Hemic Lymphatic Mediastinum and Diaphragm

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					Chapter 17: Hemic, Lymphatic , Mediastinum, and Diaphragm

Click the links to expand or collapse the menu

Chapter Introduction and Learning Objectives


Chapter Introduction
Chapter Learning Objectives
Voices of Experience
Using the Chapter Outline

Lesson 17-1: Hemic and Lymphatic


Lesson Introduction - STEP 1
Lesson 17-1 Learning Objectives
Hemic and Lymphatic Systems Subsection - STEP 2
Spleen Subheading
General Subheading
Coding Practice
Lymph Nodes and Lymphatic Channels Subheading
Lesson 17-1 Learning Activity - STEP 3
Lesson 17-1 Quiz

Lesson 17-2: Mediastinum and Diaphragm


Lesson Introduction – STEP 1
Lesson 17-2 Learning Objectives
Mediastinum and Diaphragm Systems Subsection – STEP 2
Mediastinum Subheading
Diaphragm Subheading
Coding Practice
Lesson 17-2 Learning Activity – STEP 3
Lesson 17-2 Quiz

Chapter Review


Chapter 17 Review
Chapter Review Exercises
Take A Break
Taking the Chapter Exam

Chapter Exam




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Chapter Introduction and Learning Objectives
Chapter Introduction

Greetings, you've made it to Chapter 17! This chapter is about more of the
   subsections in the Surgery section. In this chapter, you will learn about a number
of codes that represent a wide variety of specialty services in the practice of
medicine. Some of the codes are commonly used; others are usually used only by
specialized surgeons. The interesting codes you'll be learning about are those from
the Hemic and Lymphatic Systems and the Mediastinum and Diaphragm subsections.

It is very important that you are familiar with the learning objectives, or goals, that
you will be expected to accomplish in this chapter. Be sure to read them carefully
before you begin Lesson 17-1. Click Next to view the Chapter 17 Learning Objectives.




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Chapter Introduction and Learning Objectives
Chapter Learning Objectives

After completing this chapter, you should be able to do the following:

    1. Review the Hemic and Lymphatic Systems subsection format.
    2.   Understand the Hemic and Lymphatic Systems subheadings.
    3.   Demonstrate the ability to code Hemic and Lymphatic Systems services.
    4.   Review the format of the Mediastinum and Diaphragm subsection codes.
    5.   Understand the Mediastinum and Diaphragm information.
    6.   Demonstrate the ability to code Mediastinum and Diaphragm services.

Once you are familiar with these chapter learning objectives, click Next.




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Chapter Introduction and Learning Objectives
Voices of Experience

Although the path on your coding journey may seem long, it is well worn. Many have
passed along this same path in their own coding journeys, so some of the best
sources of information about the profession of coding are coders themselves!

Today I have invited some experienced coders to come and share some important
things they have learned along the way. I have asked them to share their thoughts
on just how much impact your expertise in coding has on those around you. Click
each of the experienced coders below for their thoughts on how your expertise as
a coder makes an impact on those around you.




Click Next after both experienced coders have shared their thoughts with you.

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Developer Notes:
Link image of Yvonne with Yvonne’s picture, caption, and following quotation: ―Many times, offices do not
see the wealth of information available to them through a coding specialist. Once you are in the door, you
can offer many learning opportunities to those who work with you. People want to be around knowledge
and expertise.‖

Link image of Christy with Christy’s picture, caption, and following quotation: ―I feel that what I do makes
a difference. Physicians and hospitals look to our firm for expertise in this subject…what I state and assist
in preparing affects the way physicians code their charges. I must be aware of how my recommendations
will change the patterns of their submissions. Therefore, I must present clear and concise coding
information.‖




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Chapter Introduction and Learning Objectives
Using the Chapter Outline

Generally, you will navigate through the chapter via the Next button in the upper
and lower right portion of your screen. However, if you do not go through the entire
chapter in one sitting, you may find it helpful to resume your work via the lesson
links in the Chapter Outline.

No matter where you are in the course content, the Chapter Outline is always
accessible via the blue toolbar near the top of the course screen.

Take a quick look at the Chapter Outline and then return to this screen by clicking
Previous. When you are ready to proceed to the chapter and begin learning, click
Next to continue.




