AAPC Updated CPC Exam Questions and Answers by azlan

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.

1. Procedure and CPT® Code Selection:

The obstetric panel ordered includes the following tests: syphilis screening (non-treponemal), automated CBC with manual differential WBC count, HBsAg, rubella antibody, serum antibody screen, and ABO/Rh blood typing.

CPT® Code 80055 is for a comprehensive obstetric panel that includes all these components. This code is intended to report the entire panel of tests as a bundled service rather than itemizing each individual test.

2. Rationale for Excluding Other Options:

Option B lists the individual component codes for each test in the obstetric panel (e.g., 85027, 85007, 87340, etc.), but using 80055 is more appropriate because it provides a single code to report the full obstetric panel and follows CPT® bundling guidelines.

Option C also lists the individual tests separately, which is unnecessary when 80055 includes all these components.

Option D lists 80081, which is for an obstetric panel that includes HIV testing. Since HIV testing is not part of the tests described in this scenario, 80081 is incorrect.

3. AAPC and CPT® Coding Guidelines:

AAPC guidelines recommend using the single code 80055 when all components of an obstetric panel are ordered together, as itemizing each test individually is not necessary.

Therefore, the correct answer is A. 80055.

1. Procedure Type and CPT® Code Selection:

The physician performed an injection into the wrist joint for degenerative osteoarthritis management using Synvisc (a viscosupplementation product).

Code 20606 is the correct CPT® code for an arthrocentesis, aspiration, and/or injection procedure in an intermediate joint, such as the wrist. This code specifically includes the use of ultrasound guidance, which is often standard in such injections.

Code 20551 (injection of a single tendon origin) and 20526 (injection into a carpal tunnel) are incorrect here as they do not apply to intra-articular injections for joint osteoarthritis management.

2. Diagnosis Code Selection (ICD-10-CM):

The diagnosis is degenerative osteoarthritis in the right wrist.

ICD-10-CM Code M19.231 is used for primary osteoarthritis of the right wrist. This code directly reflects the diagnosis of primary osteoarthritis affecting this specific joint.

M19.031 would represent primary osteoarthritis in the wrist but does not specify laterality; therefore, it is less accurate than M19.231, which denotes the right wrist.

3. Summary of Code Application:

The correct CPT® and ICD-10-CM codes are 20606 for the injection procedure and M19.231 for primary osteoarthritis of the right wrist.

4. AAPC and CPT® Coding Guidelines:

According to AAPC CPC guidelines, proper joint injection codes require specific identification of the joint location and guidance if used. Additionally, selecting the most specific ICD-10-CM code for laterality is essential for accuracy in musculoskeletal diagnoses.

Thus, based on CPT® and ICD-10-CM coding guidelines, the verified answer is B. 20606, M19.231.

CPT® code 69644 refers to a tympanoplasty with mastoidectomy, which includes canalplasty, middle ear surgery, and tympanic membrane repair. The specific procedure described by this code is performed with an intact or reconstructed canal wall and includes ossicular chain reconstruction. The use of a semicolon in the CPT® description helps distinguish between different variations of the procedure.

AMA ' s CPT® Professional Edition, specific code descriptions and guidelines.