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NEW QUESTION # 13
A 1-year-old patient has bilateral supernumerary digits:
Left digit contains bone and joint โ amputated
Right digit is a soft-tissue nubbin โ simple excision
What CPT coding is reported?
Answer: B
Explanation:
26910 = Excision of supernumerary digit with bone/joint involvement
11200 = Removal of skin tag / soft tissue lesion
Laterality modifiers correctly identify different procedures on different sides
NEW QUESTION # 14
A patient presents for a percutaneous needle biopsy of the liver with ultrasound guidance to assess the severity of his primary biliary cirrhosis.
What CPTand ICD-10-CM codes are reported?
Answer: D
Explanation:
1. Procedure and CPTCode Selection:
The patient underwent a percutaneous needle biopsy of the liver with ultrasound guidance to assess primary biliary cirrhosis.
Code 47000 is the CPTcode for a percutaneous liver biopsy. This code encompasses the biopsy procedure itself.
Ultrasound guidance is commonly inherent to biopsy procedures, and guidance is not separately reported if the main code (47000) includes the technique used.
2. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code K74.5 is the correct code for primary biliary cirrhosis, which is specifically indicated in this case.
K74.3 is the code for other specified cirrhosis of the liver but is less specific than K74.5, making K74.5 the appropriate choice here.
3. Exclusion of Other Codes:
Code 47100 (option A) is for an open liver biopsy, which does not apply to this percutaneous procedure.
Codes 10005 (biopsy with imaging guidance) and 76942 (ultrasound guidance) would be redundant or incorrect since the main procedure code, 47000, sufficiently describes a percutaneous liver biopsy.
4. AAPC and CPTCoding Guidelines:
AAPC guidelines state that guidance is included in certain biopsy codes when performed for the targeted organ, such as in 47000 for a liver biopsy.
Therefore, based on CPTand ICD-10-CM coding rules, the correct answer is C. 47000, K74.5.
NEW QUESTION # 15
A 43-year-old female with a history of joint pain and fatigue presents to the office with swollen salivary glands. Patient agrees to have a labial gland biopsy performed in office. Patient is numbed with a local anesthetic. Then an incision is made on the lower labial mucosa and tissue samples from the salivary gland are removed with tweezers. The incision is sutured. Pathology report findings are consistent with Sjogren's syndrome.
What CPTcode is reported?
Answer: D
Explanation:
1. Procedure and CPTCode Selection:
The scenario describes a labial gland biopsy of the salivary gland, performed in the office with a local anesthetic. The provider made an incision in the lower labial mucosa and took tissue samples from the salivary gland for biopsy.
Code 42400 is the correct CPTcode for a biopsy of a salivary gland. This code is specific to a biopsy without a more extensive excision or major surgery, aligning perfectly with the scenario of sampling salivary gland tissue.
2. Ruling Out Other Options:
Code 42408 is for the excision of a deep lobe of a parotid gland, which is a more extensive procedure than a simple biopsy and does not apply to this case.
Code 42405 is for the removal of an entire submandibular gland, which is a full excision and not applicable here.
Code 42450 is used for the removal of a sublingual gland, not for a biopsy of the labial salivary gland.
3. AAPC and CPTCoding Guidelines:
AAPC and CPTguidelines direct coders to use 42400 for minor biopsies of salivary gland tissue, particularly when only tissue samples are taken for diagnostic purposes, as described in this case.
Based on CPTcoding guidelines, the correct answer is C. 42400.
NEW QUESTION # 16
View MR 002395
MR 002395
Operative Report
Pre-operative Diagnosis: Acute rotator cuff tear
Post-operative Diagnosis: Acute rotator cuff tear, synovitis
Procedures:
1) Rotator cuff repair
2) Biceps Tenodesis
3) Claviculectomy
4) Coracoacromial ligament release
Indication: Rotator cuff injury of a 32-year-old male, sustained while playing soccer.
Findings: Complete tear of the right rotator cuff, synovitis, impingement.
Procedure: The patient was prepared for surgery and placed in left lateral decubitus position. Standard posterior arthroscopy portals were made followed by an anterior-superior portal. Diagnostic arthroscopy was performed. Significant synovitis was carefully debrided. There was a full-thickness upper 3rd subscapularis tear, which was repaired. The lesser tuberosity was debrided back to bleeding healthy bone and a Mitek 4.5 mm helix anchor was placed in the lesser tuberosity. Sutures were passed through the subcapulans in a combination of horizontal mattress and simple interrupted fashion and then tied. There was a partial-thickness tearing of the long head of the biceps. The biceps were released and then anchored in the intertubercular groove with a screw. There was a large anterior acromial spur with subacromial impingement. A CA ligament was released and acromioplasty was performed. Attention was then directed to the supraspinatus tendon tear. The tear was V-shaped and measured approximately 2.5 cm from anterior to posterior. Two Smith & Nephew PEEK anchors were used for the medial row utilizing Healicoil anchors. Side-to-side stitches were placed. One set of suture tape from each of the medial anchors was then placed through a laterally placed Mitek helix PEEK knotless anchor which was fully inserted after tensioning the tapes. A solid repair was obtained. Next there were severe degenerative changes at the AC joint of approximately 8 to 10 mm. The distal clavicle was resected taking care to preserve the superior AC joint capsule. The shoulder was thoroughly lavaged. The instruments were removed and the incisions were closed in routine fashion. Sterile dressing was applied. The patient was transferred to recovery in stable condition.
What CPT coding is reported for this case?
Answer: A
Explanation:
29827: Arthroscopic rotator cuff repair is correctly coded as 29827.
29828: Arthroscopic biceps tenodesis is an additional procedure and should be coded as 29828 with modifier -51 (Multiple Procedures).
29824: Arthroscopic claviculectomy (partial resection of the distal clavicle) is coded as 29824 with modifier -51.
29826: Arthroscopic subacromial decompression, including coracoacromial ligament release, is coded as 29826.
All these procedures were performed arthroscopically and documented in the operative report, justifying the use of these codes and the use of modifier -51 for multiple procedures.
CPT Professional Edition, AMA
NEW QUESTION # 17
A 5-year-old is brought to the QuickCare in the ED to repair two lacerations: a 3 cm laceration on her right arm and 2 cm laceration on her nose. Her arm is repaired with a simple one-layer closure with sutures. Her nose is repaired with a simple repair using tissue adhesive, 2-cyanoacrylate.
How are the repairs reported?
Answer: C
Explanation:
The CPT code 12002 is used for simple repair of superficial wounds of 2.5 cm or less. This code includes the repair of both the 3 cm laceration on the right arm and the 2 cm laceration on the nose as both are simple repairs. The other options suggest more complex repairs or multiple separate procedures, which are not necessary in this scenario.
AMA's CPT Professional Edition (current year)
NEW QUESTION # 18
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