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49 terms

CPT ch.11 /Ch.12 Musculoskeletal

STUDY
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moving healthy tissue from one site to another to replace diseased tissue
grafts
closing a wound using glue,silk thread, or wire
sutures
revision is modyfing a _______ procedure
previous
cut made into body tissue during surgery using a knife, electrosurgical unit, or laser
incision
visualizing a body cavity using an instrument that can be inserted into the body through a small incision or a natural opening
endoscopy
removing a portion or all of an organ or another tissue using a scalpel or another surgical instrument
excision
surgical currettment is scraping ___________ tissue
abnormal
Destruction is ablation/removal is removal of ________, _________, or ___________ tissue
benign, premalignant, malignant
Biopsy is removal &____________ of tissue to establish a ____________
examination, diagnosis
A flap is a __________ of a mass of tissue that has been partially __________ from one part of the body so that it retains its own _______ __________.
relocation,removed, blood supply
partial displacement of a bone from its joint
subluxation
the bones are realigned also called reduction
manipulation
the bones arent realigned and a cast or stripping device is placed around the limb
immobilize or stabilize
t/f wound exploration (reported for the treatment of wounds resulting from trauma) includes surgical exploration & enlargement of the wound, extension of dissection, debridement, removal of foreign bodies, ligation/coagulation, & repair
false, for complex intermediate, or simple repairs code from integumentary system for Repair
when major structures or major blood vessels require repair via thoracotomy or laparotomy, do your report for repair or -otomy or both?
do not report -otomy code. report the repair code
when a traumatic injury with an open wound requires surgical debridement but the type of fracture requires manipulation and casting (instead of external or internal fixation) what do you report?
report the appropriate code for closed fracture treatment in addition to the debridement code
replantation (surgical reattachment)codes include cleansing, debridement, internal fixation, repair of tendons, surgical reattachment, & what else?
arthrodesis
when replantation of an incomplete amputaion refer to the specific individual codes for repair of bones, ligaments, tendons, nerves, or blood vessels what modifier do you add?
modifier -52
what is the process of enlarging or increasing?
augmentaion
costochondral cartilage graft was harvested from left rib of a 4 year old child for laryngotracheal reconstruction to treat subglottic stenosis (narrowing of airway below the vocal cords) what should you report a code for?
the graft 31582 & the harvested rib 20910-51
t/f codes 20930-20938 are reported for bone grafts obtained for spine surgery. just one bone graft is reported for each operative session even if graft material is obtained from more than one spinal level
true
reported when graft material is obtained from bone, cartilage, fascia, or tendon
harvesting
what is surgical repair of uterine prolapse or a vaginal vault prolapse?
colpoclesis aka lefort procedure
codes 21685-21750 describe the repair, and/or reconstruction of?
soft tissue of the neck and thoracic soft tissue & bones
for back & flank when a drain is inserted &/or the incision is repaired with multiple layers of sutures, staples, or steri-strips do you separately report this?
do not seperately report those procedures they are bundled in back & flank codes
when reporting codes for spinal procedures make sure you?
differentiate spinal segments & interspaces ie T1-T2
when an arthrodesis procedure is performed in addition to another procedure what do you report?, both?
report the arthrodesis procedure code in addition to codes for other procedures performed add -51 to the arthrodesis
patient underwent arthrodesis of T1-T3 using local autograft from the ribs. dual rods were inserted with multiple hooks & sublaminar wires. how many add on codes are included for 22610, do you code for rods?
yes code for rods cause category notes for 22610 states report separate code for instruments & in addtion to 2 add on codes 22614(2)
patient underwent arthrodesis of T1-T3 using local autograft from the ribs. dual rods were inserted with multiple hooks & sublaminar wires, do you code for the autograft?
yes?
surgeon a performed a posterior exposure procedure on mary by making an incision overlying the lumbar vertebrae, separating the fascia & supraspinous ligaments in line with the incision. he then lifted ligaments & muscles out of the way. next, surgeon b performed a posterior discectomy & fusion at l2 & he performed a partial excision of the vertebral body at L3; what does surgeon b report?
surgeon b reports codes 22612-62 (exposure) & 22114 (partial excision)
what involves making incision in vertebral bone to remove pieces or wedges of bone to correct a deformity such as kyphosis?
osteotomy
when exploration of spinal fusion is performed in addtion to other definitive procedures ;what modifier is added to the exploration?
