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| Section | Weight | Objectives |
|---|---|---|
| Radiology | 5-10% | - Diagnostic Imaging |
| E/M (Evaluation and Management) | 10-15% | - Emergency Department - Office/Outpatient Visits |
| Surgery Coding | 40-50% | - Integumentary System - Respiratory System - Digestive System - Musculoskeletal System - Genitourinary System - Cardiovascular System - Nervous System |
| Laboratory / Pathology | 5-10% | - Organ and Disease Panels |
| HCPCS Level II | 5-10% | - Supplies and Equipment - Modifiers |
| ICD-10-CM (Diagnosis Coding) | 10-15% | - Code Selection - Conventions and Guidelines |
| Anatomy & Physiology | 10-15% | - Medical Terminology - Body Systems |
| Medicine | 5-10% | - Specialty Coding |
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NEW QUESTION # 102
Which statement is TRUE for an Excludes2 note that is under a code in the Tabular List for ICD-10-CM?
Answer: D
Explanation:
In ICD-10-CM coding, an Excludes2 note under a code indicates that the condition listed in the note is not included in the definition of the code, but it does not necessarily mean they cannot coexist. This type of note means that while the conditions are distinct, it may be appropriate to report both codes if a patient has both conditions at the same time.
A: is incorrect because Excludes1, not Excludes2, indicates that certain codes should not be reported together.
C: is a description of an Excludes1 note, which implies that the two conditions should not be coded together because they cannot occur simultaneously.
D: is also a description of an Excludes1 note, which serves as a "NOT CODED HERE!" directive.
Therefore, the correct answer is B. It is acceptable to report both the code and the excluded code together, when applicable.
NEW QUESTION # 103
(Full Case:Procedure:Excision of6.0 cm malignant lesionof theright forearmwithadjacent tissue transferusing arotation flap.Pre/Post-op Dx:Basal cell carcinoma, right forearm.Anesthesia:local (1% Xylocaine with epi).
Defect size:8 sq cm.Specimen:sent forfrozen section margin control; margins confirmed clear.Closure:rotation flap from adjacent healthy tissue,total area 8 sq cm, secured with layered closure (5-0 Vicryl/6-0 Prolene).
Question:What CPT coding is reported?)
Answer: C
Explanation:
The operative report documents amalignant lesion excision(basal cell carcinoma) on theright forearmfollowed by reconstruction with anadjacent tissue transfer (rotation flap)afterfrozen sectionconfirmed clear margins. In CPT, when a defect is repaired withadjacent tissue transfer/rearrangement, the flap code includes the work ofexcision (including necessary undermining and preparation of the recipient site)performed as part of creating and closing the defect; therefore the malignant excision code (e.g.,11606) isnot separately reportedin this same session when the excision is integral to the flap repair. Code selection for adjacent tissue transfer is based on theanatomic siteand thetotal defect area (primary + secondary defects). The documentedtotal area is
8 sq cm, and the site is theforearm (arm/leg grouping). For arms/legs,10 sq cm or lessis reported with14020.
Codes14040apply to a different anatomic region grouping and do not match the forearm. Frozen section pathology/margin control does not change the primary surgical coding here. Therefore, report14020 only.
NEW QUESTION # 104
According to the Repair (Closure) CPT guidelines, what type of repair is reported when a single layer closure includes copious irrigation and extensive cleaning to remove particulate matter?
Answer: C
Explanation:
According to the CPT guidelines for Repair (Closure), an intermediate repair includes the closure of a wound with one or more layers of subcutaneous tissue and superficial fascia in addition to the skin (epidermal and dermal) closure. It also involves extensive cleaning of the wound, which includes copious irrigation and the removal of particulate matter. This description fits the scenario provided in the question.References:
AMA's CPT Professional Edition, Repair (Closure) guidelines.
NEW QUESTION # 105
A 60-year-old male has three-vessel disease and supraventricular tachycardia which has been refractory to other management. He previously had pacemaker placement and stenting of LAD coronary artery stenosis, which has failed to solve the problem. He will undergo CABG with autologous saphenous vein and an extensive modified MAZE procedure to treat the tachycardia.
He is brought to the cardiac OR and placed in the supine position on the OR table. He is prepped and draped, and adequate endotracheal anesthesia is assured. A median sternotomy incision is made and cardiopulmonary bypass is initiated. The endoscope is used to harvest an adequate length of saphenous vein from his left leg. This is uneventful and bleeding is easily controlled. The vein graft is prepared and cut to the appropriate lengths for anastomosis. Two bypasses are performed: one to the circumflex and another to the obtuse marginal. The left internal mammary is then freed up and it is anastomosed to the ramus, the first diagonal, and the LAD. An extensive maze procedure is then performed and the patient is weaned from bypass. At this point, the sternum is closed with wires and the skin is reapproximated with staples. The patient tolerated the procedure without difficulty and was taken to the PACU.
Choose the procedure codes for this surgery.
Answer: D
Explanation:
The CABG procedure involved multiple bypasses, with the use of autologous saphenous vein grafts and the left internal mammary artery, along with an extensive modified MAZE procedure. CPT code 33535 describes a coronary artery bypass using arterial grafts, including at least three coronary artery bypasses. CPT code 33259-51 is for the MAZE procedure for supraventricular tachycardia, with the -51 modifier indicating multiple procedures. CPT code 33519-51 is for an additional vein graft, and CPT code 33508-51 describes the endoscopic harvesting of the vein.
Reference:
AMA's CPT Professional Edition (current year), Codes 33535, 33259-51, 33519-51, 33508-51
NEW QUESTION # 106
A patient with multiple atypical lesions on the face and trunk is in the office to perform a biopsy. A punch tool was used to obtain a full-thickness tissue sample for two lesions on the trunk.
Partial-thickness tissue sample was taken from one lesion on the forehead using a curette.
What CPTcoding is reported?
Answer: B
Explanation:
The CPTcodes for skin biopsies depend on the method used and the location of each lesion. Here, the scenario includes:
1. Two punch biopsies on the trunk: CPTcode 11104 is used for a full-thickness punch biopsy of the skin, and 11104 x 2 is appropriate since two lesions on the trunk were sampled.
2. One partial-thickness shave biopsy on the forehead: CPTcode 11102 is used for a tangential (shave) biopsy, which captures a partial-thickness sample, appropriate for the forehead lesion.
Explanation of other options:
B: 11104, 11105, 11103: Incorrect, as 11105 is an add-on for additional punch biopsies at separate sites but not used here.
C: 11104, 11103 x 2: 11103 is an add-on code for additional shave biopsies, which does not apply to the punch biopsies on the trunk.
D: 11104, 11102 x 2: Incorrect, as 11102 is only used for the shave biopsy, not for the punch biopsies.
NEW QUESTION # 107
......
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