Wiki CPC practice exam A question 3 don't understand it


Best answers
Question 3
64 year-old female who has multiple sclerosis fell from her walker and landed on a glass table. She lacerated her forehead, cheek and chin and the total length of these lacerations was 6 cm. Her right arm and left leg had deep cuts measuring 5 cm on each extremity. Her right hand and right foot had a total of 3 cm lacerations. The ED physician repaired the lacerations as follows: The forehead, cheek, and chin had debridement and cleaning of glass debris with the lacerations being closed with one layer closure, 6-0 Prolene sutures. The arm and leg were repaired by layered closure, 6-0 Vicryl subcutaneous sutures and Prolene sutures on the skin. The hand and foot were closed with adhesive strips. Select the appropriate procedure codes for this visit.
A. 99283-25, 12014, 12034-59, 12002-59, 11042-51
B. 99283-25, 12053, 12034-59, 12002-59
C. 99283-25, 12014, 12034-59, 11042-51
D. 99283-25, 12053, 12034-59

What I totally don't understand is the rationale behind the answer. It states, "To start narrowing your choices down, the hand and foot were closed with adhesive strips. The Section Guidelines in the CPT® manual for Repair (Closure) states: “Wound closure utilizing adhesive strips as the sole repair material should be coded using the appropriate E/M code.” Eliminating multiple choice answers A and B. The lacerations on the face are intermediate repairs, because debridement and glass debris was removed. The guidelines in the CPT® codebook for Repair (Closure) states: “Single-layer closure of heavily contaminated wounds that have required extensive cleaning or removal of particulate matter also constitutes intermediate repair.” Eliminating multiple choice answer C. The intermediate repair of the lacerations to the face totaled 6 cm (12053). The right arm and left leg had cuts measuring 5 cm each which totaled 10 cm requiring intermediate repair (12034)."
The problem I have with this answer is that ALL of the answers have the same E/M code in the same place - so how can you use the rationale stated above (Guidelines... B)?
Since the E&M is in all answers just ignore its automatically the correct code. I would also ignore the 12034 as well since its also automatically correct.

I would have started with 12014 vs 12053 since its in 2 of 4 answers. I would have also looked up 12002 & 11042 [FONT=&quot]since its also in 2 of 4 answers[/FONT][FONT=&quot]

12014 is Simple repair of [FONT=&quot] face, ears, eyelids, nose, lips and/or mucous membranes ([/FONT][FONT=&quot]5.1 cm to 7.5 cm) [/FONT]12053 is intermediate repair of the same area. Since the glass in the wound makes it intermediate the answers with 12014 are incorrect leaving you with B & D.

Now the only difference is 12002. Looking at 12002, its for simple repair and none of the repairs documented are simple so it knocks out answer B leaving D

If you had looked at the 12002 first it would have left C & D and 12014 vs 12053 would have knocked out C leaving D.