73630-LT.This report is for a three-view x-ray and reported without modifier -26 or -TC because Dr. Levitt completed both the professional and technical components.

24666-LT. You can find the procedure in the index of the CPT under Fracture/Radius/Head/Neck/Open Treatment. The location of the treatment (bone and area) is important when coding for fractures.

N20.0, 50590. Signs and symptoms associated routinely with a disease process are not reported unless instructional notes in ICD-10-CM indicate otherwise. To find this rule, review the ICD-10-CM introduction for conditions that are an integral part of the disease process.The procedure can be found under Lithotripsy/Kidney.

77076.You can locate the procedure in the index of the CPT® Professional Edition under Xray/Bone/Osseous Survey. The correct code indicates infant in the description.The diagnosis wont be reported as probable cases are not reported.

ICD is L60.8 and CPT is 11750-FA.Main term in the CPT index is Excision, modifying term nails, codes 11750-11752.Code 11750 is selected because the tuft of distal phalanx was not amputated.Modifier -FA is added to indicate left thumb.

ICD is N63 for breast mass and19120-RT for excision of right breast mass.

The cpt for laparoscopic aspiration or drainage of ovarian cyst is 49322 and icd is N83.20.

Cpt is 64721-RT and icd is G56.01 as it is in the right upper limb.

Cpt is 11450-RT and icd is L73.2.

CPT 55250

A patient does not have to be HIV positive to report HIV counseling services (Z71.7) rendered during an encounter.

The type of diabetes is specified as type 2, with no mention of complication. The correct ICD-10-CM code is E11.9 Type 2 diabetes mellitus without complications.

Residual effect after acute phase of an injury or illness has terminated. Sequela: A pathological condition resulting from a prior disease, injury, or attack. As for example, a sequela of polio. Verbatim from the Latin “sequela” (meaning sequel). Plural: sequelae.

The two new influenza vaccine codes are available for use February 1, 2015:
• 90620 Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B, 2 dose schedule, for intramuscular use
• 90621 Meningococcal recombinant lipoprotein vaccine, serogroup B, 2 or 3 dose schedule, for intramuscular use.

The Centers for Medicare & Medicaid Services (CMS) require very strict documentation for durable medical equipment (DME)

As per the 1995 and 1997 Documentation Guidelines for Evaluation and Management Services do not allow the history of present illness, examination, or plan and assessment to be copied, reviewed and labeled.

Closed treatment of an uncomplicated rib fracture should be reported using an appropriate E/M code, as per CPT instructions.

False. Modifier 50 is not appended as Codes 22510-22512 describe unilateral or bilateral procedures

Malta fever, Mediterranean fever and Undulant fever are included in Brucellosis as per ICD-10-CM Guidelines.

Blepharo means Eyelid, eyelids [Greek, from blepharon, eyelid]

prefix meaning “clavicle”, clavicular or collarbone: cleidocostal, cleidocranial, cleidomastoid. Also spelled clido-, clid-.

False. According to National Correct Coding Initiative (NCCI), modifier 25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service can be appended to an evaluation and management (E/M) service code when reported with minor surgical procedures or procedures not covered by global surgery rules. Because all procedures include pre-, intra-, and post-procedural work that is inherent in the procedure, providers must not report an E/M service code for this work. Payers will consider this to be “procedure code unbundling.” All the services described in this case are a standard part of the biopsy procedure. Reporting a separate E/M service will not be appropriate.

There was no biopsy done, so there is no fine needle aspiration (FNA) to code. Proper coding is 43259 Esophagogastroduodenoscopy, flexible, transoral ; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis.

Non-physician practitioner professional services can be billed as incident-to with the following guidelines: New patients are not billed as incident-to.Established patients with new problems are not billed as incident-to. The supervising physicians must be present in the office and immediately available when billing incident-to (direct supervision is required). The physician does not have to provide a personal, professional service each time the patient is seen incident-to. He or she must remain directly involved with the patient’s care, or “there must be subsequent services by the physician of a frequency that reflects the physician’s continuing active participation in and management of the course of treatment”.

Medicare do not recognize or reimburse CPT consultation codes (99241-99245, outpatient and 99251-99255, inpatient), but the Centers for Medicare & Medicaid Services (CMS) does extend coverage to telehealth consultations, using dedicated G codes (G0425-G0247, telehealth consultations for inpatients, including those in a skilled nursing facility (SNF), or to patients in an emergency department (ED) and G0406-G0408, follow-up codes for SNF or hospital inpatients, and ED patients).

When reporting an approved telehealth service, you must append modifier GT Via interactive audio and video telecommunication systems to the appropriate service code(s). The modifier tells your Medicare contractor that the beneficiary was present at an eligible originating site when the telehealth service was furnished.

Celiac disease is characterized by an abnormal proximal small intestinal mucosa, is associated with a permanent intolerance to gluten (a protein found naturally in the grain of wheat, rye, oats, and barley), and can present itself at any time in a person’s life. Although the digestive system is the source of the problem, the disease is an autoimmune disorder.

MRSA is an infection caused by a certain strain of staph bacteria resistant to common antibiotics. In 2007, the American Medical Association (AMA) introduced new procedure codes for MRSA testing: 87640 Staphylococcus aureus, amplified probe technique and 87641 Staphylococcus aureus, methicillin resistant, amplified probe technique. Since then, more affordable methodologies have come about, such as cultures by nasal swab (87081 Culture, presumptive, pathogenic organisms, screening only). CPT® 87015 Concentration (any type), for infectious agents should not be used to describe MRSA testing.

Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, is a progressive neurodegenerative disease of nerve cells affecting the brain’s ability to control muscle movement, eventually leading to paralysis and then death.

The three 2014 codes for simple, intermediate, and complex teletherapy isodose plans (77305, 77310, and 77315) have been deleted, and replaced with two codes for simple and complex teletherapy isodose plans. New codes 77306 Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s) and 77307 Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s) — which applies, in this case — include basic dosimetry calculations. This means 77300 Basic radiation dosimetry calculation, central axis depth dose calculation, TDF, NSD, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician is no longer reported in addition to these isodose plans

In this case, it’s incorrect to add 99100 Anesthesia for patient of extreme age, younger than 1 year and older than 70 (List separately in addition to code for primary anesthesia procedure) because anesthesia codes 00834 Anesthesia for hernia repairs in the lower abdomen not otherwise specified, younger than 1 year of age and 00836 Anesthesia for hernia repairs in the lower abdomen not otherwise specified, infants younger than 37 weeks gestational age at birth and younger than 50 weeks gestational age at time of surgery already take the patient’s age into consideration in the base unit value assigned, per the 2015 Relative Value Guide.

In ICD-9-CM, both childhood- type schizophrenia not otherwise specified (NOS) and schizophrenic syndrome of childhood NOS are reported using the subcategory of unspecified pervasive developmental disorder (PDD). In ICD-10-CM, these conditions are reported using subcategory F84.5 Asperger’s syndrome.

If the same provider returns a patient to the operating room (OR) during the global period of a previous procedure to treat a complication of the earlier surgery, append modifier 78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period to the CPT® code describing the follow-up procedure. “Related procedure” means the follow-up procedure is related to the original surgery, not to the underlying condition that prompted the original surgery.

Proper coding is 58150 Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s) and 56440-79 Marsupialization of Bartholin’s gland cyst. Modifier 79 Unrelated procedure or service by the same physician or other qualified healthcare professional during the postoperative period indicates the subsequent procedure is unrelated to the initial surgery (the “follow-up” procedure is not a result of the initial surgery or the diagnosis that prompted it). When you append modifier 79 to a claim, a new global period begins and the subsequent procedure is paid at 100 percent of the allowed amount, as determined by the carrier

CMS policy (Medicare Claims Processing Manual chapter 12, section 40.1.B) states, “If a less extensive procedure fails, and a more extensive procedure is required, the second procedure is payable separately.” In such a case, modifier 58 Staged or related procedure or service by the same physician during the postoperative period is appropriate.

Physicians and freestanding centers (claims submitted on the CMS-1500 form) do not report new-for-2015 CPT treatment delivery or image guidance procedure codes for Medicare patients. These entities report HCPCS Level II codes for 2015; these codes have the same definitions as their CPT® counterparts (most of which have been deleted). The appropriate HCPCS Level II code for Radiation treatment delivery, >1MeV; simple is G6003 (CPT® 77402).

In ICD-10-CM, Kanner’s syndrome is listed as inclusive of F84.0 Autistic disorder.

Phlebitis is inflammation of vein

Suffix meaning pain, painful condition

Puncture a cavity to remove fluid.

Discharge or flow

Explanation: A complete myelography is a two-step procedure. A provider will inject a contrast medium (step one) to improve the visual contrast among structures viewed under the X-ray examination that follows (step two). CPT® includes four codes to describe the complete procedure when performed by a single provider: ● 62302 Myelography via lumbar injection, including radiological supervision and interpretation; cervical ● 62303 Myelography via lumbar injection, including radiological supervision and interpretation; thoracic ● 62304 Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral ● 62305 Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical) Because two or more regions are targeted, correct coding is 62305.

Critical care illness/injury, critical care treatment, critical care time

The follow-up procedure is to correct a complication of a prior procedure.
Explanation: To append modifier 58 Staged or related procedure or service by the same physician or other qualified healthcare professional during the postoperative period, the follow-up procedure does not have to be planned ahead of time; however, in all cases, the follow-up, related procedure is performed to treat an underlying condition, rather than as a result of the prior procedure. Stated another way, the follow-up procedure will “go beyond” the initial procedure, but is not performed due to a complication of the prior procedure. When treatment for complications requires a return to the operating or procedure room, append modifier 78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period, rather than modifier 58, to the subsequent procedure code.

Explanation: A procedure with a global period of 90 days is defined as a major surgical procedure. An E/M service performed on the same day as a major surgical procedure for the purpose of deciding whether to perform the surgical procedure is separately reportable with modifier 57. Other preoperative E/M services on the same date of service as a major surgical procedure are included in the global payment for the procedure and are not separately reportable.

D56.3

Always

96372

Inhalation solution administered through durable medical equipment

Inguinal

Obturator

90472
Explanation: Arthroscopic medial and lateral meniscal repair is reported using 29883 Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral).

15
Explanation: Without start and stop times, it’s impossible to establish that a drug infusion lasted more than 15 minutes. Infusion services lasting 15 or fewer minutes are reported with intravenous (IV) push codes (96409 Chemotherapy administration; intravenous, push technique, single or initial substance/drug or 96374 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug). Infusion services lasting longer than 15 minutes are reported with time-based infusion codes.

E10.311

G47.10

4

J9080

Acute

Muscle