Click here for more sample CPC practice exam questions with Full Rationale Answers

Practice Exam

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

Practice Exam

CPC Practice Exam and Study Guide Package

Practice Exam

What makes a good CPC Practice Exam? Questions and Answers with Full Rationale

CPC Exam Review Video

Laureen shows you her proprietary “Bubbling and Highlighting Technique”

Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page

Practice Exam

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

Practice Exam

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

Tag Archives: finger

finger amputation/biopsy/Peripheral nerve block

Posted on by
Please !!!

could some one help with coding below, should I code Biopsy with Peripheral nerve block ? do I need any modifier?

PREOPERATIVE DIAGNOSES:
1. Right middle finger necrosis.
2. Right middle finger infection.

POSTOPERATIVE DIAGNOSES:
1. Right middle finger necrosis.
2. Right middle finger infection.

PROCEDURES:
1. Right middle finger irrigation and debridement of open wound.
2. Right middle finger neurectomy of radial and ulnar digital nerve.
3. Right middle finger amputation at proximal interphalangeal joint.
Code 26952

4. Peripheral nerve block radial nerve and the proper median
nerves
Code 64450

5. Biopsy: Profundus and superficialis tendons
were retracted and cut. The extensor tendon was then cut as well. The PIP
joint was disarticulated

bipsy code 26110

6. Fluoroscopic exam

Thank you

Medical Billing and Coding Forum

Excision of multiple soft tissue masses on same finger

Posted on by
Can you bill for excision of multiple soft tissue masses on the same finger that are done through one incision? In the example below, our doctor doesn’t indicate where on the finger the masses were excised from so I will have to query him. However, I’m wondering even if he does indicate where the STMs were excised from, can we bill for both masses or just one since they were removed through the same incision? Also, any supporting documentation or articles would be helpful! Thanks!

"A dorsal curviliner incision was made on the dorsum of the long finger centering over the soft tissue masses. The incision was carried thru the skin and subcutaneous tissue. Hemostasis was achieved with bipolar electrocautery. The skin was gently elevated off the underlying soft tissue mass with a #15 blade knife. The masses were dissected from the surrounding soft tissue with care taken to protect the neurovascular structures and the extensor tendon. Both masses were excised and sent for microscopic pathology. The extensor tendon remains intact."

Medical Billing and Coding Forum

Dermatologist billing B35.1 diagnosis to Medicare for finger nail fungus

Posted on by
Hello,

Medicare has that routine foot care policy that does not allow the billing of B35.1 without an underlying condition, however, what if the fungus is in the finger nails? What diagnosis codes are you billing to report the fingers rather than the toes. Medicare has denied E/M services when we bill with B35.1. Very frustrating. Must we appeal with medical notes on all of these?

Medical Billing and Coding Forum

CPT 26160 pr 26111 Mass Finger

Posted on by
Title of procedure: Incision and drainage of mass, flexor surface, distal portion of right index finger

Portion of op note: Patient had mass at flexor surface distal to distal crease. L-shaped incision made with apex at flexor crease on radial side of finger, flexor crease upside. Dissection carried down. There was a mass. Looked like sebaceous material in it. Clearly a cystic wall. Removed in its entirety……………………………….

Confused on which code to use
26160 or 26116
Have differing opinions in office?

Thanks
CW

Medical Billing and Coding Forum

Trigger Finger Release w/ Excision Dupuytren’s Nodule

Posted on by
How would you code a trigger finger release with excision of dupuytren’s nodule?

#1 – 26160, 26055-59?
#2 – 26123?

The tourniquet was inflated to 200 mmHg and a 2cm bruner incision over the A1 pulley of the left ring finger and proximally over the dupuytrens disease. Starting proximally we identified the dupuytrens cord and then sharply dissected it from the skin creating full thickness flaps. The neurovascular bundles were identified and we then proceeded distally protecting the digital nerves and vessels. Once the dupuytrens was fully excised we went ahead and bluntly dissected down to the A1 pulley and then Ragnell retractors utilized to protect the digital nerves on either side. The A1 pulley was visualized, a hemostat placed under the A1 pulley and withdrawn until a click was appreciated between the A1 and A1 pulleys and then the A1 pulley was incised sharply with a scalpel. A ragnell retractor was used to gently pull and separate any scarring between the profundus and superficialis tendons. Any additional fibers were freed up distally and proximally using blunt dissection freeing up any proximal tethering fibers and the patient was asked to make a fist to make sure there was no triggering.

