RADIOLOGY

1. This 69-year-old female is in for a magnetic resonance examination of the brain

because of new seizure activity. After imaging without contrast, contrast was
administered and further sequences were performed. Examination results
indicated no apparent neoplasm or vascular malformation.

A. 70543-26, R56.00 B. 70543-26, R56.9 C. 70553-26, R56.9 D.

70553, G40.909

Correct

2. This patient undergoes a gallbladder sonogram due to epigastric pain. The report
indicates that the visualized portions of the liver are normal. No free fluid noted
within Morison's pouch. The gallbladder is identified and is empty. No evidence of
wall thickening or surrounding fluid is seen. There is no ductal dilatation. The
common hepatic duct and common bile duct measure
0.4 and 0.8 cm, respectively. The common bile duct measurement is at the upper
limits of normal.

A. 76700-26, R10.84 B. 76705-26, R10.13 C. 76775-26, R10.33 D. 76705, R10.84

Correct

3. EXAMINATION OF: Chest.

CLINICAL SYMPTOMS: Pneumonia.

PA AND LATERAL CHEST X-RAY WITH FLUOROSCOPY.

CONCLUSION: Ventilation within the lung fields has improved compared with previous
study.
A. 71020-26, J15.8 B. 71034, J15.6 C. 71023-26, J18.9 D. 71023, J18.9

Correct
4. EXAMINATION OF: Abdomen and pelvis.

CLINICAL SYMPTOMS: Ascites.

CT OF ABDOMEN AND PELVIS: Technique: CT of the abdomen and pelvis was

performed without oral or IV contrast material per physician request. No previous CT
scans for comparison.

FINDINGS: No ascites. Moderate-sized pleural effusion on the right.

A. 74150-26, 72192-26 R18.8 B. 74176-26, J91.8

C. 74150-26, 72192-26 J91.8 D. 74176-26, R18.8

Correct
5. EXAMINATION OF: Brain.

CLINICAL FINDING: Headache.

COMPUTED TOMOGRAPHY OF THE BRAIN was performed without contrast material.

FINDINGS: There is blood within the third ventricle. The lateral ventricles show mild
dilatation with small amounts of blood.

IMPRESSION: Acute subarachnoid hemorrhage.

A. 70460-26, R51 B. 70250, R51 C. 70450-26, I60.9 D. 70450-26, R51

Correct
6. Report both the technical and professional components of the following service:
This 68-year- old male is seen in Radiation Oncology Department for prostate
cancer. The oncologist performs a complex clinical treatment planning, dosimetry
calculation, and a complex isodose plan; treatment devices include blocks, special
shields, and wedges. The patient had 5 days of radiation treatments for 2 weeks, a
total of 10 days of treatment.

A. 77263, 77300, 77307, 77334, C61

B. 77300, 77315, 77334, 77427 × 2, C61

C. 77263, 77307, 77334, 77427 × 2, C61

D. 77263, 77427 × 2, C61

Correct
7. EXAMINATION OF: Right hip.
DIAGNOSIS: Osteoarthritis right hip.

ONE-VIEW RIGHT HIP: A single frontal view is obtained of the right hip. No previous
studies are available for comparison. Right hip arthroplasty is seen. Alignment
appears grossly unremarkable on this single view. There are skin staples present. Air
is seen in the soft tissues, likely due to recent surgery. There appear to be two drains
present. The tip of one overlies the soft tissues superolateral to the greater
trochanter. The second one is more inferior. The tip overlies the right proximal
femoral prosthesis.

IMPRESSION: Single view of the right hip with findings consistent with recent right
total hip arthroplasty.

A. 72100, M25.451 B. 73501-RT, M16.9

C. 72100-26, M19.90 D. 73501-RT-26, M16.9

Correct
8. EXAMINATION OF: Cervical spine.

CLINICAL SYMPTOMS: Herniated disk.

FINDINGS: A single spot fluoroscopic film from the operating room is submitted for
interpretation. The cervical spine is not well demonstrated above the level of the
inferior aspect of C6. There is a metallic surgical plate seen anterior to the cervical
spine. The cephalic portion of the plate is at the level of C6 at its superior endplate.
That extends in an inferior direction, presumably anterior to C7; however, there is
not adequate visualization of C7 to confirm location. Density overlies the C6-7
intervertebral disk space, suggesting the presence of a bone plug in this area;
however, again visualization is not adequate in this area. Further evaluation with
plain radiographs is recommended.
A. 72100-26, M51.26 B. 72020-26, M50.20

C. 72100-52-26, M50.20 D. 72020-52-26, M51.24

Need Assistance 72020 – does not indicate fluoroscopic film guidance

procedure

Correct
9. This patient is suffering from primary lung cancer and is in for a follow-up CT
scan of the thorax with contrast material. Code the physician component only.

A. 71250-26, C78.00 B. 71260, C34.90

C. 71260-26, C34.90 D. 71250-26, D49.1

Correct
10.A patient had a whole-body thyroid carcinoma metastases imaging with uptake
completed. Select the appropriate codes to report the professional services.

a. 78015-26, 78003-26 b. 78010, 78020

c. 78028, 78020 d. 78018-26, 78020-26

Correct
11) 76-year-old female had a ground level fall when she tripped over her dog earlier
this evening in her apartment. The Emergency Department took x-rays of the wrist
in oblique and lateral views which revealed a displaced distal radius fracture, grade
I open right wrist. What radiological service and ICD-9 codes should be reported?
A. 73100-26, S52.509B, W01.0XXA, Y92.039 B. 73110-26, S52.501B, W01.10XA,
Y92.039

C. 73115-26, S52.509A, W01.0XXA, Y92.039 D. 73100-26, S52.501B, W01.0XXA,

Y92.039

Correct
12) The patient is 15 weeks pregnant with twins coming back to her obstetrician to
have a transabdominal ultrasound performed to reassess anatomic abnormalities
of both fetuses that were previously demonstrated in the last ultrasound. What
code(s) should be used for this procedure?

