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cautery. She was given another 1 g of Ancef at the 2-hour mark by our anesthesiologist, and was taken to the recovery room in good condition.What CPT? codes are reported?Selected Answer: 19318-50, 19350-59-50Correct Answer: 19318-50, 19350-59-50Response Feedback: With breast reduction surgery ?reduction mammaplasty? or ?mammoplasty? (both terms are used), in the CPT? Index, see Reduction/Mammoplasty, we are lead to CPT? 19318. Because this is a unilateral code per CPT?, append modifier 50. Additionally, the operative report indicates because so much breast tissue was removed the surgeon had to create free nipple grafts to recreate the nipple. In the CPT? see Reconstruction/Breast/Nipple, you are directed to code range 19350-19355. 19350 is the correct code. Normally, withreduction mammaplasty the patient?s nipple is moved into place after removal of the breast tissue. The Nipple reconstruction is normally bundled into the reduction surgery making it necessary to append modifier 59.•Question 25 •1.2 out of 1.2 pointsWhat temporary HCPCS Level II codes are required for use by Outpatient Prospective Payment System (OPPS) Hospitals?Selected Answer: C codesCorrect Answer: C codesResponse Feedback: Outpatient PPS (C1300-C9899) Guideline explains C codes are required for use by Outpatient Prospective Payment System (OPPS) Hospitals to report new technology procedures, medical devices, drugs, biologicals, and radiopharmaceuticals; that do not have other HCPCS codes assigned. Other facilities may report C-codes at their
discretion.•Question 26 •1.2 out of 1.2 pointsAn ICU diabetic patient who has been in a coma for weeks as the result of a head injury becomes conscious and begins to improve. The physician performs a tracheostomy closure and since the scar tissue is minimal, the plastic surgeon is not needed. What CPT? and ICD-10-CM codes are reported for this procedure?Selected Answer: 31820, Z43.0, S06.9X5A, E11.9Correct Answer: 31820, Z43.0, S06.9X5A, E11.9Response Feedback: In the CPT? Index, look for Tracheostomy/Surgical Closure/without Plastic Repair. This directs you to code 31820.In the Index to Diseases, look up Attention to/tracheostomy, and report Z43.0. It is reported as a primary code since the closure of the tracheostomy is the reason for the procedure performed. Diabetic coma (E11.641) is not reported because the coma resulted from a head injury not diabetes. Coma would not be reported because it is resolved and the patient no longer has it. In the Index to Diseases, look up Injury/headdirecting you to S06.9X5A. Diabetes is reported with E11.9.•Question 27 •1.2 out of 1.2 pointsA Grade I, high velocity open right femur shaft fracture was incurred when a 15-year-old female pedestrian was hit by a car. She was taken to the operating room within four hours of her injury for thorough irrigation and debridement, including excision of devitalized bone. The patient was prepped, draped, and positioned. Intramedullary rodding was carried out with proximal and distal locking screws. What CPT? and ICD-10-CM codes should be reported?