Thanks in advance.

Medical Billing and Coding Forum

Excision Multiple Exostosis Same Finger

Posted on by
My surgeon performed the following procedure, excision exostosis right thumb distal phalanx and proximal phalanx. I was wondering if 26210 can be billed twice?

There was one incision which was extended. The OP report states: "We started the procedure with transverse incision following the crease on the right thumb. We could then locate mass with a ganglion cyst as well as exostosis on the distal phalanx. C-arm evaluation was used during the whole time to check for appropriate removal of the exostosis. We could then see that proximal phalanx also had a bone prominence. The wound was then extended proximally and distally in a T-shaped fashion. Care was taken to identify and protect the sensory branch of the radial nerve that was running on the radial side of the wound. With the help of a rongeur, the bone prominence exostoma was removed from the proximal phalanx distal portion was well."

thank you.

Medical Billing and Coding Forum

Finger radial digital nerve exploration

Posted on by
Hello Fellow Coders,

Does anyone know if cpt 64702 can be used for exploration only. Pt has dist finger closed fractures and developed absent sensation so the MD wants to confirm the digital nerve was not lacerated as well. Surgeon incised middle aspect of the finger with exploration and closure.

I’ve exhausted my resources and not sure since 64702 states Neuroplasty as well.

Thanks in advance

Medical Billing and Coding Forum

A1 trigger release and dupuytren’s contracture same finger

Posted on by
My doctor performed right small finger Dupuyren’s partial palmar fasciectomy and PIP joint contracture release as well as A1 trigger release. He wants to bill 26123 (Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint) and 26055 (Tendon sheath incision eg, for trigger finger)

Can these codes be billed together for the same finger? The diagnoses are: Right small finger Dupuytren’s contracture and right small finger PIP joint contracture with A1 trigger.

Thank you

Medical Billing and Coding Forum

arterial bleeder of the right fifth finger with complete loss of skin of the distal

Posted on by
which CPT code would you use for a right fifth finger with complete loss of skin on the ulnar aspect of the distal phalanx. one point has pulsating bleeding. there are several other points of venous bleeding. The provider infiltrated with lidocaine the did superficial figure of eight suture was placed at the level of the arteial bleeder and at 2 other locations where venous bleeding was most prominent. the bleeding was controlled.
our coders are not agreeing 1 wants to use 35207 with modifier 52, the coder thinks should be simple repair of superficial wound 12001 -12018.. Any suggestions
:confused:

Medical Billing and Coding Forum

Finger amputation CPT code

Posted on by
Can someone please confirm that CPT 26951 is the correct code for the following procedure?
Preop DX: Traumatic amputation, right index finger with fracture through the distal phalangeal physis.
Procedure: Patient was taken to the op room and placed on the table.The right upper extremity was sterilely prepped and draped after the administration of the general anesthetic. The finger tip was then examined. Upon initial presentation in the ER dept. The finger tip was rotated by 180 degrees with a nail on the volar surface. This was reduced in the ER and upon exam under anesthesia, it is apparent that the only remaining attachmentis the flexor tendon. There was no soft tissue attachment whatsoever and no perfusion obviously of the tip of the finger. The decision was therefore made to complete the amputation by transecting the flexor tendon and then using the skin from the tip as graft in order to cover exposed bone and preserve as much length as possible. The nail was removed with an tiris scissors and then the nail bed and remainder of the distal phalanx was then dissected free. The subcutaneous tissues were dissected off of the skin and dermis. This was then placed over the tip of the finder. There was no contamination whatsoever. The nail had been avulsed from the tip and there was a small amount of germinal matrix appearing tissue on the ulnar side of the finger tip. This was removed with a scalpel. The graft was then sutured with 4-0 chromic suture. An initial dorsal stay suture was placed and then further stitches were placed around the circumference with the skin being trimmed as necessary to provide good coverage without any tension and without creating a pocket for hematoma formation. There was capillary bleeding from the distal tip of the finger, but this was minimal. The coverage was quite good. The fingers and hand was then cleaned with saline. A metacarpal block was done with .25% marcaine. A sterile dressing of Xeroform and two gauze was then applied which was tied around the wrist and then this was covered with Coban. Pt doing well transferred to postop for recovery.

Did an amputation of the bone in the finger happen? I do not read where any part of the bone was cut. I see where the bone was covered, but no bone was cut out.
What do you think, correct CPT code or if not any suggestions? Thank you.

Medical Billing and Coding Forum