AAPC Ch.8 Musculoskeletal System questions with 100% correct answers 2023/2024

AAPC Ch.8 Musculoskeletal SystemWhat is being removed for hallux valgus surgery? - correct answer Bunion Rationale: Bunion is also called a hallux valgus. In the ICD-10-CM Alphabetic look for Hallux/valgus (acquired) referring you to M20.1-. In the Tabular List under subcategory code M20.1 you will see the term bunion listed. Hallux valgus correction is known as a bunionectomy or bunion surgery. CPT® code 28292 also indicates this by looking for Bunion Repair in the CPT® Index. A patient presents to the ED with back pain and is diagnosed with a lumbar sprain. What ICD-10-CM code is reported? - correct answer S33.5XXA Rationale: In the ICD-10-CM Alphabetic Index, look for Sprain/lumbar (spine) and you are directed to S33.5-. In the Tabular List this code requires a 7th character to describe the episode of care. Because the patient is presenting to the ED, this supports the definition of initial encounter. For the 5th and 6th characters use the X placeholder to maintain the 7th character position of A. Back pain is not reported because a definitive diagnosis was documented, and pain is a symptom of lumbar sprain. (See ICD-10-CM guideline I.B.6.). ___________ fixation with pins, screws, plates, or wires is placed directly on or in the bone to immobilize a fractured bone and to maintain alignment while it heals. - correct answer Internal Rationale: Some fractures are treated with either internal or external fixation to maintain the alignment of the bone and immobilize it while it heals, or to reinforce the bone permanently. Internal fixation can be performed with pins, screws, plates or wires placed directly in or on the bone to immobilize it. A 42 year-old with chronic right trochanteric bursitis is scheduled to receive an injection at the Pain Clinic. A 22-gauge spinal needle is introduced into the trochanteric bursa, and a total volume of 8 cc of normal saline and 40 mg of Kenalog is injected. What are the CPT® codes? - correct answer 20610-RT, J3301 x 4 Rationale: In the CPT® Index look for Injection/Bursa. You are referred to 20600-20611. Review the codes to choose appropriate service. 20610 is the correct code because the injection was given in the trochanteric bursa (hip, a major joint) without ultrasound guidance for drug therapy. In the HCPCS Level II codebook look in the Table of Drugs and Biologicals for Kenalog and you see Kenalog -10 and Kenalog-40, which both refer you to See Triamcinolone Acetonide. Triamcinolone Acetonide leads to several codes J3300, J3301, and J3302. J3301 10 mg lists Kenalog in the notes below the code. Report 4 units for 40 mg of Kenalog. A 63 year-old man sustained a gunshot wound through the right maxillary sinus penetrating into the right neck. CT scan revealed no hard evidence of arterial injury but a bullet was directly in line with the internal jugular vein. He was sent to the operating room for neck exploration to rule out vascular injury and injury to the aerodigestive tract (respiratory and digestive tracts). A sternocleidomastoid incision was performed and carried down through the platysma muscle. There was no penetration of the internal jugular vein, but a foreign body was identified resting on the internal jugular vein at approximately the level of the angle of the mandible and it was removed. The parotid gland was noted to have a blast injury near the tail. This was not surgically repaired or resected. Once all bleeding was controlled, a 10 French round drain was placed in the wound. The wound was copiously irrigated. The platysma muscle - correct answer 20100 Rationale: In the CPT® Index, look for Exploration/Neck/Penetrating Wound. You are referred to 20100. Review the code to verify accuracy. 20100 is the correct code because the patient was sent to the operating room for exploration of a gunshot (penetrating trauma) wound to identify damaged structures. The category guidelines for Wound Exploration-Trauma indicate that these codes include removal of foreign bodies, ligation or coagulation of minor subcutaneous and muscular blood vessels, damaged tissue debridement, repair and wound closure. A 49 year-old presents with an abscess of the right thumb. The physician incises the abscess and purulent sanguineous fluid is drained. The wound is packed with iodoform packing. What CPT® code is reported? - correct answer 26010-F5 Rationale: There are specific Incision and Drainage (I&D) procedure codes when performed on a specific anatomical area. In the CPT® Index, look for Finger/Abscess/Incision and Drainage. You are referred to . Review the codes to choose the appropriate service. 26010 is the correct code. Code