AAPC CPC Exam - Topic 1 Question 26 Discussion

Actual exam question for AAPC's CPC exam

Question #: 26
Topic #: 1

A 60-year-old male has three-vessel disease and supraventricular tachycardia which has been refractory to other management. He previously had pacemaker placement and stenting of LAD coronary artery stenosis, which has failed to solve the problem. He will undergo CABG with autologous saphenous vein and an extensive modified MAZE procedure to treat the tachycardia.

He is brought to the cardiac OR and placed in the supine position on the OR table. He is prepped and draped, and adequate endotracheal anesthesia is assured. A median sternotomy incision is made and cardiopulmonary bypass is initiated. The endoscope is used to harvest an adequate length of saphenous vein from his left leg. This is uneventful and bleeding is easily controlled. The vein graft is prepared and cut to the appropriate lengths for anastomosis. Two bypasses are performed: one to the circumflex and another to the obtuse marginal. The left internal mammary is then freed up and it is anastomosed to the ramus, the first diagonal, and the LAD. An extensive maze procedure is then performed and the patient is weaned from bypass. At this point, the sternum is closed with wires and the skin is reapproximated with staples. The patient tolerated the procedure without difficulty and was taken to the PACU.

Choose the procedure codes for this surgery.

A33533, 33257, 33519, 33508

B33535, 33259, 33519, 33508

C33533, 33257-51, 33519-51, 33508-51

D33535, 33259 51, 33519-51, 33508-51

Show Suggested Answer

Suggested Answer: C

The procedure performed is a bilateral screening mammogram with computer-aided detection (CAD). CPT code 77067 is for bilateral screening mammography with CAD. ICD-10-CM code Z12.31 is for an encounter for screening mammogram for malignant neoplasm of the breast. Z80.3 is for a family history of malignant neoplasm of the breast. Therefore, the correct coding is 77067, Z12.31, Z80.3. Reference: CPT Professional Edition (current year), ICD-10-CM (current year).

by Marylin at Jun 19, 2024, 11:25 AM

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Noe

6 months ago

Seems like a lot of work for one surgery, but I guess it's necessary!

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Alease

6 months ago

I disagree, I believe option A is more accurate for the codes.

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Talia

6 months ago

Wait, did they really do a maze procedure too? That's intense!

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Hannah

7 months ago

I think option B makes the most sense here.

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Arminda

7 months ago

Looks like a complex case with multiple procedures involved.

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Lou

7 months ago

I think option A might be correct since it doesn't have the modifiers, but I’m worried I might be overlooking something important about the maze procedure.

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Chaya

7 months ago

I feel like I should know this, but the modifiers are throwing me off. I remember that 51 is for multiple procedures, but I can't recall if it applies here.

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Elbert

7 months ago

I practiced a similar question last week, and I think the extensive maze procedure is key here. I’m leaning towards option B, but I’m not completely confident.

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Amber

8 months ago

I remember studying the codes for CABG procedures, but I'm not entirely sure about the differences between the options. I think the maze procedure might change the coding a bit.

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Mammie

8 months ago

I feel pretty confident about this one. The key is identifying the primary procedures and then applying the appropriate modifiers. I think option C looks like the best choice here.

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Ammie

8 months ago

Hmm, this is a tricky one. I'm a little unsure about how to properly code the MAZE procedure along with the CABG. I'll need to double-check the guidelines to make sure I get this right.

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Gayla

8 months ago

Okay, let me see here. Looks like we have a CABG with saphenous vein graft, LIMA to LAD, and an extensive MAZE procedure. I think I've got this, just need to match the right codes.

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Huey

8 months ago

This looks like a pretty complex case with multiple procedures involved. I'll need to carefully review the details to make sure I select the right codes.

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Tijuana

8 months ago

Okay, I think I've got it. The key is to enable 'Ongoing Scans' to keep the recommendations up to date.

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Fletcher

8 months ago

Okay, I remember from the training that the P3O is supposed to help with benefits tracking for business owners. I'm pretty confident that's the right answer here.

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Chantay

8 months ago

This looks like a tricky ACI configuration question. I'll need to carefully review the options and think through the steps required to advertise a bridge domain subnet to an OSPF neighbor.

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Yuriko

1 year ago

Wait, so they used an endoscope to harvest the vein? I guess the surgeon was feeling a little... *maize*y that day.

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Annabelle

1 year ago

Ah, the joys of cardiac surgery coding. At least they didn't throw in a valve replacement or something to really make it interesting!

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Socorro

10 months ago

No, I believe it's B) 33535, 33259, 33519, 33508.

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German

10 months ago

B) 33535, 33259, 33519, 33508

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Madalyn

11 months ago

I think it's A) 33533, 33257, 33519, 33508.

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Mattie

11 months ago

A) 33533, 33257, 33519, 33508

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King

1 year ago

I'm leaning towards option C, but I'm a little unsure about the 51 modifier on the last few codes. Maybe I should review the coding guidelines again just to be sure.

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Basilia

12 months ago

It's always good to review the coding guidelines to make sure you're using the correct modifiers. Better safe than sorry!

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Lashawn

12 months ago

Yes, you're right. The 51 modifier is important for indicating multiple procedures. It helps avoid billing errors.

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Paola

1 year ago

I think option C is correct. The 51 modifier is used to indicate multiple procedures were performed during the same session.

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Georgiann

1 year ago

Wow, this patient has really been through the ringer! A CABG, MAZE procedure, and all that - must have been a complex surgery. I hope the coding reflects the work the team put in.

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