AAPC CPC Ch 8&9 EXAM NEW VERSION LATEST UPDATE WITH ACCURATE ANSWERS GUARANTEED PASS
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AAPC CPC
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AAPC CPC
A 49 year-old female presented with chronic deQuervain's disease and has been unresponsive to physical therapy, bracing or cortisone injection. She has opted for more definitive treatment. After induction of anesthesia, the patient's left arm was prepared and draped in the normal sterile fashion. L...
AAPC CPC Ch 8&9 EXAM NEW
VERSION LATEST UPDATE 2024-2025
WITH ACCURATE ANSWERS
GUARANTEED PASS
A 49 year-old female presented with chronic deQuervain's disease and has been
unresponsive to physical therapy, bracing or cortisone injection. She has opted for more
definitive treatment. After induction of anesthesia, the patient's left arm was prepared
and draped in the normal sterile fashion. Local anesthetic was injected using a
combination 2% lidocaine and 0.25% Marcaine. A transverse incision was made over
the central area of the first dorsal compartment. The subcutaneous tissues were gently
spread to protect the neural and venous structures. The retractors were placed. The
fascial sheath of the first dorsal compartment was then incised and opened carefully.
The underlying thumb abductor and extensor tendons were identified. The tissues were
dissected and the extensor retinaculum of the first extensor compartment was incised.
The fibrotic tissue was incised and the tendons gently released. The tendons were fre -
ANSWER 25000-LT
Rationale: The report states that the extensor retinaculum of the first extensor
compartment was incised. Look in the CPT® Index for Incision/Wrist/Tendon Sheath
25000-25001. Code 25000 shows deQuervain's disease in the description. Code 25001
refers to the flexor tendon sheath and this involved the extensor tendon making 25000
correct. Note this was an incision, not excision of the tendon of the extensor tendon
sheath. Modifier LT is appended to indicate the procedure is performed on the left side.
A 63 year-old man presents with a neck mass to be excised. The neck mass was
palpated and an incision was then made and carried down through the dermis with
electrocautery. The subcutaneous tissue of the skin was opened encountering an
organized mass with a benign appearance of a lipoma. Using careful blunt and sharp
dissection, the mass measuring 5 cm was completely excised around its entire
circumference leaving the capsule intact. The mass was removed from its posterior
attachments using electrocautery. What CPT® code is reported for this procedure? -
ANSWER 21552
Rationale: In the CPT® Index, look for Neck/Tumor/Excision. You are referred to 21552-
21558. Review the codes to choose the appropriate service. 21552 is the correct code
to report the excision of a 5 cm mass where the surgeon incised the subcutaneous
tissue to remove the mass. Codes 11426 and 11626 are reported for removal of a
benign or malignant lesion, not an internal mass.
An 85 year-old has developed a lump in her right groin. An incision over the lesion was
made and tissue was dissected through the skin and subcutaneous tissue going deep
through the femoral fascia. Sharp dissection of the mass was performed, freeing it from
,surrounding structures. The 3 cm mass was isolated and excised. The incision was
closed, the area was cleaned and dried, and a dressing applied. What CPT® code is
reported?
- ANSWER 27048
Rationale: In the CPT® Index look for Excision/Tumor/Pelvis. You are referred to 27043,
27045, 27047, 27048, 27049 and 27059. Review the codes to choose the appropriate
service. 27048 is the correct code to report the removal of the 3 cm mass below the
fascia.
A 42 year-old with chronic right trochanteric bursitis is scheduled to receive an injection
at the Pain Clinic. A 22-gauge spinal needle is introduced into the trochanteric bursa,
and a total volume of 8 cc of normal saline and 40 mg of Kenalog is injected. What are
the CPT® codes?
- ANSWER 20610-RT, J3301 x 4
Rationale: In the CPT® Index look for Injection/Bursa. You are referred to 20600-20611.
Review the codes to choose appropriate service. 20610 is the correct code because the
injection was given in the trochanteric bursa (hip, a major joint) without ultrasound
guidance for drug therapy. In the HCPCS Level II codebook look in the Table of Drugs
and Biologicals for Kenalog and you see Kenalog -10 and Kenalog-40, which both refer
you to See Triamcinolone Acetonide. Triamcinolone Acetonide leads to several codes
J3300, J3301, and J3302. J3301 10 mg lists Kenalog in the notes below the code.
