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Procedure Coding (CPT®):

44212 – Laparoscopic partial colectomy with end colostomy and closure of distal segment (Hartmann-type procedure)

Correct because:

Sigmoid/descending colon resection

Proximal colostomy created

Distal rectal stump closed

44213 – Laparoscopic mobilization of splenic flexure

Separately reportable because:

Mobilization was necessary to exteriorize colon for colostomy

Not bundled into 44212

Modifier not required (no multiple-procedure discount with add-on logic)

Diagnosis Coding (ICD-10-CM):

K57.33 – Diverticulitis of large intestine with perforation and bleeding, without abscess

Documentation supports:

Diverticulitis

Active bleeding

No abscess reported

Why Other Options Are Incorrect:

A / B – 44206 = colectomy with anastomosis (not performed)

A / B – K57.41 includes abscess (not documented)

C – Missing splenic flexure add-on explanation

CPT® & ICD-10-CM Guideline Alignment:

Hartmann procedure ≠ anastomosis

Bleeding elevates diagnosis specificity

Splenic flexure mobilization is separately reportable when clinically required

Injection of atropine: Atropine is administered to reduce sialorrhea.

Bilateral submandibular salivary glands: The physician administers the injections into the salivary glands.

Total of four glands: Indicates that multiple glands are treated in the same session.

CPT code 64611 accurately represents chemodenervation of the salivary glands, bilateral. The use of -50, -52, or x4 modifiers is not appropriate since CPT guidelines include bilateral procedures in this code without needing additional modifiers or codes.

For Mohs micrographic surgery, CPT® coding is based on the anatomic location of the lesion, the number of stages, and the number of tissue blocks per stage.

17311: This code is used for Mohs surgery on body areas such as the trunk, arms, or legs for the first stage.

17315: This is an add-on code used when more than five tissue blocks are examined in a single stage. Since this case involved six tissue blocks, 17315 is appropriate.

Explanation of incorrect answers:

A. 17313, 17314, 17315: Incorrect, as 17313 applies to the head, neck, hands, feet, or genitalia, not the arm.

C. 17313, 17315: Incorrect, as 17313 is not appropriate for the arm.

D. 17311, 17312, 17315: 17312 is used for additional stages beyond the first, which is not applicable here since only one stage was performed.

E. 85B2-335 is not a valid CPT code for Mohs surgery.

Thus, the correct answer is B. 17311, 17315, which accurately reflects a single-stage Mohs surgery with six tissue blocks on the arm.

TSH testing is reported with CPT84443. The scenario describes a workup for possible thyroid dysfunction, but there isno confirmed thyroid diagnosisprovided—only symptoms (fatigue and weight gain). In outpatient coding, when a definitive diagnosis is not established, you code thesigns/symptomsthat justify the test. Therefore, the correct ICD-10-CM codes areR53.83(other fatigue) andR63.5(abnormal weight gain), as offered. You shouldnotassign a thyroid disorder code such asE07.9(unspecified disorder of thyroid) unless the provider documents an actual thyroid disorder diagnosis; suspicion alone does not support it in the outpatient setting. Options C and D list84445, which is not the standard CPT code for TSH measurement in CPC exam coding. This question is testing both correct lab code selection and the outpatient guideline principle of codingsymptomswhen the diagnosis is not confirmed. Hence,84443 with R53.83 and R63.5is correct.