Questions and Answers
A patient arrives at the hospital from a nursing home with a stage 3 bedsore on his left hip. List the ICD-10-CM code for the bedsore.
A provider performs a punch biopsy of two pre-cancerous lesions on the patient's back, which he has determined to be actinic keratosis (AK). List the ICD-10-CM code for the AK.
Patient presents with a cyst on the arm. Select the CPT® code for the procedure performed.
A patient presents for tattooing of the nipple and areola of both breasts after undergoing breast reconstruction. Select the CPT® code(s) for this procedure.
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Select the CPT® code(s) for the removal of 18 skin tags located on the patient's neck and shoulder area.
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What CPT® code(s) should be reported for the excision of a skin lesion on the left forearm?
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A patient presents to her doctor with three medium sized suspicious lesions on her leg. What CPT® code(s) should be reported?
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What are the correct CPT® codes to report for the removal of a squamous cell carcinoma on the tip of the nose?
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When coding multiple burns, which is correct?
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Select the CPT® code(s) for the punch biopsies performed on both her left and right arm.
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What are the CPT® and ICD-10-CM codes reported for the abdominoplasty procedure?
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What are the CPT® and ICD-10-CM codes reported for the bilateral augmentation mammoplasty?
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What are the CPT® and ICD-10-CM codes reported for the excision of the large dysplastic nevus?
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What are the CPT® and ICD-10-CM codes reported for the excision of basal cell carcinoma and squamous cell carcinoma?
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What are the CPT® and ICD-10-CM codes reported for the right breast lumpectomy?
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What are the CPT® codes reported for the planned return to the OR to assess wound closure options in necrotizing fasciitis?
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Melanin is found in what layer of the epidermis?
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Which statement is TRUE regarding the Table of Neoplasms in ICD-10-CM?
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What term relates to the connection of skin to underlying muscles?
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What does the 7th character D indicate in ICD-10-CM chapter 19?
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What is the correct diagnosis code to report treatment of a melanoma in-situ of the left upper arm?
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What CPT® codes are reported for the destruction of 16 premalignant lesions and 10 benign lesions using cryosurgery?
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What CPT® code(s) is/are reported for the removal of all skin tags from a 63-year-old patient?
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What CPT® code(s) is/are reported for the removal of a squamous cell carcinoma of the right cheek?
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What CPT® code(s) is/are reported for the recurrence of a keloid with treatment by injection?
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What CPT® code(s) is/are reported for the definitive excision of malignant melanoma?
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What CPT® and ICD-10-CM codes are reported for the removal of 16 skin tags from each axilla and additional skin tags from the neck?
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What CPT® and ICD-10-CM codes are reported for the destruction of lesions using cryosurgery?
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What CPT® code is reported for the intermediate repair of a star-shaped injury on the head?
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What CPT® code(s) describe the treatment of 9 plantar warts and 6 flat warts destroyed with cryosurgery?
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What CPT® code(s) should be reported for a rhomboidal excision and closing flap procedure for a basal cell carcinoma?
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What CPT® and ICD-10-CM codes are reported for the removal of a foreign body from the forehead?
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What CPT® codes are reported for suction-assisted lipectomy on various body parts?
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What CPT® code is correct for the excision of a benign breast lesion following localization wire placement?
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What codes are reported for aspiration of a seroma after a surgical procedure?
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What CPT® codes should be reported for the excision of a basal cell carcinoma and punch biopsies?
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What ICD-10-CM codes are reported for lesions excised during a Mohs procedure?
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What CPT® and ICD-10-CM codes are reported for debridement and split thickness autografting of diabetic foot ulceration?
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What CPT® and ICD-10-CM codes are reported for excision and flap repair of a squamous cell carcinoma on the scalp?
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What CPT® and ICD-10-CM codes are reported for Mohs micrographic excision for basal cell carcinoma on the face?
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Study Notes
ICD-10-CM and CPT® Code Identification
- ICD-10-CM codes utilized for ICD scenarios such as L89 for bed sores and L57 for actinic keratosis.
