MCCG146 - Portfolio Project Weeks 3-7
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Feb 20, 2024
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MCCG146 – Portfolio Project Coding
Week 3-7 Portfolio Project Natasha Lilly
MCCG146: CPT and HCPCS Level II Coding
Professor Griffin
11/25/2023
MCCG146 – Portfolio Project Coding
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MCCG146 – CPT and HCPCS Level II Coding Portfolio Project Coding Template Week 3: Jane Smith’s Physician Office Visit
Provide CPT Evaluation and Management (E/M) Code: 99214
Reflection/Method on Code Selection – Describe in detail the steps/method you took to code the services correctly
and to ensure the services are coded correctly. I selected the billing code 99214 for a medical appointment that was complex and posed a risk
to the patient's life or bodily functions. The data to be analyzed was extensive and complicated. The requirement was that "each unique test, order, or document contributes to the combination 2 or combination of 3 in category 1". The patient, Jane, met the criteria for category 1 as she required a combination of
tests, documents, and an independent historian for her assessment. Her unique test results needed review, and each unique test had to be ordered with an assessment requiring an independent historian. Although the time spent
was only 25 minutes, I chose to use the code based on the services provided, even though the code indicates 30-39 minutes.
MCCG146 – Portfolio Project Coding
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Week 4: Jane Smith’s Imaging Services
Provide CPT Code(s) and modifier if applicable for the professional component provided for the Imaging Services:
78815
Provide the HCPCS Code(s) for the Radiopharmaceutical Agent Injected during Imaging Procedure:
A9552
Using Medicare’s website, https://www.cms.gov/medicare-
coverage-database/search.aspx
determine whether or not the CPT code has an active LCD and Answer the following question: - Does the Imaging Procedure CPT code you selected have an active Article/LCD? Yes/No? If yes, Identify Article/LCD. Yes.
Article ID: A58559
Article Title:
Billing and Coding: Independent Diagnostic Testing Facilities (IDTF)
Article Type:
Billing and Coding
Original Effective Date:
10/01/2023
Revision Ending Date:
N/A
Retirement Date:
N/A
Reflection/Method on the Code Selection. Describe in detail the steps/method you took to code the services correctly and to ensure that the services are coded correctly.
The first thing I did was look up positron emission tomography with concurrently acquired computed tomography in the Index. This provided me with the codes 78814 and 78815. The next step was to go into the tabular and locate these codes. After reviewing the codes, I determined Jane’s case matched 78815 because it includes skull base to mid-thigh. After selecting the code, I went to the Medicare website and searched 78815. I chose the first article that came up which was A58559. I then reviewed the article to ensure my code was correct.
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MCCG146 – Portfolio Project Coding
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Week 5: Jane Smith’s Pre-Op Lab (Report 1) and Outpatient Surgery (Report 2)
Provide CPT Code (s) for Pre-Op Lab Orders (Report 1)
Provide the CPT Lab Codes that have a
CCI Code Pair Edit (PTP) and include the CCI PTP associated modifier.
Provide CPT Code(s) for Surgeon’s Outpatient Surgery Services and modifier if applicable (Report 2):
Reflection/Method on the Code Selection. Describe in detail the steps/method you took to code services and to ensure the services are coded correctly.
Week 6: Jane Smith’s Inpatient Consultation with Procedure
Provide CPT Evaluation and Management (E/M) Code: Provide CPT Procedure Code for Procedure (s) and modifier if applicable:
Reflection/Method on Code Selection. Describe in detail the steps/method you took to code the services and to ensure the services are coded correctly.