I have codes 75630 and 36200. Does anyone know if I am missing another code and modifiers? I do not code these procedures.
Thanks
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Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page 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 Click here for more sample CPC practice exam questions and answers with full rationaleI have codes 75630 and 36200. Does anyone know if I am missing another code and modifiers? I do not code these procedures.
Thanks
Thank you for your help
Diagnose is Complex adnexal mass
Path states Adenocarcinoma
Operative report below:
The patient was taken to the operating room and was placed on the operating room table, general anesthesia with endotracheal intubation was started, she was prepped and draped in a normal sterile fashion and Foley catheter was inserted, perioperative antibiotics were given, after surgical timeout a low mid line incision was made from the symphysis pubis towards the umbilicus, subcutaneous tissue was divided, fascia was incised in the mid line and fascial incision was extended superiorly and inferiorly, peritoneum was incised and peritoneal incision was extended superiorly and inferiorly, intraperitoneal cavity was inspected carefully, there was a large cystic and solid mass arising from the left ovary, this mass was adherent to the bladder peritoneum and cul-de-sac peritoneum, it was very friable at the site of adhesion’s to the bladder and there was extensive area of bladder peritoneal metastases, there was no evidence of gross involvement of omentum or other upper abdominal structures, small bowel and large bowel appeared normal, rectum and sigmoid also appeared normal, stomach, liver, pancreas and spleen were palpated and appeared normal there was no palpable retro peritoneal lymphadenopathy. Samples of bladder peritoneal metastases were removed an submitted to the pathology lab and frozen section report was consistent with an undifferentiated malignancy of likely sex cord stromal type, right ovary and tube appeared normal, Peritoneum lateral to the infundibulopelvic ligament was incised the ureter was identified in the retro peritoneal space, infundibulopelvic ligament was secured cut and ligated, and the ovary and tube with attached mass was removed with the attached peritoneum, similar procedure was completed on the opposite side, bladder peritoneal involvement was removed, at the end there was no evidence of visible residual disease, hemostasis was assured, dependent omentectomy was performed, the gastroepiploic vessels on the dependent portion of omentum was ligated using a LigaSure device and removed. Then the fascia was reappoximated using the loop #1 PDS in running fashion, the skin was re-approximated using a stapler. Sponge needle counts and instrument counts were correct at the end of the operation.
I have a patient that is having bilateral ear tubes-to prevent any problems with hyperbaric oxygen therapy. The patient does not have any otorrhea, vertigo, subjective hearing loss, or tinnitus. No recent URI.
I was thinking of Z40.8 but I am not sure.
The patient has Medicare Jurisdiction L and there is not an LCD policy for CPT 69436 with modifier 50.
I would appreciate any help that you can provide.
Thanks,
Cammy Waterhouse, CPC
Would this be correct?
20610-50
20610-59-50
My thanks for any help on this case.
My urgent consult was obtained from Dr. XXX during urgent primary cesarean section. She says that once she finished closing the uterine incision and had begun to reapproximate the fascia she noticed a moderate amount of bleeding and it was difficult to identify the ultimate source. I did place an Alexis-O retractor to be able to better visualize the uterus and fallopian tubes as well as the bowel. She was found to have a 5×7 left broad ligament hematoma. This was oozing out of a tear near the attachment of the fimbriated end of the fallopian tube to the ovary. Inspection of the left corner of the uterine incision did have some oozing as well with mobilization of the uterine vessels laterally. I did place several figure-of-eight sutures in the corner of the uterine incision. This did dry up the bleeding nicely. The defect in the broad ligament near the uterine ovarian ligament that had been torn was oozing was reapproximated with 2-0 Vicryl. The hematoma was well organized by the time of my exam and did not appear to be enlarging. This was observed for several minutes and did not change.
Attention was turned to the right side. She did have small paratubal cyst as well as some oozing from what looked like a defect of a portion of the fimbriated ends of the fallopian tube on the left side. This was grasped across with a Kelly clamp, just the bleeding portion separate from the remainder of the abnormal appearing fallopian tube. The bleeding portion was clamped across with a Kelly and tied off with a 0 Vicryl. this resulted in hemostasis. The bowel was inspected. It appeared to be without surgical injury. The bowel was packed away. the uterus did appear to be firm after several minutes of inspection, really minimal oozing and no active bleeding were noted. Hematoma appeared to be stable. The case was then turned back over to Dr. XXX.
Medically Unlikely Edits (MUEs) may render certain claim lines for bilateral surgical procedures unpayable, and the Centers for Medicare & Medicaid Services (CMS) has expanded its instructions to make it all a little more clear. MUEs and Bilateral Surgery CMS points out in MLN Matters SE1422 Revised that providers and suppliers billing bilateral procedures using […]
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