CPC Exam Dumps : Certified Professional Coder (CPC) Exam

The procedure involves a tympanoplasty with a radical mastoidectomy and removal of a cholesteatoma from the middle ear, including grafting of the eardrum without ossicular chain reconstruction.

Procedure Description:

Tympanoplasty.

Radical mastoidectomy.

Removal of cholesteatoma from the middle ear.

Grafting technique used to repair the eardrum without ossicular chain reconstruction.

CPT® Coding:

69645: Tympanoplasty with mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), radical or complete, with removal of cholesteatoma; with mastoid obliteration.

AMA ' s CPT® Professional Edition (current year).

CPT® Assistant for detailed coding guidelines on otolaryngology procedures.

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.

In this encounter, the correct coding order follows ICD-10-CM guidelines for coding multiple conditions when AIDS (B20) is documented, as it takes precedence. The patient ' s diagnosis of AIDS, documented with code B20, is reported as the primary diagnosis since it is a chronic condition. The M17.31 code is used to document unilateral primary osteoarthritis of the right knee, unrelated to AIDS but causing the patient ' s knee pain.

Explanation of each answer choice:

A. B20, M17.31: Correctly lists AIDS (B20) as the primary diagnosis and osteoarthritis of the right knee (M17.31) as the secondary diagnosis.

B. Z21, M08.861: Z21 represents asymptomatic HIV, not AIDS, which is incorrect here, and M08.861 is the code for juvenile idiopathic arthritis, not relevant in this case.

C. M17.11, B20: Incorrect as M17.11 is for unilateral primary osteoarthritis of the right knee, not left, and does not prioritize B20 as required.

D. M17.31, B20: Incorrect because it does not list B20 as the primary diagnosis, which is necessary per coding guidelines when AIDS is documented.

Thus, the correct answer is A. B20, M17.31.