AAPC Updated CPC Exam Questions and Answers by inaaya

74021 = Abdomen, complete, including decubitus and erect views

-26 = Professional component

The patient is undergoing a cardiac catheterization with a CRNA providing monitored anesthesia care (MAC). Code 00520 is for anesthesia for heart catheterization procedures. Modifier QX indicates CRNA service with medical direction by a physician, QS indicates MAC, and P5 indicates a patient with a severe systemic disease that is a constant threat to life. Thus, the correct code and modifier combination is 00520-QX-QS-P5.

1. Procedure and CPT® Code Selection:

The patient underwent a thyroidectomy for malignancy in the right lobe, as well as the removal of the parathyroid gland due to a suspected malignant lesion.

CPT® Code 60505 is for the parathyroidectomy with exploration of parathyroid glands and is appropriate for the removal of the parathyroid gland due to a suspected malignancy.

CPT® Code 60220 represents a thyroid lobectomy (total removal of one lobe of the thyroid), which applies to the removal of the right thyroid lobe in this case.

2. Modifier 59:

Modifier 59 is added to 60220 to indicate that the thyroid lobectomy is a distinct procedure from the parathyroidectomy, performed in a separate anatomical site during the same surgical session.

3. Rationale for Excluding Other Options:

Code 60500 (in options A and C) is for a parathyroid exploration only, not including the actual removal of the parathyroid gland, so it does not apply here.

Code 60240 (in option D) is for a total thyroidectomy, which involves removal of the entire thyroid gland. Since only the right lobe was removed, 60220 (thyroid lobectomy) is correct.

4. AAPC and CPT® Coding Guidelines:

Per AAPC guidelines, 60505 is the appropriate code for parathyroidectomy procedures involving exploration or suspected malignancy, and 60220 with Modifier 59 accurately reflects the separate and distinct thyroid lobectomy procedure.

Thus, the correct answer is B. 60505, 60220-59.

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.