Quiz 8
In the CPT® book, 28400 and 28405 are used when coding a calcaneal fracture. What is the difference between these two codes?
Correct Answer: c. One includes manipulation and one does not Response Feedback: RATIONALE: Both codes are used when coding a CLOSED treatment of a fracture, which means that the fracture (skin) is not opened to view; surgery is not applicable for either procedure. The first code states "without manipulation" after the semicolon, and the second code states "with manipulation." Internal fixation would require surgery, and that is not a closed treatment.
How would compartment syndrome of the lower extremity caused by an auto accident be listed?
Correct Answer: a. Syndrome, compartment, traumatic, lower extremity Response Feedback: RATIONALE: Compartment syndrome is listed under Syndrome in ICD-9-CM. The three sub-categories are non-traumatic, post-surgical, and traumatic. An auto accident would be considered a traumatic injury.
How would you code a fracture of the femoral neck due to osteoporosis?
Correct Answer: c. 733.14, 733.00 Response Feedback: RATIONALE: Code 733.14 describes a pathological fracture of the femoral neck; 733.00 is the code for osteoporosis. The acute condition is coded first (fracture), followed by the chronic condition (osteoporosis).
The muscles that help control movement of the body, maintain posture, and help produce heat are of what type?
Correct Answer: a. Striated or skeletal Response Feedback: RATIONALE: Striated or skeletal muscles are often attached to bones, and help move the body. They are considered voluntary muscles—meaning we have control over their movement.
The patient came to the office for a therapeutic injection, left shoulder subacromial space. How would you code the procedure?
Correct Answer: b. 20610 Response Feedback: RATIONALE: Code 20610 describes an arthrocentesis, aspiration and/or injection; major joint or bursa (e.g.; shoulder, hip, knee joint, subacromial bursa). The code indicates that the arthrocentesis is for aspiration and/OR injection, so this can be used for an injection alone. The drug used in the injection (usually a steroid) is coded separately. Any E/M service, if significant and separately identifiable, also may be reported (append modifier 25 to the appropriate E/M service code).
Julia tripped and fell down three stairs in her apartment. X-rays show a fracture of the metatarsal bone of her left great toe, and the physician treats this fracture with a special orthotic boot. How would you code the physician's services?
Correct Answer: c. 28470-TA Response Feedback: RATIONALE: This would be considered a closed treatment because no surgery was performed. The orthotic boot could be coded separately, by whomever supplied it.
Jeff is a 13-year-old boy who fractured his left radius and ulna while snowboarding. Three weeks after the physician placed a long arm cast on Jeff, he was skateboarding and crushed the cast (without further injury to the arm). The physician replaces the cast with a short-arm fiberglass cast. How would you code the services provided after the skateboard accident?
Correct Answer: c. 29075-58 Response Feedback: RATIONALE: The first cast or splint is included as part of the initial fracture treatment; because this was a replacement cast, it can be coded.
Mrs. Smith underwent an arthrodesis of her spine for spinal deformity, posterior approach, segments L3-L5. How is this arthrodesis coded?
Correct Answer: d. 22800 Response Feedback: RATIONALE: Spinal arthrodesis is coded based on the approach; L3-L5 is considered to be three segments. Instrumentation also would be coded for this procedure, if it were used.
In ICD-9-CM, nursemaid's elbow is listed under:
Correct Answer: d. Dislocation, elbow Response Feedback: RATIONALE: Nursemaid's elbow is a partial dislocation of the proximal radial head, occurring in young children.
This type of connective tissue attaches a muscle to a bone:
Correct Answer: d. Tendon Response Feedback: RATIONALE: Tendons attach muscles to bone, and ligaments attach bones to other bones.