hillW7LCDassignment

docx

School

West Virginia Junior College, Charleston *

*We aren’t endorsed by this school

Course

101

Subject

Mechanical Engineering

Date

Feb 20, 2024

Type

docx

Pages

Uploaded by lunagirl84

MCCG146 – CPT and HCPCS Level II Coding Week 7 LCD/LCA/NCD Assignment Chasidy Hill Week 7 Scenario 1 Patient has been recently diagnosed with plantar fasciitis. The provider orders a static foot orthosis. HCPCS Level II code for static foot orthosis: L4397 LCD/LCA Article ID: L33686 State: Indiana Is this covered or non-covered? Yes, it can be covered Rationale: I went on the website for HCPCS Level 11 codes and searched for foot orthosis. Also, found the article ID L33686. After reading through everything these codes are the best option that I found. Scenario 2 Morbid obese patient is scheduled to have a laparoscopic sleeve gastrectomy. The patient has been non-compliant with other forms of medical treatment to lose weight and fails to quit smoking cigarettes. CPT code for laparoscopic sleeve gastrectomy: 43644 LCD/LCAArticle ID: L33411 State: California Is this covered or non-covered? No, Since the patient was non-compliant with other forms. Rationale: I went to the index of the CPT Codebook and looks up laparoscopic sleeve gastrectomy then went to Digestive section and found code 43644. I believe it would not be covered since the patient was non - compliant with other medical treatments.

MCCG146 – LCD/NCD Assignment 2 Scenario 3 Patient has a 0.9 cm benign skin lesion located on her forearm. She does not like the appearance of it and requested it to be removed. When the provider asked about the associated symptoms, the patient indicated that there were none; she just does not like the appearance. CPT code for removal of 0.9 cm benign skin lesion on forearm, simple repair: 11401 LCD/LCA Article ID: L34938 State: Indiana Is this covered or non-covered? Non-covered Rationale: I went to the index in the CPT coding book and looked up 0.9cm benign skin lesion on forearm then went to the Integumentary section and found the best option is 11401 code. The LCD/LCA article ID is L34938 in the state of Indiana. Scenario 4 Patient has had fibromyalgia for 2 years. She is requesting acupuncture of her muscles in her legs (sartorius, semimembranosus, semitendinosus, and gastrocnemius) as that is where she experiences most of her pain. CPT code for acupuncture of 3 or more muscles: 20561 NCD Manual Section Number: 30.3.3 Is this covered or non-covered? Covered Rationale: I went to the index section of the CPT coding book and looked up acupuncture of 3 or more muscles and went to the musculoskeletal section and found 20561. The NCD manual section number I found is 30.3.3. I believe this procedure will be covered. Scenario 5 Patient has a kidney stone and is scheduled for removal of the stone via nephrolithotomy. CPT for nephrolithotomy: 50060 NCD Manual Section Number: 230.1 Is this covered or non-covered? Covered Rationale: I went to the index section in the CPT coding book and looked

MCCG146 – LCD/NCD Assignment 3 up nephrolithotomy and then went to the urinary section and found 50060. I came up with 230.1 for the NCD manual section number. MCCG146 – LCD/ NCD Assignment Grading Rubric Criteria Exceeds Expectations Meets Expectations Needs Improvement Points CPT/ HCPCS Level II Code Identificatio n (50 points) 50 points 5/5 of the CPT/HCPCS Level II codes were identified accurately. 40 - 49 points 3-4 of the CPT/HCPCS Level II codes were identified correctly. 0 - 39 points 2 or fewer of the CPT/HCPCS Level II codes were identified correctly. LCD ID/NCD Identificatio n (20 points) 20 points 5/5 of the LCD IDs/NCDs were identified accurately. 15 - 19 points 3-4 of the LCD IDs/NCDs were identified accurately. 0 - 14 points 2 or fewer of the LCD IDs/NCDs were identified accurately. Rationale (30 points) 30 points The rationale provided is thorough and the explanation of 5/5 scenarios is accurate. 20 - 29 points The rationale provided is thorough and the explanation of at least 3-4 of the scenarios is accurate. 0 - 19 points The rationale provided is thorough and the explanation of 2 or fewer of the scenarios is accurate. Instructor Comments: Total Points:

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version