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Lesson 17-1: Hemic and Lymphatic
Lesson Introduction - STEP 1

You're really making progress in your coding journey! I just want
you to know how proud I am of you and your dedication to
learning about coding. While you are learning how to code, there
are times when it's hard to keep going. There may be days when
it just seems like it's too difficult. In times like these, it might be
helpful to keep in mind the words (shown at right) of Black Elk, a
Sioux medicine man and prominent member of his tribe.

In other words, if you keep trying, you will accomplish your goals.
The main thing is to keep trying.

Click Next to view the learning objectives for Lesson 17-1.




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Lesson 17-1: Hemic and Lymphatic
Lesson 17-1 Learning Objectives

The learning objectives for Lesson 17-1 are listed below. By the
time you have finished this lesson, you should be able to do (or know) the following:

        Review the Hemic and Lymphatic Systems subsection format.
        Understand the Hemic and Lymphatic Systems subheadings.
        Demonstrate the ability to code Hemic and Lymphatic Systems services.

          Take some time now to read pages 516-522 in your text. When you're
          finished, come back and click Next to begin learning about the Hemic and
          Lymphatic Systems and Mediastinum and Diaphragmsubsections.


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Developer Notes:
Link “learning objectives for Lesson 17-1” to a popup with the following:


Chapter 17 - Learning Objectives

  The learning objectives for Lesson 17-1 are highlighted in bold:

    1. Review the Hemic and Lymphatic Systems subsection format.
    2. Understand the Hemic and Lymphatic Systems subheadings.
    3. Demonstrate the ability to code Hemic and Lymphatic Systems
       services.
    4. Review the format of the Mediastinum and Diaphragm subsection codes.
    5. Understand the Mediastinum and Diaphragm information.
    6. Demonstrate the ability to code Mediastinum and Diaphragm services.




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Lesson 17-1: Hemic and Lymphatic
Hemic and Lymphatic Systems Subsection - STEP 2

The divisions of the Hemic and Lymphatic Systems
subsection of the Surgery section are as follows:

        Spleen
        General
        Lymph Nodes and Lymphatic Channels

Click Next to learn about the first division of this subsection,
Spleen.




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Lesson 17-1: Hemic and Lymphatic
Spleen Subheading

Spleen is a subheading within the Hemic and Lymphatic Systems subsection.

The spleen is easily ruptured and can cause massive hemorrhage, which may require
a    splenectomy. A splenectomy can be total or partial and is often performed as a
part of a more major procedure. The code description for splenectomy (38100,
38101) indicates ―separate procedure.‖ This means that when a splenectomy is an
integral part of a major procedure, is considered bundled into the main procedure and
not reported separately.

Click Next to learn about another subheading within this subsection, General.




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Lesson 17-1: Hemic and Lymphatic
General Subheading

Another subheading within the Hemic and Lymphatic Systems
subsection is General.

These codes are divided based on       aspiration,   biopsy,
harvesting, or     transplantation. Stem cells are immature blood
cells originating in the bone marrow. Stem cell transplantation is used as a treatment
for leukemia. Bone marrow can be removed from a donor by means of a large needle.
The bone marrow is aspirated as illustrated in      SlideShow 17-1.

There are two types of stem cells, those that come from a close relative (                                allogenic)
and those that are the patient's own ( autologous).

Click Next to check your understanding of this subheading.


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Developer Notes:
Link “SlideShow 17-1” to a popup with the following:




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Lesson 17-1: Hemic and Lymphatic
Coding Practice

Code the following situation. You will have two tries to code this
correctly.

Harvesting of bone marrow from a donor.


                                Reset
     Code:
Once you have coded this situation correctly, click Next to learn about the next
subheading within the Hemic and Lymphatic Systems subsection, Lymph Nodes and
Lymphatic Channels.


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Developer Notes:
Correct Answer: 38230
Correct Feedback: Wonderful job coding this situation. Harvesting of bone marrow from a donor is code
38230.
Incorrect Feedback: This is not the correct code for this procedure. Try this again after looking it up under
Bone Marrow, Harvesting.
Incorrect Feedback 2: No. The correct code is 38230.




