As a medical coder, you’ll assign CPT codes for physician procedures and services. This graded project is designed to
1. Test your knowledge of CPT coding principles and procedures
2. Gauge your ability to accurately apply coding guidelines with regard to CPT codes and modifiers
3. Analyze your accuracy with respect to HCPCS code assignment
4. Determine your ability to differentiate CPT and HCPCS5.
Summarize what you’ve learned about CPT and HCPCS coding INSTRUCTIONS your graded project has three parts. Be sure to complete all three parts prior to submitting your project.
Review the following scenario. Assign the CPT code(s). Add one or more modifiers, if necessary.
A 71-year-old male patient comes to the hospital after having been previously diagnosed with benign prostatic hypertrophy with urinary obstruction. Due to this condition, the patient is experiencing increased urination, straining during urination, and a continual feeling of fullness after the bladder has been emptied. The physician performs a cystourethroscopy to examine the condition of the bladder and urethra, and then subsequently performs a UroLift transprostatic implant procedure using three adjustable implants. CPT code(s): __600.01__ (2013 ICD-9-CM Diagnosis Code 600.01 ) (Barisa, 2016). Comment by Joyce, Barbara: -20Highlighted codes incorrectMissing two cpt codesMissing unit amountCorrect coding _ _ _ _ _ , _ _ _ _ _ x ___ (units)
Review each of the following procedures. Assign the CPT code(s). Add one or more modifiers, if necessary.
1. An established patient comes to the office complaining of migraine headaches. The physician performs an expanded problem-focused history and exam. The physician’s medical decision making is of low complexity. During the office visit, the physician also removes a benign 0.5 cm lesion from the back of the patient’s left hand. CPT code(s): CPT Code G43.909 Comment by Joyce, Barbara: -10Highlighted code incorrectMissing one E/M code with modifierMissing one cpt code with modifier
2. A physician removes an intraocular foreign body from the anterior chamber of the patient’s eye. An allergy statement in the patient’s medical record indicates that the patient is allergic to local anesthesia. For this reason, general anesthesia is administered. The anesthesiologist is not available to administer anesthesia. The surgeon performs the anesthesia administration instead.CPT code(s): CPT code 65273 Comment by Joyce, Barbara: -10Incorrect cpt code digitsMissing two modifiersCorrect coding 652_ _ – _ _ – _ _
3. A surgeon performs a total abdominal hysterectomy with partial removal of the vagina, lymph node sampling, and removal of the ovary. The coder assigns code 58200-51. Is this code correct or incorrect? Why or why not? Correct. Reasons – Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s) (Barisa, 2016). Comment by Joyce, Barbara: -5The cpt code is correct but the modifier should be omitted because the procedures are bundled into code 58200
Review each of the following procedures. Assign the HCPCS code(s).
4. A patient weighing 252 pounds sustains a hip fracture. The physician prescribes a Group 2 standard single power wheelchair with a solid seat, solid back, and as ling. Code 27267, Code 27268, and Code 27269 Comment by Joyce, Barbara: -10Highlighted codes incorrectMissing one HCPCS code
5. A patient comes to the emergency room complaining of a chronic migraine. The nurse administers a 1 unit injection of onabotulinumtoxin AN .HCPCS code(s): HCPCS 2016 Code: J0585 (Barisa, 2016).
6. A patient with chronic venous insufficiency comes to the doctor’s office complaining of leg pain. The physician prescribes two thigh-length gradient compression stockings, 45 mmHg each. HCPCS code(s): I83.811 – I83.819 (Barisa, 2016). Comment by Joyce, Barbara: -10Highlighted codes incorrectMissing one HCPCS codeMissing unit amountCorrect coding _ _ _ _ _ x ___ (units)
Review the following coding scenario. Assign the CPT code(s) for the wound repair only.
A patient comes to the emergency room after sustaining a 12.2-cm wound to the left side of her face. She was cut with a piece of glass during a physical altercation with her husband. The physician performs a detailed history and examination. Medical decision making was of moderate complexity. The physician repairs the facial wound without difficulty; however, the wound requires extensive cleaning to remove the glass particles beforehand. The physician also repaired a superficial 2.5-cm wound to the left ear. Both wounds were closed using 4-0 Vicryl.CPT code(s): 12001-12021_and G0168 (Barisa, 2016). Comment by Joyce, Barbara: -20Incorrect cpt code digitsMissing one modifierIncorrect code G0168 (not needed)Correct coding 120_ _ , 120_1 – _ _