Report 4 units for 40 mg of Kenalog.
What ICD-10-CM code is used to report effusion of the right ankle joint?
- ANSWER M25.471
Rationale: Look in the ICD-10-CM Alphabetic Index for Effusion/joint/ankle and you are
referred to M25.47-. In the Tabular List, code M25.47- requires the application of a
6thcharacter to specify the location (foot or ankle) and laterality. Report M25.471 for
effusion of the right ankle.
A 14 year-old status post injury over one year ago to her left wrist presented with
recurrent wrist pain. The patient was taken to the operating room and placed under
general anesthesia. She was placed in wrist traction. The radiocarpal joint was entered
endoscopically through sharp skin incisions and blunt dissection into the joint. There
was found to be mild synovitis in the dorsal ulnar aspect of the wrist. This was debrided
arthroscopically with a shaver. There was a peripheral tear of the triangular
fibrocartilage. This area was shaved to promote healing. Using outside-in technique, a
PDS suture was placed across the TFCC and into the capsule. There was synovitis
within the midcarpal joint, but there was no articular injury. All instruments were
removed and the wounds were closed with interrupted nylon sutures. What CPT®
code(s) is /are reported?
- ANSWER 29846-LT
, Rationale: In the CPT® Index, look for Arthroscopy/Surgical/Wrist. You are referred to
29843-29847. Code 29846 describes the arthroscopic excision and repair of triangular
fibrocartilage and joint debridement. Endoscopically, arthroscopically and through the
scope all mean the same thing. This is not an open surgery; it is arthroscopic. Modifier
LT is appended to indicate the procedure is performed on the left side. Only one code is
reported. The debridement (partial synovectomy) is included in the more intensive
procedure.
A 63 year-old man sustained a gunshot wound through the right maxillary sinus
penetrating into the right neck. CT scan revealed no hard evidence of arterial injury but
a bullet was directly in line with the internal jugular vein. He was sent to the operating
room for neck exploration to rule out vascular injury and injury to the aerodigestive tract
(respiratory and digestive tracts). A sternocleidomastoid incision was performed and
carried down through the platysma muscle. There was no penetration of the internal
jugular vein, but a foreign body was identified resting on the internal jugular vein at
approximately the level of the angle of the mandible and it was removed. The parotid
gland was noted to have a blast injury near the tail. This was not surgically repaired or
resected. Once all bleeding was controlled, a 10 French round drain was placed in the
wound. The wound was copiously irrigated. The platysma muscle
- ANSWER 20100
Rationale: In the CPT® Index, look for Exploration/Neck/Penetrating Wound. You are
referred to 20100. Review the code to verify accuracy. 20100 is the correct code
because the patient was sent to the operating room for exploration of a gunshot
(penetrating trauma) wound to identify damaged structures. The category guidelines for
Wound Exploration-Trauma indicate that these codes include removal of foreign bodies,
ligation or coagulation of minor subcutaneous and muscular blood vessels, damaged
tissue debridement, repair and wound closure.
A patient presented with a right ankle fracture. After induction of general anesthesia, the
right leg was elevated and draped in the usual manner for surgery. A longitudinal
incision was made parallel and posterior to the fibula. It was curved anteriorly to its
distal end. The skin flap was developed and retracted anteriorly. The distal fibula
fracture was then reduced and held with reduction forceps. A lag screw was inserted
from anterior to posterior across the fracture. A 5-hole 1/3 tubular plate was then
applied to the lateral contours of the fibula with cortical and cancellous bone screws.
Final radiographs showed restoration of the fibula. The wound was irrigated and closed
with suture and staples on the skin. Sterile dressing was applied followed by a posterior
splint. What CPT® code is reported?
- ANSWER 27792-RT
Rationale: In the CPT® Index look for Fracture/Fibula/Open Treatment and you are
referred to 27784, 27792, 27814. Code 27784 reports open treatment of a proximal
fibular fracture or shaft fracture. The correct code is 27792 for the open treatment and
internal fixation. Modifier RT is appended to indicate the procedure is performed on the
right side.
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