- Various CPT® codes appropriate for medical procedures, such as 10060 for cyst drainage and 19318 for breast reduction.
Procedure Specifics for Skin Lesions
- Procedures involving biopsies and excisions must use the correct CPT® codes, e.g., 11100 for multiple punch biopsies and 17311 for Mohs micrographic surgery.
- Documentation of procedures should detail lesion size, margins, and closure techniques for accurate coding.
Skin Tag and Cyst Removal Coding
- For removal of skin tags, the correct CPT® combination (11200, 11201) is essential to reflect total quantity and technique employed.
- Scissor technique used for skin tag removal, emphasizing the importance of consent and patient examination.
Coding for Surgical Interventions
- Complex repairs of wounds may involve multiple CPT® codes reflecting the nature and size of each repair.
- Accurate measurement of repaired areas (e.g., 2.7 cm or 7.4 cm) dictates the appropriate coding strategy.
Understanding the Sequence of Burns Coding
- Burn coding should prioritize the highest degree of burn, sequencing from the greatest injury to the least significant.
Emphasis on Pathological Context
- Pathology results from biopsy procedures are vital; potential malignancies should be appropriately categorized and coded only when confirmed.
Considerations for Cosmetic Procedures
- Cosmetic procedures may require special modifiers (like -50 for bilateral) to indicate symmetry or bilateral interventions.
- Abdominoplasty and liposuction cases should articulate preoperative conditions, challenges addressed, and surgical techniques for proper CPT® coding.
Importance of Documentation and Patient Consent
- Comprehensive documentation of patient identifiers, pre- and post-operative diagnoses, and patient consent is essential for appropriate billing and record-keeping.
Techniques and Materials Utilized
- Notable procedures include the use of electrocautery for hemostasis and specific suturing materials like Vicryl or Prolene to close wounds.
General Anesthesia and Patient Management
- Procedures performed under general anesthesia include detailed management protocols, always noting patient stability upon completion of each surgical intervention.
Awareness of Surgical Risks
- Possible complications linked to procedures such as infection and scarring must be discussed with patients beforehand, indicating informed consent.
Distinction in Coding for Different Conditions
- Specific ICD-10-CM codes are dedicated to skin conditions like hidradenitis (L73.2) and ambulatory surgical procedures must appropriately categorize their diagnoses post-operatively.### Surgical Codes and Diagnoses
- CPT® codes are used for reporting medical, surgical, and diagnostic services and procedures.
- ICD-10-CM codes are standardized codes for diagnosing diseases and health conditions.
Case Summaries
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Case 6:
- CPT® code: 19325-50 for bilateral augmentation mammoplasty.
- ICD-10-CM: N64.82 for breast hypoplasia.
- Safe recovery with no operative complications and minimal blood loss (<30 cc).
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Case 7:
- CPT® codes: 13101, 11403-51 for excision of a dysplastic nevus and complex repair.
- ICD-10-CM: D23.5 for the dysplastic nevus of the right chest.
- Procedure performed with local anesthesia, involving excision and complex closure techniques.
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Case 8:
- CPT® codes: 15240, 14040-51, 11643-59 for excision of skin cancers with graft and flap repairs.
- ICD-10-CM codes: C44.319, C44.629 for basal and squamous cell carcinomas.
- Included complex procedures with local anesthesia and meticulous closure to optimize healing.
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Case 9:
- CPT® code: 19301-RT for right breast lumpectomy.
- ICD-10-CM code: N63 for right breast mass.
- Surgery indicated for a growing mass, diagnosed as fibroadenoma, with layered closure and minimal complications.
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Case 10:
- CPT® codes: 15002-58 for wound excision; 15271-58-51 for skin graft.
- ICD-10-CM code: M72.6 for necrotizing fasciitis.
- Patient with severe comorbidities requiring careful surgical evaluation and management of necrotizing tissue.
Key Coding Concepts
- Melanin is primarily found in the Basal layer of the epidermis.
