need help breaking down the coding test for BC3020 week five

BC3020: Week 5 - Coding Application TEST About The coding application provides you the opportunity to apply the coding skills you've learned this week. As the courses progress and your skills increase, the rigor of the coding application will increase as well. Every professional coder will tell you the more you code, the better coder you become so practice, practice, practice. To do well on the coding application, you must read the assigned chapters and complete the exercises in your textbook. It is recommended that you look over the questions before reading the case scenario to give you an idea of what information you will be asked to answer. Be sure to read every question completely as some are asking for a written response while others are asking you to assign a code. Steps for Coding Steps for correct CPT coding: 1. 2. 3. 4. 5. 6. 7. 8. 9. Determine the procedure, test, or service to be coded Identify all terms Locate each main term in the Alphabetic Index Review and select the subterms indented below the main term Note the code number(s) found opposite the selected main term or subterm Verify the code in the Tabular List Review coding notes and coding conventions Determine modifiers when applicable Repeat steps for additional code(s) Steps for correct ICD coding: 1. 2. 3. 4. 5. 6. 7. 8. Identify all terms in the diagnosis Locate each main term in the Alphabetic Index. Refer to any subterms indented under the main term. Follow cross-reference instructions if the needed code is not located under the first main entry consulted. Verify the code in the Tabular List. Read and be guided by any instructional terms in the Tabular List. Assign codes to the highest level of specificity. Code the diagnosis until all elements are completely identified. (See next page to continue) BC3020: Week 5 - Coding Application TEST Coding Test: 45 points Directions: Read the following Case Scenario Using your ICD-10-CM, CPT, and HCPCS coding manuals, answer the questions in Parts 1 through 4 below. CASE SCENARIO: LOCATION: Inpatient, Hospital PATIENT: A. G. Vanyo ATTENDING/ADMIT PHYSICIAN: Frank Gaul, MD SURGEON: James Noonar, MD PREOPERATIVE DIAGNOSIS: Atherosclerotic heart disease. POSTOPERATIVE DIAGNOSIS: Atherosclerotic heart disease. PROCEDURE: Coronary artery bypass graft times two of the left internal mammary artery to the left anterior descending bypass and a single saphenous vein bypass from the aorta to the obtuse marginal branch of the left circumflex. ANESTHESIA: General. INDICATION: This 76-year-old male patient with unstable angina was noted on cardiac catheterization to have high-grade ostial left main coronary disease. He also had a 70% obtuse marginal branch lesion. The left ventricular function was normal. FINDINGS AT SURGERY: The left anterior descending artery was diffusely diseased throughout and measured 1.5 mm in diameter where it was grafted and was of poor quality. The internal mammary artery was a 2-mm vessel of good quality with excellent flow. The vein was a 6-mm diameter vessel of poor quality, somewhat varicosed, and was used in a reversed fashion. It was not harvested with the endoscopic technique because of the patient's unstable presentation. The obtuse marginal branch was a 2-mm diameter vessel and was of good quality. PROCEDURE: On May 8 of this year the patient was brought to the operating room and placed in the supine position, and under general intubation anesthesia, the anterior chest, abdomen, and legs were prepped and draped in the usual manner. A segment of greater saphenous vein was harvested from the left thigh and prepared for grafting. The sternum was opened in the usual fashion, and the left internal mammary artery taken down and prepared for grafting. The pericardium was incised sharply and pericardial well created. The patient was systemically heparinized and placed on single right atrial to aortic cardiopulmonary bypass with a pump in the main pulmonary artery for cardiac decompression. The patient was cooled to 26C, and on fibrillation, the aortic cross clamp was applied to potassium-rich cold crystalline cardioplegic solution administered through the aortic root with satisfactory cardiac arrest. Subsequent doses were given via the BC3020: Week 5 - Coding Application TEST coronary sinus in retrograde fashion and down the vein graft as the anastomosis was completed. The end of the greater