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| Section | Objectives |
|---|---|
| CPT Coding | - Surgical, diagnostic, and procedural coding - CPT guidelines and conventions |
| ICD-10-CM Diagnosis Coding | - ICD-10-CM guidelines - Diagnosis code selection and sequencing |
| Medical Terminology and Anatomy | - Human anatomy basics - Medical terminology structure |
| Compliance and Regulatory Guidelines | - HIPAA and medical ethics - Fraud and abuse regulations |
| HCPCS Level II Coding | - Durable medical equipment and supplies - Medicare coding procedures |
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NEW QUESTION # 12
A 67-year-old male presents with DJD and spondylolisthesis at L4-L5 The patient is placed prone on the operating table and, after induction of general anesthesia, the lower back is sterilely prepped and draped. One incision was made over L1-L5. This was confirmed with a probe under fluoroscopy. Laminectomies are done at vertebral segments L4 and L5 with facetectomies to relieve pressure to the nerve roots. Allograft was packed in the gutters from L1-L5 for a posterior arthrodesis. Pedicle screws were placed at L2, L3, and L4.
The construct was copiously irrigated and muscle; fascia and skin were closed in layers.
Select the procedure codes for this scenario.
Answer: A
Explanation:
* Laminectomy and Facetectomy (63047 and 63048): The laminectomies at L4 and L5 with facetectomies fall under CPT codes 63047 (for the initial segment) and 63048 (for each additional segment).
* Posterior Arthrodesis (22612 and 22614 x 3): The posterior arthrodesis from L1-L5 is coded with
22612 for the primary segment (L4-L5) and 22614 for each additional segment (L1-L4).
* Placement of Pedicle Screws (22842): The placement of pedicle screws at L2, L3, and L4 is captured under CPT code 22842 for segmental instrumentation.
References:
* AMA's CPT Professional Edition (current year)
* ICD-10-CM (current year)
* HCPCS Level II (current year)
NEW QUESTION # 13
A patient that delivered her second child vaginally has a history of having a previous cesarean delivery for the first child.
What CPT code is reported for the delivery of the second child with antepartum care and postpartum care with the same provider?
Answer: A
Explanation:
1. Procedure and CPT Code Selection:
The patient delivered her second child vaginally after having a previous cesarean delivery for her first child. This scenario describes a Vaginal Birth After Cesarean (VBAC).
CPT Code 59610 is specific for a vaginal delivery after a previous cesarean delivery, including antepartum and postpartum care with the same provider, which matches this case exactly.
2. Rationale for Excluding Other Options:
Code 59410 covers only vaginal delivery with postpartum care but does not include a history of previous cesarean delivery, so it is not appropriate for a VBAC.
Code 59400 is for routine vaginal delivery with antepartum and postpartum care but, again, does not account for a previous cesarean, so it does not apply in this VBAC scenario.
Code 59614 is for a VBAC but does not include antepartum care, making it incomplete for this scenario since the question specifies that antepartum, delivery, and postpartum care were provided by the same provider.
3. AAPC and CPT Coding Guidelines:
AAPC and CPT guidelines indicate that 59610 should be used for a complete VBAC service that includes antepartum, delivery, and postpartum care by the same provider.
Therefore, based on CPT guidelines, the correct answer is B. 59610.
NEW QUESTION # 14
A patient who has colon adenocarcinoma undergoes a laparoscopic partial colectomy. The surgeon removes the proximal colon and terminal ileum and reconnects the cut ends of the distal ileum and remaining colon.
What procedure and diagnosis codes are reported?
Answer: A
Explanation:
The procedure involves a laparoscopic partial colectomy where the surgeon removes the proximal colon and terminal ileum, then reconnects the cut ends of the distal ileum and remaining colon.
Procedure Description:
Laparoscopic partial colectomy.
Removal of the proximal colon and terminal ileum.
Anastomosis of the distal ileum and remaining colon.
CPT Coding:
44204: Laparoscopy, surgical; colectomy, partial, with anastomosis.
ICD-10-CM Coding:
C18.2: Malignant neoplasm of ascending colon.
AMA's CPT Professional Edition (current year).
ICD-10-CM for corresponding diagnosis codes.
NEW QUESTION # 15
A 30-year-old patient with a scalp defect is having plastic surgery to insert tissue expanders. The provider inserts the implants, closes the skin, and increases the volume of the expanders by injecting saline solution.
Tissue is expanded until a satisfactory aesthetic outcome is obtained to repair the scalp defect.
What CPT code is reported?
Answer: A
Explanation:
The CPT code 11960 is used for the insertion of tissue expanders for other than breast, which includes the scalp in this case. The procedure involves inserting the tissue expanders, closing the skin, and gradually increasing the volume of the expanders until a satisfactory outcome is achieved for repairing the scalp defect.
The other options do not accurately describe the procedure performed on the scalp.
AMA's CPT Professional Edition (current year)
NEW QUESTION # 16 
Refer to the supplemental information when answering this question:
View MR 004813
What CPTand ICD-10-CM codes are reported?
Answer: C
Explanation:
* CPT Code 43246: Esophagogastroduodenoscopy, with transoral insertion of intra-abdominal tube (e.g., gastrostomy or jejunostomy)
* This code describes the attempted PEG tube placement.
* Modifier -52: Reduced services. This modifier is appended because the procedure was aborted and the PEG tube was not successfully placed.
* ICD-10-CM Code K94.29: Other specified disorders of digestive system
* This code captures the patient's chronic feeding requirement, which is the reason for the attempted PEG tube placement.
* ICD-10-CM Code K44.9: Diaphragmatic hernia without obstruction or gangrene
* This code reports the small hiatal hernia that was found during the procedure.
References:
* CPT Code 43246: Esophagogastroduodenoscopy, with transoral insertion of intra-abdominal tube (e.g., gastrostomy or jejunostomy)
* Modifier 52: Reduced services
* ICD-10-CM Code K94.29: Other specified disorders of digestive system
* ICD-10-CM Code K44.9: Diaphragmatic hernia without obstruction or gangrene
* AAPC Coder's Desk Reference: This resource provides detailed information on coding guidelines and procedures.
NEW QUESTION # 17
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