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 short-arm 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