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Answers for CPC sample Questions

CPC sample question # 1

CPT 26123, 26125, ICD-9-CM 728.6

26123 is used for reporting the Fasciectomy, with release of 1 single digit and 26125 is for the additional dight.

Diagnosis code 728.6 is used to report the Dupuytren’s contraction

CPC sample question # 2

CPT 33208, ICD-9-CM 426.12

33208 is reported for the pacemaker with the atrial and ventricular electrodes and 71090 is reported for the fluorscopic guidance.

420.12 identifies the Mobitz Type II atriovertricular block (AHA 2007 second quarter).

CPC sample question # 3

CPT 52601, 51040-59, ICD-9-CM 600.01, 599.69

The transurethral resection and vaporization of the prostate. The prostate tissue was destroyed using electric current vaporization and 51040 for the suprapubic catheter insered at the end of the procedure. Code 51040 would need a modifier 59 appended.

600.01 is reported for the hypertrophy with urinary obstruction

599.69 is reported as under the instruction for 600.01 an addition code is reported for the obstruction using code 599.69

Reference: Coding Clinic; 4th quarter 2003

CPC sample question # 4

CPT 36215-LT, 36217-RT, 36216-LT, 36218-RT, 75650, 75685-RT, and 75685-LT, 75680, 75671

The placement of the catheter (and the injection) into the aortic arch is not reported because a nonselective catheter placement is not separately reported if was followed by selective catheter placement.

36217-RT is reported for selection of the right vertebral artery because it is a third order vessel. 36216-LT is reported for selection of the left vertbral artery because it is 2nd order vessel. The add-on code 36218-RT is reported for selection of the right common carotid artery because it is an additional 2nd order vessel within the innominate family.

75650 is reported for imaging of the aortic arch injection.

75685-RT and 75685-LT are reported for the imaging of the right and left vertebral arteries. Note that there is no bilateral code for vertebral imaging. Also, according to the July 2001 CPT® Assistant, the 50 modifier should not be reported with radiology imaging codes

The common carotid injection allowed the physician to study arteries in both the neck and head areas. 75680 (bilateral code) is reported for imaging of both the left and right carotid arteries in the neck (ie, cervical) area. 75671 is reported for imaging of both the left and right carotid arteries in the head (ie, cerebral) area. Code 75671 is a bilateral procedure and reported only once

CPC sample question # 5

CPT 43235, 43450, ICD-9-CM 787.20

CPC sample question # 6

CPT 64721, ICD-9-CM 354.0

CPC sample question # 7

CPT 43262, 43264, 74328, 74300, ICD-9-CM 574.51

CPT code(s) In the Index, “cholangiopancreatography with surgery” lists a series of code in the 43262-43269 range. A review of the code descriptions in this range shows that two codes are required to describe the procedures performed: 43262, ERCP with sphincterotomy/papillotomy; and 43264, ERCP with endoscopic retrograde removal of stone(s) from biliary and/or pancreatic ducts.

Code 74328 is reported for the biliary catheterization. (The scope was positioned in place and a guidewire was grasped by the external snare and pulled up into the bile duct out through the skin.)

74300 (Before concluding the procedure, a followed-up cholangiogram was performed and revealed no further evidence of stones within the duct). Since there was no mention of when the first cholangiogram was performed we can only report it once.       

Diagnosis code reported is 574.51, Calculus of bile duct without mention of cholecystits, with obstruction

CPC sample question # 8


CPC sample question # 9

CPT 66984, ICD-9-CM 366.14

66984 Reports the cataract extraction with the intraocular lens implant.

366.14 Identifies the posterior subcapsular senlie cataract.

CPC sample question # 10

49204, 211.8

CPC sample question # 11

43246, 31600-59, 518.81, 263.9

CPC sample question # 12

93510, 93543, 93545, 93555, 93556 

CPC sample question # 13

49322, 620.2, 617.3

CPC sample question # 14

43245, 43239-59

CPC sample question # 15

58150, 182.0


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