-51
which one of the following is NOT bundled in to the tendon repair codes: application of immobilization, extension of the excision, inserting tendon grafts from another site, treating fractures, repair & closure of tendon sheath, repairing nerves or arteries, & harvesting
codes for harvesting and inserting tendon grafts from another sire, repairing nerves or arteries, & treating fractures are reported in addition to the tendon repair
the application of casts & sstrapping heading includes codes that are reported when the cast (or splint) application or strapping is a?
replacement procedure performed during or after the period of follow-up care; initial service performed w/out restorative treatment or procedure to stablize or protect a fracture, a dislocation, or another injury and/or to provide comfort to a patient
a 7 yr old patient injured his left arm while roller-skating. a 2-view left forearm x-ray performed at sylvania community hospital's emergency dpt, revealed fractures of the radial & ulnar shafts. a level 3 ed e/m service was provided th pt's arm was placed in a splint to stabilze the fracture and the mother was informed that the treatment would have to be the nxt day cause no orthopedist was available; which services do you code for?
report the level 3 e/m 99283, the splint 29125-lt, & the x-ray 73090-lt
an outpatient e/m level 3 of this new pt was done by an orthopedic surgeon later that day the pt underwent closed manipulation of radial/ulnar shaft fractures under general anesthesia & a short-arm cast was applied the pt remained until 10pm; what do u report codes for? do you report a code for the cast?
report 25565 (manipulation) & 99203-57( e/m); dont report a separate cast because a restorative treatment for the initial service was performed & the 14st cast/splint is included
cpt notes indicate that surgical endoscopy/arthroscopy always includes?
diagnostic endoscopy/arthroscopy
endoscopy/arthroscopy is considred diagnostic when it is?
performed to visualize an abnormality to determine the extent of disease
t/f diagnostic endoscopy codes include inspection of the interior of the nasal cavity & its meatus, turbinates, & sphenoethmoid recess, report a code for each area when diagnostic endoscopy is performed on these areas
false, report just one code
patient undergoes surgical endoscopy with anterior ethmoidectomy left; and the physician uses the endoscope to evaluate other regions of the nasal cavity, what do you report?
1 code for ethmoidectomy w/endoscopy p.546
when biopsy of a lesion from the accessory sinuses is obtained as part of an excision, destruction, or other type of removal during the sam operative session, do you report a code for the biopsy?
no
a patient presents with multiple nasal polyps . pt undergoes surgical endoscopy w/polyectomy & total ethmoidectomy; what services do you code for?
the total ethmoidectomy, even tho polypectomy may have been performed prior, the polypectomy procedure is included in the more invasive ethmoidectomy
t/f when a laryngoscopy procedure is required for placement of an endotracheal tube to provide air passage in an emergency situation, separately code/report the laryngoscopy
false do not separetely code laryngoscopy
t/f when a laryngoscopy procedure is used to place an endotracheal tube for nonemergent reasons,do not separately code/report the laryngoscopy
true ie bronchoscopy
when nasal endoscopy, laryngoscopy is performed, in addition to bronchoscopy, report a code for?
the bronchoscopy procedure only fiberoptic bronchoscopy services routinely include inspection of the nasal cavity, pharynx, & larynx
when a surgical endoscopic procedure fails & is converted to an open procedure, do you report for the endoscopy?
no, report only a code for the open procedure
a long needle is inserted thru the skin & into other tissue to obtain tissue for diagnostic evaluation, what is the procedure?
percutaneous needle biopsy
a lobectomy is the removal of a single lobe of the lung each lobe contains multiple segments, do you report a lobectomy when a segment is removed ?
no report a segmentectomy
when an open lung procedure, a thoractomy, or another open chest procedure immediately follows diagnostic thorascopy, what do u report first?
report codes for both procedures & sequence the open procedure 1st; ie lung