Exam 27: Coding and Surgical Procedures

Once the claim is processed, the insurance company sends the following to the provider:

A 34-year-old infertility patient with a history of repeated miscarriages and dysmenorrhea is being seen today to evaluate the patency of her fallopian tubes. The physician suspects that there might be occlusions that are preventing the egg from implanting or preventing sperm from moving through. A transcervical catheter is used to view the fallopian tubes for patency, and a hysterosalpingography is also performed. Select the appropriate CPT and ICD-10-CM codes.

Delineation of deep structures using sound waves is a(n):

The flow of a practice's revenue, which begins when charges for services, procedures, or supplies are incurred and continues until those charges are paid in full or adjusted off the account is known as the:

Under Medicare's mutually exclusive edits, mutually exclusive codes

Jerry is a 55-year-old diabetic with ESRD. At the beginning of September, Jerry began home-based dialysis services. However, on September 18, he was admitted to the hospital where he remained until September 25 when he was discharged home. Dialysis continued on alternate days while he was in the hospital, and physician visits with expanded problem-focused history and examinations were done on those days in between. Select the appropriate CPT and ICD-10-CM codes.

A 28-year-old was in a car accident and is now in the ED due to 3 fingers on his left hand being completely amputated above the metacarpophalangeal joint during the crash. The ED physician calls in an orthopedic surgeon and the patient is taken to surgery. Under surgical microscope his index finger and middle finger were reconnected; however, his 3rd finger was not able to be reconnected due to extensive crush injuries to that finger, so that finger was surgically amputated. Select the appropriate CPT and ICD-10-CM codes.

Mr. Derek is here today for open tendon surgery in his right shoulder due to a ruptured rotator cuff. Under general anesthesia an incision of 5cm was made in the shoulder. All loose fragments of tendon, bursa, and other debris were removed. There was some subacromial smoothing to make room for the tendon. The tendon was properly placed and the incision was sewn with 5.0 vicryl. The patient tolerated the procedure well and was sent to the floor. Select the appropriate CPT and ICD-10-CM codes.

Select the appropriate CPT and ICD-10-CM codes for marsupialization to treat a pancreatic pseudocyst with acute pancreatitis caused by alcoholism.

Preoperative Diagnosis: Upper gastrointestinal bleeding Postoperative Diagnosis: Gastritis Operation: EGD Operation Description: Patient admitted for upper gastrointestinal bleeding. Patient was informed that an EGD would be completed and understands the risks involved. Consent was obtained. Patient was prepped in the usual sterile fashion. The endoscope entered the oropharynx and the esophagus inspected and revealed no ulcerations or other abnormalities. Coffee ground material was present but no fresh blood noted. Area was biopsied and then scope removed. Patient went to the recovery room in stable condition. Select the appropriate CPT and ICD-10-CM codes

George, a 59-year-old diabetic man with polyneuropathy, is prescribed a four-lead TENS unit as a method to provide a non-invasive, low-risk approach to reduce his pain. Select the appropriate CPT and ICD-10-CM codes for the unit.

What is the symbol for a resequenced CPT code?

