Mr. Roland has difficulty breathing and congestion with a productive cough. The physician takes frontal and lateral view chest X-rays in the office (the equipment is owned by the physician group). The physician reads the X-rays and determines a diagnosis of walking pneumoni
a. The physician's interpretation is placed in the patient's chart.
How does the physician bill for the chest X-ray?
For a physician who owns the equipment and interprets the chest X-rays (both frontal and lateral views), code 71046 is used. This code includes both the technical and professional components, as the equipment is owned by the physician group and the physician also provides the interpretation.
AMA's CPT Professional Edition (current year)
ICD-10-CM (current year)
Dr. Burns sees newborn baby James at the birthing center on the same day after the cesarean delivery. Dr. Burns examined baby James, the maternal and newborn history, ordered appropriate blood test tests and hearing screening. He met with the family at the end of the exam.
How would Dr. Bums report his services?
Dr. Burns is providing initial hospital or birthing center care for the evaluation and management of a normal newborn infant. CPT code 99460 is used to report initial hospital or birthing center care, per day, for evaluation and management of a normal newborn infant. This includes a comprehensive history, examination, and medical decision-making. The description of the service provided fits this CPT code accurately. Reference: CPT Professional Edition (current year), AMA.
A comatose patient is seen in the ER. The patient has a history of depression. Drug testing confirm she overdosed on tricyclic antidepressant drugs doxepin, amoxapine, and clomipramine.
What CPT code is reported?
For a comatose patient who has overdosed on tricyclic antidepressant drugs (doxepin, amoxapine, and clomipramine), the correct CPT code is 80366. This code covers drug testing for tricyclic antidepressants, which includes the specific drugs mentioned in the scenario.
AMA's CPT Professional Edition (current year)
A patient is taken to the radiology department for a radiological cardiac catheterization. An acute MI of the left anterior descending coronary artery is found. The cardiologist performs a suction thrombectomy, followed by atherectomy and a stent to the artery. A CRNA provides MAC for this patient, who is status P5.
What code/modifier combination would you report for the services of the CRNA?
The patient is undergoing a cardiac catheterization with a CRNA providing monitored anesthesia care (MAC). Code 00520 is for anesthesia for heart catheterization procedures. Modifier QX indicates CRNA service with medical direction by a physician, QS indicates MAC, and P5 indicates a patient with a severe systemic disease that is a constant threat to life. Thus, the correct code and modifier combination is 00520-QX-QS-P5. Reference: CPT Professional Edition (current year), AMA.
Patient has undergone open surgery for a left total knee arthroplasty. While in the recovery room, he continued to have severe postoperative pain. The surgeon ordered a femoral block for postoperative pain. The anesthesiologist evaluated the patient and performed a left femoral block, which provided significant post-operative pain relief.
What CPT coding is reported?
The patient has undergone a left total knee arthroplasty and subsequently received a femoral nerve block for postoperative pain management. CPT code 01402 is used for anesthesia for total knee arthroplasty. Code 64447-59-LT is for a femoral nerve block (single injection) for postoperative pain management, with modifier 59 indicating a distinct procedural service and LT indicating the left side. Therefore, the appropriate codes are 01402 and 64447-59-LT. Reference: CPT Professional Edition (current year), AMA.
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