Download AAPC CPC Chapter 9 Questions and Answers 2025 and more Exams Advanced Education in PDF only on Docsity!
AAPC CPC Chapter 9
B - answer What is the term for removal of part of the lymph system? A) Lymphoma B) Lymphadenectomy C) Lymphadenitis D) Lymphedema D - answer Which of the following is not one of the four organs of the lymph system? A) Spleen B) Thymus gland C) Tonsils D) Bone Marrow B - answer What is the ICD-10-CM code for acquired lymphedema? A) I88. B) I89. C) Q82. D) I88. A - answer A 4-month-old infant presents to the physician with cold-like symptoms, coughing, and wheezing. The infant is diagnosed with bronchiolitis due to RSV. How is this condition coded? A) J21. B) J21. C) J21.0, B97.4 D) R05, B97. D - answer A patient presents to the physician with persistent stuffiness and facial pain. The physician documents a diagnosis of nasal polyps. What ICD-10-CM code is reported? A) J33. B) J33. C) J33. D) J33. B - answer A patient with adenocarcinoma of the larynx has developed cervical adenopathy is undergoing an excisional biopsy of the right cervical node. An incision is made above the clavicle and dissection taken down into the muscle. Blunt dissection was used to work the way down to the node, which was firm and white. The entire node was taken and the wound was closed. What CPT® code is reported? A) 38500
B) 38510
C) 38520
D) 38542
D - answer Which CPT® code(s) describes VATS therapeutic wedge resection of the left upper lobe followed by left upper lobectomy? A) 32480 B) 32505, 32480 C) 32663, 32666 D) 32663 B - answer Which CPT® code describes a pneumonectomy? A) 32442 B) 32440 C) 32440- D) 32445 C - answer Patient is a mouth-breather. He is diagnosed with inflamed inferior turbinates and a superficial ablation is performed. What CPT® code is reported? A) 30802 B) 30140 C) 30801 D) 30802- B - answer A thoracotomy procedure was performed for repair of hemorrhage and lung tear. What CPT® code is reported? A) 32100 B) 32110 C) 32120 D) 32420 B - answer What is the major muscle used during respiration? A) Intercostal muscles of the ribs B) Diaphragm C) Abdominal muscles D) Chest wall or pectoral muscles A - answer What portion of the thoracic cavity lies between the lungs and contains the heart? A) Mediastinum B) Diaphragm C) Lymphatic channels D) Bone marrow D - answer What is the ICD-10-CM code selection for a patient with COPD presenting with an acute bronchitis? A) J44.
of adhesions,(Removal of the adhesions to get to the thoracic cavity was necessary to perform the pleurodesis, it is not reported separately.) we were confident that we had access to the entire thoracic cavity. Eight grams of talc were introduced into the right thoracic cavity and strategically placed under direct vision.(Pleurodesis.) The CPT® code: 31600 ICD-10-CM code: C32.0 - answer CASE 2 Preoperative diagnosis: malignant neoplasm glottis Postoperative diagnosis: malignant neoplasm glottis(Diagnosis to report for the procedure.) Procedure: An incision is made low in the neck. The trachea is identified in the middle and an opening is created to allow for the new breathing passage. A tracheostomy(This is the performed procedure.) tube is inserted and secured with sutures. The patient tolerated the procedure well and was sent to recovery without complications. What are the CPT® and ICD-10-CM codes reported? CPT® code: ICD-10-CM code: CPT® codes: 32666-LT, 31622- ICD-10-CM codes: S27.0, V03.90XA - answer CASE 3 Preoperative Diagnosis: Pedestrian in a MVA involving a car, left pneumothorax. Postoperative Diagnosis: Pedestrian in a MVA involved a car, left pneumothorax. (Report the post-operative diagnosis and verify from the operative note.) Procedure: Bronchoscopy, left VATS,(Statement of two procedures performed, must be verified in the body of the operative note.) wedge resection. Procedure: Patient was brought into the operating room and placed in supine position. IV sedation and general anesthesia was administered, per the anesthesia department. A single lumen endotrachial tube was placed for bronchoscopy, per anesthesia. Due to the nature of the trauma,(Traumatic pneumothorax.) we were interested in ruling out a bronchial tear. The bronchoscope was introduced in the mouth and passed into the throat without difficulty. There was no evidence of sanguineous drainage or bronchial trauma noted to the left mainstem. There were copious amounts of secretions noted and removed without difficulty. The right mainstem was also cannulated and found to be free of unexpected trauma. The bronchoscopy was terminated at that time.(Diagnostic bronchoscopy.) A double lumen endotracheal tube was placed, per anesthesia. The position was confirmed by bronchoscopy. The patient was placed in the decubitus position with the left side up. The chest was prepped in standard fashion with Betadine, sterile towels, sheets, and drapes. A small incision is made along the upper boarder of the fourth rib just below the intercostal space and a standard port placement was utilized to gain access to the thoracic cavity. An endoscope was inserted into the chest cavity. Initially we had excellent exposure with good isolation of the lung.(Thoracoscope was used.) We identified a large bleb at the apex of the lower lobe of the left lung, which was likely to
CPT® codes: 31259-50, 31267-50- ICD-10-CM codes: J33.0, J33.8, J32.9 - answer CASE 4 Preoperative diagnosis: 1. Chronic hyperplastic rhinosinusitis 2. Allergies 3. Status post- prior polypectomy and sinus surgery Postoperative diagnosis:
- Intranasal and sinus polyps (Report the diagnoses if no further positive findings are found in the operative note.)