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Lesson 17-1: Hemic and Lymphatic
Lymph Nodes and Lymphatic Channels Subheading

The next subheading within the Hemic and Lymphatic Systems
subsection is Lymph Nodes and Lymphatic Channels.

There are two categories of lymphadenectomies:

       Limited: removal of only the lymph nodes (38562-38564)
       Radical: removal of the lymph nodes and surrounding
        tissue (38700-38780)

Lymphadenectomies are often bundled into the more major procedure, such as a
prostatectomy.

         For some coding practice focusing on this subsection, go to your textbook
         and complete Exercise 17-1 on page 522. You can check your answers
         in Appendix B of your text once you're finished.

Click Next to apply what you have learned about this subsection in the Lesson 17-1
Learning Activity.




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Lesson 17-1: Hemic and Lymphatic
Lesson 17-1 Learning Activity - STEP 3

Using your CPT manual and what you have learned in Lesson 17-
1, code the following procedure. As this is a review/application-
type activity, you will only have one chance to code this situation correctly.

Complete cervical lymphadenectomy, unilateral.


                                Reset
     Code:
Once you have coded this procedure correctly, click Next to begin the Lesson 17-1
Quiz. You may go back and review the information in this lesson before starting the
quiz.


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Developer Notes:
Correct Answer: 38720
Correct Feedback: Great work! The correct code is 38720.
Incorrect Feedback: Sorry, but the correct code is 38720. It can be found by looking under
Lymphadenectomy, Radical, Cervical.




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                            Lesson 17-1: Hemic and Lymphatic
                            Lesson 17-1 Quiz

                    Select the best answer for each question from the choices below.
                    When you are finished, click Submit to check your answers. Click
Reset if you want to clear your answers and start over.


    1. Open excision of deep cervical nodes with scalene fat pad excision.

               CPT Code:



    2. Bone marrow harvested from a genetically similar relative is:

                      A. biogenic
                      B. autogenic
                      C. allogenic



    3. Bone marrow that is harvested from the patient for his/her own
       transplantation at a later time is:

                      A. biogenic
                      B. autogenic
                      C. allogenic
   Reset




After you are finished with the Lesson 17-1 Quiz, click Next to begin
Lesson 17-2 Mediastinum and Diaphragm subsection.


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Developer Notes:
Link ―View Answers‖ to a popup with the following:

Lesson 17-1 Quiz Answers

    1.     38520


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   2.   C
   3.   B




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Lesson 17-2: Mediastinum and Diaphragm
Lesson Introduction - STEP 1

Welcome to Lesson 17-2. In this lesson, you will be learning
about the unique features of coding procedures in the
Mediastinum and Diaphragm subsection.

Let's continue your journey now by taking a look at the learning objectives for this
lesson. Click Next to proceed.




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Lesson 17-2: Mediastinum and Diaphragm
Lesson 17-2 Learning Objectives

The learning objectives for this lesson are below. By the time
you have completed Lesson 17-2, you should be able to do (or know) the following:

        Review the format of the Mediastinum and Diaphragm subsection codes.
        Understand the Mediastinum and Diaphragm information.
        Demonstrate the ability to code Mediastinum and Diaphragm services.

          Once you're familiar with the lesson learning objectives, take some time to
          read pages 522-523 in your text. When you're finished reading, come
          back and click Next to continue.


----------------------------------------------------------------------------------------------------------------------
Developer Notes:
Link “learning objectives for this lesson” to a popup with the following:

Chapter 17- Learning Objectives

  The learning objectives for Lesson 17-1 are highlighted in bold:

    1. Review the Hemic and Lymphatic Systems subsection format.
    2. Understand the Hemic and Lymphatic Systems subheadings.
    3. Demonstrate the ability to code Hemic and Lymphatic Systems services.
    4. Review the format of the Mediastinum and Diaphragm subsection
       codes.
    5. Understand the Mediastinum and Diaphragm information.
    6. Demonstrate the ability to code Mediastinum and Diaphragm services.




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Lesson 17-2: Mediastinum and Diaphragm
Mediastinum and Diaphragm Systems Subsection - STEP 2

The divisions of the Mediastinum and Diaphragm Systems
subsection of the Surgery section are as follows:

        Mediastinum Under surgery (right-) change this bullet
         to ―Mediastinum and Diaphagm Systems‖
        Diaphragm

Click Next to learn about the first division of this subsection,
Mediastinum.




