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NEW QUESTION # 328
A 40-year-old woman with progressive sensory neural hearing loss in the right ear since the age of 13 has not gained benefit from her hearing aid. She has normal hearing in the left ear. A cochlear implant is placed for the right ear. Anesthesia is provided by a CRNA with medical direction by an anesthesiologist who is concurrently directing 5 CRNAs. PS is 3.
What anesthesia CPT and ICD-10-CM codes are reported by the Anesthesiologist?
Answer: C
Explanation:
Anesthesia CPT:
00120 - Anesthesia for ear procedures
AD modifier:
Anesthesiologist medically directing >4 CRNAs
P3 - Severe systemic disease
Diagnosis Code:
H90.41 - Sensorineural hearing loss, unilateral, right ear
Why others are incorrect:
AA - Personally performed
QX / QY - Incorrect direction model
H90.5 - Unspecified hearing loss
NEW QUESTION # 329
A patient presents with recurrent spontaneous episodes of dizziness of unclear etiology. Caloric vestibular testing is performed irrigating both ears with warm and cold water while evaluating the patient's eye movements. There is a total of three irrigations.
What CPT coding is reported?
Answer: A
Explanation:
Procedure: Caloric vestibular testing performed on both ears with three irrigations.
CPT Code:
92537: Caloric vestibular test with recording, bilateral; bithermal (i.e., one warm and one cool irrigation in each ear).
Modifier -50: Bilateral procedure.
Code Selection Justification: The procedure performed was bilateral caloric vestibular testing with bithermal irrigation, appropriately coded with 92537 and modifier -50 for bilateral procedures.
AMA CPT Professional Edition (current year)
NEW QUESTION # 330
A 45-year-old has a dislocated patella in the left knee after a car accident. She taken to the hospital by EMS for surgical treatment. In the surgery suite, the patient is placed under general anesthesia. After being prepped and draped, the surgeon makes an incision above the knee joint in front of the patella. Dissection is carried through soft tissue and reaching the patella in attempt to reduce the dislocation. When the patella is exposed, it is severely damaged due to cartilage breakdown. The tendon is dissected and using a saw the entire patella is freed and removed. The tendon sheath is closed with sutures.
What procedure code is reported for this surgery?
Answer: B
Explanation:
CPT code 27566 involves excision of the patella. Given the surgical description provided, this code is appropriate as the patella was severely damaged and removed entirely.
* Patient's Condition: Dislocated patella with cartilage breakdown and severe damage.
* Surgical Procedure: The surgeon made an incision, dissected through soft tissue, exposed, and completely removed the patella.
* Coding Decision: CPT 27566 is chosen because it specifies excision of the patella. The modifier LT indicates the procedure was performed on the left side.
References:
* AMA's CPT Professional Edition (current year).
* ICD-10-CM for corresponding diagnosis codes if needed.
NEW QUESTION # 331
(Full Case:Preoperative diagnosis:Low back pain; possible spinal stenosis L3-4.Postoperative diagnosis:No evidence of discogenic pathology or spinal stenosis at L3-4; normal discography L3-4.Procedure:Awake discography and injection, L3-4.Anesthesia:IV narcotic with reversal and local; propofol given transiently, then patient alert/responsive for pain response during injection.Technique:Patient to OR; right decubitus; sterile prep/drape; C-arm used to mark entry; local ethyl chloride + 1% Xylocaine; docking needle placed posterolateral at L3-4 under AP/lateral; inner needle advanced to disc nucleus center; contrast injected while monitoring patient response; normal bilocular pattern; 1.5 cc volume; no pain with pressurization.
Documentation:No videotape; plain films available; post-discography CT planned/reviewed for other causes.
Question:What CPT and ICD-10-CM coding is reported?)
Answer: C
Explanation:
This service is alumbar discographyat a single level (L3-L4) withinjection of contrastinto the intervertebral disc underfluoroscopic (C-arm) guidancewhile the patient is awake/able to report symptoms, which is exactly what CPT62290describes for diagnostic discography at a lumbar level. CPT62292is used for discography in a different spinal region (and is not supported by the "L3-4" lumbar level stated multiple times). The post- discography CT scan is referenced as planned/reviewed but is not clearly documented as performed
/interpreted as part of this same physician service in the stem, and it is not part of the answer choices. For ICD-
10-CM, the confirmed postoperative finding is "normal discography," but the reason for the study remains the patient'slow back painand suspected stenosis; in outpatient/procedural settings you code thereason for the testwhen the definitive suspected condition is not confirmed. Here, the stenosis was ruled out ("no evidence"), so donotcode spinal stenosis; reportM54.50for low back pain. Therefore,62290 with M54.50is correct.
NEW QUESTION # 332
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 pneumonia. The physician's interpretation is placed in the patient's chart.
How does the physician bill for the chest X-ray?
Answer: A
Explanation:
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.
References:
* AMA's CPT Professional Edition (current year)
* ICD-10-CM (current year)
NEW QUESTION # 333
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