A. 76815 B. 76816, 76816-59 C. 76801, 76802 D. 76805,

76810
Correct
 13) 56-year-old female is having a bilateral mammogram with computer aid
detection conducted as a screening since the patient has had a previous cyst in
the right breast. What radiological services are reported?

A. 77065 B. 77066 C. 77067 D. 77066, G0279

Correct
14) A CT density study is performed on a post-menopausal female to screen for
osteoporosis. Today’s visit the bone density study will be performed on the spine.
Which CPT code should be used?

A. 77075 B. 77080 C. 77078 D. 72010

Correct
15.A 32-year-old pregnant female has gestational diabetes at 34 weeks gestation.
Her doctor is concerned about decreased fetal movement. The patient is sent to the
radiology department of the hospital for a biophysical profile (BPP). The radiologist
performs and interprets four elements scored by the ultrasound an it was
reassuring, 8/8. A non-stress test will be performed by the obstetrician at the
patient's next office visit, not the radiologist. What is the correct CPT® code for the
fetal profile performed by the radiologist?

A. 76818 B. 76815 C. 76819 D.

76820

Correct
16.The physician performs a selective catheterization of the right renal
artery and renal angiography. The puncture site was the right femoral
artery.
A. 36251-RT, 36200-51, 75625-26 B. 36245-RT

C. 36215-RT, 36200-51, 75625-26 D. 36251-RT

Separate procedures will not be coded

17.A patient with colon cancer receives five sessions of radiation treatments. During
the course of treatments, the physician views the port films, reviews the treatment
parameters, and assesses the patient’s response to the treatment. The patient
receives two more treatment sessions when ending the course of treatment. Code
the radiation treatment management.

A. 77427 B. 77431 x 7 C. 77427 x 2 D.

77427, 77431

77427 -Guideline -
18 fractions = 4 weekly services
62 fractions = 12 weekly services
8 fractions = 2 weekly services
6 fractions = 1 weekly service

18.A 78-year-old with lower back pain and leg pain is scheduled for a MRI of
lumbar spine without contrast. Following the MRI, the patient is diagnosed with
spinal stenosis of the lumbar region. What are the procedure and diagnosis codes?

A. 72020-26, M54.5, M79.606, M48.06 B. 72149-26, M48.06

C. 72148-26, M48.06 D. 72158-26, M48.07, M54.5, M79.606

Correct
19.22-year-old driver loss control of her car and crashed into a light pole on the
highway. She arrived to the hospital. She had CT scans without contrast of the brain
and chest. She had X- rays of AP and PA views of her left ribs and AP and PA views
of her right ribs with a posterioanterior view of the chest. The CT scan of the brain
showed a fracture of the skull base with no hemorrhage of the brain. The CT of the
lung showed no puncture of the lungs. The X-ray showed fractures in the right and
left second, third, and fifth ribs. What CPT® and ICD-10-CM codes should be
reported.

A. 70450-26, 71250-26, 71101-26, S02.10XA, S22.43XA, V47.32XA, Y92.411

B. 70460-26, 71260-26, 71110-26, S02.01XA, S22.49XB V47.0XXA, Y92.411

C. 70450-26, 71250-26, 71111-26, 71010-26, S01.10XA, S22.49XA, V47.32XA, Y92.411

D. 70450-26, 71250-26, 71111-26, S02.10XA, S22.43XA, V47.52XA, Y92.411

71111 – Bilateral with 2 vies plus 1 view of the chest

20.The physician orders an ultrasound on a patient 25 weeks pregnant with

twins to access fetal heart rate and fetal position. Select the code(s).

A. 76805, 76810 B. 76811, 76812 C. 76816 x 2 D. 76815

Correct
21.65-year-old woman is one year post with B-cell non-Hodgkin’s lymphoma. She is
having recurrent fever and pain. Tumor recurrence was confirmed by CT studies
and chest X-ray. She has failed prior chemotherapy and radiation treatments. A
new treatment is being contemplated and she is referred for a radiopharmaceutical
distribution imaging as a requirement before starting this new treatment. The
provider injects small amounts of gamma-emitting radioactive material paying
particular attention for potential reaction. A gamma camera is used to take planar
images of the whole body for three days. Three sets of image data are interpreted.
Qualitative assessment of distribution and determination of treatment with
monoclonal antibody are provided. A report is dictated and placed in the medical
recorD. Which CPT® code is reported?

A. 78806-2 B. 78802-26 C. 78804-26 D.

78801-26
Correct

22.Due to an elevated CEA level two years following a colon resection, the
patient’s oncologist ordered a diagnostic liver ultrasound. Which radiology code is
reported for this encounter.

A. 76700 B. 78206 C. 76705 D.

76970
Correct

23.A 52-year-old male has a 3.2 cm metastasized lung cancer in his left upper lobe.
The tumor cannot be removed by surgery due to the patient having severe
respiratory conditions. He will be
receiving sterotactic body radiation therapy management under image guidance.
There is a delivery of 25 Gy for four fractions under direct supervision of the radiation
oncologist. The patient’s treatment set up is assessed to manage the execution of
the treatment to make any adjustments needed for accuracy and safety. The
oncologist reviews and approves all the images used to locate the tumor and images
of fields arranged to deliver the dose. What CPT® and ICD-9-CM codes should be
reported?

A. 77373, Z51.0, C34.92 B. 77435, Z51.0, C78.02

C. 77435, C78.02, Z51.0 D. 77402, C34.92, Z51.0

Correct
Z51 radiation therapy will coded first