Instructor Manual: Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2026 edition, ©2027, 9798214482330;
Chapter 10: Mediastinum and Diaphragm
Instructor Manual
Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems,
2026 edition, ©2027, 9798214482330; Chapter 10: Mediastinum and Diaphragm
TABLE OF CONTENTS
Purpose and Perspective of the Chapter......................................................................2
List of Student Downloads.........................................................................................................................2
Chapter Objectives........................................................................................................2
Key Terms.....................................................................................................................2
What’s New in This Chapter........................................................................................3
Chapter Outline.............................................................................................................3
Additional Discussion Questions..................................................................................3
Additional Activities and Assignments.........................................................................4
Additional Resources....................................................................................................5
Internet Resources......................................................................................................................................5
© 2027 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly 1
accessible website, in whole or in part.
a
, Instructor Manual: Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2026 edition, ©2027, 9798214482330;
Chapter 10: Mediastinum and Diaphragm
PURPOSE AND PERSPECTIVE OF THE CHAPTER
This chapter presents the codes that are used to report procedures completed on the mediastinum and
diaphragm. An overview of the anatomy of these areas is also discussed.
LIST OF STUDENT DOWNLOADS
Students should download the following items from the Student Companion Center to complete the
activities and assignments related to this chapter:
Peer Coding Audit Activities
CHAPTER OBJECTIVES
The following objectives are addressed in this chapter:
10.01 Define key terms related to coding procedures on the mediastinum and diaphragm.
10.02 Explain the location of the mediastinum and diaphragm.
10.03 Define common procedures performed on the mediastinum and diaphragm.
10.04 Select CPT codes for procedures completed on the mediastinum and diaphragm.
10.05 Identify and code procedures for the mediastinum and diaphragm from case studies.
[return to top]
KEY TERMS
anterior mediastinotomy: a mediastinotomy completed from the front of the body
cervical mediastinotomy: a mediastinotomy completed from the front of the body
diaphragm: a dome-shaped muscle that separates the thorax from the abdomen
imbrication of the diaphragm: a transthoracic or transabdominal incision to draw back abdominal
organs
mediastinoscope: a scope inserted into sternum area to visually examine the mediastinum, trachea,
and major vessels found in this area
mediastinotomy: a procedure in which an incision is made to open the mediastinum
mediastinum: the space in the thoracic cavity between the lungs
transthoracic mediastinotomy: a mediastinotomy performed through the fourth intercostal space
[return to top]
© 2027 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly 2
accessible website, in whole or in part.
a
, Instructor Manual: Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2026 edition, ©2027, 9798214482330;
Chapter 10: Mediastinum and Diaphragm
WHAT’S NEW IN THIS CHAPTER
The following elements are improvements in this chapter from the previous edition:
Review and/or Revisions to Answers for exercises, chapter review and coding assignments, and
case studies per 2026 code updates.
[return to top]
CHAPTER OUTLINE
I. Introduction
II. Guidelines Related to the National Correct Coding Initiative (NCCI)
III. Procedures Completed in the Mediastinum (39000-39499)
IV. Procedures Completed on the Diaphragm (39501-39599)
V. Comprehensive Assessments
a. Chapter Review
b. Coding Assignments
c. MindTap Quiz
d. Cognero Test Bank
VI. Case Studies
[return to top]
ADDITIONAL DISCUSSION QUESTIONS
The following are discussion questions that do not appear in the text, PPTs, or courseware (if courseware
exists) – they are for you to use as you wish. You can assign these questions several ways: in a discussion
forum in your LMS; as whole-class discussions in person; or as a partner or group activity in class.
1. Review CPT Codes: Medical providers in various settings use CPT codes to report
professional services and procedures provided to their patients. Demonstrating good CPT coding
skills can help increase revenue for your provider.
For this discussion, you will choose one coding question from this week’s material that you
thought was the most difficult, or that you got incorrect, and discuss that question with peers.
Summarize the coding question you thought was the most difficult, or which you got
incorrect.
Why was this question difficult to code?
What did you learn about coding for this type of procedure or service?
What tips can you use to identify the correct codes for this week’s material?
Read and respond to at least two peers. Include at least one of the following in your response:
© 2027 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly 3
accessible website, in whole or in part.
a
, Instructor Manual: Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2026 edition, ©2027, 9798214482330;
Chapter 10: Mediastinum and Diaphragm
What did you learn from your peer’s post?
