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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

Open wound in abdominal wall…CPT code for removal and replacement of VAC Washout.

DX Open abdomen with necrotizing fasciitis of the abdominal wall. DX code I can do.
Just need help with CPT code(s) for removal of VAC washout,replacement and some debridement. Vac dressing removed. Pulse lavage was used to irrigate the wound. And wound VAC reapplied.
Thanks!

Medical Billing and Coding Forum

CMS Open Sources QPP Software

The Centers for Medicare & Medicaid (CMS) is releasing the Quality Payment Program (QPP) computer code responsible for calculating quality measures from Medicare claims data submitted by eligible clinicians via Quality Data Codes (QDCs). This code is intended for developers interested in the calculation mechanism supporting QPP Claims to Quality. If QPP is part of your […]
AAPC Knowledge Center

Lumbar discectomy open or percutaneous

Our surgeon wants to bill the following procedure using cpt 63030, but I feel according to the description this surgery is really not an "OPEN" discectomy but rather a percutaneous discectomy in which case I am not sure what CPT code to use because CPT codes 0275T nor 62380 really doesn’t fit either. Maybe 62287 or unlisted code? I am not sure on this one. Thanks!

Procedure: Left sided L3-L4, and L4-L5 invasive tubular discectomy.

Patient placed prone on a Wilson frame, arms were protected, all bony prominences were carefully padded, low back was prepped and draped in usual sterile fashion, a needle was placed in the L3-L4 disc space from approximately 45 degrees oblique, a discogram was done using Isovue and Isogreen and showed a clear tear in the L3-L4 disc with extensive dye spread, next, a percutaneous small incision was made over the needle, A guidewire was placed in the L3-L4 disc space and dilating tube was placed into guidewire was placed in the L3-L4 disc space and dilating tube was placed into the L3-L4 disc space. Next pituitary rongeur was used to create a far lateral discectomy at L3-L4, Multiple fragments of disc material were removed. An electrocautery was used to cauterize the annulus and the disc. A 40mg of Depo Medrol as well as Marcaine were injected into the disc and the dilating tube was removed. Next the exact same procedure was done at L4-L5 via separate incision. Wounds were copiously irrigated. Both the two wounds were closed using a nylon suture.

Medical Billing and Coding Forum

Takedown of falciform ligament & removal of peritoneal lining of umbilicus with open

Oh my. This case is giving me a headache. Any insight would be unbelievably appreciated.

…………….I made a 5 mm incision in the left upper quadrant through a previous incision site into the abdomen with a Veress needle, insufflated 14 mmHg, placed a 5 mm port. There was some adhesions down above the umbilicus, placed a port in the left lower quadrant and one in the right upper quadrant through previous incision sites, got in, took down those adhesions and then looked at the falciform ligament, we used a laparoscopic Metzenbaum to take down the falciform ligament, mobilizing it, placed a 22-gauge needle through the umbilicus, identifying which was then cleaned off the peritoneum in that area. Once that was done, we placed traction on the umbilicus, found a small fistulous tract and opened that track up with the Bovie as well. There was essentially no blood loss to speak of. We closed all wounds with running subcuticula sutures of 4-0 Vicryl and placed a sterile dressing in the umbilicus.

Medical Billing and Coding Forum

Open debridement of sternoclavicular joint

Hello everyone, I’m not sure which code to use for an open debridement of the sternoclavicular joint?

OP NOTE:
An incision was made through the previous incision. There was an area of dehiscence medially and using a new #15 blade, the dehisced area was excised in an elliptical fashion for complete excision of the abnormal tissue and cosmetic re-approximation later. At this paint the fistula and infected tissue overlying the sternoclavicular joint was removed. Several Monocryl sutures were identified and removed. 6 liters of saline with antibiotics in the saline solution were used to copiously irrigate the sternoclavicular joint. A curette was used as well as a rongeur to debride between irrigation sessions. All tissue remaining was normal appearing . A rongeur was used to debride the anteromedial aspect of the proximal clavicle, taking the bone and soft tissue to clean tissue. Closure was then described.

Than you

Medical Billing and Coding Forum

RT colectomy w/ removal of termi ileum & anastamosis & LT colectomy w/anastamosi OPEN

44140 & 44160 is bundled. I’ve had this only a couple of times before & I think it was small bowel. It doesn’t seem right that two different sides of the colon are bundled.

I’m not going to post the op report as it’s quite lengthy even with cut & paste sections but the description & codes are the same.

Any input would be appreciated.

Medical Billing and Coding Forum