AAPC Chapter 11 & 20 Practical Application Quiz & Flashcards

Study Notes

Case 1: Video-Assisted Thoracoscopy

Diagnosis: Recurrent pleural effusion, stage IV right lung cancer.
Procedure: Video-assisted thoracoscopy with adhesion lysis and talc pleurodesis.
700 ml of fluid was evacuated from the pleural space.
Talc (8 grams) was introduced for pleurodesis under direct vision.
Reported Codes: CPT 32650-RT, ICD-10-CM J90, C34.91.

Case 2: Tracheostomy

Diagnosis: Malignant neoplasm of the glottis.
Procedure: Tracheostomy performed with an incision made low in the neck.
A tracheostomy tube was inserted and secured.
Reported Codes: CPT 31600, ICD-10-CM C32.0.

Case 3: Bronchoscopy and Wedge Resection

Diagnosis: Pneumothorax following MVA (Motor Vehicle Accident).
Procedures: Bronchoscopy and left Video-Assisted Thoracoscopic Surgery (VATS) with wedge resection performed.
Identified a large bleb at the apex of the left lung.
Reported Codes: CPT 32666-LT, 31622-51, ICD-10-CM S27.0XXA, V03.90XA.

Case 4: Bilateral Sinus Surgery

Diagnoses: Chronic hyperplastic rhinosinusitis, intranasal and sinus polyps.
Complex bilateral sinus surgery performed including multiple endoscopic procedures.
Specimens sent for routine and fungal cultures.
Reported Codes: CPT 31259-50, 31267-50-51, ICD-10-CM J33.0, J33.8, J32.9.

Case 5: Mediastinotomy

Diagnoses: Sarcoid of lymph nodes, new onset paratracheal adenopathy.
Procedure: Mediastinotomy performed under general anesthesia.
Major lymph node biopsied.
Reported Codes: CPT 39000, ICD-10-CM D86.1, R59.0.

Case 6: Thoracentesis Attempt

Diagnosis: Loculated left pleural effusion, chronic.
Attempted ultrasound-guided thoracentesis; thick fibrous pleura inhibited fluid aspiration.
Reported Codes: CPT 32555-LT, ICD-10-CM J90.

Case 7: Direct Laryngoscopy

Diagnosis: Left vocal cord tumor.
Procedure: Direct laryngoscopy with microscope for tumor removal.
Specimen sent to pathology, minimal bleeding reported.
Reported Codes: CPT 31541, ICD-10-CM D49.1.

Case 8: Right Upper Lobectomy

Diagnosis: Carcinoma of the right upper lobe.
Procedure: Video-Assisted Thoracoscopic Surgery (VATS) right superior lobectomy.
Two small incisions for camera access; tumor excised and sent for pathology.
Reported Codes: CPT 32663-RT, ICD-10-CM C34.11.

Case 9: Laparoscopic Bilateral Pelvic Lymphadenectomy

Diagnosis: Grade 3 squamous cell carcinoma of the penis with inguinal lymphatic metastasis.
Procedure: Laparoscopic bilateral pelvic lymphadenectomy performed.
Comprehensive dissection of lymphatics completed under visible landmarks.
Reported Codes: CPT 38574, ICD-10-CM C77.4, C60.9.

Case 10: Bronchoscopy for Carcinoma

Diagnosis: Carcinoma of the right lung and bronchus intermedius.
Procedure: Fiberoptic bronchoscopy, multiple washings, brushings, and biopsies taken for analysis.
Extrinsic compression of the right upper lobe and a submucosal tumor identified.
Reported Codes: CPT 31625-RT, 32623-51-RT, ICD-10-CM C34.81.

Description

Test your knowledge on practical applications from Chapter 9 of the AAPC coding guidelines. This quiz focuses on understanding diagnosis and procedures related to thoracic surgeries. Great for coders looking to enhance their skills in medical coding.