(Verified Answers)
Right breast was prepped, and an incision was made over the breast mass for intended
excision. The patient experienced EKG abnormalities and the physician made a
decision to discontinue the procedure and schedule it at a later date.
19120-RT
19120-53-RT
19120-52
19125-52-RT
19120-53-RT
A patient was referred by primary care to GI for rectal bleeding. The colonoscope was
advanced into the cecum. The patient had a polyp removed by snare, another polyp
was hot biopsied, and a separate area of questionable inflammation was also biopsied.
The base of the polyps was cauterized to control bleeding.
45385, 45380-51
45385, 45380-59, 45384--51, 45382-51
45385, 45380-51, 45382-51
45385, 45380-59
45385, 45380-59
One technique is allowed per polyp or lesion; therefore, a code for the polyp removed
by snare (45385) would be appropriate as well as a separate code assignment for the
biopsy(ies) performed to other sites. The polyp that was hot biopsied was not removed
and, therefore, would be included in the 45380 with biopsy code. Cauterization to
control bleeding created by the excisions or biopsies is included in the procedures
assigned.
Encounter due to family history heart disease. Patient experiencing chest pain and
chest tightness.
R07.89
R07.9, R07.89, Z86.79
R07.9, R07.89, Z82.49
R07.9
R07.9, R07.89, Z82.49
Patient scheduled for possible TAH/BSO, however, surgical abdomen is explored and
no additional procedures performed.
49000
58120
49000, 58150-52
58150-52
,49000
Since patient was scheduled for "possible" TAH/BSO following findings from exploratory
laparotomy, only exploratory laparotomy would be assigned, code 49000.
CABG, venous grafting, three vessels
33512
33519
33510
33513
33512
Left diagnostic shoulder arthroscopy was performed which revealed a large rotator cuff
tear. Repair of the rotator cuff tear was attempted arthropically; however, it was
necessary to perform a mini-arthrotomy to complete the repair of the tear.
29805-LT, 23410-LT
23410-LT, 29848-LT
29848-LT-53, 23410-LT
23410-LT
23410-LT
Scope advanced into cecum. There were multiple diverticula seen in the sigmoid and
descending colon, some were filled showing diverticulitis.
K57.92, K57.90
K57.92
K57.80
K57.90
K57.92
Diverticula has developed into diverticulitis, therefore, no need to code the diverticula.
A 17-year-old presents for his initial visit with complaints of left knee pain after playing
football. An expanded problem-focused history and exam were performed with
straightforward MDM.
99201
99202
99213
99212
99202
All three elements are met for 99202.
Modifier -26 indicates
may be used in all sections of CPT.
radiology codes for supervision/interpretation.
codes in CPT for supervision/interpretation.
only utilized in E/M section.
, codes in CPT for supervision/interpretation.
A 13-year-old presents for removal of tonsils. Tonsils are grasped and removed.
42825
42830
42826
42821
42826
Abdominal pain, gastroenteritis, probably viral
K52.9, R10.9
R10.9, K52.9
A08.4
K52.9
K52.9
Basic metabolic panel with ionized calcium
80050
80048
80053
80047
80047
Tumor removal from left temporal bone
69979
69970
61500
61563
69970
Assign code 69970 for removal of tumor from the temporal bone.
The surgical removal of a gland or gland part is called
glenectomy.
myomectomy.
lymphadenectomy.
adenectomy.
adenectomy.
Laceration to eyelid/eyebrow. Right lower eyelid laceration was sutured using 5-0 Vicryl
deep sutures and the eyebrow laceration was sutured utilizing 5-0 Vicryl sutures.
12011
12031