CPC CPT Surgery: Musculoskeletal System 2 — Questions and Answers
Question 1: A coder is assigning a code for spinal fusion. Which component is NOT separately reported when included in the primary fusion procedure?
- Bone graft harvested from the same incision site (Correct answer)
- Implantable spinal device placement
- Laminectomy at the fusion level
- Neuromonitoring performed by a separate provider
Correct answer: Bone graft harvested from the same incision site
Bone graft obtained through the same incision as the fusion is considered integral and not separately reportable.
Question 2: Which CPT code describes total knee arthroplasty (TKA)?
- 27447 (Correct answer)
- 27440
- 27442
- 27445
Correct answer: 27447
CPT 27447 describes arthroplasty, knee, condyle and plateau (medial AND lateral compartment) with or without patella resurfacing — the standard total knee replacement code.
Question 3: What does the surgical package (global surgery concept) typically include for musculoskeletal procedures?
- Pre-op evaluation on day of surgery, intra-op services, and uncomplicated post-op care (Correct answer)
- All E/M visits for one year post-surgery
- Physical therapy after discharge
- Diagnostic imaging ordered after surgery
Correct answer: Pre-op evaluation on day of surgery, intra-op services, and uncomplicated post-op care
The global surgical package includes the pre-op visit on day of surgery (or one day prior for major), intra-operative services, and routine post-op care within the global period.
Question 4: A physician performs closed treatment of a distal radius fracture without manipulation. Which CPT code applies?
- 25600 (Correct answer)
- 25605
- 25607
- 25624
Correct answer: 25600
CPT 25600 is closed treatment of distal radial fracture (e.g., Colles or Smith type) without manipulation.
Question 5: When coding multiple surgical procedures performed during the same operative session by the same surgeon, which modifier indicates the secondary procedure?
- Modifier -51 (Correct answer)
- Modifier -59
- Modifier -22
- Modifier -47
Correct answer: Modifier -51
Modifier -51 (Multiple Procedures) is appended to the secondary and subsequent procedures to indicate multiple procedures were performed at the same session.
Question 6: A patient has a 2.5 cm benign soft tissue tumor excised from the subcutaneous tissue of the forearm. Which CPT code applies?
- 25111 (Correct answer)
- 25110
- 25075
- 25076
Correct answer: 25111
CPT 25111 describes excision of ganglion, wrist (dorsal or volar); however, for a soft tissue tumor of the forearm subcutaneous tissue, CPT 25075 (excision, tumor, soft tissue, forearm and/or wrist area, subcutaneous) applies.
CPC CPT Surgery: Musculoskeletal System 2
A coder is assigning a code for spinal fusion.
Which component is NOT separately reported when included in the primary fusion procedure?