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| Section | Objectives |
|---|---|
| Topic 1: CPT Coding | - Surgical, diagnostic, and procedural coding - CPT guidelines and conventions |
| Topic 2: HCPCS Level II Coding | - Durable medical equipment and supplies - Medicare coding procedures |
| Topic 3: Medical Terminology and Anatomy | - Human anatomy basics - Medical terminology structure |
| Topic 4: Compliance and Regulatory Guidelines | - HIPAA and medical ethics - Fraud and abuse regulations |
| Topic 5: ICD-10-CM Diagnosis Coding | - Diagnosis code selection and sequencing - ICD-10-CM guidelines |
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NEW QUESTION # 149
Which statement is TRUE for an Excludes2 note that is under a code in the Tabular List for ICD-10-CM?
Answer: A
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 # 150
A patient who was experiencing severe abdominal pain underwent abdominal imaging and results showed several peritoneal tumors of various sizes.
The patient elected to have the tumors removed. An incision was made to access the intra-abdominal peritoneal cavity, where four tumors were identified, measured, and excised.
The largest was 2 cm, two were 1 cm each, and the smallest was 0.5 cm. Pathology report indicated the tumors were malignant.
What CPT and ICD-10-CM coding is reported7
Answer: D
Explanation:
Procedure Coding:
49186 - Excision or destruction of intra-abdominal tumors, 1-4 tumors
Four tumors excised โ correct code selection
Size does not alter code selection once tumor count is determined
Diagnosis Coding:
C48.2 - Malignant neoplasm of peritoneum, unspecified
Pathology confirms malignancy
C76.2 is used for ill-defined sites, not appropriate when peritoneum is specified Why Other Options Are Incorrect:
B - 49187 is for 5 or more tumors
D - K66.8 = non-malignant peritoneal disorder
NEW QUESTION # 151
Patient has a 5 cm tumor in the left lower quadrant abdominal wall. A horizontal skin incision is made directly over the tumor in the patient's left lower quadrant and dissection was carried down through the dermis and subcutaneous tissue. The tumor is located and completely excised using electrocautery. The specimen is sent immediately to pathology to rule out cancer. What CPTand ICD-10-CM codes are reported?
Answer: A
Explanation:
1. Procedure and CPTCode Selection:
The scenario describes the excision of a 5 cm tumor located in the left lower quadrant of the abdominal wall.
The tumor was excised down to the dermis and subcutaneous layers and removed using electrocautery.
Code 22903 is appropriate for the excision of a soft tissue tumor in the abdominal wall greater than 5 cm, making it the correct CPTcode.
Code 22901 applies to the excision of a soft tissue tumor in the abdominal wall but only for tumors 5 cm or less. Given that the tumor in this case is exactly 5 cm, it meets the threshold for 22903, which is more appropriate here.
2. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code D49.2 is used for a neoplasm of unspecified behavior in the abdominal area, reflecting the fact that the pathology report is pending to determine if the tumor is malignant.
Code C76.2 would be incorrect because it is for malignant neoplasms of unspecified abdominal areas, which we cannot confirm based on the initial excision. Similarly, R19.04 (indicating a mass in the abdominal region) is a symptom code and is not appropriate for a definitive diagnosis when a neoplasm code (D49.2) exists.
3. AAPC and CPTCoding Guidelines:
Per AAPC coding guidelines, the size of the tumor is critical in selecting the correct excision code for abdominal wall neoplasms. Additionally, if the tumor's pathology is not confirmed as malignant, it is coded as a neoplasm of unspecified behavior until further details are known.
Therefore, based on CPTand ICD-10-CM coding guidelines, the verified answer is B. 22903, D49.2.
NEW QUESTION # 152
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: C
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.
References:
* AMA's CPT Professional Edition (current year), Codes 33535, 33259-51, 33519-51, 33508-51
NEW QUESTION # 153
(Patient with erectile dysfunction is presenting for a penile implant. Anon-inflatable penile prosthesisis inserted. What CPT code is reported for this service?)
Answer: D
Explanation:
Penile prosthesis coding is determined by thetype of deviceand whether the procedure is asimple insertion, areplacement, or a more complex scenario. Anon-inflatable(malleable or semi-rigid) penile prosthesis is specifically reported withCPT 54416. Inflatable devices are coded differently (commonly with a different code family), and replacement/revision services may also have distinct codes depending on what is removed and replaced. In this question, the vignette is straightforward: erectile dysfunction treated with insertion of anon-inflatable prosthesis-no mention of prior implant, revision, or removal-so the correct code is the primary insertion code for that device type. The distractors include other penile procedures and prosthesis- related codes that do not match "non-inflatable insertion." CPC exam tip: lock onto "non-inflatable" vs
"inflatable," and then confirm the action isinsertionrather than revision or replacement. That leads to54416.
NEW QUESTION # 154
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