CPC Exam Dumps : Certified Professional Coder (CPC) Exam

When a prior malignancy has been eradicated and the patient is no longer receiving treatment for the primary site, ICD-10-CM directs you to use apersonal history of malignant neoplasmcode rather than an active primary cancer code. Here, the breast cancer was treated successfully last year and no further therapy was required, so the breast cancer ishistory, not active. The new current condition ismetastatic cancer to the liver, which is coded as asecondary malignant neoplasm of liver and intrahepatic bile duct (C78.7). Because the primary breast cancer is not documented as active or under current treatment, you donotcode an active breast malignancy (C50.-). Instead, you addZ85.3 (personal history of malignant neoplasm of breast)to show the prior cancer history relevant to the current metastatic disease. Option A incorrectly codes a primary liver cancer. Option C incorrectly codes active breast cancer. Option D codes metastasis to the adrenal gland, not the liver.

This is destruction of malignant lesions (SCC).

17261 = Malignant lesion destruction, trunk/arms/legs, 0.6–1.0 cm

17262 = Same location, 1.1–2.0 cm

Feet are included in trunk/arms/legs.

Therefore, 17262, 17261 is correct.

In this case, a CRNA provided anesthesia for an urgent endoscopic procedure. To select the appropriate codes, we consider both the anesthesia code for the procedures performed and the modifiers relevant to the CRNA’s role and the patient’s physical status:

1. 00813: This CPT® code covers " Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum, " which is appropriate since the colonoscopy extended to the ileum and into the lower duodenum. 00731 (anesthesia for upper GI endoscopy) would not fully apply, as the main procedure targeted lower intestinal areas as well.

2. QZ Modifier: Indicates the anesthesia was performed by a CRNA without medical direction by an anesthesiologist, which aligns with the scenario where the CRNA independently administered anesthesia.

3. P3 Modifier: Reflects the physical status of " severe systemic disease " for this patient, as she has both end-stage renal failure and myelodysplastic syndrome.

4. 99100: This code is added to reflect " special anesthesia circumstances " given the patient’s extreme frailty (platelet count of 3,000), which warrants additional consideration.

5. 99140: Used for emergency conditions, which applies here due to the urgent nature of the bleeding investigation.

Thus, 00813-QZ-P3, 99100, 99140 accurately reflects the anesthesia services provided by the CRNA in this emergency scenario.