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| Section | Weight | Objectives |
|---|---|---|
| Laboratory / Pathology | 5-10% | - Organ and Disease Panels |
| Anatomy & Physiology | 10-15% | - Medical Terminology - Body Systems |
| E/M (Evaluation and Management) | 10-15% | - Office/Outpatient Visits - Emergency Department |
| Radiology | 5-10% | - Diagnostic Imaging |
| Surgery Coding | 40-50% | - Integumentary System - Nervous System - Digestive System - Respiratory System - Cardiovascular System - Musculoskeletal System - Genitourinary System |
| ICD-10-CM (Diagnosis Coding) | 10-15% | - Code Selection - Conventions and Guidelines |
| HCPCS Level II | 5-10% | - Supplies and Equipment - Modifiers |
| Medicine | 5-10% | - Specialty Coding |
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NEW QUESTION # 294
A 65-year-old man had a right axillary block by the anesthesiologist. When the arm was totally numb, the arm was prepped and draped, and the surgeon performed tendon repairs of the right first, second, and third fingers. The anesthesiologist monitored the patient throughout the case.
What anesthesia code is reported?
Answer: C
Explanation:
The anesthesia code for an axillary block for procedures on the upper arm and elbow, which includes the monitoring by the anesthesiologist throughout the procedure, is 01830. This code is appropriate for anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of the shoulder and axilla.
CPT Professional Edition, AMA
Anesthesia Coding Guidelines
NEW QUESTION # 295
Preoperative diagnosis: Right thigh benign congenital hairy nevus. *1
Postoperative diagnosis: Right thigh benign congenital hairy 0 nevus.
Operation performed: Excision of right thigh benign congenital>1
nevus, excision size with margins 4.5 cm and closure size 5 cm.
Anesthesia: General.0
Intraoperative antibiotics: Ancef.0
Indications: The patient is a 5-year-old girl who presented with her parents for evaluation of her right thigh congenital nevus. It has been followed by pediatrics and thought to have changed over the past year. Family requested excision. They understood the risks involved, which included but were not limited to risks of general anesthesia, infection, bleeding, wound dehiscence, and poor scar formation. They understood the scar would likely widen as the child grows because of the location of it and because of the age of the patient. They consented to proceed.
Description of procedure: The patient was seen preoperatively in > I the holding area, identified, and then brought to the operating room. Once adequate general anesthesia had been induced, the patient's right thigh was prepped and draped in standard surgical fashion. An elliptical excision measuring 6 x 1.8 cm had been marked. This was injected with Lidocaine with epinephrine, total of 6 cc of 1% with 1:100,000. After an adequate amount of time, a #15 blade was used to sharply excise this full thickness.
This was passed to pathology for review. The wound required # limited undermining in the deep subcutaneous plane on both sides for approximately 1.5 cm in order to allow mobilization of the skin for closure. The skin was then closed in a layered fashion using 3-0 Vicryl on the dermis and then 4-0 Monocryl running subcuticular in the skin, the wound was cleaned and dressed with Dermabond and Steri-Strips.
The patient was then cleaned and turned over to anesthesia for S extubation.
She was extubated successfully in the operating room and taken S to the recovery room in stable condition.
There were no complications.
What CPT coding is reported?
Answer: B
Explanation:
52356 = Cystourethroscopy with ureteroscopy, lithotripsy and stent placement Combination code # do not report components separately
NEW QUESTION # 296
A suppression study includes five glucose tests and five growth hormone tests.
What CPT coding is reported?
Answer: A
Explanation:
80430 = Growth hormone suppression panel
Individual tests are reported with units
MEDICINE & CARDIOLOGY
NEW QUESTION # 297
A 52-year-old woman has been experiencing discomfort and itching In the vulvar area for several months. She has a history of abnormal Pap smears and a recent biopsy revealed vulvar intraepithelial neoplasia (VIN III). Decision has been made to perform a vulvectomy.
Procedure: Under general anesthesia, the surgeon made an incision in the vulvar area and removed the vulva (more than 80%), including the affected skin and deep subcutaneous tissue.
What CPT and ICD-10-CM codes are reported?
Answer: B
Explanation:
Procedure Coding:
56633 - Radical vulvectomy (removal of >80%), including deep subcutaneous tissue Documentation supports greater than 80% vulvar removal Deep tissue involvement confirms radical procedure Diagnosis Coding:
D07.1 - Carcinoma in situ of vulva
VIN III = high-grade squamous intraepithelial lesion
Classified as carcinoma in situ, not benign dysplasia
Why Other Options Are Incorrect:
56620 / 56625 / 56630 - Partial or simple vulvectomy
N90.1 - Mild vulvar dysplasia (incorrect severity)
ICD-10-CM Official Guideline:
VIN III is coded as D07.1, not N90.x.
NEW QUESTION # 298
An MRI guided cisternal puncture with diagnostic contrast injection is performed at the C2 level for cervical discography, with imaging supervision and interpretation.
What CPT coding is reported?
Answer: D
Explanation:
Procedure Coding:
62291 - Injection procedure for myelography and/or CT, cervical
Cisternal puncture at C2 level
72285 - Radiologic supervision and interpretation, cervical discography
77021 - MRI guidance for needle placement
Why Other Options Are Incorrect:
62290 - Lumbar injection
77012 - CT guidance, not MRI
72295 - Lumbar discography imaging
AAPC Coding Principle:
Use modality-specific guidance codes and match spinal level precisely.
NEW QUESTION # 299
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