CPC Exam Dumps : Certified Professional Coder (CPC) Exam

1. Procedure and CPT® Code Selection:

The patient initially underwent a laparoscopic total abdominal hysterectomy for endometriosis of the uterus. However, due to extensive adhesions, the surgeon converted the procedure to an open total abdominal hysterectomy to complete the surgery.

CPT® Code 58150 is appropriate for a total abdominal hysterectomy, including removal of the uterus and cervix, via an open approach. Since the procedure was converted to an open approach, 58150 is the correct code.

The -22 modifier is added to indicate increased procedural services due to the extensive adhesiolysis (removal of adhesions), which extended the surgery duration.

2. Diagnosis and ICD-10-CM Code Selection:

ICD-10-CM Code N80.00 is used for endometriosis of the uterus, which is the primary condition that prompted the hysterectomy.

ICD-10-CM Code N73.6 is appropriate for female pelvic peritoneal adhesions, reflecting the extensive adhesions that necessitated the conversion to open surgery.

3. Rationale for Excluding Other Options:

Code 58571 (in options B and C) is for a laparoscopic approach, which is incorrect because the procedure was converted to an open approach.

The -78 modifier is incorrect in this context because the conversion to open surgery was part of the same operative session and not an unplanned return to the OR.

Diagnosis code N99.4 (in options B and D) pertains to postprocedural pelvic adhesions, which does not apply here as the adhesions were not due to a prior procedure.

4. AAPC and CPT® Coding Guidelines:

AAPC guidelines specify using 58150 for an open total abdominal hysterectomy and adding the -22 modifier for increased complexity or time due to factors like extensive adhesiolysis.

Therefore, the correct answer based on CPT® and ICD-10-CM guidelines is A. 58150-22, N80.00, N73.6.

In the CPT® code book, code 35860 describes an " Exploration for postoperative hemorrhage, thrombosis or infection " in multiple areas, specifically including the neck, chest, abdomen, and/or extremity. This code is used when a surgeon explores these areas postoperatively to locate and address complications such as bleeding, clots, or infections.

B, C, and D are incorrect as they do not fully encompass all the areas listed in the actual description of CPT® code 35860, which includes all four regions (neck, chest, abdomen, and extremity).

Thus, the correct answer is A. Exploration for postoperative hemorrhage, thrombosis or infection; neck, chest, abdomen, and/or extremity.

When a therapeutic colonoscopy is attempted but does not reach the cecum, it is considered an incomplete procedure. According to the CPT® Colonoscopy Decision Tree, if the colonoscopy extends beyond the splenic flexure but does not reach the cecum, the appropriate way to code this incomplete colonoscopy is by appending modifier 53 to indicate a discontinued procedure due to extenuating circumstances or risk to the patient.

A. 45378-53 is the correct answer as it designates a diagnostic colonoscopy with modifier 53, signifying that the procedure was started but not completed.

B. 45330 is incorrect as it represents a sigmoidoscopy, which only goes up to the splenic flexure.

C. 45331-45347 refers to therapeutic colonoscopies that were completed to the cecum.

D. 45379-45398 with modifier 52 is incorrect because modifier 52 is used for reduced services, which does not accurately describe an incomplete colonoscopy.

Thus, the correct answer is A. 45378-53.