KKRINGLE HIM1103 Mod 3 Assignment Apply CPT Coding Guidelines_Modifiers_StudentWrksht 082723

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Feb 20, 2024

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Module 03 Assignment - Apply CPT Coding Guidelines and Modifiers Instructions: Read each scenario and answer the associated questions. Refer to Appendix A and Section coding guidelines in the CPT code book. Be sure to write your answer beneath each question, using complete sentences, reflecting proper spelling and grammar. Scenario 1 A patient presents to the Emergency Room following an incident in her home where she fell and hit her head on the edge of a table. She indicated she felt dizzy prior to the fall. The fall resulted in a 1.5 cm laceration to her forehead and another 0.75 cm laceration to her neck. In addition, she was experiencing a headache and some blurred vision. Note: In this scenario, the provider would need to evaluate the source of the dizziness and performed a simple repair the lacerations. Questions: 1. Indicate the modifier that would be appended to the E/M code. -25. 2. Indicate the coding guideline applied to a simple repair of two lacerations, same site. The coding guideline applied to a simple repair of two lacerations, same site is Appendix A. 3. Indicate the code for a Simple Repair of two lacerations to the forehead (scalp) and neck. he code for a Simple Repair of two lacerations to the forehead (scalp) and neck is 12032. Scenario 2 A patient is scheduled for an inpatient (hospital) surgical procedure. The patient was intubated, and anesthesia administered. The surgeon made the initial incision to access the operative site when the patient’s blood pressure dropped, and the patient became hypotensive. The procedure was aborted. Questions: 1. Indicate the modifier that the surgeon would append to the surgical CPT code? The modifier that the surgeon would append to the surgical CPT code is -53 2. Indicate the modifier that would be appended to the surgical CPT code if this was an Outpatient Procedure? The modifier that would be appended to the surgical CPT code if this was an Outpatient Procedure is -73. 3. Under which circumstances would a “Discontinued Service” modifier not be allowable based on the definition? A "Discontinued Service" modifier would not be allowable based on the definition if the procedure was discontinued due to circumstances beyond the physician's control, such as patient death, patient transfer, or patient's decision to leave against medical advice. Scenario 3 A patient is admitted for an emergency appendectomy due to a ruptured appendix with abscess. The patient is morbidly obese which presents difficulty in removing the appendix and managing the

operative site to avoid infection. Due to the obesity and complicated nature of the procedure, the procedure took 30 minutes longer than usual to perform the procedure and close the operative site. Questions: 1. Which modifier would be appended to the appendectomy CPT code due to the increase in operative time? The modifier that would be appended to the appendectomy CPT code due to the increase in operative time is -22. 2. Which CPT format (punctuation) guides the coding pathway for determining the appropriate code for Ruptured Appendix? The CPT format (punctuation) that guides the coding pathway for determining the appropriate code for Ruptured Appendix is semicolons (;). 3. What is the code for Appendectomy for a ruptured appendix with abscess? The code for Appendectomy for a ruptured appendix with abscess is 44950. Scenario 4 A patient is recovering from a recent surgical procedure and is presenting to the physician’s office for routine postoperative follow-up care. The postoperative follow-up care is included in the charges for the surgical procedure. Question: 1. Which “Surgery Guideline” states that typical postoperative follow-up care is not to be billed separately? The "Surgery Guideline" that states that typical postoperative follow-up care is not to be billed separately is Global Surgery Guidelines.

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