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AAPC CPC Exam Syllabus Topics:
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NEW QUESTION # 46
View MR 002395
MR 002395
Operative Report
Pre-operative Diagnosis: Acute rotator cuff tear
Post-operative Diagnosis: Acute rotator cuff tear, synovitis
Procedures:
1) Rotator cuff repair
2) Biceps Tenodesis
3) Claviculectomy
4) Coracoacromial ligament release
Indication: Rotator cuff injury of a 32-year-old male, sustained while playing soccer.
Findings: Complete tear of the right rotator cuff, synovitis, impingement.
Procedure: The patient was prepared for surgery and placed in left lateral decubitus position. Standard posterior arthroscopy portals were made followed by an anterior-superior portal. Diagnostic arthroscopy was performed. Significant synovitis was carefully debrided. There was a full-thickness upper 3rd subscapularis tear, which was repaired. The lesser tuberosity was debrided back to bleeding healthy bone and a Mitek 4.5 mm helix anchor was placed in the lesser tuberosity. Sutures were passed through the subcapulans in a combination of horizontal mattress and simple interrupted fashion and then tied. There was a partial-thickness tearing of the long head of the biceps. The biceps were released and then anchored in the intertubercular groove with a screw. There was a large anterior acromial spur with subacromial impingement. A CA ligament was released and acromioplasty was performed. Attention was then directed to the supraspinatus tendon tear. The tear was V-shaped and measured approximately 2.5 cm from anterior to posterior. Two Smith & Nephew PEEK anchors were used for the medial row utilizing Healicoil anchors. Side-to-side stitches were placed. One set of suture tape from each of the medial anchors was then placed through a laterally placed Mitek helix PEEK knotless anchor which was fully inserted after tensioning the tapes. A solid repair was obtained. Next there were severe degenerative changes at the AC joint of approximately 8 to 10 mm. The distal clavicle was resected taking care to preserve the superior AC joint capsule. The shoulder was thoroughly lavaged. The instruments were removed and the incisions were closed in routine fashion. Sterile dressing was applied. The patient was transferred to recovery in stable condition.
What CPT coding is reported for this case?
- A. 29827, 29828-51, 29824-51, 29826
- B. 29827, 29828-51, 29824-51, 29826, 29805-59
- C. 29827, 29824-51, 29826-51, 29805-59
- D. 29827, 29824-51, 29826-51
Answer: A
NEW QUESTION # 47
The documentation states:
He was then sterilely prepped and draped along the flank and abdomen in the usual sterile fashion. I first made a skin incision off the tip of the twelfth rib, extending medially along the banger's lines of the skin. This was approximately 3.5 cm in length. Once this incision was carried sharply, electrocautery was used to gain access through the external oblique, internal oblique, and transverse abdominis musculature and fascia.
What surgical approach was used for this procedure?
- A. Percutaneous
- B. Open
- C. Laparoscopic
- D. Cannot determine based on the documentation
Answer: B
NEW QUESTION # 48
Dr. Burns sees newborn baby James at the birthing center on the same day after the cesarean delivery. Dr. Burns examined baby James, the maternal and newborn history, ordered appropriate blood test tests and hearing screening. He met with the family at the end of the exam.
How would Dr. Bums report his services?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: A
NEW QUESTION # 49
The mediastinum is:
- A. Both the heart and lungs
- B. A small endocrine organ behind the heart
- C. A location in the chest, bounded by the sternum, diaphragm, and lungs
- D. A part of the lymphatic system
Answer: C
NEW QUESTION # 50
A 35-year-old female has cancer in her left breast. The surgeon performs a mastectomy, removing the breast tissue, skin, pectoral muscles, and surrounding tissue, including the axillary and internal mammary lymph nodes.
Which mastectomy code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: D
NEW QUESTION # 51
A patient has chronic cholesteatoma in the right middle ear. The otolaryngologist performed a tympanoplasty with a radical mastoidectomy, removing the middle ear cholesteatoma. Grafting technique was used to repair the eardrum without ossicular chain reconstruction.
What CPT code is reported for this surgery?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: B
NEW QUESTION # 52
A patient with empyema requires a Schede thoracoplasty.
