Diagnostic-related groups (DRGs) and ambulatory patient classifications (APCs) are similar in that they
are both:
a. Determined by HCPCS codes
b. Focused on hospital outpatients
c. Focused on hospital inpatients
d.
...
Diagnostic-related groups (DRGs) and ambulatory patient classifications (APCs) are similar in that they
are both:
a. Determined by HCPCS codes
b. Focused on hospital outpatients
c. Focused on hospital inpatients
d. Prospective payment systems -✔✔ d. Prospective payment systems
** Both are types of prospective payment systems (Casto and Forrestal 2015, 6).
A patient is treated for esophageal varices with hemorrhage due to cirrhosis. The diagnostic codes that
would be assigned are:
I85.01 Esophageal varices with bleeding
I85.11 Secondary esophageal varices with bleeding
K74.60 Unspecified cirrhosis of liver -✔✔ d. K74.60, I85.11
K74.60: Unspecified cirrhosis of liver
I85.11:Secondary esophageal varices with bleeding
**The patient has cirrhosis of the liver with resulting bleeding esophageal varices. Cirrhosis of liver is
sequenced first followed by the code for the bleeding esophageal varices (HHS 2017, Section I.A.13, 11).
Assign the code(s) for bronchoscopy with bilateral transbronchial biopsy for each lobe of each lung.
31628 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with
transbronchial lung biopsy(s), single lobe31629 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with
transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i)
31632 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with
transbronchial lung biopsy(s), each additional lobe
−50 Bilateral procedure -✔✔
Assign the code(s) for endoscopic sinusotomy with bilateral anterior ethmoidectomy.
31231 Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)
31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial (anterior)
−50 Bilateral procedurea.
a. 31254
b. 31254-50
c. 31254, 31254
d. 31231
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