# practice exam question on chordee



## chaimz (Jan 8, 2014)

5-year-old male with a history of prematurity was found to have penile curvature, congenital hypospadias. He presents for surgical management for straightening the curvature. Under general anesthesia, bands were placed around the base of the penis and incisions were made degloving the penis circumferentially. The foreskin was divided in Byers flaps and the penile skin was reapproximated at the 12 o'clock position. Two Byers flaps were reapproximated, recreating a mucosal collar which was then criss- crossed and trimmed in the midline in order to accommodate median raphe reconstruction. This was reconstructed with use of a horizontal mattress suture. The shaft skin was then approximated to the mucosal collar with sutures correcting the defect. Which CPT® code should be used?

Answer:
Patient does not have a penile injury, eliminating multiple choice D. Code 54360, Plastic operation on penis to correct angulation is not correct because this patient has hypospadias, eliminating multiple choice C. The surgery is not correcting a hypospadias complication, but straightening the curvature (chordee), eliminating multiple choice answer B. The correct answer is A, 54304. The penis was degloved and the foreskin divided into flaps to accommodate a plastic repair of the chordee. The hypospadias was not repaired at this time; however, the repair of the angulation is the first step before the hypospadias can be repaired.

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What's the difference between angulation and chordee?  The issue I'm having stems from this part of the above --> "Plastic operation on penis to correct angulation is not correct because this patient has hypospadias" and " the repair of the angulation is the first step before the hypospadias can be repaired." <------ This seems contradictory.

Please help me understand this,

Thanks.


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## chaimz (Jan 11, 2014)

Anyone know the answer?


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## chaimz (Jan 23, 2014)

Anyone?


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## LCR CPC (Jan 23, 2014)

Is it an AAPC practice exam?  I've had a couple of questions on their practice exams or "test yourself" quizzes on training modules.  I've used the "contact us" link at the top of the home page to send them my question via e-mail, and I've always gotten a response within a few days.


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## SMLcoder  (Oct 30, 2016)

*Practice exam question on chordee*

I need help understanding this one too. Anyone?


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