- In ICD-10-CM, the Table of Neoplasms provides essential data for coding cancer-related conditions.
- The Hypodermis connects skin to underlying muscles.
- The 7th character D in ICD-10-CM for injuries indicates a Subsequent encounter.
- CPT® coding for squamous cell carcinoma removal measures the lesion's largest diameter for accurate coding.
Questions and Answers Summary
- Melanoma treatment is coded as D03.62 for melanoma in-situ of the left upper arm.
- Skin tag removal using cryosurgery is best represented by CPT® codes 17110 and 17003.
- Treatment for 9 plantar warts is accurately captured with CPT® code 17110.
- A foreign body removal involves careful incision to ensure proper access, documented with specific CPT® coding.
This formatting helps streamline complex medical coding and surgical processes for students studying healthcare documentation and procedures.### CPT and ICD-10 Codes in Surgical Procedures
- Different surgical procedures require specific CPT (Current Procedural Terminology) and ICD-10 (International Classification of Diseases, Tenth Revision) codes for accurate billing and documentation.
Capsule Removal and Wound Closure
- Detailed removal of a stain-capsule involved hemostasis, achieved with light pressure.
- Wound closure utilized two different suture types: 4-0 Monocryl and 6-0 Prolene.
- Known correct coding choice for this procedure is D) 10121, M79.5, Z85.828.
Suction-Assisted Lipectomy
- A patient underwent suction-assisted lipectomy across various body areas including the posterior iliac crest and medial/lateral thighs.
- Total fluid infused was 2300 cc, while 2400 cc was removed.
- Correct coding reported for this procedure is D) 15877, 15879-50-51.
Breast Tissue Excision
- A localization wire placement marked for excision in the right breast; involved sharp dissection and removal of a benign nodule.
- Closure of subcutaneous tissue was achieved using 3-0 Vicryl and skin edges were approximated with 4-0 subcuticular sutures.
- Correct coding choice for the surgeon's service is D) 19125-RT.
Seroma Aspiration
- Involves aspiration of a seroma using a 16-gauge needle, after recent genitourinary surgery.
- The amount aspirated was 600 cc, noted as non-cloudy serosanguinous fluid.
- Correct codes for this procedure are A) 10160-78, N99.842.
Basal Cell Carcinoma Excision
- An 81-year-old male underwent excision for a biopsy-proven basal cell carcinoma, including punch biopsies for further lesions.
- Primary closure techniques involved complex suturing with 4.0 and 5.0 Prolene.
- The correct coding reported for this procedure is C) 13132, 11623-51, 11100-59, 11101.
Multiple Basal Cell Carcinoma Removal
- A 47-year-old patient with multiple suspected basal cell carcinomas underwent surgical excision with clear margins for all lesions.
- Complex closures were performed using layers of suturing.
- Correct ICD-10-CM codes for this procedure include A) C44.202, C44.40, D22.23, D22.39.
Diabetic Foot Ulcer Treatment
- The procedure consisted of debridement and split thickness autografting for a diabetic foot ulcer.
- A significant area of grafting was performed with a measured graft sizing approximately 60 cm².
- Correct codes for this operation are A) 15120-58, 15004-58-51, E11.621, L97.421.
Excision of Squamous Cell Carcinoma
- A procedure involving excision of a squamous cell carcinoma utilizing a Yin-Yang flap closure.
- Hemostasis was effectively achieved through Bovie cautery, and margins were confirmed clear.
- The correct coding choice for this procedure is D) 14020, C44.42.
Mohs Micrographic Excision
- A patient received Mohs micrographic surgery for a basal cell carcinoma located at the left lateral canthus eyelid.
- The defect after excision was assessed, excised further, and underwent complex repair confirming clear margins.
- Proper coding for this comprehensive procedure is C) 17313, 13152-51, C44.119.
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Description
Test your knowledge with these flashcards from AAPC CPC Chapter 7. This quiz focuses on ICD-10-CM coding for conditions such as bedsores and actinic keratosis. Perfect for healthcare professionals preparing for coding exams.
