AAPC Updated CPC Exam Questions and Answers by saif

1. Procedure and CPT® Code Selection:

The procedure involves an incision and drainage (I&D) of a deep abscess (felon) on the palmar surface of the right thumb. A felon is an abscess in the pulp of the fingertip, often involving deep tissue.

Code 26010 is specific for incision and drainage of a finger abscess, which includes the thumb. This code applies to cases where the abscess is drained from a deep tissue level.

Code 26011 is similar but involves the use of extensive drainage or debridement, which is not indicated in this case. Therefore, 26011 is not appropriate here.

Code 10061 refers to incision and drainage of abscesses at different locations on the body but not for specific areas such as the thumb, making it inappropriate in this context.

Code 10140 pertains to the evacuation of hematoma, seroma, or fluid but does not apply to abscesses, so it is not suitable for this scenario.

2. Modifier:

Modifier F5 is added to specify that the procedure was performed on the right thumb.

3. Diagnosis and ICD-10-CM Code Selection:

ICD-10-CM Code L02.511 is appropriate for cutaneous abscess of the right finger, as it accurately describes the diagnosis of a felon on the thumb.

L03.011 would represent cellulitis but does not specify an abscess, making it less precise for this case.

4. AAPC and CPT® Coding Guidelines:

The AAPC guidelines for coding finger abscess drainage emphasize the selection of specific codes for deep tissue drainage procedures in extremities. Additionally, correct laterality should be included with the use of modifiers and specific ICD-10-CM codes for an accurate representation of the site and nature of the condition.

Thus, based on the coding standards and guidelines, the verified answer is B. 26010-F5, L02.511.

Medicare provides specific codes for screening colonoscopy based on the patient's risk factors. For a Medicare patient scheduled for a screening colonoscopy who is at high risk (such as those with a history of intestinal polyps), the appropriate code is G0105.

G0105 is used for colorectal cancer screening; colonoscopy on individuals at high risk.

HCPCS Level II, current year

Medicare Guidelines for Colorectal Cancer Screening

1. E/M Service Code Selection:

On day two, the urologist provided an evaluation and management (E/M) service for a hospitalized patient with a low level for the number and complexity of problems addressed, minimal complexity for data reviewed, and moderate risk of complications.

CPT® Code 99232 is for a subsequent hospital care E/M service with a level of "Expanded Problem Focused" history and examination, with Medical Decision Making (MDM) of Moderate complexity. This matches the description provided, as the MDM includes a low number of problems, minimal data, and moderate risk.

2. Rationale for Excluding Other Options:

Code 99233 is for a subsequent hospital care visit with high complexity MDM (e.g., addressing a high number of problems or higher levels of data review), which does not align with the moderate risk described here.

Code 99221 is for initial hospital care, not a subsequent visit.

Code 99231 represents a lower level of subsequent hospital care with straightforward or low complexity MDM, which does not meet the moderate risk criteria in this scenario.

3. AAPC and CPT® Coding Guidelines:

AAPC and CPT® guidelines indicate 99232 as appropriate for subsequent hospital visits with moderate MDM, such as this visit with moderate risk but minimal data complexity.

Therefore, the correct answer is B. 99232.

The procedure described involves the removal of electrodes from the cranial area after making an incision in the scalp and performing a craniectomy.

Procedure Description:

Incision in the scalp.

Craniectomy to access the area with electrodes.

Removal of electrodes.

Closure of the surgical wound.

CPT® Coding:

61860: Removal of intracranial neurostimulator electrodes, including burr hole(s) or craniectomy.

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

CPT® Assistant for detailed coding guidelines on neurostimulator procedures.