1. Procedure and CPTCode Selection:
The physician administered the MMRV (measles, mumps, rubella, and varicella) vaccine subcutaneously and dose 3 of Hepatitis B vaccine intramuscularly. The physician also provided counseling on routine immunizations.
CPTCode 90460 is used for immunization administration with counseling by the physician for patients 18 years or younger for the first or only component of each vaccine.
CPTCode 90461 is used for each additional component in a vaccine with counseling.
90710 is the code for the MMRV vaccine.
90744 is the code for the Hepatitis B vaccine (pediatric).
2. Application of 90460 and 90461:
For the MMRV vaccine (which has four components: measles, mumps, rubella, and varicella), 90460 is reported once for the first component, and 90461 is reported three times (once for each additional component).
For the Hepatitis B vaccine, 90460 is reported again since it is a separate vaccine with one component.
3. Rationale for Excluding Other Options:
Option A (90471, 90472 x 4, 90707, 90746) uses codes for vaccine administration without counseling and incorrect vaccine codes (90707 for MMR instead of MMRV and 90746 for adult Hepatitis B instead of pediatric).
Option B and Option D also contain incorrect vaccine codes and do not correctly apply the counseling administration codes.
4. AAPC and CPTCoding Guidelines:
According to AAPC guidelines, 90460 and 90461 are the appropriate administration codes for vaccines with counseling provided to pediatric patients, with each component of a multi-component vaccine coded separately.
Therefore, the correct answer is C. 90460 x 2, 90461 x 3, 90710, 90744.

CABG coding depends on(1) number of coronary venous graftsand(2) the conduit type(venous vs arterial).
This case uses asaphenous vein graft(a venous conduit) to bypasstwocoronary targets: theobtuse marginaland theleft circumflex. The CPT code for CABG withtwo venous graftsis33511. The separate code33508is reported forendoscopic harvest of veinwhen performed for CABG, which is specifically documented here ("harvested endoscopically").33534is for anarterial graft(e.g., internal mammary artery) and does not match a saphenous vein-only description. Option D omits the separately reportable endoscopic harvest service documented. CPC exam approach: identify conduit (vein = 33510-33516 family), count distal anastomoses (two = 33511), and add endoscopic harvest (33508) when documented.

Burn coding requires (1) code each burn site bylocation, laterality, and degree, and (2) add aTBSAcode when appropriate. The patient hasthird-degree burnsof both thighs (right and left), so the correct site/degree codes areT24.311A(third-degree burn of right thigh, initial encounter) andT24.312A(third-degree burn of left thigh, initial encounter). He also hassecond-degree burnsof the right anterior chest wall and the upper back, reported withT21.21XA(second-degree burn of chest wall, initial encounter) andT21.23XA(second-degree burn of back wall, initial encounter). TBSA is24%(falls in the 20-29% category), andthird-degree is 10%(falls in the
10-19% third-degree category), so the correct TBSA code isT31.21. Option D matches the required site
/degree codes and the correct TBSA/third-degree percentage code pairing.