A dermatologist excises a 3.5 cm benign lesion from a patient’s back. After the lesion is successfully removed, the dermatologist performs an intermediate 3.5 cm layered closure. How should you report these services?

A patient presents to have corns removed from his foot. The physician performs paring to successfully remove four lesions. How should the physician report these services.

The physician removes a tumor from the patient’s neck using the Mohs micrographic surgery technique. During the first stage, the physician takes four tissue blocks and reviews them under a microscope. The exam of the tissue blocks reveals a second stage is necessary to remove areas where the tumor is still present. The physician removes two additional tissue blocks. What are the appropriate CPT® codes for reporting the procedure?

10-year-old riding his bike struck a tree stump throwing him off his bike. He received multiple lacerations. He had a 3 cm dermis laceration on his scalp with two 0.5 cm lacerations on his face. His right arm had a 5 cm laceration and right leg has a 5cm laceration. The physician stapled the laceration for the scalp. Physician used steri-strips to close the wounds on the face. The legs and arms were cleaned by heavily irrigating them with normal saline and removal of debris performed on both wounds, followed with a single- layer closure. Select the repair codes to report.

Pre-Procedure Diagnosis: Basal cell carcinoma, left chin. Procedure: Wide local excision of 3.0 cm with 0.3 cm margin basal cell carcinoma of the left chin with a 4 cm closure. Procedure: The patient’s left chin was examined. The site of intended excision was marked out. The site was then prepped. The patient was then prepped and draped in the usual fashion. A 15 blade scalpel was then used to make an incision in the previously marked site. It was carried down to the subcuticular fat. The lesion was then sharply dissected off underlying tissue bed using a 15- blade scalpel. It was tagged for pathologic orientation. The hyfrecator was used for hemostasis. The wound was then closed by advancing the tissue surrounding the lesion and closing in layers with 3-0 Vicryl for the deep layer, followed by 5-0 Prolene for the skin. The skin closure was in a running subcuticular fashion. Steri-Strips were then applied. What are the procedure codes?

A 52-year-old patient had a right breast reconstruction with free flap. The surgeon used a microsurgical technique requiring an operating microscope. How would you report this procedure?

A foreign body was removed during an excisional debridement procedure involving the subcutaneous tissue of Robert’s left elbow. Robert suffered an open dislocation to this site. How should the physician code this procedure?

A 45-year-old male presents in the office with an ingrown toenail on the right and left foot. The procedure was discussed in detail and the patient elected to have it performed. The right foot was prepped and draped in sterile fashion. The right great toe was anesthetized with 50/ Solution of 2 percent lidocaine and .05 percent Marcaine. A mini-tourniquet was placed around the toe for hemostasis in which part of the nail plate and maxtrixectomy were performed.. Phenol was then applied, the toe was then flushed. Tourniquet was released and dressing applied. At this time the patient elected to only have one performed and will return in two weeks for the left foot. Code the procedure.

A 36-year-old male presents to have multiple lesions destroyed. Three benign lesions on his face are destroyed and five actinic keratoses on his left arm are destroyed. Codes for the procedures are:

Dr. Alice, a plastic surgeon, completed a bilateral rhytidectomy of the neck and a suction assisted lipectomy of the right upper arm. What codes should be reported for Dr. Alice’s service.

What CPT code would best describe the treatment of 9 planter warts removed and 6 flat warts all destroyed with cryosurgery during the same office visit?

The physician performs simple repairs for three lacerations measuring 2.0 cm, 3.0 cm, and 3.0 cm, respectively, on the forearm. There is an additional 1.0 cm intermediate repair, also on the forearm. Which is the proper coding?

The physician documents a complex repair, chest, 15.0 cm. Which is the appropriate coding?

With which of the following codes for excision of pressure ulcer may you separately report skin graft to close the surgical wound?

Patient has basal cell carcinoma on his upper back. A map was prepared to correspond to the area of skin where the excisions of the tumor will be performed using Mohs micrographic surgery technique. There were three tissue blocks that were prepared for cryostat, sectioned, and removed in the first stage. Then a second stage had six tissue blocks which were also cut and stained for microscopic examination. The entire base and margins of the excised pieces of tissue were examined by the surgeon. No tumor was identified after the final stage of the microscopically controlled surgery. What procedure codes should be reported?

28-year-old patient had an abscess by her vulva which burst. She has developed a soft tissue infection caused by gas gangrene. The area was debrided of necrotic infected tissue. All of the pus was removed and irrigation was performed with a liter of saline until clear and clean. The infected area was completely drained and the wound was packed gently with sterile saline moistened gauze and pads were placed on top of this. The correct CPT® code is:

CPT® 2014 introduces new code(s) to describe breast biopsy, with placement of localization devices and imaging guidance. Which codes are these?

32-year-old female who has multiple sclerosis fell from her walker and landed on a glass table. She lacerated her forehead, cheek and chin and the total length of these lacerations was 6 cm. Her right arm and left leg had deep cuts measuring 5 cm on each extremity. Her right hand and right foot had a total of 3 cm lacerations. The ED physician repaired the lacerations as follows: The forehead, cheek, and chin had debridement and cleaning of glass debris with the lacerations being closed with 6-0 Prolene sutures. The arm and leg were repaired by 6-0 Vicryl subcutaneous sutures and Prolene sutures on the skin. The hand and foot were closed with adhesive strips. Select the appropriate procedure codes for this visit.

James suffered a severe crushing injury to his left upper leg. Two days after surgery, Dr. Barnes completed a dressing change under general anesthesia. How would you report this service?

A patient had a chest wall tumor excised. The procedure involved the ribs with plastic reconstruction and mediastinal lymphadenectomy. How would you report this service?

The dermatologist excises an irregularly shaped, malignant lesion from a patient’s left shoulder. The lesion measures 1.5 cm at its widest. To ensure removal of all malignancy, the dermatologist allows a margin of at least 1.5 cm on all sides. Which is the proper coding?

The surgeon removes a malignant lesion 2.5 cm in diameter, including margins, from the back of the hand. A frozen section reveals the need to excise an additional 2.0 cm margin on all sides to guarantee removal of all malignant tissue. The re-excision is performed during the same operative session. Which is the proper coding?

The physician excises three lesions, all from the left arm, with sizes 1.0 cm (benign), 1.5 cm (benign), and 2.5 cm (malignant). Which is the proper CPT® coding?

For decompression fasciotomy of the leg without debridement. What CPT code would you assign?

A patient admitted with the complaints of decubitus ulcer. Pre-operative work up planned. Excision of sacral pressure, with skin flap closure without ostectomy.

For incision and drainage of paronchyia. What CPT code would you assign?

If biopsy of a suspected skin cancer is performed on the same day as Mohs surgery because there was no prior pathology confirmation of a diagnosis. Then what code should we report for the skin biopsy and frozen section of pathology.

The physician removes a tumor from the patient’s arms using the Mohs micrographic surgery technique during that physician performed routine frozen section stain. During the first stage, the physician takes four tissue blocks and reviews them under a microscope. The exam of the tissue blocks reveals a second stage is necessary to remove areas where the tumor is still present. The physician removes two additional tissue blocks. What are the appropriate CPT® codes for reporting the procedure?

Patient came with pain in the breast, right side, tenderness+, and redness+. Puncture was done for the aspiration of cyst with magnetic resonance guidance for needle placement including supervision and interpretation.

Patient came with the complaints of hardness in the breast. Physician performed breast reconstruction by free flaps, harvesting of the flap, micro vascular transfer, closure of the donor site, and inset shaping the flap into the breast.