24 25 ENM
25-
Modifier 51 cant be used for the
54- only surgical services
55- post-op care only
51- same site but different location (cervical vs lumbar)
vs
59- procedure distinct or independent from other services
62- 2 surgeons
63- 3 surgeons
76-
1. Dr. Armstrong, a plastic surgeon, completed a bilateral rhytidectomy of the neck
and a suction-assisted lipectomy of the right upper arm. What code(s) should be
reported for Dr. Armstrong's services?
a. 15828-50, 15879-RT-59
b. 15826-59, 15879-RT-59
c. 15828-50, 15878-RT-59
d. 15826-RT, 15828-50, 15878-RT-59
Bilateral rhytidectomy of the neck: This means a facelift on both sides of the neck.
Suction-assisted lipectomy of the right upper arm: This is liposuction on the right upper arm.
The correct codes and modifiers should reflect the bilateral nature of the neck procedure and
distinguish between the different procedures performed on the right upper arm.
So, the correct answer is:
c. 15828-50, 15878-RT-59
Here's the breakdown:
15828-50: This represents the bilateral rhytidectomy of the neck with the "50" modifier
indicating that it's a bilateral procedure.
15878-RT-59: This represents the suction-assisted lipectomy of the right upper arm. "RT"
indicates right side, and "59" is used to indicate that it's a distinct procedural service from the
other procedures performed.
This coding accurately describes the procedures performed by Dr. Armstrong.
9. Amy, a 45-year-old patient, was scheduled for a biopsy following a diagnostic
mammogram that showed a mass in the right breast. Dr. Tapper completed a
percutaneous automated vacuum assisted biopsy and placement of a percutaneous
localized clip in the right breast under ultrasonic guidance. The biopsy revealed a
primary neoplasm of the lower-outer quadrant. How should you report Dr. Tapper's
professional services?
a. 19085, 19295-51, 77012-26
b. 19081, 19295-51, 76942-26
c. 19083-26, 19295-51, 77012-26
d. 19083, 19295, 76942-26
To report Dr. Tapper's professional services accurately, we need to select the
appropriate CPT codes and modifiers based on the procedures performed. Let's break
down the procedures:
1. Percutaneous automated vacuum-assisted biopsy of the right breast.
2. Placement of a percutaneous localized clip in the right breast under ultrasonic
guidance.
3. The biopsy revealed a primary neoplasm of the lower-outer quadrant.
Now, let's analyze the options:
a. 19085, 19295-51, 77012-26 b. 19081, 19295-51, 76942-26 c. 19083-26, 19295-51,
77012-26 d. 19083, 19295, 76942-26
The correct answer is:
b. 19081, 19295-51, 76942-26
Here's the breakdown:
19081: This code represents the biopsy of the breast, percutaneous, using
vacuum-assisted equipment. This code should be used to describe the biopsy
procedure.
19295-51: This code indicates placement of a percutaneous localized clip. The "-
51" modifier is used to indicate multiple procedures performed during the same
session. In this case, it represents both the biopsy and clip placement.
76942-26: This code represents ultrasonic guidance for needle placement. The "-
26" modifier indicates that only the professional component of the service is
being reported.
These codes and modifiers accurately describe the procedures performed by Dr. Tapper
for the biopsy and clip placement in the right breast under ultrasonic guidance.
A 45-year-old male patient suffers from postprandial chest pain and abdominal pain.
After workup and testing, he is diagnosed with a large paraesophageal hernia. Today, he
undergoes a laparoscopic repair with implantation of mesh and a wedge gastroplasty.
How should you report today's service? а. 43282, 43283 b. 43281, 43282, 43283 c.
43332, 43283-51 d. 43280, 43283
To report the services for the laparoscopic repair of a large paraesophageal hernia with
implantation of mesh and a wedge gastroplasty, you should choose the appropriate CPT
codes. Let's break down the procedures:
1. Laparoscopic repair of the paraesophageal hernia.
2. Implantation of mesh.
3. Wedge gastroplasty.
Now, let's analyze the options:
a. 43282, 43283 b. 43281, 43282, 43283 c. 43332, 43283-51 d. 43280, 43283
The correct answer is:
b. 43281, 43282, 43283
Here's the breakdown:
43281: Laparoscopy, surgical, repair of paraesophageal hernia, includes
fundoplasty when performed. This code represents the laparoscopic repair of the
paraesophageal hernia.
