Pass the AAPC Certified Professional Coder CPC Questions and answers with ExamsMirror

Esotropia of the right eye: Indicates strabismus surgery is required.

Resection of medial rectus horizontal and lateral rectus muscles: Specific muscles addressed during the surgery.

Adjustable sutures: Used in securing the muscles, indicating specific techniques.

Extensive scar tissue from previous surgery: Requires additional work and isolation.

CPT codes 67314 and 67334 are used to report the resection of two muscles with adjustable sutures (67314) and surgery on an extraocular muscle involving extensive scar tissue (67334).

References: AMA's CPT® Professional Edition (current year)

1. Procedure and CPT® Code Selection:

The procedure performed was a hysteroscopy to examine the uterine cavity due to abnormal vaginal bleeding. This is a diagnostic hysteroscopy.

CPT® Code 58555 is specifically for a diagnostic hysteroscopy to examine the uterine cavity, which aligns with the procedure performed in this case.

2. Rationale for Excluding Other Options:

Code 58558 is for a hysteroscopy with a surgical procedure, such as biopsy or removal of a lesion or polyp, which was not performed in this case.

Code 58579 is an unlisted procedure code for the female genital system and is unnecessary here because there is a specific code (58555) for diagnostic hysteroscopy.

Code 58578 is also an unlisted hysteroscopic procedure code and is not appropriate when a specific diagnostic code exists.

3. AAPC and CPT® Coding Guidelines:

AAPC guidelines indicate that 58555 should be used for diagnostic hysteroscopy procedures without any surgical intervention.

Therefore, the correct answer, following CPT® guidelines, is C. 58555.

The scenario involves a secondary repair of two flexor tendons in the forearm. CPT® code 25272 describes the repair of a secondary flexor tendon injury, including a graft, in the forearm and/or wrist, which fits the description provided. This code should be reported once, as the procedure encompasses the repair of multiple tendons.

References:

AMA's CPT® Professional Edition (current year), Code 25272

1. Procedure Details and CPT® Code Selection:

The patient is undergoing stage 2 treatment for double outlet right ventricle (DORV) with a removal of the pulmonary artery band and transposition repair of the great vessels.

Code 33779 is specific for correction of a double outlet right ventricle, with transposition of the great arteries. This code accurately reflects the procedure performed, including the complex repair involving the transposition of the pulmonary trunk and aortic root.

Code 33953 is used to report the initiation of extracorporeal membrane oxygenation (ECMO), which was used to maintain oxygenation during the procedure.

Code 33985 is for the termination of ECMO following the surgical repair once heart function has resumed. Both 33953 and 33985 accurately document the initiation and termination of ECMO during this complex heart repair.

2. Modifier Selection:

Modifier 78 (unplanned return to the operating room for a related procedure during the postoperative period) is appropriate here. This is a subsequent stage in the treatment plan, but due to the complexity and specific surgical intervention required, it is treated as a return to the OR for related procedure coding.

Modifier 58 (staged or related procedure during the postoperative period) would not be as suitable here because the procedure involves a new return to the OR.

3. AAPC and CPT® Coding Guidelines:

AAPC guidelines support the use of specific modifiers (78 for unplanned return) and appropriate ECMO codes (33953 and 33985) in complex cardiac cases requiring bypass and staged treatment.

Thus, the correct CPT® codes based on CPT® and AAPC coding standards are C. 33779-78, 33953-78, 33985-78.

1. CPT® Code 11604: This code is used for the excision of a malignant lesion on the back, with a size of 3.5 cm including margins. The 11600 series covers excision of malignant skin lesions, with 11604 being the correct code for a lesion size over 3.0 cm but not exceeding 4.0 cm.

2. CPT® Code 17110: This code is appropriate for the destruction of a benign lesion on the face (right cheek) via cryosurgery. 17110 covers the destruction of benign lesions (up to 14 lesions).

3. ICD-10-CM Code C44.509: This code represents unspecified malignant neoplasm of skin of trunk (back).

4. ICD-10-CM Code D23.39: This code is used for a benign neoplasm of skin of other parts of the face (right cheek).

Explanation of other options:

A. 11604, 11442, C76.8, C76.0: Incorrect because 11442 is for excision of a benign lesion, not a malignant lesion.

B. 11404, 11442, C44.509, D23.39: Incorrect because 11404 is used for a benign lesion excision, not malignant.

D. 11604, 11642, C76.8, C76.0: Incorrect as 11642 would indicate a second malignant excision rather than the benign lesion destruction.

Thus, the correct answer is C. 11604, 17110, C44.509, D23.39.

In medical billing, Place of Service (POS) code 31 is used to indicate that a service was performed in a skilled nursing facility (SNF). POS codes are standardized by the Centers for Medicare & Medicaid Services (CMS) to specify the location where services are provided.

A. 32 refers to a nursing facility (NF), which is different from a skilled nursing facility in terms of the level of care provided.

B. 20 indicates urgent care facility.

C. 22 is used for outpatient hospital services.

Thus, the correct answer is D. 31 for a skilled nursing facility.

For a patient diagnosed with sepsis and associated acute respiratory failure, the ICD-10-CM codes are:

A41.9: Sepsis, unspecified organism.

R65.21: Severe sepsis with septic shock.

J96.00: Acute respiratory failure, unspecified whether with hypoxia or hypercapnia.

These codes appropriately capture the severity of the sepsis and the presence of acute respiratory failure.

References:

ICD-10-CM guidelines

AMA's CPT® Professional Edition (current year)

The procedure involves a right nephrectomy with partial ureterectomy for a nonfunctioning right kidney with ureteral stricture.

Procedure Description:

Right nephrectomy (removal of the kidney).

Partial ureterectomy (removal of part of the ureter).

CPT® Coding:

50220: Nephrectomy, including partial ureterectomy, any open approach.

References:

AMA's CPT® Professional Edition (current year).

CPT® Assistant for detailed coding guidelines on nephrectomy procedures.

The place of service code 22 is used for services performed in an outpatient hospital setting, including outpatient surgical floors. This code indicates that the procedure was done in a hospital but not requiring an inpatient admission.References: AMA's CPT® Professional Edition (current year), Place of Service Codes.

Impending myocardial infarction is reported with I21.3 for a myocardial infarction (acute). The shortness of breath, which is a symptom, is coded separately as R06.02. According to ICD-10-CM guidelines, when a definitive diagnosis is established, the diagnosis code is sequenced first followed by symptom codes.References: ICD-10-CM (current year), Chapter 9: Diseases of the Circulatory System (I00-I99), ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.9.e.4.