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Lesson 17-2: Mediastinum and Diaphragm
Mediastinum Subheading Under surgery (right-) change this
bullet to ―Mediastinum and Diaphagm Systems‖

Mediastinum is a subheading within the Mediastinum and
Diaphragm Systems subsection.

The mediastinum is located in the area between the lungs (shown
in the text as Fig. 17-3). The codes in the mediastinum
subheading are divided by the type of procedure, which includes incision, excision,
and endoscopy. The mediastinotomy codes (39000, 39010) are divided based on
surgical approach, which includes cervical, across the thoracic, or sternum.

There is only one endoscopic procedure listed under the Mediastinum subheading,
mediastinoscopy (39400).

Click Next to learn about another subheading within this subsection, Diaphragm.

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Developer Notes:
Link ―Fig. 17-3‖ to a popup with the following:




                                                              fig. 17-3 Mediastinum and diaphragm




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Lesson 17-2: Mediastinum and Diaphragm
Diaphragm Subheading Under surgery (right-) change this
bullet to ―Mediastinum and Diaphagm Systems‖

Another subheading within the Mediastinum and Diaphragm
Systems subsection is Diaphragm.

The diaphragm is a muscle that separates the thoracic area and
the abdominal cavities. The procedures listed in the Diaphragm
subheading are all repair procedures, with the exception of one code for unlisted
diaphragm procedures. All of the codes listed in the Diaphragm subheading are
indexed under ―Diaphragm‖ in the CPT manual.

For some coding practice focusing on this subsection, go to your textbook and
complete Exercise 17-2 on page 523. You can check your answers in Appendix B
of your text once you’ve finished.

Click Next to check your understanding of this subheading.




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Lesson 17-2: Mediastinum and Diaphragm
Coding Practice

Code the following situation. You will have two tries to code this correctly.

Hiatal hernia repair, diaphragm.


                                       Reset
     CPT Code:


Once you have coded this procedure correctly, click Next to complete Lesson 17-2
Learning Activity.


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Developer Notes:
Correct Answer: 39502
Correct Feedback: Wonderful job! Repair of a hiatal hernia of the diaphragm is code 39502.
Incorrect Feedback 1: This is not the correct code for this procedure. Try this again after looking it up
under Diaphragm, Repair, Hernia in the index of the CPT manual.
                                                            Incorrect Feedback 2: No. The correct code is 39502.




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Lesson 17-2: Mediastinum and Diaphragm
Lesson 17-2 Learning Activity – STEP 3

Using your CPT manual and what you have learned in Lesson 17-
2, code the following procedure. As this is a review/application-
type activity, you will only have one chance to code this situation correctly.

Tumor excision of the mediastinum.


                                         Reset
     CPT Code:


Once you have coded this procedure correctly, click Next to begin the Lesson 17-2
Quiz. You may go back and review the information in this lesson before starting the
quiz.


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                                                        Align all of this with “Incorrect Feedback”, below.
                                                                                                 Developer Notes:
                                                                                            Correct Answer: 39220
                                                     Correct Feedback: Great work! The correct code is 39220.
Incorrect Feedback: Sorry, but the correct code is 39220. It can be found by looking under Mediastinum,
                                                                                                    Tumor, Excision.




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                            Lesson 17-2: Mediastinum and Diaphragm
                            Lesson 17-2 Quiz

                    Select the best answer for each question from the choices below.
                    When you are finished, click Submit to check your answers. Click
Reset if you want to clear your answers and start over.


    1. Mediastinotomy, with removal of foreign body, transthoracic approach.

               CPT Code:



    2. Diaphragm subheading includes procedure performed by:

                      A. incision
                      B. excision
                      C. repair



    3. The ________ is the area between the lungs.

                      A. diaphragm
                      B. mediastinum
                      C. sternum
   Reset




After you are finished with the Lesson 17-2 Quiz, click Next to begin
Chapter 17 Review.


