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200. Frage
A couple presents to the freestanding fertility clinic to start in vitro fertilization. Under radiologic guidance, an aspiration needle is inserted (by aid of a superimposed guiding-line) puncturing the ovary and preovulatory follicle and withdrawing fluid from the follicle containing the egg.
What is the correct CPT code for this procedure?
Antwort: D
Begründung:
The procedure involves the aspiration of fluid from an ovarian follicle to retrieve the egg under radiologic guidance.
Procedure Description:
Aspiration needle insertion.
Puncture of the ovary and preovulatory follicle.
Withdrawal of fluid containing the egg.
Radiologic guidance was used.
CPT Coding:
58976: Aspiration of ovarian follicle(s) with ultrasound guidance.
AMA's CPT Professional Edition (current year).
CPT Assistant for detailed coding guidelines on reproductive procedures.
201. Frage
A patient with coronary artery disease due to lipid-rich plaque undergoes coronary artery bypass grafting. The surgeon performs a left internal mammary artery graft to the left anterior descending artery. Then performs saphenous vein grafts to the obtuse marginal artery, ramus intermedius, and posterior descending artery. An endoscopic saphenous vein harvest is performed.
What CPT coding is reported for the surgical procedure?
Antwort: D
Begründung:
Procedure Coding (CPT):
33533 - CABG, arterial graft; single arterial graft (LIMA to LAD)
Correct for left internal mammary artery # LAD
33519 - CABG, venous grafts; three coronary venous grafts
Saphenous vein grafts placed to:
Obtuse marginal
Ramus intermedius
Posterior descending artery
Total = 3 venous grafts
33508 - Endoscopic harvest of saphenous vein
Separately reportable only when endoscopic
Add-on code (no modifier required)
Why Other Options Are Incorrect:
A / C - Incorrect arterial graft code (33536 = multiple arterial grafts) B - Incorrect venous graft count (33512 = two grafts) CPT Guideline Reference:
CABG codes are selected based on:
Type of conduit (arterial vs venous)
Number of distal anastomoses
Endoscopic harvest is add-on and separately reportable
202. Frage
According to the Application of Cast and Strapping CPT guidelines, what is reported when an orthopedic provider performs initial fracture care treatment for a closed scaphoid fracture of the wrist, applies a short arm cast, and the patient will be returning for subsequent fracture care?
Antwort: C
Begründung:
For initial fracture care of a closed scaphoid fracture, code 25622 is used, which includes treatment and initial casting. The application of the cast is part of the fracture care and is not reported separately. CPT guidelines specify that casting or strapping performed as part of the fracture care is included in the fracture care code.References: AMA's CPT Professional Edition (current year), Surgery section, Musculoskeletal System.
203. Frage
A driver loses control of a vehicle and crashes into a guardrail on the side of the highway. The patient sustains a fracture of the anterior fossa cranial base. Imaging confirms Involvement of the sphenoid sinus, but no cerebrospinal fluid (CSF) leak is identified. The patient undergoes a surgical nasal sinus endoscopy with sphenoidotomy lo evaluate and treat the sinus injury. No CSF leak repair is performed.
What is the correct procedure and diagnosis coding combination to report this service?
Antwort: D
Begründung:
Procedure Coding (CPT):
31287 - Nasal/sinus endoscopy, surgical; with sphenoidotomy
Correct because the surgeon performed a surgical endoscopic sphenoidotomy to evaluate and treat sphenoid sinus injury.
No CSF leak repair was performed, so codes 31290-31291 are not appropriate.
31231-59 - Nasal endoscopy, diagnostic
Diagnostic endoscopy is separately reportable because:
It was performed to evaluate traumatic injury
It is not bundled into the surgical service when it provides distinct diagnostic information Modifier -59 indicates a separate and distinct service per NCCI edits.
Diagnosis Coding (ICD-10-CM):
S02.109A - Unspecified fracture of base of skull, initial encounter for closed fracture The anterior cranial fossa fracture with sphenoid sinus involvement qualifies as a skull base fracture No CSF leak is documented Correct 7th character "A" for initial encounter Why Other Options Are Incorrect:
A - Incorrect format and duplicated CPT logic
B - 31267 = maxillary sinus, wrong sinus
D - 31291 includes CSF leak repair, which was not performed
204. Frage
A cardiologist performs remote monitoring for a 30-day period via a previously implanted hemodynamic pulmonary artery pressure monitor for a patient with congestive heart failure with resulting pulmonary edema.
The first month of monitoring includes weekly downloads, interpretations, trend analysis, and subsequent reports.
What CPTcode is reported?
Antwort: A
Begründung:
1. Procedure and CPTCode Selection:
The cardiologist provided remote monitoring over a 30-day period for a hemodynamic pulmonary artery pressure monitor implanted in a patient with congestive heart failure.
CPTCode 93264 is appropriate for remote monitoring of a hemodynamic system for up to 30 days. This code includes services such as weekly data transmissions, interpretation, trend analysis, and reporting- exactly as described in this case.
2. Rationale for Excluding Other Options:
Code 93286 is for in-person interrogation and programming of pacemakers or defibrillators, not for remote monitoring of a hemodynamic monitor, making it incorrect.
Code 93288 is for interrogation device evaluation (remote), specifically for pacemakers or defibrillators, and does not apply to a pulmonary artery pressure monitor.
Code 93279 is for in-person programming of certain cardiac devices, which does not match the remote monitoring described in this scenario.
3. AAPC and CPTCoding Guidelines:
AAPC and CPTguidelines specify that 93264 is the correct code when reporting remote hemodynamic monitoring for a pulmonary artery pressure device over a period of up to 30 days, including data review and interpretation.
Therefore, the correct answer is B. 93264.
205. Frage
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