Question

An 80-year-old gentleman presented to the hospital outpatient surgical unit for the removal of a cortical senile cataract from his left eye. The patient underwent an extra capsular cataract extraction with anterior chamber intraocular lens (IOL) implant insertion. There were no problems, and the patient was sent to the recovery room in good condition. He was later discharged home to be followed in the office.

Assign the ICD-10-CM code(s) to the first-listed diagnosis. Assign the CPT HCPCS level II code(s) to the procedure(s).

Enter the patient's CPT and HCPCS level II code(s) in the APC grouper software. Review the APC grouper results and answer the following question:

To which APC does this patient group?

Answer 1

ICD-10-CM code for the first listed diagnosis cortical senile cataract of the left eye is

- H25.012

CPT code for the procedure extra-capsular cataract extraction with IOL insertion is

- 66984

HCPCS level II code for the Anterior chamber IOL is

- V2630

APC to which patient is grouped based on CPT and HCPCS:

- Surgical procedure

APC grouping is used to determine the type and quantity of resources utilized based on which the billing will be mapped to the code with similar costs.