AAPC - Chapter 11 Practical
Applications Latest 2024/2025
CASEs1
PreoperativesDiagnosis:sHistorysofsrectalscarcinoma.
PostoperativesDiagnosis:sHistorysofsrectalscarcinoma.
ProceduresPerformed:sClosuresofsloopsileostomyswithssmallsbowelsresectionsandsenteroent
erostomyswithsintraoperativesflexiblessigmoidoscopy.
DescriptionsofsProcedure:sAftersinductionsofsadequatesgeneralsendotrachealsanesthesia,(
Generalsanesthesia.)sthespatientswasscarefullyspositionedsinsthessupinesmodifiedslithotomys
positionsinsAllensstirrups.(Lyingsonsbackswithslegssinsstirrups.)sGreatscareswasstakenstospads
andsprotectsallsareassofspotentialsbodilysinjury.sDigitalsrectalsexaminationsrevealedsaswidelys
patentscircumferentiallysintactspouchsanalsanastomosisswithins1scmsofsthesdentatesline.sFle
xiblessigmoidoscopyswassperformedsrevealingshealthyspinksmucosa.sThesabdomenswasspr
eppedsandsdrapedsinsthesusualssterilesmanner,sandsasparastomalsincision(Cuttingsaroundst
hesostomysopeningstosreleasesitsfromsthesabs-scorrectsanswers--44625
Z43.2
Z85.048
CASEs2
PreoperativesDiagnosis:sRight-sidedscolonicspolyps.
PostoperativesDiagnosis:sRight-sidedscolonicspolyps.
Procedure:sLaparoscopicsrightshemicolectomyswithsileocolicsanastomosis.
DescriptionsofsProcedure:sAftersinductionsofsadequatesgeneralsendotrachealsanesthesia,(
Generalsanesthesia.)sthespatientswasscarefullyspositionedsinsthessupine,smodified-
lithotomyspositionsandsAllensstirrups.sGreatscareswasstakenstoscarefullyspadsandsprotectsalls
areassofspotentialsbodilysinjury.sThesabdomenswasspreppedsandsdrapedsinsthesusualssteriles
manner.(Positioningsandsdrapingsthespatientsissstandardsofscares-snotsbillable.)
Usingsassupra-
umbilicalsverticalsincision,sasHassonstechnique(Typesofslaparoscopicsapproach.sThesHass
onstechniquesemployssansopenstypesofsportsinsertionssitesforslaparoscopicsprocedures.)swa
ssemployedstoscarefullysplacesas10smmscannula.sCarbonsdioxidespneumoperitoneumsofs15s
mmHgswassachieved,safterswhichsas-scorrectsanswers--44205
, K63.5
CASEs3
Procedure:sUvulopalatopharyngoplasty.(Thesproceduresisstosrepairsthesuvulasandstonsils.)
Indication:sAs63syear-oldswithsobstructivessleepsapnea.sHesissintolerantsofsCPAP.
DescriptionsofsProcedure:sIsidentifiedsthespatientsandsheswassbroughtstosthesoperatingsroom
.sGeneralsendotrachealsanesthesiaswassinducedswithoutscomplication.sTonsillarspillarssand
spalatesweresinjectedswiths0.25%sMarcaine.sThesrightstonsilswassgraspedswithsansAllissforce
pssandsdissectedsfromsthestonsillarsfossa(Rightstonsillectomy.sIt'ssnotsbillablesbecausesit'ssi
ncludedsinsthesprimarysprocedure.)swithsascombinationsofsbluntsandscauterysdissection.sThe
sposteriorspillarsremainedsintactsassIsproceededstosdossimilarsmobilizationsofsthesleftstonsil.(L
eftstonsillectomy.sIt'ssnotsbillablesbecausesit'ssincludedsinsthesprimarysprocedures-
scannotsbesunbundled.)sIsthensmadesasmucosasincisionsacrosssthesbasesofsthespalatesappro
ximatelys0.5scmsfromsts-scorrectsanswers--42145
G47.33
CASEs4
PreoperativesDiagnosis:sMorbidsobesity.sSleepsapnea.sBMIs40.
PostoperativesDiagnosis:sMorbidsobesity.sBMIs40.
ProceduresPerformed:sLaparoscopicssleevesgastrectomy.sIntraoperativesesophagogastro
duodenoscopy.(Laparoscopic—SleevesGastrectomy.)
Intraoperativesendoscopy
Anesthesia:sGeneralsendotrachealsanesthesia.
OperativesProcedure:sThespatientswassbroughtstosthesoperatingsroomsandsplacedsonsthesO
Rstablesinssupinesposition.sOncesgeneralsendotrachealsanesthesiaswassachievedsandspre-
opsantibioticssweresgiven,sthesabdomenswasspreppedsandsdrapedsinsthesstandardssurgicalsf
ashion.sAccessstosthesabdominalscavityswassthroughsas1scmssupraumbilicalsincisionswithsan
sOptiviewstrocar.(Laparoscopicsprocedure.)sCo2swassinsufflatedstosachievesansintraabdomi
nal(Gassissusedstosextendsthesabdomenstosimprovesthesvisualsfield.)spressuresofsapproxima
telys15smmHg.sAccessorystrocarssweresplacedsinsthessubxiphoid,sright,smid,sandsls-
scorrectsanswers--43775
E66.01
Z68.41
CASEs5
Applications Latest 2024/2025
CASEs1
PreoperativesDiagnosis:sHistorysofsrectalscarcinoma.
