Monthly Madness

Front 1

CMS changed the DRG system to the total number of DRGS from 538 to what?

Back 1

745 MS DRGS

Front 2

True or False-2 examples of CCs that were removed from the MCC and CC list with the new DRGs are CHF and Acute Blood loss anemia

Back 2

False. It is chronic blood loss anemia that was removed, not acute.

Front 3

CMS will reduce the payment rate for FY 2008 by what percentage?

Back 3

1.2%

Front 4

What is a Catheter via burr hole and when do you use the code (01.28)?

Back 4

Code 01.28, Placement of intracerebral catheter via burr hole was created for insertion of an intracerebral catheter to deliver medication directly to the brain. Only assign code 01.28 when the burr hole is for administrating meds directly to the brain.

Front 5

what is the difference between Protein malnutrition and Protein calorie malnutrition?

Back 5

Protein malnutrition is usually caused by inadequate nutrients intake in conjunction with the stress response. Protein calorie malnutrition is long-term nutritional repletion is usually required. Typically emaciated, elderly and chronically ill.

Front 6

TRue or false
Severe protein calorie malnutrition is a CC with the new DRG system.

Back 6

False. It is a MCC.

Front 7

what is the definition of a free skin graft?

Back 7

An unattached portion of skin that is transferred to another site.

Front 8

What CPT codes are used to code for autogenous tissue cultured skin grafts?

Back 8

Codes 15100-15121

Front 9

What is adjacent Tissue Transfer/Flaps?

Back 9

A tissue flap is created by surgically freeing the skin and underlying subcutaneous tissue and/or fascia. The base of the tissue flap remains connected to one or more borders of the donor site.

Front 10

WhatCPT code would you use to report adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips defect 10sq cm or less?

Back 10

14060

Front 11

what is the appropriate code to report for cryo-destruction of cutaneous vascular proliferations?

Back 11

Depending on the size of the proliferative lesion, code 171076 Destruction of cutaneous vascular proliferative lesions (eg. Laser technique); less than 10 sq cm, code 17107 Destruction of cutaneous vascular proliferative lesions (eg. Laser technique); 10.0 to 50.0 sq cm, or code 17108, Destruction of cutaneous vascular proliferative lesions (eg. Laser technique); over 50.0 sq cm, would be appropriate.

Front 12

What is the appropriate code to report for destruction of bleeding ectasias, such as spider angioma?

Back 12

Code 17110, Destruction(eg. Laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement) of benign lesions other than skin tags or cutaneous vascular lesions; up to 14 lesions, and code 17111, Destruction (eg. Laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement) of benign lesions other than skin tags or cutaneous vascular lesions; 15 or more lesions should be reported for treating ectasias that are disfiguring or bleeding as appropriate.

Front 13

What is the appropriate code to report for placement of 2 chest tubes inserted into the pleural cavity, one on the left side and one on the right side, in the same setting?

Back 13

Code 32020, Tube thoracostomy with or without water seal (eg. For abscess, hemothorax, emphysema,) (separate procedure), describes the insertion of a tube through one of the intercostals spaces into the pleural cavity. Fluid is drained from the pleural cavity through the tube. If the chest tubes are inserted into the pleural cavity on both the left and right sides, then the code 32020 should be reported one time appended by modifier 50, bilateral procedure. Modifier 50 indicates that the tubes were placed bilaterally.

Front 14

How should a diagnosis of lymphoma with malignant pleural effusion be coded?

Back 14

Assign code 202.80, Other lymphomas, unspecified site, extranodal and solid organ sites, for the lymphoma and code 197.2, Secondary malignant neoplasm of respiratory and digestive systems, Pleura, for the malignant pleural effusion. There are no coding guidelines that prohibit the assignment of these codes together. Per the ICD 9 cm index, malignant pleural effusion is classified as a secondary malignant neoplasm. Coding clinic p. 3.

Front 15

2. The physician listed alcoholic cirrhosis as well as cirrhosis due to chronic hepatits C. However, coding both alcoholic and nonalcoholic cirrhosis is contradictory and may distort statistics. In this case, the physician’s documentation clearly supports both diagnoses. What are the appropriate code assignments?

Back 15

Assign code 571.2, alcoholic cirrhosis of liver, and code 070.54, chronic hepatitis C without mention of hepatic coma. The assignment of code 571.5 identifies cirrhosis of the liver without mention of alcohol and is unnecessary because the cirrhosis associated with the hepatitis is included in code 070.54.