CPC Surgical Coding Principles 2 — Questions and Answers
Question 1: What is the correct code sequence when a surgeon performs an unplanned return to the OR during the global period?
- Append modifier -78 (Correct answer)
- Append modifier -79
- Append modifier -76
- No modifier needed
Correct answer: Append modifier -78
Modifier -78 is used for an unplanned return to the operating room for a related procedure during the postoperative period.
Question 2: Which CPT subsection is used to report wound repair involving the use of local anesthesia, chemical or electrocauterization, thermocauterization, and/or adhesive strips?
- Simple repair (Correct answer)
- Intermediate repair
- Complex repair
- Layered closure
Correct answer: Simple repair
Simple repair involves superficial wound closure with a single-layer closure and local anesthesia or adhesives.
Question 3: When coding an open fracture treatment, what does the CPT definition of 'open treatment' mean?
- The fracture site is surgically opened for visualization (Correct answer)
- The skin overlying the fracture is broken
- The fracture fragments are displaced
- The patient has a compound injury
Correct answer: The fracture site is surgically opened for visualization
In CPT terminology, 'open treatment' means the fracture site is surgically opened and exposed, regardless of whether the overlying skin is intact.
Question 4: Which modifier is appended when a procedure is discontinued after anesthesia was administered but before the surgical incision?
- -53 (Correct answer)
- -52
- -73
- -74
Correct answer: -53
Modifier -53 is used by physicians when a procedure is discontinued after anesthesia induction due to extenuating circumstances.
Question 5: In the Surgery section, what is a 'separate procedure' designation?
- A procedure not billable when performed with a related, more comprehensive service (Correct answer)
- A procedure always billed independently
- A procedure requiring a different surgeon
- A procedure requiring prior authorization
Correct answer: A procedure not billable when performed with a related, more comprehensive service
A 'separate procedure' code should not be reported when it is performed as an integral part of a more comprehensive procedure.
Question 6: What does unbundling refer to in surgical coding?
- Billing component parts of a procedure separately when a comprehensive code exists (Correct answer)
- Combining two procedures into one code
- Reporting a lesser procedure than performed
- Using multiple modifiers on a single claim
Correct answer: Billing component parts of a procedure separately when a comprehensive code exists
Unbundling is the improper practice of billing separately for services that should be included in a single comprehensive CPT code.
CPC Surgical Coding Principles 2
What is the correct code sequence when a surgeon performs an unplanned return to the OR during the global period?