TLDR;
Alright, so in this video, we're tackling some important practice questions related to coding guidelines for the CPC exam in 2025. The main areas covered are ICD-10-CM guidelines, CPT coding, modifier usage, and understanding parenthetical notes. Key takeaways include using modifier 59 for distinct procedures, selecting specific ICD-10-CM codes, understanding the global surgical package, and differentiating between diagnostic and screening codes.
- Modifier 59 indicates distinct procedures.
- ICD-10-CM codes must be specific.
- Global surgical packages include pre- and post-operative care.
- Diagnostic codes are for diagnosed conditions, not screening codes.
Introduction [0:03]
The video kicks off with a welcome and an intro to the topic: solving practice questions on coding guidelines for the 2025 CPC exam. It's highlighted that coding guidelines are super important, with about seven questions in the CPC exam covering ICD-10-CM, CPT, modifiers, and parenthetical notes. The presenter encourages viewers to like, share, and subscribe to the channel.
CPT Coding and Modifier 59 [0:41]
The first question is about CPT coding: when two procedures are performed together but aren't usually reported together, what do you do? The options are unbundling, using a bundled code, applying modifier 59, or reporting only the primary procedure. The correct answer is modifier 59, which tells that the procedures are distinct and unrelated, preventing unbundling errors when services usually bundled are done separately.
Scenarios for Modifier 59 [1:20]
Next up, the video asks which scenario needs modifier 59 to show a distinct procedural service. The choices are procedures on the same organ, unrelated procedures at the same visit, a complex procedure bundled into a simpler one, and a diagnostic service with a therapeutic procedure. The right answer is unrelated procedures at the same visit. Modifier 59 is used when procedures on the same day are distinct and should be reported separately, but not when they're related.
ICD-10-CM Coding Guidelines [2:11]
The third question focuses on ICD-10-CM codes. The options are about whether ICD codes are only for inpatient diagnostic coding, whether every code must be specific, whether the first-listed diagnosis must always be primary, and whether you can use a broad code as long as it's in the same chapter. The correct answer is that every ICD-10-CM code must be specific to the condition and include all relevant details. Coders need to pick the most detailed and specific code that reflects the patient's exact condition.
Global Surgical Package [3:00]
The video then asks which service isn't covered under the global surgical package. The options are pre-operative visits, inpatient care, post-operative care within the global period, and follow-up visits for an unrelated issue. The correct answer is follow-up visits for unrelated issues. The global surgical package includes pre-operative, intra-operative, and post-operative care, but not routine follow-ups unrelated to the surgery.
Diagnostic vs. Screening Codes [3:34]
The last question covers correct coding practice when doing a diagnostic test for a patient already diagnosed with a condition. The choices are always using a screening code, using a diagnostic code, coding for both diagnosis and symptoms, and only using the ICD-10 code for the condition being treated. The right answer is to use a diagnostic code, not a screening code. If the patient is already diagnosed, use diagnostic codes instead of screening codes, which are for patients without the condition.
Conclusion [4:14]
The video wraps up with a thank you and a see-you-next-time message.