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NEW QUESTION # 134
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: A
Explanation:
27380 = Repair, quadriceps muscle
S76.311A = Strain of muscle, fascia, tendon of right thigh, initial encounter Code selection is based on specific muscle group and laterality
NEW QUESTION # 135
(A 52-year-old woman has vulvar intraepithelial neoplasia (VIN II). The surgeon performs avulvectomyremovingless than 80%of the vulva, including affected skin and deep subcutaneous tissue. What CPT and ICD-10-CM codes are reported?)
Answer: C
Explanation:
This question tests two things: theextentof vulvectomy and the correct diagnosis code forVIN II. VIN II corresponds tomoderate vulvar dysplasia, which is coded asN90.1. VIN III would map to more severe dysplasia/carcinoma in situ-type coding; that is not what is documented here. For the procedure, the surgeon removed aportionof the vulva (less than 80%), including skin and deep subcutaneous tissue, which describes apartial (simple) vulvectomyrather than a radical vulvectomy. CPT56625represents asimple partial vulvectomy(partial removal). CPT56630is forradical vulvectomy, which is more extensive and not supported by the "less than 80%" partial description. Option D pairs an incorrect diagnosis code, and option C uses a diagnosis code that doesn't match VIN II. Therefore, the correct combination is56625 with N90.1.
NEW QUESTION # 136
A patient underwent a cystourethroscopy with a pyeloscopy using lithotripsy to break up the ureteral calculus. An indwelling stent was also inserted during the same operative session on the same side. This service was performed in the outpatient hospital surgery center.
What CPT coding reported?
Answer: B
Explanation:
Cystourethroscopy: This is a procedure that involves the use of a cystoscope to look inside the urethra and bladder.
Pyeloscopy: Involves the examination of the upper urinary tract, typically done through the cystoscope.
Lithotripsy: A procedure that uses shock waves or a laser to break up stones in the kidney, bladder, or ureter.
Indwelling stent insertion: A procedure to place a stent in the ureter to help urine flow from the kidney to the bladder.
52356: Cystourethroscopy with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization and/or ureteral stent placement).
The code 52356 includes all components mentioned: cystourethroscopy, pyeloscopy, lithotripsy, and stent insertion performed in the same operative session.
Reference:
AMA's CPT Professional Edition (current year)
ICD-10-CM (current year), HCPCS Level II (current year)
NEW QUESTION # 137
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?
Answer: C
NEW QUESTION # 138
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: C
NEW QUESTION # 139
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