- Chronic hyperplastic rhinosinusitis (Report the diagnosis if no further positive findings are found in the operative note.) Operative procedure: Left sinusotomy (three or more sinuses) including: • Nasal and sinus endoscopy • Endoscopic intranasal polypectomy • Endoscopic total sinus ethmoidectomy • Endoscopic sphenoidotomy • Endoscopic nasal antral windows, middle meatus, and inferior meatus • Endoscopic removal of left maxillary sinus contents Right sinusotomy (three or more sinuses) including: • Nasal and sinus endoscopy • Endoscopic intranasal polypectomy(Indication the surgery will be performed through an endoscope.) • Endoscopic total sinus ethmoidectomy • Endoscopic sphenoidotomy • Endoscopic nasal antral windows, middle meatus, and inferior meatus • Endoscopic removal of right maxillary sinus contents Specimens sent to pathology: 1. Left ethmoid and sphenoid contents for routine and fungal cultures 2. Right maxillary contents for routine and fungal cultures 3. Left intranasal ethmoid, sphenoid, and maxillary specimens for pathology
- Right ethmoid, sphenoid, maxillary, and right intranasal contents for pathology Findings: Complete nasal obstruction by polyps(Report this diagnosis for the intranasal polyps.) obscuring of all of the normal landmarks. The right middle turbinate was found and preserved. The residual body of the left middle turbinate was found and preserved. There was thickened hyperplastic mucosa throughout the sinuses with some polyps in the sinuses,(Documentation supports the presence of sinus polyps.) and the majority CPT® code: 39000 ICD-10-CM codes: D86.1, R59.0 - answer CASE 5 Preoperative Diagnoses
- Sarcoid of lymph nodes(Diagnosis if no further positive findings are found in the operative note.)
- New onset paratracheal adenopathy(Diagnosis if no further positive findings are found in the operative note.) Postoperative Diagnoses
- Sarcoid of lymph nodes
- New onset paratracheal adenopathy Procedure Performed: Mediastinotomy(Indication of what procedure is being performed.) Description of Procedure: The patient was brought to the operating room and placed in supine position. IV sedation and general anesthesia was administered by the anesthesia department. The neck was prepped in standard fashion with betadine scrub, sterile towels and drapes. A standard linear incision was made over the trachea.(Procedure performed with the anterior cervical approach.) We were able to dissect down the pretracheal fascia into
lobe. The dissection began by ligating the superior pulmonary vein and its branches, and the upper lobe was freed up. The small fissure was incomplete, and I proceeded with the lobectomy. The pulmonary artery branches were then ligated. The bronchus was ligated, as well. The superior branches to the upper lobe were ligated with Endo GIA. The lobe was freed up and sent to pathology. The wound was then closed in layers. A chest tube was placed to suction, and the patient was sent to recovery in stable condition. Pathology confirmed carcinoma. What are the procedure and diagnosis codes for this procedure? CPT® code: ICD-10-CM code: CPT® code: 38571 ICD-10-CM codes: C77.4, C60.9 - answer CASE 9 Preoperative Diagnosis:
- Grade 3 squamous cell carcinoma of penis with inguinal lymphatic metastasis Postoperative Diagnosis
- Grade 3 squamous cell carcinoma of penis with inguinal lymphatic metastasis Procedure Performed: Laparoscopic bilateral pelvic lymphadenectomy Description of Procedure: The patient is placed in supine position with thigh abduction. A 1.5 cm incision was made 2 cm distally of the lower vertex of the femoral triangle. The second incision was made 2 cm proximally and 6 cm medially. Two 10 mm Hasson trocars were inserted in these incisions. The last trocar was placed 2 cm proximally and 6 cm laterally from the first port. Radical endoscopic bilateral pelvic lymphadenectomy was performed.The main landmarks-adductor longus muscle medially, the sartorius muscle laterally and the inguinal ligament superiorly, were well visualized. The retrograde dissection using a harmonic scalpel was started distally near the vertex of the femoral triangle towards the fossa ovalis, where the saphena vein was identified, clipped, and divided, towards the femoral artery laterally. After the procedure, one can identify the skeletonized femoral vessels and the empty femoral channel, showing that the lymphatic tissue in this region was completely resected. The surgical specimen was removed through the first port incision. A suction drain was placed to prevent lymphocele, and were kept until the drainage reached 50 ml or less in 24 hours. Patient tolerated the procedure well and was transferred to recovery in stable condition. What CPT® and ICD-10-CM codes are reported? CPT® code: ICD-10-CM codes (2): CPT® codes: 31625-RT, 31623-51-RT ICD-10-CM code: C34.81 - answer CASE 10 Preoperative Diagnosis: Carcinoma, right lung and bronchus intermedius. Procedure Performed: Bronchoscopy. DESCRIPTION OF PROCEDURE:
Two liters of oxygen were supplied nasally. The right nostril was anesthetized with two applications of 4% lidocaine and two applications of lidocaine jelly. The posterior pharynx was anesthetized with two applications of Cetacaine spray. The Olympus PF fiberoptic bronchoscope was introduced into the patient's right nostril. The posterior pharynx, epiglottis, and vocal cords were normal. The trachea and main carina were normal. The entire tracheobronchial tree was then visually examined and the major airways. No abnormalities were noted on the left side. There was, however, extrinsic compression of the posterior segment of the right upper lobe. There also appeared to be a submucosal tumor involving the bronchus intermedius between the right upper lobe and right middle lobe. Multiple washings, brushings, and biopsies were taken from the right upper lobe bronchus and bronchus intermedius. The specimens were sent for cytology and routine pathology. The patient tolerated this without complications. The CPT® and ICD-10-CM codes to report are: CPT® codes (2): ICD-10-CM code: D - answer What ICD-10-CM code is reported for a patient that has RSV (respiratory syncytial virus) pneumonia? A) J18. B) B97. C) J21. D) J12. B - answer In ICD-10-CM, codes for Factors Influencing Health Status and Contact with Health Services begin with which letter? A) A B) Z C) V D) E B - answer What CPT® code is reported for an emergency endotracheal intubation to save the patient's life? A) 31600 B) 31500 C) 31603 D) 31502 A - answer Johnny has a penny removed from his left nostril in the provider's office. What CPT® code is reported? A) 30300 B) 30320 C) 30160 D) 30100 D - answer What CPT® code is reported for a major thoracotomy for post-op hemorrhage following an endoscopic upper lobectomy?
B - answer A 55 year-old patient has history of lung cancer of the right lower lobe. He is complaining of difficulty breathing and mild chest pain. Patient is scheduled for a diagnostic VATS (Video-assisted thoracoscopic surgery). Under general anesthesia he was placed in left lateral decubitus position and a thoracoscope was inserted through a port site. The VATS exploration immediately revealed a mass of the left upper lobe. A biopsy was performed and sent to pathology. Results from pathology revealed small cell carcinoma. Decision was made to remove the upper lobe of his left lung by performing an open procedure. The thoracoscope is withdrawn and the surgeon opens the chest cavity and rib spreaders are inserted to separate the ribs to gain access to the lung. The upper lobe of the left lung is identified, isolated and removed. The instruments are removed and the chest incision is closed in layers. What CPT® codes are reported? A) 32440 B) 32480-58, 32608- C) 32663 D) 32663, 32601- A - answer An 18 month-old patient is seen in the ED unable to breathe due to a toy he swallowed which had lodged in his throat. Soon brain death will occur if an airway is not established immediately. The ED provider performs an emergency transtracheal tracheostomy. What CPT® and ICD-10-CM codes are reported? A) 31603, T17.290A B) 31601, 31603, T17.228A C) 31601, J34.9, T17.298A D) 31603, T17.220A B - answer A patient is seen in the OR for removal of a hepatic adenoma which has invaded the diaphragm. The resection of the diaphragm portion of the mass was repaired with primary sutures. What CPT® code is reported for the diaphragmatic mass resection? A) 39540 B) 39560 C) 39545 D) 39561 D - answer Provide the correct ICD-10-CM code(s) for acute RSV bronchiolitis. A) J21.8, B97. B) J20. C) J21. D) J21. C - answer A patient with AML (Acute Myelogenous Leukemia) has just learned his sister is an HLA (Human Leukocyte Antigen) match for him. Stem cells taken from the donor (the patient's sister) will be transplanted into the patient to help with his treatment. What CPT® code is used to report the harvesting of the stem cells from the donor (his sister)? A) 38206
B) 38204
C) 38205
D) 38207
