Discuss AAPC CPC Exam Topic 3 Question 43

A 4-year-old, critically ill child is admitted to the PICU from the ED with respiratory failure due to an exacerbation of asthma not manageable in the ER. The PICU provider takes over the care of the patient and starts continuous bronchodilator therapy and pharmacologic support with cardiovascular monitoring and possible mechanical ventilation support.

What is the E/M code for this encounter?

A99285

B99475

C99291

D99471

Suggested Answer: A

29827: Arthroscopic rotator cuff repair is correctly coded as 29827.

29828: Arthroscopic biceps tenodesis is an additional procedure and should be coded as 29828 with modifier -51 (Multiple Procedures).

29824: Arthroscopic claviculectomy (partial resection of the distal clavicle) is coded as 29824 with modifier -51.

29826: Arthroscopic subacromial decompression, including coracoacromial ligament release, is coded as 29826.

All these procedures were performed arthroscopically and documented in the operative report, justifying the use of these codes and the use of modifier -51 for multiple procedures.

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34 comments · newest first

Maddie 10 months ago

Surprised they didn't go straight to mechanical ventilation!

Lashandra 11 months ago

I thought 99291 was for more intensive monitoring.

Arlen 11 months ago

Wait, isn't 99475 for pediatric patients?

Fernanda 11 months ago

I agree, 99285 fits for that level of care.

Gracia 11 months ago

Sounds like a critical situation, definitely 99285.

Salome 12 months ago

I’m leaning towards 99291 because it seems to fit the critical care aspect, but I’m not entirely confident about the details of the codes.

Daniel 12 months ago

I feel like 99475 is related to pediatric patients, but I don't remember if it applies here since the child is critically ill.

My 12 months ago

I remember practicing a similar question, and I think 99285 is for emergency department visits, but I can't recall the specifics for PICU admissions.

Lenny 1 year ago

I think this might be a critical care code since the child is in respiratory failure, but I'm not sure if it's 99291 or something else.

Bo 1 year ago

I feel pretty confident about this one. The patient is in the PICU, requiring advanced respiratory support and cardiovascular monitoring, so 99291 is the most appropriate E/M code for this encounter.

Kimi 1 year ago

Based on the information provided, I'm leaning towards 99291 as the correct code. The patient is in the PICU and requires continuous monitoring and potential mechanical ventilation, which seems to fit that code description.

Carissa 1 year ago

I'm a bit confused on the difference between some of these codes. 99285 and 99291 both seem like they could apply, but I'm not sure which one is more appropriate.

Sena 1 year ago

Okay, let's see. The patient is a critically ill 4-year-old in the PICU with respiratory failure from an asthma exacerbation. I think the key is identifying the appropriate level of care.

Vallie 1 year ago

Hmm, this seems like a tricky one. I'll need to carefully review the details of the case and the E/M code options.

Barney 1 year ago

Wait, are we coding for the patient or the PICU provider's headache from this tricky question?

Kaycee 1 year ago

↳ replying to Barney

C) 99291

Layla 1 year ago

↳ replying to Barney

B) 99475

Elly 1 year ago

↳ replying to Barney

A) 99285

Theodora 1 year ago

I'm going with B) 99475. The patient is a 4-year-old, and this code is for the subsequent hospital care of a critically ill child.

Viki 1 year ago

↳ replying to Theodora

C: I agree with B, 99291 seems to be the most appropriate code for this encounter.

Gilma 1 year ago

↳ replying to Theodora

A: Let's double check the documentation to make sure we are selecting the right code.

Leanora 1 year ago

↳ replying to Theodora

A: Oh, I see. I thought it was for initial hospital care, but you're right.

Yuonne 1 year ago

↳ replying to Theodora

B: I believe it's C) 99291, which is for critical care provided in the PICU.

Felicia 1 year ago

↳ replying to Theodora

B: I disagree, I believe it is C) 99291.

Maurine 1 year ago

↳ replying to Theodora

A: I think the correct E/M code is A) 99285.

Laurel 1 year ago

↳ replying to Theodora

A: I think the correct E/M code is A) 99285. It's for the critical care of a critically ill or injured patient.

Rebbecca 1 year ago

D) 99471 sounds right to me. The child is a pediatric patient, and this code is for the initial hospital care of a critically ill child.

Owen 1 year ago

Hmm, I'm not sure. This question is really making my head spin! Maybe I should have paid more attention in class.

Susana 1 year ago

↳ replying to Owen

B) 99475

Weldon 1 year ago

↳ replying to Owen

A) 99285

Salome 1 year ago

I think the correct answer is C) 99291. This code represents the critical care services provided to the critically ill child in the PICU.

Lynna 2 years ago

I'm not sure, but I think it might be 99475 because of the critical care involved in this case.

Deangelo 2 years ago

I agree with Alise, 99285 seems like the correct code for this scenario.

Alise 2 years ago

I think the E/M code for this encounter is 99285.

AAPC CPC Exam - Topic 3 Question 43 Discussion