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2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

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Click here for more sample CPC practice exam questions and answers with full rationale

Nail avulsion, nail debridement, 1ncision and drainage

Hi Just wanted to get clarification on the procedures below and wondering if it’s coded correctly. Any thoughts?

PROCEDURE Each nail border was debrided of callused nail grooves, incurvated and ingrown areas, hypertrophied cuticle and mycotic and necrotic debris. Betadine solution was used to cleanse each nail plate for antiseptic reasons after debridement was performed.

OPERATION the affected areas were prepped in the usual sterile manner. The initial approach was made with an english nail splitter using that instrument to excise the nail border spicule along the full length of the nail from the tip to the eponychial attachment., Using a freer elevator and a medium hemostat the nail border was removed. The defect was curretted clean removing all necrotic and calloused nail groove and diseased cuticle.

The pus pocket paronychia abscess was incised and drained and any visible necrotic skin and tissue removed., The surgical wound was dressed using a Betadine pad drain, antiobiotic ointment, 4×4 digital cut, kling and stockinette.

CPT: 11721, 11730, 10060

Medical Billing and Coding Forum

Nail debridement, nail avulsion, I&D paranychia

Hi Just wanted to get clarification on the procedures below and wondering if it’s coded correctly. Any thoughts?

PROCEDURE Each nail border was debrided of callused nail grooves, incurvated and ingrown areas, hypertrophied cuticle and mycotic and necrotic debris. Betadine solution was used to cleanse each nail plate for antiseptic reasons after debridement was performed.

OPERATION the affected areas were prepped in the usual sterile manner. The initial approach was made with an english nail splitter using that instrument to excise the nail border spicule along the full length of the nail from the tip to the eponychial attachment., Using a freer elevator and a medium hemostat the nail border was removed. The defect was curretted clean removing all necrotic and calloused nail groove and diseased cuticle.

The pus pocket paronychia abscess was incised and drained and any visible necrotic skin and tissue removed., The surgical wound was dressed using a Betadine pad drain, antiobiotic ointment, 4×4 digital cut, kling and stockinette.

CPT: 11721, 11730, 10060

Medical Billing and Coding Forum

64772 – Transection or avulsion of other spinal nerve, extradural

Hello,

I work in a pain management practice and one of our providers is being trained to perform a endoscopic rhizotomy. There are not many recourses out there for coding this procedure. Unfortunately, I do not have a description of procedure yet. My provider states this is not a percutaneous approach, that an incision is made through the layers of the skin to accommodate the scope; he then will have direct visualization of the location of the rhizotomy. The procedure representative is telling my physician that CPT code 64772 would be appropriate. I have found a couple of payer policies that state to bill an endoscopic rhizotomy with CPT code 64999 or they deem it experimental all together. I am hesitant, would this approach my provider is describing qualify as MIS as he states his approach is not percutaneous. If it does, then could an open procedure code be used even though it is not in the endoscopic section?

Thank you for your advice.
Sharon

Medical Billing and Coding Forum

ORIF Tibial eminence fracture / ACL avulsion

I have 27540 for ORIF tibial eminence/ intercondylar spine. But I’m not sure if 27428 for ACL repair of the avulsion is coded in addition.?

OP Note:
Open reduction internal fixation of tibial eminence fracture

A medial para-patellar incision was made approximately 8 cm long. The patellar tendon was retracted with a Gelpi. Additional hoffa’s fat pad was debrided. The fracture fragment was elevated and fracture hematoma and fragments were removed. The fracture fragment was reduced while freeing the medial meniscus. The fracture was reduced using a ball spike pusher. The fracture was held in place with a threaded K-wire. Fluoroscopic images were obtained to verify satisfactory fracture reduction in both the AP and lateral planes. The anterior cruciate ligament was then sutured with #2 Fiberwire in a locking Krakow stitch with 2 sutures. Attention was then turned to creating 2 tibial bone tunnels with the anterior cruciate ligament guide with a beath pin through the tibia and fracture fragment. The 4 tails from the sutures were passed through the tunnels and the sutures were tied over a button and bone bridge at 30 deg of knee extension with an posterior drawer applied. Final fluoroscopic images showed satisfactory fracture reduction in both the AP and lateral planes.

Thank you,
Cindy

Medical Billing and Coding Forum