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Peritoneal dialysis with two (repeated) physician evaluations. CPT Code: ___
The coder should refer to the Alphabetic Index of the CPT-4 manual. Locate the main term "dialysis" then find the subterm "Peritoneal." The coder is given the code range 90945-90947, 4055F, After carefully reviewing each code the coder should select 90947. The description states requiring "repeated physician evaluations."
Family psychotherapy without the patient present.
The coder should begin by referring to the Alphabetic Index of the CPT-4 manual. Locate the main term "Psychotherapy" then the subterm "Family. The coder is given a code of 90846-90849, 99510. After carefully reviewing each code the coder selects 90846 because it states without patient present.
Replacement of contact lenses.
The should refer to the CPT-4 manual alphabetic index. Locate the main term "Contact Lens Services", then reference the subterm "Replacement." The coder is given the code 92326. After carefully reviewing the code in the Tabular list the coder should choose this code.
Three allergy injections with the provision of the extract and professional service.
The coder should refer to the CPT-4 manual Alphabetic Index. Locate the main term "Allergen Immunotherapy" because the they are trying build the patients immunity to an allergy. Then locate the subterm "allergen" because that is the substance that is being injected. The coder should then refer to the subcategory "prescription/supply/injection." The coder is given the code range 95120-95125. After carefully reviewing each of the codes. the coder should select 94525 because it indicates the 2 more injections were given.
A 48-year-old woman presents to the hospital for a unilateral simple mastectomy for breast cancer. During the surgery, the surgeon implants a single saline prosthesis.Provide the correct HCPCS Level II code for the implant.
The coder should refer to the Alphabetic Index in the HCPCS manual. Locate the main term "Prosthesis", then locate the subterm "Implant." The coder is given the code range L8600-L8690. After reviewing each code the coder select L8600 because it states "silicone or equal."
A patient who suffers from head and neck cancer is sent home with enteral nutrition with standard nutrients to be infused via pump. On the second day home, the alarm goes off on the infusion pump and would not stop.The patient returns to the clinic where the pump is replaced.Provide the correct HCPCS Level II code for the replacement pump and the appropriate HCPCS Level II modifier since this is a replacement due to a defect.
HCPCS Code:__________HCPCS Level II National Modifier _______
The coder should refer to the Alphabetic Index in the HCPCS manual. Locate the main term "Pump", since the case states the pump is to be used for enteral nutrition to be infused, the coder should select enteral infusion and given the codes B9000, B9002. After reviewing the codes in the Tabular section of the HCPCS manual, the coder should select B9002 because the cases states that the "alarm goes off". The coder should attach modifier -FB because the pump was replaced due a defect. (Note: if the student provides the HCPCS modifier - add 1 point - extra credit.)
50 year old male Medicare patient comes in for a colorectal screening of the entire colon; patient has a family history of colon cancer.
Screenings of Medicare patients should always be coded from the HCPCS manual. The coder should reference the Alphabetic Index and reference the main term "Screening" and then the subterm colorectal. The coder is given a code range of G0104-G0106. After carefully reviewing each code the code selects G0105 because this patient has a family history of colon cancer therefore, he is at a much higher risk than a person who does not have a family history.
3/10/xx Jacob Bond, MD
Patient in for follow-up appointment status-post mastectomy on 2/10/xx. Hospital course was complicated by atrial fibrillation and embolism, requiring embolectomy. Patient also developed pleural effusion requiring pleuracentesis. Patient has now been discharged from the hospital for 10 days. Other than some incisional pain, patient seems to be doing well. No major complaints: denies shortness of breath, nausea loss of appetite, fever, or pain in extremities. Energy levels seems to be returning to normal. Incision sites are examined, with no erythema or infection notes. Sutures removed. Patient is instructed not to lift, push or pull objects and to return to activities slowly. Wound care is reviewed. Patient is instructed to follow-up 2 weeks or sooner if complaints.
Since the patient is only there fora post-operative visit. The coder should locate the main term "Post-Op Visit." The coder is should review the code in the CPT medicine section. After carefully reviewing the code the coder should select 99024
A patient, involved in an auto accident, is transported by ambulance to the hospital with a possible broken leg.
Provide the correct HCPCS Level II code for the emergency ambulance service. HCPCS Code:________
The coder should refer to the Alphabetic Index in the HCPCS manual. Locate the main term "Ambulance", choose the code range A0021-A0999. After reviewing each code the coder should select A0429. Because the leg is "possibly broken" and it was an accident it is an emergency. The patient was not unconscious so it is basic life support that is given. We append the modifiers "S" and "H" because it indicates the origin of the accident and the patient's final destination.
Hospital bed, fixed height with rails and mattress.Provide the correct HCPCS Level II code for the hospital bed.
The coder should refer to the Alphabetic Index in the HCPCS manual. Locate the main term "Bed" and then the subterm "Hospital." The coder is given the code E0250-E0270, E0300-E0329. After carefully reviewing each code, the coder selects E0250. The description indicates any type of rails; the cases does not indicate what type of rails the bed has, so this would be the best choice.
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