This Week Assignment Question & Answer Guide (With Explanation)

This question focuses on applying theory to practical scenarios.

What This Question Is About

This question relates to this week assignment and requires a structured academic response.

How to Approach This Question

Focus on explaining concepts clearly and supporting them with examples.

Key Explanation

This topic involves this week assignment. A strong answer should include explanation, application, and examples.

Original Question

This week’s assignment involves the coding of 3 case studies followed by the completion of the bottom portion of the CMS 1500 claim form. This part of the claim form is for your practice in documenting the CPT codes and the ICD-10 codes that meet the requirement for medical necessity. We are going to pretend that the 3 fictitious case studies are being performed in an outpatient surgical facility. This activity that will help to instill in you the ability to choose the CPT codes that are the most labor intensive. Connect the CPT code on a claim form with the ICD-10 code that demonstrates medical necessity. This information will go on the HCFA 1500 claim form. I only need help with the CPT code, modifiers, and the ICD-10-CM’s that follow the above directions. 17 – The physician’s name (DO NOT NEED) 21 – The ICD-10 codes 24 A – The date of service with no spaces(MM DD YYYY). DO NOT NEED) 24 D – The CPT code and up to four modifiers 24 E – the ICD-10 indicator, which will be the letter of the code in box 21 of the ICD-10 codes that shows medical necessity for each CPT code. Case Study 1: Dr. Bones DOS 02-17-2020 A Grade I, high velocity open right femur shaft fracture was incurred when a 15-year-old female pedestrian was hit by a car. She was taken to the operating room within four hours of her injury for thorough irrigation and debridement, including excision of devitalized bone. The patient was then reprepped, redraped, and repositioned. Intramedullary rodding was then carried out with proximal and distal locking screws. Codes to use: 11012 Intramedullary rod, RVU = 6.87 27506, RVU = 19.65 Modifier -51 needs to be added to your second listed CPT code ICD-10 = S72.309B Case Study 2: Dr. Cystspur DOS 02-15-2020 Under general anesthesia, a curvilinear incision was centered over the lesion itself. Soft tissue dissection was carried down through to the ganglion. The ganglion was clearly identified as a gelatinous material. It was excised directly off the bone and sent to pathology. There was noted to be a large bony spur at the level of the 1st metatarsal. Using double action rongeurs, the spur itself was removed and sequestrectomy was performed. Following that, a rasp was utilized to smooth the bone surface. The eburnated bony surface was then covered, utilizing bone wax. The wound was irrigated and closed in layers. Codes to use: 28122 – RVU = 6.76 28090 – RVU = 4.55 Modifier -51 needs to be added to your second listed CPT code ICD-10 codes: M77.32 bone spur M67.472 ganglion left foot Case Study 3: Dr. Nodes DOS 02-16-2020 An operative report lists excisional bilateral biopsies of deep cervical nodes and biopsy of right deep axillary nodes as the procedures performed. The pathology report comes back confirming lymphadenitis. . Codes to Use: 38525-RT axillary – RVU = 6.43 38510 cervical – RVU = 6.74 x 2 Modifier -51 needs to be added to your second listed CPT code Modifier -50 needs to be added to the bilateral procedure ICD-10 codes: L04.9 bilateral Cervical L04.2 right axillary

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