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Developer Notes:
Link ―View Answers‖ to a popup with the following:

Lesson 17-2 Quiz Answers

    1.     39010
    2.     C
    3.     B


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Chapter Review
Chapter 17 Review

Now that you have completed all of the online lessons
for Chapter 17, it's time to review what you have
learned. There are two parts to this review: the
Chapter Objectives Review and the Chapter Review
Exercises.

Take a few moments to review the learning objectives
for this chapter. Click the icon next to any objective
below to brush up on the relevant material. Simply close the new window with the
review screens when you are finished with each. After you have reviewed these
Chapter Learning Objectives, you will be given the opportunity to practice what you
have learned in this chapter in the Chapter 17 Review Exercises located on the next
screen.

                1. Review the Hemic and Lymphatic Systems subsection format.
                2. Understand the Hemic and Lymphatic Systems subheadings.
                3. Demonstrate the ability to code Hemic and Lymphatic Systems services.
                4. Review the format of the Mediastinum and Diaphragm subsection codes.
                5. Understand the Mediastinum and Diaphragm information.
                6. Demonstrate the ability to code Mediastinum and Diaphragm services.
                   Move the arrows, above, next to “4.”, so that there is one in front of each
                   “4.”, “5.”, and “6.”
Once you have reviewed the objectives of your choice, click Next to begin the
Chapter 17 Review Exercises.




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Chapter Review
Chapter Review Exercises

Because you may have specific areas where you feel you need review, I will provide
you with several specific types of review activities:

         Theory Exercises: Designed to check your understanding of important terms
          and concepts in the chapter.
         Practical Exercises: Designed to allow you to practice coding various
          procedures discussed in this chapter.

For all of these review activities, the scores you receive are for your information
only. You can do these activities as many times as you like. Click below to select the
type of review activity you wish to engage.




**For more Chapter 17 review exercises, go to pages 524-525 in your textbook.
  Once you have finished reviewing, click Next for a special treat.
  **---Move this textbook up in front of the word ―For‖ at the beginning of the
  above section.

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Developer Notes:
Link “Theory Exercises” to page 2a with the following:




Without the use of reference materials, answer the questions in the theory exercises below to check your
understanding of important terms and concepts in Chapter 17. When you are finished with these
exercises, close the new window to return.

  Exercise #1
Instructions:            Match the items on left to the correct descriptions. Drag your response from the left column and place
it on top of the answer in the right column.

Correct Feedback: "Correct!"          Incorrect Feedback: "Incorrect. Try again."
Term: splenectomy
Answer: excision of the spleen

Correct Feedback: "Yes! Excellent." Incorrect Feedback: "Incorrect. Try again."Term: allogenic
Answer: of the same species, but genetically different


Correct Feedback: "Yes! Very good." Incorrect Feedback: "Wrong. Try again."Term: aspiration
Answer: use of a needle and syringe to withdraw fluid


Correct Feedback: "Yes. You're doing great."
Incorrect Feedback: "Incorrect. Try again."Term: transplantation


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Answer: grafting of tissue from one source to another

Correct Feedback: "Yes!" Incorrect Feedback: "Wrong. Try again."Term: lymphadenitis
Answer: inflammation of a lymph node


   Exercise #2
Instructions: Match the items on left to the correct descriptions. Drag your response from the left column and place it on
top of the answer in the right column.


After you are finished, click Previous to return to the Chapter 17 Review page to select another type of
review activity.
Link “Practical Exercises” to page 2b with the following:




Using your CPT manual, identify the correct codes in the practical exercise below. When you are finished
with this exercise, close the new window to return.

   Exercise #1
Instructions: Code the following. Use "x" and "-" to separate units or modifiers. Example: 12345x6. USE NO SPACES IN
ANY QUESTION. Click Submit to answer, then Next to go on.Question: Incision and drainage of a simple lymph node
abscessCorrect Feedback: "Correct."Incorrect Feedback 1:"Incorrect. Try looking under
Lymphadenitis, Incision and Drainage in the index of your CPT manual."Incorrect Feedback
2:"That is not correct. The correct answer has now been displayed."
Answer: 38300
 Question: Injection procedure for a radiographic view of the lymphatic systemCorrect Feedback:
"Correct."Incorrect Feedback 1:"Incorrect. Try looking under Lymphangiography, Injection in the
index of your CPT manual."Incorrect Feedback 2:"That is not correct. The correct answer has now
been displayed."
Answer: 38790
 Question: Bone marrow harvesting for transplantationCorrect Feedback: "Correct."Incorrect Feedback
1:"Incorrect. Try looking under Harvesting, Bone Marrow in the index of your CPT
manual."Incorrect Feedback 2:"That is not correct. The correct answer has now been displayed."
Answer: 38230


