week 7 seminar coding the medicine section (chapter 18)

Week 7 SeminarWeek 7 SeminarCoding the Medicine SectionCoding the Medicine Section

(Chapter 18)(Chapter 18)

Medicine CPT CodesMedicine CPT Codespg. 728pg. 728

• What are What are • Noninvasive proceduresNoninvasive procedures• Minimally invasive proceduresMinimally invasive procedures

• What’s special/unique about the medicine codes?What’s special/unique about the medicine codes?

• What guidelines are in the medicine section?What guidelines are in the medicine section?

Medicine CPT Codes GuidelinesMedicine CPT Codes Guidelines• Multiple ProceduresMultiple Procedures

• Same date serviceSame date service

• Add-On CodesAdd-On Codes• + = addition to primary code+ = addition to primary code• Parenthetical note = primaryParenthetical note = primary

• Separate ProceduresSeparate Procedures• Comprehensive vs. SeparateComprehensive vs. Separate• Modifier -59Modifier -59

Medicine CPT Codes GuidelinesMedicine CPT Codes Guidelines• Bundled CodesBundled Codes

• OCEOCE• NCCINCCI• Unbundling Unbundling

• Unlisted Service or ProcedureUnlisted Service or Procedure• MaterialsMaterials

• CPT 99070 or HCPCS Level II?CPT 99070 or HCPCS Level II?

Medicine CPT CodesMedicine CPT CodesSpecial ConsiderationsSpecial Considerations

• Immune Globulins Immune Globulins • Supply vs. AdministrationSupply vs. Administration• Modifier -51?Modifier -51?

• Immunizations – how many codes?Immunizations – how many codes?• Administrative codesAdministrative codes• Vaccine codesVaccine codes• Modifier -51?Modifier -51?• New vaccine identifier?New vaccine identifier?

Medicine CPT CodesMedicine CPT CodesSpecial ConsiderationsSpecial Considerations

• Psychiatry Psychiatry • Who can report an E&M (office visit) code?Who can report an E&M (office visit) code?

• What “alternative” therapies are in the What “alternative” therapies are in the Medicine section?Medicine section?

• Difference between Hemodialysis and Difference between Hemodialysis and Peritoneal DialysisPeritoneal Dialysis

• Qualifying Anesthesia CircumstancesQualifying Anesthesia Circumstances• QC vs. Anesthesia P ModifiersQC vs. Anesthesia P Modifiers• Conscious Moderate SedationConscious Moderate Sedation

Review Practice QuestionsReview Practice QuestionsPage 766Page 766

11.11. An 8-year-old received DT An 8-year-old received DT immunization injection.immunization injection.

12. Binaural hearing aid check12. Binaural hearing aid check

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ANSWERSANSWERS

11.11.An An 8-year-old8-year-old received received DT immunization DT immunization injectioninjection..

d. 90718, d. 90718, 9047190471

12. 12. BinauralBinaural hearing aid check hearing aid check

d. 92593d. 92593

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15.15. Inhalation bronchial challenge Inhalation bronchial challenge testing with histaminetesting with histamine

17. Physical therapy reevaluation17. Physical therapy reevaluation

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ANSWERSANSWERS

15.15.Inhalation bronchial challenge testing with Inhalation bronchial challenge testing with histaminehistamine

a. 95070a. 95070

17.17.Physical therapy reevaluationPhysical therapy reevaluation

b. 97002b. 97002

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18.18. Patient and wife received 30 minutes of Patient and wife received 30 minutes of ftf education and training from a ftf education and training from a qualified NP for patient self-qualified NP for patient self-management of diabetic testing suppliesmanagement of diabetic testing supplies

20. Psychiatrist used dolls to communicate 20. Psychiatrist used dolls to communicate with a 5-year-old during a psychiatric with a 5-year-old during a psychiatric interviewinterview

