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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

icd-10-cm code for vaginal cuff dehiscence post hysterectomy

What’s the best diagnosis for a vaginal cuff rupture/dehiscence? This is about 3 months after hysterectomy, op report says "vaginal cuff open approximately 1 inch with bowel present at the cuff edge.". I keep finding N99.3-vaginal vault prolapse after hysterectomy– but that doesn’t sound right to me.

Medical Billing and Coding Forum

Correct Coding for Laparoscopically Assisted Vaginal Hysterectomy

Be sure you know the difference between the various types of laparoscopic hysterectomies. In the article “Pinpoint Correct Hysterectomy Coding” (August 2018, pages 16-18), the statement, “… a laparoscopic-assisted vaginal approach — a ‘subset’ of the vaginal approach — in which a scope is inserted via small incisions in the vagina,” is incorrect, and is […]
AAPC Knowledge Center

Diagnosis Codes for Annual, Pap smear, hysterectomy, hx cancer

Which diagnosis codes do you use for Preventative GYN visit 993xx and 88175 Pap smear, patient has had a hysterectomy due to endometrial cancer and vag Pap is done. Would Z01.419, Z90.710, Z85.42 be correct?

Would the same diagnosis codes used for this for both commercial insurance or Medicare?

Medical Billing and Coding Forum

Hysterectomy following C-section, done by a diff. Dr., at same DOS

Our Dr. is called in as a specialist for complex cases, to perform a hysterectomy right after a C-section.

What code should we be billing the Hysterectomy? C-section was done by another Dr. (not in our practice). Our Dr. simply is doing the hysterectomy, bladder sling, etc. 58150 ? But the patient was cut open already….maybe with a Mod 52 (reduced services)? Or Mod 62 (two surgeons)?

Any help would be much appreciated!

Medical Billing and Coding Forum

Ureter Injury during hysterectomy…. I need help please :)

Here is the section of the note that is regarding this part…

right ureteral injury was transected as this area could not be visualized during the operative procedure. We then trimmed both ends, made a cystostomy, threaded a J-wire and then a right double J- ureteral stent over the J-wire up to the renal pelvis. We then repaired the ureter with …sutures circumferentially with good reapproximation under no tension.

after that, he put in a "left ureteral catheter."

then, he says "once both stents were in place, the bladder was repaired with 2 layers of running 3-0 Vicryl sutures…"

he wants to report 50760 and 51880 for this.

There is no CCI edit, however, it does not seem right to report the closure of the bladder from the stent placement during the same encounter of the actual stent placement. Then, he says that he inserted a catheter on the left side. I’m thinking it is temporary, but he did not state that he removed it. He calls it a "bilateral stent placement" in the header. that was not documented as the right side, though. he did not call it a j-wire or anything.

does the 50760 get a RT modifier?
What would you do for the LT side "catheter" vs "stent"
does he get the bladder closure because of the sutures or is this the layer closure included in the 50760?

Thank you for your assistance!!

Medical Billing and Coding Forum

Hysterectomy post C-section

We have a bill for C-Section (59510), tubal ligation (58611) and hysterectomy (58150). CPT 58150 denied stating 59252 should be used instead. Upon appeal from provider, they indicated the 59510 and 58611 were done. Certain factors caused the need to return to surgery, anesthesia given,prepped and draped, incision reopened etc., for a complete (total) hysterectomy. Therefore, they used CPT 58150. I have two questions:
1)If, after some time, prior incision reopened and patient had to return to OR, would it be appropriate to bill 58150 or 58150-52 or 59525?
2)If incision for c-section/tubal was closed but patient did not leave OR setting and decision was made to perform hysterectomy as mentioned above, would appropriate billing be 58150, 58150-52 or 59525?

Thank you for any input.

Medical Billing and Coding Forum

Laparoscopic Hysterectomy with TVT sling

Hi Thank you in advance for your reviews:
Physician is performing Laparoscopic Hysterectomy
After performing Laparoscopic Hysterectomy all instruments were removed, and gas expressed, he then developed the periurethral tunnels, and right at mid urethra. She had a previously placed tranobturator sling which was not angled enough, so he decided to do a retropubic sling, he made 2 stab incisions right/left of pubic symphysis and with little finger placed the trocar through each of these incisions and it came out the periurethral tunnel, then he grabbed the sling and pulled it through. He removed the plastic tab and closed the vagina.

My question is do you consider the a 51992 Laparoscopic or 57288 open?

Medical Billing and Coding Forum

Uterus weight for hysterectomy

So I’ve been trying to find clarification online…but haven’t found anything so far.
I’m new to OB/GYN coding and have found I have a problem reading a little too much in between the lines and making sure my codes fit EXACTLY. With that being said:
On my path report the pathologist states she received "multiple fragments of uterine tissue that together weigh 367g and measured…."
My question:
I know for LAVH codes (and a few others) they are dependent upon the weight of the uterus…as the path statement above states, it’s not JUST the uterus weight they listed but rather the TOTAL weight of the tissue. Would I just code to the lesser 58552 (uterus less than 250g) if the path report doesn’t specifically state the uterus itself was 250g+?

I’m billing for our private dr who did this as an outpatient procedure at a big hospital here, the hospital did the path. I don’t know if we can request going forward that the uterus be weighed independently for coding purposes???

Thanks in advance!! I’m sure I’ll be seeing you guys around quite frequently now that I’ve found this forum! Excited to learn as much as I can!

Medical Billing and Coding Forum