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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Reimbursement & Revenue Cycle | 5-7% | |
| Topic 2: HCPCS Level II Coding | 5-7% | |
| Topic 3: Medical Terminology & Anatomy | 8-10% | |
| Topic 4: Compliance & Regulations | 8-10% | - Reimbursement rules - HIPAA, fraud & abuse |
| Topic 5: Modifiers | 5-7% | |
| Topic 6: ICD-10-CM Coding | 15-17% | - Code selection & sequencing - Diagnosis coding guidelines |
| Topic 7: CPT® Coding | 45-50% | - Surgery (10000–69999) - Radiology, Pathology/Laboratory, Medicine - Evaluation & Management (E/M) |
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NEW QUESTION # 304
Preoperative diagnosis: Right thigh benign congenital hairy nevus. *1
Postoperative diagnosis: Right thigh benign congenital hairy 0 nevus.
Operation performed: Excision of right thigh benign congenital>1
nevus, excision size with margins 4.5 cm and closure size 5 cm.
Anesthesia: General.0
Intraoperative antibiotics: Ancef.0
Indications: The patient is a 5-year-old girl who presented with her parents for evaluation of her right thigh congenital nevus. It has been followed by pediatrics and thought to have changed over the past year. Family requested excision. They understood the risks involved, which included but were not limited to risks of general anesthesia, infection, bleeding, wound dehiscence, and poor scar formation. They understood the scar would likely widen as the child grows because of the location of it and because of the age of the patient. They consented to proceed.
Description of procedure: The patient was seen preoperatively in > I the holding area, identified, and then brought to the operating room. Once adequate general anesthesia had been induced, the patient's right thigh was prepped and draped in standard surgical fashion. An elliptical excision measuring 6 x 1.8 cm had been marked. This was injected with Lidocaine with epinephrine, total of 6 cc of 1% with 1:100,000. After an adequate amount of time, a #15 blade was used to sharply excise this full thickness.
This was passed to pathology for review. The wound required limited undermining in the deep subcutaneous plane on both sides for approximately 1.5 cm in order to allow mobilization of the skin for closure. The skin was then closed in a layered fashion using 3-0 Vicryl on the dermis and then 4-0 Monocryl running subcuticular in the skin, the wound was cleaned and dressed with Dermabond and Steri-Strips.
The patient was then cleaned and turned over to anesthesia for S extubation.
She was extubated successfully in the operating room and taken S to the recovery room in stable condition. There were no complications.
What CPT and ICD-10-CM codes are reported?
Answer: B
Explanation:
45540 = Repair of rectal prolapse, abdominal approach
52332 = Cystourethroscopy with ureteral stent
K62.3 = Rectal prolapse
NEW QUESTION # 305
What modifier is appended to indicate when a procedure performed during the postoperative period is unrelated to the original surgery?
Answer: B
Explanation:
Modifier -79 is used to indicate an unrelated procedure or service performed by the same physician during the postoperative (global) period.
-57 = decision for surgery
-25 = significant, separately identifiable E/M
-55 = postoperative management only
Modifier usage is a high-yield CPC exam topic.
NEW QUESTION # 306
An incision is made in the scalp, a craniectomy is performed to access the area where electrodes are present. The electrodes are removed. The surgical wound is closed.
What procedure code is reported?
Answer: D
Explanation:
The procedure described involves the removal of electrodes from the cranial area after making an incision in the scalp and performing a craniectomy.
Procedure Description:
Incision in the scalp.
Craniectomy to access the area with electrodes.
Removal of electrodes.
Closure of the surgical wound.
CPT Coding:
61860: Removal of intracranial neurostimulator electrodes, including burr hole(s) or craniectomy.
AMA's CPT Professional Edition (current year).
CPT Assistant for detailed coding guidelines on neurostimulator procedures.
NEW QUESTION # 307
The procedure is performed at an outpatient radiology department. From a left femoral access, the catheter is placed in the abdominal aorta and is then selectively placed in the celiac trunk and manipulated up into the common hepatic artery for an abdominal angiography. Dye is injected, and imaging is obtained. The provider performs the supervision and interpretation.
What CPT codes are reported?
Answer: A
NEW QUESTION # 308
A 35-year-old female has cancer in her left breast. The surgeon performs a mastectomy, removing the breast tissue, skin, pectoral muscles, and surrounding tissue, including the axillary and internal mammary lymph nodes.
Which mastectomy code is reported?
Answer: A
Explanation:
For a mastectomy that involves removing the breast tissue, skin, pectoral muscles, and surrounding tissue, including the axillary and internal mammary lymph nodes, the appropriate CPT code is:
* 19306: Mastectomy, radical, including pectoral muscles, axillary lymph nodes.
This code captures the extent of the surgery, including the removal of the breast tissue, skin, pectoral muscles, and lymph nodes.
References:
* CPT Professional Edition (current year)
* Surgery guidelines for mastectomy procedures
NEW QUESTION # 309
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