History: A 62-year-old woman (height, 1.7 m; weight, 61 kg) was scheduled for resection of a sigmoid colon carcinoma. Her medical history revealed hypothyroidism, vitamin B12 deficiency, and stiff person syndrome. This syndrome started with low back pain, which rendered her unable to walk. She was experiencing stiffness, involuntary jerks, and painful cramps. Neurologic examination revealed extreme hypertonia of the body and proximal legs, with intercurrent, painful spasms. Reflexes were symmetrical without Babinski signs. Laboratory findings showed positive glutamic acid decarboxylase (GAD) and negative amphiphysin antibodies. The patient was successfully treated with baclofen and diazepam. Subsequently, prednisone as immunosuppressive therapy was started. The stiffness diminished, and the patient was able to walk unaided. The neurologic examination was unremarkable, except for a slight stiffness in the legs. Her medication at admission was prednisone 20 mg once a day, baclofen 12.5 mg twice a day (daily dose = 25 mg), diazepam 7.5 mg twice a day (daily dose = 15 mg), levothyroxine 25 ?g once a day, and vitamin B12 injections. Her medical history included urologic and gynecologic surgery under general anesthesia before she experienced SPS. Procedure: No premedication was given. Anesthesia was induced with propofol (2.5 mg/kg) and sufentanil (0.25 ?g/kg). After the administration of atracurium (0.6 mg/kg), the trachea was intubated, and anesthesia was continued with isoflurane (0.6-1.0 vol %) and oxygen/air for the duration of the procedure. Cefuroxime 1,500 mg, clindamycin 600 mg, and dexamethasone 10 mg were administered IV. In the following 2 hours, additional atracurium (35 mg), sufentanil (10 ?g), and morphine (8 mg) were administered. At the end of the procedure, which was uneventful, neuromuscular monitoring showed four strong twitches. Although the patient was responsive, she could not open her eyes, grasp with either hand, or generate tidal volumes beyond 200 mL. Neostigmine 2 mg (0.03 mg/kg) and glycopyrrolate 0.2 mg did not alter the clinical signs of muscle weakness. The patient was sedated with propofol and further mechanically ventilated in the recovery room. After 1 hour, the sedation was stopped and mechanical ventilation was terminated. At that time, baclofen 12.5 mg was administered into the gastric tube. Two hours later she was in a good clinical condition, and her trachea was extubated. Select the appropriate ICD-10-CM and CPT code(s):

CT Scan of the Chest and Adrenals History: Left pulmonary nodule on chest x-ray Technique: Helical transaxial images, 7 mm, of the chest were obtained after the administration of oral and intravenous contrast. Findings: The patient's chest x-rays from February 24 and 25 were reviewed. There is an ill-defined opacity suggested in the left midlung zones on those studies, including oblique views. Within the left lower lobe laterally, there is an approximately 2-cm area of parenchymal density that has the appearance of interstitial changes without findings of a significant nodule or mass. This finding can relate to scarring. There is no other nodule, mass, or effusion. Within the mediastinum, there is no evidence of adenopathy seen. The heart and great vessels are normal in appearance. There is a suggestion of minimal pericardial thickening anteriorly that is not specific. Osseous structures show degenerative changes with osteophyte formation at multiple levels in the thoracic spine. Visualized upper abdominal structures, including liver, spleen, kidneys, pancreas, aorta, and para-aortic retroperitoneum, show no specific finding. The adrenal glands are not enlarged. Impression: There is a small focal area of increased parenchymal density that has an interstitial pattern. There is no significant nodule or mass. This is suggestive of scarring. There is no nodule, mass, effusion, or adenopathy seen. Consider chest x-ray follow-up of this lesion to assess stability. Select the appropriate ICD-10-CM and CPT code(s):

Clinical history: Carcinoma of the breast with skeletal metastasis. Study performed: Total Body Bone Scan. Impression: Abnormal total body bone scan with abnormalities noted in the ribs and spine and possibly within the skull. Select the appropriate CPT and ICD-10-CM codes.

Clinical History: Patient with neuropathy and pain in arm. Diagnosed with possible cervical disc. Study performed: Cervical Myelogram -injection procedure and radiological supervision and interpretation. Impression: Moderate ventral extradural defect C5-6 with bilateral C-6 root encroachments. Select the appropriate CPT and ICD-10-CM codes.

The doctor performs a puncture aspiration of a soft tissue hematoma on the left thigh. Select the appropriate CPT and ICD-10-CM codes.

The patient-responsible portion of a set amount per service or encounter is the definition of:

White blood cells include

A 2-month-old infant with congenital hydrocephalus presented for replacement of a previously placed VP shunt system. Select the appropriate CPT and ICD-10-CM codes.