Question: Complete radical axillary lymphadenectomyCorrect Feedback: "Correct."Incorrect Feedback
1:"Incorrect. Try looking under Lymphadenectomy, Radical, Axillary in the index of your CPT
manual."Incorrect Feedback 2:"That is not correct. The correct answer has now been displayed."
Answer: 38740



Question: Neonatal diaphragmatic hernia repair with chest tube insertionCorrect Feedback: "Correct."Incorrect
Feedback 1:"Incorrect. Try looking under Repair Diaphragm, Hernia in the index of your CPT
manual."Incorrect Feedback 2:"That is not correct. The correct answer has now been displayed."
Answer: 39503


After you are finished, click Previous to return to the Chapter 17 Review page to select another type of
review activity.




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Chapter Review
Take A Break

Now that you've finished reviewing, TAKE A
LITTLE BREAK to relax before beginning the
chapter exam. Click the park bench icon (at
right) to reward yourself for the hard work you've
done and to rest a moment before taking the
Chapter 17 Exam.

Once you feel relaxed, refreshed, and ready to
take the exam, click Next to begin.




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Developer Notes:
Link “Take a Break” to a popup with the following:




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Chapter Review
Taking the Chapter Exam

Now that you've had a chance to relax in preparation for the Chapter Exam, it's
time to get ready for the exam. Since this is a Chapter Exam, your score will be
recorded/tracked.

There are two parts to this Exam, Part 1 and Part 2. You will need to complete Part 1
first, and then once you have submitted your scores for Part 1, you will need to
access and take Part 2. Following are some instructions for accessing and taking both
parts of this exam. You may want to print this screen with the instructions for your
reference while taking the Exam.

To access the exam (Evolve/Blackboard users):

        Click on the Course Documents button in the left menu.
        From the Chapter 17 menu, select Chapter 17 Exam, Part 1.
        Once you are finished with Part 1, return to the Chapter 17 menu and select
         Chapter 17 Exam, Part 2 to access the second half of the exam.
        When you are finished with Part 2, click on the Course Documents button to
         continue on to the next chapter.

To access the exam (WebCT users):

        Click the Homepage link in the left menu.
        Click on the Course Documents icon.
        From the Chapter 17 menu, select Chapter 17 Exam, Part 1.
        Once you are finished with Part 1, return to the Chapter 17 menu and select
         Chapter 17 Exam, Part 2 to access the second half of the exam.
        When you are finished with Part 2, click on the Course Documents icon to
         continue on to the next chapter.

If at any time you would like to take the Chapter 17 Exam and are not on this
screen, you can access the Chapter 17 Menu directly by clicking on the Course
Documents button/icon.

Good luck on the exam—I know you will do well.




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Chapter 17 Exam, Part 1

Instructions: Without the use of reference material, complete the following. To print this
exam for easier reading, use your browser’s print feature.


1. The ________ is located in the left upper quadrant of the abdomen.

       A. mediastinum
       B. spleen
       C. diaphragm
     D. suprahyoid
Answer: B
2. ________ is the procedure in which donor marrow or stem cells are injected into a
   patient.

       A. harvesting
       B. autologous
       C. aspiration
     D. transplantation
Answer: D
3. This bone marrow is taken from a close relative, so there is a genetic similarity.

       A. allogenic
       B. transogenic
       C. autogenic
     D. biogenic
Answer: A
4. This bone marrow is collected from the patient and later transplanted or reinfused back
   into the patient from whom it came.

       A. allogenic
       B. transogenic
       C. autogenic


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     D. biogenic
Answer: C
5. What word describes a lymphadenectomy in which only the lymph nodes are
   removed?

