Cardiovascular Surgery Quiz

1. A 66 yrs old male patient is brought to the operating room for pacemaker placement. The
Cardiologist inserted two leads via a subclavian vein and the electrodes are placed in the right atrial
and another one in the right ventricle. Both the leads are connected with the generator. He created
a skin pocket in the right side of chest below the clavicle to keep the pulse generator. Finally closed
all the area with sterile technique. The patient tolerated the procedure well and transferred to the
designated area in stable condition, Assign the appropriate CPT codes for this procedure?

A. 33208, 33202 - 51

B. 33206

C. 33208

D. 33213, 33217 – 51

Leads are connected with the generator. He created a skin pocket in the right side of chest below the
clavicle to keep the pulse generator. Finally closed all the area with sterile technique. The patient
tolerated the procedure well and transferred to the designated area in stable condition, Assign the
appropriate CPT codes for this procedure?

A. 33208, 33202 - 51

B. 33206

C. 33208

D. 33213, 33217 – 51
2. 73 yrs old male patient is brought to the operating room for a CABG procedure. Following general
anesthesia a median Sternotomy incision is made and cardiopulmonary bypass is initiated. The
saphenous vein is harvested from his right leg. The two vein graft was prepared. Two bypasses are
performed using the vein graft (one to the right posterior descending and one for the marginal
artery). Proximal and distal anastomoses are looking good. A branch of the subclavian artery is
brought down to the left circumflex and anastomosed. The patient was warmed and weaned from
the cardiopulmonary bypass and the incision site was closed in layers in the usual fashion. The leg
incision site was closed as well. Sterile dressings were applied and the patient is transferred to the
Coronary intensive care unit in stable condition. Assign the appropriate CPT codes for this service?

A. 33511

B. 33533, 33518

C. 33533, 33511

D. 33533, 33518, 35500

3. A 58 yrs old patient is brought to the operating room for Angiography procedure, Access: The
right femoral artery, Catheter advanced into aorta images were taken following dye, Images reveals
normal anatomy, Catheter was manipulated into the celiac trunk and dye was injected and an
angiogram was performed images shows patent artery, then catheter moved to common hepatic
artery, the dye was injected and images were taken it shows 40% stenosis of the vessel. Assign the
appropriate CPT codes for this service?

A. 36246, 75726 – 26, 75774 – 26

B. 36246, 75726 – 26

C. 36246, 36248, 75726 – 26

D. 36245, 36246, 75726 – 26, 75774 – 26

4. A 55 yrs female patient with h/o breast cancer requires a port-A-cath for the administration of
anti-neoplastic drugs for long term treatment schedule. At the patient’s bedside in the hospital,
using ultrasound guidance right Subclavian vein was located and a needle and a guidewire placed. A
transverse incision was made just inferior to this and a subcutaneous pocket was created. After
tunnelling, the introducer was placed over the guidewire and the power port line was placed with
the introducer and the introducer was peeled away. The tip of the catheter was placed in the right
atrium under fluoroscopic guidance and the catheter connected to the power port device. The
locking mechanism was fully engaged. The port was placed in the subcutaneous pocket. It was
secured to the underlying soft tissue with 2-0 silk stitch. What is the appropriate CPT codes for the
procedure performed?

A. 36571, 76937 – 26, 77001 – 26

B. 36571, 76937, 77001

C. 36560, 76942 – 26, 77001 – 26

D. 36561, 76937 – 26, 77001 – 26

5. A male (67 yrs ) patient is brought to the operation room for Re-vascular procedure. The patient
is suffering from a severe atherosclerotic plague in his right anterior tibial and posterior tibial artery
the physician is planned to place two stent in the vessels to restore the vascular flow. A catheter is
advanced from right femoral artery to the right anterior tibial artery and an angiography confirms
the stenosis, pre-dilation with a balloon is performed followed by placement of a bare-metal stent
post angiography images show excellent results the same thing repeated in the posterior tibial
artery. What are the appropriate CPT codes for the procedure performed?

A. 37230
B. 37230, 37234

C. 37231, 37234

D. 37230, 37232, 37234

6. A 71 yrs patient is brought to the operating room for Re-vascular procedure. The patient is
suffering from severe stenosis in his left femoral and popliteal artery. A catheter is advanced from
the right side of the femoral artery in retrograde fashion advanced into the left iliac system and
moved to the left femoral artery, angiography confirms the stenosis and Pre-dilation with a balloon
is performed followed by placement of a stent in the femoral artery. Post angiography images show
excellent results following that catheter is advanced to the popliteal artery crossing the stenosis a
stent was deployed, post images show good results. What are the appropriate CPT codes for the
procedure performed?

A. 37230, 37234

B. 37226, 37226 – 59

C. 37226, 37224 – 59

D. 37226

7. A patient with severe occlusive disease in the inferior mesenteric artery was brought to the
operating room to undergo percutaneous transluminal Thrombectomy and stent placement, a
catheter is advanced from right femoral artery to aorta, aortography images show patent vessel and
the catheter is moved into inferior mesenteric artery at the site of occlusion the short segment of
embolus was removed followed by placement of a stent is performed successfully. Post images
show excellent results. What are the appropriate CPT codes for the procedure performed?
A. 37238, 37184

B. 37236, 37184

C. 37236, 37286

D. 37221, 37286

8. A female patient with vaginal bleed due to rupture of the aneurysm is here for vascular
embolization procedure. Via the right femoral artery, the catheter is advanced into the internal iliac
artery and further advanced into its branches and embolization coils are placed in the distal,
beyond third-order branch of the iliac vascular family, follow up images shows cessation of the
bleeding and occlusion of the vessel. What are the appropriate CPT codes for the procedure
performed?

A. 37244

B. 37242

C. 37244, 37244 – 59

D. 37242, 37244 – 59

9. A 69 yrs Female patient with bilateral leg swelling is admitted in the hospital, after sterile prep
and drape the physician inject dye into the webbing between the first and second toes on each
foot. The physician selects one of the larger lymphatic channels and numb the area. He made a
small incision and then inserts a tube into the channel; this process was repeated on the other foot.
Once both tubes are in place more contrast was slowly injected. Fluoroscopic images were taken
and it shows stenosis on either side. How would you report the physician’s service?
 A. 38790 – 50, 75803 – 26

B. 38790, 75803 – 26

C. 38790 – 50, 75803

D. 38790, 75801 – 26

10. 47yrs male patient is suffering from prostate cancer is here to undergo a biopsy of axillary lymph
nodes due to abnormal enlargement of right axillary lymph nodes. After sterile prep and drape
following local anesthesia the physician insert 16 gauge needles under CT guidance to take 3
samples from three axillary lymph nodes and sent all samples to pathology. How would you report
the physician’s service?

A. 38525

B. 38525 x 3

C. 38505, 77012 – 26

D. 38505 x 3, 77012 – 26
Answers:

1. C

2. B

3. A

4. D

5. B

6. D

7. C

8. A
9. A

10. C