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Chapter 7 CPC Integumentary System

Mar 26, 2025

CPC Certification Review Training

Introduction

  • Purpose: Assist in passing the CPC certification exam.
  • Prerequisite: Not for beginners; requires prior understanding of the coding process.

Exam Focus: Integumentary System

  • Topics Covered:
    • Skin, subcutaneous tissues, accessory structures, nails, pilonidal cysts, repairs, destructions, and breast procedures.
  • Anatomy of the Skin:
    • Epidermis: Top protective layer.
    • Dermis: Middle layer with blood vessels, connective tissue, nerves, etc.
    • Subcutaneous Tissue: Below dermis, contains connective and adipose tissue.

Diagnosis Codes & Common Conditions

  • Neoplasm Section (Chapter 2)
  • Skin & Subcutaneous Tissue (Chapter 12)
  • Injuries & Poisoning (Chapter 19)
  • Common Conditions:
    • Erythema Multiform: Allergic reaction causing rash/lesion.
    • Pressure Ulcers: Occur due to prolonged pressure; on bony prominences.
    • Burns & Corrosions: Require 7th character for encounter type; TBSA for >20% body affected.

Breast-Related Services

  • Diagnosis Codes (Chapter 14)
  • Conditions: Benign mammary dysplasia, inflammatory disorders, etc.

Procedures & Coding

  • Biopsy Techniques:
    • Tangential, punch, incisional.
    • One primary biopsy code reported per different methods.
  • Removal Techniques:
    • Simple and complex IND, debridement, skin tag/shaving, lesion excision.
  • Nail Procedures: Codes for fingernails/toenails, mainly for podiatrists.

Specialized Treatments

  • Pilonidal Cyst Excision: Complexity of excision affects coding.
  • Wound Repair:
    • Simple, intermediate, complex.
    • Adjacent tissue transfer techniques.

Skin Grafting & Replacement

  • Size & Location: Key factors in coding.
  • Types of Grafts: Autograft, allograft, xenograft, cultured tissue.

Lesion Destruction

  • Techniques: Electro surgery, cryosurgery, laser, chemical treatment.
  • Coding:
    • Type, location, and size of lesion matter.
    • Separate code for each lesion.

Mohs Micrographic Surgery

  • Physician Roles: Surgeon and pathologist.
  • Key Concepts: Anatomic location, number of stages, blocks per stage.

Breast Biopsy & Mastectomy

  • Biopsy: Approach, imaging guidance included.
  • Mastectomy: Complexity, muscle removal (partial, radical, modified radical).

Resources

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