What CPT code is reported for this procedure?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: D
NEW QUESTION # 53
Eric is buying his first life insurance policy from XYZ Life Insurance Company. The company requires Eric have a physical exam prior to issuance of the policy. Eric sees his primary care provider who completes the required documentation and forms provided by the insurance company.
How does the primary care provider report his services?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: C
NEW QUESTION # 54
Which place of service code is submitted on the claim for a service that is performed in an outpatient surgical floor?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: D
NEW QUESTION # 55
A patient presents with recurrent spontaneous episodes of dizziness of unclear etiology. Caloric vestibular testing is performed irrigating both ears with warm and cold water while evaluating the patient's eye movements. There is a total of three irrigations.
What CPT coding is reported?
- A. 92537-52
- B. 92537-50-52
- C. 92538-50
- D. 92537-50
Answer: A
NEW QUESTION # 56
A 60-year-old male has three-vessel disease and supraventricular tachycardia which has been refractory to other management. He previously had pacemaker placement and stenting of LAD coronary artery stenosis, which has failed to solve the problem. He will undergo CABG with autologous saphenous vein and an extensive modified MAZE procedure to treat the tachycardia.
He is brought to the cardiac OR and placed in the supine position on the OR table. He is prepped and draped, and adequate endotracheal anesthesia is assured. A median sternotomy incision is made and cardiopulmonary bypass is initiated. The endoscope is used to harvest an adequate length of saphenous vein from his left leg. This is uneventful and bleeding is easily controlled. The vein graft is prepared and cut to the appropriate lengths for anastomosis. Two bypasses are performed: one to the circumflex and another to the obtuse marginal. The left internal mammary is then freed up and it is anastomosed to the ramus, the first diagonal, and the LAD. An extensive maze procedure is then performed and the patient is weaned from bypass. At this point, the sternum is closed with wires and the skin is reapproximated with staples. The patient tolerated the procedure without difficulty and was taken to the PACU.
Choose the procedure codes for this surgery.
- A. 33533, 33257, 33519, 33508
- B. 33535, 33259 51, 33519-51, 33508-51
- C. 33535, 33259, 33519, 33508
- D. 33533, 33257-51, 33519-51, 33508-51
Answer: A
NEW QUESTION # 57
A 4-year-old, critically ill child is admitted to the PICU from the ED with respiratory failure due to an exacerbation of asthma not manageable in the ER. The PICU provider takes over the care of the patient and starts continuous bronchodilator therapy and pharmacologic support with cardiovascular monitoring and possible mechanical ventilation support.
What is the E/M code for this encounter?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: C
NEW QUESTION # 58
A patient with malignant lymphoma is administered the antineoplastic drug Rituximab 800 mg and then 100 mg of Benadryl.
Which HCPCS Level II codes are reported for both drugs administered intravenously?
- A. J9312, J1200
- B. J9312, Q0163
- C. J9312 x 80, J1200 x 2
- D. J9312 x 80, 00163 x 2
Answer: D
NEW QUESTION # 59
Which one of the following is an example of a case in which a diabetes-related problem exists and the code for diabetes is never sequenced first?
- A. If the patient is being treated for type 2 diabetes
- B. If the patient has hyperglycemia that Is not responding to medication
- C. If the patient has an underdose of insulin due to an insulin pump malfunction
- D. If the patient is being treated for secondary diabetes
Answer: C
NEW QUESTION # 60
Patient has undergone open surgery for a left total knee arthroplasty. While in the recovery room, he continued to have severe postoperative pain. The surgeon ordered a femoral block for postoperative pain. The anesthesiologist evaluated the patient and performed a left femoral block, which provided significant post-operative pain relief.
What CPT coding is reported?
- A. 01404, 64450, 01996
- B. 01380, 64447-59-LT
- C. 01402, 64448-59-LT, 01996
- D. 01402, 64447-59-LT
Answer: C
NEW QUESTION # 61
An incision is made in the scalp, a craniectomy is performed to access the area where electrodes are present. The electrodes are removed. The surgical wound is closed.
What procedure code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: C
NEW QUESTION # 62
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