(A patient has aliver massand presents for apercutaneous needle biopsy of the liver with CT guidance. Four core specimens are taken to rule out benign hepatic adenoma. What CPT and ICD-10-CM codes are reported?)
Correct Answer: D
The procedure is apercutaneous needle biopsy of the liver, which is reported withCPT 47000(needle biopsy of liver; percutaneous). Because the biopsy is performed withCT guidance, you also report the appropriate imaging guidance code77012(CT guidance for needle placement). The number of core specimens (four) doesnotchange the CPT reporting here; you code the biopsy service, not each specimen. For diagnosis, the biopsy is performed to evaluate aliver mass, which supports reporting the sign/symptom/abnormal finding code provided in the options (R16.0) rather than a definitive benign neoplasm code, because "rule out benign hepatic adenoma" is not a confirmed diagnosis. Options A-C incorrectly assignD13.4(benign neoplasm of liver) despite the condition being unconfirmed in the question stem, and/or include unrelated codes. Therefore, the correct coding combination is47000, 77012, R16.0.
CPC Exam Question 222
A patient suffering from idiopathic dystonia is seen today and receives the following Botulinum injections: three muscle injections in both upper extremities and seven injections in six paraspinal muscles. How are these injections reported according to the CPT guidelines?
Correct Answer: B
For the injections, CPT code 64642 is used for chemodenervation of one extremity; 64643 for each additional extremity, and 64647 for chemodenervation of muscles in the paraspinal region. The modifier -50 is added to 64642 and 64643 to indicate bilateral procedures. According to CPT guidelines, when multiple sites are treated, each site is coded separately, and appropriate modifiers are used. AMA's CPT Professional Edition (current year), Surgery section, Nervous System.
CPC Exam Question 223
(A physician performsexcisional debridementfor a patient with multiple wounds. A wound on thelower backmeasures12 cmand involves thefasciafor the debridement. A wound on theleft shouldermeasures8 cmand one on theleft lower legmeasures16 cminvolvessubcutaneous tissuefor the debridement. What CPT codes are reported?)
Correct Answer: D
Debridement coding depends ondeepest tissue removedand thetotal surface areadebrided at each depth. Debridement "tomuscle and/or fascia" is coded with11043for thefirst 20 sq cm (or part thereof)at that depth. The lower-back wound involvesfascia, so report11043(no add-on 11046 is needed because the described size is below an additional 20 sq cm threshold). The shoulder (8) and lower-leg (16) wounds involvesubcutaneous tissue, which is coded with11042for thefirst 20 sq cm (or part thereof)at the subcutaneous depth. Their combined area is24 sq cm, so you report11042plus add-on11045for theadditional 4 sq cmbeyond the first 20. Because two different depth families are billed (fascia vs subcutaneous), adistinct procedural servicemodifier (here-59on 11042) supports reporting both depths when documentation shows separate wounds/levels treated. This matches optionD.
CPC Exam Question 224
A pediatric patient with a congenital double inlet ventricle undergoes corrective cardiac surgery. The surgeon performs a modified Fontan procedure to redirect systemic venous blood flow directly to the pulmonary arteries as part of staged repair for a single-ventricle physiology. What CPT and ICD-10-CM codes are reported?
Correct Answer: A
The procedure documented is a modified Fontan procedure # 33615 (Fontan-type single-ventricle repair per the choices given). The congenital diagnosis documented is double inlet ventricle # Q20.2. Why the other options are incorrect based on the statements provided: Q20.4 is not "double inlet ventricle" as stated in the question. Adding Q20.1 is not supported by the documentation (the question only states double inlet ventricle). Therefore, the best match is 33615, Q20.2 # A.
