Certified Professional Coder CPC Dumps PDF

42820 = Tonsillectomy and adenoidectomy, under age 12

J35.03 already includes chronic tonsillitis and adenoiditis

Hypertrophy is included and not separately coded

1. Procedure and CPT® Code Selection:

The patient underwent a partial nephrectomy (removal of part of the left kidney) via a laparoscopic approach.

CPT® Code 50543 is specifically used for a laparoscopic partial nephrectomy, which is an accurate description of this procedure.

2. Rationale for Excluding Other Options:

Code 50548 is used for a laparoscopic radical nephrectomy, which involves the complete removal of the kidney and surrounding structures; therefore, it does not apply to this partial nephrectomy.

Code 50220 represents an open partial nephrectomy, not a laparoscopic approach, and is therefore incorrect for this procedure.

Code 50546 is for a laparoscopic radical nephrectomy with bilateral removal of kidneys, which is not applicable in this case where only a partial removal of the left kidney was performed.

3. AAPC and CPT® Coding Guidelines:

AAPC and CPT® guidelines indicate that the use of 50543 is appropriate for any laparoscopic partial nephrectomy, regardless of the laterality, and it specifically identifies laparoscopic technique over open surgery.

Therefore, based on CPT® guidelines, the correct answer is C. 50543.

1. Procedure and CPT® Code Selection:

The physician administered the MMRV (measles, mumps, rubella, and varicella) vaccine subcutaneously and dose 3 of Hepatitis B vaccine intramuscularly. The physician also provided counseling on routine immunizations.

CPT® Code 90460 is used for immunization administration with counseling by the physician for patients 18 years or younger for the first or only component of each vaccine.

CPT® Code 90461 is used for each additional component in a vaccine with counseling.

90710 is the code for the MMRV vaccine.

90744 is the code for the Hepatitis B vaccine (pediatric).

2. Application of 90460 and 90461:

For the MMRV vaccine (which has four components: measles, mumps, rubella, and varicella), 90460 is reported once for the first component, and 90461 is reported three times (once for each additional component).

For the Hepatitis B vaccine, 90460 is reported again since it is a separate vaccine with one component.

3. Rationale for Excluding Other Options:

Option A (90471, 90472 x 4, 90707, 90746) uses codes for vaccine administration without counseling and incorrect vaccine codes (90707 for MMR instead of MMRV and 90746 for adult Hepatitis B instead of pediatric).

Option B and Option D also contain incorrect vaccine codes and do not correctly apply the counseling administration codes.

4. AAPC and CPT® Coding Guidelines:

According to AAPC guidelines, 90460 and 90461 are the appropriate administration codes for vaccines with counseling provided to pediatric patients, with each component of a multi-component vaccine coded separately.

Therefore, the correct answer is C. 90460 x 2, 90461 x 3, 90710, 90744.

To accurately code this emergency department visit, we need to assess the three key components: history, examination, and medical decision making (MDM).

History:

The documentation supports an expanded problem-focused history. This includes a chief complaint, a brief history of present illness (HPI), a review of systems (ROS) with pertinent positives and negatives, and a past medical history.

Examination:

The examination is also expanded problem-focused. The physician focused on the relevant systems (constitutional, HENT, respiratory) and documented specific findings related to the chief complaint (appears tired).

Medical Decision Making:

The MDM complexity is low. The physician is assessing a new problem (shortness of breath and weakness) with a low level of risk. No further testing or treatment is documented in this encounter.

Based on these components, 99283 is the most appropriate code.

Why other options are incorrect:

99282: Requires a problem-focused history and examination, which is less comprehensive than what was documented.

99284 and 99285: Require a higher level of MDM (moderate or high complexity) and/or a more detailed examination. The documentation doesn't support this level of service.