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1. Procedure and CPT® Code Selection:

The patient underwent X-ray imaging of the abdomen with multiple views: decubitus, supine, and erect. This is a comprehensive study that includes different positioning to evaluate the abdomen.

CPT® Code 74022 is appropriate for an abdominal X-ray with a minimum of three views. This code accurately reflects the multiple views taken in this scenario.

2. Modifier 26:

Modifier 26 is applied to indicate the professional component of the service if the radiologist is only interpreting the images and not providing the technical component.

3. Rationale for Excluding Other Options:

Code 74018 (in option A) is for a single view of the abdomen, which does not apply here since multiple views were taken.

Code 74019 (in option C) covers two views of the abdomen, which is insufficient for this three-view study.

Code 74021 (in option D) represents an abdominal X-ray with more limited or focused views and does not align with the comprehensive three-view study described.

4. AAPC and CPT® Coding Guidelines:

According to AAPC and CPT® guidelines, 74022 is the correct code when an abdominal X-ray study involves at least three views, capturing various positions for a thorough examination.

Therefore, the correct answer is B. 74022-26.

In coding burns, ICD-10-CM guidelines indicate that each burn site is coded separately, specifying the degree, location, and extent of the burn. Additionally, a code for total body surface area (TBSA) burned is included when burns cover more than 10% of the body. Here’s the breakdown:

1. T24.311A: Represents a third-degree burn on the left thigh, initial encounter.

2. T24.312A: Represents a third-degree burn on the right thigh, initial encounter.

3. T21.21XA: Represents a second-degree burn on the anterior chest wall, initial encounter.

4. T21.23XA: Represents a second-degree burn on the upper back, initial encounter.

5. T31.21: Represents burns with 20–29% TBSA involvement, with third-degree burns covering 10–19% of the TBSA.

Explanation of incorrect answers:

A includes an incorrect TBSA code (T31.21).

B has the correct codes but lists an incorrect TBSA code for third-degree burns.

C uses incorrect burn site codes for the areas involved and incorrect TBSA percentages.

Therefore, the correct answer is D. T24.311A, T24.312A, T21.21XA, T21.23XA, T31.21, which accurately captures the burns' degrees, locations, and TBSA.

1. Procedure and CPT® Code Selection:

The patient underwent an appendectomy performed via laparoscopic approach. The procedure involved removal of the appendix using a scope inserted through an umbilical incision.

CPT® Code 44970 is specific for a laparoscopic appendectomy, which is the correct code for this procedure.

Code 44950 would be used for an open appendectomy, but since this case was performed laparoscopically, 44970 is appropriate.

2. Diagnosis and ICD-10-CM Code Selection:

The diagnosis given by the physician is chronic appendicitis.

ICD-10-CM Code K36 is used to report chronic appendicitis, which is the definitive diagnosis in this case.

Additional codes for symptoms such as nausea (R11.2) and right lower quadrant pain (R10.31) are not necessary because the primary diagnosis of chronic appendicitis (K36) fully explains the symptoms, according to ICD-10-CM guidelines on coding symptoms when a definitive diagnosis is available.

3. AAPC and CPT® Coding Guidelines:

AAPC guidelines indicate that when a definitive diagnosis is established, symptom codes should not be reported separately. The use of 44970 for laparoscopic appendectomy and K36 for chronic appendicitis is fully supported by these coding standards.

Therefore, the correct answer is C. 44970, K36.

In CPT® Surgery 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.

The patient presented for a follow-up visit for chronic conditions, including hypokalemia, hypertension, and esophageal reflux. During this visit, the physician reviewed and discussed lab results, managed prescriptions, and noted that there were no new symptoms or complaints.

The level of service provided included an appropriate history and exam, as well as the management of multiple chronic conditions, which aligns with the criteria for CPT® code 99214. This code is used for an established patient office or other outpatient visit that requires at least 2 of the following 3 key components: a detailed history, a detailed examination, and medical decision-making of moderate complexity.

References:

CPT® Professional Edition, AMA

Evaluation and Management Coding Guidelines

A diagnostic mammogram performed on both breasts with computer-aided detection (CAD) is reported with CPT® code 77066. This code is used when CAD is utilized to further analyze the images for possible lesions, and it covers both breasts.

References:

AMA's CPT® Professional Edition (current year)

CPT code 99450 is used for the examination of a patient for the purpose of establishing medical baseline information or for insurance purposes. Since Eric's primary care provider completed the required physical exam documentation for his life insurance policy, this is appropriately reported with code 99450. References: CPT® Professional Edition (current year), AMA.

Procedure: Caloric vestibular testing performed on both ears with three irrigations.

CPT® Code:

92537: Caloric vestibular test with recording, bilateral; bithermal (i.e., one warm and one cool irrigation in each ear).

Modifier -50: Bilateral procedure.

Code Selection Justification: The procedure performed was bilateral caloric vestibular testing with bithermal irrigation, appropriately coded with 92537 and modifier -50 for bilateral procedures.

References:

AMA CPT® Professional Edition (current year)

The CPT code 12002 is used for simple repair of superficial wounds of 2.5 cm or less. This code includes the repair of both the 3 cm laceration on the right arm and the 2 cm laceration on the nose as both are simple repairs. The other options suggest more complex repairs or multiple separate procedures, which are not necessary in this scenario.References: AMA's CPT® Professional Edition (current year)

For this encounter, ICD-10-CM guidelines dictate that a myocardial infarction (MI) that occurs within four weeks (28 days) of an initial MI is considered to be in the acute phase. Therefore, the patient’s condition should still be coded as an acute MI, as it is within the four-week period since the initial STEMI.

B. I21.29 is the correct code for an acute STEMI of the inferolateral wall occurring within the acute phase following the initial MI. The code I21.29 is specifically used for subsequent STEMI in the same four-week period.

Explanation of incorrect options:

A. I22.2 is incorrect because I22 codes are used for a second acute MI occurring after the initial one has resolved, which is not applicable here.

C. I21.19 and D. I21.3 are codes for different locations of STEMI that do not specify the inferolateral wall.

Therefore, the correct answer is B. I21.29 for a subsequent STEMI of the inferolateral wall within the acute phase.