What additional tips might you have for coding this type of procedure or service?
[return to top]
ADDITIONAL ACTIVITIES AND ASSIGNMENTS
The following are activities and assignments developed by Cengage but not included in the text, PPTs, or
courseware (if courseware exists) – they are for you to use if you wish.
1. Peer Coding Audit Activities: Students learn through communicating, working with, and
teaching others. In this activity, students review coding scenarios and apply the skills they have
learned by assigning codes based on coding guidelines. Students then review coding scenarios
completed by a classmate and provide constructive feedback to their classmate regarding their
code choices.
This activity is designed to help students understand the importance of the coding guidelines and
the coding process. The review and feedback process may also better prepare students to speak
with confidence on these topics during an interview.
You can assign this activity in one of two ways.
a. Assign applicable Code Sets from “Peer Coding Audit Activities,” available on the
Companion Site. These Code Sets were designed specifically for this activity. There are
two sets of codes for each assignment. Code Set 1 has scenarios for one student and Code
Set 2 has scenarios for the second student. “Solution and Answer Guide – Peer Coding
Audit Activities” is also available on the Companion Site.
b. Assign coding scenarios from the textbook, MindTap, or test bank.
A rubric for evaluation of student performance on this activity is provided in the appendix of the
Instructor Manual and on the Companion Site.
Student-facing instructions are included below. These instructions are also included directly in
the Peer Coding Audit Activities, available on the Companion Site.
STUDENT-FACING INSTRUCTIONS:
Step 1: Receive an assignment to either Code Set 1 or Code Set 2 from your instructor.
Step 2: Review the Code Set you are assigned to. Use your coding manual(s) to assign the
correct code(s) in the proper sequence. In addition to assigning the code(s), explain how you
arrived at the code(s). Your explanation should include what you determined to be the
diagnoses/procedures, how you looked these up in the coding manual, and any guidelines you
followed to assign the correct code(s).
Step 3: Share your answers with your assigned classmate and review codes assigned by your
classmate. Provide a written review that answers the following questions:
1. Are all the questions answered correctly? If not, which questions are incorrect?
2. For any answers that were incorrect, please explain the correct answer.
© 2027 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly 4
accessible website, in whole or in part.
a
Chapter 10: Mediastinum and Diaphragm
Instructor Manual
Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems,
2026 edition, ©2027, 9798214482330; Chapter 10: Mediastinum and Diaphragm
TABLE OF CONTENTS
Purpose and Perspective of the Chapter......................................................................2
List of Student Downloads.........................................................................................................................2
Chapter Objectives........................................................................................................2
Key Terms.....................................................................................................................2
What’s New in This Chapter........................................................................................3
Chapter Outline.............................................................................................................3
Additional Discussion Questions..................................................................................3
Additional Activities and Assignments.........................................................................4
Additional Resources....................................................................................................5
Internet Resources......................................................................................................................................5
© 2027 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly 1
accessible website, in whole or in part.
a
, Instructor Manual: Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2026 edition, ©2027, 9798214482330;
Chapter 10: Mediastinum and Diaphragm
PURPOSE AND PERSPECTIVE OF THE CHAPTER
This chapter presents the codes that are used to report procedures completed on the mediastinum and
diaphragm. An overview of the anatomy of these areas is also discussed.
LIST OF STUDENT DOWNLOADS
Students should download the following items from the Student Companion Center to complete the
activities and assignments related to this chapter:
Peer Coding Audit Activities
CHAPTER OBJECTIVES
The following objectives are addressed in this chapter:
10.01 Define key terms related to coding procedures on the mediastinum and diaphragm.
10.02 Explain the location of the mediastinum and diaphragm.
10.03 Define common procedures performed on the mediastinum and diaphragm.
10.04 Select CPT codes for procedures completed on the mediastinum and diaphragm.
10.05 Identify and code procedures for the mediastinum and diaphragm from case studies.
[return to top]
KEY TERMS
anterior mediastinotomy: a mediastinotomy completed from the front of the body
cervical mediastinotomy: a mediastinotomy completed from the front of the body
diaphragm: a dome-shaped muscle that separates the thorax from the abdomen
imbrication of the diaphragm: a transthoracic or transabdominal incision to draw back abdominal
organs
mediastinoscope: a scope inserted into sternum area to visually examine the mediastinum, trachea,
and major vessels found in this area
mediastinotomy: a procedure in which an incision is made to open the mediastinum
mediastinum: the space in the thoracic cavity between the lungs
transthoracic mediastinotomy: a mediastinotomy performed through the fourth intercostal space
[return to top]
© 2027 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly 2
accessible website, in whole or in part.
a
, Instructor Manual: Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2026 edition, ©2027, 9798214482330;
Chapter 10: Mediastinum and Diaphragm
WHAT’S NEW IN THIS CHAPTER
The following elements are improvements in this chapter from the previous edition:
Review and/or Revisions to Answers for exercises, chapter review and coding assignments, and
case studies per 2026 code updates.
