- In the case of a hip revision surgery, which CPT® code should be used if both the complete acetabular and complete femoral components are revised?
A. 27137
B. 27134
C. 27138
D. 27091
Rationale: In cases where the femoral head and acetabular liner are exchanged, but not the femoral stem and acetabular cup, it is appropriate to use code 27134 Revision of total hip arthroplasty, both components (acetabular and femoral), with or without autograft or allograft.
2. A patient arrived at the ER with shortness of breath. After radiology and other tests, it is determined that she has bronchiolitis obliterans, more popularly known as popcorn lung. The physician directly links this condition to her vaping habit. How is this coded?
A. U07.0, J44.81, F17.290
B. U07.1, J44.81, F17.210
C. U07.0, J44.81, F17.210
D. U07.1, J44.81, F17.290
Rationale: Answers B and D can be eliminated because those include U07.1 COVID-19, which is not mentioned in the scenario. Answer C is incorrect because the popcorn lung is vaping-related, and F17.210 Nicotine dependence, cigarettes, uncomplicated refers to cigarette smoking.
3. A patient has arrived for a review of his chronic conditions. He has hypertension and used to smoke cigarettes but has changed to vaping in hopes that it is a healthier choice. How is this coded?
A. I10, Z87.891, F17.211, F17.290
B. I15.9, U07.0, F17.290
C. I10, F17.290
D. U07.1, I10, F17.210, F17.290
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Rationale: You can rule out answer A because it doesn’t say the patient’s cigarette use is in remission (represented by code F17.211 Nicotine dependence, cigarettes, in remission) or that it’s a complete quit (F17.290 Personal history of nicotine dependence). You also can rule out answer B because there is no mention that the hypertension is secondary. And lastly, you can rule out answer D because there is no mention of U07.1 COVID-19.
4. A doctor documents “Cyclops lesion in RT knee status post-ACL repair 2 years ago.” How is this coded?
A. M24.661
B. T84.82XA
C. T84.82XA, M24.661
D. M24.661, T84.82XA
Rationale: Oftentimes, cyclops lesion or cyclops syndrome is coded for ankylosis of the knee joint (stiffness of the knee) M24.661 (right) or M24.662 (left). The first-listed code, however, should be T84.82XA Fibrosis due to internal orthopedic prosthetic devices, implants and grafts, initial encounter. This is then followed by the ankylosis code to identify the specific complication.
5. When an infection occurs after a hip replacement, which CPT code is used for a procedure where the surgeon performs debridement but no components are exchanged?
A. 27091
B. 20704
C. 27030
D. 27134
Rationale: The surgeon performs a thorough debridement of the hip joint. No components are exchanged. This is coded as CPT 27030 Arthrotomy, hip, with drainage (e.g., infection).
6. In the case of a staged revision for infection after a hip replacement, which CPT code should be used for the second stage of the surgery, once the infection has resolved and the new total hip arthroplasty components are implanted?
A. 27030
B. 27137
C. 27134
D. 27091
Rationale: In the second stage of the surgery, which occurs once the infection has been resolved, the surgeon removes the temporary spacer and replaces it with a new, balanced, and functional hip arthroplasty. This is reported as a full revision procedure with 27134 Revision of total hip arthroplasty, both components (acetabular and femoral), with or without autograft or allograft.
7. How many post-op days are in the global period for a major surgery?
A. 0
B. 10
C. 30
D. 90