D - answer A patient underwent bilateral nasal/sinus diagnostic endoscopy. Finding the airway obstructed the provider fractures the middle turbinates to perform the surgical endoscopy with total bilateral ethmoidectomy and nasal septoplasty. What CPT® codes are reported? A) 31231, 30130-51, 31255- B) 30930, 30520-51, 31255- C) 30520, 31255- D) 30520, 31255-50- D - answer A patient presents to the emergency department (ED) with a sucking chest wound. The ED provider on duty performs an immediate tube thoracostomy in order to restore normal breathing to the patient before rushing him to surgery for another provider to address other injuries. What CPT® code is reported by the ED provider? A) It is not coded, as it will be bundled with any procedures performed during surgery. B) 31500 C) 31603 D) 32551 B - answer A returning 2 year-old child is seen in the pediatrician's office with stridor and a bark like cough. The pediatrician examines the child quickly and determines the child has stridulous croup. The child is given a nebulizer breathing treatment in the office to improve PO2 levels. Medication used is breathable Epinephrine. What CPT® and ICD-10-CM codes are reported? A) 94644, R06.1, R B) 94640, J38. C) 94644, J04. D) 94642, J38.5, R05, R06. C - answer A patient with recurrent pneumothoraces presents for chemopleurodesis. Under local anesthesia a small incision is made between the ribs. A catheter is inserted into the pleural space between the parietal and pleural viscera. Subsequently, 5g of sterile asbestos free talc was introduced into the pleural space via the catheter. What CPT® and ICD-10-CM codes are reported? A) 32601, 32560, J95. B) 32650, 32560, J93. C) 32560, J93. D) 32650, J95. A - answer The surgeon makes an incision in the neck near the cricothyroid membrane for an emergency tracheostomy for a patient who arrives in the emergency
D) 31560, 69990, J38.02C
B - answer A 14 year-old boy presents at the Emergency Department experiencing an uncontrolled epistaxis. Through the nares, the ED provider packs his entire nose via an anterior approach with extensive packing of medicated gauze. In approximately 15 minutes the nosebleed stops. What CPT® and ICD-10-CM codes are reported? A) 30901-50, R04. B) 30903-50, R04. C) 30901, I78. D) 30905, R04. B - answer What ICD-10-CM code is reported for spontaneous pneumothorax? A) S27.0XXA B) J93. C) J95. D) S27.2XXA B - answer What CPT® code is reported for a frontal sinusotomy, nonobliterative, with osteoplastic flap, brow incision? A) 31080 B) 31086 C) 31084 D) 31087 A - answer What ICD-10-CM code is reported for pyopneumothorax with fistula? A) J86. B) J95. C) J93. D) J86. A - answer A surgeon performed a transthoracic median sternotomy for exploration of the space around the lung sacs and for drainage of fluid, caused by pneumonia. What is/are the appropriate code(s) for this scenario? A) 39010 B) 39220, 32554- C) 39000, 32554- D) 39401 A - answer What anatomical cavity or compartment contains all of the thoracic viscera except the lungs? A) Mediastinum B) Peritoneum C) Mesentery D) Thoracic C - answer Where in the respiratory system is the carina located?
A) Inferior turbinate B) Sphenoid sinus C) Tracheal bifurcation D) Left bronchus C - answer Which statement is TRUE regarding coding COPD with asthma in ICD- 10-CM? A) Only the asthma is reported. B) COPD with bronchitis is reported for COPD with asthma. C) The type of asthma is reported along with the COPD. D) Only the COPD is reported. D - answer A patient's nose was hit with a baseball during a high school baseball game. At that time reconstruction was performed with local grafts. Patient returns now as an adult, discontent with the bony prominence along the bony pyramid and flat look of the tip of the nose. He underwent major repair with osteotomies and nasal tip work. What CPT® code is reported? A) 30462 B) 30410 C) 30435 D) 30450 B - answer A 25 year-old male presents with a deviated nasal septum. The patient undergoes a nasal septum repair and submucous resection. Cartilage from the bony septum was detached and the nasoseptum was realigned and removed in a piecemeal fashion. Thereafter, 4-0 chronic was used to approximate mucous membranes. Next, submucous resection of the turbinates was handled in the usual fashion by removing the anterior third of the bony turbinate and lateral mucosa followed by bipolar cauterization. What CPT® codes are reported? A) 30620, 30999- B) 30520, 30140- C) 30420, 30140- D) 30450, 30999- A - answer A 20 year-old female who returned from spring break in Mexico six days ago, presents to the ED with a high fever for three days, a sore throat, general aches and a miserable cough. The ED provider suspects flu and orders a rapid flu test. What ICD-10-CM code(s) is reported? A) R50.9, J02.9, R52, R B) J11.1, R50.9, J02.9, R C) J11. D) J09.X D - answer How are multiple moderate lacerations of the spleen, initial encounter coded in ICD-10-CM? A) S36.030A
