1. Which does not indicate the catheter was placed on the right side of the heart?

  1. Pulmonary artery
  2. Pulmonary wedge
  3. Right ventricle
  4. Aorta

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2.Which can be coded separately by the physician’s office during a cardiac catheterization?1

  1. Intravascular ultrasound
  2. Road mapping of artery
  3. Interpretation of imaging
  4. Placement of closure device

Rationale:  Since all the diagnostic cardiac catheterization CPT codes does not include intravascular ultrasound, it should be reported separately while coding cardiac catheterization procedures. These procedures include introduction, positioning and/or repositioning of the catheter within the vascular system; road mapping angiography, recording of intracardiac and/or intravascular pressures; intraprocedural injection for angiography; supervision and interpretation of angiography; and contrast injection to image the access site for placing a closure device.

Intravascular ultrasound CPT code +92978  should be coded separately in addition with primary procedure and use CPT code +92979 for each additional vessel.

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3. Which ICD-10-CM code would support medical necessity for an implantable cardioverter defibrillator placement for non-primary (secondary) prevention of sudden cardiac death?

  1. I25.2
  2. I25.5
  3. I42.1
  4. I47.2

Rationale: The list of ICD 10 codes except I47.2 does not meet indications for primary prevention. Implantable cardioverter defibrillator implantation of non-primary prevention of sudden cardiac death is performed due to the patient already experiencing an abnormal heart rhythm or cardiac arrest.

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4. True or False: When assigning ICD-10-CM codes, assume there is a link between diabetes and CKD when both conditions are documented.

  1. True
  2. False

Rationale: As per new updates, the physician documentation is not required to provide a link between the diagnoses of diabetes and chronic kidney disease (CKD). This link is assumed.

5. True or False: ICD-10-CM presumes a linkage between diabetes and osteomyelitis.

  1. True
  2. False

Rationale: ICD-10-CM does not presume a linkage between diabetes and osteomyelitis. The provider needs to document a linkage or relationship between the two conditions before it can be coded as such.

6. Which is proper ICD-10-CM coding for a patient with type 2 diabetes with documented diabetic ketoacidosis?

  1. E10.10
  2. E11.0, E87.2
  3. E13.10
  4. E13.10, E87.2

Rationale: Type 2 diabetes with diabetic ketoacidosis (DKA) is reported with E13.10 Other specified diabetes mellitus with ketoacidosis without coma. Do not separately report the DKA. No code exists for DKA with type 2 diabetes.