CPC Chapter Review - Hemic & Lymphatic - Medical Coding Course Review and Practice Questions

Summary

In this medical coding review session, Victoria Mole focuses on CPT and ICD-10 coding for the lymphatic system, covering procedures like spleen excisions, bone marrow transplants, and lymph node surgeries. She explains key concepts such as the difference between limited and radical lymphadenectomy, as well as the distinctions between bone marrow biopsy and aspiration. Victoria also addresses the anatomical components of the lymphatic system, including the tonsils, spleen, and thymus. Throughout the session, she provides coding examples and decision-making tips to help viewers understand and apply the correct codes for various lymphatic and hematological procedures.

Takeaways

• 😀 The medical coding review focuses on hematology (heme) and lymphatics (lymph), which is often covered alongside cardiovascular coding due to their proximity in the CPT chapters.
• 😀 Medical coding for the spleen includes procedures like excision, repair, laparoscopies, and bone marrow procedures such as biopsies and post-transplantation cellular infusions.
• 😀 Lymphatic system procedures include lymphadenectomy (limited and radical), mediastinum and diaphragm surgeries, and various lymph node-related procedures.
• 😀 ICD-10-CM codes for lymphatic neoplasms cover malignant tumors, diseases of the veins and lymphatic vessels, and conditions related to circulatory systems.
• 😀 The lymphatic system transports lymph (fluid containing infection-fighting white blood cells) and consists of vessels, lymph nodes, and organs such as tonsils, spleen, and thymus.
• 😀 Limited lymphadenectomy involves removing only lymph nodes, while radical lymphadenectomy removes lymph nodes along with surrounding tissues and glands.
• 😀 Bone marrow procedures are differentiated between biopsy (removal of a bone sample with attached marrow) and aspiration (removal of marrow fluid).
• 😀 When coding for mediastinal tumor resection, the appropriate CPT code is 39220, with ICD-10 code D15.2 for benign tumors.
• 😀 For a percutaneous needle biopsy of the mediastinum, the correct CPT code is 32408, which includes imaging guidance when performed.
• 😀 To answer exam questions regarding the lymphatic system, referencing anatomical illustrations and coding books is key to identifying whether an organ is part of the lymphatic system.

Q & A

What is the primary function of the lymphatic system?

The primary function of the lymphatic system is to transport lymph, which contains infection-fighting white blood cells, throughout the body. It helps rid the body of toxins, waste, and other materials.

Which organs are part of the lymphatic system?

The lymphatic system includes the lymphatic vessels, lymph nodes, tonsils, adenoids, spleen, and thymus.

What is the difference between a limited and a radical lymphedectomy?

A limited lymphedectomy involves removing only the lymph node, whereas a radical lymphedectomy removes the lymph nodes along with surrounding glands and tissues.

How do a bone marrow biopsy and a bone marrow aspiration differ?

In a bone marrow biopsy, a small sample of bone with the attached marrow is taken using a needle, whereas in a bone marrow aspiration, only the marrow fluid is extracted using a needle or trocar.

What ICD-10 code is used for a benign tumor in the mediastinum?

The ICD-10 code for a benign tumor in the mediastinum is D15.2.

Which CPT code is used for the resection of a benign tumor of the mediastinum?

The CPT code for the resection of a benign tumor of the mediastinum is 39220.

What is the difference between CPT codes 39220 and 39010?

CPT code 39220 refers to the resection of a mediastinal tumor, whereas CPT code 39010 refers to a mediastinotomy with exploration and drainage removal, which is a different procedure.

What CPT code is used for a percutaneous needle biopsy of the mediastinum?

The CPT code for a percutaneous needle biopsy of the mediastinum is 32408.

Why does CPT code 32408 fall under the respiratory system section despite being related to the mediastinum?

CPT code 32408 falls under the respiratory system section because the mediastinum is closely related to the lung area, and the procedure is often performed in that context.

What are the common diseases categorized under ICD-10 Chapter 9 related to the lymphatic system?

ICD-10 Chapter 9 includes diseases of the circulatory system, specifically diseases of the veins, lymphatic vessels, and lymph nodes (I-80 through I-89), as well as conditions like lymphangitis in Chapter 12.