Transcript Document

Seminar #3-Medical Coding
• Welcome, during the seminar, the chat
feature will be disabled so that I am
able to complete my agenda for the
evening! Be sure to have your AMA
CPT coding manual out for tonight! I
will answer questions at the end.
Thanks, Professor Campbell
Week 3
Radiology, Pathology, Medicine
Discussion, Reimbursement Rules, 30 Points
Exercises, Challenge exercises, 40 points
Seminar, Attend Seminar or complete Option 2, 20 points
Radiology
• 7xxxx codes
• Subsections
– Diagnostic radiology (diagnostic imaging)
– Diagnostic ultrasound
– Radiation oncology
– Nuclear medicine
• Main term
– X-ray, CT, etc.
Professional/Technical
Components
• Technical component
– UB-04 Claim Form
– Own equipment
– Hire technicians
– Supplies
• Professional component (Modifier 26)
– CMS-1500 Claim Form
– Supervise process
– Read and interpret films
Case 1
• Complete x-ray (four views) of the
mandible. How should the images taken
be reported?
Case 2
• Contrast-enhanced images of the patient's
lower left leg using computerized axial
tomography. How should the images taken
be reported?
Case 3
• MRI of HEART: A complete view of the
heart and cardiac structures reviewed no
abnormalities. Heart valves were normal in
appearance. Cardiac function was normal.
CONCLUSION: Normal imaging of the
heart. How should the images taken be
reported?
Case 4
• DIAGNOSTIC ULTRASOUND: The
scrotum is normal in size. All tissue within
appears normal. The testes are normal in
appearance. The epididymis appears
normal in structure. How should the
images taken be reported?
Case 5
• NUCLEAR LIVER-SPLEEN SCAN: The liver is of normal
size with homogeneous uptake. The spleen is enlarged
and is almost the same size as the liver. There is also
increased activity in the spleen. I do not see any focal
areas of diminished activity, and there is no significant
bone marrow uptake. CONCLUSION: Splenomegaly.
How should the images taken be reported?
Pathology and Laboratory
• 8xxxx codes
• Subsections
– Organ/disease panels
– Urinalysis
– Chemistry
– Pathology
Case 1
• A pregnant patient presented to her OB/GYN's office for
her first trimester exam. The OB/GYN ordered the
practice's standard "obstetric panel" to be performed by
the OB/GYN's in-office lab. How should these lab
services be reported?
Case 2
• An automated urinalysis with microscopy
was performed. How should these lab
services be reported?
Case 3
• Testing for triglyceride level. How should
these lab services be reported?
Case 4
• In preparation for a transfusion, the lab
thawed 3 units of fresh frozen plasma.
How should these lab services be
reported?
Case 5
• Gross and microscopic pathology
examination of paranasal tissue taken
during a biopsy. How should these lab
services be reported?
Medicine
• 90281–99607 codes
• Variety of services and procedures
– Immunization
– Psychiatry
– Ophthalmology
– Rehabilitative procedures
– Home Health Procedures/Services
– Medication Therapy Management Services
Case 1
• A 40-year-old male patient presented for a
hepatitis A and B vaccine. This was
administered by the nursing staff, IM in the
left arm. How should these services be
reported?
Case 2
• Patient participated in a psychotherapy session
for a total of 30 minutes. This session was done
at a local community hospital in the mental
health inpatient unit. How should these services
be reported?
Case 3
• A physician took a history and performed an
intermediate level eye exam (both eyes) for an
established patient. The physician also wrote a
prescription for glasses. How should these
services be reported?
Case 4
• A physician performs a percutaneous
transluminal coronary angioplasty and
places one stent in the left main coronary
artery. How should these services be
reported?
Case 5
• IV infusion of chemotherapy drugs, two
hours. How should these services be
reported?
Seminar #4-Medical Coding
• Welcome, during the seminar, the chat
feature will be disabled so that I am
able to complete my agenda for the
evening! Be sure to have your AMA
CPT coding manual out for tonight! I
will answer questions at the end.
Thanks, Professor Campbell
Week 4
Reading-Chapters 4, 5 , 6, 7 and 8 in
Understanding Procedural Coding: A
Worktext
Exercises-Challenge exercises-40 points
Seminar-Seminar or complete option 2-20
points
Anesthesia Coding
• A 74-year-old patient undergoes a total
knee arthroplasty to the right knee. The
anesthesiologist provides regional block
as the patient’s anesthesia because of the
patient’s mild COPD and diabetes. Assign
the correct anesthesia code for the
procedure.
Integumentary System
Coding
• Local anesthesia was injected using 1 percent
lidocaine with epinephrine 1.5 cc. Incision was
made along the postauricular sulcus through the
drainage point with retraction applied. A 3.0 cm
sebaceous cyst was evident, and it was drained.
A small bandage was placed over the incision
and drainage site.
Musculoskeletal Coding
• Patient underwent closed treatment of
fractured tip of the right radius at distal
end, which included application of a shortarm cast.
Respiratory Coding
• Patient underwent indirect endoscopy of the
larynx with biopsy. The physician used a small,
round mirror to examine the vocal cords, tongue,
and of the throat for signs of disease or injury.
Biopsy of larynx was performed for evaluation
and diagnosis.
Cardiovascular Coding
• A physician drains fluid from the pericardial space for the
first time. How should this service be reported?
Questions