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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

Strengthen Bone Mass Measurement Coding

Approximately 10 million Americans have osteoporosis and about 34 million more are at risk, according to Noridian Healthcare Solutions. To bring attention to this preventable disease, May has been declared National Osteoporosis Awareness Month. Early Detection is Key A bone mass measurement or bone density study can aid in the early detection of osteoporosis before fractures happen, provide information […]
AAPC Knowledge Center

77080-26 Bone Density Interp. Denying Palmetto GBA

77080 with modifier 26 for interp. is denying through Palmetto GBA with denial code- N130-Consult plan benefit documents/guidelines for information about restrictions for this service. I can’t find anything on CMS on why this is denying. Our physician’s file the interp. only and hospital files the TC portion. Does anyone know of any reason these would be denying? Has the benefit changed on these??/ Any help will be appreciated.

Medical Billing and Coding Forum

Percutaneous internal fixation with AccuFill bone filler

I’m trying to code a surgery for a medicare patient and I am lost.

The wording of the procedure is as follows:

1) Right knee percutaneous internal fixation of medial femoral condyle trabecular bone fracture with Accufill bone void filler.
2) Right proximal medial tibia, trabecular bone fracture internal fixation, percutaneous with Accufill bone void filler.
3) Right knee arthroscopic partial medial meniscectomy.
4) Right knee arthroscoic limited synovectomy.
5)Less than one hour c-arm fluoroscopy.

I coded as follows:

1) 27509
2) ?
3)29881
4)included in 29881
5)76000-26

Any suggestions?

Medical Billing and Coding Forum

Accessory navicular bone and Bone spur service code

Hello everyone!
We are having a debate on what’s the best service code for an accessory navicular bone and a bone spur – 304 or 305?

One of our pathologists had argued that a bone spur is more appropriate as a 304 for a bone fragment and the same for an accessory navicular bone but another one of our pathologists answered this with the email below:

"Kind of a gray area and I don’t feel strongly about it, but I still favor exostosis for a bone spur (and probably an accessory navicular bone as well), because they are both attached to the surface of the bone. I guess once they have detached, then one could argue that they could be considered loose bodies, but I don’t think whether it was still attached/detached is necessarily specified all that often on the requisitions we get"

We are all pretty split down the middle on whether these should be a 304 or a 305 – does anyone have any thoughs?

Medical Billing and Coding Forum

bone density test prior to treatment for breast cancer

Our oncologist likes a bone density prior to starting therapy for breast cancer. It is recommended on the NCCN guidelines to get a baseline bone density test before starting an aromatase inhibitor and periodically thereafter. What diagnosis code would we use for this particular bone density – Would it be a screening or is there something else because of the breast neoplasm? thank you in advance.

Medical Billing and Coding Forum

Debridement to bone with advancement flap

Hello,

Could someone help with this:

Debridement to the bone of stage 4 right ischial ulcer 6cm x 8 cm with a 4cm x 4cm ischial osteotomy. Then elevating the semimembranosus and semitendinosus off of the inferior border of the ischium and carrying the dissection deep to the muscle flap so we were able to advance the side flap up into the ischial defect. The advancement flap was 25 cm x 12cm. The apex of the chronic ulcer was debrided down to healthy tissue and was closed in an inverted Y shape. The myocutaneous flap was advanced into the tissue defect.

Do I use 15937 instead of the debridement codes (11044&11047), I know I can’t use both. Do I use 14301/14302 codes vs. the 15734 code??

Please help

Medical Billing and Coding Forum

Debridement to bone with advancement flap

Hello,

Could someone help with this:

Debridement to the bone of stage 4 right ischial ulcer 6cm x 8 cm with a 4cm x 4cm ischial osteotomy. Then elevating the semimembranosus and semitendinosus off of the inferior border of the ischium and carrying the dissection deep to the muscle flap so we were able to advance the side flap up into the ischial defect. The advancement flap was 25 cm x 12cm. The apex of the chronic ulcer was debrided down to healthy tissue and was closed in an inverted Y shape. The myocutaneous flap was advanced into the tissue defect.

Do I use 15937 instead of the debridement codes (11044&11047), I know I can’t use both. Do I use 14301/14302 codes vs. the 15734 code??

Please help

Medical Billing and Coding Forum

Medial collateral ligament lengthening & bone marrow venting

Does anyone know if I can use 29879 for the above procedure or should I use unlisted 29999 or would this be considered part of 29882? Has anyone heard of bone marrow venting?
Op Report: Anterolateral portal established–Patellofemoral trochlear surfaces normal as well as medial lateral gutters. Medial joint line was entered. A valgus stress was applied. We saw the radial-type tear of the posterior horn & body junction of the medial meniscus. An anteromedial portal was established parallel to tibial plateau. We noted the superior articular edge of the tear was approximately 50% whereas the undersurface tear was nearly 100% of the meniscus. We used a shaver, rasp & needle to trephinate the capsular tissues. We also used a spinal needle 18-gauge to trephinate the medial collateral ligament to allow for a medial collateral ligament lengthening procedure so that we could enter the medial compartment without damaging the articular surfaces of the medial femoral condyle or tibial plateau. We then from both the anterolateral & anteromedial portal used a Arthrex scorpion device to place vertical mattress sutures across the radial tear. The sutures were tied with sliding & locking knots with alternating half hitches & post. A total of 4 sutures were inserted. There is anatomic approximation of the medial meniscus tear. The ACL & PCL were intact. The lateral meniscus, lateral femoral condyle & tibial plateau articular surfaces were normal. We then used a 45 degree awl to perform a bone marrow venting procedure of the lateral femoral condyle just anterior to the anterior cruciate ligament insertion site. Following this the water was turned off. There was bone marrow & blood extravasating from the bone. Wounds were closed, steri-strips applied & dressings applied.

Medical Billing and Coding Forum

Bone Marrow Aspiration/Marrow Coding HELP!

Can anyone give me some insight on reporting 38220, 38221 for Hospital Outpatient coding and reporting guidelines? This is a big discussion within our department.

some feel that 38221 is the only code that should be reported for aspiration/biopsy.

Others feel that if they do aspiration and biopsy that both should be reported, 38220 and 38221.

How can we distinguish the two and know what codes are accurate to report?

Medical Billing and Coding Forum