       A. radical
       B. partial
       C. segmental
       D. limited
Answer: D
6. The steps used to preserve, prepare, and purify bone marrow prior to transplantation
   can be reported ____ per day

       A. 1
       B. 2
       C. 3
       D. 0
Answer: A
7. Surgical laparoscopy always includes a diagnostic laparoscopy.

       A. True
     B. False
Answer: A
8. A sentinel lymph node biopsy is not included in a planned lymphadenectomy.

       A. True
     B. False
Answer: B
9. The term complete neck dissection is the same as a:

       A. Modified neck dissection
       B. Modified radical neck dissection


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       C. Radical neck dissection
     D. Limited neck dissection
Answer: C
10. There is/are ____ mediastinoscopy code(s) in the Mediastinum subheading.

        A. 0
        B. 1
        C. 2
      D. 3
Answer: B


Chapter 17 Exam, Part 2

Instructions: Using your CPT manual, code the following. DON’T USE ANY SPACES
IN YOUR ANSWERS OR THEY WILL BE SCORED AS INCORRECT. Also, separate
multiple codes with a forward slash (e.g. XXXXX/YYYYY). To print this exam for
easier reading, use your browser’s print feature.


1. Transplant preparation of hematopoietic progenitor cells for red blood cell removal.
   CPT Code:____________



Answer: 38212
2. Excision of a mediastinum cyst. CPT Code:____________



Answer: 39200
3. Repair of a diaphragmatic hernia, transthoracic approach. CPT Code:____________



Answer: 39520
4. Bone marrow transplantation from a cadaver. CPT Code:____________




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Page 31
Answer: 38240
5. Splenoportography injection procedure with radiological supervision and
   interpretation. CPT Codes:____________,____________



Answer: 38200/75810
6. Repair of ruptured spleen with partial splenectomy. CPT Code:____________



Answer: 38115




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Page 32
Chapter 17 Exam, Part 1 (Self-Study Edition)

Instructions: Without the use of reference material, complete the following. Since this is
a Chapter Exam, your score will be recorded/tracked.


1. You would find codes for the spleen in this subsection:

       A. Digestive
       B. Hemic and Lymphatic
       C. Mediastinum/Diaphragm
     D. Endocrine
Answer: B
2. The two categories of lymphadenectomies are:

       A. direct/indirect
       B. open/closed
       C. limited/radical
     D. percutaneous/open
Answer: C
3. Bone marrow harvested from a genetically similar relative is:

       A. biogenic
       B. allogenic
       C. autogenic
     D. xenogenic
Answer: B
4. You would find codes for the transplantation of bone marrow in this subsection.

       A. Medicine
       B. Endocrine
       C. Hemic and Lymphatic
     D. Cardiothoracic
Answer: C

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Page 33
5. Bone marrow harvested from a cadaver is:

       A. biogenic
       B. allogenic
       C. autogenic
     D. xenogenic
Answer: B
6. The diaphragmatic nerve is also known as the phenic nerve.

       A. True
     B. False
Answer: A
7. The difference between the mediastinum incision codes is whether the procedure is
   performed with or without a biopsy.

       A. True
       B. False
Answer: B
8. The mediastinoscopy may be performed with or without a biopsy.

       A. True
     B. False
Answer: A
9. The wall of muscle that separates the thoracic and abdominal cavities is:

       A. diaphragm
       B. mediastinum
     C. spleen
Answer: A


10. The ________ is composed of lymph tissue.

        A. diaphragm


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Page 34
        B. mediastinum
        C. spleen
      D. lymphatic channels
Answer: C


Chapter 17 Exam, Part 2 (Self-Study Edition)

 Instructions: Using your CPT manual, code the following. DON’T USE ANY SPACES
IN YOUR ANSWERS OR THEY WILL BE SCORED AS INCORRECT. Also, separate
multiple codes with a forward slash (e.g. XXXXX/YYYYY). Since this is a Chapter
Exam, your score will be recorded/tracked.




1. Surgical splenectomy, laparoscopic.



Answer: 38120
2. Bone marrow biopsy.



Answer: 38221
3. Mediastinum, without biopsy.



Answer: 39400
4. Resection of diaphragm with complex repair.



Answer: 39561


5. Laceration repair of diaphragm.



Answer: 39501

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Page 35
6. Suture of thoracic duct, abdominal approach.



Answer: 38382




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