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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

Clear Up Dementia Coding Confusion

2023 ICD-10-CM update expands F01-F03 code categories to allow providers to indicate disease stage and symptoms. The 2023 update to ICD-10-CM finally provided an expansion of the dementia codes, which has been needed for a very long time. Previously, we were only able to report with/without behavioral disturbance and a code option for wandering (Z91.83) […]

The post Clear Up Dementia Coding Confusion appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Code FESS With a Clear Head

Consider anatomy and coding guidance to put things into perspective. Functional endoscopic sinus surgery (FESS) is a surgical procedure performed endoscopically on the nasal/sinus cavities. The purpose of the surgery is to reduce the symptoms of chronic sinusitis such as congestion, drainage, post-nasal drip, headaches, and facial pain. Coding FESS can be unnerving because there […]

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AAPC Knowledge Center

Can’t clear an edit; 61322 & 61313 done on the same day

Physician billing;

Physician billed a 61322 – CPT® Code in category: (Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma)
Shortly thereafter the patient developed an intracranial bleed requiring a return to the OR the same day for a 61313 – CPT® Code in category: (Craniectomy or craniotomy for evacuation of hematoma, supratentorial)
As per coding guidelines these 2 cpt codes cannot be billed together on the same day. Considering the circumstances I advised to bill the charge with a -78 modifier “unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the post-operative period and appeal if need be.

I’ve been advised to bill 61322 twice with the 76 modifier (Repeat Procedure by Same Physician – is used to indicate that a procedure or service was repeated in a separate session on the same day by the same physician) which I’m not comfortable in using because the 2nd OP note does not support this code. It does support the bleed CPT 61313.

I’d like others opinions.

Medical Billing and Coding Forum

Clear Up Confusion as to When Cancer Becomes “History Of”

Look to documentation for clues that tell you if a patient’s cancer is active or past history. By Emily Bredehoeft, COC, CPC, AAPC Fellow A hot topic in oncology is when to start coding history of cancer rather than active cancer. Luckily, ICD-10-CM Official Guidelines for Coding and Reporting provides an answer. Section 1.C.2 Provides […]
AAPC Knowledge Center

Clear Every ER/PR Coding Snag with These Steps

The adage to ‘always report the most specifc CPT code’ could ensnare your estrogen receptor (ER) and progesterone receptor (PR) coding for breast cases. Here our experts help you sort out the difference between specific analyte and specific method to ensure you select the right code every time.

Reserve 84233 and 84234 for assays

If you are searching for specific codes when a surgical pathology report references estrogen and/or progesterone receptor testing, you should not miss 84233 and 84234. However are those always the correct choice?

The 84233 and 84234 definitions create a confusion for medical coders reporting ER/PR tests. The question is whether you must report 84233/84234 as the definitions specify ER/PR, or if you can in its place report a generic immunohistochemistry code such as 88342 for certain ER/PR testing.

Codes 84233 and 84234 describe laboratory tests for estrogen and progesterone receptors that use a biochemical ligand-binding assay method like dextran-coated charcoal assay. However most labs evaluate ER/PR using immunohistochemistry as clinical studies have consistently shown the superiority of immunohistochemistry over biochemical assay methods for ER/PR testing.

Watch out for immunohistochemistry (IHC)

When the lab method involves immunohistochemistry for tissue specimens like evaluating breast tumors for ER and PR status, you should look to the following codes to describe the service: 88342, 88360, 88361.

Although these code definitions are ‘generic’ in the sense that they do not specifically identify estrogen or progesterone receptors, you should report them for an ER or PR (or any other) immunohistochemistry antibody strain.

Differentiate qualitative/quantitative codes

Choosing among 88342, 88360, or 88361 calls for knowing whether the immunohistochemistry analysis is qualitative or quantitative and whether quantification uses computer-assisted technology or “manual” counting, including visual approximation. You might choose to go for any of these three codes for ER, PR, Her- 2/neu, Ki-67, or any of various other IHC analyses

Count antibodies

You should report one unit of the right code for each antibody stain, irrespective of which antibody you are coding.

For more information on this and other CPT codes, sign up for a one-stop medical coding website. Such a site comes stocked with CPT codesets among other things.

We provide you simple, instant connection to official code descriptors & guidelines and other tools for 2010 CPT code, HCPCS lookup that help coders and billers to excel in the work they do every day.

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