Resolved CPC Practice Test (Sapphire)

[HeatherB_67613]

I have a question regarding the CPC practice test (sapphire). I'm a little confused on the codes that say "separate procedure" such as on question 10, code 29875. I thought you could only code a "separate procedure" code by itself? But the rationale for this question said that if you append modifier 59 to indicate it was done at a separate site it was okay and can be used along with another procedure code (answer A). Is this true for every separate procedure? For question 10 I chose answer C because I saw that 29875 was a separate procedure and I figured that since you couldn't code it with another procedure that the synovectomy was bundled into the 29880 code.

How can I avoid making this mistake again?

 

[Lori]

CPT “Separate procedure” definition:

The narrative for many HCPCS/CPT codes includes a parenthetical statement that the procedure represents a "separate procedure". The inclusion of this statement indicates that the procedure can be performed separately but should not be reported when a related service is performed. A “separate procedure” should not be reported when performed along with another procedure in an anatomically related region through the same skin incision or orifice, or surgical approach. HCPCS/CPT code____ (the column two HCPCS/CPT code) is designated as a "separate procedure". Therefore, if it is reported with HCPCS/CPT code______ (the column one HCPCS/CPT code), HCPCS/CPT code (the column two HCPCS/CPT code) is bundled into HCPCS/CPT code_____ (the column one HCPCS/CPT code).

https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/Downloads/2017-NCCI-Correspondence-Manual.pdf