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A physician documents a comprehensive electrophysiologic evaluation with an unsuccessful attempted induction of arrhythmi a. Upon review, the bundle-of-His recording is missing. What code(s) should be reported?
A. 93610, 93602, 93612, 93603, 93618
B. 0
C. 93620-52
D. 93619-52
Answer: A
Explanation:
To bill a comprehensive electrophysiologic evaluation (93619-93622), the following five components must be documented: right atrial pacing (93610), right atrial recording (93602), right ventricular pacing (93612), right ventricular recording (93603), and bundle-of-His recording (93600). If the documentation does not support all five components, each study must be reported separately, as opposed to billing the procedure with a "reduced services" modifier. The exception to this rule would be if an add-on procedure were performed and required to be reported in addition to the comprehensive electrophysiologic evaluation. In this case, however, the attempted induction arrhythmia (93618) is not an add-on code and can be reported in addition to the primary procedures.
NEW QUESTION # 137
A surgeon performs a craniectomy to excise a meningioma located above the tentorium cerebelli. During the procedure, an extradural hematoma is noted and removed via the same craniectomy site. How should the surgeon report the procedure?
A. 61512, 61312-59
B. 61519, 61314-51
C. 61312-22
D. 0
Answer: D
Explanation:
Surgical procedures on the nervous system are identified by where inside the skull they occur. A meningioma is being excised from above the tentorium cerebelli, otherwise known as supratentorial (CPT 61512). The removal of an extradural hematoma is inclusive to the primary craniectomy code because the finding is incidental and the same surgical site is used for its removal.
If the surgeon had to create a separate incision to access the extradural hematoma, that excision could be reported separately with modifier 59.
NEW QUESTION # 138
If a physician administers cyclophosphamide over 154 minutes, irinotecan over 72 minutes, and panitumumab over 15 minutes intravenously to a patient with pancreatic cancer, how should this be reported?
A. 96413, 96413-59, 9641512, 96417
B. 96413, 96413-59x2, 96415, 96417
C. 94613, 96415x2, 96417x2
D. 96413, 96415x3, 96417x2
Answer: D
Explanation:
Unless a separate IV site is established for a secondary or tertiary administration, CPT
96413 should be reported only once to represent the initial drug infusion. In this case, it is the cyclophosphamide. The remaining 94 minutes are reported with Ovo units of add-on CPT 96415, which may be reported ifthe time spent beyond the first hour is between 31 and 60 minutes. CPT
96417 is reported only once per subsequent infusion of a different drug up to the first hour.
Consequently, the 72 minutes of irinotecan is reported with a single unit of CPT 96417, and the 15 minutes of panitumumab is also reported with one unit ofthat same CPT code.
NEW QUESTION # 139
A male patient with cancerous cells in his right bronchus is given 150 mg of porfimer sodium via a single and slow intravenous injection and told to return to the office in 3 days.
Upon his return, the physician enters the right bronchus by means of a bronchoscope and activates LED for a total of 38 minutes to destroy the cancer cells. What should the physician report?
A. 96573, J9600x2
B. 96573, 96409, J9600x2
C. 31641, 96570, 96571, 96409,J9600x2
D. 31641, 96570, 96571, J9600x2
Answer: D
Explanation:
Photodynamic therapy applies a photosensitizing agent by either an external or endoscopic application. An external application is applied directly onto a patient's lesions, whereas an endoscopic application is an injection into the bloodstream, where it is absorbed by cells all over the body. Based on this differentiation, the documentation supports only an endoscopic application.
The code notes for CPT 96570 and 96571 indicate they are add-on codes to the bronchoscopy procedure, which is represented by CPT 31641. Any drug administration is inclusive to photodynamic therapy, making CPT 96409 not separately billable.
NEW QUESTION # 140
The relative value units of a procedure are based on how much effort is involved, expenses that the practice will incur, and the level of risk associated with it.
A. True
B. False
Answer: A
Explanation:
The statement is true. An insurance carrier will use these three measures to determine what the RVU of a procedure should be. Then, based on that, a medical coder can determine what the expected payment should be. Generally, the higher the RVU of a procedure is, the higher the payment will be.
NEW QUESTION # 141
......
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