Review Practice QuestionsReview Practice QuestionsPage 766Page 766ANSWERSANSWERS

18.18.Patient and wife received 30 minutes of Patient and wife received 30 minutes of ftf ftf education and training from a qualified NP for education and training from a qualified NP for patient self-management of diabetic testing suppliespatient self-management of diabetic testing supplies

a. 98960a. 98960

20.20.Psychiatrist used Psychiatrist used dollsdolls to communicate with a 5- to communicate with a 5-year-old during a psychiatric year-old during a psychiatric interviewinterview

b. 90802b. 90802

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27.27. 14-year-old with cystic fibrosis, was seen for 14-year-old with cystic fibrosis, was seen for chest wall cupping to help clear mucous chest wall cupping to help clear mucous secretion. Initial demo observed by patient’s secretion. Initial demo observed by patient’s mother as teaching opportunity for home care mother as teaching opportunity for home care by parent.by parent.

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ANSWERS = 94667ANSWERS = 94667

27.27. 14-year-old with cystic fibrosis, was seen for 14-year-old with cystic fibrosis, was seen for chest wall chest wall cupping cupping to help clear mucous to help clear mucous secretion. secretion. Initial demo Initial demo observed by patient’s observed by patient’s mother as teaching opportunity for home care mother as teaching opportunity for home care by parent.by parent.

Review Practice QuestionsReview Practice QuestionsPage 768Page 768

32.32. After placing patient on adjustment table, After placing patient on adjustment table, chiropractic manipulation of C7, T4, and L1 chiropractic manipulation of C7, T4, and L1 were performed to reduce subluxation and were performed to reduce subluxation and increase blood flow. The patient was increase blood flow. The patient was scheduled for another appointment in one scheduled for another appointment in one week’s time.week’s time.

Review Practice QuestionsReview Practice QuestionsPage 768Page 768

ANSWERS = 98941ANSWERS = 98941

32.32. After placing patient on adjustment table, After placing patient on adjustment table, chiropractic manipulation chiropractic manipulation of of C7, T4, and L1 C7, T4, and L1 were performed to reduce subluxation and were performed to reduce subluxation and increase blood flow. The patient was increase blood flow. The patient was scheduled for another appointment in one scheduled for another appointment in one week’s time.week’s time.

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33. 40-year-old male presented for hepatitis A & B 33. 40-year-old male presented for hepatitis A & B vaccine. Administered by nursing staff, IM in vaccine. Administered by nursing staff, IM in left arm.left arm.

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ANSWERS = 90636, ANSWERS = 90636, 90471 90471

33. 40-year-old male presented for hepatitis 33. 40-year-old male presented for hepatitis A & B A & B vaccinevaccine. Administered by nursing staff, . Administered by nursing staff, IMIM in in left arm.left arm.

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35.35. Patient was awake when electrodes Patient was awake when electrodes were placed on his head for were placed on his head for recording. An extended EEG was recording. An extended EEG was performed during a 3 hour period. performed during a 3 hour period. Patient was awake for entire EEG.Patient was awake for entire EEG.

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ANSWERS = 95813ANSWERS = 95813

35.35. Patient was awake when electrodes Patient was awake when electrodes were placed on his head for recording. were placed on his head for recording. An extended An extended EEGEEG was performed during was performed during a a 3 hour 3 hour period. Patient was awake for period. Patient was awake for entire EEG.entire EEG.

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49.49. ESRD services for 25-year-old male ESRD services for 25-year-old male for month of September. Number of for month of September. Number of services for the month totaled 12.services for the month totaled 12.

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ANSWERS = 90921 = deletedANSWERS = 90921 = deleted

To report ESRD services for patients 20 years To report ESRD services for patients 20 years and older see 90960-90962, 90966, 90970and older see 90960-90962, 90966, 90970

So answer is? So answer is?

49.49. ESRD services for ESRD services for 25-year-old25-year-old male for male for month of Septembermonth of September. Number of . Number of services for the month totaled services for the month totaled 1212..

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35.35. IV infusion of chemo drugs, two hours.IV infusion of chemo drugs, two hours.

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ANSWERS = 96413, ANSWERS = 96413, 9641596415

What kind of code is 96415?What kind of code is 96415?

50. 50. IV infusion IV infusion of chemo drugs, of chemo drugs, two hourstwo hours..