[return to top]
CHAPTER OUTLINE
I. Introduction
II. Guidelines Related to the National Correct Coding Initiative (NCCI)
III. Procedures Completed in the Mediastinum (39000-39499)
IV. Procedures Completed on the Diaphragm (39501-39599)
V. Comprehensive Assessments
a. Chapter Review
b. Coding Assignments
c. MindTap Quiz
d. Cognero Test Bank
VI. Case Studies
[return to top]
ADDITIONAL DISCUSSION QUESTIONS
The following are discussion questions that do not appear in the text, PPTs, or courseware (if courseware
exists) – they are for you to use as you wish. You can assign these questions several ways: in a discussion
forum in your LMS; as whole-class discussions in person; or as a partner or group activity in class.
1. Review CPT Codes: Medical providers in various settings use CPT codes to report
professional services and procedures provided to their patients. Demonstrating good CPT coding
skills can help increase revenue for your provider.
For this discussion, you will choose one coding question from this week’s material that you
thought was the most difficult, or that you got incorrect, and discuss that question with peers.
Summarize the coding question you thought was the most difficult, or which you got
incorrect.
Why was this question difficult to code?
What did you learn about coding for this type of procedure or service?
What tips can you use to identify the correct codes for this week’s material?
Read and respond to at least two peers. Include at least one of the following in your response:
© 2027 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly 3
accessible website, in whole or in part.
a
, Instructor Manual: Bowie, Understanding Current Procedural Terminology & HCPCS Coding Systems, 2026 edition, ©2027, 9798214482330;
Chapter 10: Mediastinum and Diaphragm
What did you learn from your peer’s post?
What additional tips might you have for coding this type of procedure or service?
[return to top]
ADDITIONAL ACTIVITIES AND ASSIGNMENTS
The following are activities and assignments developed by Cengage but not included in the text, PPTs, or
courseware (if courseware exists) – they are for you to use if you wish.
1. Peer Coding Audit Activities: Students learn through communicating, working with, and
teaching others. In this activity, students review coding scenarios and apply the skills they have
learned by assigning codes based on coding guidelines. Students then review coding scenarios
completed by a classmate and provide constructive feedback to their classmate regarding their
code choices.
This activity is designed to help students understand the importance of the coding guidelines and
the coding process. The review and feedback process may also better prepare students to speak
with confidence on these topics during an interview.
You can assign this activity in one of two ways.
a. Assign applicable Code Sets from “Peer Coding Audit Activities,” available on the
Companion Site. These Code Sets were designed specifically for this activity. There are
two sets of codes for each assignment. Code Set 1 has scenarios for one student and Code
Set 2 has scenarios for the second student. “Solution and Answer Guide – Peer Coding
Audit Activities” is also available on the Companion Site.
b. Assign coding scenarios from the textbook, MindTap, or test bank.
A rubric for evaluation of student performance on this activity is provided in the appendix of the
Instructor Manual and on the Companion Site.
Student-facing instructions are included below. These instructions are also included directly in
the Peer Coding Audit Activities, available on the Companion Site.
STUDENT-FACING INSTRUCTIONS:
Step 1: Receive an assignment to either Code Set 1 or Code Set 2 from your instructor.
Step 2: Review the Code Set you are assigned to. Use your coding manual(s) to assign the
correct code(s) in the proper sequence. In addition to assigning the code(s), explain how you
arrived at the code(s). Your explanation should include what you determined to be the
diagnoses/procedures, how you looked these up in the coding manual, and any guidelines you
followed to assign the correct code(s).
Step 3: Share your answers with your assigned classmate and review codes assigned by your
classmate. Provide a written review that answers the following questions:
1. Are all the questions answered correctly? If not, which questions are incorrect?
2. For any answers that were incorrect, please explain the correct answer.
© 2027 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly 4
accessible website, in whole or in part.
a
