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AAPC - Chapter 11 Practical Applications questions & answers rated A+ 2023/2024
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AAPC - Chapter 11 Practical ApplicationsCASE 1 Preoperative Diagnosis: History of rectal carcinoma. Postoperative Diagnosis: History of rectal carcinoma. Procedure Performed: Closure of loop ileostomy with small bowel resection and enteroenterostomy with intraoperative flexible sigmoidosco...

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  • November 23, 2023
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  • 2023/2024
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AAPC - Chapter 11 Practical Applications
CASE 1
Preoperative Diagnosis: History of rectal carcinoma.
Postoperative Diagnosis: History of rectal carcinoma.
Procedure Performed: Closure of loop ileostomy with small bowel resection and enteroenterostomy with
intraoperative flexible sigmoidoscopy.
Description of Procedure: After induction of adequate general endotracheal anesthesia,(General anesthesia.) the patient was carefully positioned in the supine modified lithotomy position in Allen stirrups.(Lying on back with legs in stirrups.) Great care was taken to pad and protect all areas of potential bodily injury. Digital rectal examination revealed a widely patent circumferentially intact pouch anal anastomosis within 1 cm of the dentate line. Flexible sigmoidoscopy was performed revealing healthy pink mucosa. The abdomen was prepped and draped in the usual sterile manner, and a parastomal incision(Cutting around the ostomy opening to release it from the ab - correct answer 44625
Z43.2
Z85.048
CASE 2
Preoperative Diagnosis: Right-sided colonic polyps.
Postoperative Diagnosis: Right-sided colonic polyps.
Procedure: Laparoscopic right hemicolectomy with ileocolic anastomosis. Description of Procedure: After induction of adequate general endotracheal anesthesia,(General anesthesia.) the patient was carefully positioned in the supine, modified-lithotomy position and Allen stirrups. Great care was taken to carefully pad and protect all areas of potential bodily injury. The abdomen was prepped and draped in the usual sterile manner.(Positioning and draping the patient is standard of care - not billable.)
Using a supra-umbilical vertical incision, a Hasson technique(Type of laparoscopic approach. The Hasson technique employs an open type of port insertion site for laparoscopic procedures.) was employed to carefully place a 10 mm cannula. Carbon dioxide pneumoperitoneum of 15 mmHg was achieved, after which a - correct answer 44205
K63.5
CASE 3
Procedure: Uvulopalatopharyngoplasty.(The procedure is to repair the uvula and tonsils.)
Indication: A 63 year-old with obstructive sleep apnea. He is intolerant of CPAP .
Description of Procedure: I identified the patient and he was brought to the operating room. General endotracheal anesthesia was induced without complication. Tonsillar pillars and palate were injected with 0.25% Marcaine. The right tonsil was grasped with an Allis forceps and dissected from the tonsillar fossa(Right tonsillectomy. It's not billable because it's included in the primary procedure.) with a combination of blunt and cautery dissection. The posterior pillar remained intact as I proceeded to do similar mobilization of the left tonsil.(Left tonsillectomy. It's not billable because it's included in the primary procedure - cannot be unbundled.) I then made a mucosa incision across the base of the palate approximately 0.5 cm from t - correct answer 42145
G47.33
CASE 4
Preoperative Diagnosis: Morbid obesity. Sleep apnea. BMI 40.
Postoperative Diagnosis: Morbid obesity. BMI 40.

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