saphenous vein was then anastomosed to the proximal portion of the obtuse marginal branch with 7-0 Prolene. The left internal mammary artery was then brought down to the junction of the middle and distal one third of the left anterior descending and anastomosed thereto with 8-0 continuous Prolene. Please note that all grafts were pro patent prior to closure. The aortic cross clamp was removed after 47.6 minutes with spontaneous cardioversion to a normal sinus rhythm. The patient was then warmed to 37C esophageal temperature and weaned from cardiopulmonary bypass without difficulty after 72 minutes. No inotropes were used. The patient was decannulated, protamine given, and hemostasis achieved. Temporary pacer wires were placed in the right atrium and right ventricle. The chest was drained with two chest tubes and closed in layers in the usual fashion. The leg was closed similarly. Sterile compression dressings were applied, and the patient returned to surgical intensive care unit in satisfactory condition. Sponge count and needle count correct times two. PART 1: Abstracting 1. What is the name of the physician performing the procedure? (1 point) Type answer here 2. What is the procedure, test, or service to be coded? (2 points) Type answer here 3. Was the grafting done with arterial grafts, venous grafts, or both? (2 points) Type answer here 4. Was the arterial grafting a single graft or multiple grafts? (2 points) Type answer here 5. Is the harvesting of the vein graft reported separately? (2 points) Type answer here 6. Is the cardiopulmonary bypass and cooling reported by the cardiologist? (2 points) Type answer here (See next page to continue) BC3020: Week 5 - Coding Application TEST 7. Is this procedure performed on the native vessel or a grafted vessel? (1 point) Type answer here PART 2: Surgical Procedure 1. What are all possible terms for the surgical procedure used in the Alphabetic Index of the CPT coding manual? (2 points) Type answer here 2. What subterm(s) are identified under the main term in the Alphabetic Index? (1 point) Type answer here 3. What additional subterm is referenced to identify all elements of the procedure? (1 point) Type answer here 4. What code(s) are listed in the Alphabetic Index for arterial bypass? (1 point) Type answer here 5. What code range is listed in the Alphabetic Index for arterial-venous bypass? (1 point) Type answer here 6. What section in the Tabular List of the CPT manual did you find the code(s)? (1 point) Type answer here 7. Are there any relevant guidelines or parenthetic notes associated with the arterial graft that should be applied to this CPT code?? (1 point) Type answer here (See next page to continue) BC3020: Week 5 - Coding Application TEST 8. Are there any relevant guidelines or parenthetic notes associated with the arterial-venous graft that should be applied to this CPT code?? (1 point) Type answer here 9. What type of codes are found in the range 33517-33530? (2 points) Type answer here 10. Will the code identified in the 33517-33530 range be listed as the first or second procedure? (1 point) Type answer here PART 3: Diagnosis 1. What is the documented condition to be coded? (2 points) Type answer here 2. What is the main term in the ICD-10-CM Alphabetic Index? (1 point) Type answer here 3. What is the subterm that identifies the condition? (1 point) Type answer here 4. What, if any, are the additional subterms you need to reference? (1 point) Type answer here 5. Are there any cross reference instructions in the Alphabetic Index that should be followed? (1 point) Type answer here (See next page to continue) BC3020: Week 5 - Coding Application TEST 6. What code (s) are listed for the condition in the index? (1 point) Type answer here 7. What is the category code referenced in the Tabular List? (1 point) Type answer here 8. Are there any instructional notes in the Tabular List that should be applied to this ICD-10-CM code? (1 point) Type answer here 9. Have all documented diagnoses been identified for this scenario? (1 point) Type answer here PART 4: Assigning Codes 1. What is the CPT code for the surgical procedure? (3 points) Type answer here 2. What is the additional CPT code for the surgical procedure? (3 points) Type answer here 3. What is the ICD-10-CM code for the diagnosis? (3 points) Type answer here 4. Have all identified procedures, services and diagnoses been reported with these codes? (1 point) Type answer here