a snare device. Under the fluoroscopic guidance the snare device is negotiated into the bladder through the sheath and used to grasp the pigtail portion of the double-J ureteral stent tube within the bladder and the indwelling stent tube is pulled out of the bladder and urethra far enough to allow retrograde introduction of a guide wire through the stent, directed into the renal pelvis. Using fluoroscopic guidance to negotiate the wire through the inner lumen of the ureteral stent tube rather than through side holes, a diagnostic catheter is positioned over the wire into the renal pelvis, allowing opacification and visualization of the renal pelvis. The guide wire is repositioned into the renal pelvis and the diagnostic catheter removed. A new double-J ureteral stent tube is introduced and positioned. The guide, sheath and safety wire are removed after appropriate position is confirmed with fluoroscopy and a permanent image is obtained for the medical record. What code is used to describe the exchange?

A patient will be undergoing a transplant and needs HLA tissue typing with DR/DQ multiple antigen and lymphocyte mixed culture. How will these services be coded?

Procedure: Right femoral angiography, percutaneous transluminal tibioperoneal angioplasty and stenting. Description of Procedure: The patient was premedicated and brought to the cardiovascular laboratory. The right inguinal region is prepped and draped in the usual sterile fashion. Local cutaneous anesthesia was obtained with 1% Lidocaine. A 6 French sheath was inserted antegrade into the right femoral artery. It was kinked and was replaced with a 6 French Arrow sheath.Findings: Selective injections into the right femoral artery revealed diffuse irregularities of the superficial femoral artery with a 95 percent mid to distal stenosis and a 60 percent distal stenosis. The distal popliteal artery had an eccentric 60 percent stenosis. The tibial peroneal trunk was diffusely diseased with sequential 95 percent stenosis present. The anterior tibial and posterior tibial arteries are both occluded. We gave intravenous heparin 2,500 units. The distal vessel was wired with a V18 wire. We then dilated both superficial femoral artery lesions with a 5 x 4 Diamond balloon and achieved good angiographic result. We then elected to approach the tibial peroneal trunk that was a high-grade stenosis leading into the only remaining circulation. This was dilated with a 3 x 4 Diamond balloon. This had satisfactory results, but we elected to stent this for a better long-term patency. We exchanged out the V18 wire for a coronary extra support wire and deployed a 3.5 x 40 mm GR2 coronary stent. This was then post-dilated to high pressures with a 3.5 x 40 mm NC Bandit balloon. We then performed inflations in the popliteal artery with a 4 x 2 Symmetry balloon, also achieving a satisfactory angiographic result. The balloon catheter was then withdrawn. The final angiographic result was excellent, with wide patency from the superficial femoral artery into the peroneal down to the ankle. Following the procedure, an ACT was obtained. The sheath was removed. A strong popliteal pulse was obtained. The patient was transported in stable condition to the recovery unit.Impression:      1. Successful percutaneous transluminal angioplasty of sequential 95 and 60 percent mid and distal superficial femoral artery lesions.      2. Successful percutaneous transluminal angioplasty of a 60 percent popliteal lesion.      3. Successful percutaneous transluminal angioplasty of diffuse 95 percent tibial peroneal trunk stenosis with stenting producing a residual stenosis to 0 percent. Which angioplasty codes are correct to report?

A patient with laryngeal spasms undergoes therapeutic injection of the vocal cords. Topical anesthesia is administered to the oral cavity, pharynx and larynx. Using an operating microscope, a direct laryngoscope is inserted into the patient’s mouth. The interior larynx is examined, and the surgeon injects the vocal cords at two sites with glycerin. What CPT® and ICD-10-CM codes are reported?

The provider documents CKD stage 5 and ESRD. What ICD-10-CM code(s) is/are reported?

The physician is on the hospital floor for the medical management of a 56-year-old patient who he admitted one day ago with chest pain due to aspiration pneumonia. Patient indicates no chest pain at present, but still SOB and some swelling in his lower extremities. Patient was tachypneic yesterday; examination of the lungs reveals course crackles in both bases, right worse than left. The physician writes instructions to continue with intravenous antibiotic treatment and respiratory support with ventilator management. He reviewed chest X-ray and labs that were ordered yesterday. Patient is improving and a pulmonary consultation has been requested. What CPT® code is reported?

What is the ICD-10-CM code for swine flu?

A 49-year-old presents with an abscess of the right thumb. The physician incises the abscess and purulent sanguineous fluid is drained. The wound is packed with iodoform packing. What CPT® code is reported?