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?
Correct Answer: C
For a mastectomy that involves removing the breast tissue, skin, pectoral muscles, and surrounding tissue, including the axillary and internal mammary lymph nodes, the appropriate CPT code is: 19306: Mastectomy, radical, including pectoral muscles, axillary lymph nodes. This code captures the extent of the surgery, including the removal of the breast tissue, skin, pectoral muscles, and lymph nodes. CPT Professional Edition (current year) Surgery guidelines for mastectomy procedures
CPC Exam Question 62
The CPT code book provides full descriptions of medical procedures, with some descriptions requiring the use of a semicolon (;) to distinguish among closely related procedures. What is the full description of CPT code 35860?
Correct Answer: A
In the CPT code book, code 35860 describes an "Exploration for postoperative hemorrhage, thrombosis or infection" in multiple areas, specifically including the neck, chest, abdomen, and/or extremity. This code is used when a surgeon explores these areas postoperatively to locate and address complications such as bleeding, clots, or infections. B, C, and D are incorrect as they do not fully encompass all the areas listed in the actual description of CPT code 35860, which includes all four regions (neck, chest, abdomen, and extremity). Thus, the correct answer is A. Exploration for postoperative hemorrhage, thrombosis or infection; neck, chest, abdomen, and/or extremity.
CPC Exam Question 63
A 53-year-old male arrived at the ER due to severe ocular trauma to the right eye. He was at work on a metal drilling machine and a metallic item penetrates his right eyeball. A foreign body is in the posterior segment of the eye and corneal laceration with multiple posterior perforated sites were noted. He is brought back to the surgical suite. The surgeon removes the metallic foreign body using large retinal forceps. The laceration of the cornea is sutured and the provider also performs a pars plana lensectomy. What is the CPTand ICD-10-CM codes are reported?
Correct Answer: A
1. Procedure and CPTCode Selection: The patient required surgical intervention for severe ocular trauma involving removal of a foreign body from the posterior segment of the eye, suturing of the corneal laceration, and a pars plana lensectomy. CPTCode 65265 is for removal of a foreign body from the posterior segment of the eye without the use of a magnet. This code is appropriate for the removal of the metallic foreign body using retinal forceps. CPTCode 66852 covers the pars plana lensectomy, which was performed as part of the surgical treatment. CPTCode 65280 is used for repairing a corneal laceration with multiple perforations, which applies to the corneal suturing. 2. Modifiers: Modifier RT is used to indicate that the procedures were performed on the right eye. Modifier 51 is added to indicate multiple procedures performed during the same surgical session. 3. Diagnosis and ICD-10-CM Code Selection: ICD-10-CM Code S05.51XA is appropriate for penetrating wound of the right eyeball with a foreign body in the posterior segment. ICD-10-CM Code W31.1XXA is used to indicate that the injury was caused by contact with a metalworking and woodworking machine. 4. Rationale for Excluding Other Options: Codes 65235 and 65275 in options B, C, and D refer to foreign body removal from the anterior chamber and the anterior segment, respectively, which are not appropriate since the foreign body was located in the posterior segment. Codes S05.31XA and W31.0XXA in options C and D represent different eye injuries and types of machines, which do not match the scenario described. 5. AAPC and CPTCoding Guidelines: According to AAPC guidelines, codes should be selected based on the specific location (posterior segment) and the type of foreign body removal. Each procedure, including the corneal repair, should be coded to capture the full extent of the treatment. Therefore, the correct answer is A. 65265-RT, 66852-51-RT, 65280-51-RT, S05.51XA, W31.1XXA.
CPC Exam Question 64
A cardiologist performs and interprets a 12-lead ECG in the office. What CPT coding is reported?
Correct Answer: D
93000 = ECG with tracing, interpretation, and report 93010 = Interpretation only
CPC Exam Question 65
Regarding the CPTSurgery Guidelines for a surgical code designated as a "Separate Procedure", which statement is FALSE?
Correct Answer: D
In CPTSurgery Guidelines, a "separate procedure" code is used to identify a service that is typically performed as part of a larger procedure and should not be coded separately when it is an integral component of that primary service. However, it may be reported independently if it is performed alone or is unrelated to the primary procedure. A: is true because a separate procedure may be reported if it is performed independently or is unrelated to the primary procedure. B: is true, as "separate procedure" codes are not reported in addition to the code for the primary procedure when they are part of the total procedure. C: is correct because "separate procedure" designation indicates that the service is often part of a more comprehensive procedure but can be reported separately when performed alone. D: is false because modifier 79 is not used for unrelated "separate procedures." Instead, modifier 59 is typically used to indicate a "distinct procedural service" when reporting a separate procedure that is unrelated to the primary service. Therefore, the correct answer is D. To identify a service designated as a "separate procedure" that is reported with an unrelated primary service, append modifier 79 to the code.