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NEW QUESTION # 19
Mrs. Wilder presents with right and left leg swelling. Venous thrombosis imaging of each leg is done and shows deep venous embolism and thrombosis in each leg.
What CPTand ICD-10-CM codes are reported?
Answer: C
Explanation:
1. Procedure and CPTCode Selection:
The patient underwent venous thrombosis imaging of each leg to assess for deep venous thrombosis (DVT).
CPTCode 78457 is used for a venous thrombosis imaging study. This code is appropriate for imaging to detect DVT.
Modifier 50 is applied to indicate a bilateral procedure, as imaging was performed on both legs.
2. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code I82.403 is used for acute embolism and thrombosis of unspecified deep veins of bilateral lower extremities. This code accurately describes the finding of DVT in both legs.
Other ICD-10-CM options, such as I82.401 and I82.402, specify unilateral lower extremity involvement, which does not accurately reflect the bilateral findings in this case.
3. Rationale for Excluding Other Options:
Code 78458 (in options A and D) is for a more comprehensive study, often cardiac or whole-body blood pool imaging, and is not specific to leg venous thrombosis.
Option C, which lists 78457 with individual RT and LT modifiers, is incorrect as Modifier 50 is appropriate for bilateral imaging on both legs.
4. AAPC and CPTCoding Guidelines:
According to AAPC and CPTguidelines, 78457 with Modifier 50 should be used for bilateral venous imaging studies, and I82.403 correctly captures bilateral DVT.
Thus, the correct answer is B. 78457-50, I82.403.
NEW QUESTION # 20
View MR 004397
MR 004397
Operative Report
Preoperative Diagnosis: Calculi of the gallbladder
Postoperative Diagnosis: Calculi of the gallbladder, chronic cholecystitis Procedure: Cholecystectomy Indications: The patient is a 50-year-old woman who has a history of RUQ pain, which ultrasound revealed to be multiple gallstones. She presents for removal of her gallbladder.
Procedure: The patient was brought to the OR and prepped and draped in a normal sterile fashion. After adequate general endotracheal anesthesia was obtained, a trocar was placed and C02 was insufflated into the abdomen until an adequate pneumoperitoneum was achieved. A laparoscope was placed at the umbilicus and the gallbladder and liver bed were visualized. The gallbladder was enlarged and thickened, and there was evidence of chronic inflammatory changes. Two additional ports were placed and graspers were used to free the gallbladder from the liver bed with a combination of sharp dissection and electrocautery. Cystic artery and duct are clipped. Dye is injected in the gallbladder. Cholangiography revealed no intraluminal defect or obstruction. Gallbladder is dissected from the liver bed. The scope and trocars are removed.
What CPT coding is reported for this case?
Answer: C
Explanation:
* 47563: Laparoscopic cholecystectomy with cholangiography is coded as 47563. The report details the laparoscopic removal of the gallbladder with intraoperative cholangiography.
* 74300-26: The radiological supervision and interpretation for the cholangiography is coded as 74300 with modifier -26 (Professional Component) since the interpretation was done by the physician.
References:
* CPT Professional Edition, AMA
NEW QUESTION # 21
View MR 001394
MR 001394
Operative Report
Procedure: Excision of 11 cm back lesion with rotation flap repair.
Preoperative Diagnosis: Basal cell carcinoma
Postoperative Diagnosis: Same
Anesthesia: 1% Xylocaine solution with epinephrine warmed and buffered and injected slowly through a 30-gauge needle for the patient's comfort.
Location: Back
Size of Excision: 11 cm
Estimated Blood Loss: Minimal
Complications: None
Specimen: Sent to the lab in saline for frozen section margin control.
Procedure: The patient was taken to our surgical suite, placed in a comfortable position, prepped and draped, and locally anesthetized in the usual sterile fashion. A #15 scalpel blade was used to excise the basal cell carcinoma plus a margin of normal skin in a circular fashion in the natural relaxed skin tension lines as much as possible The lesion was removed full thickness including epidermis, dermis, and partial thickness subcutaneous tissues. The wound was then spot electro desiccated for hemorrhage control. The specimen was sent to the lab on saline for frozen section.
Rotation flap repair of defect created by foil thickness frozen section excision of basal cell carcinoma of the back. We were able to devise a 12 sq cm flap and advance it using rotation flap closure technique. This will prevent infection, dehiscence, and help reconstruct the area to approximate the situation as it was prior to surgical excision diminishing the risk of significant pain and distortion of the anatomy in the area. This was advanced medially to close the defect with 5 0 Vicryl and 6-0 Prolene stitches.
What CPT coding is reported for this case?
Answer: B
NEW QUESTION # 22
The patient has a ruptured aneurysm in the popliteal artery. The provider makes an incision below the knee and dissects down and around the popliteal artery. After clamping the distal and proximal ends of the artery, the provider cuts out the defect, sutures the remaining ends of the artery together, and places a patch graft to fill the gap. What is the correct CPTcode for the aneurysm repair?
Answer: D
Explanation:
1. Procedure and CPTCode Selection:
The patient underwent a repair of a ruptured aneurysm in the popliteal artery, involving incision, dissection, clamping, removal of the aneurysmal section, and patch grafting.
Code 35151 is the correct CPTcode for the repair of an aneurysm in the popliteal artery, as it specifically describes aneurysm repair in this location.
Code 35081 applies to aneurysm repair in the abdominal aorta, which does not pertain to the popliteal artery location.
Code 35152 is for an aneurysm repair involving the popliteal artery with vein graft, but there is no mention of a vein graft in this scenario, only a patch graft.
Code 35045 is used for repair of an aneurysm in the brachial artery and does not apply to the popliteal artery.
2. AAPC and CPTCoding Guidelines:
According to AAPC guidelines, CPTcodes for aneurysm repair should be chosen based on the specific artery involved. Code 35151 is precisely for popliteal artery aneurysm repair without a vein graft, making it the most accurate choice.
Thus, based on CPTguidelines and procedural details, the verified answer is B. 35151.
NEW QUESTION # 23
A diagnostic mammogram is performed on the left and right breasts. Computer-aided detection is also used to further analyze the image for possible lesions.
What CPT coding is reported for this radiology service?
Answer: A
NEW QUESTION # 24
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