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AAPC Certified Professional Coder (CPC) Exam Sample Questions (Q63-Q68):
NEW QUESTION # 63
What CPT coding is reported for a subtotal thyroidectomy for malignancy with radical neck dissection?
Answer: C
Explanation:
60254 = Subtotal thyroidectomy for malignancy with radical neck dissection
60260 = Total thyroidectomy
60220 = Partial thyroidectomy, benign
60252 = Total thyroidectomy with radical neck dissection
NEW QUESTION # 64
A patient is having a thyroidectomy for malignancy on the right lobe. During the procedure, a lesion was found on the left lower side of the parathyroid gland and is suspected for malignancy.
The total right lobe of the thyroid and the parathyroid gland are removed.
What is the CPTcodes are reported for this encounter?
Answer: A
Explanation:
1. Procedure and CPTCode Selection:
The patient underwent a thyroidectomy for malignancy in the right lobe, as well as the removal of the parathyroid gland due to a suspected malignant lesion.
CPTCode 60505 is for the parathyroidectomy with exploration of parathyroid glands and is appropriate for the removal of the parathyroid gland due to a suspected malignancy.
CPTCode 60220 represents a thyroid lobectomy (total removal of one lobe of the thyroid), which applies to the removal of the right thyroid lobe in this case.
2. Modifier 59:
Modifier 59 is added to 60220 to indicate that the thyroid lobectomy is a distinct procedure from the parathyroidectomy, performed in a separate anatomical site during the same surgical session.
3. Rationale for Excluding Other Options:
Code 60500 (in options A and C) is for a parathyroid exploration only, not including the actual removal of the parathyroid gland, so it does not apply here.
Code 60240 (in option D) is for a total thyroidectomy, which involves removal of the entire thyroid gland.
Since only the right lobe was removed, 60220 (thyroid lobectomy) is correct.
4. AAPC and CPTCoding Guidelines:
Per AAPC guidelines, 60505 is the appropriate code for parathyroidectomy procedures involving exploration or suspected malignancy, and 60220 with Modifier 59 accurately reflects the separate and distinct thyroid lobectomy procedure.
Thus, the correct answer is B. 60505, 60220-59.
NEW QUESTION # 65
A 53-year-old male arrived at the ER due to severe ocular trauma to the right eye. He was at work on a metal drilling machine and a metallic item penetrates his right eyeball. A foreign body is in the posterior segment of the eye and corneal laceration with multiple posterior perforated sites were noted. He is brought back to the surgical suite. The surgeon removes the metallic foreign body using large retinal forceps. The laceration of the cornea is sutured and the provider also performs a pars plana lensectomy.
What is the CPTand ICD-10-CM codes are reported?
Answer: D
Explanation:
1. Procedure and CPTCode Selection:
The patient required surgical intervention for severe ocular trauma involving removal of a foreign body from the posterior segment of the eye, suturing of the corneal laceration, and a pars plana lensectomy.
CPTCode 65265 is for removal of a foreign body from the posterior segment of the eye without the use of a magnet. This code is appropriate for the removal of the metallic foreign body using retinal forceps.
CPTCode 66852 covers the pars plana lensectomy, which was performed as part of the surgical treatment.
CPTCode 65280 is used for repairing a corneal laceration with multiple perforations, which applies to the corneal suturing.
2. Modifiers:
Modifier RT is used to indicate that the procedures were performed on the right eye.
Modifier 51 is added to indicate multiple procedures performed during the same surgical session.
3. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code S05.51XA is appropriate for penetrating wound of the right eyeball with a foreign body in the posterior segment.
ICD-10-CM Code W31.1XXA is used to indicate that the injury was caused by contact with a metalworking and woodworking machine.
4. Rationale for Excluding Other Options:
Codes 65235 and 65275 in options B, C, and D refer to foreign body removal from the anterior chamber and the anterior segment, respectively, which are not appropriate since the foreign body was located in the posterior segment.
Codes S05.31XA and W31.0XXA in options C and D represent different eye injuries and types of machines, which do not match the scenario described.
5. AAPC and CPTCoding Guidelines:
According to AAPC guidelines, codes should be selected based on the specific location (posterior segment) and the type of foreign body removal. Each procedure, including the corneal repair, should be coded to capture the full extent of the treatment.
Therefore, the correct answer is A. 65265-RT, 66852-51-RT, 65280-51-RT, S05.51XA, W31.1XXA.
NEW QUESTION # 66
The pulmonologist performs a bronchoscopy with fluoroscopic guidance. The scope is introduced into the right nostril and advanced to the vocal cords and into the trachea. The scope is advanced to the right upper lobe and a lung nodule is noted. An endobronchial biopsy is performed.
What CPT code is reported for the procedure?
Answer: B
Explanation:
The CPT code 31625 is used for bronchoscopy with a transbronchial lung biopsy. This includes the use of fluoroscopic guidance, as described in the scenario.
References:
* AMA's CPT Professional Edition (current year)
NEW QUESTION # 67
A patient had surgery a year ago to repair two extensor tendons in his wrist. He is in surgery for a secondary repair for the same two tendons with free graft. What CPTcoding is reported?
Answer: A
Explanation:
1. Procedure Type: This scenario describes a secondary repair of two extensor tendons in the wrist with a free graft. According to CPTcoding guidelines, the secondary repair with a free graft suggests a more complex repair than primary closure.
2. CPTCode Selection:
Code 25270 is used for a primary repair of an extensor tendon in the forearm or wrist. Since this is a secondary repair, 25270 does not apply, ruling out options A and C.
Code 25272 represents the repair of a single extensor tendon in the forearm or wrist, which includes both primary and secondary repairs. However, it does not involve free grafts, ruling out option D.
Code 25274 specifically addresses the secondary repair of an extensor tendon with free graft in the forearm or wrist, which is the correct scenario described in the question.
3. Applying the Code for Multiple Tendons:
Since the procedure involves two tendons, 25274 should be reported twice (25274 x 2) to account for the secondary repair on each tendon individually.
4. Reference from AAPC CPC Guidelines:
In AAPC CPC and CPTcoding principles, tendon repair codes require careful distinction between primary repairs and secondary repairs with grafts. The guidelines specify that multiple tendons should be coded with individual codes when performed on separate anatomical structures, hence the use of 25274 twice for both tendons.
Therefore, the verified and precise answer based on CPTguidelines and AAPC coding standards is B.
25274 x 2.
NEW QUESTION # 68
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