Forum - Questions & Answers
Integumentary and Musculoskeletal questions
I'm a student studying for my midterm in CPT coding. Can someone help me code the following scenarios? Please fill in the blanks.
30 year old male with a diagnosis of Staphylococcus Aureus Abscess on her left arm. The physician preps the area and performs and Incision and Drainage. The patient was issued a prescription and told to follow up in the office in 5 days.
Principal Diagnosis _______________________
Secondary Diagnoses _______________________
ICD-9 Procedure(s) ________________________
CPT(s)/Modifier (s) ________________________
A 78 year old male diagnosed with a 2 cm in diameter basal cell carcinoma of the scalp. The physician excises the lesion along with a 4 cm margin. The wound required extensive undermining for the closure using 3-0 Vicryl. The patient has a history of hypertension.
Principal Diagnosis ________________________
Secondary Diagnoses ________________________
ICD-9 Procedure(s) ________________________
CPT(s)/Modifier (s) ________________________
Destruction of 10 fibrocutaneous skin tags on the outer left ear
Principal Diagnosis ________________________
Secondary Diagnoses ________________________
ICD-9 Procedure(s) _______________________
CPT(s)/Modifier (s) ________________________
Excision of basal cell carcinoma 4 sq. cm on the upper arm and 3.2 sq cm on the lower arm with advancement flaps for closure. The patient has metastasis into the lung, liver and pancreas.
Principal Diagnosis ________________________
Secondary Diagnoses ________________________
ICD-9 Procedure(s) ________________________
CPT(s)/Modifier (s) ________________________
Old tear of the left medial meniscus involving the posterior horn. Patient also has chondromalacia.
Arthroscopic medial meniscectomy was performed.
Principal Diagnosis ________________________
Secondary Diagnoses ________________________
ICD-9 Procedure(s) ________________________
CPT(s)/Modifier (s) ________________________
A patient with a large bunion has a Mitchell Chevron Osteotomy through the neck of the first metatarsal.
Principal Diagnosis ________________________
Secondary Diagnoses ________________________
ICD-9 Procedure(s) ________________________
CPT(s)/Modifier (s) ________________________
now wait a minute
how about you give your answers and we tell you if we think they are correct. You can't learn if we give the answers!
skin procedures
I suggest you pull out your CPT book for these, all of them are in the skin section, that starts the surgery section.
Here are some hints that will help:
Start in the index with your key words and then move to the tabular section
CPT is literal. That is, if it says 1-14, then code one to fourteen lesions as one unit. If it says each additional, then code each additional as one unit.
Review how the book wants you to measure the length of excisions: it includes the margins.
There are two sets of codes for lesion excision: one for benign and one for malignant.
Review the introductory comments in front of the repaid codes, so you can see when you can code a repair in addition to another procedure
Good luck--we'll help, but no one will code them all for you.