Quiz 5

A 10-month-old child is taken to the operating room for removal of a laryngeal mass. What is (are) the appropriate anesthesia code(s)?

00326

What is the CPT® code for excision of a 3.2cm benign lesion of the trunk?

11404

Claim for excision of squamous cell carcinoma from the posterior aspect of the neck, 3 cm in diameter, including margins of resection with a W-plasty to close surgical defect, less than 10 sq cm. Which code(s) is (are) correct?

14040

Laparoscopic cholecystectomy is performed for a patient with RUQ pain and abnormal ultrasound. Which code is used for this procedure?

47562

A gastrostomy tube placement was performed under fluoroscopic guidance, with conversion to a gastro-jejunostomy tube in the same session. What code(s) is (are) used on the claim?

49440, 49446

An 18-year-old male is taken to the operating room to resolve a urethral stricture. A cystoscope was passed through the urethra and bladder and a series of urethral dilators up to 20 French were then placed, dilating the stricture. What CPT® code is used for this procedure?

52281

Colonoscopy performed only to 40 cm, because of the large diverticula and the inflammation seen around it. I did not want to go further. Of note; through one of the large diverticula, I could see some blood vessels and stranding of tissue. Which modifier is added to the procedure code for this case?

53

Newborn male is scheduled for a circumcision. He is sterilely prepped and draped. A penile nerve block is performed. The circumcision is performed by a ring device. Hemostasis is achieved. Vaseline Gauze dressing applied. Patient tolerated the procedure well. How is this encounter coded?

54150

Claim is billed 58555, 58558-51 for a patient having a diagnostic hysteroscopy. Hysteroscopy cervical biopsy is performed. Is this coding correct? If not, what code(s) is (are) used?

58558

A 12-month-old is coming in to see the pediatrician to receive an MMR vaccination subcutaneously. Counseling was provided to the mother about the vaccine. What codes are reported for the vaccination?

90707, 90460, 90461 x 2

A patient presents to her oncologist's office for scheduled chemotherapy. The patient is severely dehydrated. The physician decides to schedule the chemotherapy for another day and orders hydration therapy to be performed today instead of the chemotherapy. The therapy is ordered and administered for 1 hour and 10 minutes. Select the code(s) reported for the hydration.

96360

A 2-year-old is brought to the ER by EMS for near drowning. EMS had gotten a pulse. The ER physician performs endotracheal intubation, blood gas, and a central venous catheter placement. The ER physician documents a total time of 30 minutes on this critical infant in which the physician already subtracted the time for the other billable services. Select the E/M service and procedure code(s) to report for the ER physician?

99291-25, 36556, 31500

A 68-year-old Medicare patient presented for an annual examination and had no complaints. Her claim, billed as 99387, was denied. Was this billed correctly? If not, what is needed to bill this encounter correctly?

It will depend on the documentation

Codes for surgery include the performance of the surgery as well as:

Local anesthesia, including digital nerve blocks

When a patient is seen for evaluation and the decision is made for a minor procedure on the same day, which modifier is appended to the claim to allow reimbursement for the E/M and the procedure?

Modifier 25

A claim is submitted for an assistant surgeon. What modifier would NOT be used for an assistant surgeon?

Modifier 62

The patient is 15 weeks pregnant with twins is coming back to her obstetrician to have a transabdominal ultrasound performed to reassess anatomic abnormalities of both fetuses that were previously demonstrated in the last ultrasound a week ago. The physician bills 76816, 76816-51. Is this correctly billed? If not, how is the ultrasound billed?

No, it is billed 76816, 76816-59