43282: Laparoscopy, surgical, implantation of mesh for hiatal hernia. This code
represents the implantation of mesh.
43283: Laparoscopy, surgical, wedge gastroplasty. This code represents the
wedge gastroplasty procedure.
These three codes together accurately describe the procedures performed during the
laparoscopic repair of the paraesophageal hernia with implantation of mesh and wedge
gastroplasty.
Dr. Smith completed an initial diagnostic left heart catheterization including left
ventriculography and supravalvular aortography. At the conclusion of this diagnostic
study it was determined that the patient required a (TAVR/TAVI) transcatheter aortic
valve replacement with a prosthetic valve, which was completed via a transaortic
approach. How should Dr. Smith report his services? a. 33365-62, 93452-59, 93567 b.
33365, 93452-51, 93567-51 c. 33365-62 d. 0318T, 93452-59, 93567-51
To report Dr. Smith's services accurately for the initial diagnostic left heart
catheterization, left ventriculography, and supravalvular aortography, as well as the
subsequent transcatheter aortic valve replacement (TAVR) with a prosthetic valve via a
transaortic approach, you should choose the appropriate CPT codes. Let's break down
the procedures:
1. Initial diagnostic left heart catheterization, including left ventriculography and
supravalvular aortography.
2. Transcatheter aortic valve replacement (TAVR) with a prosthetic valve via a
transaortic approach.
Now, let's analyze the options:
a. 33365-62, 93452-59, 93567 b. 33365, 93452-51, 93567-51 c. 33365-62 d. 0318T,
93452-59, 93567-51
The correct answer is:
b. 33365, 93452-51, 93567-51
Here's the breakdown:
33365: Transcatheter aortic valve replacement (TAVR/TAVI), percutaneous, open
or via thoracotomy approach. This code represents the TAVR procedure.
93452-51: Left heart catheterization, single or multiple injections, during
congenital heart surgery; with aortic valve imaging, including aortic valve crossed
by catheter, when performed, initial diagnostic study only. The "-51" modifier is
used to indicate that this is a separate procedure from the TAVR.
93567-51: Injection procedure during cardiac catheterization; for selective
coronary angiography, each vessel studied. The "-51" modifier is used to indicate
that this is a separate procedure from the TAVR.
These codes and modifiers accurately describe the procedures performed by Dr. Smith
for the initial diagnostic study and the TAVR with a prosthetic valve via a transaortic
approach.
A patient underwent a complex cystometogram with bladder voiding pressure study and
a urethral MG. What codes should you use to report these services? a. 51728, 51784-51
b. 51725, 51785-51 c. 51726, 51797-59 d. 51728, 51784-59
To report the services for the complex cystometrogram with bladder voiding pressure
study and a urethral pressure profile (urethral MG), you should choose the appropriate
CPT codes. Let's break down the procedures:
1. Complex cystometrogram with bladder voiding pressure study.
2. Urethral pressure profile (urethral MG).
Now, let's analyze the options:
a. 51728, 51784-51 b. 51725, 51785-51 c. 51726, 51797-59 d. 51728, 51784-59
The correct answer is:
b. 51725, 51785-51
Here's the breakdown:
51725: Complex cystometrogram (ie, calibrated electronic equipment); with
voiding pressure studies (ie, bladder voiding pressure), any technique. This code
represents the complex cystometrogram with bladder voiding pressure study.
51785-51: Urethral pressure profile, any technique. The "-51" modifier is used to
indicate that this is a separate procedure from the complex cystometrogram.
These codes and modifiers accurately describe the procedures performed for the
complex cystometrogram with bladder voiding pressure study and the urethral pressure
profile (urethral MG).