PostoperativesDiagnosis:sHistorysofsrectalscarcinoma.
ProceduresPerformed:sClosuresofsloopsileostomyswithssmallsbowelsresectionsandsenteroent
erostomyswithsintraoperativesflexiblessigmoidoscopy.
DescriptionsofsProcedure:sAftersinductionsofsadequatesgeneralsendotrachealsanesthesia,(
Generalsanesthesia.)sthespatientswasscarefullyspositionedsinsthessupinesmodifiedslithotomys
positionsinsAllensstirrups.(Lyingsonsbackswithslegssinsstirrups.)sGreatscareswasstakenstospads
andsprotectsallsareassofspotentialsbodilysinjury.sDigitalsrectalsexaminationsrevealedsaswidelys
patentscircumferentiallysintactspouchsanalsanastomosisswithins1scmsofsthesdentatesline.sFle
xiblessigmoidoscopyswassperformedsrevealingshealthyspinksmucosa.sThesabdomenswasspr
eppedsandsdrapedsinsthesusualssterilesmanner,sandsasparastomalsincision(Cuttingsaroundst
hesostomysopeningstosreleasesitsfromsthesabs-scorrectsanswers--44625
Z43.2
Z85.048
CASEs2
PreoperativesDiagnosis:sRight-sidedscolonicspolyps.
PostoperativesDiagnosis:sRight-sidedscolonicspolyps.
Procedure:sLaparoscopicsrightshemicolectomyswithsileocolicsanastomosis.
DescriptionsofsProcedure:sAftersinductionsofsadequatesgeneralsendotrachealsanesthesia,(
Generalsanesthesia.)sthespatientswasscarefullyspositionedsinsthessupine,smodified-
lithotomyspositionsandsAllensstirrups.sGreatscareswasstakenstoscarefullyspadsandsprotectsalls
areassofspotentialsbodilysinjury.sThesabdomenswasspreppedsandsdrapedsinsthesusualssteriles
manner.(Positioningsandsdrapingsthespatientsissstandardsofscares-snotsbillable.)
Usingsassupra-
umbilicalsverticalsincision,sasHassonstechnique(Typesofslaparoscopicsapproach.sThesHass
onstechniquesemployssansopenstypesofsportsinsertionssitesforslaparoscopicsprocedures.)swa
ssemployedstoscarefullysplacesas10smmscannula.sCarbonsdioxidespneumoperitoneumsofs15s
mmHgswassachieved,safterswhichsas-scorrectsanswers--44205
, K63.5
CASEs3
Procedure:sUvulopalatopharyngoplasty.(Thesproceduresisstosrepairsthesuvulasandstonsils.)
Indication:sAs63syear-oldswithsobstructivessleepsapnea.sHesissintolerantsofsCPAP.
DescriptionsofsProcedure:sIsidentifiedsthespatientsandsheswassbroughtstosthesoperatingsroom
.sGeneralsendotrachealsanesthesiaswassinducedswithoutscomplication.sTonsillarspillarssand
spalatesweresinjectedswiths0.25%sMarcaine.sThesrightstonsilswassgraspedswithsansAllissforce
pssandsdissectedsfromsthestonsillarsfossa(Rightstonsillectomy.sIt'ssnotsbillablesbecausesit'ssi
ncludedsinsthesprimarysprocedure.)swithsascombinationsofsbluntsandscauterysdissection.sThe
sposteriorspillarsremainedsintactsassIsproceededstosdossimilarsmobilizationsofsthesleftstonsil.(L
eftstonsillectomy.sIt'ssnotsbillablesbecausesit'ssincludedsinsthesprimarysprocedures-
scannotsbesunbundled.)sIsthensmadesasmucosasincisionsacrosssthesbasesofsthespalatesappro
ximatelys0.5scmsfromsts-scorrectsanswers--42145
G47.33
CASEs4
PreoperativesDiagnosis:sMorbidsobesity.sSleepsapnea.sBMIs40.
PostoperativesDiagnosis:sMorbidsobesity.sBMIs40.
ProceduresPerformed:sLaparoscopicssleevesgastrectomy.sIntraoperativesesophagogastro
duodenoscopy.(Laparoscopic—SleevesGastrectomy.)
Intraoperativesendoscopy
Anesthesia:sGeneralsendotrachealsanesthesia.
OperativesProcedure:sThespatientswassbroughtstosthesoperatingsroomsandsplacedsonsthesO
Rstablesinssupinesposition.sOncesgeneralsendotrachealsanesthesiaswassachievedsandspre-
opsantibioticssweresgiven,sthesabdomenswasspreppedsandsdrapedsinsthesstandardssurgicalsf
ashion.sAccessstosthesabdominalscavityswassthroughsas1scmssupraumbilicalsincisionswithsan
sOptiviewstrocar.(Laparoscopicsprocedure.)sCo2swassinsufflatedstosachievesansintraabdomi
nal(Gassissusedstosextendsthesabdomenstosimprovesthesvisualsfield.)spressuresofsapproxima
telys15smmHg.sAccessorystrocarssweresplacedsinsthessubxiphoid,sright,smid,sandsls-
scorrectsanswers--43775
E66.01
Z68.41
CASEs5
