Wednesday, August 1, 2012

Integumentary system--incision and drainage

Hello, everyone,
This is a review on Incision and Drainage (I&D) of the Integumentary system:

The codes in the CPT are based on:

  1. the types of the lesions: acne, abscess, pilonidal cyst, foreign body, hematoma, puncture aspiration, postoperative wound infection.
  2. the complexity of the I & D: simple/single; complicated/multiple.

When you answer the questions,

First look for words "incision and drainage" to make sure you are suppose to find the codes under "I&D". Also make sure the lesions belong to integumentary system. There are I & D in other system too.

Second, you need to find the words indicating the number and complexity of the I & D.

Sample questions:

1. Mr. Smith came in the office with an upper arm abscess. I & D is performed. Pus is aspired and dry gauze dressing is applied.
Answer: You only need to pay attention to the above 3 bolded sections. I &D procedure, abscess, one;
Code 10060.

2. Mr. Smith came in the office with 3 upper arm abscesses. I&D are performed. Dry gauze dressing applied.
Answer: Pay attention to 3, arm abscess, I & D.
Code 10061.

This may look easy to you. I am just trying to demonstrate that you need to pick the words in the questions to match with the words in the CPT codes.

Knowledge is necessary, but strategies can save you time and agony.

Good luck

Tuesday, July 3, 2012

Integumentary System--A & P

Hello, everyone, here is the anatomy and physiology of Integumentry system

Major structures of the skin are:
  • Epidermis: keratinized stratified squamous epithelium
    • cell types:
      • keratinocytes=produce keratin
      • melanocytes=produce melanin
      • Merkel cells=touch receptors
      • Langerhans' cells=macrophages
    • 5 layers: deepest to superficial
      • stratum basale=basal layer(germinativum); melenocytes, keratinocytes start from here
      • stratum spinosum=prickly layer; melanin & Langerhans' cells most abundant here
      • stratum granulosum=granular layer; keratohyaline and lamellated granules accumulate here
      • stratum lucidum=clear layer; a few rows of flat, dead keratinocytes
      • stratum corneum=horny layer; outermost layer of keratinized cells, account for 3/4 of the epidermal thickness
  • Dermis: strong, flexible connective tissue
    • 2 layers:
      • papillary=top layer, contain capillary loops, Meissner's corpuscles, free nerve endings
      • reticular =make up 80% of the thickness of the skin, elastin fibers and collagen fibers
  • Hypodermis(superficial fascia): subcutaneous layer

Other structures in Integumentary System:
  • Sebaceous glands:oil/sebum
  • sweat glands=sudoriferous glands =cerumen/milk
  • hair=dead keratinized cells;
    • arrector pili=erector muscles
    • melanocytes give pigmentation
  • nails=scalelike modification of the epidermis
    • nail body=hard, translucent
    • nail bed=nourish the nail free edge
The functions of the skin are:
  • waterproof, prevent fluid loss
  • major receptor for sense of touch
  • synthesize vit. D
  • screen out some harmful UV radiation
  • first line of defense in Immune System
The functions of sebaceous glands: sebum
  • lubricate the skin
  • discourage the growth of bacteria on the skin
The functions of sweat glands: sweat
  • perspiration regulate body temperature & water content
  • secrete small amount of metabolic waste
The functions of hair:
  • control loss of heat
The functions of nails:
  • protect dorsal surface of the last bone of each toe and finger
This is an overview. Here are some A&P books from amazon that you can check out.

If you want me to answer any questions you may have, leave comment or email me.

Good luck

Thursday, June 28, 2012

Integumentary system --- Burns

Hello, everyone,

On page 77 of 2012 CPT manual, there are drawings of percentage of infant and adult when calculate total body surface area (TBSA).

The differences between infant and adult:

14% each
18% each

Sample questions:
An infant has: 
  • 1st degree burns on the face, approximately 3% of TBSA. Treated with dressing.
  • 2nd degree burns on both arms. Treated with dressing.
What is the CPT codes?

1st code: the highest degree burn first. So both arms go first. TBSA of both arms=18%. Choose the code 16030.

2nd code: 1st degree burn on face. So choose 16000.
Since this is a procedure on the face, different site from the arms, add -59 behind the 16000.
           So the correct answer for this question is: 16030, 16000-59

Good luck

Wednesday, June 27, 2012


Hello, everyone,

Welcome to the medical coding field! In order to become a "Certified Professional Coder", you need to become an active member of AAPC first.

Go to website: for more information.

CPC exam uses CPT, ICD-9-CM, HCPCS level II manuals. I strongly suggest you purchase your own copies because you need to make many notes and highlights on the manuals to help you speed up answering the questions.

On AAPC website, you can buy these books in bundles which will save you some money.

Lots of people run out of time when they take the exam. So anything that could help you to speed up is strongly recommended.

One of my strategies for taking this exam is to answer the easier questions first. This way you have more time for those hard lengthy questions.

Quoted from the AAPC website: "...CPC exam is designed to evaluate a physician practice coder’s knowledge of the following:
  • Anesthesia
  • Radiology
  • Medicine
  • Nervous
  • Endocrine
  • Digestive
  • Urinary
  • Musculoskeletal
  • Male/Female Genital
  • Hemic & Lymphatic
  • Maternity & Delivery
  • Eye & Ocular Adnexa
  • Pathology
  • Integumentary
  • Respiratory
  • Laboratory
  • Mediastinum & Diaphragm
  • Evaluation and Management
  • Anatomy and Physiology
  • Practice Management
  • ICD-9-CM
  • HCPCS Level II
  • Coding Guidelines
  • Medical Terminology
I will start my review with the CPT manual's "surgery" section because there are more questions on this section. Then, I will go through "anesthesia", "radiology", "pathology", "medicine", and "E/M".

Then, I will review ICD-9, and HCPCS.

If you are new to medical field, or you need to brush up on your medical terminology, you can check out some of the books here:

If you have questions that you would like me to answer, please write in the comment, I will try to answer them for you.

Good luck